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Gallstone pancreatitis: pathophysiology.

The stools of 45 patients with proven gallstones pancreatitis were screened for gallstones. An equal number of peripheral with gallstones but without pancreatitis served as the control group. Gallstones were found in the stools of 38 of the 45 patients (84 percent) with gallstone pancreatitis and in only five (11 percent) patients of the control group. The patients with gallstone pancreatitis experienced a relief of symptoms and a decrease in the levels of serum amylase and bilirubin prior to rectal passage of the stones. Operative cholangiography revealed reflux of contrast material into the pancreatic duct of 67 percent of the patients with gallstone pancreatitis and in only 18 percent of the controls. Of the 38 patients that passed stones, 30 cholangiograms (79 percent) demonstrated a functioning common channel. it would appear that a functioning common channel is necessary for reflux and in addition favors stone passage. This study suggests that the pathophysiology of gallstone pancreatitis relates to the temporary impaction of migrating stones at the ampulla of Vater.

Acute Disease↗

Two neglected categories of immigrants to Canada: temporary immigrants and returning Canadians.

Results are presented from an attempt to improve Canadian statistics on international migration so as to comply with U.N. guidelines by including data on long-term residents with temporary status and Canadian citizens and permanent residents returning from abroad. "The estimation procedures involve extensive operations on three Canadian administrative data systems: the Visitors Immigration Data System of Employment and Immigration Canada; the Family Allowances Files of Health and Welfare Canada; and the Customs and Excise Files of Revenue Canada. These data are used to produce the number of immigrants in both of the neglected categories, as well as to calculate the geographic (origin and destination) and demographic (sex, age, marital status) structures of these groups. Results of the analysis of estimates for the period 1982-1988 show that, due to their size and characteristics, both of these neglected categories of immigrants constitute a significant part of immigration to Canada, and their importance has and will continue to increase over time."

Americas↗

The acute phase protein haptoglobin is locally expressed in arthritic and oncological tissues.

Haptoglobin is an acute phase protein known to be highly expressed in the liver. Recently, we showed increased local arterial haptoglobin expression after flow-induced arterial remodelling and found that haptoglobin is involved in cell migration and arterial restructuring probably through accumulation of a temporary gelatin matrix. Since cell migration and matrix turnover are important features in the pathology of arthritis and cancer, we hypothesized that haptoglobin is also locally expressed in arthritic and oncological tissues. In this study, we investigated local haptoglobin expression in arthritic rats (n = 12) using semi-quantitative PCR and Western blotting, and we studied haptoglobin mRNA localization in human kidney tumours (n = 3) using in situ hybridization. The arthritic rats demonstrated an increase of haptoglobin mRNA (2.5-fold, P < 0.001) and protein (2.6-fold, P < 0.001) in the arthritic Achilles tendon. Haptoglobin protein was also increased in the arthritic ankle (2.6-fold, P < 0.001) but not in the non-arthritic knee. In human kidney tumours, tumour and stromal cells produced haptoglobin mRNA. This study shows that the liver protein haptoglobin is, in addition to the artery, also expressed in arthritic and oncological tissues that are recognized for enhanced cell migration and matrix turnover.

Animals↗

Adherence and migration of guinea pig granulocytes after enzyme treatment of the cell surface.

Glycogen-induced polymorphonuclear granulocytes (PMN) from the peritoneal cavity of guinea pigs were examined (1) for their adherence to nylon fibers in the absence and presence of the adherence-enhancing chemotactic peptide formyl-methionyl-leucyl-phenylalanine (f-MLP), (2) for their random migration through the filter of a Boyden chamber and (3) for their chemotactic migration towards f-MLP. The cells were analyzed before and after treatment with the enzymes neuraminidase, papain and trypsin. PMN adhesiveness was increased by neuraminidase digestion but reduced by treatment with the proteolytic enzymes. Neuraminidase and trypsin had no effect on cell migration, while papain reduced random migration without affecting f-MLP-induced chemotaxis. The data suggest that the type of adherence measured by the nylon fiber method differs from the temporary attachment of cells migrating through a chemotaxis filter towards an attracting substance.

Animals↗

Fluid migration through the tail of the Dalkon shield intrauterine device.

X-ray radiographs were used to monitor the migration of Renouve -dip radiopaque tracer through the multifilament tail of Dalkon Shield intrauterine devices (IUDs). The movement of the tracer was more rapid and migrated a greater distance through the long end of the tail than through the short end of the tail. The double knot serves as at least a temporary barrier to the migration of tracer from the long end of the tail, but this barrier was circumvented when drops of Renouve -dip radiotracer were placed at both ends of the tail. Migration of Renouve -dip radiotracer was prevented when the end of the Dalkon Shield tail was fused by heating. No migration of this tracer occurred on the tails of commonly used IUDs which possessed monofilament tails, thus demonstrating that fluid migration occurs within and not on the surface of the multifilament tail.

Capillary Action↗

Percutaneous management of extensive clot trapped in a temporary vena cava filter.

PURPOSE: To present percutaneous management of extensive clot trapped in a temporary inferior vena cava (IVC) filter. CASE REPORT: A 20-year-old man with a large sacral tumor and left external iliac vein thrombosis had a wire-mounted Günther temporary filter (GTF) prophylactically placed in the infrarenal IVC prior to tumor resection. The 7-day postsurgical venogram prior to filter removal showed extensive clot trapped by the filter, as well as interval cephalic migration, with the filter tip now at the level of the renal veins. A Günther Tulip MReye (GTM) filter was deployed but not released above the renal veins to prevent clot migration during caudal withdrawal of the wire-mounted GTF. After creating enough space in the infrarenal IVC, the GTM was repositioned and fully released with its apex now below the renal veins. The GTF was then uneventfully removed. There was no clinical evidence for significant pulmonary embolism 12 months after placement. CONCLUSIONS: Cephalic migration of a clotted temporary IVC filter can be managed with intraprocedural protection against pulmonary embolism by first deploying a Günther Tulip filter above the renal veins, with subsequent advancement below the renal veins before temporary filter removal.

Adult↗

Use of a temporary caval filter in a young man with pulmonary embolism to prevent migration of massive caval thrombus during an attempt of caval thrombolysis.

A 33 year old male with no known risk factors for hypercoagulability developed a massive thrombi in the inferior vena cava (IVC). The patient had a history of both pulmonary embolism and embolism related syncope. The thrombus which extended proximally to the level of the renal vein and distally to the left superficial femoral vein did not respond to anticoagulant therapy or thrombolysis. Thirteen days after admission, we decided to use a temporary caval filter to provide protection from migration of the thrombus while attempting invasive thrombolytic therapy, which was performed using a tissue type plasminogen activator through a coaxial catheter of the temporary filter. This resulted in a marked decrease in the size of the thrombus, and multiple thrombi were found to be trapped in the temporary filter. Although the temporary caval filter was effective in capturing emboli, resulting in a decrease in the thrombus size, the thrombus was not completely dissolved within two weeks, which is the maximal implantation time. A permanent filter was eventually used to prevent pulmonary embolism, which could arise from the remaining thrombus. We have found placement of a temporary caval filter to be a safe and effective adjunct, in select cases, when attempting thrombolysis of massive thrombi in the IVC. Since we inserted the temporary filter 13 days after admission, use of a temporary filter during thrombolysis may have been more effective if conducted earlier in our patient's clinical course.

Adult↗

Population distribution policy in China: a review.

"After briefly reviewing China's development strategy in the post-1949 period, this article describes the policies and programmes adopted by the Chinese government for controlling internal migration. The effects of those policies and programmes on total migration rates, rural-to-urban migration, interregional migration, interprovincial migration, and population distribution among cities of different size are also assessed. The increasing number of temporary migrants, including China's 'floating population,' will be examined as well, together with recent policy changes in population migration and movement." A comment by Lawrence J. C. Ma is included (pp. 188-91).

Asia↗

Temporary versus permanent population mobility in Melanesia: a case study from Vanuatu.

"Melanesia's urban population tripled from...7 percent of the region's total population in 1955 to 20 percent by 1985. The recency and magnitude of this development...virtually rules out natural population growth as the principal cause behind this process of rapid urbanization and suggests massive internal population mobility as the most likely cause....This article argues that much of the alleged continued predominance of circular mobility owes more to its underlying operationalizations, ways of measurement, and theoretical conceptualizations than reflects contemporary reality. This argument is substantiated by an analysis of recent developments in Vanuatu mobility set in the local and historical conditions of migration from the island of Paama.... Evidence for this mobility change is derived from a comparative analysis of lifetime mobility histories of urban and rural Paamese men and women."

Demography↗

Novel genetic association with migratory diapause in Australian monarch butterflies.

BACKGROUND: Monarch butterflies (Danaus plexippus) are a charismatic and culturally important North American butterfly species famous for their unique, dramatic migratory life history. While non-migratory populations of the species are widespread and apparently stable, migratory populations in North America have recently seen declines, prompting concern that the migratory phenomenon in North America may be at risk of disappearing. In contrast, a relatively recently-established monarch population in Australia has rapidly re-acquired a migratory life history following hundreds of generations of residency and successive bottlenecks as the species island-hopped across the Pacific during the late 1800s and early 1900s. The process by which migration re-emerged in Australian monarchs is not currently known. RESULTS: We raised and sequenced individuals from Queensland, Australia under environmental conditions associated with migration initiation and found strong variance in reproductive diapause, a key migratory trait, between families which was associated with variation at the spectrin beta chain protein Karst. This protein is known to be involved in diapause termination in monarchs but has not previously been identified as associated with migratory life history variance. The most strongly associated migratory SNPs are also present at a low frequency in North America, suggesting that the Australian population is leveraging standing variation which persisted across repeated bottlenecks as Monarchs spread across the Pacific. CONCLUSIONS: Our results provide an intriguing example of how the temporary loss of migration-in this case likely over hundreds of generations-may not entail the loss of genetic variation associated with this complex life history strategy.

Animals↗

[Evolution of the role of women in temporary emigration in Friuli-Venezia Giulia].

Changes in the characteristics of female migrants are analyzed using data from a 1982 survey in which 1,489 returning families in the Friuli region of Italy were interviewed. "The survey identifies three main periods of this temporary emigration: the first period shows first generation migrants, whose family structure is still traditional and women's role enters into conflict with the new socio-economic reality." The second period is characterized by an increase in the percentage of married female emigrants; in the third period an increase in the percentage of single females is noted. (summary in ENG, FRE)

Demography↗

Intracellular free calcium level and its response to cAMP stimulation in developing Dictyostelium cells transformed with jellyfish apoaequorin cDNA.

A new method is described for measuring intracellular free calcium concentrations, [(Ca2+)i], in the cells of Dictyostelium discoideum transformed with apoaequorin cDNA of the jellyfish, Aequorea victoria. Aequorin, a calcium-specific indicator, was regenerated in vivo from apoaequorin produced in the cells by incubation with coelenterazine. The results showed that [(Ca2+)i] in developing cells markedly increases at the aggregation stage and again at the culmination stage after a temporary drop at the migration stage. Except for the vegetative stage, the cells at all stages of development exhibit a sharp transient increase in [(Ca2+)i] upon stimulation with a cAMP (50 nM) pulse, high responses being observed at the migration and culmination stages. Separated prestalk cells of migrating slugs contain more than twice as much [(Ca2+)i] and show three times as large a response to cAMP stimulation as prespore cells.

Aequorin↗

Responses of Arctic and tropical men to a standard cold test and peripheral vascular responses to local cold stress in the Arctic.

Thermoregulatory, metabolic and peripheral vascular responses to cold were studied in two groups (six each) of healthy men during exposure to the natural cold environment of the Arctic. Group A comprised of two arctic natives and four temporary residents who had migrated from the temperature zone of Russia. Group B consisted of six soldiers from a tropical region (India). Group B was airlifted to the arctic (70 degrees N, 38 degrees E). Both groups stayed in a field camp. The experiments were conducted during the 7th week of the stay. The volunteers were subjected to a standard cold test at 10 degrees C for 2 h wearing only shorts. Their heart rate, blood pressure, ventilation, oxygen consumption, oral temperature, mean skin and extremity temperatures were recorded initially and at 30 min intervals during standard cold test. The cold-induced vasodilatation response in both groups was also studied separately. The tropical natives (Group B) were flown back to Delhi and retested after 6 weeks. The physiological responses to general cold exposure as well as peripheral vascular response to local arctic cold stress were similar in both groups. The observation suggested that cold acclimatization in tropical men is similar to that of the people of Russian origin from a temperature zone.

Acclimatization↗

China: surplus labour and migration.

Surplus labor force and migration trends in China are examined, with emphasis on the impact of underemployment in rural areas. "Government policy encourages surplus labourers to transfer out of crop farming into agricultural sidelines or non-agricultural work. Peasants are urged to stay where they are, shifting jobs without shifting location; however, many rural areas are poorly endowed for providing alternative employment, so their surplus workers must also leave the village to find work. Many do not formally migrate, but rather move on a seasonal basis or set up 'temporary' residence in an urban place. This 'floating' population has been escalating rapidly in recent years....[The authors argue] that China's cities and towns can absorb millions of surplus labourers from rural areas each year, to the mutual benefit of sending and receiving areas."

Agriculture↗

Use of immigration policy to manage nursing shortages.

PURPOSE: To examine long-term implications of using temporary, nonimmigrant nurse programs to manage fluctuations in the demand for registered nurses. ORGANIZING FRAMEWORK: This discussion is located in the full context of migration--reviewing theories and concepts of labor migration--referring to experience with guest-worker programs worldwide, outlining recent nursing shortages in the United States, describing the Immigration Nursing Relief Act (INRA), and raising questions for nurses in the United States and in the global marketplace. SOURCES: Review of scholarly literature on international migration, existing studies on nurse migration to the United States, and original research, conducted between 1992 and 1994, for the Immigration Nursing Relief Advisory Committee (INRAC) Report. METHODS: Policy analysis of theories, concepts, and perspectives related to nurse migration. FINDINGS: In the United States, highly skilled foreign nurses tend to complement rather than displace local labor. Yet recruiting foreign-educated nurses for entry-level jobs perpetuates patterns of dependency in the sending country and delays creative solutions to staff development in the host country. Nonimmigrant status creates a vulnerable workforce. There may be a disparity between the ideal of nurse migration as collaborative exchange and the reality of institutionalized occupational migration networks. CONCLUSIONS: While foreign nurse recruitment might solve short-term needs, repetitive temporary nurse migration programs create long-term consequences that are not in the best interests of the profession. The absence of consistent policy creates an opportunity for nursing to take an active role in developing the rules and direction of future nurse migration.

Emigration and Immigration↗