Uterine perforation and laparoscopic retrieval of a levonorgestrel intrauterine system (Mirena).
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Adult↗
Biomedical subjects
C C Welch
Publications and source records attributed to C C Welch.
ARC POMC mRNA and PVN alpha-MSH are lower in obese relative to lean zucker rats.
Effects of obesity on gene expression for opioid peptides and neuropeptide-Y (NPY) in the arcuate nucleus (ARC), and on opioid peptides and alpha-melanocyte stimulating hormone (alpha-MSH) in the paraventricular nucleus (PVN) were examined in obese Zucker rats (18 weeks old). Obese Zucker rats are insulin-resistant, diabetic and hyperleptinemic as indicated by high serum glucose, insulin and leptin levels. ARC proOpiomelanocortin (POMC) mRNA levels were significantly lower in the obese relative to lean Zucker rats and ARC proNeuropeptide Y (proNPY) mRNA levels were higher (P<0.05). There were no differences in proDynorphin and proEnkephalin mRNA levels in the ARC (0.05). Obese Zucker rats had lower alpha-MSH and dynorphin A(1-17) peptide levels in the paraventricular nucleus (PVN) (P<0.05), but did not have lower PVN beta-endorphin peptide levels (0.05). The decrease in POMC in the ARC and decrease in alpha-MSH in the PVN seen in the obese Zucker rat in the present study suggest that reduced activity of the melanocortin system in the ARC to PVN pathway may contribute to the related hyperphagia. Reduced activity of the melanocortin system in the ARC to PVN pathway may be due to a disturbance of leptin signaling coupling to POMC.
Animals↗
STZ-induced diabetes decreases and insulin normalizes POMC mRNA in arcuate nucleus and pituitary in rats.
Effects of streptozotocin (STZ)-induced diabetes and insulin on opioid peptide gene expression were examined in rats. In experiment 1, three groups were administered STZ (75 mg/kg ip single injection). Two groups were killed at either 2 or 4 wk. In the third group, insulin treatment (7.0 IU/kg x 1 day for 3 wk) was initiated 1 wk after STZ injection. STZ induced hyperphagia and reduced weight gain. Insulin decreased food intake and increased body weight relative to diabetes. Proopiomelanocortin (POMC) mRNA in arcuate nucleus (Arc) and pituitary decreased in diabetes and normalized after insulin treatment. Prodynorphin (proDyn) mRNA increased in diabetes and normalized in the pituitary after insulin but not in the Arc. Diabetes did not alter proenkephalin (proEnk) expression in the Arc or pituitary, nor dynorphin A1-17 or beta-endorphin in paraventricular nucleus (PVN). alpha-Melanocyte-stimulating hormone (alpha-MSH) peptide levels were decreased in the PVN and normalized following insulin treatment. Diabetes increased Arc neuropeptide Y mRNA, and insulin suppressed this increase. In experiment 2, insulin (2.5 IU/kg sc) daily for 1 wk in normal rats increased Arc POMC mRNA, but not proDyn and proEnk mRNA. These results suggest that Arc POMC expression and PVN alpha-MSH peptide levels decrease in diabetes. Also, insulin may influence Arc and pituitary POMC activity in neurons that regulate energy metabolism.
Animals↗
Effects of palatability-induced hyperphagia and food restriction on mRNA levels of neuropeptide-Y in the arcuate nucleus.
This study examined the effect of feeding either a bland cornstarch-based diet (BCD) or a highly palatable, high fat diet containing sucrose (HPD) on hypothalamic arcuate nucleus (ARC) gene expression for neuropeptide-Y (NPY). Male Sprague-Dawley rats received either BCD ad libitum, HPD ad libitum, HPD pair-fed to the caloric intake of the BCD, or the HPD at 60% of ad libitum HPD intake for 7 days. Animals receiving the HPD ad libitum consumed more calories and gained more weight than animals receiving the BCD (P<0.001). The HPD did not affect ARC NPY mRNA levels, whether the subjects were allowed to overeat or pair-fed to the BCD (P>0.05). However, feeding the HPD at 60% of ad libitum intake of the HPD, increased NPY mRNA levels in the ARC relative to the other treatments (P<0.01). The present data are consistent with the view that NPY in ARC responds to energy deficits rather than to hyperphagia stimuli related to palatability.
Animals↗
Lactation decreases mRNA levels of opioid peptides in the arcuate nucleus of the rat.
The state of lactation results in increased food intake to compensate for the increased energy expenditure to produce nutrients supplied to the offspring. In this study, Sprague-Dawley female rats lactating for 10-16 days, and rats 7 days post-lactation were implanted with osmotic minipumps infusing either naltrexone (NTX) (70 microg/h) or saline (0.9%) over a 48 h period. mRNA levels of pro-dynorphin (proDYN), pro-opiomelanocortin (POMC) and pro-enkephalin (proENK) were measured in the arcuate nucleus (ARC) and whole pituitary of both groups. In both saline- and NTX-treated lactating subjects, food intake was higher than in post-lactating subjects (P < 0.01). In post-lactating subjects, NTX decreased food intake by 27% during the infusion period (P < 0.05). There were no significant differences in body weight between the treatment groups; however, naltrexone decreased body weight gain in both lactating and post-lactating subjects. In both saline and NTX-treated lactating subjects, ARC mRNA levels of proDYN, POMC and proENK were significantly decreased compared with the saline or NTX-treated post-lactating subjects (P < 0.01). NTX did not significantly influence gene expression of opioid peptides in the ARC in either the lactating or the post-lactating subjects. Neither the lactation condition nor NTX administration significantly changed mRNA levels of proDYN, POMC or proENK in whole pituitary. Thus, as has been noted in energy-deprived rats, opioid peptide gene expression is decreased in the ARC of lactating rats, a period during which rats have increased energy requirements.
Animals↗
Palatability-induced hyperphagia increases hypothalamic Dynorphin peptide and mRNA levels.
Opioid involvement in regulating the intake of highly palatable diets was studied by examining the effect of feeding either a cornstarch-based diet (CHO) or a high fat diet containing sucrose (Fat/Sucrose) on hypothalamic opioid levels. Rats received either CHO ad libitum, Fat/Sucrose ad libitum, Fat/Sucrose pair-fed to the caloric intake of CHO, or Fat/Sucrose at 60% of ad libitum Fat/Sucrose intake. Animals receiving Fat/Sucrose ad libitum consumed more calories and gained more weight than animals receiving CHO (P < 0.001). Relative to CHO, ad libitum intake of Fat/Sucrose elevated proDynorphin mRNA levels in the arcuate and Dynorphin A1-17 levels in the paraventricular nucleus (PVN) (P < 0.05), but did not affect arcuate mRNA levels of proEnkephalin or proOpiomelanocortin (POMC), or PVN levels of Met-Enkephalin or beta-Endorphin. Pair-feeding the Fat/Sucrose diet to the level of intake of the CHO diet resulted in levels of proDynorphin and Dynorphin A1-17 that were similar in the two diet groups. Pair-feeding Fat/Sucrose reduced mRNA levels of proDynorpin, proEnkephalin and POMC, and Dynorphin A1-17 levels, relative to ad libitum feeding of Fat/Sucrose. Met-Enkephalin and beta-Endorphin were not affected by dietary treatment. Feeding Fat/Sucrose at 60% of ad libitum intake resulted in mRNA levels of proDynorphin, proEnkephalin and POMC, and Dynorphin A1-17 levels that were similar to those observed in CHO group. Hypothalamic Dynorphin A1-17 and proDynorphin mRNA levels are stimulated by feeding a highly palatable diet rich in fat and sucrose. The increased synthesis may be due in part to a palatability-induced overconsumption of calories. Caloric restriction of the same diet decreases mRNA levels of proDynorphin, proEnkephalin and POMC, as well as levels of Dynorphin A1-17.
Animals↗
Chronic food restriction and acute food deprivation decrease mRNA levels of opioid peptides in arcuate nucleus.
Although opioid administration induces food intake, the relationship between endogenous opioid synthesis and food consumption is unclear. Two studies examined the effects of food restriction and deprivation on opioid mRNA levels in the arcuate nucleus (ARC) of the rat. Body weight significantly decreased following food restriction and deprivation (P < 0.0001). In experiment 1, food restriction of 10,20,30, and 40% (g) of ad libitum intake for 14 days decreased proDynorphin (proDyn), proEnkephalin (proEnk), and proOpiomelanocortin (POMC) mRNA levels in a linear fashion relative to changes in body weight (r = 0.398, P = 0.0011; r = 0.455, P = 0.0028; r = 0.292, P = 0.0642, respectively). In experiment 2, 48 h deprivation significantly decreased mRNA levels of proDyn and POMC by 23.7% (P < 0.05) and 45.6% (P < 0.01), respectively, whereas 24 h food deprivation decreased POMC mRNA by 43.% (P < 0.01). proEnk mRNA was not affected by 24- or 48-h food deprivation. Restricting food intake suppressed mRNA levels of proDyn, proEnk, and POMC by 29.7, 22.3, and 44.4%, respectively, in 20% restricted rats and by 35.5, 26.8, and 45.6%, respectively, in 40%restricted rats (P < 0.01). It appears that ARC mRNA levels of proDyn, proEnk, and POMC are directly related to the amount of food consumed and/or changes in body weight in food-restricted and food-deprived rats.
Animals↗
Preference and diet type affect macronutrient selection after morphine, NPY, norepinephrine, and deprivation.
The orexigenic agents morphine, neuropeptide Y (NPY), and norepinephrine (NE) and deprivation have been reported to induce selection of specific macronutrients: fat, carbohydrate (CHO), CHO, and fat, respectively. We utilized analysis of covariance to compensate for the influence of baseline preference on feeding induced by six experimental procedures: morphine, NPY, NE, 24 and 48 h food deprivation, and chronic dietary restriction. Rats received one of two dietary regimens: three macronutrient diets containing CHO, protein, or fat (regimen I) and two nutritionally complete diets that were high CHO or high fat (regimen II). Baseline preference significantly influenced dietary selection after all six experimental procedures studied in regimen I and after NPY, NE, 48 h food deprivation, and chronic dietary restriction in regimen II (covariate P < 0.05). In both dietary regimens, morphine (5 mg/kg) increased consumption of fat, NPY (5 micrograms icv) increased selection of CHO, and consumption of all diets was induced equally after NE injections (20 micrograms icv). After 24 or 48 h food deprivation, animals consumed more fat in regimen I and more CHO diet in regimen II. Restricting food intake by 20% increased fat and protein consumption in regimen I but had no effect in regimen II. Diet selection is affected by prior preference, feeding stimulus, and type of diet choice presented.
Analysis of Variance↗
Naloxone's anorectic effect is dependent upon the relative palatability of food.
It has been suggested that opioids modify food intake by enhancing palatability. In the present series of studies we evaluated the effect of naloxone on food intake of a preferred food (chocolate chip cookies), normal rat chow, and an "aversive" food (high fiber chow). We found that naloxone decreased 18- and 48-h deprivation-induced intake of chocolate chip cookies much more potently than that of chow, when these foods were presented on separate occasions. When these foods were presented concurrently, this difference in naloxone's potency was no longer apparent. When rats were offered high fiber chow, only the 10 mg/kg dose of naloxone decreased intake. In these same rats naloxone significantly decreased normal chow intake at a dose of 0.1 mg/kg. Thus, naloxone's ability to decrease food intake appears to be dependent upon the palatability of the food.
Animals↗
Electroconvulsive therapy for post-stroke depressed geriatric patients.
Medical records were retrospectively reviewed for 20 medically ill geriatric patients who received electroconvulsive therapy (ECT) for post-stroke depression from January 1982 to January 1991 at Massachusetts General Hospital. Of the 19 patients (95%) who improved with ECT, 7 patients (37%) suffered relapses despite maintenance anti-depressant medications. Relapses typically developed approximately 4 months after ECT. Five patients (23%) developed ECT-related medical complications. Three patients (15%) developed transient interictal confusion or amnesia. No patient experienced an exacerbation of preexisting neurologic deficits. These findings indicate that ECT is a generally well tolerated and effective treatment for depressed, medically ill post-stroke geriatric patients.
Aged↗
Comparative clinical trial of fenticonazole ovule (600 mg) versus clotrimazole vaginal tablet (500 mg) in the treatment of symptomatic vaginal candidiasis.
A multi-centre, randomized, single-blind, parallel-group clinical trial was undertaken in 50 patients (26 fenticonazole, 24 clotrimazole) with symptomatic vaginal candidiasis to compare the antifungal efficacy and tolerability of single-dose intra-vaginal treatment with a fenticonazole ovule (600 mg) or a clotrimazole vaginal tablet (500 mg). Assessment was by laboratory mycological investigation and symptomatic assessments for a period of 3 weeks from the day of treatment. Of the 50 patients, 43 (23 fenticonazole, 20 clotrimazole) returned for assessment 1 week after drug administration and 32 (17 fenticonazole, 15 clotrimazole) were re-assessed 3 weeks after drug administration. Both treatments resulted in very similar and highly significant improvements in symptoms, associated with disappearance of detectable Candida in approximately 70% of patients. There were no significant differences between treatments and no appreciable incidence of relapse during the 3-week period of observation. At the end of this period, 10 (59%) of 17 fenticonazole patients were totally disease-free, as compared with 10 (67%) of 15 patients after clotrimazole treatment. The cure rate observed was somewhat less than that previously seen when intra-vaginal cream formulations of the same two drugs were given on a multiple-dose basis. Both drugs were very well tolerated, with no reports of appreciable local or systemic adverse reactions to either drug.
Administration, Intravaginal↗
Further investigation of the dietary protein level-monensin interrelationship in broiler chicks: influence of dietary protein source and type of anticoccidial drug.
Three experiments were conducted to evaluate the influence of dietary protein source on the monensin response in healthy chicks fed diets varying in CP. The interrelationship between dietary CP level and four different anticoccidial drugs was evaluated in a fourth experiment. The experiments were conducted from 8 to 21 or 22 days posthatching. In Experiment 1, crossbred chicks were fed corn-soybean meal (SBM) diets containing either 24 or 16% CP or casein-dextrose diets containing 20, 15, or 10% CP in the presence or absence of 160 mg/kg monensin. When CP level was decreased in the corn-SBM treatments, the resulting monensin-induced growth depression was greater. However, this interaction was not observed in chicks fed casein-dextrose diets. Experiments 2 and 3 were conducted to determine if the monensin-protein level interrelationship is influenced by the source of dietary soybean protein or by high levels of animal protein (AP). Monensin at 140 mg/kg produced a much greater growth depression at 16 than at 24% CP in chicks fed a corn-SBM diet, whereas amounts of monensin depression in chicks fed a corn-isolated soy protein diet were similar for both CP levels. As dietary protein was reduced from 24 to 16% in Experiment 3, 140 mg/kg monensin caused growth depressions of 10 and 40%, and 14 and 28%, respectively, in broiler chicks fed corn-SBM and corn-AP diets.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Further investigation of the dietary protein and monensin level interrelationship in broiler chicks: influence of Eimeria acervulina infection, increased dietary protein, and level of feed intake.
Three experiments were conducted to evaluate the influence of several dietary factors on the monensin response in commercial broiler chicks fed corn-soybean meal diets varying in crude protein (CP). All experiments were conducted between 8 and 22 days posthatching. Trial 1 had a 2 X 2 X 2 factorial design wherein diets containing 16 or 24% CP and 0 or 121 mg/kg monensin were fed in the presence and absence of Eimeria acervulina infection. The monensin-induced growth depression was greater at 16% CP than at 24% CP. Coccidial infection had no effect on the monensin X protein level interaction. Monensin supplementation markedly improved performance of chicks infected with E. acervulina. Trial 2 was conducted to determine if the monensin-induced depression in performance caused by feeding a high level of monensin (140 mg/kg) could be moderated by feeding a high protein diet. Monensin supplementation reduced growth rate 18 and 10% in chicks fed 20 and 24% CP, respectively. Increasing CP to 28% alleviated the adverse effects of monensin on weight gain. Pair-feeding was used in Trial 3 to determine the extent to which the monensin-induced growth depression observed in chicks fed low protein diets was due to reduced feed intake. As expected, reducing the dietary CP from 24 to 16% resulted in a marked increase in the growth depression caused by 121 mg/kg monensin. Pair-feeding indicated that most of monensin's adverse effects in low protein diets could be attributed to its anorexic properties.
Animals↗
A comparison of Lamicel and prostaglandin E2 vaginal gel for cervical ripening before induction of labor.
The efficiency and safety of Lamicel, a new synthetic cervical ripening agent, were compared with those of intravaginal prostaglandin E2 gel in a group of 80 primigravid women about to undergo induction of labor. Lamicel caused less uterine activity and fetal distress than prostaglandin gel, although the induction-delivery intervals were similar in both groups. More normal deliveries occurred in the Lamicel group than in the prostaglandin group. It is suggested that Lamicel is a useful, efficient preinduction ripening agent that is safer than intravaginal prostaglandin gel.
Apgar Score↗
Preoperative dilatation of the first-trimester cervix: a comparison between Lamicel and 16,16-dimethyl-trans delta 2 prostaglandin E1 methyl ester pessaries.
Both Lamicel and 16,16-dimethyl-trans delta 2 prostaglandin (PG) E1 methyl ester pessaries have recently been shown to be effective for cervical dilatation prior to first-trimester abortion. In the study described, the force required to dilate the cervix prior to vaginal termination of pregnancy was measured in three groups of patients--a control group, a group which received Lamicel , and a group which received 16,16-dimethyl-trans delta 2 PGE1 methyl ester pessaries. The total force required to dilate the cervix to 10 mm was significantly reduced in the treated groups, but there was no significant difference between the two treatment regimens. The use of Lamicel is associated with fewer side effects.
16,16-Dimethylprostaglandin E2↗
Cervical dilatation by Lamicel--studies on the mechanism of action.
Lamicel is a synthetic hydrophilic polymer tent which produces cervical softening and dilatation when inserted into the endocervical canal. To investigate the mechanism of action of Lamicel, the intrauterine pressure and levels of 6-keto-prostaglandin F1 alpha, 13-14-dihydro-15-keto-prostaglandin F2 alpha, oestradiol and progesterone in plasma and amniotic fluid were measured in patients undergoing second trimester abortion. There was no significant change in any of the measured hormones during a 2-h treatment with Lamicel, but uterine activity increased significantly for 10 min after insertion, then settled spontaneously to below pre-treatment levels. Peripheral plasma levels of magnesium sulphate measured in patients undergoing first trimester abortion were not significantly raised after insertion of Lamicel. Light microscopic examination of cervical specimens, obtained at hysterectomy from patients pre-treated with Lamicel for 24 h, revealed minimum increase in vascularity, mast cell population and ground substance mucopolysaccharides.
6-Ketoprostaglandin F1 alpha↗
Lamicel: a new technique for cervical dilatation before first trimester abortion.
Mechanical dilation of the cervix can be both difficult and dangerous and has potentially serious complications. Lamicel, a synthetic hydrophilic polymer, was inserted into the cervix between 2 and 24 h before termination by vacuum aspiration in the first trimester in 48 nulliparae. A control group of 12 nulliparae were not treated with Lamicel. The force needed to dilate the cervix, accurately measured with a specifically designed force-measuring instrument, was found to be significantly reduced in all treated groups. The greatest rate of dilatation occurred within the first 2 h after insertion.
Abortion, Induced↗
Prognosis of 1000 young women studied by coronary angiography.
One thousand women younger than age 50 years suspected of having coronary disease were followed for at least 5 years (average 8.4 years) to determine their course after coronary arteriography. Three patients were lost to follow-up; all had normal arteriograms. The survival rate was 96.9% at 5 years for 761 patients who had less than 50% narrowing of any artery. One patient who had coronary ectasia died within 5 years, and one woman who had minimal lesions suffered sudden death. Seven of 727 women who had normal arteries or less than 30% narrowing of any artery had coronary events (death, myocardial infarction, bypass operation for progressive disease), and six of 34 women who had 30 to almost 50% obstruction of at least one artery had coronary events. Calculations of survival for 236 women who had severe coronary lesions were affected by withdrawal for operation. Five-year survival was 74%.
Adult↗