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PubMed2002

Personality disorders in the community: results from the Australian National Survey of Mental Health and Wellbeing Part II. Relationships between personality disorder, Axis I mental disorders and physical conditions with disability and health consultations.

BACKGROUND: The aims of this study were threefold. First, to ascertain whether personality disorder (PD) was a significant predictor of disability (as measured in a variety of ways) over and above that contributed by Axis I mental disorders and physical conditions. Second, whether the number of PD diagnoses given to an individual resulted in increasing severity of disability, and third, whether PD was a significant predictor of health and mental health consultations with GPs, psychiatrists, and psychologists, respectively, over the last 12 months. METHOD: Data were obtained from the National Survey of Mental Health and Wellbeing, conducted between May and August 1997. A stratified random sample of households was generated, from which all those aged 18 and over were considered potential interviewees. There were 10,641 respondents to the survey, and this represented a response rate of 78 %. Each interviewee was asked questions indexing specific ICD-10 PD criteria. RESULTS: Five measures of disability were examined. It was found that PD was a significant predictor of disability once Axis I and physical conditions were taken into account for four of the five disability measures. For three of the dichotomously-scored disability measures, odds ratios ranged from 1.88 to 6.32 for PD, whilst for the dimensionally-scored Mental Summary Subscale of the SF-12, a beta weight of -0.17 was recorded for PD. As regards number of PDs having a quasi-linear relationship to disability, there was some indication of this on the SF-12 Mental Summary Subscale and the two role functioning measures, and less so on the other two measures. As regards mental consultations, PD was a predictor of visits to GPs, psychiatrists and psychologists, over and above Axis I disorders and physical conditions. CONCLUSION: The study reports findings from a nationwide survey conducted within Australia and as such the data are less influenced by the selection and setting bias inherent in other germane studies. However, it does support previous findings that PD is a significant predictor of disability and mental health consultations independent of Axis I disorders and physical conditions.

Australia↗
PubMed2002

Shared genes influence sensitivity to the effects of ethanol on locomotor and anxiety-like behaviors, and the stress axis.

RATIONALE: In rodents, a common response to many drugs of abuse, including ethanol (EtOH), is locomotor stimulation. It has been proposed, although debated, that EtOH-induced locomotor stimulation may represent an animal model of EtOH's euphoric effects. Another possibility is that this behavioral phenotype may represent an altered state of anxiety, and/or stress axis activation. OBJECTIVES: Mouse lines selectively bred for sensitivity (FAST) or resistance (SLOW) to EtOH's low dose locomotor stimulant effects were tested for differential sensitivity to EtOH's anxiolytic and/or stress axis activating effects, with the goal of detecting genetic correlations. METHODS: Saline- and EtOH-treated FAST and SLOW mice were tested on the elevated plus maze and the light-dark box, two widely used measures of anxiety-related behavior in rodents. In addition, serum corticosterone (CORT) levels were measured at various time points following injection of saline or ethanol. RESULTS: Behavioral data from both anxiety tests showed that FAST mice were less sensitive to EtOH's anxiolytic effects than were SLOW mice. Moreover, late recovery of elevated serum CORT levels following mild saline injection stress, as well as reduced CORT release in response to EtOH, suggested that FAST mice may possess a less responsive stress axis. CONCLUSIONS: These results provide evidence that sensitivity to the effects of EtOH on locomotor behavior, anxiety-like behavior, and the stress axis share some genetic influence.

Animals↗
PubMed2002

Potential role for the hypothalamo-pituitary-adrenal axis in the conditioned reinforcer-induced reinstatement of extinguished cocaine seeking in rats.

RATIONALE: We have previously reported that pretreatment with the corticosterone synthesis inhibitor ketoconazole blocks the electric foot-shock-induced reinstatement of cocaine-seeking behavior in rats, suggesting a potential role for the hypothalamo-pituitary-adrenal (HPA) axis in this animal model of relapse. OBJECTIVES: This experiment was designed to investigate whether or not ketoconazole would also inhibit the reinstatement of cocaine seeking induced by the presentation of a conditioned reinforcer. The effects of the corticotropin-releasing hormone 1 (CRH1) receptor antagonist CP-154,526 were also investigated to further determine the involvement of the HPA axis in this behavior. METHODS: Adult male rats were implanted with jugular catheters and trained to self-administer cocaine (0.25 mg/kg per infusion) during daily 2-h sessions. During training, cocaine delivery was paired with the presentation of a tone and the illumination of a house light. Once a stable baseline of cocaine self-administration was observed, lever pressing was extinguished to less than 20% of baseline rates. During reinstatement testing, responding by rats in the contingent group resulted in the presentation of the conditioned reinforcer (i.e., the house light and tone previously paired with self-administered cocaine). Rats in the non-contingent group were presented with the tone/house light compound stimulus once every 5 min, regardless of responding. Rats were pretreated with ketoconazole (25 mg/kg, i.p.) or CP-154,526 (20 mg/kg, i.p.) 30 min prior to testing for reinstatement with the contingent presentation of the conditioned reinforcer to determine the role for the HPA axis in this behavior. RESULTS: The response-contingent presentation of the conditioned reinforcer reliably reinstated extinguished cocaine-seeking behavior, while the non-contingent presentation of the same stimulus did not. Increases in plasma corticosterone were evident during cocaine self-administration as well as during extinction and reinstatement testing. However, while plasma corticosterone returned to basal levels by the end of the session during extinction, it remained elevated through the end of the session during reinstatement. Pretreatment with ketoconazole reversed the conditioned reinforcer-induced reinstatement of extinguished cocaine-seeking behavior and also attenuated the conditioned increases in plasma corticosterone observed during reinstatement. Pretreatment with CP-154,526 resulted in a similar decrease in cocaine seeking. CONCLUSIONS: These data suggest a potential role for the HPA axis in the ability of environmental cues to stimulate cocaine-seeking behavior.

Analysis of Variance↗
PubMed2005

Long-term citalopram administration reduces responsiveness of HPA axis in patients with major depression: relationship with S-citalopram concentrations in plasma and cerebrospinal fluid (CSF) and clinical response.

RATIONALE: A dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is a well-documented neurobiological finding in major depression. Moreover, clinically effective therapy with antidepressant drugs may normalize the HPA axis activity. OBJECTIVE: The aim of this study was to test whether citalopram (R/S-CIT) affects the function of the HPA axis in patients with major depression (DSM IV). METHODS: Twenty depressed patients (11 women and 9 men) were challenged with a combined dexamethasone (DEX) suppression and corticotropin-releasing hormone (CRH) stimulation test (DEX/CRH test) following a placebo week and after 2, 4, and 16 weeks of 40 mg/day R/S-CIT treatment. RESULTS: The results show a time-dependent reduction of adrenocorticotrophic hormone (ACTH) and cortisol response during the DEX/CRH test both in treatment responders and nonresponders within 16 weeks. There was a significant relationship between post-DEX baseline cortisol levels (measured before administration of CRH) and severity of depression at pretreatment baseline. Multiple linear regression analyses were performed to identify the impact of psychopathology and hormonal stress responsiveness and R/S-CIT concentrations in plasma and cerebrospinal fluid (CSF). The magnitude of decrease in cortisol responsivity from pretreatment baseline to week 4 on drug [delta-area under the curve (AUC) cortisol] was a significant predictor (p<0.0001) of the degree of symptom improvement following 16 weeks on drug (i.e., decrease in HAM-D21 total score). The model demonstrated that the interaction of CSF S-CIT concentrations and clinical improvement was the most powerful predictor of AUC cortisol responsiveness. CONCLUSION: The present study shows that decreased AUC cortisol was highly associated with S-CIT concentrations in plasma and CSF. Therefore, our data suggest that the CSF or plasma S-CIT concentrations rather than the R/S-CIT dose should be considered as an indicator of the selective serotonergic reuptake inhibitors (SSRIs) effect on HPA axis responsiveness as measured by AUC cortisol response.

Adrenocorticotropic Hormone↗
PubMed2001

Orientation of the opposition axis in mentally simulated grasping.

Five normal subjects were tested in a simulated grasping task. A cylindrical container filled with water was placed on the center of a horizontal monitor screen. Subjects used a precision grip formed by the thumb and index finger of their right hand. After a preliminary run during which the container was present, it was replaced by an image of the upper surface of the cylinder appearing on the horizontal computer screen on which the real cylinder was placed during the preliminary run. In each trial the image was marked with two contact points which defined an opposition axis in various orientations with respect to the frontal plane. The subjects' task consisted, once shown a stimulus, of judging as quickly as possible whether the previously experienced action of grasping the container full of water and pouring the water out would be easy, difficult or impossible with the fingers placed according to the opposition axis indicated on the circle. Response times were found to be longer for the grasps judged to be more difficult due to the orientation and position of the opposition axis. In a control experiment, three subjects actually performed the grasps with different orientations and positions of the opposition axis. The effects of these parameters on response time followed the same trends as during simulated movements. This result shows that simulated hand movements take into account the same biomechanical limitations as actually performed movements.

Adult↗
PubMed2001

Adaptive changes in smooth pursuit eye movements induced by cross-axis pursuit-vestibular interaction training in monkeys.

The smooth pursuit system interacts with the vestibular system to maintain the accuracy of eye movements in space. To understand neural mechanisms of short-term modifications of the vestibulo-ocular reflex (VOR) induced by pursuit-vestibular interactions, we used a cross-axis procedure in trained monkeys. We showed earlier that pursuit training in the plane orthogonal to the rotation plane induces adaptive cross-axis VOR in complete darkness. To further study the properties of adaptive responses, we examined here the initial eye movements during tracking of a target while being rotated with a trapezoidal waveform (peak velocity 30 or 40 degrees/s). Subjects were head-stabilized Japanese monkeys that were rewarded for accurate pursuit. Whole body rotation was applied either in the yaw or pitch plane while presenting a target moving in-phase with the chair with the same trajectory but in the orthogonal plane. Eye movements induced by equivalent chair rotation with or without the target were examined before and after training. Before training, chair rotation alone resulted only in the collinear VOR, and smooth eye movement-tracking of orthogonal target motion during rotation had a normal smooth pursuit latency (ca 100 ms). With training, the latency of orthogonal smooth tracking eye movements shortened, and the mean latency after 1 h of training was 42 ms with a mean gain, at 100 ms after stimulus onset, of 0.4. The cross-axis VOR induced by chair rotation in complete darkness had identical latencies with the orthogonal smooth tracking eye movements, but its gains were <0.2. After cross-axis pursuit training, target movement alone without chair rotation induced smooth pursuit eye movements with latencies ca 100 ms. Pursuit training alone for 1 h using the same trajectory but without chair rotation did not result in any clear change in pursuit latency (ca 100 ms) or initial eye velocity. When a new target velocity was presented during identical chair rotation after training, eye velocity was correspondingly modulated by just 80 ms after rotation onset, which was shorter than the expected latency of pursuit (ca 100 ms). These results indicate that adaptive changes were induced in the smooth pursuit system by pursuit-vestibular interaction training. We suggest that this training facilitates the response of pursuit-related neurons in the cortical smooth pursuit pathways to vestibular inputs in the orthogonal plane, thus enabling smooth eye movements to be executed with shorter latencies and larger eye velocities than in normal smooth pursuit driven only by visual feedback.

Adaptation, Physiological↗
PubMed2006

CT analysis of the axis for transarticular screw fixation of rheumatoid atlantoaxial instability.

OBJECTIVE: To investigate the morphological characteristics of the axis of rheumatoid arthritis (RA) patients with atlantoaxial instability and to determine, by means of sagittal reconstructed computed tomography (CT), the suitability for atlantoaxial transarticular screw fixation. DESIGN AND PATIENTS: Twenty-seven patients, who had undergone reconstructed cervical spine CT scanning preoperatively and posterior atlantoaxial arthrodesis for atlantoaxial instability, were identified from a database for inclusion in this study. The isthmus height and internal height of the lateral mass of the axis were measured using digital imaging software. RESULTS: The mean isthmus height and internal height of the lateral mass of the axis in RA patients (n=14) were significantly lower than in non-RA patients (n=13) (P<0.01). A high-riding vertebral artery (VA) was present in 54% (15 joints, 9 patients) of the 28 atlantoaxial joints in the RA group and in 12% (3 joints, 2 patients) of the 26 atlantoaxial joints in the non-RA group (P<0.01). CONCLUSIONS: In RA patients, the axis showed more extensive thinning of the isthmus and lateral mass than in non-RA patients. A precise preoperative evaluation of screw trajectory using reconstruction CT imaging may be useful in atlantoaxial transarticular fixation, particularly for RA patients with atlantoaxial instability.

Arthritis, Rheumatoid↗
PubMed2005

Arterial reconstruction during pancreatoduodenectomy in patients with celiac axis stenosis--utility of Doppler ultrasonography.

Celiac axis stenosis is found at an incidence of 2%-24% in the general population. During pancreatoduodenectomy in patients with celiac axis stenosis, division of the gastroduodenal artery from the common hepatic artery may cause acute ischemia of the upper abdominal organs, such as the liver, stomach, or spleen. Under these circumstances, the clinical indications of arterial reconstruction remain controversial. Between 1994 and 2003, seven patients with celiac axis stenosis (n = 4) or occlusion (n = 3) underwent pancreatoduodenectomy at our hospital. Arterial reconstruction, including division of the median arcuate ligament, was conducted in two patients; the replaced right hepatic artery was preserved in one patient, and no vascular refinement was undertaken in the remaining four of the seven patients. In two of the four patients without arterial reconstruction or preservation, the serum levels of liver enzymes were markedly elevated (> 800 IU/l) on postoperative day 1, and these patients subsequently developed liver abscesses. Two patients who underwent arterial reconstruction and three patients who showed no decrease in intrahepatic arterial flow under Doppler ultrasonography after clamping of the gastroduodenal artery developed no ischemic complications. Although our experience is limited, when intraoperative Doppler ultrasonography indicates a decrease in the hepatic arterial signals, we believe that reconstruction of the hepatic artery will be necessary to minimize ischemic complications in the liver in patients with celiac axis stenosis.

Aged↗
PubMed2002

Neural representations of the axis of acoustic particle motion in nucleus centralis of the torus semicircularis of the goldfish, Carassius auratus.

Experiments examined differential coding of acoustic particle motion axis in the auditory midbrain of goldfish. Animals were exposed to vibratory stimuli varying in axis orientation as action potentials were recorded from single units in the central neuropil of nucleus centralis in the torus semicircularis. Response magnitudes as a function of stimulation axis were visualized in three dimensional plots called directional response profiles. These are generally comparable to directional responses observed among primary saccular afferents in having substantially vertical orientations. Distortions in shape from the peripheral patterns indicate neural information processing. A three-dimensional model was used to evaluate the hypothesis that responses in the auditory midbrain reflect the convergence of excitatory and inhibitory primary afferent-like responses. Model afferent inputs were generated and combined arithmetically. This analysis gives insight into the mechanisms of information processing that appear to occur in brainstem nuclei. The lack of diversity in best axis directions suggests that this mechanism alone cannot account for directional hearing abilities in this species. The roles that this directional representation and processing may play in directional hearing and sound source localization are not yet clear. Implications of these data on current models of fish directional hearing are discussed.

Acoustic Stimulation↗
PubMed2000

New mode of hypothalamic-pituitary-adrenocortical axis regulation: significance for stress-related disorders.

Two types of corticosteroid receptors have been identified in the brain and pituitary that play an important role in the regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis. These glucocorticoid hormone binding receptors are the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GR). Evidently, a tight control of the concentration and function of these receptors is of prime importance for maintaining and regaining homeostasis after stressful challenges. Here, we describe a novel mechanism revealing a rapid upsurge in MR density in the hippocampus (a limbic structure highly involved in HPA axis regulation) after an acute psychologically stressful challenge. This rise in MR is accompanied by a stronger MR-mediated inhibitory control of the HPA axis. Thus, an acute stressful experience results in a reorganization of the HPA axis involving a principal role of the hippocampal MR. This novel mechanism may be of significance for increasing our understanding of the etiology of stress-related disorders.

Animals↗
PubMed2003

Effect of the angle between the optical axis of the endoscope and the instruments' plane on monitor image and surgical performance.

BACKGROUND: The aim of the study was to examine the effect of the angle between optical axis of the endoscope and the instruments' plane (OAIP) on the monitor display angle (approach angle between the two instruments on a two-dimensional monitor) and endoscopic task performance. METHODS: Two experiments were carried out in the Advanced Dundee Endoscopic Psychomotor Tester (ADEPT) using a standard two-dimensional video endoscopic system. In the first experiment, the monitor display angle was measured during use, with OAIP angles ranging between 0 and 80 degrees (at 10 degrees increments) and manipulation angles varying between 45 and 120 degrees (at 15 degrees increments). In the second experiment, 10 surgeons tied 500 intracorporeal knots with OAIP angles of 0 degrees (optical axis in the same plane as the instruments), +15 degrees and +30 degrees (viewing above the instruments' plane), and -15 and -30 degrees (optical axis looking from below instruments' plane). The end points were the execution time and knot quality score (KQS). RESULTS: In the first experiment, instruments entered the visual field from lateral sides of the monitor with an apparent 180 degrees monitor display angle with a 0 degrees OAIP angle, whereas the monitor display angle approached the actual manipulation angle between the two needle drivers when an 80 degrees OAIP angle was used. In the second experiment, the instruments appeared to enter the image field from the side of the surgeon when the endoscope viewed the instruments from above, whereas instruments entered the field from the opposite side to the surgeon when the endoscope viewed instruments' plane from below. As a result, use of 0 and +15 degrees OATP angles yielded significantly shorter execution times: 70 s compared to 83, 93, and 77 s for +30, -30, and -15 degrees OAIP angles ( p < 0.001), with KQS of 39 degrees and 40 vs 38, 36, and 34%, respectively ( p = 0.257). CONCLUSIONS: The angle between the optical axis of the endoscope and instruments' plane determines how the instruments appear to enter the operative field. The monitor display angle between the instruments is different from the real manipulation angle unless the OAIP angle is near 80 degrees. The apparent entry of instruments into the operative field becomes intuitive for the surgeon only if the endoscope is viewing from above or in the same plane as the instruments. Hence, the best performance for endoscopic knot tying is obtained with this configuration, and execution time increases significantly with viewing from below the instruments' plane.

Endoscopes↗
PubMed1999

Influence of the optical axis-to-target view angle on endoscopic task performance.

BACKGROUND: The location of the optical port and the choice of endoscope determine the angle subtended between the optical axis of the endoscope and the plane of the operation target: the optical axis-to-target view (OATV) angle. The aim of the study was to investigate the influence OATV angle on endoscopic task performance. METHODS: The Dundee Endoscopic Psychomotor Tester was used for objective assessment of endoscopic task performance. Ten surgeons carried out a standard task with the optical axis of the endoscope subtending 90 degrees, 75 degrees, 60 degrees and 45 degrees to the target surface. Each subject underwent three test sessions. Each session consisted of one run with each of the OATV angles in a random order. The outcome measures were the errors rate, the execution time, and the force applied on the target. RESULTS: The 90 degrees OATV angle had the best accuracy, the shortest execution time, and the lowest force applied on the back plate. The errors rate increased from 17% with the 90 degrees OATV angle to 79% with the 45 degrees angle. There was a significant increase in execution time and force with the decrease in the OATV angle (p < 0.0001). CONCLUSIONS: The best task performance is obtained when the optical axis of the endoscope is perpendicular to the target plane.

Analysis of Variance↗
PubMed2000

Distal pancreatectomy with resection of the celiac axis and reconstruction of the hepatic artery for carcinoma of the body and tail of the pancreas.

Distal pancreatectomy with resection of the celiac axis can increase resectability of carcinoma of the body and tail of the pancreas. We performed reconstruction of the hepatic artery to avoid complications caused by a decrease in hepatic arterial flow. We carried out distal pancreatectomy with resection of the celiac axis for carcinoma of the body and tail of the pancreas in four patients. When pulsation in the proper hepatic artery was weak after occlusion of the celiac axis, we performed reconstruction of the hepatic artery, using the splenic artery, which had been taken beforehand from the resected specimen. In two patients, we performed reconstruction of the hepatic artery. These two patients underwent reconstruction of the portal vein combined with prolonged clamping of the portal vein. Levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated just after the operation, but recovered to normal levels within 10 days. No complications related to hepatic ischemia were observed. These results suggested that reconstruction of the hepatic artery allowed us to safely perform distal pancreatectomy with resection of the celiac axis for carcinoma of the body and tail of the pancreas.

Aged↗
PubMed1998

Pancreaticoduodenal artery aneurysms associated with celiac axis stenosis due to compression by median arcuate ligament and celiac plexus.

Celiac axis stenosis is frequently associated with pancreaticoduodenal artery aneurysms. Although the cause of stenosis was not clear in most of the reported cases, compression of the median arcuate ligament of the diaphragm was found to be responsible for the stenosis in 7 of 42 reported cases of this type of aneurysm. We report a case of aneurysm caused by compression of the median arcuate ligament of the diaphragm and celiac plexus. An asymptomatic 43-year-old Japanese man was admitted with a low echoic lesion in the uncus of pancreas. Computed tomographic scan and angiogram revealed stenosis of the celiac axis and two aneurysms in the inferior posterior pancreaticoduodenal artery. The celiac plexus and median arcuate ligament were divided surgically and normal flow was reestablished in the celiac axis. One of the aneurysms was resected and the afferent artery of the other aneurysm was ligated. In the setting of pancreaticoduodenal artery aneurysm associated with celiac axis stenosis, management of stenosis should be considered in addition to local treatment of the aneurysm. In this context, division of median arcuate ligament and celiac plexus or aorto-celiac bypass may normalize the flows in the pancreaticoduodenal arcade and could be effective in preventing aneurysm reformation.

Adult↗
PubMed2004

Distal femoral cut perpendicular to the mechanical axis may induce varus instability in flexion in medial osteoarthritic knees with varus deformity in total knee arthroplasty: a pitfall of the navigation system.

Two factors that influence the external rotation angle of the femoral rotational axis in total knee arthroplasty (TKA) were assessed in 40 medial osteoarthritic knees with varus deformity. First, the anatomic configuration of the femur was assessed using standardized radiographs of the patients' lower extremities before TKA. Second, the degree of medial soft tissue release was assessed during TKA. The radiographs showed that the characteristics of the femur were lateral bowing of the shaft and external rotation of the condyle in the coronal plane. Therefore, when the distal femur is cut perpendicular to the mechanical axis, the cut surface may be in too much of a valgus position. Furthermore, some degree of medial soft tissue release was necessary in all knees. Medial soft tissue release rotates the femur externally in extension in the coronal plane, and it rotates the femur externally around the femoral axis in flexion relative to the tibia. A distal femoral cut in too much of a valgus position and medial soft tissue release induces varus instability in flexion in knees with lateral bowing of the femoral shaft. Anatomic variation such as femoral bowing should be considered when a navigation system is used for TKA because the navigation system shows only the mechanical axis.

Aged↗
PubMed2006

Normal range of human left ventricular volumes and mass using steady state free precession MRI in the radial long axis orientation.

BACKGROUND: The radial long-axis orientation for the measurement of left ventricular (LV) volume and mass has been shown to have advantages over the short-axis orientation. Previous work has highlighted the need for technique specific normal ranges. The purpose of this study was therefore to establish normal ranges of LV volume and mass for the radial long-axis orientation. MATERIALS AND METHODS: Forty normal subjects (20 males, average age 32.3, age range 19-58; 20 females, average age 37.4, age range 21-54) were examined utilising a steady state free precession (SSFP) pulse sequence. Two observers analysed the images independently using in-house validated software. RESULTS: The normal ranges for LV end-diastolic volume measurements after adjustment to body surface area (BSA) were 62-120 ml for males and 58-103 ml for females. LV mass indexed to BSA ranged from 50-86 g for males and 36-72 g for females. The normal range for ejection fraction was 49-73% for males and 54-73% for females. CONCLUSION: A gender specific normal range using SSFP in the radial long-axis orientation was established.

Adult↗
PubMed2006

The GH1/IGF-1 axis polymorphisms and their impact on breast cancer development.

The growth hormone 1/insulin-like growth factor-1 (GH1/IGF-1) axis plays an essential role in the development of the breast by regulating cell proliferation, differentiation and apoptosis. Imbalances within this axis lead to an aberrant signalling and recent research has focussed on the overexpression of these growth factors and their involvement in breast cancer development. The increased understanding of the molecular mechanisms and signalling pathways connected to the GH1/IGF-1 axis has provided important insights into aetiology, prevention and therapy for breast cancer. However, to identify the contribution of the GH1/IGF-1 signalling pathway to cancer risk still remains a challenge since the results of various studies are controversial. Here, we discuss the influence of low-penetrance polymorphisms in the genes along the GH1/IGF-1 axis and their impact on hormone levels and cancer risk, especially breast cancer. We point out what is known about the effects of the variants and show how the interaction of genetic variants affects breast cancer risk.

Breast Neoplasms↗
PubMed1986

Urethral axis and sphincteric function.

Position and mobility of the urethral axis are considered factors influencing urethral competence. Specific correlation between the urethral axis and its sphincteric function is lacking. Eighty-four patients with the symptom of stress urinary incontinence and 31 patients with sensory symptomatology but not urinary incontinence underwent clinical and urodynamic evaluation. This included objective assessment of urethral axial positions and mobility with use of a specially designed protractor. Comparative analysis of urethral axial data was done between 70 incontinent women with objective evidence of sphincteric incompetence and 24 continent women without it. The urethral axis at rest, during bearing down, and in its total excursion were found to be not significantly different and distributed similarly between both groups. Assessment of the urethral axis was found to be not predictive of urethral function.

Cough↗