Metaidoioplasty: an alternative phalloplasty technique in transsexuals.

The various techniques for phalloplasty in female-to-male transsexuals produce results that are more or less acceptable, both aesthetically and functionally. However, all these techniques will lead to extensive scarring of the donor area. Metaidoioplasty uses the clitoris, overdeveloped by hormonal treatment, to construct a microphallus in a way comparable to the correction of chordae and lengthening of urethra in male pseudohermaphrodites and in cases of severe hypospadias.

Major and minor depression in later life: a study of prevalence and risk factors.

In this paper, the results of a community-based study into the prevalence and risk factors associated with depression in the older (55-85 years) population of The Netherlands are presented. The prevalence of major depression was 2.02%, that of minor depression 12.

Time-resolved and steady-state spectroscopic analysis of membrane-bound reaction centers from Rhodobacter sphaeroides: comparisons with detergent-solubilized complexes.

The spectroscopic analysis of the antenna-deficient Rhodobacter sphaeroides strain RCO1 has been extended to an investigation of the kinetics and spectroscopy of primary charge separation. Global analysis of time-resolved difference spectra demonstrated that the rate of charge separation in membrane-bound reaction centers is slightly slower than in detergent-solubilized reaction centers from the same strain. A kinetic analysis of the decay of the primary donor excited state at single wavelengths was carried out using a high repetition rate laser system, with the reaction centers being maintained in the open state using a combination of phenazine methosulfate and horse heart cytochrome c.

Personal incentives as determinants of adolescent health behavior: the meaning of behavior.

It has been suggested that prevailing theories do not fully incorporate the less rational, more emotional elements of adolescent health and risk behavior. To address this limitation, the perceived incentives construct from Tappe's Model of Personal Investment is split into intrinsic and extrinsic incentives, with the intrinsic incentives representing personal meanings of adolescent health and risk behaviors. Intrinsic incentives were operationalized using transcripts from focus group interviews for three behavioral domains: sleeping habits, eating habits at lunch and eating habits after school.

Screw fixation following bilateral sagittal ramus osteotomy for mandibular advancement--complications in 700 consecutive cases.

The use of transbuccal positional screws for stabilisation of bony segments following bilateral sagittal split osteotomy for mandibular advancement was assessed in 700 consecutive cases. In 19 patients (2.7% of cases) screw fixation was not used as the method of fixation.

The effect of immunosuppressive agents on monocyte generation and cytokine expression.

: The purpose of this study was to determine the effect of immunosuppressive drugs on the production of inflammatory cytokines and on the generation of macrophages from bone marrow precursors. Lipopolysaccharide-stimulated peripheral blood mononuclear cells (PBMCs) were cultured in the presence of therapeutic concentrations of 6-mercaptopurine (6-MP), methotrexate (MTX), or prednisolone. The effect of these drugs on the expression of interleukin (IL)-lβ, IL-8, and tumor necrosis factor-α (TNF-α) was studied using bioassays and Northern analysis.

The association of physical health and depressive symptoms in the older population: age and sex differences.

Physical health and depression are closely related in the elderly. This has been found in both cross-sectional and longitudinal studies. In this study the relation between four aspects of physical health and depressive symptom levels were studied in a community-based sample of older inhabitants of a small town in the Netherlands (n = 224).

Dextran sulfate sodium-induced colitis occurs in severe combined immunodeficient mice.

Background/aims: Oral administration of dextran sulfate sodium (DSS) has been reported to induce colitis in mice. The purpose of this study was to determine whether the possible pathogenic mechanism involved the acquired immune system.

Methods: Normal BALB/c and related C.

The expression pattern of contractile and intermediate filament proteins in developing skeletal muscle and rhabdomyosarcoma of childhood: diagnostic and prognostic utility.

In order to investigate whether rhabdomyosarcoma (RMS) can be related to equivalent stages of skeletal muscle development, muscle tissue of 21 human foetuses and 112 primary RMSs were characterized immunohistochemically using antibodies directed against vimentin, desmin, muscle-specific actin (HHF35), sarcomeric actin (sr-actin), smooth muscle actin (sm-actin), and troponin-T. During fetal skeletal muscle development, all myotubes/fibres of the first and second generations expressed desmin, HHF35, and sr-actin. Vimentin was almost exclusively present in immature primary and secondary myotubes/fibres.

Expression of developmentally regulated muscle proteins in rhabdomyosarcomas.

Human skeletal muscle differentiation and maturation follows a precise sequence of events. To investigate whether and to what extent rhabdomyosarcoma (RMS) cells follow a comparable sequence, 29 fresh frozen specimens of RMS (14 primary and 15 relapses) were immunostained with antibodies directed against developmentally regulated myosin heavy chains (MHC), ie, fetal, fast, and slow MHC, in addition to desmin and vimentin. Four distinct patterns of expression were observed: I) RMS cells expressing exclusively vimentin and desmin (n = 7), II) in addition to expression of vimentin and desmin, a minority of neoplastic cells were immunoreactive with fetal MHC (n = 6), III) in addition to pattern II, fast MHC was expressed (n = 7), and IV) RMS cells simultaneously expressing vimentin, desmin, fetal, fast, and slow MHC (n = 9).

Histopathological classification of childhood rhabdomyosarcomas: relationship with clinical parameters and prognosis.

To define a useful and prognostically relevant classification system for rhabdomyosarcomas (RMSs), tissue sections of 113 well-documented, protocol-treated cases were retrieved from the files of the Emma Kinderziekenhuis Amsterdam, the Netherlands, and reclassified by a panel of pediatric pathologists. The following subtypes were recognized: embryonal RMS (n = 66), alveolar RMS (including the solid variant) (n = 16), botryoid RMS (n = 11), embryonal sarcoma (n = 6), and spindle cell RMS (n = 5). Nine cases were classified as RMS not otherwise specified (NOS).

Palatal changes after lip surgery in different types of cleft lip and palate.

This study concerns palatal development during 6 months following primary lip closure. The sample consisted of 75 children with different forms of cleft lip and palate and 51 noncleft children. The palate was measured at 3 months of age, just before lip surgery, after surgery at 6 months, and again at 9 months of age.

Autogenic training and cognitive self-hypnosis for the treatment of recurrent headaches in three different subject groups.

The aims of this study were to (a) investigate the efficacy of autogenic training (AT) and cognitive self-hypnosis training (CSH) for the treatment of chronic headaches in comparison with a waiting-list control (WLC) condition, (b) investigate the influence of subject recruitment on treatment outcome and (c) explore whether the level of hypnotizability is related to therapy outcome. Three different subjects groups (group 1, patients (n = 58) who were referred by a neurological outpatient clinic; group 2, members (n = 48) of the community who responded to an advertisement in a newspaper; and group 3, students (n = 40) who responded to an advertisement in a university newspaper) were allocated at random to a therapy or WLC condition. During treatment, there was a significant reduction in the Headache Index scores of the subjects in contrast with the controls.

Historical study: Cornelia C. de Lange (1871-1950)--a pioneer in clinical genetics.

The life and work in the field of clinical genetics of one of the most outstanding Dutch pediatricians of the first half of the twentieth century, Cornelia C. de Lange (1871-1950), is described against the background of the development of pediatrics, anthropogenetics, and clinical genetics in the Netherlands. Cornelia de Lange specialized in and worked on all aspects of the broad field of pediatrics.

Energy migration and trapping in a spectrally and spatially inhomogeneous light-harvesting antenna.

In this paper, we analyze the process of excitation energy migration and trapping by reaction centres in photosynthesis and discuss the mechanisms that may provide an overall description of this process in the photosynthetic bacterium Rhodospirillum (Rs.) rubrum and related organisms. A wide range of values have been published for the pigment to pigment transfer rate varying from less than 1 ps up to 10 ps.

Histopathological features and grading in rhabdomyosarcomas of childhood.

Rhabdomyosarcoma represents a large group of soft tissue sarcomas displaying heterogeneous histopathological features. In addition to their histopathological classification, the variable expression of a number of histopathological features may contribute to the heterogeneity and may be related to prognosis. Tissue sections of 113 well-documented, protocol-treated patients with long term follow-up (mean 6 years) were analysed by a panel of four paediatric pathologists.

Trapping kinetics in mutants of the photosynthetic purple bacterium Rhodobacter sphaeroides: influence of the charge separation rate and consequences for the rate-limiting step in the light-harvesting process.

The primary light-harvesting processes, energy transfer in the light-harvesting antenna, and trapping of the excited states by reaction centers were studied in several mutant strains of the photosynthetic purple bacterium Rhodobacter sphaeroides. The mutants had reaction centers in which the rates of electron transfer were modified by site-directed mutations at the M210 position. Low-intensity pump-probe laser spectroscopy was used to monitor the absorbance transients in the Qy region of the antenna pigments, and it was found that despite a wide variation in charge separation rates within the RC, produced by the alterations at Tyr M210, there was relatively little corresponding variation in the overall trapping rate.

Quantitative analysis of two-dimensional observations of premalignant clones in the presence or absence of malignant tumors.

Based on a two-mutation model for carcinogenesis the mathematical theory is developed which is needed for the quantitative analysis of premalignant clones induced by specific carcinogens. In particular, the article deals with the situation where additional knowledge about the presence or absence of malignant tumors in the tissue of interest is available. The main difficulty arises from the fact that the data on premalignant clones are as a rule obtained from observation of a two-dimensional plane section of the tissue, so that the model needs to be translated from three dimensions into two before it is applicable to the data.

Prognostic importance of DNA flow cytometric variables in rhabdomyosarcomas.

Aim: To determine whether DNA ploidy patterns and S phase fraction offer prognostic information in patients with rhabdomyosarcoma (RMS).

Methods: DNA flow cytometry was performed on formalin fixed, paraffin wax embedded samples from primary tumours, and metastatic deposits or recurrences in 70 patients. DNA histogram analysis was done using a semi-automated cell cycle analysis program.

Assessment of postdialysis dry weight: a comparison of techniques.

Because clinical indices of hydration state are insensitive, the estimation of correct postdialysis dry weight is still major problem. Recently, some new techniques have been introduced to assess postdialysis dry weight more accurately. The plasma concentrations of the biochemical markers atrial natriuretic peptide (ANP) and cGMP are related to intravascular hydration state.

Affected by the tooth of time: legislation on infectious diseases control in five European countries.

The exercise of compulsory powers for the protection of society against the spread of infectious diseases may impose severe restrictions on individual liberty. The law should therefore enable public health officials to strike the proper balance between public health and individual rights. An overview of the infectious diseases control legislation of five European countries (Germany, Switzerland, England, Sweden and the Netherlands) shows outdated medical approaches to infectious diseases, deficiencies in substantive statutory criteria and a lack of suitable procedural protection.