Symptom-giving pelvic girdle relaxation of pregnancy, postnatal pelvic joint syndrome and developmental dysplasia of the hip. The Norwegian Association for Women with Pelvic Girdle Relaxation (Landforeningen for Kvinner Med Bekkenl?sningsplager)

OBJECTIVES: To describe the clinical characteristics and outcomes of a large group of women with symptom-giving pelvic girdle relaxation of pregnancy and postnatal pelvic joint syndrome. To determine if there is an increased incidence of developmental dysplasia of the hip in the children of women with such pelvic problems. METHODS: A postal survey of 1,609 Norwegian women registered as having pregnancy-initiated pelvic joint pain. The response rate was 79% and from the answers 1,115 women were defined as having had symptom-giving pelvic joint syndrome of pregnancy and/or postnatal pelvic joint syndrome. RESULTS: Pelvic pains began in the first pregnancy in 74% of the respondents usually beginning in the first trimester. Pelvic pain worsened with subsequent pregnancies and persisted for a mean of 6.25 years, often causing major incapacity and lifestyle changes. Rest and physical supports brought temporary relief only. Sacroiliac joints and the symphysis pubis were the commonest sites of pain but peripheral joints were also often affected. There was a strong family history of both pelvic joint syndrome and developmental dysplasia of the hip. The incidence of hip dysplasia in the children of women surveyed was 45/1,000 which is 5 times the Norwegian incidence. CONCLUSION: Pelvic joint syndrome nearly always follows pelvic girdle relaxation of pregnancy and may have prolonged debilitating effects which do not respond long term to current therapies. The incidence of developmental dysplasia of the hip in the children of these women was high. A genetic susceptibility to joint dysfunction in both mother and fetus, possibly due to an aberration of relaxin physiology, is surmized. Identification of possible relaxin receptor changes in affected joints is a hypothesis worthy of testing with a view to the design of selective relaxin receptor modulators in pregnancy.     

High-dose edatrexate with oral leucovorin rescue: a phase I and clinical pharmacological study in adults with advanced cancer

Our objective was to determine the maximum tolerated dose and toxicity of i.v. edatrexate with p.o. leucovorin. Thirty-one adults with advanced solid tumors received edatrexate as a 2-h infusion, once a week for 3 weeks, recycled every 28 days. p.o. leucovorin (10 mg/m2, every 6 h for 10 doses) began 24 h later. All had urinary alkalinization and p.o. hydration. Nine dosage levels ranging from 120 to 3750 mg/m2 were explored. Fatigue, epistaxis, nausea/emesis, mucositis, rash, myalgias, leukopenia, thrombocytopenia, and transient elevations of serum aspartate transferase were observed. Leukoencephalopathy with clinical manifestations occurred in two patients (one had prior cranial irradiation). Pharmacokinetic studies carried out at the 120- and 1080-mg/m2 dose levels revealed no significant difference in the elimination half-life at the two dose levels studied and no significant intrapatient variability between day 1 and day 8 edatrexate administration. Serum edatrexate levels measured using a dihydrofolate reductase inhibition assay correlated with those by high-performance liquid chromatography. Three major and two minor antitumor responses occurred. The maximum tolerated dose was 3750 mg/m2, with grade 3 or 4 leukopenia (one patient), stomatitis (one patient), and leukoencephalopathy (one patient). Because of the occurrence of leukoencephalopathy, further study of high-dose edatrexate with leucovorin rescue is not recommended.     

AZTDIS--a two-phase real-time ECG data compressor

An ECG sampled at a rate of 360 samples s-1 or more produces a large amount of redundant data that are difficult to store and transmit; we therefore need a process to represent the signals with clinically acceptable fidelity and with as small a number of code bits as possible. In this paper, a real-time ECG data-compression algorithm, AZTDIS, is presented. AZTDIS is an efficient algorithm which locates significant samples and at the same time encodes linear segments between them by using linear interpolation. The significant samples selected include, but are not limited to, the samples that have significant displacement from the encoded signal such that the allowed maximal error is limited to a constant epsilon, which is specified by the user. The way that AZTDIS computes the displacement of a sample from the encoded signal guarantees that the high activity regions are more accurately coded. The results from AZTDIS are compared with those from the well-known data-compression algorithm, AZTEC, which is also a real-time algorithm. It is found that under the same bit rate, a considerable improvement of root-mean-square error (RMSerr) can be achieved by employing the proposed AZTDIS algorithm. An average value of RMSerr of 9.715 can be achieved even at an average bit rate of 0.543 bits per sample by employing AZTDIS. By tuning the allowed maximal error of AZTDIS such that it has similar bit rate to AZTEC, the average value of RMSerr achieved by AZTDIS is 5.554 while the average value of RMSerr achieved by AZTEC under the same bit rate is 19.368.     

Expression of cytokine messenger RNA after heart transplantation: relationship with rejection and serum cytokines

Different groups of cytokines may initiate or inhibit the rejection process. We used the polymerase chain reaction to study the expression of cytokine mRNA for interleukin (IL)-2, -4, -6 and -10, tumor necrosis factor-alpha, and interferon-gamma in 187 biopsy specimens from 24 human cardiac transplant recipients 5-555 days after transplantation. Cytokine levels in the serum were also measured. Cytokine mRNA was detected in 38.5% of biopsy specimens. IL-10 mRNA was detected more frequently with mild or absent rejection (11.6% in grades 0 and 1 - vs. 1.4% in grades 2 and 3, P=0.01). Up to 90 days after transplantation, IL-2 mRNA was detected more frequently with moderate rejection (13% in grades 2 and 3 vs. 0% in grades 0 and 1, P=0.076), and IL-4 mRNA was detected more frequently with mild or absent rejection (16% in grades 0 and 1 - vs. 0% in grades 2 and 3, P=0.061). More than 90 days after transplantation, IL-2 mRNA was detected more frequently with mild or absent rejection (10% in grades 0 and 1 vs. 0% in grades 2 and 3, P=0.078). Serum IL-4 levels corresponding to biopsy specimens positive for IL-4 mRNA were higher than those corresponding to specimens negative for IL-4 mRNA (59 pg/ml vs. 32 pg/ml medians, P=0.028). Our results suggest that IL-10 and possibly IL-4 (T helper 2 cytokines) may suppress graft rejection, whereas IL-2 (T helper 1 cytokine) may promote cellular rejection. In addition, cytokine profiles may change with length of time after transplantation. The association of elevated serum levels of IL-4 with increased expression of intragraft IL-4 mRNA may suggest release of this cytokine from the graft into the circulation.     

Chrysosporium gourii Jain, Deshmukh & Agrawal sp. nov

A new keratinophilic species, Chrysosporium gourii, an isolate of cattle farm soil of Sagar, India, is described and illustrated. The differences between this and other similar keratinophilic species of Chrysosporium are discussed.     

American Heart Association Report on the Public Access Defibrillation Conference, December 8-10, 1994. American Heart Association Taskforce on Automatic External Defibrillation

Experimental conditions (pH 6.5, 24 h reaction, peptide:biotin ratio 1:5) were defined for preferential incorporation of the biotin molecule in the N-terminal alpha-amino group of peptides. This strategy could be helpful in numerous applications when an entire peptide chain must remain accessible for antibody or receptor binding. We illustrate this advantage in a solid-phase enzyme immunoassay designed to detect antibodies specific for bovine beta-lactoglobulin present in rabbit or human sera. This test involves synthetic peptides biotinylated in different positions and immobilized on a solid phase. The use of biotin/streptavidin interactions permitted more efficient detection of specific anti-peptide antibodies than solid phases prepared using conventional passive-adsorption techniques. The highest levels of antibody binding were measured when biotinylation occurred at the N-terminal extremity of immobilized peptides.     

Sex differences in dependency: a comparison of objective and projective measures

The relationship between scores on two widely used measures of dependency--one objective and one projective--was examined in a sample of 102 undergraduate subjects (60 women and 42 men). Consistent with previous studies in this area, significant sex differences were found on the objective measure of dependency, with women obtaining higher dependency scores than men. However, as predicted, men and women obtained comparable scores on the projective measure of dependency. Additional analyses confirmed that scores on the objective and projective measures of dependency were significantly intercorrelated in both men and women, although the magnitudes of these correlations were somewhat larger in women than in men. Implications of these results for the assessment of dependent personality traits in research and clinical settings are discussed.     

Cytoreductive surgery in ovarian carcinoma patients with a documented previously complete surgical response

The lipoprotein distribution profile was examined in Type 2 (non-insulin-dependent) diabetic patients (n = 52), with particular emphasis on factors influencing low density lipoproteins (LDL). Triglycerides were negatively correlated with LDL-2 (r = 0.34, p < 0.05) and positively correlated with smaller, denser LDL-3 (r = 0.57, p < 0.001). This yielded a highly significant, negative correlation between triglycerides and the LDL-2/LDL-3 mass ratio (r = -0.59, p < 0.001) which is an indication of the presence of smaller LDL particles. Parameters of glycaemic control, in the form of fasting blood sugar and glycated haemoglobin (HbA1c), were also negatively correlated with the LDL-2/LDL-3 mass ratio in univariate analyses; both remained significantly correlated with the mass ratio when corrected for triglycerides. Stepwise multiple regression analysis identified a three-parameter model comprising triglycerides, HbA1c, and high density lipoprotein cholesterol as best defining the variations in the LDL-2/LDL-3 mass ratio (adjusted r2 = 0.52). These observations are consistent with an independent impact of diabetes on the LDL distribution profile and the possibility that the latter may be subjected to multiple pathological influences in diabetic patients.