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Repetitive sequence based-PCR fingerprints based on REP primers allow a classification of plant pathogenic Pseudomonas spp. that supports most of the recognised species. The classification also supports a pathovar-based system but indicates that some clusters of strains were isolated from unrelated hosts. Standardisation of methods is essential, and improved DNA extraction methods may be necessary before identification can be made based on comparisons with a database.

An oxidant/antioxidant imbalance in favour of oxidants has been identified as playing a decisive role in the pathogenesis of chronic inflammatory airway diseases. Nutritional antioxidant supplementation might reduce oxidative damage by enhancement of the antioxidant defence, thereby modulating inflammatory processes. In a placebo-controlled, blind study, it was tested whether a dietary antioxidant supplement administered for 4 weeks would improve lung function and reduce airway inflammation in heaves-affected horses. Eight horses in clinical remission of heaves were investigated at rest and after a standardised exercise test before and after treatment with an antioxidant supplement (consisting of a mixture of natural antioxidants including vitamins E and C and selenium from a variety of sources) or placebo (oatfeed pellets without additive). Pulmonary function and exercise tolerance were monitored; systemic and pulmonary lining fluid uric acid, glutathione and 8-epi-PGF(2alpha) were analysed, and bronchoalveolar lavage (BAL) cytology and inflammatory scoring of the airways were performed. The antioxidant treatment significantly improved exercise tolerance and significantly reduced endoscopic inflammatory score. Plasma uric acid concentrations were significantly reduced, suggesting downregulation of the xanthine-dehydrogenase and xanthine-oxydase pathway. Haemolysate glutathione showed a nonsignificant trend to increase, while plasma 8-epi-PGF(2alpha) remained unchanged. Pulmonary markers and BAL cytology were not significantly affected by antioxidant supplementation. The present study suggests that the antioxidant supplement tested modulated oxidant/antioxidant balance and airway inflammation of heaves-affected horses.

Antioxidants have been implicated in the reduction and prevention of oxidative stress during exercise. We hypothesised that a dietary supplement containing a mixture of natural antioxidants together with vitamins E, C and selenium, given for 4 weeks, would increase the systemic and pulmonary antioxidant capacity leading to a reduction in markers of oxidative damage and an improvement in pulmonary function during exercise. In 6 healthy horses studied, the antioxidant supplement significantly increased plasma concentrations of ascorbic acid (from mean +/- s.d. 16 +/- 7 to 23 +/- 4 micromol/l; P = 0.007) and alpha-tocopherol (from 10 +/- 3 to 14 +/- 3 micromol/l; P = 0.02) and increased the bronchoalveolar lavage pulmonary epithelial lining fluid (ELF) concentration of ascorbic acid compared to a placebo, but not significantly (2.0 +/- 0.9 mmol/l and 1.2 +/- 0.9 mmol/l, respectively; P0.05). Alpha-tocopherol was not detected in ELF either before or after supplementation or exercise. The mean concentration of malondialdehyde (MDA) in ELF was lower following antioxidant supplementation compared to placebo and control periods, but not significantly. An intermittent exercise test consisting of 2 min at 70, 80 and 90% of the horses' individual maximum oxygen uptake, failed to induce significant systemic or pulmonary oxidative stress (based on the glutathione redox ratio (GRR) and the ascorbic acid redox ratio (ARR)) and lipid peroxidation (based on the concentration of thiobarbituric acid reactive substances in plasma and MDA in ELF) either for placebo or antioxidant treatments. There was a strong correlation between GRR and ARR in the pulmonary epithelial lining fluid (r = 0.89; P0.0001). In healthy horses on a diet containing adequate levels of antioxidants, additional antioxidant supplementation has no apparent beneficial or detrimental effect on pulmonary function during moderate intensity exercise. The importance of antioxidant supplementation may only become apparent if the diet is deficient in antioxidants, if exercise intensity is higher or more prolonged, or if disease or additional stresses are present.

To determine the effects of exercise, high heat and humidity and acclimation on plasma adrenaline, noradrenaline, beta-endorphin and cortisol concentrations, five horses performed a competition exercise test (CET; designed to simulate the speed and endurance test of a three-day event) in cool dry (CD) (20 degrees C/40% RH) and hot humid (30 degrees C/80% RH) conditions before (pre-acclimation) and after (post-acclimation) a 15 day period of humid heat acclimation. Plasma adrenaline and noradrenaline concentrations pre-acclimation were significantly increased compared with exercise in the CD trial at the end of Phases C (P0.05) and D (P0.05 and P0.01, respectively) and at 2 min recovery (P0.01), with adrenaline concentrations still elevated after 5 min of recovery (P0.001). Plasma beta-endorphin concentrations were increased at the end of Phases C (P0.05) and X (P0.01) and at 5 and 30 min recovery (P0.05) in the pre-acclimation session. Plasma cortisol concentrations were elevated after the initial warm up period pre-acclimation (P0.01) and at the end of Phase C (P0.05), compared with the CD trial. A 15 day period of acclimation significantly increased plasma adrenaline concentrations at 2 min recovery (P0.001) and plasma cortisol concentration at the end of Phase B (P0.01) compared with pre-acclimation. Acclimation did not significantly influence noradrenaline or beta-endorphin responses to exercise, although there was a trend for plasma beta-endorphin to be lower at the end of Phases C and X and after 30 min recovery compared with pre-acclimation. Plasma adrenaline, noradrenaline, beta-endorphin and cortisol concentrations were increased by exercise in cool dry conditions and were further increased by the same exercise in hot humid conditions. Exercise responses post-acclimation suggest that adrenaline and noradrenaline may play a role in the adaptation of horses to thermal stress and that changes in plasma beta-endorphin concentrations could be used as a sensitive indicator of thermal tolerance before and after acclimation. The use of plasma cortisol as a specific indicator of heat stress and thermal tolerance before or after acclimation in exercising horses appears limited.

In heaves-affected horses the relation between oxidant status, airway inflammation (AI) and pulmonary function (PF) is unknown. The oxidant status of blood and pulmonary epithelial lining fluid (PELF) of healthy (H, n = 6) and heaves-affected horses in clinical remission (REM, n = 6) and in crisis (CR, n = 7) was assessed at rest, during and after standardised exercise test by measurement of reduced and oxidised glutathione, glutathione redox ratio [GRR%]; uric acid and 8-epi-PGF2alpha. Oxidant status was related to PF parameters (mechanics of breathing and arterial blood gas tension) and Al parameters (bronchoalveolar lavage [BAL] neutrophil % and AI score). Haemolysate glutathione was significantly different between groups and was correlated with PF and AI parameters; GRR in PELF was increased during CR and was correlated with PF and AI parameters. Exercise induced an increase of plasma uric acid that was significantly higher both in REM and CR. PELF 8-epi-PGF2alpha was significantly increased in CR and correlated with PF and AI parameters. These results suggest that oxidative stress occurring in heaves is correlated with PF and AI and may be locally assessed by PELF glutathione status, uric acid and 8-epi-PGF2alpha. Systemic repercussions are reflected by assay of GSH in resting horses and by uric acid in exercising horses.

Objective To create twin centile charts for size. Design Retrospective study. Setting Aberdeen Maternity Hospital. Methods Ultrasound measurements of abdominal circumference (AC), biparietal diameter (BPD) and femur length (FL) for 1011 twin pregnancies were extracted from a databank. The methodology is based on that described by Altman and Chitty [Br. J. Obstet. Gynaecol. 101 (1994) 29.]; only one measurement from each twin was used, polynomial regression models were fitted separately to the mean and standard deviation (SD) of the ultrasound parameter as functions of gestational age. The centiles were obtained assuming that at each gestation, the measurements had a normal distribution. Results The growth pattern of AC for twins appear to follow closely that of singletons until 32 weeks. Thereafter, there is a gradual but definite fall off in growth away from singleton standards. The pattern of growth of FL is largely similar to that of singletons. From mid to early third trimester, the BPD of twin babies was larger than that of singletons.

Prolonged low-medium intensity exercise is associated with increased oxidative stress in humans. We hypothesized that competitive equine endurance racing would induce changes in circulatory antioxidants and produce systemic oxidative stress. Forty horses competing in a 140-km endurance race in warm conditions [shade temperature 15-19 degrees C; 62-88% relative humidity (%RH)] were sampled before (Pre), immediately after exercise (End) and at approximately 16 h into recovery (+16 h). Plasma ascorbic acid concentration was not different between Pre [11.1 (median); 4.6-20.3 micromol/L (range)] and End [9.7; 3.0-38.9 (range) micromol/L] but was significantly decreased at +16 h (5.5; 2.8-15.5 micromol/L; P0.05). Total red cell hemolysate glutathione (TGSH) concentration was significantly reduced by exercise (Pre 1261; 883-1532 micromol/L; End 1065; 757-1334 micromol/L; P0.05) and at +16 h recovery (1032; 752-1362 micromol/L; P0.05). Glutathione redox ratio was unchanged by exercise but was significantly decreased at +16 h compared with that at both Pre and End (P0.05). The concentration of total barbituric acid reactive substances (TBARS) in plasma was increased compared with that at Pre (309; 66-1048 nmol/L), both at End (408; 170-1196 nmol/L; P0.05) and +16 h (380; 99-1161 nmol/L; P0.05). alpha-Tocopherol was unchanged by exercise or recovery. Mean race speed was 16.5 +/- 1.6 km/h and ranged from 13.9 to 19.7 km/h. Mean speed during competition in horses that completed the full 140 km (n = 28) was significantly correlated with end of exercise ascorbic acid (r = 0.622; P = 0.0004). Although there were increases in creatine phosphokinase (CK), aspartate aminotransferase (AST) and TBARS and a loss of TGSH, this study failed to demonstrate evidence of classical oxidative stress.

Fundamental research into the growth of twins is lacking. Twin growth in utero is commonly assumed to follow similar patterns of growth as that of singletons. This preliminary descriptive study on twin pregnancy aimed to define growth velocity as gestation advances, and to study if twin order, fetal sex, zygosity and chorionicity have any relationship to growth velocity.One hundred and sixty-two women with twin pregnancies had an ultrasound examination at fortnightly intervals from 16 weeks until delivery. Fetal measurements of biparietal diameter, abdominal circumference and femur length were performed at each examination. Growth velocity for each parameter was defined as the difference in measurements for that parameter divided by the time interval between measurements. Postnatally, zygosity and chorionicity were determined by genetic fingerprinting and inspection of the placenta, respectively.Growth velocity for all parameters decreased as gestation advanced, with the downward trend more noticeable after 32 weeks. Maximum and minimum growth occurred at 22-23 weeks and 36-37 weeks, respectively. Maximum and minimum growth velocities for the abdominal circumference were 1.7 and 0.8 cm/week, respectively. Birth order, fetal sex, chorionicity and zygosity were not related to growth velocity.These preliminary results suggest that growth velocity in twins decreases after 32 weeks' gestation. It appears that growth velocity is independent of birth order, fetal sex, chorionicity and zygosity.

TaqMan™ PCR exploits the 5‘ nuclease activity of Taq DNA polymerase (4) in conjunction with fluoroenic DNA probes (6). Each probe, designed to hybridise specifically to the target PCR product, is labelled with a fluorescent reporter dye and a quencher dye. During PCR amplification the probe is digested by Taq DNA polymerase, separating the dyes, resulting in an increase in reporter fluorescence. Repeated PCR cycles result in exponential amplification of the PCR product and corresponding increase in fluorescence intensity.

It is estimated that 15–20% of confirmed pregnancies will spontaneously miscarry. Treatment options for early fetal demise (EFD) include expectant management, medical treatment and surgical intervention in the form of evacuation of retained products of conception (ERPC) under general anaesthetic or manual vacuum aspiration (MVA) under local anaesthetic. Aim of our study was to assess efficacy of treatment options offered to women with EFD. Secondary outcome measures included assessing complications of treatment options. Data was collected prospectively from October 2007 to September 2009, entered and analysed using SPSS 17.0. Selection criterion was diagnosis of EFD in women attending an early pregnancy unit (EPAU). Of the 798 patients diagnosed with EFD, 42.9% (342) women chose medical management, while 7% (56) women opted for expectant management. Half of the women (50.1%) chose surgical management, which included 37.5% (299) opting for evacuation of retained products of conception (ERPOC) and 12.7% (101) MVA. Mean age was 31.4 years (±SD 6.4). Median parity was two (range 0–13). The mean gestation by dates was 74.9 days (±SD 17.6) and scan was 58.9 (±SD 16.5) days. Efficacy of medical management was 89.5% and expectant management was 91%. Efficacy of MVA was 99% and no patients required repeat ERPC. 71% were managed as day cases. 10% of women had early and 0.4% late complications. All of the above treatment options have a high efficacy and low complication rates and should be offered to all women presenting with EFD to an EPAU thereby increasing women9s choice of treatment options.

Angiotensin II (Ang II) promotes norepinephrine (NE) release from cardiac sympathetic nerve endings. We assessed in a human model in vitro whether locally formed Ang II contributes to NE release in myocardial ischemia. Surgical specimens of human right atrium were incubated in anoxic conditions. After 70 min of anoxia, NE release (carrier-mediated; caused by NE transporter reversal) was 8-fold greater than normoxic release. Angiotensin-converting enzyme inhibition with enalaprilat failed to reduce anoxic NE release. In contrast, prevention of chymase-dependent Ang II formation with chymostatin, Bowman-Birk inhibitor, or alpha(1)-antitrypsin significantly inhibited anoxic, but not exocytotic, NE release. Two mast-cell stabilizers, cromolyn and lodoxamide, markedly reduced NE release, implicating cardiac mast cells as a major source of chymase. Angiotensin type 1 receptor (AT(1)R) blockade with EXP3174 inhibited NE release, whereas angiotensin type 2 receptor (AT(2)R) blockade with PD123319 did not. Interestingly, PD123319 reversed the inhibitory effect of EXP3174. Furthermore, synergisms were uncovered between EXP3174 and an AT(2)R agonist, and between EXP3174 and a Na(+)/H(+) exchanger inhibitor. Thus, angiotensin-converting enzyme-independent Ang II formation via chymase is important for carrier-mediated ischemic NE release in the human heart. Locally generated Ang II promotes NE release by acting predominantly at AT(1)Rs, which are likely coupled to the Na(+)/H(+) exchanger. Effects of Ang II at AT(2)Rs, seemingly opposite to those resulting from AT(1)R activation, are uncovered when AT(1)Rs are blocked. Because NE release is associated with coronary vasoconstriction and arrhythmias, and mast-cell density and chymase content increase in the ischemic heart, the notion that chymase-generated Ang II plays a major role in carrier-mediated NE release may have important clinical implications.

Summary The effect of a COPD crisis on arterial blood gases, heart rate, lactate and indices of oxidative stress were investigated before, during and 1 h after a ‘run up to fatigue’ in 6 COPD horses. They were investigated twice, randomly: once in acute crisis (C) and once in clinical remission (R). Arterial and mixed venous blood samples were collected and analysed for partial pressures in O2 and CO2. The mixed venous blood was also analysed for plasma lactate (LA) and packed cell volume (PCV), as well as for indices of oxidative stress, i.e. reduced glutathione, glutathione disulphide, glutathione redox ratio (GRR) and lipid hydroperoxides (LPH). The exercise test was an effort of increasing intensity on a treadmill at 0% slope, which was stopped when the horses showed signs of exhaustion. Their performance was evaluated by the number of steps and the running time in the last step. Heart rate was monitored continuously during the test Blood sampling was performed before, just after and 1 h after the end of the test. The COPD crisis significantly reduced the time to fatigue. However, despite the fact that the exercise intensity and length were lower, peak HR and peak LA were similar in C and R, while arterial hypoxaemia and hypercapnia, and PCV were significantly higher in C, indicating a higher physiological stress in this condition. By contrast, the oxidative stress seemed to be higher in R than in C as suggested by the fact that, 1 h after exercise, GRR and LPH were significantly increased with regards to their pre-exercise values in R and not in C. The fact that exercise did not induce an oxidative stress in C could be partly related to (1) the lower exercise intensity reached by the horses, and (2) to the more severe hypoxaemia experienced in this condition. In conclusion, COPD horses in acute crisis show a significant decrease in performance. The reasons for this exercise intolerance remain unclear, but do not appear to be related to any increase of the oxidative stress in C.

Herceptin (Trastuzumab) is licensed for use in recurrent as well as early stage human epidermal growth factor receptor (HER) 2 positive breast cancer. It is recommended that Herceptin be used with ...

In myocardial ischemia, adrenergic terminals undergo ATP depletion, hypoxia, and intracellular pH reduction, causing the accumulation of axoplasmic norepinephrine (NE) and intracellular Na(+) [via the Na(+)-H(+) exchanger (NHE)]. This forces the reversal of the Na(+)- and Cl(-)-dependent NE transporter (NET), triggering massive carrier-mediated NE release and, thus, arrhythmias. We have now developed a cellular model of carrier-mediated NE release using an LLC-PK(1) cell line stably transfected with human NET cDNA (LLC-NET). LLC-NET cells transported [(3)H]NE and [(3)H]N-methyl-4-phenylpyridinium ([(3)H]MPP(+)) in an inward direction. This uptake was abolished by the NET inhibitors desipramine (100 nM) and mazindol (300 nM) and by extracellular Na(+) removal. Na(+)-gradient reversal induced an efflux of (3)H-substrate from preloaded LLC-NET cells. Desipramine and mazindol blocked this efflux. Because of its greater intracellular stability and higher sensitivity to Na(+)-gradient reversal, [(3)H]MPP(+) proved preferable to [(3)H]NE as an NET substrate; therefore, only [(3)H]MPP(+) was used for subsequent studies. The K(+)/H(+) ionophore nigericin (10 microM) evoked a large efflux of [(3)H]MPP(+). This efflux was potentiated by the Na(+),K(+)-ATPase inhibitor ouabain (100 microM), was sensitive to desipramine, and was blocked by the NHE inhibitor 5-(N-ethyl-N-isopropyl)-amiloride (EIPA; 10 microM). In contrast, EIPA failed to inhibit the [(3)H]MPP(+) efflux elicited by the Na(+) ionophore gramicidin (10 microM). Furthermore, [(3)H]MPP(+) efflux induced by the NHE-stimulant proprionate (25 mM) was negatively modulated by imidazoline receptor activation. Our findings suggest that LLC-NET cells are a sensitive model for studying transductional processes of carrier-mediated NE release associated with myocardial ischemia.

To test the hypothesis that reactive oxygen species could be associated to the lower airway disorders occurring in horses suffering from recurrent airway obstruction (RAO), indices of oxidative stress were studied in blood and pulmonary epithelium lining fluid in 5 RAO horses either in clinical remission or 24 h after the onset of a crisis of bronchospasm and in 5 healthy horses. Venous blood and bronchoalveolar lavage fluid (BALF) samples were collected and analysed for reduced glutathione (GSH), oxidised glutathione (GSSG), total glutathione (TGSH), glutathione redox ratio (GRR) in blood haemolysate and pulmonary epithelium lining fluid (PELF). The haemolysate concentrations of GSH, GSSG, TGSH and GRR were similar in the 3 groups. The PELF glutathione status was significantly different in the RAO horses in acute crisis compared to healthy horses, indicating the occurrence of an oxidative stress. When RAO horses were in crisis their GSH and TGSH remained unchanged but their GSSG and GRR were significantly increased compared to the remission. These results support the hypothesis that oxidative stress is associated with lower airway disorders occurring in horses suffering from RAO.

A routine detailed ultrasound examination performed at 20 weeks' gestation demonstrated the presence of nuchal thickening as an apparently isolated finding. The concentration of maternal alpha-fetoprotein was normal and the risk of Down's syndrome was 1 in 6800. Amniocentesis was performed and chromosome analysis showed the karyotype 46,XY, del(11)(q23) found in Jacobsen syndrome. Fetal autopsy performed following medical termination at 23 weeks confirmed the phenotype and internal abnormalities found in Jacobsen syndrome.

Mills, Paul C., David J. Marlin, Caroline M. Scott, and Nicola C. Smith. Nitric oxide and thermoregulation during exercise in the horse. J. Appl. Physiol. 82(4): 1035–1039, 1997.—The effect of inhibition of nitric oxide production on sweating rate (SR) and on core, rectal, and tail skin temperatures was measured in five Thoroughbred horses during exercise of variable intensity on a high-speed treadmill. A standard exercise test consisting of three canters [∼55% maximum O2uptake (V˙o2 max)], with walking (∼9%V˙o2 max) and trotting (∼22% V˙o2 max) between each canter, was performed twice (control or test), in random order, by each horse. NG-nitro-l-arginine methyl ester (l-NAME; 20 mg/kg), a competitive inhibitor of nitric oxide synthase, was infused into the central circulation and induced a significant reduction in the SR measured on the neck (31.6 ± 6.4 vs. 9.7 ± 4.2 g ⋅ min−1⋅ m−2; 69%) and rump (14.7 ± 5.2 vs. 4.8 ± 1.6 g ⋅ min−1⋅ m−2; 67%) of the horses during canter ( P< 0.05). Significant increases in core, rectal, and tail skin temperatures were also measured ( P < 0.05).l-Arginine (200 mg/kg iv) partially reversed the inhibitory effects ofl-NAME on SR, but core, rectal, and tail skin temperatures continued to increase ( P < 0.05), suggesting a cumulation of body heat. The results support the contention that nitric oxide synthase inhibition diminishes SR, resulting in elevated core and peripheral temperatures leading to deranged thermoregulation during exercise. The inhibition of sweating byl-NAME may be related to peripheral vasoconstriction but may also involve the neurogenic control of sweating.

Allopurinol was administered to six horses in a cross-over study to determine the relative contribution of xanthine oxidase (XO) activity to the formation of reactive oxygen species (ROS) in the horse during intense exercise. Exercise increased the mean (SEM) plasma lipid hydroperioxide concentration to a maximum of 492.7 (33.4) microM within one minute of exercise completion and maximum levels of both oxidised glutathione (GSSG) in haemolysates of red blood cells and the glutathione redox ratio (GRR) occurred 20 minutes after exercise (87.2 [12.2] microM and 8.9 [0.9] per cent, respectively). Allopurinol significantly reduced lipid hydroperoxides, GSSG and the GRR at the corresponding maximal times after exercise measured during control exercise (217.5 [32.1] microM. 63.8 [8.6] microM and 6.8 [0.7] per cent, respectively). Significantly higher levels of hypoxanthine and xanthine were measured after exercise in the plasma of horses that received allopurinol than in control horses, although uric acid levels remained constant. In control horses, plasma uric acid concentrations increased after exercise to a maximum 20 minutes after exercise of 28.1 (2.6) microM, significantly higher than in horses given allopurinol (9.6 [1.3] microM). The results show that the inhibition of XO by allopurinol leads to a decrease in the formation of ROS during exercise, and thus a reduction in oxidative stress.

Background: Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare tumour-like condition mostly affecting the tubular bones of the hands and feet. Although it recurs in 50% of cases after local excision, it is a form of heterotopic ossification and its behaviour is otherwise benign. The present study describes seven cases of BPOP collected by the Bone Tumour Registry of New South Wales. Methods: Clinical data, radiographs and histological specimens collected by the Bone Tumour Registry of New South Wales were examined, and further clinical data were sought from the referring doctor where necessary. Results: Six males and one female aged 18 to 37 years (median 30 years) presented between 1988 and 1995. There were three cases involving the hands, three involving the feet and one involving the distal humerus. Initial treatment was by local excision in all cases. There was local recurrence in three cases. The initial diagnosis was wrong in five of the seven cases. Radiologically, BPOP appears as a well-defined tumour arising directly from the bony cortex, without periosteal reaction or change to the underlying bone. Histologically, a large amount of hypercellular cartilage shows maturation to trabecular bone, which frequently contains spindle cells in the intertrabecular spaces. Conclusion: BPOP is a rare, locally recurrent but otherwise benign condition of bone which must be distinguished from more sinister lesions such as parosteal osteosarcoma and chondrosarcoma.

To investigate the effects of ozone and airway inflammation on indices of oxidant injury in horses.5 clinically normal horses and 25 horses referred for poor performance.Blood, tracheal wash, and bronchoalveolar lavage fluid samples were collected before and after ozone exposure (n = 5) or from clinical cases (n = 25), and were analyzed for reduced glutathione (GSH), glutathione disulfide (GSSG), and free and total iron (Fe) values. A scoring system (0 to 5) was used to assess airway inflammation on the basis of clinical signs and cytologic analysis of the tracheal wash and bronchoalveolar lavage fluid samples.Ozone induced significant (P0.05) increases in GSH (195.4 +/- 68.5 microM), GSSG (19.4 +/- 6.4 microM), and free (25.5 +/- 16.1 microM) and total (93.1 +/- 13.4 microM) Fe values in the pulmonary epithelial lining fluid, compared with preozone samples (49.2 +/- 18.6, 2.4 +/- 1.2, 0.0, and 33.1 +/- 5.9 microM, respectively). The presence of airway inflammation (19/25) was associated with high GSSG and free and total Fe, but not GSH, values in epithelial lining fluid, compared with values for clinically normal horses (6/25). There were no differences in the systemic values of GSH, GSSG, and free and total Fe between any of the groups. A strong correlation (r = 0.84; P0.001) existed between inflammation score and the glutathione redox ratio (GSSG/[GSH + GSSG]) in the 25 horses admitted for clinical examination.Oxidant injury in the lung will induce changes in the glutathione status and Fe homeostasis that could affect pathogenesis of the disease.Measurement of indices of oxidant injury may be useful in the diagnosis of airway inflammation and the response to inhaled oxidants.

The effects of prolonged variable-intensity and short-term high-intensity exercise on indices of oxidative stress and iron homeostasis were compared in six fit horses under cool [20 degrees C, 40% relative humidity (RH)] or hot/humid (30 degrees C, 80% RH) environmental conditions. The exercise protocols were designed to simulate equine competition, including racing (intense exercise) or the speed and endurance phase of a 3-day event (prolonged exercise). Increased plasma concentrations of lipid hydroperoxides and haemolysate concentrations of oxidised glutathione (GSSG) were measured within 30 min of the completion of exercise, indicating production of reactive oxygen species (ROS) and lipid membrane peroxidation. The horses were unable to complete the prolonged exercise protocol at high temperature and humidity. This coincided with higher maximal values of lipid hydroperoxides [138.2 (17.7) microM and GSSG [110.6 (18.2) microM], compared to high-intensity [105.2 (14.9) microM and 63.6 (8.6) microM, respectively] or prolonged [100.7 (18.7) microM and 86.2 (9.1) microM, respectively] exercise performed under cooler environmental conditions. Significant correlations were found between the duration of the final stage of exercise during hot/humid environmental conditions and increased levels of lipid hydroperoxides (r = 0.85), GSSG (r = 0.94), xanthine (r = 0.92) and uric acid (r = 0.96). Exercise also decreased the iron (Fe)-binding antioxidant activity of the plasma and increased the total plasma Fe levels, although this was only significant for prolonged exercise in ambient conditions. There was no detectable free Fe in the plasma at any stage of exercise. Other changes in biochemical parameters had returned to pre-exercise levels within 24 h after exercise. The results show that exercise can induce changes in biochemical parameters that are indicative of oxidative stress in the fit horse and that this was, exacerbated during exercise at high temperature and humidity.

The reliability of assessment of gestational age by ultrasonic fetal abdominal circumference in late pregnancy was evaluated in 204 Scottish women. The results showed that the method was very accurate, reliable and compared favourably with the data from other communities. The relationship between the target (gestational age) and the independent (abdominal circumference) variables as verified by a simple regression equation was a linear one. This method could therefore be very useful within the limit of two standard deviations of the mean in the prediction of gestational age and in the monitoring of fetal growth in late pregnancy.

Oxidative stress occurs when antioxidant defence mechanisms are overwhelmed by free radicals and may lead to damage to DNA, which has been implicated in processes such as ageing and cancer. The Comet assay allows detection of oxidative DNA damage in individual cells. As horses with recurrent airway obstruction (RAO) have been shown to demonstrate low antioxidant status and oxidative stress, we hypothesised that peripheral blood mononuclear cells (PBMC) of horses with RAO would demonstrate increases in DNA damage following natural allergen challenge.Six horses (mean age 15 years, range 8-23 years) diagnosed with RAO (in remission) and 6 healthy breed matched controls (mean age 9 years, range 5-15 years) were studied. Blood samples were collected 7 days prior to challenge and immediately and 3 days after stabling on mouldy hay and straw for 24h. All animals were kept at grass prior to and after the challenge period. Bronchoalveolar lavage (BAL) was performed and neutrophil counts determined.

Objective To determine the optimum interpregnancy interval after miscarriage in a first recorded pregnancy. Design Population based retrospective cohort study. Setting Scottish hospitals between 1981 and 2000. Participants 30 937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant. Main outcome measures The primary end point was miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy. Secondary outcomes were rates of caesarean section and preterm delivery, low birthweight infants, pre-eclampsia, placenta praevia, placental abruption, and induced labour in the second pregnancy. Results Compared with women with an interpregnancy interval of 6-12 months, those who conceived again within six months were less likely to have another miscarriage (adjusted odds ratio 0.66, 95% confidence interval 0.57 to 0.77), termination (0.43, 0.33 to 0.57), or ectopic pregnancy (0.48, 0.34 to 0.69). Women with an interpregnancy interval of more than 24 months were more likely to have an ectopic second pregnancy (1.97, 1.42 to 2.72) or termination (2.40, 1.91 to 3.01). Compared with women with an interpregnancy interval of 6-12 months, women who conceived again within six months and went on to have a live birth in the second pregnancy were less likely to have a caesarean section (0.90, 0.83 to 0.98), preterm delivery (0.89, 0.81 to 0.98), or infant of low birth weight (0.84, 0.71 to 0.89) but were more likely to have an induced labour (1.08, 1.02 to 1.23). Conclusions Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy.

Digital examination of the cervix has traditionally been the "gold standard" for cervical assessment. However, it can be subject to inter- as well as intra-observer variation. The usefulness of transvaginal ultrasonography for cervical assessment is examined in this study. Although differences between measurements of transvaginal ultrasonography and digital examinations were observed, transvaginal ultrasonography appears to be a potentially useful and reproducible technique for assessing cervical changes in pregnancy and for prediction of onset of labor.

Successful reproduction has ensured the survival of the human race despite disease and famine. However, a good standard of living, combined with a well-balanced diet, is closely related to low maternal, perinatal and infant mortality rates. In the third world, anaemia, rheumatic heart disease, tuberculosis and other infections are still common and the poorly nourished are more susceptible to them. In the Western world food is plentiful but often the individual's diet is poorly balanced. Invariably the fetus takes all the nutrients required from the mother and, if a deficiency occurs, this is reflected in the maternal reserves only. The weight of the baby at birth has a wide biological variation and correlates in the extremes with maternal weight but there are many other factors responsible for fetal growth. In early pregnancy the developing embryo may be susceptible to specific dietary deficiencies and structural malformations may result. A clear link has recently been established between folic acid supplementation and the prevention of recurrence of neural tube defects. Excessive doses of vitamin A should be avoided.

OBJECTIVE To examine the effect of epidural analgesia on the progress and outcome of spontaneous labour in women with a singleton breech presentation at term (greater than or equal to 37 weeks). DESIGN A retrospective study. SETTING Data Bank, Aberdeen Maternity Hospital. SUBJECTS 643 women (273 primiparae and 370 multiparae) with a singleton breech presentation and spontaneous onset of labour at term. OUTCOME MEASURES Duration of labour; augmentation of labour with oxytocin infusion; caesarean section rates. RESULTS Epidural analgesia was associated with a significantly increased need for augmentation of labour with oxytocin infusion (P less than 0.001) and longer duration of labour (P less than 0.001), irrespective of parity. Comparing women who had epidural analgesia with those who did not, there was no significant difference in caesarean section rates in the first stage of labour in primiparae (odds ratio 1.79; 95% CI 0.88-3.63) or multiparae (odds ratio 0.97; 95% CI 0.48-1.96). Epidural analgesia was associated with a significantly increased likelihood of caesarean section in the second stage of labour, both in primiparae (odds ratio 5.43; 95% CI 2.46-11.95) and multiparae (odds ratio 5.37; 95% CI 2.07-13.87). The increased likelihood of caesarean section in the second stage in primiparae with epidurals was independent of the extent of cervical dilatation (less than 3 cm or greater than or equal to 3 cm) on admission. However, in multiparae with epidurals, the difference in second stage caesarean section rate was significant only when initial cervical dilatation was less than 3 cm (odds ratio 3.65; 95% CI 1.14-11.65). CONCLUSION Epidural analgesia was associated with longer duration of labour, increased need for augmentation of labour with oxytocin infusion and a significantly higher caesarean section rate in the second stage of labour.

SummarySummaryA prospective observational study to assess the effect of epidural and general anaesthesia on bladder function of 50 parturients delivered by elective caesarean section. All the women had pre-and postoperative bladder volume assessed using a trans-abdominal ultrasound scan. Women delivered under epidural block (n = 30) had increased postoperative residual bladder volumes (P > 0.01) but there was no increase in the incidence of urinary retention.

For pt.I see ibid., vol.8, p.929 (1975). Three-dimensional continuum model chains up to 1000 links in length have been generated, with both freely varying and fixed bond angles. The geometric expansion of intermediate length (

In a series of studies, we have shown that phenytoin, 300 mg daily for one week, produces consistent hepatic microsomal enzyme induction, resulting in a decrease of 25% in misonidazole half-life, without causing any toxicity per se. A longer period of administration gives only a slightly greater induction. Phenobarbitone in a daily dose of 90 mg causes a reduction of 18% and 23% in misonidazole half-life after 1 and 2 weeks' pre-treatment respectively, but is less suitable clinically because of its sedative effect. A further series of studies using phenytoin as the inducing agent has shown that, despite adequate enzyme induction and increased misonidazole metabolism, it is impossible to increase the total dose of misonidazole beyond the usually accepted value of 12 g/m2 because of unacceptable neuropathy (a rate of 50% at a dose of 14 g/m2 over three weeks). In single doses of above 3.0-4.0 g of misonidazole, severe nausea and vomiting are prominent, so that this side effect is a determining factor in the treatment fractionation. Audiometric studies show no correlation between the incidence of peripheral neuropathy and abnormal audiograms, and have no value in the early prediction of neurotoxicity. It seems that despite causing increased metabolism, enzyme induction does not protect against neurotoxicity and thus will not permit the use of higher doses of misonidazole for increased radiosensitisation.

Fetal scalp blood lactate was measured during labour by a simple, rapid method and its value as an indicator of fetal intrauterine hypoxia was assessed and compared with that of pH measurement. The normal ranges of lactate concentration and of pH values were calculated. Significantly higher concentrations of lactate and lower pH values were found in samples of scalp blood taken close to delivery from babies with Apgar scores of less than or equal to 6 at 1 min compared with those from healthy babies with Apgar scores of greater than or equal to 7 at 1 min. A similarly significant difference was observed between the cord blood lactate and pH values of these two groups of babies. Ominous fetal heart rate patterns were associated with higher lactate concentrations and lower pH values in fetal scalp blood than were normal fetal heart rate patterns. The measurement of fetal scalp blood lactate or pH, or continuous electronic fetal heart rate monitoring were equally good at predicting the condition of the infant at birth.

Recent publications on the configurational properties of polymer chains subject to excluded volume restraints, as deduced from studies of off-lattice model chains, are briefly reviewed. It is shown that the data for such models cast doubt on the validity of the frequently quoted equations (RN2)=aN6/5 and (SN2)=a'N6/5 where (RN2) and (SN2) are respectively the mean square end-to-end length and mean square radius of gyration of N-link chains, and a and a' are constants. The use of the technique of inversely restricted sampling to generate off-lattice model chains, with either freely varying or fixed bond angles, and free rotation about bonds, is described.

Summary. Adapting Sir Dugald Bairďs concept of primary obstetric causes of perinatal mortality, a revised clinico-pathological classification has been evolved to take account of new knowledge and developments, and to direct attention to potentially avoidable deaths and to where intensified efforts and investigation are needed. Categories highlighting the importance of intrauterine growth retardation, unexplained intrauterine death and spontaneous premature labour have been introduced, intrapartum hypoxia is separated from birth trauma, and infection again has its own category. Regular perinatal audit at one obstetric hospital, since 1979, has shown that the new system provides a workable and useful means for classifying not only perinatal deaths, but also late abortions, late neonatal deaths and perinatally related infant deaths. The rate of total perinatally related wastage, defined in this way, was almost twice that for perinatal mortality (22–8 compared with 11.9 per 1000 births). The former is advocated as a more realistic index for the audit of perinatal care. The revised and extended system is put forward as a contribution to the current debate on classifying and reporting such wastage, in the hope that it may be tested as a model for regional as well as hospital surveys.

Adapting Sir Dugald Baird's concept of primary obstetric causes of perinatal mortality, a revised clinico-pathological classification has been evolved to take account of new knowledge and developments, and to direct attention to potentially avoidable deaths and to where intensified efforts and investigation are needed. Categories highlighting the importance of intrauterine growth retardation, unexplained intrauterine death and spontaneous premature labour have been introduced, intrapartum hypoxia is separated from birth trauma, and infection again has its own category. Regular perinatal audit at one obstetric hospital, since 1979, has shown that the new system provides a workable and useful means for classifying not only perinatal deaths, but also late abortions, late neonatal deaths and perinatally related infant deaths. The rate of total perinatally related wastage, defined in this way, was almost twice that for perinatal mortality (22.8 compared with 11.9 per 1000 births). The former is advocated as a more realistic index for the audit of perinatal care. The revised and extended system is put forward as a contribution to the current debate on classifying and reporting such wastage, in the hope that it may be tested as a model for regional as well as hospital surveys.