Contribution of cervical smooth muscle activity to the duration of latent and active phases of labour.

OBJECTIVE: To identify the effect of cervical muscle activity as an additional factor influencing the duration of the latent and active phase of labour. DESIGN: Prospective observational study. SETTING: The Ljubljana Maternity Hospital. PARTICIPANTS: Fifty healthy nulliparous women requiring induction of labour having relatively unripe cervices. METHODS: At the onset of labour an open-ended catheter was inserted to measure intrauterine pressure during the latent and active phase of labour. Electromyographic activity of the cervix was registered by two bipolar spiral needle electrodes placed in the transverse direction on the proximal part of the cervix in the vagina. The mean intensity of distinctive peaks in an electromyographic spectrogram were calculated in the time/frequency domain. Multiple linear regression was used to find factors affecting the duration of the latent and active phase of labour. MAIN OUTCOME MEASURES: Duration of the latent and active phase of labour. RESULTS: Eleven independent variables explained 64% of the variance of the latent phase duration, the most important being the effacement and consistency of the cervix, and intensity of electromyographic signals. For the duration of the active phase the same variables explained 36% of the variance; the most important variables were mean duration of uterine contractions, mean maximum intensity of uterine contractions and the newborn's head circumference. CONCLUSIONS: The cervical smooth muscle activity, expressed as an electromyographic signal, contributes to the duration of the latent phase but not to the duration of the active phase. However, frequent cervical contractions are not associated with a longer latent phase.

Conservation of glp-1 regulation and function in nematodes.

The Caenorhabditis elegans (Ce) glp-1 gene encodes a Notch-like receptor. We have cloned glp-1 from C. briggsae (Cb) and C. remanei (Cr), two Caenorhabditis species that have diverged from C. elegans by roughly 20-40 million years. By sequence analysis, we find that the Cb-GLP-1 and Cr-GLP-1 proteins have retained the same motif architecture as Ce-GLP-1, including number of domains. In addition, two regions (CC-linker and regions flanking the ANK repeats) are as highly conserved as regions previously recognized as essential for signaling (e.g., ANK repeats). Phylogenetic analysis of glp-1 sequences suggests a C. briggsae/C. remanei clade with C. elegans as a sister taxon. Using RNAi to test biological functions, we find that Ce-glp-1, Cb-glp-1, and Cr-glp-1 are all required for proliferation of germline stem cells and for specifying blastomere fates in the embryo. In addition, certain biological roles of Cb-glp-1, e.g., in the vulva, have diverged from those of Ce-glp-1 and Cr-glp-1, suggesting a change in either regulation or function of the Cb-glp-1 gene during evolution. Finally, the regulation of glp-1 mRNA, previously analyzed for Ce-glp-1, is conserved in Cb-glp-1, and we identify conserved 3' UTR sequences that may serve as regulatory elements.

"Hello, I need your help!"--the Lifeline community alarm system for home care.

In many countries, homes for the elderly are filled to capacity. New technologies and technical solutions are available, which support endeavours to care for vulnerable people in a community. Home care enables those people to stay in their homes as long as possible. So-called "safety alarm systems"--special technical aids based on a telephone unit enable immediate contact between a caller and a caregiver. The systems are designed to enable people to call for help even if they cannot reach the telephone. The calls are directed to a community control centre, which is a headquarters for home-based care in a community. It is staffed for 24-hours a day accepting calls and arranging or providing adequate help. The Lifeline system is described which enables an increased independence to the system users and provides them with security and reassurance. The system is adaptive to suit requirements of smaller or larger communities.

Active contractions of the cervix in the latent phase of labour.

OBJECTIVE: To study the activity of the human uterine cervix at the onset of labour and further characterise cervical asynchronous electromyographic (EMG) activity in the latent phase. DESIGN: Prospective observational study. SETTING AND PARTICIPANTS: Clinical hospital in Ljubljana. PARTICIPANTS: Forty-seven healthy nulliparous women with relatively unripe cervices requiring induction of labour. METHODS: Simultaneous registration of a cervical EMG and of the intrauterine pressure at the very early stage of labour; subsequent EMG signal processing to determine its time, amplitude and frequency parameters. MAIN OUTCOME MEASURES: Simultaneous comparison of the cervical EMG and the mechanical activity of the uterine corpus to deduce electrical properties of the cervical smooth muscle tissue and its activity. RESULTS: EMG bursts, asynchronous with the contractions of the uterine corpus, were registered in 20 out of 47 women. In 14 women bursts appeared independent of uterine corpus contractions and in six they followed the peak of contractions. The bursts had low average median frequency (0.3 Hz). In seven women bursts were superimposed onto a background EMG (median frequency = 1.2 Hz). CONCLUSIONS: Bursts in the cervical EMG may appear asynchronously with the uterine contractions. Bursts not related to contractions suggest active and independent cervical muscle activity. The bursts which follow contractions may be an active response of the cervical musculature to passive stretching during a contraction. The EMG frequency content suggests two different contraction mechanisms or a different origin of the EMG in the cervix.

The community social alarm service as a primary health care service.

The history of calls to the community social alarm centre in Ljubljana and the service subscribers' records were analysed with the aim of finding out how the service helps in emergencies when calls related to health problems are received. The network, being a pilot project in Slovenia, was established in 1992 primarily to offer social services to elderly and disabled people living in their own home environments. The article highlights the role of the network in solving the medical problems of the users of the system. Among the 18,500 calls received in four years at the centre, 395 (2.1%) of them were health-related. An additional 24 emergency calls (0.2%) were received from non-subscribers to the centre using an "ordinary" telephone. Although the absolute number of health-related calls is low, the network plays an important role in preventive primary health care aimed at the observed population groups. The network meets most of the specific technical and organisational requirements for a community health care emergency call system. From a telematic point of view it is important that a telematic device--an emergency call unit--has entered an elderly or disabled person's home and been well accepted.

Could the community social alarm system serve also as a primary health care service?

The history of calls to the first community social alarm centre in Ljubljana and the service subscribers records were analysed with the aim of finding out how the service helps in emergencies when calls related to health problems are received. The network, being a pilot project in Slovenia, was established in 1992 primarily to offer social services to elderly and disabled people living in their own home environments. The article highlights the role of the network in solving the medical problems of the users of the system. Among the 18,500 calls received in four years at the centre, 395 (2.1%) of them were health-related. An additional 24 emergency calls (0.2%) of them were received from non-subscribers to the centre using an "ordinary" telephone. Although the absolute number of health-related calls is low, the network plays an important role in preventive primary health care aimed at the observed population groups. The network meets most of the specific technical and organisational requirements for a community health care emergency call system. The described system suitability and low percentage of calls related to health problems suggest that there is no need for two parallel call systems: one to cover social and the other one to fulfil emergency calls for medical help to elderly and disabled at their homes. From a telematic point of view it is important that a telematic device--an emergency call unit--has entered an elderly or disabled person's home and been accepted. The unit could be a basic communication device for different telemedical applications.

Activity of smooth muscles in human cervix and uterus.

OBJECTIVE: To find the similarities and dissimilarities between the activity of the human smooth muscles in the cervix and in the uterine corpus at the onset of induced labour. STUDY DESIGN: Electromyographic activity was measured in 14 primiparous women after amniotomy. The data were sampled and stored digitally in real time. For statistical analysis, the first 20 min of recordings following amniotomy were analyzed. The ratio between the mean activity at a given time and the mean activity over the whole 20 min was used for the comparison between the cervical and uterine activity. RESULTS: The analysis of correlation showed that the electromyographic activity in the cervix differed from that in the uterine corpus in the majority of the enrolled cases. CONCLUSIONS: The muscular activity in the cervix is independent of that in the uterine corpus at the onset of induced labour.

Genes required for GLP-1 asymmetry in the early Caenorhabditis elegans embryo.

The translation of maternal glp-1 mRNA is regulated both temporally and spatially in the early Caenorhabditis elegans embryo (T. C. Evans, S. L. Crittenden, V. Kodoyianni, and J. Kimble, Cell 77, 183-194, 1994). To investigate the control of embryonic glp-1 expression, we have examined the distribution of GLP-1 protein in selected maternal effect mutants that affect pattern or fate in the early embryo. We find that mutants that disrupt anterior-posterior asymmetry in the early embryo (par-1-par-6, emb-8, Par(q537)) disrupt the spatial but not temporal control of GLP-1 expression: GLP-1 is observed at the normal stage of embryogenesis in par-like mutants; however, it is uniformly distributed. In contrast, mutants that alter blastomere identity (skn-1, pie-1, mex-1, apx-1) do not affect the normal GLP-1 pattern. We conclude that genes controlling the asymmetry of cellular components, including P granules, also control GLP-1 asymmetry in the early embryo. The finding that mutants that disrupt anterior-posterior asymmetry translate GLP-1 in all blastomeres suggests that loss of embryonic asymmetry causes translational activation of GLP-1 in the posterior.

Community social alarm network in Slovenia.

The article deals with a case report on the technology transfer of the Lifeline community social alarm system to Slovenia. The main reason the project was initiated is the ageing of the Slovenian population (11% of the population is 65 or over). With this system we intend to support the public's wish to allow the elderly to remain in their own homes for as long as possible instead of placing them in institutional care. Between 1992 and 1995 the following results were achieved: the acceptability of the system in the social environment was increased; a pilot control centre in Ljubljana was established and has been operational for two-and-a-half years; a national dissemination plan was prepared; the integration of the programme into other information systems has been started. One of the main conclusions is that for the successful transfer of a technology which also affects social values in society, a social innovation must support the process.

Caring network based on community social alarm centers in Slovenia: a country in transition.

Elderly, disabled, and sick people should be assisted to remain living in their own homes for as long as possible--this is a generally accepted philosophy of modern societies. A caring network based on community social alarms can significantly improve home-based care coordination, its efficiency, and quality. According to long-term experiences in some developed European countries, this has multifold positive influences on the society. Promising results have encouraged the implementation of such a system in Slovenia--a young mid-european country in transition, where restrictive governmental economic policy also influences social and medical standards that were agreed to under the former socialistic government. In Ljubljana--the capital of Slovenia with 250,000 inhabitants--the first community social alarm center was established in 1992. Based on two years of experience, a national plan for several regional centers, covering the whole country, was prepared. The government should provide a telecommunication infrastructure, but the local authorities and formal service providers should establish local conditions for its implementation. The project has been seeking to obtain its legitimacy as a governmental project.

New Ecdysteroids from Serratula tinctoria.

Six new ecdysteroids have been isolated from SERRATULA TINCTORIA; these are: the 2,22- and 3,22-diacetates of 20-hydroxyecdysone, 5beta-hydroxyrubrosterone, 3-epi-poststerone, 3-epi-rubrosterone, and 22-oxo-20-hydroxyecdysone. These minor compounds were found together with the known ecdysteroids, 20-hydroxyecdysone, its 2-, 3-, and 22-monoacetates, rubrosterone, poststerone, polypodine B (5beta,20-dihydroxyecdysone), pterosterone (25-deoxy-20,24-dihydroxyecdysone), and makisterone C (24-ethyl-20-hydroxyecdysone). All these ecdysteroids were isolated by a combination of several chromatographic techniques (liquid chromatography on alumina, DCCC, and HPLC), then identified using standard mass spectrometric and 2D (1)H-NMR techniques.

Effect of spasmoanalgetic Dolantin on the electromyographic activity of the cervix during labour.

The influence of spasmoanalgetic Dolantin on electrical activity of the smooth musculature of the cervix during labour was studied in 50 primiparous women after induction of labour. The highest electrical activity was measured at the time of uterine contraction (AC) and between contractions (BC). The basic pattern of Dolantin-produced changes in muscular contractions in the cervix observed via EMG activity is that of the EMG activity diminishing with contractions of the uterine corpus and even more so in the period between contractions. Dolantin administered during the latent phase of induced labour did not accelerate cervical dilatation either in the latent or in the active phase of amniotomy- and Oxytocin-induced labour.

Changes in electromyographic activity of the cervix after stimulation of labour with oxytocin.

The electrical activity of the cervix can be measured during labour. The influence of oxytocin on electromyographic (EMG) activity of the cervical musculature was studied in 80 primiparous women after induction of labor. The highest electrical activity registered at the time of uterine contraction and between two contractions was used for analysis. The basic pattern of oxytocin-produced changes in muscular contractions in the cervix observed via EMG activity is that of the activity increasing with contractions of the uterine corpus and diminishing between contractions. The effect of oxytocin on cervical musculature is different in ripe and unripe cervices.

Longitudinally and circularly measured EMG activity in the human uterine cervix during labour.

The role of the smooth cervical muscle has not yet been sufficiently explored. For that reason cervical EMG was measured during induced labour of several primiparas and multiparas. Three spiral electrodes were placed on the cervix in order to measure the EMG in the longitudinal and circular direction referred to the cervical axis. A quantitative analysis of changes in the amplitude and frequency of the EMG signals was performed by means of the spectral method. It was found that the EMG measured from the two leads differed in unripe cervices in the latent phase of labour. The differences are illustrated by two cases. Some possible explanations for the different activity are discussed.

Electromyographic observations on the human cervix during labor.

The activity of smooth muscles in the cervix is one of the relevant factors for its dilatation during labor, but in humans it has not yet been sufficiently studied. Muscular activity may be observed by measuring electromyographic phenomena. In 60 parturient women of different parity and with various degrees of cervical ripeness at the onset of labor, the cervical electromyographic activity was measured through the entire course of labor in synchronization with uterine pressure measurements and also in 30 cases in synchronization with measurements of the uterine corpus electromyographic activity. The conditions necessary for successful measurements are described. The intensity of the cervical electromyographic activity was found to decrease with the level of cervical ripeness and with parity. When measured in the longitudinal direction, the cervical electromyographic activity resembled that of the uterine corpus, but when picked up from the circular lead, in a few cases of unripe cervices it differed from the electromyographic activity of the uterine corpus.