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Recent decelerated decline in perinatal mortality rate of unlike-sexed twins in Japan.

The effect of assisted reproductive technology is more pronounced in unlike-sexed twins than in like-sexed. Trends in perinatal mortality of twins were compared between the two types of sex combination. Certificates for births (478,276 cases), stillbirths (50,542 cases), and early neonatal deaths (8747 cases) were the subjects of this analysis. Since 1984, the decline in the perinatal mortality of unlike-sexed twins has been slower than that of like-sexed twins. In both light-for-dates (LFD) and non-LFD, the decline in the gestational age standardised mortality ratio has been slower in unlike-sexed twins. We suggest this is due to the introduction of assisted reproductive technologies.

Birth Certificates↗

Deceleration trauma to the heart and great vessels after road-traffic accidents.

Four young men involved in high-speed car crashes developed cardiovascular trauma. Two patients had aortic aneurysms, one rupture of the mitral valve, and one ventricular septal defect; successful surgical correction was undertaken in all. The importance of considering the possibility of cardiovascular trauma in these circumstances is emphasized, and x-ray films (repeated if necessary) should be taken even when there are no external signs of trauma.

Acceleration↗

Glibenclamide decelerates the responses of coronary regulation in the goat.

The role of blocking ATP-sensitive potassium (KATP) channels by glibenclamide on the dynamic responses of coronary resistance to abrupt changes in perfusion pressure and heart rate was investigated. The left main coronary artery of the open-chest anesthetized goat was perfused with constant pressure (Pp). Pp and arterial flow were averaged per beat, and their ratio was calculated as index of coronary resistance. Responses of resistance index after heart rate (HR) and Pp changes before and after administration of glibenclamide were compared. Their rate of change was quantified by t50, the required time to obtain half of the complete response. During control, t50 for the dilating response induced by a decrease in Pp or increase in HR was 3.8 +/- 0.2 and 6.2 +/- 0.5 (SE) s, respectively. With glibenclamide these values were 24.4 +/- 1.6 and 14.9 +/- 2.1 s. For the constricting response, the numbers for control were 5.8 +/- 0.3 (increase Pp) and 7.2 +/- 0.8 (decrease HR) s. With glibenclamide these values were 22.1 +/- 1.5 and 16.0 +/- 2.9 s. The steady-state adjustment of coronary flow was not altered by glibenclamide. It was concluded that glibenclamide has a minor effect on coronary flow control but reduces the rate of change of coronary resistance index up to a factor of four. Because glibenclamide is supposed to act on KATP channels, it may be concluded that these channels play a major role in the dynamics of coronary blood flow regulation.

Animals↗