Norms for emotion-false memory lists.

False memory has been a flourishing research area for decades, and recently there has been considerable interest in how emotional content affects it. Literature reviews have noted a lack of normed materials that vary in emotional valence and arousal as a factor that contributes to the mixed findings on emotion-false memory effects. We report a pool of normed materials of this sort, the Cornell/Cortland Emotional Lists (CEL). This is a Deese/Roediger/McDermott (DRM) type list pool in which words' mean valence and arousal ratings are factorially manipulated across 32 lists. These lists' levels of mean backward associative strength (MBAS) are all high enough to induce significant levels of false memory. The lists were normed by administering them to 228 subjects at three different universities, all of whom responded to recall and recognition tests for the lists. The norming data revealed that false recall and false recognition were higher for negative lists than for positive lists, whereas true recall and true recognition were higher for positive lists than for negative lists. In addition, high arousal strengthened the valence effects on both true and false recall. These results indicate that the CEL lists are useful tozols for emotion-false memory research.

Developmental reversals in false memory: Effects of emotional valence and arousal.

Do the emotional valence and arousal of events distort children's memories? Do valence and arousal modulate counterintuitive age increases in false memory? We investigated those questions in children, adolescents, and adults using the Cornell/Cortland Emotion Lists, a word list pool that induces false memories and in which valence and arousal can be manipulated factorially. False memories increased with age for unpresented semantic associates of word lists, and net accuracy (the ratio of true memory to total memory) decreased with age. These surprising developmental trends were more pronounced for negatively valenced materials than for positively valenced materials, they were more pronounced for high-arousal materials than for low-arousal materials, and developmental increases in the effects of arousal were small in comparison with developmental increases in the effects of valence. These findings have ramifications for legal applications of false memory research; materials that share the emotional hallmark of crimes (events that are negatively valenced and arousing) produced the largest age increases in false memory and the largest age declines in net accuracy.

Assessing the effectiveness of warnings and the phenomenological characteristics of false memories.

The phenomenology of false memories was investigated in three experiments in which participants heard two experimenters read lists of items that were related to critical nonpresented items. In Experiments 1, following a recognition memory test, participants rated the phenomenological characteristics of their memories immediately and after a 48-hour delay. False recognition was prevalent and on several dimensions participants rated their true memories as more vivid than their false memories. In Experiments 2 and 3, following the study phase, participants were warned about the phenomenological differences between true and false memories and were instructed to use this information to avoid reporting nonpresented items. This type of warning was ineffective at reducing false recall (Experiment 2) and false recognition (Experiment 3) relative to unwarned participants. Importantly, the inability of explicit warnings to impact illusory recollections demonstrates that the false memories cannot be attributed simply to a criterion shift.

Accuracy and qualities of real and suggested memories: nonspecific age differences.

This study examined adult age differences in the accuracy, confidence ratings, and vividness ratings of veridical and suggested memories. After seeing either one or two exposures of a vignette depicting a theft, young adults (M = 19 years) and older adults (M = 73 years) were given misleading information that suggested the presence of particular objects in the episode. Memory accuracy was higher for younger adults than for older adults, and the frequency of falsely reporting the presence of suggested objects was greater for older adults than for young adults. Further, levels of confidence and vividness ratings of the perceptual attributes (colors, locations) of falsely recognized items were higher for older adults than for young adults. Both young adults and older adults used more perceptual references when describing veridical memories than when describing suggested memories. Age differences in the suggestibility of memory were attributed to nonspecific or nondissociated memory aging effects.

Recall accuracy and illusory memories: when more is less.

In two experiments it was revealed that manipulations that increased recall of studied list items also increased false recall of theme-related, critical nonpresented words. In Experiment 1 subjects listened to a series of short word lists, each containing items associatively related to a theme, while engaging in either semantic or nonsemantic processing. On an immediate free recall test semantic processors demonstrated greater correct recall as well as more illusory memories of critical nonpresented items than nonsemantic processors. In Experiment 2, the short study lists were combined to form longer lists that were presented either blocked by theme or in a random presentation order. Retention interval was also varied as participants were tested either immediately, one week after, or three weeks after the study phase. Presenting the target items in a blocked, as opposed to random, format increased recall accuracy, but this was at the expense of a higher intrusion rate for theme-consistent items. Interestingly, the level of false memories was not affected by retention interval even though typical decrements in the recall of study items were observed over time. The results of these experiments highlight the persistence of the false memory effect, as well as pointing to several factors, primarily semantic processing, that may lead to the creation of false memories. Interpretations are offered within the theoretical frameworks of source monitoring and fuzzy trace theory.

Pathophysiology of anorectal dysfunction.

Anorectal disorders are the cause of significant discomfort and embarrassment in women. The onset typically follows childbirth and symptoms increase with age. Anal incontinence, rectovaginal fistula, rectal prolapse, anal fissure, and constipation are considered.

Internal and external anal sphincter anatomy as it relates to midline obstetric lacerations.

OBJECTIVE: To examine the anatomy of the internal and external anal sphincters in the area of midline obstetric lacerations, to gain insight into sphincter damage and repair. METHODS: The length, craniocaudal extent, and overlap of the internal and external anal sphincters in the perineal body were measured in 17 cadavers. Further anatomic observations were made in four sets of whole pelvis cross-sections taken in the sagittal, coronal, and transverse planes. During the repair of 20 acute fourth-degree lacerations, observations were made to determine the internal sphincter visibility following birth. RESULTS: The external and internal and sphincters overlap by 17.0 mm (standard deviation [SD] 6.9), with the internal sphincter lying between the external sphincter and the anal canal. The internal sphincter extends an additional 12.2 mm (SD 5.9) cranial to the proximal extent of the external sphincter, whereas the caudal margin of the internal sphincter lies 3.7 mm (SD 7.2) cranial to the distal margin of the external sphincter. In pregnant women who sustained a fourth-degree laceration, we found that the internal sphincter can be identified as a rubbery white layer adjacent to the anal submucosa lying between the external sphincter and the anal canal. CONCLUSION: The internal anal sphincter lies between the anal mucosa and the external anal sphincter and extends more than a centimeter above the cranial margin of the external sphincter, a region where it is disrupted when a fourth-degree obstetric laceration has occurred.

The blocked-random effect in pictures and words.

Picture and word recall was examined in conjunction with list organization. 60 subjects studied a list of 30 items, either words or their pictorial equivalents. The 30 words/pictures, members of five conceptual categories, each represented by six exemplars, were presented either blocked by category or in a random order. While pictures were recalled better than words and a standard blocked-random effect was observed, the interaction indicated that the recall advantage of a blocked presentation was restricted to the word lists. A similar pattern emerged for clustering. These findings are discussed in terms of limitations upon the pictorial superiority effect.

Venous thromboembolism during pregnancy: a current review of diagnosis and management.

Pregnancy is widely recognized to be a physiologic state with a markedly elevated risk for thromboembolic complications. The diagnosis and management of venous thromboembolic events during pregnancy, however, remains controversial because of the lack of prospective, randomized trials that have included pregnant women. Significant progress has been made in the last 10 years in the management of these conditions in the nonpregnant patient and strong clinical guidelines have been established recently. Obstetrician-gynecologists may modify these guidelines and apply them to the pregnant patient based on their knowledge of the physiologic changes in pregnancy. Objective diagnostic techniques should be used liberally when the diagnosis of deep vein thrombosis or pulmonary emboli is considered because early intervention may prevent serious maternal sequelae including death. Heparin remains the anticoagulant of choice during pregnancy because of its proven safety for both the patient and the fetus. It is likely that long-term anticoagulation is necessary when venous thromboembolism occurs antepartum, although the most efficacious regimen has yet to be established. There is some concern about the prolonged use of heparin during pregnancy, particularly regarding the risk of osteopenia.

Evaluation of colposcopic skills in an obstetrics and gynecology residency training program.

OBJECTIVES: To evaluate objectively the colposcopic skills of resident physicians in an obstetrics and gynecology training program. METHODS: One hundred and ten colposcopic examinations were performed in a nonstructured fashion by 16 resident physicians supervised by the full-time gynecology faculty. Data were collected prospectively and were classified according to the resident's ability at colposcopic grading of cervical lesions (accuracy) and their ability to recognize the presence or absence of dysplasia (sensitivity and specificity, respectively) when compared to the corresponding histological interpretations. In addition, results between three groups were compared-junior residents (PGY1 and PGY2), senior residents (PGY3), and chief residents (PGY4)-to analyze learning progression. RESULTS: The numbers of evaluations performed by junior, senior, and chief residents were 43, 33, and 34, respectively. The overall accuracy, sensitivity, and specificity of the residents' colposcopic assessments were 31.8%, 96.7%, and 22%, respectively. There was no difference in any of these measures between the groups analyzed. CONCLUSIONS: Residents correctly identified cervical dysplasia in the majority of cases but had difficulty in distinguishing between low-grade and high-grade cervical dysplasia and in differentiating dysplasia from benign cellular changes, such as metaplasia and inflammation. Colposcopic accuracy, sensitivity, and specificity did not seem to improve with increasing experience. Resident colposcopic skills may improve if more structured training is implemented, particularly if emphasis is placed on teaching differences between benign cellular changes and dysplastic lesions.

Tubo-ovarian abscess formation in users of intrauterine devices remote from insertion: a report of three cases.

BACKGROUND: The association between tubo-ovarian abscess formation and the presence of an intrauterine device (IUD) is well recognized. It has been suggested that the risk of upper-genital-tract infection is highest during the immediate period following the insertion of an IUD, returning to baseline by 5 months postinsertion. We present 3 cases of women who, 10-21 years after insertion of their IUDs, developed tubo-ovarian abscesses that were not causally related to sexually transmitted diseases (STDs) or actinomycetes. CASES: Three women, ages 39-47 years, presented to our gynecology service for evaluation of abdominal pain. One woman had bilateral tubo-ovarian abscesses and the other 2 had unilateral tubo-ovarian abscesses. All 3 were IUD users, with an interval from IUD insertion to presentation of 10-21 years. In each case, the cervical cultures for gonorrhea and chlamydia were negative at presentation and the sexual history was not consistent with an STD mode of spread. All 3 women initially received broad-spectrum antibiotics, but 2 eventually required definitive surgical therapy. CONCLUSION: Long-term users of IUDs remain at risk for serious, indolent pelvic infections. These women should be counseled by their gynecologists on an ongoing basis as to this persistent risk. Tubo-ovarian abscess should be strongly considered in the differential diagnosis of an IUD user who presents with an adnexal mass, fever, or abdominal pain.

Anal incontinence and the obstetrician-gynecologist.

OBJECTIVE: To gather, synthesize, and present useful scientific information concerning the anal continence mechanism that will aid obstetrician-gynecologists in managing vaginal birth and evaluating women with anal incontinence not caused by disruption of the external anal sphincter. DATA SOURCES: Sources included a Medline search and reference lists of relevant articles and standard textbooks. METHODS OF STUDY SELECTION: Articles were identified that contained scientific data on the pathophysiology of anal incontinence, the influence of vaginal delivery on the continence mechanism, and therapeutic measures. Only those presenting original research results were included. Studies concerned exclusively with surgical management of the ruptured perineum were excluded. DATA EXTRACTION AND SYNTHESIS: All articles were reviewed and the physiologic data summarized. These findings were grouped by their relevance to each anatomical or physiologic issue involving anal incontinence and by whether they considered the issue of injury at the time of vaginal delivery. The data were then assembled into a functionally oriented overview of the continence mechanism. The subject of injury at the time of vaginal delivery was considered separately against a background of continence pathophysiology. CONCLUSION: Vaginal delivery may initiate damage to the continence mechanism by direct injury to the pelvic floor muscles, damage to their motor innervation, or both. Additional denervation may occur with aging, resulting in a functional disability many years after the initial trauma. These factors should be kept in mind when conducting vaginal birth and planning therapy for anal incontinence.

Pelvic fluid collections following hysterectomy and their relation to febrile morbidity.

OBJECTIVE: To determine the incidence of pelvic fluid collections after hysterectomy, detected by transvaginal sonography and pelvic examination, and to correlate these findings with postoperative febrile morbidity. METHODS: Thirty-eight women, aged 26-65, were studied by pelvic examination and transvaginal sonography 1-5 days after vaginal or abdominal hysterectomy. The sonographer was unaware of the patient's clinical course before the examination and was not involved in clinical decision making. The results of the study were not made available to the treating physician. RESULTS: Transvaginal sonography revealed a sonolucent mass consistent with a fluid collection above the vaginal cuff ranging in size from 3.9-74.7 cm3 in 13 of 38 patients (34.2%). Only one of the 13 fluid collections was evident on pelvic examination performed before ultrasound. Nine of 13 women (69.2%) with fluid collections developed febrile morbidity, compared to three of 25 (12%) who did not have fluid collections (P = .006, Fisher exact test). Cuff cellulitis was clinically diagnosed in seven of the 13 women (53.8%) with fluid collections, compared to none of 25 women without fluid collections (P < .001, Fisher exact test). CONCLUSIONS: Pelvic fluid collections are common after hysterectomy. Women who develop post-hysterectomy fluid collections appear to be at increased risk for the development of febrile morbidity and cuff cellulitis. Transvaginal sonography may facilitate the diagnosis of post-hysterectomy pelvic fluid collections, which are not readily detected by pelvic examination.

Recognition performance level and the magnitude of the misinformation effect in eyewitness memory.

The issue of whether misleading postevent information affects performance on the modified recognition test introduced by McCloskey and Zaragoza (1985) was examined in a meta-analysis. Results indicated that a misinformation effect can be obtained with the modified test. The meta-analysis also revealed that recognition hit rates are higher in studies that yield a misinformation effect than in studies in which the misinformation effect is not significant. The data from the meta-analysis were also used to assess whether the misinformation effect is related to the length of the retention interval. Results showed that a misinformation effect is more likely to be obtained with long retention intervals, although in the available data there is a confound between the length of the retention interval and the recognition level obtained.

Laparoscopic irrigation using a prewarmed pressurized system.

An automatic pressure infusion system equipped with a fluid warmer has been developed for rapid intravenous infusion of homeothermic fluids. The use of this system for irrigation during operative laparoscopy provides the surgeon with the ability to irrigate at a relatively high flow while avoiding the hypothermic effects of irrigation with cool fluids.

Mode of suppression of pituitary and gonadal function after acute or prolonged administration of a luteinizing hormone-releasing hormone antagonist in normal men.

LHRH antagonists compete with endogenous LHRH for binding to receptors on pituitary gonadotrophs and thereby inhibit gonadotropin secretion and, consequently, gonadal function. We studied the pituitary and gonadal suppression following single doses and short term administration (1-3 weeks) of a recently developed LHRH antagonist in normal men. First, the antagonist Nal-Glu ([Ac-D2Nal1, D4ClPhe2,D3Pal3,Arg5,DGlu6(AA),DAla10]LHRH ), was given as a single sc injection to five normal men at three dose levels of 1, 5, and 20 mg (study I). Serum FSH, immunoreactive LH (IR-LH), bioactive LH (bio-LH), testosterone, and estradiol were measured before and at frequent intervals for 48 h after Nal-Glu administration. Mean serum FSH decreased (P less than 0.001) by 28.9 +/- 5.4% (+/- SE), 38.2 +/- 7.9%, and 44.5 +/- 3.6% after the 1-, 5-, and 20-mg doses, respectively. Mean serum IR-LH decreased (P less than 0.001) by 39.0 +/- 13.8%, 53.2 +/- 10.0%, and 53.1 +/- 14.4% after the three doses. Serum bio-LH levels and the ratio of bio-LH/IR-LH decreased (P less than 0.001) after the 20-mg dose by 87.8% and 78.5%, respectively. Serum testosterone levels decreased (P less than 0.001) more than 78.5% after all Nal-Glu doses. The duration of testosterone suppression, but not the nadir reached, was dose dependent (P = 0.012). Serum estradiol levels also decreased (P less than 0.001), but the rate of decrease was slower than that of serum testosterone. The apparent plasma disappearance half-life of Nal-Glu after administration of 5 mg was 12.8 +/- 2.7 h. The Nal-Glu antagonist also was given daily as a single sc injection of 5 mg to eight normal men for 21 days (study II) or twice daily to five men for 7 days (study III). In study II, serum FSH, IR-LH, bio-LH, testosterone, estradiol, and 17-hydroxy-progesterone were measured daily, immediately before the next injection, and on days 1, 7, and 21 in frequent blood samples drawn for 24 h. The mean serum testosterone level in study II decreased (P less than 0.001) from 17.6 +/- 2.2 to 4.1 +/- 1.0 nmol/L on day 1, increased (P less than 0.05) between days 2 and 8, and then progressively decreased to below 2 nmol/L from day 18 until 24 h after the end of the study. Serum FSH, IR-LH, and bio-LH levels paralleled those of testosterone.(ABSTRACT TRUNCATED AT 400 WORDS)

Hepatic uptake of chylomicrons and triglyceride emulsions in rats fed diets of differing fat content.

The hepatic removal of plasma chylomicrons was determined for rats fed the following diets: a) containing no triglyceride, b) regular chow diet with 4.5% of its mass as lipid and, c) a corn oil-supplemented chow with triglyceride accounting for 20% of the mass. The fractional hepatic uptake of either radiolabeled chylomicrons or a triglyceride emulsion was reciprocally related to the amount of lipid in the diet. The animals receiving only carbohydrate and protein calories had the most active hepatic uptake of particulate triglyceride and were observed to have a significant decrease in the plasma concentration of the C apolipoproteins. The addition of either C-I, C-II, or C-III apoproteins to the triglyceride emulsion prior to intravenous injection produced a significantly lower hepatic triglyceride recovery of emulsions containing apoC-III. When the plasma of animals fed a fat-free diet was supplemented with human C-III-1 apolipoprotein, the distribution into the liver of either enterally administered fatty acid or parenteral triglyceride was diminished. The triglyceride content in the liver of the rats fed fat-free or corn oil-supplemented diets was significantly greater than that of the control rats and composition was somewhat similar to that of lymph triglyceride. The studies indicate an important influence of dietary lipid on both the partition of plasma triglyceride into the liver and the steady state hepatic triglyceride content.