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[History and sidelights on the forceps].

The author starts by showing that the first forceps were originally designed to handle hot metal in founderies and that the word derived from "formus" (hot) and "capere" (to take). The author, Professor Dumont, tries to trace the history of the development of modern forceps, discussing whether the Arabs or such well known authors of classical works as Roesslin, Raynald, Rueff and Rousset knew of the instrument or whether they just described instruments of destruction. Crainz in 1941 had written an article to discuss whether the early Romans had forceps and came to no firm conclusion. Speert in 1957 said that a live baby had been born earlier than the 17th Century, possibly as early as the 2nd or 3rd century of the Roman empire, i.e. over 300 years before Jesus-Christ, by forceps. The description is given of a bas-relief depicting forceps delivery but no one knows whether the bas-relief is genuine or not. The discovery of the Chamberlen forceps in 1813 at Woodham Mortimer Hall in Essex, England, and the lengthy description of how the Chamberlens kept the secret of the invention of the forceps over several generations is very well described. Then follows the story of Jean Palfyn's "mains de fer" which led later to Levret and his long curved forceps. Returning to England, the authors describes how William Smellie covered his forceps with leather so that the patients should not feel the cold metal or hear the clink of the handles. The author then quotes Dr Slop, who appears in Laurence Sterne's "Tristram Shandy" and who knew the Smellie's forceps. Sacombe was an arch enemy of instrumental delivery. The role of the Dane Saxtorph, and how Antoine Dubois delivered Napoleon's son, the future King of Rome, by forceps, is reviewed. Madame La Chapelle and her work as well as that of Scanzoni, and finally of Simpson who first used anaesthesia after inventing a forceps, continues the history. Great names such as Pajot, Tarnier with his axis-traction forceps and finally Barton, Piper and Kielland with their inventions are all described in this beautiful history of forceps.

Extraction, Obstetrical↗

Body composition prediction in university football players.

This study was intended to determine if previously-developed body composition prediction equations were valid for use with a Division I university football team. A sample of 68 Division I football players with a mean age of 19.7 yr, was assessed for body density (BD) by underwater weighing (UWW), residual volume by helium dilution, and 26 selected anthropometric measures. A predicted BD was obtained by using two sets of equations developed from college football players and from three generalized equations. The differences between predicted and observed body densities were analyzed. Seven of the nine models examined failed to accurately predict the BD for this population of university football players. One sport-specific equation of White, Mayhew, and Piper for individuals in the backfield and a generalized model of Jackson and Pollock (JP) containing two circumferences performed well when considering the mean of differences and the magnitude of total error relative to the published standard error. However, both of these models overestimate body density for players with low BD and underestimate BD when actual BD is high. Using the JP model for a player whose actual BD is near the sample mean of 1.070, the estimated mean is very close at 1.069. However, for players with actual BD of 1.050, the estimated mean is 1.054, and if actual BD is 1.085, the JP estimated mean is 1.078. The bias is linear between these points.

Adult↗

The aetiology of oral submucous fibrosis: the stimulation of collagen synthesis by extracts of areca nut.

Oral submucous fibrosis is a chronic disabling disease developing in up to 0.5% of the estimated 500 million habitual chewers of the "betel" quid. The quid, or chew, usually comprises a leaf of the Piper betel vine in which is wrapped fragments of the nut of Areca catechu, together with slaked lime and varied additives, including tobacco. The precise aetiology of oral submucous fibrosis (OSF) remains obscure, but epidemiological and animal studies have pointed to a close association with the prolonged usage of A. catechu nuts. Epithelial atypia and epidermoid carcinoma have been reported in 15% and 7%, respectively, of patients with established OSF. Preparations from varieties of A. catechu nuts have been tested for their ability to stimulate collagen synthesis in microwell cultures of human fibroblasts, using a pulse of 3H-proline and subsequent analysis of the cultures for radioactive collagen. Crude extracts of three varieties of areca nuts were extracted with ethanol and lyophilised before dilution in the culture medium. Control media contained identical concentrations of ethanol where appropriate. The three extracts at a concentration of 10 micrograms/ml stimulated collagen synthesis by approximately 150%, suggesting that this effect might be involved in the aetiology of oral submucous fibrosis.

Areca↗

Subcellular distribution of aluminium in wheat roots.

At the sublethal and lethal concentration of Al in the medium total Al content in root tips and in the nuclear, mitochondrial and cytosol fractions was 5-7 times higher in the Al-tolerant than in the Al-sensitive wheat genotype. This contradicts the "avoidance" type of tolerance mechanism. At the sublethal Al concentration about 30% of Al was accumulated in nuclei and 10% in mitochondria in roots of the Al-tolerant genotype whereas only 10% of total Al was found in nuclei and 20% in mitochondria of the Al-sensitive genotype. A significant shift of Al from cytosol to nuclei was observed in both genotypes at the Al concentration lethal for each genotype, with practically no change in relative concentration of Al in mitochondria. The assay of Al concentration in plant tissue with catechol violet is more specific and sensitive than with Eriochrome Cyanine R. Mineralization is prerequisite before any Al assay; and the wet-ashing method of Piper (cf Jones & Thurman, Plant Soil, 1957, 9, 131-141) was found more satisfactory than dry digestion.

Aluminum↗

Cloning of Thai strain Giardia intestinalis.

Axenic cultures of Giardia intestinalis trophozoites were successfully established from human fecal specimens and rectal swabs from dogs using sucrose gradient centrifugation to separate the cysts from fecal material, the excystation method of Robert-Thompson et al. and culture of the preparation in TYI-S-33 medium supplemented with human serum, vitamin mixture and piper acillin and amikacin antibiotics, respectively. Fungal contamination could be controlled by amphotericin B at 10 micrograms per ml of medium. Clones of the parasites were obtained using a combination of dilution method and micromanipulation technique.

Animals↗

Divergence of the phytochrome gene family predates angiosperm evolution and suggests that Selaginella and Equisetum arose prior to Psilotum.

Thirty-two partial phytochrome sequences from algae, mosses, ferns, gymnosperms, and angiosperms (11 of them newly released ones from our laboratory) were analyzed by distance and character-state approaches (PHYLIP, TREECON, PAUP). In addition, 12 full-length sequences were analyzed. Despite low bootstrap values at individual internal nodes, the inferred trees (neighbor-joining, Fitch, maximum parsimony) generally showed similar branching orders consistent with other molecular data. Lower plants formed two distinct groups. One basal group consisted of Selaginella, Equisetum, and mosses; the other consisted of a monophyletic cluster of frond-bearing pteridophytes. Psilotum was a member of the latter group and hence perhaps was not, as sometimes suggested, a close relative of the first vascular plants. The results further suggest that phytochrome gene duplication giving rise to a- and b- and later to c-types may have taken place within seedfern genomes. Distance matrices dated the separation of mono- and dicotyledons back to about 260 million years before the present (Myr B.P.) and the separation of Metasequoia and Picea to a fossil record-compatible value of 230 Myr B.P. The Ephedra sequence clustered with the c- or a-type and Metasequoia and Picea sequences clustered with the b-type lineage. The "paleoherb" Nymphaea branched off from the c-type lineage prior to the divergence of mono- and dicotyledons on the a- and b-type branches. Sequences of Piper (another "paleoherb") created problems in that they branched off from different phytochrome lineages at nodes contradicting distance from the inferred trees' origin.

Base Sequence↗

Pharmacological profile of AD-5423, a novel antipsychotic with both potent dopamine-D2 and serotonin-S2 antagonist properties.

The pharmacological properties of AD-5423 [2-(4-ethyl-1-piper-azinyl)-4- (4-fluorophenyl)-5,6,7,8,9,10-hexahydrocycloocta[b]pyridine] were studied in biochemical and behavioral tests. In vitro, AD-5423 bound preferentially to dopamine (DA)-D2 (Ki, 14.8 nM; cf. haloperidol, 8.79 nM; and clozapine, 149 nM) and serotonin (5-HT)-S2 (Ki, 3.98 nM; cf. haloperidol, 26.8 nM; and clozapine, 8.66 nM) receptors. It displayed low affinity for adrenaline (Ad)-alpha-1 (Ki, 56.3 nM) receptors and was virtually devoid of binding to DA-D1 (Ki, 2870 nM), 5-HT-S3, Ad-alpha-2, Ad-beta, muscarine, tau-aminobutyric acid and benzodiazepine receptors. In addition, AD-5423 was only a weak inhibitor of DA, 5-HT and noradrenaline uptake systems. When administered p.o., AD-5423 (0.3-10 mg/kg) increased brain contents of the DA metabolites 3,4-dihydroxyphenylacetic acid and homovanillic acid in mice and rats and the 5-HT metabolite 5-hydroxyindoleacetic acid in mice. Behaviorally, AD-5423 (0.2-2 mg/kg p.o.) decreased exploratory activity in mice, suppressed conditioned avoidance responding and methamphetamine-induced hyperactivity in mice and rats, antagonized apomorphine-induced gnawing in rats and vomiting in dogs and reduced hostile responses in monkeys. In these effects, AD-5423 was more or less equi-potent to haloperidol. However, AD-5423 (10 mg/kg p.o.), unlike haloperidol, did not antagonize SKF38393-induced vacuous oral movements in rats. Head twitches induced by 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane in mice and by para-chloroamphetamine in rats were antagonized by AD-5423 at much lower doses (0.5-2 mg/kg p.o.) than those of haloperidol and clozapine.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Hawaiian materia medica for asthma.

A literature search and traditional narration determined that at least 58 herbs with scientific names were commonly used by Hawaiians for asthma. Of particular note were Piper methysticum, solanum americanum, and Aleurites molucana with oral tradition singling out Sophora chrysophylla. These four therapeutic agents, especially Sophora, have scientific merit and warrant further investigation because of the recent increase in asthma mortality, their potential for improved patient compliance, minimal of side effects, and the low cost.

Asthma↗

Abdominal rescue using the vacuum extractor after entrapment of the aftercoming head.

BACKGROUND: Fetal replacement into the uterus for ceasarean delivery after failed vaginal delivery has been reported for both vertex and breech presentations. Although an option, this mode of delivery frequently is the last maneuver to deliver a viable infant after other methods to allow vaginal delivery have failed. We report the adjunctive use of a vacuum extractor to facilitate abdominal rescue after entrapment of the aftercoming head during an attempted vaginal breech delivery. CASE: A multiparous woman presented at term with two fetal feet bulging through the membranes at the introitus. During vaginal breech delivery, the aftercoming head became entrapped. Unsuccessful maneuvers to facilitate descent included Dührssen incisions, the Mauriceau maneuver, placement of Piper forceps, and halothane administration. At emergency ceasarean delivery, the infant was pushed upward from below, and rapid, successful delivery of a 2530-g neonate was accomplished with assistance by a vacuum extractor. Apgar scores were 3, 6, and 7 at 1, 5, and 10 minutes, respectively. Umbilical artery blood gas revealed a pH of 7.18 and base excess of -6. A head sonogram and electroencephalogram were normal. Both mother and infant were discharged without complications. CONCLUSION: After entrapment of the aftercoming head during attempted vaginal breech delivery, use of the vacuum extractor may expedite the abdominal rescue and ceasarean.

Adult↗

Patterns of fatigue and activity and rest during adjuvant breast cancer chemotherapy.

PURPOSE/OBJECTIVES: To describe the patterns of fatigue and activity and rest and their relationship during adjuvant breast cancer chemotherapy. DESIGN: Prospective, descriptive, repeated measures. SETTING: Midwestern oncology clinics and subjects' homes. SAMPLE: 72 women, ages 30-69, who were receiving chemotherapy after surgery for stage I or II breast cancer. METHODS: The Piper Fatigue Scale was used to measure fatigue 48 hours after each treatment and at treatment cycle midpoints for three cycles. Wrist actigraphs were used to measure activity and rest cycles for 96 hours at each treatment and for 72 hours at each cycle midpoint. MAIN RESEARCH VARIABLES: Fatigue, activity and rest cycles, chemotherapy protocols (doxorubicin- or non-doxorubicin-based protocols). FINDINGS: Total and subscale fatigue scores were significantly different over time, with scores higher at treatments and lower at cycle midpoints. Activity levels were significantly different over time in a mirror-image pattern of fatigue. Fatigue was negatively correlated with activity levels at all times except the cycle 2 midpoint and positively correlated with awakenings at night only at the cycle 2 midpoint. Activity levels were significantly lower in women receiving doxorubicin-based protocols. CONCLUSIONS: Roller-coaster patterns of fatigue and activity have not been previously reported in this patient population. Examination of the inverse relationship between fatigue and activity will assist nurses in the development and testing of interventions to modify fatigue. IMPLICATIONS FOR NURSING PRACTICE: Women should be instructed to monitor the intensity of fatigue and encouraged to maintain activity levels balanced with efficient rest periods. Nurses can inform women that these patterns may be expected to be similar during the first three chemotherapy cycles.

Activity Cycles↗

Permeability characteristics of piperine on oral absorption--an active alkaloid from peppers and a bioavailability enhancer.

Piperine, [1-[5-[1,3-benzodioxol-5-yl]-1-oxo-2,4, pentadienyl] piperidine], is a pungent alkaloid present in Piper nigrum Linn, and P. longum Linn. It is shown to enhance the bioavailability of various structurally and therapeutically diverse drugs. A concise mechanism responsible for its bioavailability enhancing action is poorly understood. This study is an effort to understand the absorption dynamics of piperine in intestine on oral absorption. It encompasses intestinal everted sacs as an experimental model. Cycloheximide treatment and exclusion of Na+ salts from incubating medium were the variables used. Absorption half life, absorption rate, absorption clearance and apparent permeability co-efficient were computed from the data. Experiments to denote physico-chemical characteristics of this moiety exhibited that it is a weak base, highly lipophilic in nature with partial solubility in aqueous media. It exhibited passive diffusion constituting non-saturable absorption kinetics. Transport of piperine was not resisted by UWL and was proposed to be absorbed through transcellular pathway. It displayed short absorption clearance and high apparent permeability co-efficient. Data thus obtained suggested that piperine is absorbed very fast across the intestinal barrier. It may act as an apolar molecule and form apolar complex with drugs and solutes. It may modulate membrane dynamics due to its easy partitioning thus helping in efficient permeability across the barriers.

Absorption↗

[Kava-kava preparations--alternative anxiolytics].

Since Cook's world cruises (1772-1775) there is written evidence of the use of kava-kava by the inhabitants of the Pacific Islands. In last decades kava-kava, an extract of the plant Piper methysticum was used in several European countries (drugs like Laitan, Antares, Viocava, Mosaro etc.). In the presented paper the authors describe the pharmacology, toxicology and pharmacokinetics of the active compounds of kava-kava the kavapyrones. The discussion concerning the therapeutic value of kavapyrones ends with the conclusion of the authors, that kava-kava may be a useful alternative for synthetic anxiolytics.

Animals↗

Factors influencing quality of life in cancer patients: anemia and fatigue.

Anemia is a multi-symptom syndrome involving both physical and emotional problems that can be evaluated for their impact on quality of life. Fatigue is the cardinal symptom of anemia, reported by three of four cancer patients using the general version of the Functional Assessment of Cancer Therapy (FACT-G) questionnaire. A subscale of the FACT-G, consisting of the FACT-Fatigue (FACT-F) and the FACT-Anemia (FACT-An), has been developed to specifically address this problem. The FACT-F is comprised of the FACT-G plus 13 questions related to fatigue, while the FACT-An is comprised of the FACT-F plus an additional set of seven miscellaneous (non-fatigue) questions relevant to anemia in cancer patients. The FACT-An subscale was initially validated in a cohort of 50 cancer patients. Tests of internal consistency and stability confirmed the reliability of the fatigue component, as well as that of the FACT-G (27 items), the FACT-F (FACT-G plus 13 fatigue items), and the FACT-An (FACT-G plus 20 anemia subscale items) measurement systems. Quality of life scores on these FACT scales significantly decline as patient performance status worsens, and the scales correlate well with other questionnaires (Profile of Mood States and Piper Fatigue Scale) purported to measure the same thing. The scores on the FACT-An subscale also clearly differentiate between patients with low and high hemoglobin levels. Low hemoglobin levels are associated with greater fatigue, poorer overall quality of life, and decreased ability to work (beyond that related directly to fatigue). Interventions that reverse fatigue and other anemia-related symptoms should have a positive effect on quality of life.

Anemia↗

["An appropriate forceps"--150-year anniversary of Simpson's forceps].

Despite the increasing use of caesarean section and vacuum extraction, obstetric forceps is still in frequent use in obstetric wards. There has, in fact, been an increase due to more active management of births. More than 600 obstetric forceps have been described in detail, but only three of them are in use in Norway today: Simpson's and Kielland's forceps for vertex presentation and Piper's forceps for aftercoming head in breech presentation. This year it is 150 years since James Young Simpson (1811-70) of Edinburgh presented his forceps for the first time. Simpson's forceps has been the most widely used forceps in Norway over the last 120 years. This article describes James Young Simpson, his long forceps, and its use in Norwegian obstetrics.

Female↗

In vitro 2,3,7,8-tetrachlorodibenzo-p-dioxin interference with the anterior pituitary hormone adrenocorticortropin.

Treatment of male Sprague-Dawley rats with a single oral dose of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has been shown to increase serum adrenocorticotropin (ACTH) and decrease serum corticosterone. The present in vitro study was designed to assess whether TCDD has a direct effect on the anterior pituitary under basal and stimulated conditions. Primary anterior pituitary cell cultures were prepared from normal 180- to 220-g male Sprague-Dawley rats and the cultures treated with 10(-9)-10(-19) M TCDD. Maximal secretion of ACTH occurred between 10(-11) and 10(-15) M TCDD for both medium (2-fold) and intracellular (1.5-fold) concentrations after 24 h TCDD exposure. TCDD treatment also caused an early (6 h) and persistent (10 days) increase in basal medium (1.4- to 2.8-fold) and intracellular (1.1- to 1.7-fold) ACTH concentrations. However, while stimulation with corticotropin-releasing hormone (CRH) increased intracellular ACTH 1.5- to 1.7-fold in pituitary cells treated for 24 h with 10(-9)-10(-13) M TCDD, ACTH secreted into the media was decreased by 30-50% compared with controls. Lastly, the secretagogue arginine-8-vaso-pressin (AVP), did not increase the amount of ACTH secreted above levels observed with basal TCDD exposure. From this study, it appears that TCDD stimulates in vitro synthesis and secretion of ACTH by the anterior pituitary under basal conditions, but decreases the pituitary's responsiveness to CRH and AVP stimulation.

Adrenocorticotropic Hormone↗

Lipid peroxidation in the adrenal glands of male rats exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD).

This study was performed to determine whether TCDD (50 micrograms/kg; single oral dose) could induce adrenal microsomal lipid peroxidation, which might be correlated to decreased levels of cytochrome P-450 and 21-hydroxylase activity. The amount of malondialdehyde (MDA) formed was significantly higher than controls at days 1 through 5 following TCDD treatment. Microsomal cytochrome P-450 levels were depressed after lipid peroxidation at days 1, 3, and 5, and 21-hydroxylase activity decreased at day 5 after TCDD treatment. This study shows that TCDD stimulates adrenal microsomal lipid peroxidation which is associated with decreased cytochrome P-450 levels and 21-hydroxylase activity.

Adrenal Glands↗

TCDD alters pituitary-adrenal function. I: Adrenal responsiveness to exogenous ACTH.

Plasma ACTH concentrations in 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD)-treated rats (50 micrograms/kg; single, oral dose) were 2.1-, 2.1-, 2.9-, 1.7-, 1.5-, 2.0- and 3.0-fold greater than control values, respectively, at days 1, 3, 5, 7, 10, and 14. At days 1 and 5 plasma corticosterone concentrations were increased 5.1- and 8.0-fold, respectively; whereas, at days 10 and 14 they were depressed to values of 50% and 39% of controls, respectively. Adrenal glands were excised from rats treated with TCDD and corticosterone production was assessed. Basal corticosterone concentrations produced by treated adrenals were depressed to 81%, 72%, and 71% of control values at days 5, 7, and 14, respectively. Corticosterone secretion by ACTH stimulated adrenals was equivalent to controls. These findings suggest that TCDD exposure decreases the bioactivity of the ACTH secreted by the anterior pituitary.

Adrenal Glands↗

Development and qualification of a novel virus removal filter for cell culture applications.

Commercial bioreactors employing mammalian cell cultures to express biological or pharmaceutical products can become contaminated with adventitious viruses. The high expense of such a contamination can be reduced by passing all gases and fluids feeding the bioreactor through virus inactivation or removal steps, which act as viral barriers around the bioreactor. A novel virus barrier filter has been developed for removing viruses from serum-free cell culture media. This filter removes the 20 nm minute virus of mice by >3 log reduction value (LRV), the 28 nm bacteriophage PhiX174 by >4.5 LRV, the mycoplasma Acholeplasma laidlawii by > or =8.8 LRV, and the bacteria Brevundimonas diminuta by > or =9.2 LRV. Robust removal occurs primarily by size exclusion as demonstrated over a wide range of feedstocks and operating conditions. The filtered media are indistinguishable from unfiltered media in growth of cells to high densities, maintenance of cell viability, and productivity in expressing protein product. Insulin and transferrin show high passage through the filter. The virus barrier filter can be autoclaved. The relatively high membrane permeability enables the use of a moderate filtration area.

Acholeplasma laidlawii↗