Preventing pregnancy with tubal ties.

PIP: This article describes the tubal ligation method of female sterilization. This method, which uses different endoscopes through which the tubes can be cauterized or occluded by the application of clips, is 100% effective, has no major complications, and is easily adaptable to the day surgery center. Electrocoagulation is not used, and the procedure can be performed with general or local anesthesia, through a minilaparotomy incision or a conventional laparoscope. Equipment preparation for this procedure includes the KLI instrumentation, laparoscopic instrument tray, minor tray, laparoscopic light power tank/carbon dioxide tank, and fallopian tube ligation rings. Care must be taken when placing the patient in the lithotomy position. Postoperatively, the patient will have minimal discomfort and no restrictions need to be placed on activity. Failure rates, which are minimal, are attributable to application of a single tube, incomplete tubal occlusion, or application of the mesosalpinx and tuboperitoneal fistula. This tubal ligation does not damage the fimbriae of the proximal portion of the tube, thus theoretically permitting easier reconstruction or reanastomosis of the tube.^ieng

The radioresponsiveness of normal and tumour microvasculature.

Mouse tails bearing DMH-II tumours were irradiated to a total of 80 Gy in 8 Gy fractions, twice a day for 5 consecutive days. The normal tail vasculature was minimally affected for up to 60 days post-irradiation. In contrast tumour capillaries which showed minor changes on day 6 post-irradiation were severely affected by day 14. DMH-II proved to be a radioresistant tumour. The radiation dose used in this experiment was the maximum total dose which could be tolerated by the mouse tail. The tumour began to regenerate at approximately 40 days post-irradiation. Tumour infiltrating into the surrounding normal tissue was observed by 60 days following irradiation. As the tumour regenerated, there was no accompanying regeneration of tumour capillaries. This study suggests that: a) tumour capillaries were more acutely radioresponsive than the normal microvasculature in the murine tail, and b) regenerating tumour did not elicit a neovascular response from the irradiated tumour bed.

MET17 and hydrogen sulfide formation in Saccharomyces cerevisiae.

Commercial isolates of Saccharomyces cerevisiae differ in the production of hydrogen sulfide (H(2)S) during fermentation, which has been attributed to variation in the ability to incorporate reduced sulfur into organic compounds. We transformed two commercial strains (UCD522 and UCD713) with a plasmid overexpressing the MET17 gene, which encodes the bifunctional O-acetylserine/O-acetylhomoserine sulfhydrylase (OAS/OAH SHLase), to test the hypothesis that the level of activity of this enzyme limits reduced sulfur incorporation, leading to H(2)S release. Overexpression of MET17 resulted in a 10- to 70-fold increase in OAS/OAH SHLase activity in UCD522 but had no impact on the level of H(2)S produced. In contrast, OAS/OAH SHLase activity was not as highly expressed in transformants of UCD713 (0.5- to 10-fold) but resulted in greatly reduced H(2)S formation. Overexpression of OAS/OAH SHLase activity was greater in UCD713 when grown under low-nitrogen conditions, but the impact on reduction of H(2)S was greater under high-nitrogen conditions. Thus, there was not a good correlation between the level of enzyme activity and H(2)S production. We measured cellular levels of cysteine to determine the impact of overexpression of OAS/OAH SHLase activity on sulfur incorporation. While Met17p activity was not correlated with increased cysteine production, conditions that led to elevated cytoplasmic levels of cysteine also reduced H(2)S formation. Our data do not support the simple hypothesis that variation in OAS/OAH SHLase activity is correlated with H(2)S production and release.

Specificity and sensitivity of methacholine challenge test in children with normal and hyperreactive airways.

To assess the ability of the methacholine challenge test for separation between normals and patients with clinically apparent mild airway hyperreactivity, the provocative dose of inhaled methacholine required to cause a 20% drop in the forced expiratory volume in one second was evaluated in two selected pediatric populations. On the basis of a standardized respiratory questionnaire, 70 subjects, 4-16 years of age were identified. Included were 49 normal individuals, and 21 individuals with mild airway hyperreactivity who responded to bronchodilators. Methacholine inhalation challenges were performed by use of a standard inhalation procedure. Forty-seven percent of the normals (23/49) had a positive methacholine challenge test while 24% (5/21) of the patients with hyperreactive airways had a negative test by the standard criteria. A wide spectrum of specificity and sensitivity of methacholine challenge was obtained at different doses of methacholine. The greater the sensitivity, the lower the specificity. Therefore, we postulate that the methacholine challenge test can be helpful in making the clinical diagnosis but it does not allow a clear and perfect separation between normal and clinically apparent mildly airway reactive patients in a pediatric age population.

Maternal - neonatal folate and vitamin B12 serum concentrations in Greeks and in Albanian immigrants.

BACKGROUND: Low folate and vitamin B(12) concentrations during pregnancy are implicated with neural tube defects (NTD) and neurological manifestations in the neonates. AIM: To compare serum concentrations of folate and vitamin B(12) in 1025 Greek mothers, 908 immigrant Albanian mothers at delivery and in the cord blood of their neonates. METHODS: A 30 days food diary was kept from each mother. Folate and vitamin B(12) sera concentrations were measured with Bayer ADVIA Centaur System. RESULTS: Energy, carbohydrates and total fat intake were significantly higher in Albanian mothers when compared with those of Greek origin. On the contrary, total protein, and especially animal protein intake were higher in the Greek mothers. Folate intake was similar between the two ethnic groups whereas vitamin B(12) intake in Albanians was evaluated lower (1.8 +/- 0.13 microg day(-1)) when compared with that of Greeks (2.8 +/- 0.12 microg day(-1); P < 0.001). Folate serum concentrations in mothers and newborns were similar (17.7 +/- 9.1 and 26.5 +/- 15.2 nm versus 18.1 +/- 8.6 and 24.6 +/- 14.7 nm, respectively P > 0.05) in the two ethnic groups. In contrast, vitamin B(12) serum concentration was significantly lower (135.0 +/- 19.6 pm) in the Albanian mothers compared with that of Greeks (164.5 +/- 17.7 pm, P < 0.0001). Consequently, the vitamin concentrations was found lower in the newborns of Albanian origin (133.6 +/- 11.8 pm) compared with that of Greek neonates (213.3 +/- 11.4 pm, P < 0.0001). CONCLUSIONS: (a) Folate serum concentrations in Greek and Albanian mothers and in their neonates were similar, (b) vitamin B(12) serum concentrations, evaluated for first time in these ethnic groups, were significantly low in Albanians, both in mothers and newborns, (c) the low protein and especially the reduced animal protein intake from the Albanian mothers, possibly due to their low socio-economic status, may be responsible for their decreased vitamin B(12) serum concentrations and (d) vitamin B(12) supplementation along with an increase of animal protein intake might improve the vitamin serum status in the Albanians.