Perceptions of caring. Comparison of antepartum and postpartum patients

An exploratory, comparative survey design was used to describe and compare similarities and differences in perception of caring behaviors between hospitalized antepartum and short-stay postpartum patients. Forty-two patients completed the 63-item Caring Behavior Assessment instrument (CBA). The scale, based on Watson's theory of caring, contains seven categories. There were no statistically significant differences in age, education, gravida, or para between the two groups. Significantly more women in the postpartum group were married. There were no statistically significant differences or correlations in the total CBA scores and the demographic variables. No statistically significant differences in total CBA scores were found between antepartum participants and postpartum participants. These findings corroborate the results of "caring" studies in other patient populations, that satisfying basic needs--that is, evidence of technical knowledge and skills--is more important to patients than meeting higher order needs.     

Biosynthesis of progesterone derived neurosteroids by developing avian CNS: in vitro effects on the GABAA receptor complex

Although enthusiasm for measuring health-related quality of life (HRQL) in clinical trials exists, information is limited on the meaning of scores. We examined the relation between scores from the 34-item Medical Outcomes Study HIV Health Survey (MOS-HIV) and the more detailed HIV Overview of Problems-Evaluation System (HOPES) using the responses of 318 HIV-infected outpatients being treated in Los Angeles and Baltimore. With the HOPES problem statements as independent variables, statistically significant predictors of the variation in MOS-HIV scores for the Physical Function, Mental Health, and Energy/Fatigue scales were identified using stepwise regression. Approximately 60% to 70% of the variation in each of the scores was explained by five to seven different HOPES problem statements, with a single item explaining 47% to 59% of the variation. We created illustrative profiles for each of the three MOS-HIV scales using the HOPES items identified in the regressions. Independent of the scale, persons scoring in the top MOS-HIV quartile tended to report few if any problems, whereas a decline in score to the next quartile was characterized by functional difficulties (e.g., "HIV interferes with work"). The onset of specific problems might trigger further evaluation and potential intervention from health care providers to help maintain patient functioning.     

Serum from diabetic BB/W rats enhances calcium currents in primary sensory neurons

We examined the hypothesis that exposure of nondiabetic rat dorsal root ganglion (DRG) neurons to sera from diabetic BB/W rats would produce an increase in calcium currents associated with impaired regulation of the inhibitory G protein-calcium channel complex. Acutely dissociated rat DRGs were incubated for 18-24 h in medium supplemented with sera (10% vol/vol) from either diabetic rats with neuropathy or age-matched, nondiabetic controls. Exposure of DRG neurons to sera from diabetic BB/W rats resulted in a surface membrane immunofluorescence pattern when treated with an anti-rat light-chain antibody that was not observed in neurons exposed to control sera. Calcium current density (IDCa) was assessed with the use of the whole cell variation of the patch-clamp technique. IDCa in neurons exposed to diabetic sera was significantly increased compared with neurons exposed to control sera. Guanine nucleotide-binding (G) protein regulation of calcium channel function was examined with the use of a two-pulse "facilitation" or IDCa enhancement protocol in the presence of activators [guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S)] or antagonists [guanosine 5'-O-(2-thiodiphosphate) (GDP beta S) and pertussis toxin (PTX)] of G protein function. Facilitation was significantly decreased in neurons exposed to diabetic sera. Intracellular diffusion of neurons with GDP beta s blocked facilitation, whereas dialysis with GTP gamma s increased facilitation to a similar magnitude in neurons exposed to either diabetic or control sera. Treatment with PTX resulted in a significant increase in IDCa and approximately 50% decrease in facilitation in neurons treated with control sera but no significant changes in neurons exposed to diabetic sera. We conclude that serum from diabetic BB/W rats with neuropathy contains an autoimmune immunoglobulin that impairs regulation of the inhibitory G protein-calcium channel complex, resulting in enhanced calcium influx. Regulation of the inhibitory G protein-calcium channel complex involves PTX-sensitive and -insensitive G proteins.     

Comparison of CT and MR imaging in staging of neck metastases

OBJECTIVE: To determine whether adaptive cytoprotection exists in human intestinal cells under in vitro conditions and what role, if any, endogenous prostaglandins or calcium may play in mediating this protective response. SUMMARY BACKGROUND DATA: Adaptive cytoprotection can be defined as that process whereby the administration of a low concentration of a damaging agent, termed a "mild irritant," which by itself is not injurious, can attenuate gastrointestinal mucosal injury subsequently induced by the application of higher concentrations of the same or other necrotizing agents. Despite substantial investigation, the mediator or mediators of adaptive cytoprotection remain poorly understood. METHODS: Postconfluent Caco-2 cells were used in all experiments. Cellular death was quantitated using a dual-component fluorescent assay. Changes in intracellular calcium concentration were quantitated by measuring fluorescent signal changes of the single wavelength calcium indicator (Fluo-3). Finally, prostaglandin E2 release into the media was quantitated by radioimmunoassay. RESULTS: Pretreatment of Caco-2 cells with low concentrations of ethanol (mild irritant) significantly attenuated injury induced by higher damaging concentrations of ethanol. The protection conferred by the mild irritant was directly dependent on both the concentration of the irritant used and the duration of exposure and was abrogated when cells were pretreated with an endogenous prostaglandin inhibitor (indomethacin) or if the mild irritant was administered in calcium-free media. Cells exposed to ethanol had a significant and concentration-dependent increase in intracellular calcium concentration, an effect that was highly related to cellular injury. Pretreatment with a mild irritant significantly decreased intracellular calcium increases induced by not only ethanol but also by a calcium ionophore (A23187). Cells treated with low concentrations of ethanol demonstrated no significant elevation in prostaglandin E2 release. CONCLUSIONS: Adaptive cytoprotection induced by ethanol exists in human colonocytes under in vitro conditions independent of mucosal blood flow, neural innervation, or circulating humoral factors. The authors' data suggest that this response does not require endogenous prostaglandin synthesis but may involve processes whereby intracellular calcium accumulation is prevented.     

Primary structure of gene H of cattle plague virus strain K]

The paper analyzes the standard legal and methodological assurance of the quality and safety of animal food raw materials and foodstuffs (meat, meat products, fish, shellfish, crayfish and their processing products) by the parasitic purity rates according the requirements under the Russian Federation's laws "On Sanitary and Epidemiological Well-Being of the Population", "On Protection of Consumer's Rights", "On Certification of Products and Services", those of SanPiN, such as 2.3.2.560-96 "Sanitary Requirements for the Quality and Safety of Food Raw Materials and Foodstuffs" and 3.2.569-96 "Prevention of Parasitic Diseases in the Russian Federation".     

Teaching hooded crows (Corvus cornix L.) the abstract rule of choice by the matching/oddity of the sample

Six hooded crows (Corvus cornix) were trained in alternative simultaneous matching-to-sample and oddity-from-sample tasks with visual stimuli. Bird's ability to acquire the abstract same/different concept was investigated. For this purpose three stimulus sets of the following categories were used: color (black and white cards), shape (Arabic numerals "1" and "2"), and numerousness (heterogeneous arrays of 1 or 2 elements). These three sets were used for training successively and repeatedly; each time the stimulus set was changed for the next one after the criterion (80% correct or better over 30 successive trials) was reached with the previous one. The training procedure was repeated until the criterion could be reached for each of the three stimulus sets within the initial 30-50 trials. After that, the abstractness of the rule acquired by birds was tested. First, the "partial" transfer tests were conducted, which consisted in presentation of novel stimuli with familiar ones (numerals and arrays in the range from 1 to 4). At the final stage, only sets of novel numerals and arrays in the range from 5 to 8 were presented. The crows demonstrated successful transfer in all of these tests, including the test with absolutely novel stimuli (in the first 24 presentations: min 75.0%, p < 0.02; max 83.3%, p < 0.01). The level of correct choices did not differ from the baseline (p > 0.05). This allows us to conclude that birds are capable for formation of the abstract same/different concept.     

Experimental analysis of functional stability of sagittal split ramus osteotomies secured by miniplates and position screws

PURPOSE: This study determined the relative functional stabilities of various miniplate systems and configurations used to stabilize sagittal split ramus osteotomies (SSROs) and compared them with conventional internal screw fixation. MATERIALS AND METHODS: The biomechanical model was a reproducible prototype of a mandible sagittal osteotomy with consistent material and geometric properties. After advancing the distal segment by 7 mm, each set of mandible analogs (1 set = 3 analogs) was fixed bilaterally by one of three miniplate systems applied in various configurations, and tested with and without a supplemental 2.4-mm bicortical screw applied in the retromolar region. Reduced analogs were placed in a straining frame, and simulated masticatory loads were applied alternatively to the mandibular first molars. Ensuing osteotomy site displacements were measured by transducers attached to a computer-based data acquisition program. A coordinate transformation procedure was used to convert the component displacements captured by the individual transducers into a common "instability factor" to reflect fixation stability for each construct and loading condition. Instability factors for the individual constructs were compared with each other and with those obtained from analogs reduced exclusively with 2.4-mm position screws. RESULTS: Osteotomies stabilized with a combination of miniplates and position screws were more stable than those stabilized exclusively with miniplates (P < .0001). Post-hoc comparisons of mean instability factors (Dunnet's method) showed the miniplate-position screw combinations to be more stable than the 2.4-mm position screw system used as standard (P < .05). Miniplate systems alone were the least stable of the test constructs, with differential rates of failure between the individual miniplate systems. CONCLUSIONS: Exclusive use of miniplate fixation may not provide the consistent stability necessary for early functional restoration after SSROs. The addition of a position screw in the retromolar region substantially enhances the fixation stability of miniplate systems. The use of miniplates with retromolar position screws offers both technical and stability advantages over conventional miniplate or internal screw fixation. The fixation stability of the miniplate-position screw combination is independent of the type of miniplate system used.     

Evaluation of two commercial kits for serum gastrin assay, and comparison with a conventional radioimmunoassay procedure

We compared two gastrin radioimmunoassay kits ("Immutope" kit, Squibb & Co.; "Gastrin R.I.A." kit, Schwarz/Mann) to the conventional gastrin radioimmunoassay of Yalow and Berson [Gastroenterology 58, 1 (1970)] as run by us and by a second reference laboratory. Although both kits were found to effectively discriminate above-normal and normal values for serum gastrin, they significantly underestimated very high values (greater than 1500 ng/liter). The Schwarz/Mann kit clearly had a superior quality label (lower nonspecific binding and higher specific activity) and a shorter incubation time. However, the 90-min incubation period cited for their kit caused overestimation of gastrin values in the lower range (5-300 ng/liter), which could be corrected by prolonging the incubation to 24 h. The Squibb antibody had fairly good cross reactivity to all gastrin species tested; the Schwarz/Mann antibody had poor affinity for natural human gastrin G34-II. Good correspondence was found for sera run by both reference laboratories (y = 0.96x + 10, r = 0.997), and values obtained with the Schwarz/Mann kit correlated best (+ 0.815) with those from the conventional radioimmunoassay procedure.     

Morphology of pneumopathies and their role in the development of asphyxia neonatorum

Histories of deliveries and development records of 44 newborns with penumopathies who had died on the first days of life in the presence of phenomena of the syndrome of respiratory disorder were analysed and the newborns' lungs were morphologically investigated. The investigation made it possible to single out the following forms of pneumopathy in newborns: edematous-hemorrhagic, hyaline, atelectatic, aspirated, and mixed. In the majority of cases the syndrome of respiratory disorder was a sequela of hypoxia of the intrauterine origin which continued during the first hours and days of life after birth. Such "primary asphyxia" may lead to the development of pneumopathy in a neonate. On the other hand, "secondary asphyxia" in many cases represent sequelae of penumopathy destructural and functional immaturity of the pulmonary tissue, hypoxia, a higher permeability of vessels of the microcirculatory bed, spasm of small pulmonary arteris contributed considerably to the development of penumopathies.     

Effects of substitutions in the binding surface of an antibody on antigen affinity

The interactions between the Fab and single-chain Fv (scFv) fragments of an antibody (NC10) and its antigen, influenza virus neuraminidase, were analysed in the crystal structures of the Fab-neuraminidase and scFv-neuraminidase complexes. To investigate the contribution to binding made by cavities, salt links and hydrogen bonds in the antibody- antigen interface, 14 single amino acid replacements were made at six contact residues in the scFv fragment by site-directed mutagenesis. The binding affinity of each mutant scFv antibody for neuraminidase was determined with a BIAcore optical biosensor. Four of the mutations resulted in large changes in the free energy of binding to neuraminidase (deltadeltaG > 1 kcal/mol) and together may account for approximately 70% of the free energy of binding. Hence these data support the theory that a small number of residues form the 'functional epitope' and are most important for binding of NC10 to neuraminidase. The salt link between antibody residue (Asp)H56 and (Lys)N432 from neuraminidase was demonstrated to be important for affinity, since substitution of (Asp)H56 with Asn caused a large reduction in the free energy of binding (deltadeltaG = +2.8 kcal/mol). Hydrogen bonds provided by (Tyr)L32 and (Asp)H56 were also important for binding: mutation of (Tyr)L32 to Phe resulted in a significant reduction in binding affinity (deltadeltaG = +1.7 kcal/mol). Disruption of hydrophobic interactions (van der Waals contacts) led to significant reductions in affinity also ((Tyr)H99 to Ala, deltadeltaG = +1.5 kcal/mol; (Leu)L94 to Ala, deltadeltaG > +3.0 kcal/mol). An attempt to increase binding affinity by filling a cavity in the interface with a larger antibody side chain was unsuccessful, as the free energy gained by new antibody-antigen interactions did not compensate for the removal of cavity-bound water molecules.