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PubMed1983

Factors determining the loss of ductus arteriosus responsiveness to prostaglandin E.

The ductus arteriosus of the newborn infant varies in its ability to dilate when doses of prostaglandin E (PGE) are administered. We infused PGE2 into 15 late-gestation newborn lambs to determine which factors regulate the ability of the ductus arteriosus to respond to PGE. PGE2 dilated the ductus in 10 lambs (responders); in five other lambs, despite similar PGE2 concentrations, there was no effect (nonresponders). The measured ductus resistance after the PGE2 infusion was directly related to the ductus resistance before the infusion. Responders had a larger left-to-right shunt through the ductus before the PGE infusion than nonresponders. Ductus that were isolated and studied in vitro from lambs that were nonresponsive to PGE2 (in vivo) were limited in their ability to relax with PGE2 as well as to actively contract with oxygen and indomethacin. This generalized loss of ductus responsiveness was directly related to the amount of the left-to-right shunt through the lumen of the ductus. These observations are consistent with the hypothesis that the constriction of the ductus arteriosus after birth limits the ability of the ductus to respond to PGE therapy.

Animals↗
PubMed2006

Can 'abnormally' fertilized zygotes give rise to viable embryos?

Conventional practice in in vitro fertilization or intracytoplasmic sperm injection is to select the best quality embryos based on their morphology and cleavage status from a cohort of fertilized oocytes in which two pronuclei were observed at the time they were checked for fertilization. However, in a small proportion of cycles, the selection is limited to embryos that appeared to be either unfertilized (displaying zero pronuclei) or abnormally fertilized (displaying one or three pronuclei) at the time they were checked for fertilization. There is a lack of consensus on whether such embryos should be transferred to the uterus. Cytogenetic analysis of embryos from oocytes with one pronucleus has shown a proportion is diploid. Transfer of such embryos has resulted in healthy births. Limited cytogenetic analysis of oocytes that divide despite the absence of pronuclei at fertilization check indicates that a proportion also have a normal cytogenetic constitution. Cytogenetic analysis of embryos from oocytes with three pronuclei has shown high rates of triploidy and chaotic cell divisions. Subsequent foetuses have extremely unfavourable outcomes. Here, we review the published literature on the cytogenetic analysis of 'unfertilized' and 'abnormally fertilized' embryos and discuss possible pathways which lead to their formation. The limited evidence indicates that oocytes with one pronucleus and oocytes that show normal onward division despite the absence of pronuclei may be considered for replacement in certain circumstances.

Cell Nucleus↗
PubMed1997

Dubowitz assessment of gestational age and agreement with prenatal methods.

We compared assessment of gestational age by Dubowitz score with ultrasonic measurement of the biparietal diameter (BPD), and then evaluated how infants were classified by these methods as small-for-gestational age (SGA), and as pre- or post-term births. BPD gestational age was assessed at week 17 to 20 of pregnancy while the Dubowitz scoring was done at birth. "Limits of agreement" between methods and kappa values were calculated and used to evaluate agreement. Among 839 included infants, there was moderate agreement between Dubowitz score and BPD (limits of agreement; -2.3; +2.1 weeks; weighted kappa: 0.46) in the assessment of gestational age. Agreement between Dubowitz score and BPD in the classification of SGA (kappa: 0.75, 95% confidence interval [CI]: 0.69-0.81) and preterm infants (kappa: 0.68, 95% CI: 0.56-0.80) was good, whereas agreement on infants born post-term was no better than chance (kappa: 0.14, 95% CI: -0.02(-)+0.30). We conclude that despite moderate agreement between Dubowitz score and BPD in the assessment of gestational age, agreement in the classification of low-birth-weight infants as SGA and as premature births was good.

Cephalometry↗
PubMed1994

Reduction in lung injury after combined surfactant and high-frequency ventilation.

Previous studies demonstrated that high-frequency oscillatory ventilation (HFOV) begun at birth limits the development of alveolar proteinaceous edema in premature monkeys at risk for hyaline membrane disease (HMD). We hypothesized that exogenous surfactant combined with HFOV would lead to even further reductions in edema. Twenty Macaca nemestrina monkeys were delivered at 134 d gestation (term = 168 d) and treated with either HFOV or conventional mechanical ventilation (CMV) from the first breath; modified bovine surfactant (Survanta [beractant]) was introduced into the trachea over the first few minutes of life. These animals were compared with 20 animals treated with either CMV or HFOV but without surfactant. At 6 h the lung was rapidly frozen in situ during inflation for determination of the volume fraction of alveolar edema. The combined use of surfactant and HFOV from the first breath reduced alveolar proteinaceous edema (3 +/- 1%; mean +/- SEM) from that seen with CMV alone (27 +/- 3%, p < 0.0001), CMV after surfactant (21 +/- 3%, p < 0.0001), and HFOV alone (13 +/- 3%, p < 0.015). We conclude that the use of surfactant with HFOV after premature birth is superior to either surfactant or HFOV alone in reducing lung injury during the first few hours of life. We speculate that this reduction in lung injury may reduce the incidence or severity of bronchopulmonary dysplasia.

Animals↗
PubMed1978

Microscopic age changes in the frontal bone of the domestic rabbit.

This study reveals age related changes in the microscopic structure of the paired frontal bone of the domestic rabbit. Undecalcified ground sections were prepared from anterior frontal bone slices removed from New Zealand White rabbits ranging from birth to 24 months of age. Included were 40 females, 4 males and 6 rabbits less than 14 days old of unknown sex. The ground sections revealed both qualitative and quantitative age changes. Qualitative changes include change in bone tissue types and developmental processes, and presence or absence of primary and secondary osteones. Quantitative changes were measured by counting primary osteones in the outer table of each frontal bone half within 1.6 mm of the metopic suture. In this region, primary osteones were absent at birth, limited in number at 14 days and generally numerous between one and three months of age. In animals older than three months, numbers of primary osteones generally decreased with increasing age. No animals older than 16 months revealed primary osteones. Possible sources of variability in the relationship between observed primary osteone number and age include ability to recognize primary osteones, methods of sampling and processing bone slices, sex related differences and diseases afflicting specimen. Significance of this study includes increased knowledge of frontal bone growth and histology.

Aging↗
PubMedDate not supplied

Reproductive health/family planning and the health of infants, girls and women.

The 1994 International Conference on Population and Development developed international consensus amongst health providers, policy makers, and group representing the whole of civil society regarding the concept of reproductive health and its definition. In line with this definition, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. Reproductive health care saves lives and prevents significant levels of morbidity through family planning programmes, antenatal, delivery and post-natal services, prevention and management programmes for reproductive tract infections (including sexually transmitted diseases and HIV/AIDS), prevention of abortion and management of its complications, cancers of the reproductive system, and harmful practices that impact on reproductive function. Reproductive health care needs are evident at all stages of the life cycle and account for a greater proportion of disability adjusted life years (DALYS) in girls and women than in boys and men. Reproductive health protects infant health by enabling birth spacing and birth limitation to be practiced through family planning. The prevention and early detection of reproductive tract infections, including sexually transmitted diseases and HIV, through the integration of preventive measures in family planning service delivery not only improves the quality of care provided but is also directly responsible for improvement in survival and health of infants. Addressing harmful practices such as son preference, sex selection, sexual violence and female genital mutilation complements the positive impact of planned and spaced children through family planning services on infant mortality and the reproductive health of young girls and women. They are also in addition to prenatal, delivery and postnatal services, positive determinants of low maternal mortality and morbidity and are integral to the promotion of reproductive health in women of child bearing age. Reproductive tract infections, including sexually transmitted diseases and HIV contribute to significant level of ill-health in women of reproductive age and continue to pose a threat through the menopause which in turn brings with it increasing risk of cancers of the reproductive system.

Adolescent↗
PubMed2006

The effect of vaginal and cesarean delivery on lower urinary tract symptoms: what makes the difference?

A prospective cohort study was undertaken to evaluate the effect of pregnancy and childbirth in nulliparous pregnant women. The focus of this paper is on the difference in the prevalences and risk factors for lower urinary tract symptoms (LUTS) between woman who delivered vaginally or by cesarean and secondly the effect of LUTS on the quality of life between these two groups was analyzed. Included were 344 nulliparous pregnant women who completed four questionnaires with the Urogenital Distress Inventory and the Incontinence Impact Questionnaire (IIQ). Two groups were formed: vaginal delivery group (VD), which included spontaneous vaginal delivery and an instrumental vaginal delivery and cesarean delivery group (CD). No statistical significant differences were found in the prevalences of LUTS during pregnancy between the two groups. Three months after childbirth, urgency and urge urinary incontinence (UUI) are less prevalent in the CD group, but no statistical difference was found 1 year postpartum. Stress incontinence was significantly more prevalent in the VD group at 3 and 12 months postpartum. The presence of stress urinary incontinence (SUI) in early pregnancy is predictive for SUI both in the VD as in CD group. A woman who underwent a CD and had SUI in early pregnancy had an 18 times higher risk of having SUI in year postpartum. Women were more embarrassed by urinary frequency after a VD. After a CD, 9% experienced urge urinary incontinence. Urge incontinence affected the emotional functioning more after a cesarean, but the domain scores on the IIQ were low, indicating a minor restriction in lifestyle. In conclusion, after childbirth, SUI was significantly more prevalent in the group who delivered vaginally. Besides a vaginal delivery, we found both in the VD and in the CD group that the presence of SUI in early pregnancy increased the risk for SUI 1 year after childbirth. Further research is necessary to evaluate the effect of SUI in early pregnancy on SUI later in life. Women were more embarrassed by urinary frequency after a vaginal delivery. UUI after a CD compared to a vaginal birth limited the women more emotionally; no difference was found for the effect of SUI on the quality of life between the two groups.

Cesarean Section↗
PubMed1995

Congenital symmetrical weakness of the upper limbs resembling brachial plexus palsy: a possible sequel of drug toxicity in first trimester of pregnancy?

We report a 14-month-old girl with a symmetrical paralysis from birth, limited to the upper limbs and resembling a severe, complete bilateral brachial plexus palsy. The presence of dimples over the wrists, shoulders and scapulae and abnormal palmar dermatoglyphics suggested an early prenatal onset. Previous reports and the course of the disease in our case suggest this sporadic condition is not progressive. Although no definitive causative factor has been identified in previously reported cases, the affection in our case is possibly related to Debendox (Bendectin) and nitrofurantoin taken in early pregnancy for nausea and renal tract infection, respectively.

Age of Onset↗
PubMed2004

"Yes" to abortion but "no" to sexual rights: the paradoxical reality of married women in rural Tamil Nadu, India.

This study in rural Tamil Nadu, India, explored the reasons why many married women in India undergo induced abortions rather than use reversible contraception to space or limit births in terms of women's sexual and reproductive rights within marriage, and in the context of gender relations between couples more generally. It is based on in-depth interviews with two generations of ever-married women, some of whom had had abortions and others who had not, from 98 rural hamlets. The respondents were 66 women and 44 of their husbands. Non-consensual sex, sexual violence and women's inability to refuse their husband's sexual demands appeared to underlie the need for abortion in both younger and older women. Many men seemed to believe that sex within marriage was their right, and that women had no say in the matter. The findings raise questions about the presumed association between legal abortion and the enjoyment of reproductive and sexual rights. A large number of women who had abortions in this study were denied their sexual rights but were permitted, even forced, to terminate their pregnancies for reasons unrelated to their right to choose abortion. The study brings home the need for activism to promote women's sexual rights and a campaign against sexual violence in marriage.

Abortion, Induced↗
PubMed2002

Complexities in ETS-domain transcription factor function and regulation: lessons from the TCF (ternary complex factor) subfamily. The Colworth Medal Lecture.

The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.

Amino Acid Sequence↗
PubMed2006

Quality of care in China: scaling up a pilot project into a national reform program.

China's family planning program ranks as history's most intensive effort to control national population growth. Although advocates for global population control have lauded China's effort to limit births as afundamental part of its sustainable development goals, the country's population policy has also generated much international criticism. As China enters the new millennium, a long-overdue reform of its approach to implementing its family planning program has begun to refocus the program on clients' needs, informed choice of contraceptives, and better-quality services. Originally inspired by the 1994 International Conference on Population and Development held in Cairo, the reform program began as a pilot project among six counties and has now become a blueprint for reorienting the national family planning program. This article reviews the process by which a small, innovative pilot project was scaled up into a national reform effort and the key lessons learned about scaling up sensitive but necessary innovation in a difficult political environment.

China↗
PubMed1986

Characterization of endothelial cell transport in the developing mouse blood-brain barrier.

The cerebromicrovasculature of immature mice ranging in age from 1-24 days after birth was studied by electron microscopy. A micromanipulator apparatus enabled us to facilitate direction of a needle cannula and injection into leg veins or hearts with horseradish peroxidase (HRP) or ferritin (anionic and cationic) tracers and subsequent perfusion fixatives. Numerous HRP-filled vesiculocanalicular transport structures appearing in endothelial cells (ECs) of brain microblood vessels (MBVs) were observed in time periods ranging from 1-14 days. In addition to HRP transport across the ECs by tubulovesicular profiles, some of these structures appeared to become connected to multivesicular bodies. Between 14 and 24 days after birth, limited HRP was transported across the ECs to the basement membrane in only a few short segments of subpial arterioles. The decoration pattern with cationized ferritin (CF) on the luminal surface of the ECs depends upon whether the surface was exposed to the ligand before or after fixation. Quenching of aldehyde groups in fixed brain tissue has critical importance for the decoration pattern of CF on the luminal plasmalemmal surface. The absence of CF labeling on the delimiting membranes of plasmalemmal vesicles and tubular structures suggests that these structures represent differentiated microdomains engaged in macromolecular transport in the ECs of the developing mouse brain.

Animals↗