Sex selection: regulating technology enabling the predetermination of a child's gender.
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Abortion, Induced↗
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Ultrasound guidance for selected dilatation and evacuation procedures.
Intraoperative ultrasound was used as an adjunct in difficult dilatation and evacuation (D&E) procedures for first-trimester abortions. This technique was useful in eight technically difficult D&Es in the presence of acute retroflexion, acute anteflexion, cervical stenosis and lower uterine segment fibroids.
Abortion, Therapeutic↗
[Clinical discussion: indication for gynecologic operation and selection of methods. 4].
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Abortion, Induced↗
Definitive assignment of proton selectivity and attoampere unitary current to the M2 ion channel protein of influenza A virus.
The viral ion channel protein M2 supports the transit of influenza virus and its glycoproteins through acidic compartments of the cell. M2 conducts endosomal protons into the virion to initiate uncoating and, by equilibrating the pH at trans-Golgi membranes, preserves the native conformation of acid-sensitive viral hemagglutinin. The exceptionally low conductance of the M2 channel thwarted resolution of single channels by electrophysiological techniques. Assays of liposome-reconstituted M2 yielded the average unitary channel current of the M2 tetramer--1.2 aA (1.2 x 10(-18) A) at neutral pH and 2.7 to 4.1 aA at pH 5.7--which activates the channel. Extrapolation to physiological temperature predicts 4.8 and 40 aA, respectively, and a unitary conductance of 0.03 versus 0.4 fS. This minute activity, below previous estimates, appears sufficient for virus reproduction, but low enough to avert abortive cytotoxicity. The unitary permeability of M2 was within the range reported for other proton channels. To address the ion selectivity of M2, we exploited the coupling of ionic influx and efflux in sealed liposomes. Metal ion fluxes were monitored by proton counterflow, employing a pH probe 1,000 times more sensitive than available Na+ or K+ probes. Even low-pH-activated M2 did not conduct Na+ and K+. The proton selectivity of M2 was estimated to be at least 3 x 10(6) (over sodium or potassium ions), in agreement with electrophysiological studies. The stringent proton selectivity of M2 suggests that the cytopathology of influenza virus does not involve direct perturbation of cellular sodium or potassium gradients.
Cations, Monovalent↗
A discrepancy between cystic echinococcosis confirmed by ultrasound and seropositivity in Turkish children.
In three randomly selected villages of Manisa, Turkey, 630 primary school children were examined for cystic echinococcosis (CE) by a portable ultrasound scanner (US) and chest microfilm. Sera samples of 483 (76.7%) children were tested for anti-E. granulosus antibodies by ELISA and indirect hemagglutination (IHA) tests. Hepatic CE were detected in two cases (0.3%) by US, while 43 (8.9%) and 49 (10.1%) cases were found to be positive for CE by ELISA and IHA, respectively. The high seropositivity levels could have been attributed to extra-abdominal or abortive Echinococcus infections, but probably most of them were false-positives. Due to the discrepancy in results, US should be selected as the primary test in field studies and serologic tests should be performed in all cases with suspected lesions. We could not find any reported community based study on CE in Turkey, in which US was applied; but our results suggest that extensive epidemiological studies are required.
Adolescent↗
Retinal tumor induction by ocular inoculation of human adneovirus in 3-day-old rats.
A direct causal relationship between a human DNA virus, adeno serotype 12, and malignant transformation in target cells (sensory retinal neuronal precursors) was suggested by the development of a remarkably uniform retinoblastoma-like neoplasm in rats. In order to focus upon incipient photoreceptor differentiation, 27 3-day-old CD rats were selected for intraocular virus inoculation. A single injection of 0.03 ml of the virus fluid, 104.5 TCID50 HeLa cells/0.1 ml was given in the left eye. Within 73 to 167 days after the virus inoculation, 12 rats (44.4%) developed retinal tumors in the left eye. Although retinal tumors mimicking human retinoblastoma with true rosettes were anticipated, the highly uniform histopathologic appearance of all 12 eyes was virtually indistinguishable from that of 0-day-old rats. However, multiple foci of malignant cells fusing with the inner segment of relatively well-differentiated retinal layers were found haphazardly throughout the cases; such retinal remnants were not detectable in tumors of 0-day-old rats. Electron microscopy revealed poorly differentiated tumor cells that possessed a single cilium consisting of a typical ring of nine doublets with no axial pair (a 9 plus 0 pattern). Advenovirus-specific T-antigens detected in vivo by the immunofluorescein microscopic procedure in abortively infected or transformed cells clearly indicated that some neuronal precursors destined for part of the ganglioneuronic layer are selectively susceptible to viral oncogenesis. No preferential involvement of the photoreceptor cells was observed. No control animals developed retinal neoplasms.
Adenoviridae↗
Progesterone in diagnosis of ectopic pregnancy.
Previous reports suggest that serum progesterone value may be useful in the diagnosis of ectopic pregnancy. These studies have based discriminatory thresholds on a limited number of patients without using statistical correction for biologic variability in an infinitely large population. This study was designed to determine the ability of a single progesterone value to discriminate between normal, ectopic and blighted pregnancies. Sera were obtained from all positive beta HCG tests at Shands Hospital, University of Florida. All samples were assayed simultaneously with a solid phase RIA for progesterone and the results compared with pregnancy outcome. The mean progesterone for normal pregnancies was 32.8 +/- 4.25 ng/ml (n = 49), for ectopic pregnancies 7.8 +/- 0.79 ng/ml (n = 51), and pregnancies which spontaneously aborted 8.1 +/- 0.91 ng/ml (n = 74). Using individual prediction limits progesterone greater than 24 ng/ml would exclude an ectopic pregnancy in 99% of patients. Thus, this test may be useful in selected patients when the diagnosis is unsure after beta HCG and transvaginal ultrasound have been performed.
Abortion, Spontaneous↗
Tumor cell-selective cytotoxicity by targeting cell cycle checkpoints.
Cell cycle checkpoints act to protect cells from external stresses and internal errors that would compromise the integrity of the cell. Checkpoints are often defective in cancer cells. Drugs that target checkpoint mechanisms should therefore be selective for tumor cells that are defective for the drug-sensitive checkpoint. Histone deacetylase inhibitors typify this class of agents. They trigger a G2-phase checkpoint response in normal cells but are cytotoxic in tumor cells in which this checkpoint is defective. In this study, we investigated the molecular basis of the tumor-selective cytotoxicity of these drugs and demonstrated that it is due to the disruption of two cell cycle checkpoints. The first is the histone deacetylase inhibitor-sensitive G2-phase checkpoint, which is defective in drug-sensitive cells and permits cells to enter an aberrant mitosis. The second is the drug-dependent bypass of the mitotic spindle checkpoint that normally detects aberrant mitosis and blocks mitotic exit until the defect is rectified. The disruption of both checkpoints results in the premature exit of cells from an abortive mitosis followed by apoptosis. This study of histone deacetylase inhibitors demonstrates that drugs targeting cell cycle checkpoints can provide the selectivity and cytotoxicity desired in effective chemotherapeutic agents.
Antineoplastic Agents↗
Identification and characterization of leukotriene D4 receptors in adult and fetal human lung.
Leukotriene D4 (LTD4) receptors were identified and characterized in adult and fetal human lung membranes. Macroscopically normal adult lung tissue was selected from seventeen surgical biopsy specimens, and twenty-seven fetal lung samples were obtained from therapeutic abortions. Binding assays were performed using pooled adult or fetal human lung membranes at 30 degrees under conditions which prevented metabolism of [3H]LTD4. Specific binding reached equilibrium within 30 min, remained constant for 60 min, was enhanced by Mg2+, and was inhibited by Na+ and guanyl-5'-yl-imidodiphosphate. Computer-assisted analyses of saturation binding data showed a single class of binding sites with similar apparent Kd (0.15 +/- 0.09 and 0.12 +/- 0.003 nM) and Bmax (68 +/- 29 and 62 +/- 14 fmoles/mg protein) values for adult and fetal samples respectively. Competition binding studies with [3H]LTD4 showed the same rank order potency for adult and fetal lung receptors (5S, 6R-LTD4 greater than 5S, 6R-LTD1 greater than 5R, 6S-LTD4 greater than 5S,6R-LTE4 greater than FPL 55712). A comparison of the receptor binding affinities of these compounds with their smooth muscle contractile agonist (pD2) and antagonist (-log[KB]) activities in guinea pig lung and trachea showed a good correlation (r = 0.88), suggesting that the saturable, high-affinity, stereoselective [3H]LTD4 specific binding sites identified in human lung may be physiologically relevant receptor moieties.
Adult↗
Upper face morphology of second-trimester fetuses.
The characteristics of the ear auricle and the palpebral fissures are prominent aspects of upper face morphology in second-trimester human fetuses. We report on the ear auricle morphology of 106 normal second-trimester abortuses and on the palpebral fissure characteristics of 88 similar abortuses. All the aborted fetuses had detailed autopsy to define normality of external and internal morphology. Our data will permit selection of criteria for defining upper face dysmorphism in second-trimester formalin-preserved human fetuses. Recognition of such dysmorphism at autopsies could provide useful insight into abnormal human development in response to various genetic and environmental factors.
Ear↗
Preimplantation genetic diagnosis and human implantation--a review.
By selecting chromosomally normal embryos for replacement, PGD for aneuploidy can (i) increase implantation rates, (ii) reduce spontaneous abortion rates, and (iii) avoid aneuploid conceptions. When eight chromosomes are analysed, a significant increase in implantation is achieved. PGD is also found to significantly reduce the incidence of spontaneous abortion and chromosomally abnormal conceptions. PGD for patients of advanced maternal age with an adequate number of embryos will improve their chances of childbirth via improved implantation and sustained gestation. PGD has also been used to help other specific groups of patients with high rates of chromosome abnormalities such as patients with recurrent spontaneous abortions, non-obstructive azoospermia, repeated IVF failure, and patients previous trisomic offspring. Recently, PGD has been performed using comparative genome hybridization, which counts all chromosomes; but time constraints require embryo cryopreservation, which reduces the potential of improved implantation
Adult↗
Traditional management of invasive cervical cancer.
Cervical carcinoma is staged clinically by examination and simple radiological procedures. CT and MRI can, however, be used to guide management. Prognosis is best made by tumor size. depth of invasion, parametrial involvement, nodal status, LVSI, and histology. CIN III and CIS can be treated by ablative or excisional procedures. Hysterectomy should not be the primary treatment. Microinvasive (<3 mm) Stage IA cervical carcinoma can be treated conservatively with conization in patients who desire fertility, but the standard of care remains simple hysterectomy. Stages IB and IIA can be treated with either radical hysterectomy or radiation therapy dependent upon the patient's health and preference. Risk factors after radical hysterectomy (eg, bulky tumors, deep invasion, involved nodes or margins. LVSI) might warrant adjuvant radiation therapy. Chemoirradiation is the current standard of care for treatment for Stages IIB, III, and [VA. Some clinicians also use this modality in patients with Stage IB disease who are undergoing radiation as the primary treatment. Locally recurrent disease can be treated with either radiation (after radical hysterectomy) or pelvic exeteration (after primary radiation therapy). Exenteration in appropriately selected patients yields 5-year survival rates up to 82% with low complication rates. Many exenterations are aborted intraoperatively because of distant or unresectable disease, however. The incidence of glandular carcinoma of the cervix is rising, particularly in younger women. Cervical carcinoma detected during pregnancy requires the combined efforts of the gynecologic oncologist and the maternal-fetal medical specialist to determine the timing and method of treatment.
Carcinoma in Situ↗
Endogenous adenosine protects preconditioned heart during early minutes of reperfusion by activating Akt.
Ischemic preconditioning (IPC) is thought to protect by activating survival kinases during reperfusion. We tested whether binding of adenosine receptors is also required during reperfusion and, if so, how long these receptors must be populated. Isolated rabbit hearts were subjected to 30 min of regional ischemia and 2 h of reperfusion. IPC reduced infarct size from 32.1 +/- 4.6% of the risk zone in control hearts to 7.3 +/- 3.6%. IPC protection was blocked by a 20-min pulse of the nonselective adenosine receptor blocker 8-(p-sulfophenyl)-theophylline when started either 5 min before or 10 min after the onset of reperfusion but not when started after 30 min of reperfusion. Protection was also blocked by either 8-cyclopentyl-1,3-dipropylxanthine, an adenosine A1-selective receptor antagonist, or MRS1754, an A2B-selective antagonist, but not by 8-(3-chlorostyryl)caffeine, an A2A-selective antagonist. Blockade of phosphatidylinositol 3-OH kinase (PI3K) with a 20-min pulse of wortmannin also aborted protection when started either 5 min before or 10 or 30 min after the onset of reperfusion but failed when started after 60 min of reflow. U-0126, an antagonist of MEK1/2 and therefore of ERK1/2, blocked protection when started 5 min before reperfusion but not when started after only 10 min of reperfusion. These studies reveal that A1 and/or A2B receptors initiate the protective signal transduction cascade during reperfusion. Although PI3K activity must continue long into the reperfusion phase, adenosine receptor occupancy is no longer needed by 30 min of reperfusion, and ERK activity is only required in the first few minutes of reperfusion.
Acetamides↗
Social impacts of technological diffusion: prenatal diagnosis and induced abortion in Brazil.
Scientific and technological development plays an essential part in shaping contemporary societies, and medicine and health care are considered to be particularly receptive to the incorporation of new concepts, techniques and products, producing impacts not only on the health problems for which they were originally intended, but also varied 'side-effects', less frequently recognised and studied. In this study the point of departure was the hypothesis that the intensive diffusion in Brazil of prenatal ultrasound would create new problems for individuals (pregnant women, their families and health professionals) and society in coping with foetal malformations, due to the existence of a very restrictive induced abortion legislation. The objective of the research was to study the social visibility of these problems, in the written mass media. The period under analysis went from 1991 to 1996. The four most important daily newspapers and two medical council journals were studied, with a criteria oriented selection of articles, and their macrotextual thematic analysis. The results indicate that the basic elements in the relationships between medical technology, prenatal diagnosis, foetal malformations and induced abortions stayed the same along the period - a restrictive Penal Code, the public recognition of the disseminated and usually tolerated practice of induced abortion, done in risky conditions for the majority of women, with very evident consequences on maternal health, a divided Congress, a divided 'public opinion', religious opposition and new scientific and technological practices in health care. Nevertheless, tension between these 'contradictory' factors increases, so much so, that new elements are introduced which make an accommodation possible, without implying in major changes of position. This is achieved through the development of new alliances between Science, the judiciary and obstetrical leaders, which benefit individual initiatives, instead of leading to a public recognition of the problem and changes in the law.
Abortion, Legal↗
Screening for cervical Chlamydia trachomatis infections in two Dutch populations.
Endocervical cultures for Chlamydia trachomatis and Neisseria gonorrhoeae were taken from 492 women attending an outpatient clinic for sexually transmitted diseases (group I) and 560 women seeking legal abortion (group II). Possible risk factors for C trachomatis infection were evaluated by multivariate analysis. The prevalence rates for C trachomatis and N gonorrhoeae were 7.3% and 2.5% in group I and 9.4% and 0.4% in group II. From multivariate analysis it was found that age (p less than 0.01), number of sexual partners (p less than 0.01), abnormal vaginal discharge (p less than 0.01), and endocervical mucopus (p = 0.02) were independently associated with chlamydial infection in group I. In the abortion clinic age (p = 0.03) and endocervical mucopus (p = 0.03) were the only significant independent predictors of C trachomatis. In all women vaginal discharge was collected for Gram staining. A significant higher number of polymorphonuclear cells was seen in the smears of C trachomatis positive women (group I: p = 0.04; group II: p = 0.03). In group II there was also a significant association between C trachomatis and Gardnerella type bacterial flora (p = 0.02) and the presence of comma-shaped rods (p = 0.04). Screening for C trachomatis infection may help to decrease the incidence of (post-abortal) pelvic inflammatory disease. Because screening in abortion clinics is not always possible, decreasing the incidence of postabortal pelvic inflammatory disease could be achieved by using prophylactic antibiotics. Selective use of prophylaxis in high risk patients can minimise costs and the incidence of side effects.
Adult↗
[Immunotherapy of primary habitual abortion].
OBJECTIVE: To investigate whether different number of times of immunization and different immunogens have any effect on the outcome of pregnancy in patients with history of primary habitual abortion. METHODS: 38 cases of pregnant women with history of primary habitual abortion immunized with lymphocytes were analysed retrospectively. RESULTS: The results showed that the successful pregnancy rate was 87.5% (14/16) in the women immunized two times and was 86.4% (19/22) in the women immunized four times. There was no significant difference between the two groups. The successful pregnancy rate was 84.2% (16/19) in women immunized with their husbands' lymphocytes and 89.5% (17/19) in women immunized with donors' lymphocytes. There was also no significant difference between the two groups. CONCLUSIONS: In order to prevent hematogenous infection, active immunization could be reduced from four to two times and the immunogens may be selected from the husband or from healthy donor.
Abortion, Habitual↗
[Perinatal risk factors for infection in the newborn. Multicenter clinico-epidemiologic investigation].
UNLABELLED: The neonate, in particular if preterm, has a specific immunological system that makes him/her more susceptible to infections which are still a major cause of mortality and morbidity. The early onset infective patterns are often vertically transmitted from the mother to the fetus in the perinatal period. Some mother conditions like genitourinary infections, pre-delivery fever, PROM, pPROM, preterm delivery, abortions, fetal demise are important neonatal risk factors. The role of these factors as causes of early onset neonatal infections was evaluated by an Italian multicentric epidemiologic investigation supported by the MIUR. Mothers admitted to obstetrician hospitals for parturition were studied in a case control retrospective analysis. Mothers presenting with the selected risk factors were the cohort of cases while the admissions without risk factors next to each case represented the controls. The following risk factors were considered for analysis: 2nd trimester abortion, PROM, pPROM, preterm delivery and fetal demise. Eight hospitals entered the multicentric research and 29610 patients have been analyzed: 2466 PROM, 478 pPROM, 946 preterm delivery, 244 abortions, 133 fetal demise. Every woman received a microbiological screening by cervico-vaginal and rectal swab and/or urine culture. As much as 3892 cases from the University Hospitals of Parma and Torino concern, the cervicovaginal swab was positive in 76.5% pPROM, in 50.6% PROM and 50.5% preterm deliveries. The positivity of the swabs showed statistical relevance in cases compared to controls. In cases presenting with abortion the frequency of positive cultures (44.1%) was higher than the controls, but it did not reach statistical relevance. Conversely, positivity of cultures was lower in cases with fetal demise than control group but without statistical difference. In the cohort of 675 women selected from our Institute (University of Parma) the overall rate of positivity of cervico-vaginal swabs was about 44% and only one germ was isolated in 94.6% cases: 49,8% Gram positive and negative, 14.1% Streptococcus hemolyticus B group, 34.7% Candida. The rate of cultural tests performed before delivery was statistically higher in cases than controls (74.3% vs 23.2%, p < 0.001). Furthermore 14.3% newborns from mothers in the case group and 2.3% newborns from mothers in the control group were admitted to the neonatal care unit. Among them 8.4% and 1.2% respectively needed antibiotics while 0.4% and 0.2% respectively presented with early onset infection. Ear swabs were performed in 48,8% of infants born to mothers from the case group and in 26.9% of infants born to mothers from the control group, in 6.5% and in 2.9% respectively were the skin swabs performed as well. No statistical difference was met. The choice to perform cultural examinations was statistically higher in cases than controls, but the positivity rate was similar in both groups, perhaps because of a more specific choice in the control group. CONCLUSION: our data confirm the relationship between infections and preterm delivery, PROM, pPROM and support the hypothesis that infections might be the cause of these conditions and not simply an association. A prompt maternal microbiological control during pregnancy and delivery, especially in women presenting with known risk factors, gives the possibility to do early diagnostic-therapeutic interventions and to minimize the frequency and severity of early sepsis in newborns.
Adult↗
[Emergency cerclage. Definition, technical procedure and prognosis (author's transl)].
Report on 27 cases on emergency cerclage. Six infants survived. Among these were four with birth weights over 2500 grams. The high abortion rate of 59% and the high perinatal mortality of the live born infants (5 of 11) make it imperative to be highly selective in this procedure. In emergency cerclage during labor or maternal pyrexia is contraindicated. Local and systemic antibiotic profolaxsis is recommended. Proposals for the definition technique and post-operative care in cases of emergency cerclage are discussed.
Abortion, Spontaneous↗