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Microdistribution of immature African blackflies resulting from water velocity and turbulence preferences.

1. The velocity preferences of larval and pupal blackflies were studied experimentally by comparing the colonization of plastic strings placed in different velocity ranges; and also by investigating the simuliid microdistribution under natural conditions in the river. This required a novel method described for taking spot measurements of water velocity. 2. Simulium mcmahoni de Meillon, S. hirsutum Pomeroy and S. cervicornutum Pomeroy were most abundant in slow velocities (0.3-1.0 m s-1), S. colasbelcouri Grenier & Ovazza and S. hargreavesi Gibbins preferred 1.1-1.8 m s-1, S. squamosum Enderlein and S. vorax Pomeroy 1.9-2.2 m s-1. 3. The larvae of S. hargreavesi and S. cervicornutum preferred a higher velocity range compared with their pupae. 4. In moderate velocities (1.1-1.4 m s-1), the abundance of S. hargreavesi was greater under turbulent conditions than in smooth-flowing water, but this was reversed at very high velocities (2.3-2.6 m s-1). 5. Velocity had no apparent effect on substrate preference when substrates of different flexibilities were compared for three blackfly species. All avoided the most flexible substrates and preferred ones consisting of rigid articulating plates. Anisopteran predators were found to have a similar substrate choice.

Analysis of Variance

[Sterilization--where are we and what do we want?].

According to the estimation from the mid-eighties, about 135 million people were sterilized, 95 million females and 40 million males. In 1977, sterilization was legalized in Slovenia, in 1978 in Croatia. In the period from 1978 to 1989, 4,503 females and 654 males were sterilized in Slovenia. The majority of female sterilizations were performed in the interval and post partum (the third cesarean section), applying laparoscopy or mini-laparotomy according to Pomeroy, in some cases the obsolete Madlener technique, while vasectomies were performed by using the standard method. The accurate statistical data on complications are not available but are estimated to be minimal. Requests for a tubal or seminal duct reconstruction have been exceptional. With a higher number of sterilizations the incidence of induced abortions in women at the age of more than 35 years would be reduced and the use of contraception would be increased. Yugoslavia, besides Albania and the Soviet Union, was the last to resort to contraceptives.

Female

Fertility outcome after laparoscopic microsurgical tubal anastomosis.

OBJECTIVE: To evaluate fertility outcome after laparoscopic microsurgical tubal anastomosis. DESIGN: A retrospective study. SETTING: Infertility Medical Center affiliated with University Medical School. PATIENT(S): Fifty-four patients, who had previously undergone tubal sterilization, seeking reversal. INTERVENTION(S): Laparoscopic microsurgical tubal anastomosis was performed. MAIN OUTCOME MEASURE(S): Pregnancy success was assessed. RESULT(S): The overall pregnancy rate (PR) was 77.5% (38/49) and 29 patients already have delivered healthy offspring. Pregnancy in seven patients is ongoing and one case ended in abortion. There was one case of ectopic pregnancy. The pregnancy success according to the method of previous tubal sterilization was 16 of 24 with the Fallope-ring method, 14 of 15 in cases of cauterization, and 8 of 10 in patients in whom the Pomeroy technique was used. The pregnancy success according to the site of anastomosis was 3 of 4 in cornual-isthmic, 4 of 5 in isthmic-isthmic, 26 of 35 in isthmic-ampulla, 3 of 3 in cornual-ampulla, and 2 of 2 in ampulla-ampulla. The pregnancy success according to the tubal length was 5 of 7 at a length < or = 4 cm, 3 of 5 at 5 cm, 15 of 17 at 6 cm, and 15 of 20 at lengths > or = 7 cm. CONCLUSION(S): Considering the high PR in our minimal follow-up period of 12 months, laparoscopic microsurgical tubal anastomosis could be an alternative procedure to microsurgical laparotomy in patients requesting reversal of tubal sterilization.

Adult

Kinetic urine creatinine determination with the Gemsaec analyzer.

A rapid automated method for urinary creatinine with the Jaffé reaction is described. Interferences by protein, glucose and ketones are circumvented by the reaction rate kinetics. The precision and accuracy of this centrifugal method on the ENI-Gemsaec analyzer are comparable to the manual end-point Jaffé reaction with deproteinization and to the common Auto-Analyzer technique.

Acetone

[Quality control of testosterone and digoxin radioimmunoassays and cortisol competitive protein binding assay by the reference sample method].

The inclusion of a minimum of 2 reference samples in the radioimmunoassay of testesterone and digoxin, and the competitive protein binding assay of cortisol served as a simple and practical index of overall assay performance. Statistical parameters, the mean plus or minus 2 standard deviation limits as well as the % coefficient of variation were determined at 3 clinically significant values for these samples. While a 50% intercept served mainly to indicate standard curve sensitivity, quality control sera provided a valid assessment of annay precision.

Binding, Competitive

Changes in the circulating levels of hemoglobin, hematocrit, serum iron and total iron binding capacity after four methods of surgical tubal sterilization.

One-hundred women requesting voluntary surgical sterilization were included and enrolled into four groups (each n = 25). Four sterilization modalities were used namely: Falope ring, electrocoagulation, clip and Pomeroy ligation. The circulating levels of hemoglobin, hematocrit, serum iron and total iron binding capacity were studied before sterilization and at 3, 6 and 12 months thereafter. No significant changes were observed at 3 and 6 months post-sterilization. At 12 months a significant increase in the hemoglobin and serum iron was observed with a significant decrease in total iron binding capacity. Falope ring, clip and Pomeroy ligation were of a higher rank in this context versus electrocoagulation.

Adult

A placebo-controlled, double-blind crossover study of naltrexone hydrochloride in outpatients with normal weight bulimia.

The endogenous opioid system plays an important role in the control of feeding behavior. Previous research has shown that antagonism of endogenous opioids will suppress feeding in certain models in both human and infrahuman species. In the current study, 16 normal-weight bulimic women were treated with low-dose naltrexone, the long-acting, orally active narcotic antagonist, and placebo in a crossover design. The use of the active drug was not associated with a clinically significant reduction in binge eating or vomiting episodes. Suggestions for further research in this area are offered.

Adult

[Methods of female sterilization].

The author gives a short review and the development of sterilization techniques. According to data from the literature and his limited experience, he concludes that to the Yugoslav population of women minilaparotomy with Pomeroy and Uchida occlusion techniques, as well as the laparoscopic approach with electrocoagulation or the application of clips and rings can be used. Vaginal approach should be reserved only for exceptional cases. Ljubljana.

Electrocoagulation

Maternal hydration increases amniotic fluid index.

Although adequate amniotic fluid (AF) volume is considered an important aspect of fetal well-being, the etiology of decreased AF volume is not well understood. A randomized blinded trial was designed to examine our hypothesis that maternal hydration would increase the AF index in women with low AF indexes. Women seen in our testing centers were randomized into control or hydration groups. The control group was instructed to drink their normal amount of fluid; the hydration group was instructed to drink 2 L of water, in addition to their usual amount of fluid, 2-4 hours before the post-treatment AF index. The women returned for the post-treatment AF index the same or following day. The mean post-treatment AF index was significantly greater in the hydration group (6.3 versus 5.1; P less than .01), as was the mean change in AF index (post-treatment AF index--pre-treatment AF index: 1.5 versus 0.31; P less than .01). These findings suggest that maternal oral hydration increases AF volume in women with decreased fluid levels.

Amniotic Fluid

A in vivo assay for standardizing heparin preparations.

The limitations of currently used in vitro assays of heparin have demonstrated the need for an in vivo method suitable for routine use. The in vivo method which is described in this paper uses, for each heparin preparation, four groups of five mice which are injected intravenously with heparin according to a "2 and 2 dose assay" procedure. The method is relatively rapid, requiring 3 to 4 hours to test five heparin preparations against a standard preparation of heparin. Levels of accuracy and precision acceptable for the requirements of the British Pharmacopoeia are obtained by combining the results of 3 to 4 assays of a heparin preparation. The similarity of results obtained in vivo method and in vitro method of the British Pharmacopoeia for heparin preparations of lung and mucosal origin validates this in vivo method and, conversely, demonstrates that the in vitro method of the British Pharmacopoeia gives a reliable estimation of the in vivo activity of heparin.

Animals

Microsurgical reversal of female sterilization. Long-term follow-up of 117 cases.

A prospective study of 117 consecutive microsurgical reversals of female sterilization from April 1981 to December 1984 was carried out to determine which factors affected the pregnancy outcome. Nylon sutures, 8-0, were placed through the muscularis and mucosal layers. A short abdominal incision was made. The patients were followed for 3.5 to 7.0 years. The term delivery, intra-uterine pregnancy, spontaneous abortion and ectopic pregnancy rates were 81.2%, 83.8%, 1.7% and 1.7%, respectively; two ectopic pregnancies occurred 14 and 24 months after the reversal procedures. We found that the time interval between sterilization and reversal and the methods of sterilization affected the pregnancy outcome. The success rate with intervals of less than five years was much higher than with intervals of more than five years; Pomeroy cases were more reversible than Uchida cases. We did not observe any influence of the anastomosis site on the pregnancy results. The term delivery rates for isthmus-isthmus, isthmus-ampulla and ampulla-ampulla anastomoses were 78.8%, 80.0% and 84.6%, respectively. Patients should be followed for two years at least to determine the pregnancy outcome as well as the occurrence of ectopic pregnancy.

Anastomosis, Surgical

Prospective randomized double-blind trial of nabilone versus domperidone in the treatment of cytotoxic-induced emesis.

A prospective randomized double-blind trial comparing the butyrophenone analogue domperidone (D) and the synthetic cannabinoid nabilone (N) in the treatment of cytotoxic-induced emesis was conducted in 38 patients receiving highly emetogenic chemotherapy regimens (70% containing cisplatin). Patients received 20 mg D or 1 mg N the night before chemotherapy and 8-hourly on each chemotherapy day for two consecutive cycles of treatment. Three of 19 patients randomized to N completed only one cycle because of disease progression or subjectively adverse effects. Four of 19 patients completed only one cycle of D because of lack of efficacy or chemotherapy toxicity. In all, 32 cycles of N and 33 cycles of D were evaluable for efficacy. The mean number of vomiting episodes in cycle 1 was 4.76 for N and 12.95 for D (P less than 0.02). The corresponding values for cycle 2 were 4.27 and 7.69 (P greater than 0.10), and for cycles 1 and 2 combined, 4.53 for N and 10.81 for D (P less than 0.01). Nausea and food intake scores did not differ significantly, although there was a trend towards less nausea and an increased food intake with N. Subjectively adverse effects were more frequent with N and included drowsiness, dizziness, dry mouth, and postural hypotension. N is superior to D for the control of cytotoxic-induced emesis.

Adult

Diagnosis of radiosensitive hypothalamic tumors without craniotomy: endocrine and neuroradiologic studies of intracranial atypical teratomas.

Three patients with intracranial atypical teratomas presented with symptoms of endocrine dysfunction (diabetes insipidus, hyperprolactinemia, and anterior hypopituitarism) suggestive of a hypothalamic disorder. Computer-assisted tomography done in two of the three cases enabled us to document the presence of a mass and institute radiotherapy, without prior neurosurgical exploration. Computer-assisted tomography also provided a safe and effective method of assessing the effects of radiotherapy.

Adolescent

[Tubal sterilization by postpartum minilaparotomy].

This is a review of 209 cases of salpingochlasia by minilaparotomy, post-partum. Frequency was 13.2%. The larger group was 20 to 29 years of age, 52%; 14.3% were unmarried. Multiparae were most frequent, 52.2%. One previous section 3.5%; with four to six live children, 54%. No previous anticonceptive method, 91%; pre-natal control, 69%. With anemia, Hb less than 10 g, 11%, and only 3.5% required blood transfusion. Eutocic delivery, 89%. Ruptured membranes, before delivery, less than six hours, 97%. Anesthesia during delivery, 59.1%; it was epidural anesthesia, as well as for the salpingochlasia in 100%, without complications. The indication was completed parity in 100%, the technique mostly used was Pomeroy's in 77.3%. There were no pre, trans or post-operative complications. The interval between delivery and salpingochlasia in first 12 hours, 98% and from surgery to hospital discharge, 12 to 24 hours, 89.2%. Hospital stay was two days, 90%. Pomeroy's technique failure, 0.6% and for Kroener's, 2.1%. Two pregnancies occurred out of 1,238 months-woman observation.

Adult

Measurement of the heparin neutralizing capacity of protamine.

Several methods of estimating the heparin neutralizing capacity of protamine were investigated for their reliability and practicability. The results from two chemical methods were compared with those from two in vitro biological assays, one of which was the method of the British Pharmacopoeia (1973). An in vivo method using mice was used to assess the accuracy of the in vitro test methods. Three standard heparin preparations were tested against the W.H.O. 1st International Reference Preparation for Protamine. Two of the heparin preparations were of mucosal origin, one of which was the 3rd International Standard, and the third heparin preparation was of lung origin (the 2nd International Standard for Heparin). The mean neutralization values (all methods) of heparin by protamine for a House Reference Preparation and the 3rd and 2nd International Standards for Heparin were 95.8, 109.8 and 89.9 units per mg of Protamine, respectively. All methods read the House Reference Preparation to have a lower value than the 3rd International Standard, which had a higher value than the 2nd International Standard for Heparin. There was a constant relationship between the results of any one method and those of another. The chemical and in vitro biological methods gave results of comparable precision although the latter required a greater degree of technical skill and time to perform.

Animals

Isoflavones from red clover improve systemic arterial compliance but not plasma lipids in menopausal women.

The possibility that the heightened cardiovascular risk associated with the menopause can be reduced by increasing dietary isoflavone intake was tested in 17 women by measuring arterial compliance, an index of the elasticity of large arteries such as the thoracic aorta. Compliance diminishes with age and menopause. An initial 3- to 4-week run-in period and a 5-week placebo period were followed by two 5-week periods of active treatment with 40 mg and then 80 mg isoflavones derived from red clover containing genistein, daidzein, biochanin, and formononetin in 14 and 13 women, respectively, with 3 others serving as placebo controls throughout. Arterial compliance, measured by ultrasound as a pressure (carotid artery) and volume (outflow into aorta) relationship, was determined after each period; plasma lipids were measured twice during each period. Urinary output of isoflavones was also determined. Arterial compliance rose by 23% relative to that during the placebo period with the 80-mg isoflavone dose and slightly less with the 40-mg dose (mean +/- SEM: placebo, .197 +/- .015; 40 mg, .237 +/- 0.007; 80 mg, .244 +/- .014). In the three women receiving continuous placebo, compliance was .16 +/- .022, similar to that during the run-in period for the remaining subjects (.17 +/- .021) [corrected]. ANOVA showed a significant (P = < 0.001) difference between treatments; by Bonferroni multiple comparisons and by paired t test, differences were significant between placebo and 40- and 80-mg isoflavone doses (by paired t test: P = 0.039 for placebo vs. 40 mg; P = 0.018 for placebo vs. 80 mg). Plasma lipids were not significantly affected. An important cardiovascular risk factor, arterial compliance, which diminishes with menopause, was significantly improved with red clover isoflavones. As diminished compliance leads to systolic hypertension and may increase left ventricular work, the findings indicate a potential new therapeutic approach for improved cardiovascular function after menopause.

Adult