A randomised, double-blinded, placebo-controlled study of acupressure wristbands for the prevention of nausea and vomiting during labour and delivery.

INTRODUCTION: Approximately 50% of women experience nausea or vomiting during labour. P6 acupoint stimulation reduces postoperative nausea and vomiting in early pregnancy and after chemotherapy. The aim of this randomised, double-blinded, placebo-controlled trial was to determine whether P6 acupressure prevented nausea and vomiting during labour and delivery. METHODS: After ethical approval and informed consent, women admitted for induction of labour, or in spontaneous labour, were randomised to receive either acupressure bands (Pressure Right) (Group A) or sham placebo bands (Group P) applied to each wrist. Exclusions included recent nausea or vomiting. RESULTS: We consented 365 women and randomised 340 (170 per group). The groups had similar patient and labour characteristics. The incidence of nausea and/or vomiting did not significantly differ (Group A 53% vs. Group P 50%, P=0.58). There was no significant difference between groups (A vs. P, respectively) in the incidence of nausea (52% vs. 45%), vomiting (27% vs. 28%), rescue antiemetic treatment (27% in both), severity of nausea or vomiting, satisfaction with control of nausea or ratings of inconvenience or discomfort from the bands (10% vs. 11%). Factors significantly associated with emetic symptoms were smoking (OR 2.16, 95% CI 1.07-4.37), opioid analgesia (OR 1.95, 95% CI 1.06-3.59), history of motion-induced or postoperative nausea and vomiting (OR 1.85, 95% CI 1.17-2.94) and higher body mass index (OR 1.07, 95% CI 1.01-1.12). CONCLUSION: In this study acupressure wristbands applied bilaterally did not reduce the incidence of nausea and vomiting during labour and delivery.

Systematic review: the chemoprevention of oesophageal adenocarcinoma.

The incidence of oesophageal adenocarcinoma is increasing in the UK faster than any other malignancy. Despite its relatively poor prognosis and the limited success of existing treatments, there is enthusiasm that chemopreventive agents might be able to stem the transition from normal squamous epithelium to adenocarcinoma. We discuss gastro-oesophageal reflux as the main risk factor for the development of Barrett's metaplasia, the only known precursor of oesophageal adenocarcinoma. Treatment options for reflux disease are considered with regard to their effects on cancer risk. Recent advances in the molecular and cell biology of Barrett's are outlined, and potential targets for chemoprevention examined. Available treatments for reflux disease have not convincingly altered the likelihood of cancer development. Epidemiological and animal studies support the use of non-steroidal anti-inflammatory drugs as potential chemopreventive agents. Dietary agents, however, have a more favourable side-effect profile and may prove to be an attractive alternative, although more work is needed to fully explore this prospect.

Absence of toxic effects in F344/N rats and B6C3F1 mice following subchronic administration of chromium picolinate monohydrate.

Chromium picolinate monohydrate (CPM) is a synthetic compound heavily marketed to consumers in the United States for use as a dietary supplement for muscle building and weight loss. The National Toxicology Program (NTP) tested the toxicity of this compound based on the potential for widespread consumer exposure and lack of information about its toxicity. Groups of 10 male and 10 female F344/N rats and B6C3F(1) mice were exposed to 0, 80, 240, 2000, 10,000, or 50,000 ppm CPM in feed for 13 weeks. CPM administration produced no effect on body weight gain or survival of rats or mice. Organ weights and organ/body weight ratios in exposed animals were generally unaffected by CPM. No compound-related changes in hematology and clinical chemistry parameters were observed. There were no histopathological lesions attributed to CPM in rats or mice.

High resolution emission spectra of TL materials.

High resolution emission spectra of several TL materials, that are commonly used in dosimetry, were measured using a low cost fibre optic spectrometer containing a 2048 pixel CCD array. The spectra were taken from 177 to 890 nm with a wavelength resolution of 1.3 nm. This allowed for line width discrimination and the resolution of transitions that have not been seen so far. For rare earth doped materials like CaF2:Tm (TLD-300) and CaF2:Dy (TLD-200) the spectral lines were compared to the energy levels measured by Dieke and Crosswhite leading to the identification of most of the transition lines.

Consumption of fish oil leads to prompt incorporation of eicosapentaenoic acid into colonic mucosa of patients prior to surgery for colorectal cancer, but has no detectable effect on epithelial cytokinetics.

Fish oil (FO) was previously reported to partially normalize colorectal crypt cell cytokinetics in patients with colorectal neoplasms. We determined the effect of FO on the fatty acid composition of colonic mucosa and mesenteric adipose tissue and on rectal crypt cell proliferation in patients undergoing surgery for colonic carcinoma. Patients (49-28 males; 21 females) were randomly assigned to consume FO capsules (2 g b.d.; FO group) containing 1.4 g eicosapentaenoic acid (EPA) and 1.0 g docosahexaenoic acid per day, or safflower oil capsules (2 g b.d.; placebo group) for an average of 12.3 +/- 0.5 d prior to surgery. Rectal biopsies were obtained at entry, at surgery, and 8-12 wk postsurgery. Colonic biopsies and samples of mesenteric adipose tissue were analyzed for fatty acids by gas-liquid chromatography. Mitosis was determined in whole crypt mounts. The proportion of EPA (g/100 g total fatty acids) in mucosal lipids was significantly greater in FO patients compared to the placebo group, but there was no effect on mesenteric adipose tissue. However self-reported use of FO supplements prior to surgery was associated with higher levels of EPA in adipose tissue. There was no significant effect of FO on the frequency or spatial distribution of crypt cell mitosis. EPA from marine oil supplements is rapidly incorporated into the colonic mucosal lipids of humans, but the levels achieved in the present study did not modify colorectal cytokinetics.

Synthesis and biological evaluation of a new class of vaccine adjuvants: aminoalkyl glucosaminide 4-phosphates (AGPs).

A novel series of acylated omega-aminoalkyl 2-amino-2-deoxy-4-phosphono-beta-D-glucopyranosides (aminoalkyl glucosaminide 4-phosphates) was synthesized and screened for immunostimulant activity. Several of these compounds enhance the production of tetanus toxoid-specific antibodies in mice and augment vaccine-induced cytotoxic T cells against EG.7-ova target cells.

"You worked on your own, making your own decisions and coping on your own": midwifery knowledge, practice and independence in the workplace in Britain, 1936 to the early 1950s.

Midwifery knowledge is a complex entity-comprising of training and experiential elements-not fixed but mutable, both informed and altered by practice. This study uses oral history accounts to explore how midwives viewed themselves and how they interacted with widwifery knowledge in an attempt to gain a greater understanding of their power and independence in the workplace and, as a result, of their professional status. Midwifery knowledge cannot simply be defined as the technical skills taught in training; it was also shaped by the environment in which practice took place and midwife's relationships with women and with doctors.

Deglycosylation of flavonoid and isoflavonoid glycosides by human small intestine and liver beta-glucosidase activity.

Flavonoid and isoflavonoid glycosides are common dietary phenolics which may be absorbed from the small intestine of humans. The ability of cell-free extracts from human small intestine and liver to deglycosylate various (iso)flavonoid glycosides was investigated. Quercetin 4'-glucoside, naringenin 7-glucoside, apigenin 7-glucoside, genistein 7-glucoside and daidzein 7-glucoside were rapidly deglycosylated by both tissue extracts, whereas quercetin 3,4'-diglucoside, quercetin 3-glucoside, kaempferol 3-glucoside, quercetin 3-rhamnoglucoside and naringenin 7-rhamnoglucoside remained unchanged. The Km for hydrolysis of quercetin 4'-glucoside and genistein 7-glucoside was approximately 32+/-12 and approximately 14+/-3 microM in both tissues respectively. The enzymatic activity of the cell-free extracts exhibits similar properties to the cytosolic broad-specificity -glucosidase previously described in mammals.

Induction of the anticarcinogenic marker enzyme, quinone reductase, in murine hepatoma cells in vitro by flavonoids.

Some flavonoids induce phase II enzymes both in vivo and in vitro. We have determined the structural requirements for this activity by examining the ability of naturally-occurring flavonoids to induce the phase II enzyme, quinone reductase (NAD(P)H:quinone oxidoreductase; EC 1.6.99.2), in murine Hepalclc7 cells. Hydroxylation of the B ring is not essential for induction, since galangin and kaempferol (with 0 and 1 hydroxyl in the B ring, respectively) are better inducers than quercetin (2 B ring hydroxyls). A 2,3 double bond in the C ring is essential for induction, since taxifolin, which has the same substitution pattern as quercetin but lacks the 2,3 double bond, is not an inducer. This is supported by catechin and epicatechin, which do not possess the 2,3 double bond and are also not inducers. A 3-hydroxyl group increases the activity but is not essential for induction, since apigenin is an inducer but kaempferol (which has the same structure as apigenin but possesses a 3-hydroxyl group) is more effective. The data show that, of the flavonoids, the flavonols are the most effective inducers of quinone reductase activity in Hepa1c1c7 cells (kaempferol approximately galangin > quercetin > myricetin approximately apigenin (a flavone)) and that flavanols and flavans are ineffective.

A preliminary study on the effect of germination on saponin content and composition of lentils and chick peas.

Two cultivars of chick peas (Cicer arietinum) and one cultivar of lentils (Lens culinaris) were subjected to germination in the dark for 6 days at 20 degrees C. Soyasaponin VI, also known as soyasaponin beta g, a DDMP- (2,3-dihydro-2,5-dihydroxy-6-methyl-4H-pyran-4-one-) conjugated form of soyasaponin I, was the only saponin detected in both the unprocessed and germinated seed. No significant changes in saponin content were observed for chick peas or lentils after a 6-day germination.

Molecular cloning and functional identification of a plant ornithine decarboxylase cDNA.

A cDNA for a plant ornithine decarboxylase (ODC), a key enzyme in putrescine and polyamine biosynthesis, has been isolated from root cultures of the solanaceous plant Datura stramonium. Reverse transcription-PCR employing degenerate oligonucleotide primers representing conserved motifs from other eukaryotic ODCs was used to isolate the cDNA. The longest open reading frame potentially encodes a peptide of 431 amino acids and exhibits similarity to other eukaryotic ODCs, prokaryotic and eukaryotic arginine decarboxylases (ADCs), prokaryotic meso-diaminopimelate decarboxylases and the product of the tabA gene of Pseudomonas syringae cv. tabaci. Residues involved at the active site of the mouse ODC are conserved in the plant enzyme. The plant ODC does not possess the C-terminal extension found in the mammalian enzyme, implicated in rapid turnover of the protein, suggesting that the plant ODC may have a longer half-life. Expression of the plant ODC in Escherichia coli and demonstration of ODC activity confirmed that the cDNA encodes an active ODC enzyme. This is the first description of the primary structure of a eukaryotic ODC isolated from an organism where the alternative ADC routine to putrescine is present.

Tropane alkaloid production in transformed root cultures of brugmansia Candida.

Transformed root cultures of BRUGMANSIA CANDIDA were established by infection with AGROBACTERIUM RHIZOGENES LBA 9402. Several clones with different growth index and tropane alkaloid pattern and content were obtained and two were examined in depth. The alkaloid content and pattern changed during the time course. At 21 days of culture clone 1 revealed an alkaloid spectrum dominated by 3alpha-acetoxytropane (about 50% of the total alkaloid) and hyoscyamine (about 25%), with a ratio of hyoscyamine to scopolamine of 11.2. In clone 40 this ratio was 1.5 and the content of 3alpha-acetoxytropane was low (2%). The maximum concentrations of hyoscyamine were obtained at 3 weeks of culture, and were 700 and 500 microg/g FW in clone 1 and 40, respectively.

Factors Affecting the Growth and Hyoscyamine Production during Batch Culture of Transformed Roots of Datura stramonium.

The growth and hyoscyamine production of transformed roots of DATURA STRAMONIUM (cell line DS 1) were investigated in batch culture experiments at three different temperatures and in media of varying total ion composition and sucrose level. Growth rate was not greatly affected by the level of Gamborg's B5 salts or the sucrose concentration. Growth rates of roots in a range of media were similar at 25 degrees C (doubling time T (d) 1.2-1.6 days) and at 30 degrees C (T (d) 1.2-1.7 days) but roots grew slower at 20 degrees C (T (d) 1.9-3.5 days). The total root yield on a fresh weight basis was higher in full strength B5 media compared with half strength B5 media at all sucrose levels tested. However, the dry weight content of the roots increased significantly (4-20%) as the sucrose level in the medium was raised (2-10%) at each of the three temperatures. At 20 degrees C, the hyoscyamine content of the roots was higher than that at 25 degrees C or 30 degrees C at all sucrose levels tested and was unaffected by increasing sucrose levels. However, increasing the level of sucrose (1-5%) in either half or full strength B5 media at 25 degrees C or 30 degrees C increased the hyoscyamine content of the roots by up to eight fold. At 20 degrees C, the total yield of hyoscyamine per flask or per unit of sucrose supplied was also higher than at 25 degrees C or 30 degrees C with sucrose levels up to 5%. The highest rates of hyoscyamine production by cell line DS 1 were obtained with full strength B5 medium with 5% sucrose at either 20 degrees C or 25 degrees C. Under these conditions, rates of hyoscyamine formation of up to 7.4 mg/l/d were observed under batch culture conditions. The amount of hyoscyamine released into the culture medium was much greater at 30 degrees C (up to 14% of the total) than at either 20 degrees C or 25 degrees C (up to 4% of the total).

The effects of endophyte-infected tall fescue consumption and use of a dopamine antagonist on intake, digestibility, body temperature, and blood constituents in sheep.

Two experiments were conducted with lambs that consumed endophyte-infected (Acremonium coenophialum) tall fescue diets under elevated temperature and humidity and supplemented with the dopamine antagonist metoclopramide (M). In Exp. 1, 12 ruminally cannulated wethers (average weight 49 kg) were allotted by weight to either an endophyte-free diet (E-) or endophyte-infected diet (E+; 1,170 ppb of ergovaline), or E+ supplemented with M (15 mg/kg of lamb BW; E+M). Ad libitum DM intake and digestibility were lower (P < .05) for E+ than for E- diet. Supplementation of E+ with M increased (P < .05) DM intake by 27.6% but did not change DM digestibility. Body temperature increased (P < .05) when lambs consumed E+ and was further increased when M was supplemented. For Exp. 2, 19 wether lambs (average weight 24 kg) were allotted to treatments to evaluate the effects of endophyte consumption (0 vs 2,430 ppb of ergovaline) and supplementation with M (0 vs 20 mg/kg BW). An interaction (P < .05) of main effects was measured for DM intake. Lambs that consumed E+M consumed more DM than did lambs fed only E+, but lambs offered the E- diet and supplemented with M did not increase DM consumption. Diet DM digestibility was not different among treatments. Skin vaporization decreased (P < .05) due to E+ consumption and M supplementation. The concentration of prolactin in plasma was decreased (P < .05) by consumption of E+ (8 vs 136 ng/mL) and did not increase due to M supplementation.(ABSTRACT TRUNCATED AT 250 WORDS)

Nonsteroidal antiinflammatory drugs for postthoracotomy pain. A prospective controlled trial after lateral thoracotomy.

Diclofenac (Voltarol) as an adjunct to papaveretum for pain relief was examined by a prospective, randomized trial in 44 patients who had lateral thoracotomies. Patients given diclofenac, 75 mg intramuscularly twice daily, required less papaveretum in the first 3 days after operation (p less than 0.005) and had lower pain scores on a visual analog scale on all 5 postoperative days (p = 0.02 to less than 0.001); their respiratory vital capacity on the first postoperative day was also significantly higher (p less than 0.02). Diclofenac is a useful adjunct in the management of postthoracotomy pain.

The formation of 3 alpha- and 3 beta-acetoxytropanes by Datura stramonium transformed root cultures involves two acetyl-CoA-dependent acyltransferases.

Tropine (tropan-3 alpha-ol) is an intermediate in the formation of hyoscyamine. An acyltransferase activity that can acetylate tropine using acetylcoenzyme A as cosubstrate has been found in transformed root cultures of Datura stramonium. A further acyltransferase activity that acetylates pseudotropine (tropan-3 beta-ol) with acetyl-coenzyme A is also present. These two activities can be partially resolved by anion-exchange chromatography, some fractions containing only the pseudotropine-utilizing activity. The basic properties of these two enzymes are reported and their roles in forming the observed alkaloid spectrum of D. stramonium roots discussed.

Strategies for the genetic manipulation of alkaloid-producing pathways in plants.

Increasingly, as a result of recent biochemical work, there exists a realistic possibility of taking a molecular genetic approach to the manipulation of alkaloid-producing pathways in plant tissue cultures. In the pathways forming indole alkaloids in CATHARANTHUS ROSEUS, tropane alkaloids in DATURA and HYOSCYAMUS species, and nicotine in NICOTIANA species, recent studies have identified a number of key enzymes and at least some of the factors that regulate their levels of activity. Such knowledge contributes the basis upon which it has become feasible to design a strategy by which the flux in these pathways may be enhanced at the genomic level. This review presents a summary of the state-of-the-art pertaining to these pathways and discusses the strategy to be adopted for a molecular approach to their manipulation, together with some of the pitfalls that may arise when trying to alter their natural regulation.