[Need for changes in obstetrical health and nursing care].
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Biomedical subjects
Publications and source records attributed to E Pedersen.
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An improved method of sphincterometry is described, which is easy to perform in men and also may be used in women. It gives reproducible results in the individual patient. The maximum pressure was found by radiographic and reflexological examinations of the external urethral sphincter. When 0.5 mg./kg. body weight dantrolene sodium was injected intravenously the resistance of the external urethral sphincter was found to be reduced significantly, presumably reflecting a reduction of reflex activity.
By perianal electrical stimulation and EMG recording from the external anal sphincter the anal reflex was constantly present in normal subjects. The latency decreased within certain limits with increasing stimulation to an average minimum latency of 50 ms (SD 10.5). There was no difference between the minimum latency in normal subjects and patients with suprasegmental lesions of the CNS. The latency may be prolonged in patients with lesion of the reflex arc. By stimulation over the posterior tibial nerve behind the medial malleolus a reflex reaction could be picked up constantly from the anal sphincter in normal subjects. This reflex had a longer latency but a lower threshold than the reflex reaction from the tibialis anterior muscle. The average minimum latency from the anal sphincter was 93 ms (SD 21.1) and from the tibialis anterior muscle 64 ms (SD 7.9). In the absence of the anal reflex it may be possible to localise the defect to the afferent or efferent parts of the reflex by using types of stimulation. Preliminary studies of spinal shock revealed a perianally elicited anal reflex in all cases, but also a response to peripheral stimulation in some of the cases, more frequently found in the anal sphincter than in the tibialis anterior muscle.
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Recording of the visually evoked scalp potential (VESP) elicited with flash stimulation was completed in six subjects presenting with normal vision. From the four separate signals recorded over the visual cortex, it was concluded that stimulation frequency affects some of the components of the VESP. Accordingly, in studies of the VESP character, the influence of stimulation frequency is a critical factor which must be taken into account when analyzing the resultant activity.
Flavoxate, a smooth muscle relaxant, compared with propantheline showed no significant difference in clinical effect on voiding disturbances in hyperactive neurogenic bladders, but fewer side effects. Both drugs increased bladder capacity significantly, but flavoxate did not increase residual urine in contrast to propantheline.
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Liver function tests, performed in 11 epileptics under antiepileptic treatment for 10-35 years, showed a slight increase in serum alanine amino-transferase in six patients and a marked increased level of serum alkaline phosphatases in four. Liver biopsies revealed few uni- or paucicellular necroses in five patients. Granulomatous hepatitis was found in one patient in whom sarcoidosis was later diagnosed. None of the biopsies showed signs of permanent liver damage.
Propranolol administered i.v. to spastic patients was found to be capable of depressing clonus. The drug exerts its action on the spinal cord but does not influence dynamic spindle activity or alpha-motoneurone activity as tested by the T (Achilles tendon) and H reflexes. It may disinhibit the tonic stretch reflex. Thus, clonus is dependent not only on dynamic spindle activity but also on another, probably inhibitory, mechanism.
In normal subjects and in patients with spasticity and/or urological complaints changes in somatic muscle reflexes associated with filling of the urinary bladder were observed. Two different patterns of reflex changes occurred. One pattern was associated with easy initiation of voiding: it consisted of increasing H and T reflexes and decreasing flexor reflexes with concomitant decreasing sphincter muscle activity. The other pattern was associated with difficulty in initiation of voiding: it consisted of increasing flexor relfexes including sphincter muscle activity and decreasing H and T reflexes. The importance of these reflex patterns in disturbances of micturition is discussed. During voiding, decreasing flexor relfexes with increasing H and T reflexes occur as the general pattern.
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We have studied the physical interaction between macrophages and lymphocytes during the immune response to purified protein derivative of tuberculin (PPD) in vitro. Mixtures of peritoneal macrophages and lymph node lymphocytes from guinea pigs immunized with tubercle bacilli formed cell clusters during 20 h of culture with PPD. The number of clusters produced was correlated to the number of immune lymphocytes in the cultures. Peritoneal macrophages which had been pulsed with PPD and untreated lymph node lymphocytes produced cell clusters in the absence of free PPD in numbers equivalent to those produced by the same cells in the presence of free PPD. In cultures containing a mixture of PPD-pulsed macrophages, not-pulsed macrophages, and immune lymphocytes with no free PPD, cell clusters developed mainly between the antigen-pulsed macrophages and lymphocytes. Cluster formation was antigen-specific with the specificity residing in the lymphocytes, mainly or exclusively in the T lymphocytes. These data indicate that in the process of cell cluster formation macrophages serve as antigen-binding (or -processing) cells, while a subpopulation of lymphocytes interact physically and specifically with the macrophages.
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