Assessing family members' motivational readiness and decision making for consenting to cadaveric organ donation.

This study assessed the applicability of two important components of the transtheoretical model of behavior change (TTM) to family consent for cadaveric organ donation. Men and women (N = 169), who consented or refused to donate the organs of a family member, completed a telephone survey reflecting the stage of change and decisional balance constructs. Psychometric analyses resulted in a two-factor decisional balance scale: a seven-item scale representing negative perceptions of consent (cons), and a seven-item scale representing positive perceptions of consent (pros). The pros and cons were significantly associated with stage of readiness for donation consent and with the family consent decision. Research utilizing this measure has the potential to enhance intervention programs to increase donation consent rates.

Factors that influence personal perceptions of the risk of an acute myocardial infarction.

Personal risk perceptions of acute myocardial infarction (AMI) affect people's preventive health behaviors as well as their beliefs during a heart attack episode. The authors investigated factors that are associated with personal risk perceptions of having an AMI. A random-digit-dial survey was conducted among 1294 respondents, aged 18 years or older, in 20 communities across the nation as part of the Rapid Early Action for Coronary Treatment (REACT) trial. Results of two mixed-model linear regression analyses suggested that worse perceived general health, more risk factors, and greater knowledge were associated with greater perception of AMI risk. The results also showed that women who answered, incorrectly, that heart disease is not the most common cause of death for women in the United States reported significantly lower risk perceptions than women who answered this question correctly. The findings in this study suggest that interventions need to target specific misconceptions regarding AMI risk.

Metastatic carcinoid diagnosed at laparoscopic excision of pelvic endometriosis.

Carcinoid tumors are uncommon lesions that arise from the intestinal tract or ovaries. Metastatic carcinoid was found in a 35-year-old woman who underwent laparoscopic excision of pelvic endometriosis. The primary tumor was in the distal appendix, and metastatic carcinoid coexisted with endometriosis in both pelvic sidewall specimens. This unusual situation is another reason to consider excision of presumed pelvic endometriosis. It is important to be aware of other uncommon gastrointestinal and pelvic conditions, such as the occasional carcinoid in the appendix or ovary.

Excision of endometriosis with laparosonic coagulating shears.

Excision of endometriotic lesions allows the diagnosis to be confirmed and may provide long-term relief of symptoms. Laparoscopic excision is generally accepted for treatment of all stages of disease and can be accomplished safely with laser, electrosurgery, or ultrasonic energy. Ultrasonic energy uses the 5-mm hook blade for excision and 5-mm harmonic scalpel ball electrode for coagulation. Disease was excised by laparosonic coagulating shears (LCS) in 14 women. All patients had an uneventful postoperative course, with 13 (93%) remaining pain free 7 to 18 months postoperatively. The LCS is easy to use and allows endometriosis to be excised with an adequate margin of safety. (J Am Assoc Gynecol Laparosc 6(2):195-199, 1999)

Gallstones presenting as a cul-de-sac mass.

BACKGROUND: Pelvic masses requiring surgical evaluation have many different causes. CASE: In an unusual case, a pelvic mass was found to comprise approximately 40 gallstones. Laparoscopy was performed, and the gallstones were removed easily. CONCLUSION: Nongynecologic causes should be considered in the differential diagnosis of pelvic masses.

Laparoscopic-assisted vaginal hysterectomy using the laparosonic coagulating shears.

The use of the Laparosonic Coagulating Shears (LCS) for laparoscopic-assisted vaginal hysterectomy (LAVH) was evaluated in three women. The indications for surgery included chronic pelvic pain, adhesions, endometriosis, symptomatic uterine fibroids, and abnormal bleeding. The entire laparoscopic portion of the LAVH was performed with the LCS. All three patients had an uneventful postoperative course, and continue to do well one year postoperatively. The harmonic scalpel produces surgical incisions with concomitant hemostasis. With the introduction of the LCS, larger vessels can be managed safely. The LCS produces less charring and less thermal tissue injury, reduces postoperative adhesions, and promotes faster healing. The cavitational effect facilitates dissection, and the minimal heat production and absence of current through the patient contribute to safety. Ultrasonic activated technology is easy to use, cost effective, and affords the surgeon a greater margin of safety. This is only a preliminary report, and further study is needed, but the benefits of ultrasonically activated technology and the LCS are readily apparent.

Lysis of uterine adhesions with the four-channel hysteroscope.

Hysteroscopy with direct visualization of the uterine cavity has made intrauterine surgery easier and safer. Most hysteroscopes have one operating channel. This report illustrates the four-channel Baggish-Weck hysteroscope, which allows simultaneous clearing of the surgical field and lysis of adhesions.

Antineurofilament antibody evaluation in neuropsychiatric systemic lupus erythematosus. Combination with anticardiolipin antibody assay and magnetic resonance imaging.

We used Western blot analysis to examine the occurrence and titer of antibody to cytoskeletal neurofilament protein antigens in patients with neuropsychiatric manifestations of systemic lupus erythematosus (SLE) and in controls. Twenty-two patients with neuropsychiatric SLE (NPSLE) had an increased incidence of antineurofilament antibody (ANFA) compared with 34 patients with SLE without neuropsychiatric symptoms, 78 patients with other disease processes, and 22 healthy controls. ANFA were found to be directed against the 205,000- and 160,000-dalton proteins of the neurofilament triplet. Patients with a diffuse NPSLE clinical presentation had the greatest frequency of serum ANFA (7 of 12, 58%) compared with all other groups examined. Magnetic resonance imaging and serum anticardiolipin antibody testing were also performed in selected patients with NPSLE. Patients with a focal clinical presentation of NPSLE, positive magnetic resonance imaging findings, and negative serum ANFA had significantly elevated levels of anticardiolipin antibody.

Biology of mouse thymic virus, a herpesvirus of mice, and the antigenic relationship to mouse cytomegalovirus.

Mouse thymic virus (TA) is a herpesvirus which produces extensive necrosis of the thymus of newborn mice 7 to 14 days after infection. Infectious virus can be recovered from the thymus for only 10 days after infection, with highest titers occurring between days 5 and 7. In mice 5 days old or less, TA infects thymus cells and produces massive necrosis. TA also infects the salivary glands and persists as a chronic infection. Newborn mice infected with TA have no detectable humoral immune response. Infected adult mice respond, and humoral antibody is detected 7 days after infection. Titers are maintained for months thereafter. Regardless of the age of the mice inoculated with TA, persistent infection was established in the salivary glands, but no evidence for thymus involvement was observed when adults were infected. TA does not cross-react serologically by immunofluorescent, complement fixation, or virus neutralization tests with mouse cytomegalovirus; however, interestingly, the epidemiology of the two herpesviruses are similar. Both mouse cytomegalovirus and TA were isolated from the same animals in populations of laboratory and wild mice. Evidence of infection with mouse cytomegalovirus and TA were most apparent by virus isolations, since humoral antibody responses are rarely observed. All strains of mice tested were susceptible to TA infection. However, in some strains maximum necrosis occurred at 7 days, compared with 10 to 14 days for other strains. The difference in age susceptibility and the target tissue of thymus in newborn mice suggests that TA is a model herpesvirus for studying the effects of viral infections on humoral and cell-mediated immunological functions.

A study of the long-range effectiveness of teaching blood pressure screening in a dental college.

The University of Tennessee College of Dentistry has been actively involved in teaching the fundamentals of blood pressure screening since 1964. To determine the effectiveness of this instruction a sample of practitioners who have graduated since 1964 was surveyed to determine the degree to which they use blood pressure screening in their practices.

Structural components of Oriboca virus.

Analysis of purified Oriboca virions by neutral, sodium dodecyl sulfate polyacrylamide-gel electrophoresis indicated the presence of three structural polypeptides designated V-1, V-2, and V-3 on the basis of their relative electrophoretic mobilities in 8% gels. Polypeptides V-2 and V-3 are glycopeptides associated with the virion envelope as demonstrated by the preferential incorporation of labeled glucosamine into the polypeptides and by release of the polypeptides from the intact virion by the nonionic detergent NP-40. Polypeptide V-1 is the protein component of the nucleoprotein core of Oriboca virus as evidenced by the specific incorporation of uridine into the nucleoprotein, its release from the intact virion by NP-40 treatment, and its separation by both rate-zonal and isopycnic density gradient centrifugation from both the intact virion and envelope components. Molecular weights have been tentatively assigned to the polypeptides by extrapolation from the structural polypeptides of Sindbis virus when both are run in the same gel. Polypeptide V-1 has an apparent molecular weight of 20,000 to 23,000; V-2, 30,000 to 32,000; and V-3, 83,000 to 85,000.

Status of women microbiologists.

The general picture that emerges from this study is that the woman microbiologist, upon entering the professional job market, faces (i) slower advancement; (ii) restricted extramural recognition; and (iii) fewer positions of a supervisory or administrative nature, when compared to men. Most striking is the salary differential, which increases with increasing educational level, with increasing rank, and with increasing seniority. From the beginning of her professional training, the woman microbiologist feels handicapped by lack of encouragement and proper role models. She generally receives little advice regarding her professional future and rarely feels pushed to take the most challenging position. Should she be married, she feels that her mobility is severely restricted. Even though the subjective nature of these feelings may be interpreted as projections of failure, subtle inducements for women to stay at lower levels may well exist, in addition to more objective measurements, such as lower salary levels and slower professional advancement. Despite these handicaps, professional women continue to work. As a group, they work for the same reasons that men do, they work as long and as hard as men do, and they remain at their positions as long as men do. Women and men rate themselves equally as to job performance, degree of independence, and publication rate. On the basis of this study, it should not be surprising that women professionals are less visible than men and that only a small proportion of women become what is considered successful by the usual external criteria. If women were to receive continued encouragement, scientific contact, and professional recognition at each stage of their professional lives, they would undoubtedly become more visible. The lack of encouragement and selfconfidence leading to isolation, which then leads to lack of recognition, is a vicious circle that must be broken for the woman professional. This can be done most easily for the beginning student. For older women, there must be increased placement in positions of responsibility and visibility. Protective practices that discourage women from entering arenas of competition can only be viewed as discrimination on the basis of sex, since women professionals are rarely given the choice between being protected and being independent. Unexpectedly, this study illustrates the lower status of another group of individuals who are considered deviants from the expected roles of the established society-single men with doctorates, who were found in the positions predominately filled by women. In conclusion, this study of a select group of scientists probably has general applicability to all women professionals in their roles vis-à-vis men. Examination and documentation of discriminatory practices based on sex points to the areas in which women must direct their demands for equality.