In vitro neuroteratogenicity of valproic acid and 4-en-VPA.

Mouse embryos displaying 8 to 9 pairs of somites were cultured during 26 h in presence of 0.75 mM of VPA, or of 1 mM of 4-en-VPA. These concentrations induced approximately 50% of dysmorphogenic embryos. Irregular suture of caudal neural tube, abnormal head shape, cranial neural tube defects, and deformed optic vesicles were the most common defects observed with both compounds. The main differences in the types of dysmorphogeneses detected between the two compounds concerned the suture of the caudal neural tube and the telencephalic region. Other macroscopic effects induced by the two compounds were similar. Several of the observed abnormalities can be correlated with defects reported after in vivo exposure. The major alteration of the histological structure of the neural tube concerned a specific area in the hindbrain : VPA and 4-en-VPA induced an abnormal and irregular budding of the neuroepithelium at this level. Immunohistology with an antibody specific for radial glial fibers (RC-2) as well as SEM analysis showed a moderate effect on glial development, mainly after exposure to VPA.

Is there a place for paradoxical "maneuvers" in conventional psychotherapy?

This paper reviews the literature concerning the use and theoretical background of paradoxical maneuvers in conventional psychotherapy. By demonstrating a clinical example we highlight the usefulness of such an approach and the necessity for further research in finding valid indications and contraindications for its use.

Blood pressure and serum cholesterol among male Ethiopian immigrants compared to other Israelis.

STUDY OBJECTIVE: The aim was to determine the effect of migration from a non-industrialised to an industrialised society on age related changes in blood pressure and serum cholesterol. DESIGN: The study was a comparison of major risk factors for cardiovascular disease in cross sectional surveys in two groups: Ethiopian immigrants and Israeli industrial employees. SETTING: Ethiopian immigrants were examined at Army induction centres in Israel; industrial employees were examined in the course of a national Israeli study on occupational risk factors for cardiovascular disease. PARTICIPANTS: Participants were a sample of 387 male Ethiopians, aged 20-49 years, examined in 1987, who had immigrated to Israel three to four years previously, and a sample of 2747 male Israeli industrial employees in the same age group examined in 1985-7. MEASUREMENTS AND MAIN RESULTS: Among the Ethiopians there were no cases of overweight (Quetelet's index above 2.8) and only 6.7% were smokers, as compared with 20.7% overweight and 47.1% smokers among the other Israelis (p less than 0.001 for both variables). There were no significant differences in the prevalence of hypertension (11.6% and 13.0% for Ethiopians and other Israelis respectively). Hypercholesterolaemia (greater than 5.2 mmol/litre, 200 mg/dl) was much more prevalent among the other Israelis (42.0% v 9.6%, p less than 0.001). Blood pressures were similar and increased with age in both groups. However, in contrast to the other Israelis, average serum cholesterol among the Ethiopians was low and increased minimally with age. After regression adjustment for age and body mass index, blood pressures were higher among the Ethiopians, whereas serum cholesterol remained considerably higher among the other Israelis. Serum cholesterol was correlated with blood pressure in both groups. CONCLUSIONS: Since Ethiopian immigrants have been found to have uniformly low blood pressures on arrival in Israel, these findings suggest that there is an age dependent effect on blood pressure resulting from migration which is not reflected in the serum cholesterol values.

Atrial fibrillation and atrial enlargement in patients with mitral stenosis.

The present study was designed to assess the relative contribution of atrial fibrillation and left atrial pressure to changes in the size of the left and right atria in patients with mitral stenosis. The study included 155 subjects, 102 of whom underwent prospective echocardiography and Doppler cardiography, and 69 of whom underwent cardiac catheterization. The size of the atria was determined by two-dimensional echocardiography. There were no significant hemodynamic differences between patients with mitral stenosis who were in either sinus rhythm or atrial fibrillation. The left atrium was larger (p less than 0.001) in patients with mitral stenosis and atrial fibrillation (37.6 +/- 10.8 cm2) than in patients in sinus rhythm (27.8 +/- 7.7 cm2) or normal subjects (15 +/- 3.3 cm2). The size of the right atrium was larger (p less than 0.001) in patients with mitral stenosis and atrial fibrillation (21.7 +/- 5.2 cm2) than in patients in sinus rhythm (13.4 +/- 3.9 cm2) or normal subjects (13.8 +/- 3.7 cm2). Multiple regression analysis showed that the severity of mitral stenosis accounted for 38%, age for 7%, and atrial fibrillation for 11% of the change in the size of the left atrium. Atrial fibrillation accounted for 24%, age for 11, and mitral valve area for 3% of the change in the size of the right atrium. The analysis suggests that the onset of left atrial dilatation in mitral stenosis is the result of an early increase in left atrial pressure. Atrial fibrillation, which develops irrespective of the severity of the mitral stenosis, contributes to a further enlargement of the left and right atria.