Polycystic ovary syndrome

Polycystic ovary syndrome is a syndrome and not a disease. It reflects multiple potential etiologies and variable clinical presentations that are reviewed in this article. In addition to menstrual dysfunction and hyperandrogenism, women with polycystic ovary syndrome also may have hypothalamic-pituitary abnormalities, polycystic ovaries on pelvic ultrasonography, infertility, obesity, and insulin resistance. A familial pattern occurs in some cases, suggesting a genetic component to the disorder. The three major pathophysiologic hypotheses that have been proposed to explain the clinical findings of the disorder as well as treatment options are reviewed in this article.     

Quantitative evaluation of local drug delivery using the InfusaSleeve catheter

BACKGROUND: Rural women are less likely to receive screening mammography at recommended intervals. This study evaluated efforts to promote screening mammography among women in rural communities through community education interventions and low-cost mobile mammography van services. METHODS: Two matched sets of communities were identified in an isolated rural region. One area received community education programs in addition to the mammography van for 2 years; the second area received only the van services. The educational programs were designed using diagnostic research methods; they included recruitment of opinion leaders to organize small group breast screening education sessions, an information campaign using direct mail, and primary health care provider education. RESULTS: A household telephone survey conducted 6 months after completion of these programs indicated that mammography utilization and perceived mammography norms were higher among women in the Program area than among women in the Comparison area. Process data were consistent with these findings. Clinical examination and self-examination behaviors were not influenced by the programs. CONCLUSIONS: This study showed that well-focused educational interventions for rural women can increase utilization of screening mammography when access and cost barriers also are reduced.     

Neonatal nursing staff time involved with medication-related activities

A work sampling study involving 1920 observations derived from 48 2-hour observation periods is described. Approximately one-tenth of neonatal nurse time was spent on medication-related activities. just over one-third of this time involved medication preparation. It is suggested that the use of a pharmacy medication preparation service may be more cost-effective.     

Activation of cultured vascular endothelial cells by antiphospholipid antibodies

Circulating antiphospholipid antibodies (aPL) are associated with a syndrome of thrombosis, recurrent fetal loss, and thrombocytopenia. We have demonstrated the activation of cultured human umbilical vein endothelial cells (HUVEC) by IgG from patients with anticardiolipin antibodies (aCL). Incubation of HUVEC for 4 h with purified IgG (100 micrograms/ml) from patients with high-titer aCL induced a 2.3-fold increase in monocyte adhesion over that seen in HUVEC incubated with IgG's from normal subjects. The effect of aCL was not attributable to LPS contamination, Fc receptors, or immune complexes. Monocyte adhesion was not induced when the aCL were added in serum-free media but was restored by the addition of purified beta 2GP1, previously described as a necessary cofactor for aCL reactivity. Purified rabbit polyclonal IgG raised against beta 2GP1 also induced monocyte adhesion when incubated with HUVEC. Preadsorption of patient serum with cardiolipin reduced monocyte adhesion by 60%. Immunofluorescent microscopy demonstrated that endothelial cells incubated with patient IgG expressed cell adhesion molecules, including E-selectin, vascular cell adhesion molecule-1, and intracellular adhesion molecule-1. These data support the hypothesis that aPL activate vascular endothelial cells, thereby leading to a pro-thrombotic state.     

User interface design for SONET networks

The evolution of user interface design from first-stage element management systems to potential third-stage service management systems is reviewed. Requirements for user interface design are discussed. It is argued that network and service management systems for synchronous optical networks (SONETs) will benefit from the object-oriented programming approaches now being popularized in graphical windowed interfaces     

The two nonallelic Xenopus insulin genes are expressed coordinately in the adult pancreas

Eighty-eight [corrected] patients selected from a depot neuroleptic clinic in the hospital outpatients department were assessed clinically on various demographic and clinical variables with a view to determining the factors that may contribute to high rates of rehospitalisation amongst schizophrenics in remission. It was found that rehospitalisation rates during the preceding 5 years correlated with an early age of onset of illness, severity of positive and affective symptoms, current neuroleptic dose and total AIMS score, all reflecting the severity of underlying psychotic disorder and the neuroleptic treatment required to treat the psychosis. Poor compliance with neuroleptic prophylaxis was not found to be of importance in contributing to high relapse rates in this sample. It was concluded that patients who repeatedly relapse may do so because of the clinical characteristics of their illness.     

A new concept for the pathogenesis and treatment strategies for oral lichen planus

Mounting evidence points out to the immunologic basis of lichen planus (LP). Tumour necrosis factor (TNF-alpha) is a cytokine with multiple biologic activities, some of which may be relevant to the pathogenesis of LP. The present study was thus conducted to assess its production by peripheral blood leucocytes in patients with active lesions of oral lichen planus (OLP) compared to age matched healthy control volunteers. For the assessment, the quantitative immunometric sandwich technique was employed. Significantly greater amounts of TNF-alpha were found in serum samples of OLP patients compared to healthy individuals, suggesting a possible association between this cytokine and the pathogenesis of OLP and pointing out to the primary initiative role played by altered keratinocytes. This pointed out the beneficial effect of anti-TNF drugs in the management of OLP.     

Effects of zinc deficiency on protein synthesis and expression of specific mRNAs in rat liver

The effects of zinc deficiency on protein synthesis and expression of specific mRNAs were assessed in rat liver. Zinc deficiency had no apparent effect on liver weight, protein content, or RNA content when these properties were compared with values obtained using pair-fed rats. However, zinc deficiency resulted in a lower rate of hepatic protein synthesis. The decreased rate of protein synthesis was due to a decrease in the rate of synthesis of proteins retained in the liver, with no apparent change in the synthesis of secreted proteins. Analysis of expression of specific gene products, as assessed by in vitro translation of total RNA followed by two-dimensional gel analysis, showed that the expression of only a few mRNAs was altered by zinc deficiency. The patterns of change in gene expression resulting from zinc deficiency varied from almost complete repression to full expression. In additional studies, cDNA clones to serum retinol-binding protein and transthyretin were used to examine the effect of zinc deficiency on the relative abundance of mRNA for these two proteins. The relative abundance of mRNA for transthyretin was specifically elevated as a result of zinc deficiency. In contrast, the relative abundance of mRNA for hepatic serum retinol-binding protein was increased in both zinc-deficient and pair-fed rats. Therefore, the observed change in mRNA for serum retinol-binding protein was apparently at least in part due to the inanition that accompanies zinc deficiency. Overall, the results suggest that zinc can regulate the synthesis of specific proteins in rat liver through changes in the relative abundance of specific mRNAs.     

Intestinal obstruction in southeastern Nigerian children

In a 10-year (1981-1990) retrospective study of acute intestinal obstruction in the University of Calabar Teaching Hospital, Calabar, Nigeria, of the 295 paediatric cases reviewed, the major causes were ascaris worms (25%) and intussusception (22%). Other important lesions include imperforate anus (11%), volvulus (10%), external hernias (9%) and adhesions (7%) each. Ascaris-induced and hernial obstruction were most rampant in children aged above 5 years while intussusception had its peak frequency at the ages one to 12 months. Intussusception was largely (95%) ileo-caecal; volvulus involved mainly the ileum and ileo-caecum in 50% of cases each. The obstructed hernias were more common in the umbilicus (59%) than the groin (41%). The mortality (13%) was chiefly due to associated infection but lack of expertise in management of cases cannot be ignored. Generally, the pattern of intestinal obstruction among children in this region appears markedly different from that seen in Europe and North America. There is a need to create a specialist paediatric surgical unit as a means of reducing morbidity and mortality from this condition.