Preliminary study of responses in mussel (Mytilus edilus) exposed to bisphenol A, diallyl phthalate and tetrabromodiphenyl ether.

Environmental pollutants with hormonal activity including bisphenol, diallyl phtalate and tetrabromodiphenyl ether, have the potential to alter gonadal development and reproduction in aquatic wildlife. Little is known about the biological impact of environmentally relevant concentrations in mussels. To investigate some aspects of their potential estrogenic action, mussels were continuously exposed during 3 weeks. Gonadal development and vitellogenin like protein levels were examined. Bisphenol (50 microg/l) induced the expression of phospho-proteins in females and spawning in both sexes. Diallyl phthalate and tetrabromodiphenyl ether decreased phospho-protein levels in both sexes and induced spawning in males. Moreover, severe damaging effects on ovarian follicles and ovocytes were observed in both bisphenol A- and tetrabromodiphenyl ether-exposed female mussels.

Biochemical and histological responses in mussel (Mytilus edulis) exposed to North Sea oil and to a mixture of North Sea oil and alkylphenols.

Several environmental chemicals are suspected to be responsible for adverse health effects on the reproductive system in various organisms. During this work, environmentally relevant concentrations of North Sea oil were used alone or in combination with alkylphenols and additional PAH to study the effect on vitellogenin-like protein expression and gonadal development in mussels. North Sea oil (0.5 ppm) induced the expression of phospho-proteins in both sexes indicating that some compounds are oestrogen-mimics. This induction was not seen in samples dosed with the mixture but signs of toxic effects were observed in the gonads. Indeed, numerous degenerating ovarian follicles in females and foci, similar to vertebrate melanomacrophage centres, were observed in testes.

[Voice rehabilitation from the viewpoint of the laryngectomized patient. Results of a patient survey]. / Die Stimmrehabilitation aus der Sicht der Laryngektomierten. Ergebnisse einer Patientenbefragung.

105 of 292 patients who had been laryngectomised at the Zentralkrankenhaus Bremen, between 1975 and 1990, were asked retrospectively by questionnaires concerning the state of their voice rehabilitation. 66.6% of them had learnt oesophageal speech, 36.2% used an external vibrator, and 9.4% a voice prosthesis (since 1985). 82.8% used only one kind of substitute (non-laryngeal) speech. If patients used more than one non-laryngeal speech pattern, the most frequent combination was oesophageal speech and an external vibrator. The most rapid voice rehabilitation was achieved by patients using a voice prosthesis (71.3% within six weeks). In the same period of time, 45.5% of the patients learnt to use the electronic voice aid, and only 16.1% learnt oesophageal speech. It took a whole year before all patient who eventually used oesophageal speech, had learned to handle it. Ambulant speech therapy was the predominant treatment leading to voice rehabilitation, followed by the support given by self-aid groups. A comparison of the various non-laryngeal speech patterns with regard to daily communication problems, and of the general satisfaction achieved with the type of non-laryngeal speech used, showed quantitative predominance of oesophageal speech as a positively rated method for voice restoration, even though a clear trend towards increased use of the voice prosthesis since its introduction is noticeable.

The case for managed cooperation (not competition): South Dakota Mental Health Linkage Project.

Promotion of collaboration among rural health providers is a needed strategy to improve integration, accessibility, and quality of mental health care. To support this viewpoint, pertinent outcome data from the authors' South Dakota (SD) project is presented. The data indicated that the project was successful in improving coordination of mental health care in south-central South Dakota. The authors feel that rural mental health care reform should emphasize rural cooperation and not managed competition. They support the recommendation that any health care reform should include training funds for the health care providers from underserved rural areas.

Enhanced transformation of digitoxin to dihydrodigitoxin in humans with renal failure.

A gas-chromatographic mass-spectroscopic technique was used to identify dihydrodigitoxin, a metabolite of digitoxin, in the plasma of healthy volunteers and patients with renal failure. Digitoxin and dihydrodigitoxin were extracted from plasma and derivatized with heptafluorbutyric anhydride. In normal subjects, only minimal concentrations of dihydrodigitoxin in plasma could be determined (1 ng/ml) after an intravenous bolus injection of digitoxin. Under a chronic treatment with a daily dose of 0.1 mg digitoxin in three out of seven individuals, detectable dihydrodigitoxin plasma levels were observed (0.7, 1.5, and 1.7 ng/ml) (Table I). On the other hand, in seven patients with renal failure, high dihydrodigitoxin plasma concentrations (8.9 +/- 0.9 ng/ml) were shown which were in a similar range as those of the parent compound (8.7 +/- 2.2 ng/ml) under a maintenance treatment with digitoxin.