Successful pregnancies in the presence of spinal muscular atrophy: two case reports

We report two cases of successful pregnancy in women with chronic, infantile onset, or type II spinal muscular atrophy, both of whom delivered healthy, unaffected babies. The patients required concurrent management by a physiatrist, pulmonologist, and perinatologist throughout the pregnancy. Complications included recurrent urinary tract infections, dyspnea and worsening of pulmonary function, wheelchair seating and positioning problems, and musculoskeletal and low back pain. These problems resolved postpartum. One woman had vaginal delivery, the other had caesarean section, both of which were well-tolerated. Because of severe musculoskeletal deformity, pelvic assessment is necessary to determine the mode of delivery. The uterus has normal contractility and effective labor patterns can be established. Spinal/epidural anesthesia may be contraindicated because of spine deformity. The pregnancies had no deleterious effect on the progression of the disease in our patients, both of whom reported a positive experience with great personal fulfillment.     

Anti-inflammatory activity of myricetin-3-O-beta-D-glucuronide and related compounds

OBJECTIVE AND DESIGN: The anti-inflammatory effect of myricetinglucuronide (MGL) was investigated and structurally-related compounds were compared to examine the structure/activity-relationship in carrageenan-induced rat paw edema. MATERIALS AND SUBJECTS: In vitro studies were performed using rat basophilic leukemia (RBL-1) cells, human polymorphonuclear leukocytes (PMNL), COX-1 from ram seminal vesicle, COX-2 from sheep placenta and human venous blood. For the in vivo tests male Wistar rats were used, for the ex vivo test perfused rabbit ears. TREATMENT: 1-300 microg/kg MGL or myricetinmethylglucuronate and 0.1-5 mg/kg other related compounds administered p.o. (carrageenan edema). 5, 50 and 150 microg/kg MGL p.o. for 14 days (Freund's adjuvant arthritis), 5 and 50 microg/kg p.o. for 6 days (ulceration). METHODS: Anti-inflammatory effects were measured in carrageenan edema and in adjuvant arthritis. Incidence of gastric lesions was tested in an ulcerogenicity model in vivo. Influence on COX was determined in the perfused rabbit ear, in PMNL and in a test assay using COX-1 and COX-2. 5-LOX activity was studied using PMNL and RBL-1. The influence on platelet aggregation was evaluated measuring light transmission. RESULTS: MGL exerted a marked and dose-dependent anti-inflammatory effect in acute (carrageenan edema, ED50 15 microg/kg, indomethacin ED50 10 mg/kg) and chronic (adjuvant arthritis, inhibition at 150 microg/kg 18.1 % left paw, 20.6% right paw, indomethacin 3 mg/kg 18.0% and 19.4%)) models of inflammation. In the perfused rabbit ear 1 microg MGL inhibited the release of PGI2, PGD2 and PGE2 to the same extent as 1 microg indomethacin. The inhibition of COX-1 in the intact cell system was IC50 = 0.5 microM, that of indomethacin 0.0038 microM. In the isolated enzyme preparations of COX-1 and COX-2 the IC50 was 10 microM and 8 microM, that of indomethacin 9.2 mM and 2.4 microM. In the RBL-1 and PMNL test assay the inhibition of 5-LOX was 0.1 microM and 2.2 microM. An orally administered dose of 50 microg/kg/day induced no gastric ulcers in rats treated for 6 days. The investigations on carrageenan edema showed a close relationship between the structure of MGL and the anti-inflammatory effect. CONCLUSIONS: MGL is a COX-1, COX-2 and 5-LOX inhibitor. In view of the moderate in vitro activity and the very potent in vivo activity an additive mechanism must be involved. Small changes in the molecular structure lead to the loss or reduction of the anti-inflammatory activity.     

Resistance to care

Resisting care is defined as any patient behavior which prevents or interferes with the care provider performing or assisting with ADLs for the patient, including bathing, eating, toileting, dressing and grooming. Significant consequences of resisting care include malnutrition, skin breakdown, dehydration, constipation and weight loss. Creativity, flexibility and patience are key components of any intervention. Due to the lability of the person with cognitive impairment, a plan that works perfectly one day may never work again.     

An automotive engine oil viscosity sensor

For the evaluation of the condition of automotive engine oil, the oil's viscosity is one of the most important parameters. Using microacoustic viscosity sensors, an oil-viscosity measurement can be performed on-board. In this contribution, we discuss the behavior of the viscosity of engine oil, its temperature dependence, and the resulting representation in terms of output signals of microacoustic viscosity sensors. These considerations are illustrated by means of measurement results obtained for used oil samples, which have been obtained from test cars and fresh oil samples out of different viscosity classes. Finally, the detection of the viscosity increase due to soot contamination is demonstrated.     

Alcohol in Munich secondary school students--a study for dissemination of experiences, knowledge, attitude and behavior

The Munich Community Health Service (Medical School-Service Department) conducted an alcohol prevention project in ten public secondary schools. The 423 pupils (11-17 years of age) filled in a questionnaire on alcohol and discussed it afterwards under the guidance of a school physician and a teacher using guideline information. The results of the survey are presented in this paper. Additionally, suggestions for transferring the results to conceptualize and carry out preventive measures are made. The results indicate that the first experience with alcohol occurred early in life. One-fifth of the sample had already tried alcohol at the age of six. Immediate effects of alcohol (e.g. state of drunkenness) were experienced by 35.7 percent of the sample group. Kiosks, shops, and beverage stores were named most frequently as sources for alcohol. The sources of social support varied with respect to sex and age. With increasing age of the children, parents were contacted less frequently whereas the role of peers increased. The present results supply possible paths of action for the development of successful prevention strategies, e.g. by pointing out the early age of onset as well as specific sources of alcohol acquisition.     

Proton exchange membranes by radiation grafting of styrene onto fep films. III. Structural investigation

Structural investigation on proton-exchange membranes, obtained by the radiation grafting of styrene onto FEP films and subsequent sulfonation, was carried out by differential scanning calorimetry. The membrane crystallinity was found to show a decreasing trend with increasing degree of grafting. The melting temperature of all the membranes also showed a slight decrease as compared to the ungrafted FEP. The results have been explained in terms of the cumulative effect of the decrease in the crystalline/amorphous ratio by the incorporation of amorphous polystyrene grafts and of disruption of spherulitic crystallites of the FEP component in the membranes. The glass transition temperature of the membranes with different water contents was also evaluated. A correlation of the glass transition temperature with the residual water in dried membranes was established. © 1994 John Wiley & Sons, Inc.