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Mesenchymal stem cells (MSC) are adult multipotential progenitors which have a high potential in regenerative medicine. They can be isolated from different tissues throughout the body and their homogeneity in terms of phenotype and differentiation capacities is a real concern. To address this issue, we conducted a 2-DE gel analysis of mesenchymal stem cells isolated from bone marrow (BM), adipose tissue, synovial membrane and umbilical vein wall. We confirmed that BM and adipose tissue derived cells were very similar, which argue for their interchangeable use for cell therapy. We also compared human mesenchymal to embryonic stem cells and showed that umbilical vein wall stem cells, a neo-natal cell type, were closer to BM cells than to embryonic stem cells. Based on these proteomic data, we could propose a panel of proteins which were the basis for the definition of a mesenchymal stem cell proteomic signature.

Stromal cells from bone marrow and adipose tissue are attractive sources of adult progenitors for cell-based therapy. However, whether those cell populations represent intrinsically different cell types is still largely under debate. The aim of this study was to systematically and quantitatively compare adipose-derived stromal cells (ADSC) and bone marrow-derived multipotent mesenchymal-stromal cells (BM-MSC). The quantitative comparison was realized using Taqman Low Density Array, 2D electrophoresis and differentiation functional assays in vitro. Furthermore, cells engineered to express TGFbeta1 were injected into the intra-articular space of mouse knee joints in order to determine whether they were able to form new differentiated tissues in vivo. Our data revealed cell specific differences at transcriptional and proteomic levels between both cell types according to their tissue origin as well as functional differences in their differentiation processes towards adipogenic, osteogenic and chondrogenic programs. Nevertheless, in vitro as well as in vivo ADSC displayed the same ability than MSC to differentiate towards chondrocytes/osteoblasts, comforting the status of both cell sources as promising regenerative cells. In summary, our observations indicate that ADSC and MSC are fundamentally different cell types and differently committed cells.

Adipose tissue is now considered as an endocrine organ implicated in energy regulation, inflammation and immune response, and as a source of multipotent cells with a broad range of differentiation capacities. Some of these cells are of a mesenchymal type which can -- like their bone marrow (BM) counterpart -- support hematopoiesis, since in a previous study we were able to reconstitute lethally irradiated mice by cells isolated from adipose tissue. In the present study, we established that cells derived from the stroma-vascular fraction of human subcutaneous fat pads support the complete differentiation of hematopoietic progenitors into myeloid and B lymphoid cells. However, these cells are unable to maintain the survival and self-renewal of hematopoietic stem cells. These features, similar to those of BM adipocytes, are the opposite of those of other cell types derived from mesenchymal progenitors such as BM myofibroblasts or osteoblasts. Because it is abundant and accessible, adipose tissue could be a convenient source of cells for the short-term reconstitution of hematopoiesis in man.

In mammals, two types of adipose tissues are present, brown (BAT) and white (WAT). WAT itself can be divided into subcutaneous and internal fat deposits. All these tissues have been shown to present a great tissue plasticity, and recent data emphasized on the multiple differentiation potentials obtained from subcutaneous WAT. However, no study has compared the heterogeneity of stroma-vascular fraction (SVF) cells and their differentiation potentials according to the localization of the fat pad. This study clearly demonstrates that WAT and BAT present different antigenic features and differentiation potentials. WAT by contrast to BAT contains a large population of hematopoietic cells composed essentially of macrophages and hematopoietic progenitor cells. In WAT, the non-hematopoietic population is mainly composed of mesenchymal stem cell (MSC)-like but contains also a significant proportion of immature cells, whereas in BAT, the stromal cells do not present the same phenotype. Internal and subcutaneous WAT present some discrete differences in the phenotype of their cell populations. WAT derived SVF cells give rise to osteoblasts, endothelial cells, adipocytes, hematopoietic cells, and cardiomyoblasts only from inguinal cells. By contrast, BAT derived SVF cells display a reduced plasticity. Adipose tissues thus appear as complex tissues composed of different cell subsets according to the location of fat pads. Inguinal WAT appears as the most plastic adipose tissue and represents a potential and suitable source of stem cell, considering its easy sampling as a major advantage for cell therapy.

Purpose: Analgesia and sedation, routinely used as adjunct medications for regional anesthesia, are rarely used in the pregnant patient because of concerns about adverse neonatal effects. In an effort to obtain more information about maternal analgesia and sedation we studied neonatal and maternal effects of iv fentanyl and midazolam prior to spinal anesthesia for elective Cesarean section., Methods: In this double-blinded, randomized, placebo-controlled trial, 60 healthy women received either a combination of 1 microg x kg(-1) fentanyl and 0.02 mg x kg(-1) midazolam intravenously or an equal volume of iv saline at the time of their skin preparation for a bupivacaine spinal anesthetic. Sample size was based on a non-parametric power analysis (power > 0.80 and alpha = 0.05) for clinically important differences in Apgar scores. Fetal outcome measures included Apgar scores, continuous pulse oximetry for three hours, and neurobehavioural scores. Maternal outcomes included catecholamine levels, and recall of anesthesia and delivery., Results: There were no between-group differences of neonatal outcome variables (Apgar score, neurobehavioural scores, continuous oxygen saturation). Mothers in both groups showed no difference in their ability to recall the birth of their babies., Conclusions: Maternal analgesia and sedation with fentanyl (1 microg x kg(-1)) and midazolam (0.02 mg x kg(-1)) immediately prior to spinal anesthesia is not associated with adverse neonatal effects.

Placement of epidural catheters for labor analgesia is a common procedure that has become more popular in recent years. However, this procedure can often cause paresthesia, which is typically characterized as a transient and intense burning pain radiating to the hip or leg. In this case report, we describe a patient who had persistent paresthesia in her right foot caused by an indwelling epidural catheter, which was successfully relieved following a partial withdrawal of the epidural catheter. More interestingly, we also observed dramatic changes in skin color and temperature (cold and pale) on her right foot that was well correlated both in time and location with the epidural-induced paresthesia. This cold and pale skin on the right foot represents a localized sympathetic discharge associated with the epidural-induced paresthesia, a phenomenon that has not previously been described. Based on the location of the paresthesia and the pathway of the sympathetic nerve fibers, it is unlikely that this localized sympathetic discharge was due to a direct irritation of the preganglionic sympathetic fibers in the spinal nerve roots by the epidural catheter and thus, a spinal reflex was probably involved. This phenomenon provided us with additional clinical evidence of nerve root irritation, which prompted us to act quickly, and resulted in a favorable outcome.

Social Values, no less than medical science, have shaped the medical management of the pain of childbirth. Nineteenth century feminists fought for greater use of anesthesia in obstetrics at a time when physicians held back for fear of its effects on labor, hemorrhage, rates of infection and the condition of the child. A century later, after physicians became comfortable with the use of anesthesia, a new generation of feminists challenged the use of such drugs, once again citing social considerations. The personalities of colorful and charismatic obstetricians such as James Young Simpson and Grantley Dick-Read played a strong part in the outcome of each confrontation.

Connexins have been implicated in many cell functions, even though in most cases it is still unclear whether these functions may actually be mediated by other proteins that are secondarily affected by connexin changes. Secretory systems provide useful models in which to tackle this central question. Primary pancreatic beta-cells and insulin-producing lines are connected by gap junction channels made of Cx36. Using stable transfection of an antisense Cx36 cDNA, we have previously obtained clones of MIN6 cells that featured a markedly reduced expression of Cx36 and impaired insulin secretion. Here, we first show that this change also resulted in loss of E-cadherin and occludin expression, thus preventing the attribution of the secretory defects to a specific type of membrane protein. To investigate this question, we have now restored the expression of either Cx36 or E-cadherin in the Cx36 antisense-transfected cells. We show that a lentivirus-mediated transduction efficiently restored Cx36 expression in MIN6 cells and allowed for expression of variable levels of this protein. We further document that adequate but not excessive levels of Cx36 allowed for recover of normal insulin secretion in response to various secretagogues. Finally, we demonstrate that restoration of normal E-cadherin expression was not able to achieve the same secretory correction. The data demonstrate that Cx36, but not E-cadherin, is necessary to control specific steps of beta-cell secretion.

We have generated novel lentiviral vectors to integrate various connexin cDNAs into primary, non-dividing cells. We have used these vectors to test whether proper control of insulin secretion depends on a specific connexin isoform and/or on its level of expression. We have observed that transduced connexin32, connexin36 and connexin43 were expressed by primary adult beta-cells at membrane interfaces, were packed into typical gap junction plaques and formed functional channels that allowed a variable coupling, depending on the type and level of connexin expressed. The infected cells spontaneously reaggregated into three-dimensional pseudo-islet organs that could be maintained in culture. We have found that pseudo-islets made by cells transduced with either GFP- or connexin43-expressing lentivirus released insulin in response to various secretagogues similarly to controls. By contrast, pseudo-islets made by cells expressing connexin32, a connexin exogenous to pancreatic islets, or over-expressing connexin36, the endogenous islet connexin, featured a marked decrease in the secretory response to glucose. The data show: (1) that lentiviral vectors allow stable modulation of various connexin in primary, non-proliferating cells; (2) that specific connexin isoforms affect insulin secretion differently; and (3) that adequate levels of coupling via connexin36 channels are required for proper beta-cell function.

Cx36 is the predominant connexin isoform expressed by pancreatic beta-cells. However, little is known about the role of this protein in the functioning of insulin-secreting cells. To address this question, we searched for a cell line expressing Cx36 and having glucose-induced insulin secretion comparable to that of primary beta-cells. By evaluating Cx36 expression in MIN6, betaTC3, RIN2A, INS1, and HIT cell lines, which differ in their sensitivity to glucose, we found that wild-type MIN6 cells fit these requirements. Therefore, we stably transfected MIN6 cells with a cDNA coding for a Cx36 antisense sequence to study the role of Cx36 in these cells. Independent clones of MIN6 cells were obtained that had a markedly reduced Cx36 expression. Loss of Cx36 decreased functional gap junctional conductance in these clones. This alteration impaired the synchronization of glucose-induced [Ca(2+)](i) oscillations and insulin secretion in response to glucose, to secretagogues that increase [cAMP](i), and to depolarizing conditions. These data provide the first evidence that Cx36-made channels 1) mediate functional coupling in MIN6 cells, 2) provide for synchronous [Ca(2+)](i) oscillations, and 3) are necessary for proper insulin secretion in response to metabolizable and nonmetabolizable secretagogues.

Pancreatic beta-cells are connected by gap junction channels made of a connexin protein, referred to as Cx36. Through these channels, beta-cells are coupled to each other, i.e. exchange cytoplasmic ions and small metabolites. Previous experiments have indicated that these exchanges are important for coordinating the function of individual cells within pancreatic islets, particularly with regard to glucose-induced insulin secretion. Advances in molecular biology, genetics and mouse transgenic approaches allow now for a direct experimental testing of this mechanism in vitro as well as in vivo. Recent experiments in rodent and culture models suggest that connexin-dependent cell-to-cell crosstalk is a significant player in the multifactorial regulation of insulin secretion and, possibly, of other beta-cell functions, such as growth. Elucidating the still obscure mechanism whereby connexin signalling exerts this influence will provide insights on the contribution of direct cell-to-cell interactions in the physiological regulation of beta-cell life. The presence of Cx36 within human pancreatic islets, raises the further challenge to determine whether a dysfunction of connexin signaling may contribute to the pathophysiology of beta-cell dysfunctions in type I and/or type II diabetes. Efforts to understand the functions of beta-cell connexins are also a prerequisite for the engineering of surrogate cells and their proper tridimensional packaging, which are instrumental for the future implementation of a replacement cell therapy in diabetic patients.

Connexin channels clustered at gap junctions are obligatory attributes of all macroscopic endocrine and exocrine glands investigated so far and also connect most types of cells which produce secretory products in other tissues. Increasing evidence indicates that connexins, and the cell-to-cell communications that these proteins permit, contribute to control the growth of secretory cells, their expression of specific genes and their differentiated function, including their characteristic ability to biosynthetize and release secretory products in a regulated manner. Since the previous reviews which have been published on this topic, several lines of evidence have been added in support of multiple regulatory roles of gland connexins. Here, we review this novel evidence, point to the many questions which are still open and discuss some interesting perspectives of the field.

First introduced to medical practice in 1847, anesthesia for childbirth has undergone constant changes. Current practice reflects evolving social values as well as new discoveries in science and medicine.

This report describes the background and process for a rigorous project to improve understanding of labor pain and its management, and summarizes the main results and their implications. Labor pain and methods to relieve it are major concerns of childbearing women, with considerable implications for the course, quality, outcome, and cost of intrapartum care. Although these issues affect many women and families and have major consequences for health care systems, both professional and public discourse reveal considerable uncertainty about many questions, including major areas of disagreement. An evidence-based framework, including commissioned papers prepared according to carefully specified scopes and guidelines for systematic review methods, was used to develop more definitive and authoritative answers to many questions in this field. The papers were presented at an invitational symposium jointly sponsored by the Maternity Center Association and the New York Academy of Medicine, were peer-reviewed, and are published in full in this issue of the journal. The results have implications for policy, practice, research, and the education of both health professionals and childbearing women.

Purpose: Hypotension is the most frequent complication of spinal anesthesia in pregnant patients. This study was designed to identify patients at risk for postspinal hypotension based on preoperative vital signs before and after an orthostatic challenge., Methods: Forty healthy women scheduled for elective Cesarean section were enrolled in this prospective trial. Blood pressure (BP) and heart rate (HR) were recorded with the patient in the lateral supine position and after standing up. After a bupivacaine spinal anesthetic, BP was obtained every two minutes for 30 min. Ephedrine treatment was administered based on the degree of hypotension observed. Hemodynamic parameters were correlated to ephedrine requirements (Spearman's rank order correlation)., Results: There was a significant correlation in baseline maternal HR and ephedrine requirements (P=0.005). The degree of orthostatic changes in mean arterial BP and HR did not correlate with postspinal hypotension., Conclusions: Baseline HR may be predictive of obstetric spinal hypotension. Higher baseline HR, possibly reflecting a higher sympathetic tone, may be a useful parameter to predict postspinal hypotension.

Implications: In this article we discuss the development of epidural needles and the historical factors leading to their invention. The most popular needles are described and their inventors acknowledged.

The secretory, duct, connective and vascular cells of pancreas are connected by gap junctions, made of different connexins. The insulin-producing beta-cells, which form the bulk of endocrine pancreatic islets, express predominantly Cx36. To assess the function of this connexin, we have first studied its expression in rats, during sequential changes of pancreatic function which were induced by the implantation of a secreting insulinoma. We observed that changes in beta-cell function were paralleled by changes in Cx36 expression. We have also begun to investigate mutant mice lacking Cx36. The absence of this protein did not affect the development and differentiation of beta-cells but appeared to alter their secretion. We have studied this effect in MIN6 cells which spontaneously express Cx36. After stable transfection of a construct that markedly reduced the expression of this connexin, we observed that MIN6 cells were no more able to secrete insulin, in contrast to wild type controls, and differentially displayed a series of still unknown genes. The data provide evidence that Cx36-dependent signaling contributes to regulate the function of native and tumoral insulin-producing cells.

The influence of Queen Victoria on the acceptance of obstetric anesthesia has been overstated, and the role of John Snow has been somewhat overlooked. It was his meticulous, careful approach and his clinical skills that influenced many of his colleagues, Tyler-Smith and Ramsbotham and the Queen's own physicians. The fact that the Queen received anesthesia was a manifestation that the conversion of Snow's colleagues had already taken place. This is not to say that this precipitated a revolution in practice. Medical theory may have changed, but practice did not, and the actual number of women anesthetized for childbirth remained quite low. This, however, was a reflection of economic and logistical problems, too few women were delivered of newborn infants during the care of physicians or in hospitals. Conversely, it is important to recognize that John Snow succeeded in lifting theoretical restrictions on the use of anesthesia.

To our knowledge, this is the first attempt at adapting an existing cardiovascular model to simulate the hemodynamics of a particular patient population. Despite attempts to define the physiologic alterations in advance, we discovered there were critical parameters not completely defined in the literature. These were discovered through the iterative process of testing, comparing resulting vital signs with targets, and literature review. A list of the parameters that should be sought for future modeling efforts is provided (Table 3), but this list is by no means exhaustive. As further work is performed in this area, additional independent and essential parameters will be identified (pressure characteristics of valvular anomalies, for example). To define a physiology that is less well described in the literature, empirical alterations and best-guess estimates of parameter changes will be required with significantly more iterations. Finally, we have described only modeling of cardiovascular physiology, modeling the respiratory system will require a similar process.

The authors utilized inhalation of 35% carbon dioxide and 65% oxygen as a diagnostic tool in the evaluation of suspected panic disorder. In two inpatients admitted for a medical evaluation for pheochromocytoma and carcinoid syndrome, respectively, a positive response to the double-blind administration of CO2/O2 or room air was consistent with a diagnosis of panic disorder by psychiatric history. In two additional patients in whom denial of mental illness was a psychological impediment to proper treatment, a positive CO2/O2 challenge resulted in therapeutic benefit.

Blood samples of nine sheep were taken over time and analyzed for estrone, estradiol, and progesterone. Results were plotted for each sheep, and graphs were evaluated by 26 evaluators with various previous experience. Sheep were sampled for different time periods. Repeatabilities for the number of spikes of estrone, estradiol, and progesterone recorded for sheep were variable, ranging from .019 to .547. Repeatabilities for evaluators ranged from .033 to .427, but these values decreased to < .001 to .030 when adjusted by covariance for the number of spikes possible. Results indicated that either an objective procedure for counting spikes should be used in comparable research or that evaluators should be trained in visual counting procedures to improve their repeatability.

Patterns of variation in progestin concentrations were studied in pregnant sheep during the last half of gestation. In three sets of experiments, blood was drawn daily or every 4 h for 24 h or every 10 min for 8 h. Peripheral arterial concentration of progestin was examined for 'peaks' using the Pulsar program which identified peaks in daily samples and in samples collected every 10 min, though less often than in daily samples. Ovariectomy did not affect the frequency or character of the peaks. The data suggest that large variations in progestin concentrations occur during the last half of pregnancy. They are superimposed on a gradual increase in average concentration and last for 2 to 3 days.

Cows were prepared for surgery, either within 12 h after parturition (Day 0, n = 3), on Day 1 (n = 1) or on Day 2 (n = 1) postpartum. The previously gravid uterine horn was exposed through a high lumbar laparotomy, and catheters inserted into an uterine branch of the ovarian vein (UBOV) and in the main uterine artery (UA) via a branch of the main uterine artery. A blood flow transducer (8-13 mm, internal diameter) was placed around the UA. Starting 12-24 h following surgery, simultaneous blood samples were collected from UBOV and UA at 15-min intervals for 1 or 2 h daily from Days 1 to 10 postpartum (mean = 5.3 days). Concurrently, uterine blood flow (UBF) was recorded daily for 6 h. Mean concentrations of prostaglandin F2 alpha (PGF2 alpha) and 15-keto-13, 14-dihydro-PGF2 alpha (PGFM) were higher (P less than 0.01) in UBOV than UA (4.64 +/- 0.6, n = 96 vs. 0.08 +/- 0.02 ng/ml, n = 92 and 5.67 +/- 0.41, n = 98 vs. 1.02 +/- 0.09, n = 94, ng/ml, respectively). Concentrations of PGF2 alpha and PGFM in the UBOV increased (P less than 0.1) on Days 2 and 3 and decreased (P less than 0.01) thereafter. Mean UBF (ml/min) decreased (P less than 0.01) from 3079 +/- 683 on Day 1 to 602 +/- 56 on Day 2 and was 413 +/- 55 on Day 5.(ABSTRACT TRUNCATED AT 250 WORDS)

Fourteen pregnant sheep were prepared for measurements of blood flow through a major uterine artery (UBF) and of arterial concentrations of estrone, estradiol, and progestagen. Five of the animals were ovariectomized. Measurements were made daily (n = 12) or every 4 h for 24 h (n = 4). Statistically significant (P less than 0.01) correlation coefficients were detected between UBF and hormone, either alone or in combination; the closest and most consistent associations were those in which estrogen and progestagen concentrations were summed or multiplied. Ewes with higher hormonal concentrations were those that had the higher rates of UBF. Correlation coefficients were statistically significant more often among ovariectomized animals. No associations were detected within one animal that delivered a growth-retarded fetus nor from any of the 24-h data. Estrogens and progestagen accounted for as much as 25% of the daily variation of UBF among and within sheep during the last half of pregnancy.

In a series of foetal lambs weighing between 1,100 and 5,228 g, the circulating plasma volume was estimated by the dye dilution method, using Evans Blue, to test the possibility that the plasma volume could be used as an index of foetal weight in chronic studies. The data, analysed by the method of least squares regression, indicate that plasma volume and foetal weight are closely correlated (R-2 equals 0.922) and linearly so in the range of data studied. There was no evidence that the relation differed for singlets and twins. A single equation, Y equals 71.8 plus 10.11 X--where Y is the estimated weight and X the plasma volume, can be used to predict the weight from plasma volume in both. Some results of the application of the method in chronic studies are presented.

Aspiration is common in the intubated human neonate. Thus, the ventilatory and blood gas responses to citric acid and saline instillation into different airway sites were studied in ten awake, unanesthetised lambs, breathing spontaneously via a tracheostomy tube. With a system of balloons, 1 ml of saline or citric acid was placed selectively into the midtrachea, the laryngeal area, or the lower trachea (lower tr). Changes in minute ventilation (VE), after a 30 sec baseline period, were measured 30 sec and 1 and 2 min after the challenge. Arterial blood gas changes were measured at 30 sec and 2 min. Major increases in VE were seen only when saline or citric acid was instilled into the lower tr, the citric acid responses exceeding saline ones. The arterial oxygen tension (PaO2) fell after lower tr saline, whereas the arterial CO2 tension (PaCO2) fell with midtracheal saline instillation. A rise in pH and a fall in PaCO2 accompanied citric acid given into the lower tr. An initial rise in PaO2 after citric acid into the lower tr was followed by a return to baseline despite hyperventilation. The ventilatory and blood gas changes with saline and citric acid depend on the site of airway instillation.

Catheters were placed in the carotid artery via a facial artery (n = 12) and in the ovarian vein (n = 12), and, in conjunction, electromagnetic flow meters were placed around the ovarian artery (n = 6) in cyclic beef cows. Androstenedione was quantitatively the highest and dehydroepiandrosterone the lowest of the ovarian androgens measured. Ovarian androgens were correlated positively with each other (P less than 0.05) but not with ovarian blood flow or day of the cycle. There was a trend for spikes of androgen release (ovarian vein concentration x ovarian blood flow) from the ovary to be greatest during the period of decreasing progesterone and CL regression. However, only with testosterone were spikes of release different (Days--13 to--9 less than Days -8 to -4; P less than 0.05; Day 0 = oestrus). The dynamic changes in ovarian androgens noted in this study were compatible with the concept of continuous follicular development and atresia throughout the oestrous cycle.

When metkephamid, a systemically active analog of methionine enkephalin, was administered intracisternally to male or female prepubescent lambs as early as the first week of life, we observed a behavioral pattern akin to Flehmen, which is a well-characterized grimace displayed by mature ungulates during mating. This metkephamid-induced Flehmen was preceded by transient bradycardia and apnea followed by somnolence for approximately 1 hour, during which Flehmen was observed intermittently. Pretreatment with the specific opiate antagonist, naloxone, blocked this behavioral response. These observations indicate that endogenous opioid peptides may be involved in Flehmen.

The influence of a systemic lytic state on reperfusion obtained after intracoronary streptokinase (SK) therapy has been evaluated in 15 patients with acute myocardial infarction and complete coronary occlusion. Coronary angiographic studies and measurements of blood fibrinolytic parameters were repeated at 15 min intervals during the infusion of a standard dose of SK and were compared with the results with approximately one-tenth the standard dose. Successful reperfusion was obtained in only 20% (2/10) of patients receiving the low dose, compared with a 75% to 80% success rate in patients receiving the standard dose as initial treatment (4/5) or as follow-up treatment of patients in whom low-dose therapy failed (6/8). There was a striking association between reperfusion and development of the lytic state in that all 12 treatments resulting in reperfusion also caused a lytic state and all seven treatments that failed to produce a lytic state also failed to induce reperfusion (p less than .001). Among the successfully treated patients, the dose of SK that induced a lytic state was relatively constant. However, coronary arterial thrombi differed in susceptibility to treatment. Sensitive thrombi (5/12) dissolved before the lytic state occurred and at a lower SK dose than that needed to cause a lytic state; more resistant thrombi (7/12) required a longer time and a significantly larger SK dose to dissolve. These results indicate that intrinsic properties of the thrombus influence the rate and outcome of treatment and that a minimal dose of SK (about 200,000 U) is required to ensure lasting reperfusion in susceptible patients.(ABSTRACT TRUNCATED AT 250 WORDS)

To study the function of the corpus luteum (CL) through its major secretory product, progesterone (P4), catheters were inserted into the carotid artery (via the facial artery) and the ovarian vein (n = 12), and electromagnetic flow transducers were placed around the ovarian artery in cycling Angus and Hereford cows (n = 6). Blood samples were taken four times daily (at 0600, 1200, 1800 and 2400 h) and ovarian blood flow (OBF) was monitored for 60 min immediately after each blood sampling. After chromatography, P4 was measured by radioimmunoassay. The P4 concentrations in the ovarian vein (OP4) were correlated with day of the estrous cycle (r = .25; P less than .05) and were higher during the morning hours (P less than .05). Arterial progesterone (SP4) was correlated to OP4 (r = .24; P less than .05) and day of the cycle (r = .35; P less than .05). The OBF changed among days (P less than .05). The highest rates were noted during luteal maturation (23 ml/min; SE = .09) and the lowest were noted with the demise of the CL (SP4 less than 1 ng/ml) and approach of estrus (8 ml/min; SE = .07). The OBF was correlated with SP4 (r = .24; P less than .05), although no within-day trends were noted. Exogenous estrone (6 mg) administered via jugular vein decreased OBF within 30 to 45 min, but similar injections of P4 (up to 100 mg) had no effect. Progesterone release (P4R) from the ovary [(OP4 - SP4) x OBF] was higher in the morning hours (P less than .05). The P4 concentration (OP4, SP4) and release (P4R) exhibited wide variations among and within days. The changes in OP4 and P4R were both good indicators of CL development, maturation and regression, as associated with SP4 changes. Oxygen (O2) and carbon dioxide (CO2) concentrations monitored in the carotid artery and ovarian vein indicated that the ovary with the CL was not limited in O2 availability or CO2 removal during periods of low blood flow or high secretion of P4.

Maternal cardiac output changes were evaluated in 10 patients undergoing second-trimester abortion induced by prostaglandin E2 suppositories. The peak cardiac output increased by an average of 64.5% above preinduction values. This is similar to the percent increase described during oxytocin-induced labor at term. Inasmuch as resting cardiac output tends to be higher in midpregnancy than at term, absolute values during prostaglandin E2 induction were higher than those observed in laboring term patients.

The local anesthetics bupivacaine, etidocaine, lignocaine and chloroprocaine were infused intravenously for 30 min to pregnant sheep, prepared for chronic studies. The amide compounds reached highere plasma concentrations than chloroprocaine. All local anaesthetics decreased uterine blood flow and O2 consumption without marked alterations of arterial or uterine venous blood gases. These changes were within the wide physiological range of variation, which was established in controls during 24 h. The findings may be of significance during paracervical block or pathological states of UBF or fetal homeostasis.

Daily measurements of the rate of uterine blood flow (ml/min) during the last half of pregnancy of four normal sheep reflected a 17-day cyclic fluctuation (range, 9.5-42 days) superimposed on a linear increase over time. The cyclic increase was not detected in two (of 7) intact ewes or in four pregnant ewes that had been ovariectomized. The cyclic pattern of increase may be related to ovarian activity.

The effects of burnout of 192 employees of a state institution were examined to determine whether these problems were different from conditions resulting from stress. Each subject completed a packet including the Maslach Burnout Inventory and Ivancevich's Job Stress Scale. For all groups, high burnout emerged in the form of low personal accomplishment, with moderate degrees of burnout measured by the Burnout Inventory subscales Emotional Exhaustion and Depersonalization. One of the stress variables (underutilization) correlated significantly with one Burnout Inventory subscale (Emotional Exhaustion). Results generally indicated that stress and burnout were separate constructs that can be best thought of as distinct entities.

Fetuses of 42 near-term sheep were killed while they were in utero. Uterine blood flow, oxygen consumption, A-V O2, and maternal arterial plasma concentrations of estradiol and progestins were observed for the next 4 hours. There was an immediate (88 per cent) fall in oxygen consumption; blood flow decreased by 50 per cent within 30 minutes. Hormone concentrations changed, but only after 2 hours. Circulatory changes appeared to be related to local changes within the uterus, particularly to decomposition of the chorioallantoic membrane. This relationship was best seen in the experiments in which one of a set of twins was killed. The experiments are in accord with the theory that the rate of uterine blood is not directly related to acute changes in respiratory gases nor to plasma concentrations of certain hormones.

Blood flow transducers were placed around one uterine artery per ewe and observations of the rate of blood flow through this artery and the peripheral plasma concentrations of free, unconjugated oestrone, oestradiol and progestagens were made at intervals of 1-3 days during the last 2-3 weeks of pregnancy and at hourly intervals after spontaneous delivery at term. Rates of uterine blood flow decreased on average by 50% or more within the first hours of parturition and patterns of change in blood flow varied considerably among the animals. Spontaneous daily (pre partum) and hourly (post partum) changes in uterine blood flow were significantly correlated (P < 0.01) with the product of the concentrations of progestagens and of total free oestrogens (oestrone and oestradiol) and with the product of progestagens and oestradiol in peripheral blood.

Intact and ovariectomized mixed-breed sheep were studied in chronic experiments during the last weeks of pregnancy. Measurements were made of the rate of uterine blood flow (ml/min and ml X min-1 X kg-1, combined weight of fetus, uterus, and placenta) and of arterial and uterine venous concentrations of progestagens, estrone, and estradiol. The birth weight of the lamb was directly related to mean maternal concentrations of estrone and estradiol and to the rate of progestagen release by the uterus and its contents (ng X ml-1 X kg-1), calculated by taking the product of the rate of blood flow and the arteriovenous progestagen difference. Ovariectomy altered the relationship between birth weight and progestagen release. Data suggest that rates of progestagen release both by the fetoplacental unit and by the ovary are proportional to the birth weight of the lamb.

The effect of pretreatment with d-tubocurarine on the incidences of succinylcholine-induced fasciculations and post-operative muscle pain, and the time to onset of and 50% recovery from neuromuscular blockade were studied in 75 obstetric patients. Thirty women with term pregnancies undergoing general anesthesia for elective cesarean section or cesarean section indicated by cephalopelvic disproportion were randomly assigned to two groups. Group C-1 patients received 0.05 mg/kg of d-tubocurarine followed by 1.5 mg/kg of succinylcholine, and group C-2 patients received 1.5 mg/kg of succinylcholine, and group C-2 patients received 1 ml of normal saline followed by 1 mg/kg of succinylcholine. An investigator, unaware of the relaxant regimen used, judged severity of fasciculations and postoperative muscle pain and measured times to onset of and 50% recovery from neuromuscular blockade. This same study design was followed in a group of 30 women undergoing tubal ligation 1 day after vaginal delivery (groups T-1 and T-2). The incidence of both fasciculations and postoperative muscle pain was low and was not significantly different between pretreated and nonpretreated groups. Time to 100% twitch depression was also not significantly different between pretreated and nonpretreated groups. Time to 50% recovery from neuromuscular blockade was significantly longer in both nonpretreated groups (C-2 and T-2). An additional group of 15 patients undergoing general anesthesia for cesarean section using 0.7 mg/kg of succinylcholine without d-tubocurarine pretreatment was studied (group C-3). This smaller dose of succinylcholine produced onset and 50% recovery times similar to the group pretreated with d-tubocurarine (group C-1).(ABSTRACT TRUNCATED AT 250 WORDS)

Fifteen crossbred gilts were used to determine the influence of heat stress during Days 8 to 16 after onset of estrus on the development of conceptuses and uterine and endocrine functions. Ten gilts were bred 12 and 24 h after the onset of estrus (Day 0), and five gilts were nonbred controls. On Day 5, catheters were inserted into the uterine-ovarian vein (UV), saphenous artery (SA) and saphenous vein (SV) of each gilt. An electromagnetic blood flow transducer was implanted around the main uterine artery. Pregnant (n=5) and nonbred (n=5) control gilts were exposed to 21 +/- 1 degrees C, and pregnant heat-stressed gilts (n=5) were exposed to 37 +/- 1 degrees C for 12 h and 32 +/- 1 degrees C for 12 h daily during Days 8 through 16 after estrus. Treatment did not influence the partial pressure of oxygen (PO(2)) and of carbon dioxide (PCO(2)) in the UV, SA and SV blood. Uterine blood flow was not altered by heat stress. On Day 16, total wet weight of conceptuses was reduced in the gilts that were heat-stressed compared with conceptuses from control gilts. Incorporation of (3)H-leucine into macromolecules in vitro by conceptuses from the heat-stressed gilts was reduced compared with control gilts. Concentrations of 15-keto-13, 14-dihydro prostaglandin F(2alpha) (PGFM) in peripheral blood were greater than 1 ng/ml between Days 13 to 16 after estrus in 20% of the pregnant control gilts, 60% of the heat-stressed pregnant gilts, and 100% of the nonbred gilts. Concentrations of estradiol in the SA were affected by treatment. These results indicate that heat stress of gilts between Days 8 to 16 after estrus reduced the amount of conceptus tissue and altered concentrations of estradiol in the peripheral circulation, but uterine blood flow and PO(2) and PCO(2) in blood were not affected.