Two mothers and a donor: exploration of children's family concepts in lesbian households.

BACKGROUND: Although children from lesbian families appear to make a distinction between a residential father and a donor, defining these two concepts seems to be a challenge. They need to appeal to more familiar concepts such as the hetero-normative concept of 'mother' to give a definition of the unfamiliar concepts they are confronted with. METHODS: The study is based on qualitative in-depth interviews with 6 children (9-10 years old) from lesbian families, all of which have been conceived using anonymous sperm donation. Semi-structured interviews were conducted. RESULTS: Two findings stand out. First, in defining the concepts of biological and non-biological mother, both mothers were described as equal parents. No difference was attached by the children to the mothers' position as a parent. Second, the concepts 'non-biological mother' and 'donor' were defined by looking at the hetero-normative concepts of 'mummy' and 'daddy'. To define the non-biological mother, both a 'mummy' and a 'daddy' were used as a reference. To define the donor concept, often references were made to a daddy. This comparison with a 'daddy' turned out to be complex due to the conflict between the role as a progenitor and the lack of a social relationship. The lack of language surrounding this concept turned out to be difficult. WIDER IMPLICATIONS OF THE FINDINGS: This study illustrates the complexity and ambiguity of children's experiences and perceptions when dealing with issues related to genetic and social parenthood.

Influence of coronary anatomy and reimplantation on the long-term outcome of the arterial switch.

BACKGROUND: Abnormal coronary artery anatomy is reported to have a significant influence on the outcome of the arterial switch operation. This study examines the impact of coronary anatomy and the occurrence of late coronary obstruction on left ventricular (LV) function and long-term outcome. METHODS: Coronary artery anatomy, of 170 patients after arterial switch operation (1977-1999), was determined based on operative reports and pre-operative aortograms. Current status was evaluated using ECGs, echocardiograms, scintigraphy, and post-operative coronary angiograms. RESULTS: In 133/170 patients, coronary artery anatomy consisted of an anterior descending (LAD) and circumflex artery (Cx) from the left sinus and the right coronary artery (RCA) from the right or posterior sinus. The left coronary had an intramural initial course in two of these patients. Fifteen patients had the LAD from the left and Cx and RCA from the right sinus; eight had LAD and RCA from one sinus and Cx from the other; four had single ostium; and three had three separate ostia. Four patients had complex patterns and four patients had a supra commissural coronary. To date, follow-up angiography was performed in 59 patients. Surgical coronary sequellae were found in five patients. Two patients had an occluded left ostium. Initially, they were asymptomatic but showed polymorphic ventricular extrasystoles on ECG and moderate LV dysfunction with large irreversible perfusion defects on scintigraphy. Both patients developed ventricular fibrillation at the age of 14 years. One patient did not survive. The other patient required implantation of a defibrillator. One patient has an occluded RCA, one patient has stenosis of the right ostium and one patient has multiple tortuous collaterals without obstruction of a major branch. In the latter three patients, coronary sequellae were not suspected on ECG, echo, or scintigraphy and were only found on follow-up angiography. Retrograde collateral flow was noted in all three occluded coronaries. LV dysfunction, with normal coronaries, was noted in three patients. All, of these patients, had peri-operative ischaemia suggesting failure of myocardial protection. Two are now asymptomatic with mild LV dysfunction. One patient continues to have severe myocardial dysfunction and secondary aortic insufficiency. A Ross-like procedure was performed placing the original aortic valve in the neo-aortic root. Coronary artery anatomy did not influence early survival or late coronary sequellae. CONCLUSION: Abnormal coronary anatomy was not a determinant of outcome in our study. Surgical coronary obstruction is independent of original anatomy. It can be almost silent and is potentially fatal. Follow-up angiography must be considered in all patients after the arterial switch operation.

2', 3'-cyclic nucleotide 3'-phosphodiesterase in cerebrospinal fluid.

The activity of the myelin-associated enzyme 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNP) was assayed in the cerebrospinal fluid (CSF) of 107 neurologic patients by a new and sensitive fluorometric method. The activity of CNP was about 20 nmol per hour per milligram protein or 12 nmol per hour per milliliter CSF. At these extremely low levels, the presence of even a small amount of blood (which has slightly greater activity) significantly elevated CNP values. Patients with radicular syndromes had slightly higher than average CNP activities, but there was no difference in enzyme activities of 47 patients with multiple sclerosis and the general neurologic population. CNP activity was not related to stage of demyelinating illness or intrathecal injection of steroid. CNP-like myelin basic protein may be released into the CSF after destruction of myelin, but our results suggest that the enzyme activity is lost in the process.

The activity of 2',3'-cyclic nucleotide 3'-phosphodiesterase in rat tissues.

The activity of the myelin-associated enzyme 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNP) was measured in 14 rat tissues and in subcellular fractions of rat liver by a sensitive fluorometric method, using cyclic NADP as substrate. CNP activity in brain (339 mumol/h/mg protein) was fourfold that of the sciatic nerve. The activities in tissues outside the nervous system ranged from a low of 0.42 mumol/h/mg protein in the unwashed red blood cell to a high of 9.96 in the spleen. The activity was highest in tissues containing cells with membranes capable of undergoing transformation and elaboration (spleen and thymus) and low in those in which the cell membranes are morphologically stable (muscle and red cell). The enzyme was found in all major liver subfractions, with the highest activities in the microsomal and nuclear fractions. Despite the large difference in the maximal velocities of CNP in brain and liver, the affinity of the liver enzyme for the substrate (km) was similar to that of brain enzyme. Brain CNP was stable over a 48-h postmortem period.

Regional distribution of catalase in the adult rat brain.

Catalase activity was measured in 11 areas of perfused adult rat brain. The hypothalamus and substantia nigra contained the highest activities. The corpus callosum, a white-matter structure, contained intermediate activity. The caudate-putamen and frontal cortex contained the lowest activities. Regional catalase bears some relationship to the reported distribution of microperoxisomes, but considerable activity is present in areas with few microperoxisomes. Catalase may function as one of the systems detoxifying H2O2 formed in CNS amine metabolism.

Regional distribution of glutathione reductase in the adult rat brain.

Glutathione reductase was measured in 10 selected areas of the adult rat brain. Activitives varied over a 2.5-fold range. The caudate-putamen and cortical areas contained the highest activities. Several gray matter structures contained intermediate activities. The substantia nigra and the corpus callosum, a white matter structure, contained the lowest activities. The caudate-putamen, a catecholamine rich area, may produce H2O2 via MAO and would require glutathione reductase to recycle glutathione oxidized by glutathione peroxidase. However, the distribution of glutathione reductase activity also suggests a role in reducing oxidants formed during tissue respiration.