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Temporal changes in rates and reasons for medical induction of term labor, 1980-1996.

OBJECTIVE: This study was undertaken to assess temporal changes in rates and reasons for medical induction of term labor. STUDY DESIGN: A retrospective medical record review was conducted on a population-based cohort of 1293 women with term deliveries. RESULTS: The rate of medical labor induction increased from 12.9% in 1980 to 25.8% in 1995. Stated indications also changed, with a 2-fold increase in induction for postdate gestation, a 23-fold increase in induction for macrosomia, a 15-fold increase in elective induction, and a 22-fold decline in induction for premature rupture of membranes. The average gestational age at delivery of postdate pregnancies declined from 41.9 weeks in 1980 to 41.0 weeks in 1995. By 1995, the average maternal length of stay and the percentage of cesarean deliveries were higher among women with induced labor at term than among those with spontaneous labor at term. CONCLUSION: Induction of term labor has almost doubled in prevalence during the past 15 years. The most common indications are elective induction and postdate pregnancy, often applied to gestations of 40 to 41 weeks' duration.

Adult↗

Temporal changes in gene expression after injury in the rat retina.

PURPOSE: The goal of this study was to define the temporal changes in gene expression after retinal injury and to relate these changes to the inflammatory and reactive response. A specific emphasis was placed on the tetraspanin family of proteins and their relationship with markers of reactive gliosis. METHODS: Retinal tears were induced in adult rats by scraping the retina with a needle. After different survival times (4 hours, and 1, 3, 7, and 30 days), the retinas were removed, and mRNA was isolated, prepared, and hybridized to the Affymatrix RG-U34A microarray (Santa Clara, CA). Microarray results were confirmed by using RT-PCR and correlation to protein levels was determined. RESULTS: Of the 8750 genes analyzed, approximately 393 (4.5%) were differentially expressed. Clustering analysis revealed three major profiles: (1) The early response was characterized by the upregulation of transcription factors; (2) the delayed response included a high percentage of genes related to cell cycle and cell death; and (3) the late, sustained profile clustered a significant number of genes involved in retinal gliosis. The late, sustained cluster also contained the upregulated crystallin genes. The tetraspanins Cd9, Cd81, and Cd82 were also associated with the late, sustained response. CONCLUSIONS: The use of microarray technology enables definition of complex genetic changes underlying distinct phases of the cellular response to retinal injury. The early response clusters genes associate with the transcriptional regulation of the wound-healing process and cell death. Most of the genes in the late, sustained response appear to be associated with reactive gliosis.

Animals↗

Temporal changes in the gonococcal serovar patterns in Stockholm during two years with special reference to PPNG strains.

OBJECTIVE: To analyse temporal changes in gonococcal serovar patterns in Stockholm during a two year study period (1987-1989) to elucidate the dynamics of gonorrhoea epidemiology. DESIGN: The study population comprised 857 patients with culture proven gonorrhoea and with serotyped gonococcal isolates. The probable geographical origin of the infection was determined in 690 of the patients. RESULTS: A total of 108 Ph/GS-serovars were identified. Most (73%) of the serovars were recognised only during one or two quarters of the study period and comprised 16% of the isolates. Seven serovars were encountered during all eight quarters. Three of these serovars i.e. Arost/Aedgkih (IA-1, IA-2), Bropt/Bajk (IB-3, IB-6), Brpyust/Bacejk (IB-1, IB-2) were the most prevalent in the overall study, accounting for 60% of the isolates during the first quarter of the study and 36% of the isolates during the last quarter. Fifty-seven percent of the patients were infected in Stockholm (endemic infection). The proportion of endemic isolates among the three most common serovars declined throughout the study period (77% during the first quarter; 47% during the last quarter). A total of 32 Ph/GS-serovars were recognised among 80 PPNG strains. Only four of these 32 serovars were encountered during more than two quarters. Of 57 patients with PPNG strains and with geographical origin of the infection known, only seven (12%), all infected in Sweden, might have transmitted their infection further into the society. CONCLUSIONS: The decline in the total number of gonorrhoea cases seen in Stockholm during the study period, was due mainly to a decline of endemic isolates of the three most prevalent serovars. Results from contact tracing and serotyping indicated that PPNG infections acquired abroad seldom become established in the community. Serovar determination seems valuable mainly as a tool for surveillance whereby the introduction and circulation of gonococcal strains in the community can be pursued.

Contact Tracing↗

Temporal changes in ACTH, cortisol and IAP in rats under immunochemotherapy with 5-FU and Krestine.

In this study we investigated temporal changes in both the endocrine system and immunity in rats under immunochemotherapy with 5-FU and Krestine (PSK). This immunochemotherapy was performed on two types of groups, non-cancer-bearing rats and cancer-bearing rats. As hosts, inbred strain WKA/HA 5-week-old male rats and as tumors, transplantable ascitic liver cancer KDH-8 cells were used. Our results indicated that 1) in the non-cancer-bearing rats, 5-FU administration led to an increase in serum cortisol and IAP, however, PSK concurrent administration clearly lowered the levels of cortisol and IAP; 2) in the cancer-bearing rats, the levels of ACTH, cortisol and IAP increased as the cancer progressed, but in the immunothemotherapy administration groups these levels were lower; 3) the immunothemotherapy administration group had greater effects on both tumor growth and liver metastasis.

Adjuvants, Immunologic↗

Temporal changes in posterior laxity after isolated posterior cruciate ligament injury: 35 patients examined by stress radiography and MRI.

We examined the temporal changes in posterior laxity and MRI findings in acute isolated posterior cruciate ligament (PCL)-injured knees. 35 patients with acute isolated PCL injuries who attended our clinic within 10 weeks of an injury underwent nonoperative treatment, and were chronologically evaluated for posterior laxity and MRI. We divided them in 3 groups, as regards the evolution of laxity and MRI findings. In 20 patients, the degree of posterior laxity was slight throughout the observation periods. In 9 patients, who had severe posterior laxity on their initial visit, the laxity had improved markedly 6 months after injury and did not deteriorate. In 6 patients the severe posterior laxity did not improve during the study. 4 patients whose PCL on MRI was seen as a continuous swollen band having high signal intensity and showed consistently good stability or even an improvement. We conclude that acute isolated PCL injuries with a continuous swollen band on MRI should be treated conservatively for at least 6 months after injury, even if the posterior laxity is severe initially.

Adolescent↗

Temporal changes in suicide rates for persons treated and not treated with antidepressants in Denmark during 1995-1999.

OBJECTIVE: To compare the temporal changes in suicide rate among patients treated with antidepressants with the change in suicide rate among persons who have not been treated with antidepressants during 1995-1999. METHOD: In a historic prospective national pharmacoepidemiological register linkage study by using four Danish registers we included 438,625 patients who had purchased antidepressants, and compared them with 1,199,057 population based control persons. The annual rate of suicide was estimated using Poisson regression analyses. RESULTS: The suicide rate decreased for persons treated with antidepressants as well as for persons not treated with antidepressants. The proportion of persons, who committed suicide and who had not been treated with antidepressants decreased. The reduction in suicide rate was more pronounced among persons treated with SSRIs or older antidepressants than among persons not treated with antidepressants. CONCLUSION: Several factors contribute to the decreasing suicide rate. The most pronounced decrease in suicide rate was found among persons treated with antidepressants.

Adolescent↗

Temporal changes and histologic relation of postsystolic thickening in an animal model of acute ischemia and reperfusion.

BACKGROUND: We investigated the incidence and temporal changes of postsystolic thickening (PST) during myocardial ischemia and reperfusion to determine factors associated with PST. METHODS: The inferoposterior wall infarction was induced by coronary artery ligation (L) in 22 male cats. Epicardial echocardiographic examination including 2-dimensional, M-mode, and pulsed wave myocardial Doppler imaging of inferoposterior wall was performed at short-axis view before L, and regularly repeated during L until PST was not detected by myocardial Doppler image. Reperfusion (R) was done immediately after PST disappeared, and epicardial echocardiographic examination was repeated for 1 hour. Transmural extent of myocardial necrosis was morphometrically analyzed with triphenyltetrazolium chloride staining. RESULTS: PST measured by myocardial Doppler image was well correlated with that by M-mode (r = 0.63, P <.001). Immediately after L, all 22 cats showed akinesia in 2-dimensional imaging; among them PST was present in 13 cats (59%) and absent in the other 9 cats. The extent of ischemia by perimetric measurement with 2-dimensional imaging was smaller in cats with PST compared with those without (32 +/- 10% vs 47 +/- 5%, P <.001). In 13 cats with PST, the occlusion time until disappearance of PST (90-270 minutes, 160 +/- 70) and transmural extent of myocardial necrosis (0%-72%, 22 +/- 24) were quite variable. After R, PST promptly reappeared in all 13 cats. PST persisted until 1 hour after R in 5 cats, whereas it disappeared in 8 cats as systolic thickening became predominant; occlusion time was significantly longer (220 +/- 40 vs 120 +/- 40 minutes, P <.005) and transmural extent of myocardial necrosis was larger (43 +/- 17% vs 8 +/- 15%, P <.005) in cats with persistent PST until 1 hour after R. CONCLUSION: In acute ischemia and R, we observed variable patterns of PST genesis and maintenance, and different factors were related with these phenomena in each stage. PST could be used not only as a marker of acute ischemia but also as a marker of successful myocardial R, and further study is necessary to test whether PST represents different status of myocardial mechanics according to the extent of myocardial ischemia and necrosis in the clinical setting.

Animals↗

Temporal changes in expression of neuronal nitric oxide synthase mRNA in the rat hippocampus associated with kainate-induced seizures.

We studied the temporal changes in expression of neuronal nitric oxide (NO) synthase (nNOS) mRNA in the hippocampus of rats treated with kainic acid by use of in situ hybridization technique. Intraperitoneal injection of 10 mg kg-1 kainic acid decreased expression of nNOS mRNAs in the dentate gyrus and CA3 region of the hippocampus at 3 h and 8 h and increased it in the dentate gyrus and CA1 at one week after treatment. Although our previous study indicated that administration of kainic acid increased NO generation in the rat hippocampus, present results suggest that the injection of kainic acid results in differential regulation of nNOS mRNA and NO formation in the rat hippocampus.

Animals↗

A generalized approach for estimating effective population size from temporal changes in allele frequency.

The temporal method for estimating effective population size (Ne) from the standardized variance in allele frequency change (F) is presented in a generalized form. Whereas previous treatments of this method have adopted rather limiting assumptions, the present analysis shows that the temporal method is generally applicable to a wide variety of organisms. Use of a revised model of gene sampling permits a more generalized interpretation of Ne than that used by some other authors studying this method. It is shown that two sampling plans (individuals for genetic analysis taken before or after reproduction) whose differences have been stressed by previous authors can be treated in a uniform way. Computer simulations using a wide variety of initial conditions show that different formulas for computing F have much less effect on Ne than do sample size (S), number of generations between samples (t), or the number of loci studied (L). Simulation results also indicate that (1) bias of F is small unless alleles with very low frequency are used; (2) precision is typically increased by about the same amount with a doubling of S, t, or L; (3) confidence intervals for Ne computed using a chi 2 approximation are accurate and unbiased under most conditions; (4) the temporal method is best suited for use with organisms having high juvenile mortality and, perhaps, a limited effective population size.

Alleles↗

Temporal changes in hippocampal theta activity following twenty minutes of forebrain ischemia in the chronic rat.

The present study was designed to examine the temporal changes in the theta (theta) rhythm recorded from the dorsal hippocampal formation of the chronic rat following 20 min of cerebral ischemia. Recordings were made during both wakefulness and paradoxical sleep. The experimental results show that ischemia resulted in a drastic amplitude reduction in both superficial and deep theta. Amplitude reduction occurred between days 1 and 4 postischemia and was maintained across the subsequent survival period. This EEG alteration was associated with an excessive loss of pyramidal cells in the hippocampal CA1 area, as observed by light microscopy. The above data strongly support our previous conclusions that neural components of the CA1 area may be of fundamental importance for the appearance and the maintenance of not only superficial theta but also deep theta. Moreover, they suggest that the preparation used in the present study may be a useful model for investigations on the neuroanatomophysiological effects of transient cerebral ischemia.

Animals↗

[Temporal change of the disc in normal adults (author's transl)].

We have recently proposed a procedure called stereochronoscopy which allows the detection of temporal changes in the disc by stereoscopic observation of exactly centered fundus pictures. We show that this procedure can also be applied in a slightly modified form to fundus pictures that are not specially centered, although with less precision. Using this technique we were able to show on material covering 10 years (50 eyes) that the discs of healthy adults do not as a rule change over a period of at least 8 years. This is valid for observation of the pictures with an overall magnification of X 14.

Adult↗

Temporal changes in posterior capsulotomy dimensions following neodymium:YAG laser discission.

We prospectively evaluated 20 eyes of 19 consecutive patients to determine the nature of temporal changes in posterior capsulotomy size, shape, and contour six weeks following neodymium:YAG laser posterior capsular disruption. Mean capsulotomy area increased by 32% (range 0 to 134%, P less than .05, Student t-test), although mean capsulotomy perimeter did not change appreciably. Capsular enlargement tended toward sphericity over time, with smoothing of edge contour from capsular tag retraction. Remodeling of opening size, shape, and contour was most likely to occur with preoperative evidence of capsular traction, and highly irregular capsulotomy borders immediately post-discission.

Aged↗

Temporal changes in the calcium-force relation during histamine-induced contractions of strips of the coronary artery of the pig.

1. We examined temporal changes in the relationship between cytosolic calcium concentrations ([Ca2+]i) and developed tension during histamine-induced contractions of strips of the coronary artery of the pig, by making use of simultaneous measurements of fura-2 fluorescence and force. 2. The relationship between [Ca2+]i and developed tension observed with cumulative applications of extracellular Ca2+ ([Ca2+]o), ranging from 0 mM to 10 mM, during 118 mM K(+)-depolarization was similar to that observed in chemically skinned strips of the porcine coronary artery, as noted by other investigators. [Ca2+]i at 0 mM [Ca2+]o, at 50% of maximum, and at maximum tension development were 76 nM, 424 nM, and 3050 nM, respectively. 3. Cumulative applications of histamine induced dose-dependent increases in [Ca2+]i and tension and the extent of tension for a given change in [Ca2+]i increased, i.e. greater effectiveness of [Ca2+]i-tension relationship, than seen with K(+)-depolarization. 4. When histamine 10(-5) M was applied, [Ca2+]i abruptly rose and reached the first peak within several seconds. After a slight dip at 30 s, [Ca2+]i reached a second peak at 3 min, and then gradually declined. On the other hand, tension developed rapidly reached a maximum at 4 min, then gradually declined. The relation between [Ca2+]i and tension in the early, rising phase of contraction was similar to that obtained during depolarization. At the time of maximum tension development, the relation was greater than that observed during depolarization, which persisted in the phase of declining tension. 5. To examine the role of protein kinase C in the increased effectiveness of [Ca2+]i-tension relation of histamine-induced contractions, we used 1-(5-isoquinolinesulphonyl)-2-methylpiperazine (H-7), as an inhibitor. Exposure of strips to H-7, i0-' M, reduced the effectiveness of [Ca2+]i-tension relation toward the level observed during depolarization, while it had no effect on the [Ca2 ]i-tension relation in the early phase of contraction either in the presence or absence of extracellular Ca2 + 6. In intact smooth muscle of the coronary artery of the pig, the relationship between [Ca2+]i and developed tension varies during contraction. Histamine, a receptor-mediated stimulus, induced a greater tension for a given change in [Ca2+]i during the steady state of contraction than did depolarization. The greater effectiveness of contraction, particularly in the later phase, seems to be mediated by activation of an H-7-sensitive mechanisms.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗

Temporal changes in PTHrP, Bcl-2, Bax, caspase, TGF-beta, and FGF-2 expression following growth plate irradiation with or without radioprotectant.

This study examined temporal changes in growth plate apoptosis molecules and growth factors in an animal model of radiation injury with and without a radioprotectant. Thirty weanling 5-week Sprague-Dawley rats underwent right knee irradiation with single-fraction 17.5 Gy while the left served as internal control. Six animals each were sacrificed at 0.5, 1, 2, 3, or 4 weeks after irradiation. Half of the animals received pretreatment with amifostine (WR-2721) radioprotectant. Immunohistochemical staining for PTHrP, Bcl-2, Bax, caspase-3, FGF-2, and TGF-beta was performed. PTHrP decreased to a nadir at 1 week after irradiation but rebounded to above control levels at 2 weeks in the reserve and transitional zones. The radioprotectant amifostine blunted the decrease in PTHrP but kept PTHrP expression lower than controls during the rebound phase in untreated irradiated animals. Hypertrophic zone Bax expression was decreased by amifostine in both irradiated and non-irradiated limbs at 1 and 2 weeks. FGF, TGF-beta, Bcl-2, and caspase levels generally decreased at 1 week and returned thereafter toward control levels. These findings underscore the importance of PTHrP in response to growth plate irradiation and show the novel finding of a decrease in Bax expression with amifostine pretreatment.

Amifostine↗

Temporal changes and rural-urban differences in cardiovascular disease risk factors and mortality in China.

We summarize several studies, from the last 10 years, of temporal changes and rural-urban differences in the risk factors of cardiovascular disease (CVD) in China to indicate the influences of economic modernization. Two national blood pressure surveys have shown that the prevalence of hypertension increased from 5.1% to 7.7% between 1958-1959 and 1979-1980. Throughout China hypertension is more prevalent in urban areas than in rural areas. Within the Shanghai region body mass index, blood pressure, and total serum cholesterol were higher in urban districts than in rural areas. Rural-urban differences in lipid levels were also found in the Beijing and Guangzhou regions. A related four-year followup study showed that total serum cholesterol and triglycerides increased markedly in both urban and rural areas of Guangzhou. In Shanghai part-time farmers who worked in factories had a higher age-adjusted prevalence of definite hypertension than farmers who worked full-time in the fields (5.0% versus 2.3%). In a prospective study in Wuhan a new productivity-based salary system was associated with increased serum cholesterol and blood pressure. Age-adjusted CVD mortality increased from 1973 to 1982 in a rapidly industrializing county in the Shanghai metropolitan region. The results from several studies indicate that China is undergoing the expected increase in modernization-related CVD risk factors and mortality, especially in urban metropolitan regions.

Adult↗

Temporal changes in regional end-diastolic wall thickness early after reperfusion in acute anterior myocardial infarction: relation to myocardial viability and vascular damage.

We investigated early temporal changes in end-diastolic wall thickness (EDWT) of the infarcted myocardium in 46 patients with reperfused anterior acute myocardial infarction in relation to myocardial viability. Two-dimensional echocardiography was performed on days 1 and 2 of acute myocardial infarction, and the EDWT of the anterior segment was measured in the short-axis view. Patients were divided into three groups on the basis of day 1 to day 2 ratio of EDWT: the ratio < or = 0.85 as group A (n = 13), >0.85 but < or = 1.15 as group B (n = 23), and >1.15 as group C (n = 1 0). Left ventricular functional improvement was significantly better in group B than in groups A and C. Substantial size of "no reflow" phenomenon was observed only in groups A (n = 9, 69%) and C (n = 6, 60%). The frequency of transient ST re-elevation after reperfusion was the highest in group C (70%), and left ventricular expansion was observed at day 2 only in group A. We conclude that changes in the EDWT of the infarct segment early after reperfusion, either decreases or increases, are related to irreversibly damaged myocardium. A decrease in EDWT and concomitant ventricular expansion may be related to impaired myocardial perfusion. An increase in EDWT after reperfusion may be caused by accelerated myocardial and microvascular damage after reperfusion.

Adult↗

Temporal changes in aggregation: a laboratory study.

Changes in the variance to mean ratio and the parameter k of the negative binomial distribution were used to study temporal changes in the degree of aggregation of the monogenean parasite, Gyrodactylus turnbulli in free-running laboratory populations of the guppy, Poecilia reticulata. The parasite undergoes recurrent epidemic cycles in the host population under conditions of regular immigration of uninfected guppies. During the early phase of the epidemic, heterogeneity among fish together with direct reproduction are thought to contribute to the increasing degree of aggregation. During the increasing phase of the epidemic cycle, parasites become increasingly aggregated in the host population, presumably because of the direct reproduction of the parasite on the surface of a single host. As the peak prevalance and abundance are approached, the parasites become less aggregated with lowest clumping occurring during the declining phase of the cycle. This is thought to be a function of density-dependent death of infected hosts, and density-dependent reduction in parasite survival and reproduction on hosts that recover from infection. This study clearly indicates that the variance to mean ratio and the parameter k of the negative binomial distribution do not quantify the same aspect of the frequency distribution. It is suggested that the variance to mean ratio is a better measure when the prevalence and/or mean burden are changing and when the tail of the distribution is of particular interest, and that k may be a preferred parameter when the zero class or the lightly infected hosts are of primary interest.

Animals↗

Temporal changes in cardiovascular autonomic regulation in type II diabetic patients: association with coronary risk variables and progression of coronary artery disease.

AIM: This research was designed to study the temporal changes in cardiovascular autonomic regulation, assessed by 24-hour heart rate (HR) variability, and the possible relation of changes in HR variability to cardiovascular risk factors and progression of coronary artery disease (CAD) among type II diabetic subjects. METHOD: In a single-center substudy of The Diabetes Atherosclerosis Intervention Study (DAIS), 53 patients assigned to fenofibrate (n = 26) or placebo (n = 27), underwent time and frequency domain and fractal analysis of HR variability, coronary risk variable analyses and quantitative coronary angiograms at baseline and after three years' follow-up. RESULTS: Twenty-four hour standard deviation of sinus intervals (SDNN) decreased from 113 +/- 35 to 94 +/- 30 msec (P < 0.001) during the three year period. Low frequency power spectral component and short-term fractal scaling exponent also decreased (P < 0.001 and P < 0.05, respectively). The reduction of SDNN was weakly related to a change in the triglyceride level (r = -0.33, P < 0.05), glucose level (r = -0.28, P < 0.05) and total cholesterol concentration (r = -0.35, P < 0.01). Furthermore, the reduction of SDNN was related to a decrease in the minimum lumen and mean segment diameter of the coronary arteries (r = 0.36, P < 0.01, and r = 0.39, P < 0.01, respectively). This association was more marked in the placebo group (r = 0.50, P < 0.01 and r = 0.44, P < 0.05, respectively) than among the patients randomized to fenofibrate (not significant for both). CONCLUSIONS: Cardiovascular autonomic regulation assessed by HR variability deteriorates rapidly in type II diabetic subjects with CAD during the time course. Impairment in HR variability is associated with changes in common coronary risk variables and with a progression of CAD.

Adult↗