Mechanisms In Women Research Articles

Association between hypertension and variation in the α- and β-adducin genes in a white population

The substitution of tryptophan for glycine at amino acid 460 (Gly460Trp polymorphism) of the alpha-subunit of the heterodimeric cytoskeleton protein adducin increases renal sodium reabsorption and may be involved in the pathophysiology of essential hypertension. In the present study, we investigated in multivariate analyses whether the risk of hypertension was associated with the C1797T polymorphism of the beta-adducin gene. A total of 1848 subjects randomly selected from a white population were genotyped. Study nurses measured blood pressure at the participants' homes. The frequencies of the alpha-adducin Trp and beta-adducin T alleles were 0.23 and 0.11, respectively. In men (N = 904), the beta-adducin T allele was not associated with hypertension [adjusted relative risk (RR) vs. CC homozygotes 0.94, P = 0.77], but T allele carriers had lower plasma renin activity (PRA) and 24-hour urinary aldosterone excretion (P < 0.04). In all women (N = 944), beta-adducin T allele carriers had a higher risk of hypertension than CC homozygotes (RR 1.81, CI 1.18-2.77, P = 0.007), but similar PRA and 24-hour urinary aldosterone excretion (P> 0.29). In 345 post-menopausal women and 190 users of oral contraceptives, the RRs of hypertension were 2.47 (CI 1.34-4.64, P = 0.003) and 2.56 (CI 0.83-7.86, P = 0.10), respectively. For systolic pressure in women, there was a significant interaction (P = 0.02) between the alpha- and beta-adducin polymorphisms. Only in female carriers of the mutated alpha-adducin Trp allele was the systolic pressure significantly higher in beta-adducin T allele carriers compared with CC homozygotes (+3.8 mm Hg, P = 0.02). Furthermore, in the presence of the mutated alpha-adducin Trp allele, the RRs associated with the beta-adducin T allele were 2.35 (P = 0.01) in all women, 2.92 (P = 0.03) in post-menopausal subjects, and 3.79 (P = 0.09) in users of oral contraceptives. The 1797T allele of the beta-adducin gene is associated with increased risk of hypertension in post-menopausal women and in users of oral contraceptives, particularly in the presence of the mutated alpha-adducin Trp allele. We hypothesize that inhibition of the renin-aldosterone system in men and absence of such a compensatory mechanism in women may explain, at least to some extent, the sexual dimorphism of the blood pressure phenotype in relation to the C1797T beta-adducin polymorphism.

The Emergence of a Global Gender Equity Regime

INTRODUCTIONInternational regimes embody mutually accepted principles and practices on which there is, for the most part, compliance. Thus, a regime constitutes a high level of acceptance by states and comes close to international law. Gender issues have recently emerged as a global concern, but scholars have not yet asked whether there is a global gender equality regime or, if there is, how it can be identified, how it arose, and how it is being implemented.Since the early 1980s, gender equality has received unprecedented attention at international forums. There is a growing international understanding that gender equality is a prerequisite to achieving human and sustainable development. Over the past quarter century, the United Nations has convened five world conferences on women's issues: Mexico City (1975), Copenhagen (1980), Nairobi (1985), Beijing (1995), and New York (2000). Each marked a stage in a process that has raised gender equality to the centre of the global agenda.(1) Together they underscored the fact that women lag behind in virtually all aspects of life (education, health, literacy, access to income, labour markets, and so on) and established platforms of action to promote gender equality.(2) They also provided a platform for women's non-governmental organizations (NGOs) and global women's networks to lobby for a gender perspective in development policies and strategies. The cross-cutting coalitions they generated from all classes and economic groups from North and South have had an unprecedented and indisputable effect on changing awareness and programmes for women in many countries.(3)In the two decades between Mexico City and Beijing, gender equality has been embodied in an international legal instrument, the Convention on the Elimination of Discrimination Against Women (CEDAW), which entered into force in 1981 and has been ratified by 169 countries - more than two-thirds of the members of the United Nations.(4) Signature of CEDAW, the various platforms of action, and other regional conventions constitute a set of norms and rules related to gender equality. Some states have established national women's mechanisms on gender issues (bureaucracies, departments, policies, and programmes) and some have changed laws and policies to follow up on global commitments. Together these actions point to the possibility of a regime.Fields as diverse as international financial exchanges, security, and climate change have tried in recent years to utilize 'regimes' to address global problems.(5) They have drawn on a wide literature on the factors that lead to regime formation, affect regime maintenance, and determine how regimes can be utilized to address global problems in the future.(6) International relations scholars are also exploring the tensions and contradictions among normative principles in international life and how states are embedded in dense networks of transnational and international relations that shape their perceptions and their preferences. But, surprisingly, even though there is an extensive literature on global women's networks and the role of the United Nations as an ally, gender issues have not been systematically explored from the perspective of international regimes.IDENTIFYING A GENDER REGIMEOne could examine the rise and maintenance of a gender equality regime in terms of both its legal instruments and compliance mechanisms and its underlying normative principles, that is, the tensions and contradictions of gender equality that have begun to shape perceptions and preferences of states.Virtually all discussions of international regimes proceed from Stephen Krasner's 'consensus definition' in which regimes are 'implicit or explicit principles, norms, rules and decision-making procedures around which actors' expectations converge in a given area of international relations. Principles are beliefs of fact, causation and rectitude. Norms are standards of behavior defined in terms of rights and obligations. …

A new death domain associated with gestational trophoblastic diseases induces apoptosis in distinct cell types

Gestational trophoblastic diseases, like the complete hydatidiform mole (CHM), are a group of human interrelated neoplasms whose etiology and progression is poorly understood at the molecular level. We have previously reported the cloning and expression of a new tumor necrosis factor receptor (TNF-R) related transcript, named CHMS-1 that encodes a potential death domain. Here we show that ectopic expression of the putative CHMS-1 death domain specifically induced apoptosis in a dose-dependent manner, in trophoblastic (JEG-3) and non-trophoblastic (COS-7) cells. We also investigated the expression of apoptosis-related molecules such as Bcl-2 and p53 and demonstrated that Bcl-2 is repressed in CHM while p53 is overexpressed in CHM compared with persistent gestational trophoblastic tumors. Altogether, these data indicate that the CHMS-1 death domain is able to trigger apoptosis, thus suggesting that this new entity might be an important inducer of molar regression mechanisms in women.

Gender Differences in the Expression of Sleep-Disordered Breathing: Role of Upper Airway Dimensions

Obstructive sleep apnea (OSA) is a common disorder that is characterized by repetitive episodes of upper airway narrowing and collapse. Obesity is a major risk factor for OSA. Compared with men, women have greater total body fat and are more obese, and yet the prevalence of OSA is much higher in men. The airway size and compliance and pharyngeal muscle tone are important determinants of upper airway patency during sleep. The discrepancy between greater frequency of obesity and lower prevalence of OSA in women has not been explained and suggests a different pathogenetic mechanism underlying this condition. Most clinical studies in OSA have either combined the sexes or have described results from men only. The object of this study was twofold: (1) to examine the effect of obesity on pharyngeal size in both men and women, and (2) to determine the role of upper airway dimensions in the expression of sleep-disordered breathing (SDB) and its relationship to gender. Prospective study of subjects referred for evaluation of SDB. University-based sleep center. Seventy-eight male patients (mean +/- SE age, 49.2 +/- 1.5 years) and 52 female patients (mean age, 47.4 +/- 1.5 years). All subjects underwent in-laboratory polysomnography with measurement of upper airway size using the acoustic reflectance method. Although the two groups were similar in age, the female patients were slightly heavier than the male patients (body mass index [BMI], 36.0 +/- 1.7 kg/m(2) vs 33.3 +/- 0.8 kg/m(2), respectively; p < 0.0001). Despite similar clinical presentation of snoring and excessive daytime sleepiness, women had mild OSA (respiratory disturbance index [RDI], 9.2 +/- 2.7 events per hour) or increased upper airway resistance syndrome compared with men with more severe OSA (RDI, 28.0 +/- 3.5 events per hour; p < 0.0001). In contrast, women had a significantly smaller oropharyngeal junction and pharynx than men (p < 0.02). Upper airway size correlated significantly with the severity of sleep apnea in men only. There was no correlation between BMI and pharyngeal size in either gender. This study demonstrates that the static properties of upper airway in awake men but not women correlate with the severity of sleep apnea. This suggests inherent structural and functional differences in upper airway during sleep between men and women with more favorable airway mechanics in women.

Reduced pain tolerance during and after pregnancy in women suffering from fear of labor

Pain tolerance in women suffering and not suffering from fear of labor during and after pregnancy were compared. Twenty women with labor fear and 20 control women were subjected to a cold pressor test (CPT) on average 1 month before delivery and 9 months later. Half the volunteers were nulliparous and half parous. Pain endurance time (PET) and intensity of pain (Visual Analogue Scale, VAS) during CPT was assessed. Patients in the fear group tolerated CPT for a significantly shorter time than did women without fear both in pregnancy (154.8±109.9 s vs. 282.5±60.1 s (mean±SD), P<0.001), and in the postpartum period (128.6±111.7 s vs. 279.6 ±60.3 s, P=0.002). Those with labor fear experienced CPT as significantly more painful than did the controls both during pregnancy (VAS 6.68±1.9 vs. 3.78±2.0 (mean±SD), P<0.001) and after (VAS 7.73±1.5 vs. 5.92±3.0, P=0.04). PET and VAS values correlated during pregnancy ( r=−0.62, P<0.001), but not after pregnancy ( r=−0.30, not significant). Parity was not associated with either PET or VAS scores. As a rule, pain in all women during CPT was regarded to be lower during pregnancy than after pregnancy (VAS 4.87±2.4 vs. 6.60±2.6, P=0.001). Patients with fear of labor were characterized by pain intolerance also in circumstances other than labor. This fact may indicate enhanced sensitivity to pain-causing mechanisms in women who develop fear of labor.

Tension-free vaginal tape: why an unusual concept is so successful.

The surgical treatment of female stress urinary incontinence has been dramatically changed during the last 5 years, after Ulmsten introduced the tension-free vaginal tape procedure. This technique is based on a series of experimental investigations of the urethral closure mechanisms in women. The procedure is easy to learn, could be performed on an outpatient basis, and is recognized as a minimally invasive surgery. Despite these arguments, the most probable reason for its present success is the reproducibility of the results in the various published series. The success rate is estimated at between 85 and 95% for correction of genuine stress urinary incontinence. However, longer follow-up will be necessary to confirm these preliminary results, and probably to determine what are the most valuable prognostic factors.

Women's participation in rural credit programmes in Bangladesh and their demand for formal health care: is there a positive impact?

Within the overall aim of poverty alleviation, development efforts have included credit and self-employment programmes. In Bangladesh, the major beneficiaries of such group-based credit programmes are rural women who use the loans to initiate small informal income-generating activities. This paper explores the benefits of women's participation in credit programmes on their own health seeking. Using data from a sample of 1798 households from rural Bangladesh, conducted in 1991-1992 through repeated random sampling of 87 districts covered by Grameen Bank, Bangladesh Rural Advancement Committee (BRAC) and Bangladesh Rural Development Board (BRDB), this paper addresses the question: does women's participation in credit programmes significantly affect their use of formal health care? A non-unitary household preference model is suggested to test the hypothesis that women's empowerment through participation in these programmes results in greater control of resources for their own demand for formal health care. The analysis controls for endogeneity due to self-selection and other unobserved village level factors through the use of a weighted two stage instrumental variable approach with village level fixed effects. The findings indicate a positive impact of women's participation in credit programmes on their demand for formal health care. The policy simulations on the results of this study highlight the importance of credit programmes as a health intervention in addition to being a mechanism for women's economic empowerment.

On veiling, vision and voyage

This article is concerned with the changing significance of the veil in Turkey in the early years of the twentieth century. Its discussion of the political significance of women's dress in a period of accelerated social change is conducted through the analysis of two illustrated books, one by a visiting English feminist and one by a Turkish woman who writes about life in Turkey and her travels in Europe. In this way, the debate about the veil is examined through an analysis of cross-cultural dressing which takes into account the different significations of seclusionary mechanisms for women constructed as Oriental and as Occidental. The study engages with recent theories about cross-dressing and transgression but argues that such theories are often unthinkingly Eurocentric in their valorization of transgression. Its analysis of the photographs and written elements in its primary sources suggests that cross-cultural dressing is a practice unevenly open to differently racialized social subjects. To this end, the article examines the sartorial self-presentation of a Turkish woman who, though elite in local terms, is arguably exoticized and culturally inferiorized within the terms of the dominant Occidental discourse in which she intervenes. This paper extends an analysis of cultural and of racialized difference to discussions of cross-dressing, which are often seen mainly in relation to gender difference. The reading of the photographs draws attention to the role of photography in the development of ethnographic regimes of representation and elaborates the shifting significance of the veil in the performance of an Ottoman female identity for an Occidental audience. The extent to which such performative identities can be recognized cross-culturally and to which individual cultural producers can manipulate transculturated codes is explored.

The Ileal Neobladder to the Female Urethra

In the author's opinion, in the properly selected woman undergoing radical cystectomy for transitional cell carcinoma of the bladder, the ileal neobladder to the female urethra is a viable option. Ten years of experience with 23 patients have led to a nerve and urethral support cystectomy technique with the ileal neobladder anastomosed to the proximal urethra. Even then, however, retention in 20% of patients rather than the expected incontinence is the critical issue. Incontinence has never been a problem. The advent of orthotopic lower urinary reconstruction in women is a major achievement in the evolution of urinary diversion. With our increasing understanding of the continence mechanism in women and with increasing evidence that the female urethra can be safely preserved after cystectomy, orthotopic lower urinary tract reconstruction by the ileal neobladder can now be offered safely not only to men but also to women undergoing cystectomy with superb functional results.

A possible link between stress urinary incontinence and detrusor instability in the female--urodynamic (pressure/flow) data and speculative considerations.

The aim of the present investigation was to check voiding mechanics in women with stress urinary incontinence (SUI) for differences between patients with stable bladders and those with detrusor instability (DI). There were 70 females, 35 with stable and 35 with unstable bladders, who had urodynamically proven SUI. All underwent medium-fill water cystometry and pressure/flow studies. A relatively enhanced detrusor contractility, mirrored by higher values of maximum external voiding power and shortening velocity, could be found in the unstable patients. Of these, 27 were reassessed urodynamically following surgical cure of the SUI. After the operative treatment 17 of the 27 showed stable bladders and a reduced detrusor contractility, but no reduced contractility was found in the other 10, whose bladders remained unstable. The data reported may suggest that the factor responsible for 'idiopathic' DI in SUI patients would also be able to yield enhanced bladder mechanical capability. It was tentatively assumed that this factor involves an increased urethral sensitivity, possibly secondary to incompetence of the urethral closure mechanism, and persisting at times even should SUI be surgically relieved.

THE ILEAL NEOBLADDER TO THE FEMALE URETHRA

In the author's opinion, in the properly selected woman undergoing radical cystectomy for transitional cell carcinoma of the bladder, the ileal neobladder to the female urethra is a viable option. Ten years of experience with 23 patients have led to a nerve and urethral support cystectomy technique with the ileal neobladder anastomosed to the proximal urethra. Even then, however, retention in 20% of patients rather than the expected incontinence is the critical issue. Incontinence has never been a problem. The advent of orthotopic lower urinary reconstruction in women is a major achievement in the evolution of urinary diversion. With our increasing understanding of the continence mechanism in women and with increasing evidence that the female urethra can be safely preserved after cystectomy, orthotopic lower urinary tract reconstruction by the ileal neobladder can now be offered safely not only to men but also to women undergoing cystectomy with superb functional results.

Negotiating Gender in Uncertainty: A Mechanism of Women's Marginalization in the Japanese Workplace*

Abstract Women have been long absent from important white‐collar positions in large Japanese organizations. Two approaches have been made to understand women's work experiences and career outcomes in these organizations, namely, the structuralist and the rational choice approaches. The underlying assumption of both approaches is that individual women's career orientations are basically fixed and larger factors outside the workplace play central roles to determine women's career outcomes. In order to understand women's work experiences and perspectives more realistically, however, we need to turn our attention to the workplace itself and to examine the mechanisms through which women are constantly marginalized, if inadvertently, in everyday interactions with others. Drawing on a developing perspective that focuses on the dynamic nature of women's career experiences. this paper, based on a case study, demonstrates a major way in which the influences of outside factors, specifically of women's attitude toward work, are in fact reinforced within the workplace. A major component of this mechanism is women's sense of uncertainty generated through their day‐to‐day work lives.

Urethral profilometry in women with uterovaginal prolapse

The aim of the study was to investigate the continence mechanism in women with uterovaginal prolapse by analysing urethral pressure profiles. Twenty-four women (mean age 59.0±11.9 years, mean parity 3.1±1.6) with prolapse underwent urodynamic evaluation. Urethral pressure profiles were obtained with prolapse and after reduction of the prolapse with a swab stick in the posterior vaginal fornix. After reduction the maximum urethral closure pressure (MUCP) and pressure transmission ratios (PTR) in all four quartiles of the urethra decreased, the position of the MUCP was shifted proximally and the functional urethral length was increased. Thirteen women reported a history of continence and 11 reported incontinence. Ten of 13 women (77%) who reported continence with prolapse were incontinent with their prolapse reduced. In these women, MUCP and PTRs in the first three quartiles of the urethra decreased significantly upon prolapse reduction. In the patients who reported incontinence with prolapse, only the MUCP decreased significantly upon prolapse reduction. Comparisons between the historically continent and incontinent women showed a statistically significant difference only for PTRs in the second and third quartiles of the urethra before prolapse reduction. Because the position of maximum urethral closure pressure before reduction was located in the distal half of the urethra in all patients, we conclude that direct pressure of the prolapsed mass on the urethra (rather than kinking) is the mechanism masking incompetence of the urethral closure mechanism in women with uterovaginal prolapse. The 77% rate of latent incontinence in this series suggests that women with severe pelvic relaxation should undergo careful urogynecologic evaluation before an attempt at surgical correction.

Distal urethral compensatory mechanisms in women with an incompetent bladder neck who remain continent, and the effect of the menopause

Distal urethral compensatory mechanisms in women with an incompetent bladder neck who remain continent, and the effect of the menopause

Distal urethral compensatory mechanisms in women with an incompetent bladder neck who remain continent, and the effect of the menopause

AbstractFemale continence is thought to be maintained at the level of the bladder neck and by the external sphincter. However, many women have an incompetent bladder neck, that is their bladder neck opens under stress. However, they still remain continent, presumably by use of their distal external sphincter. To establish the effect of age and the menopause on this phenomenon, data from 202 climacteric urodynamically normal and continent women were examined. The overall prevalence of videocystourethographically diagnosed bladder neck incompetence in these women was 51 ± 4%. The median age in this group was 50.4 years but the prevalence of bladder neck incompetence in women below 50.4 years was not significantly different from older women (&gt;50.4 years) being 49 ± 5% and 53 ± 5%, respectively. Of the 202 women studied the prevalence of bladder neck incompetence in perimenopausal women was 54 ± 5% and 48 ± 5% in postmenopausal women, there being no statistically significant difference between the two subgroups separated on the basis of their estrogen status. These data do not support the contention that bladder neck integrity is estrogen dependent nor is there any evidence from these data that is it age dependent. To understand how women with bladder neck incompetence maintain continence, 55 of the 202 women also underwent urethral pressure profilometry. Bladder neck incompetence results in a proximal shortening of the stress urethral pressure profile but these women maintained their stress urethral functional length by decreased distal shortening of the stress profile. In other words, they made more use of the distal portion of the urethra. This is achieved by augmentation of their distal transmission pressure ratios.

The Structure of Psychological Defense Mechanisms in Women as a Function of Alcohol Intoxication

The present experiment tested whether moderate alcohol intoxication influences the relative strength of different psychoanalytic defense mechanisms and whether the overall level of defense activity is changed. Thirty-six women were randomly assigned to either an alcohol, a placebo, or a control group. The alcohol dose was 1.0 ml of 100% alcohol/kg body weight. Subjects were tested with the Defense Mechanism Test (DMT), which gives a valid measure of both elaborate or late and primitive or early defense mechanisms. Results indicated no significant effects of alcohol intoxication on any aspect of the defense system. This was taken as supportive of the psychoanalytic notion in respect of the stability of the defense system. Possible complications were discussed.

The mechanism of urinary continence in women with severe uterovaginal prolapse: Results of barrier studies

Eleven continent women with severe degrees of uterovaginal prolapse underwent a complete urodynamic evaluation that included passive and dynamic urethral pressure profilometry with and without careful barrier reduction of their prolapse. The aim of barrier placement was to reduce, but not overcorrect, the prolapse and to restrict stress-induced mobility of the viscera posterior and superior to the urethra. Each of the women had very high pressure transmission ratios in each quarter of the urethra (means of 257, 187, 170, and 166% from internal to external quarters) that were significantly reduced with barrier placement (means of 78, 84, 85, and 101%). Eight of 11 subjects had pressure transmission ratios less than 90% in the proximal three-quarters of the urethra with the barrier in place, a finding in nearly all subjects with genuine stress urinary incontinence. Maximum urethral closure pressure on passive urethral pressure profilometry also decreased significantly from a mean of 75 to 45 cm H2O with the barrier in place. We conclude that the stress continence mechanism in women with severe prolapse results from posterior-superior visceral descent with stress, causing mechanical obstruction of the less mobile urethra. The evaluation methods described may be useful in predicting which of these patients may require concurrent urethropexy at the time of prolapse reduction surgery to prevent postoperative stress urinary incontinence.

Breast feeding and post-partum amenorrhea in Serere women in Senegal.

The duration of post-partum amenorrhea and of breast-feeding was studied in a population of Serere people in Senegal, using an actuarial method. The use of the Cox method enabled us to show a positive correlation between these two factors and a negative correlation between the duration of amenorrhea, the survival of the breast-fed child, and the weaned status of the child. The characteristics of the diet of these sedentary women were similar to those found for amenorrheic American marathon runners. Given the results of other studies of African populations, these observations are discussed in the light of recent models of gonadotrophic involvement in the possible regulatory mechanisms in women who breast-feed for long periods whilst having an energy balance which is close to zero or even negative.

Self-Defense as an Exoskeletal Coping Mechanism in Women

Women enrolled in a Beginners' Judo-jujitsu class, as compared to women in Crafts, Physical Fitness, and Advanced Judo-jujitsu classes, were found to perceive the world as more threatening as measured by word lists involving bodily concern and fearfulness and to employ exoskeletal defenses as measured by adornment on the DAP. It was suggested that the exoskeletal coping mechanism may play an important role in the way in which women defensively handle threat.

Effects of postovulatory synthetic corticosteroid administration on ovarian function in women (author's transl)

It has been shown that a single dose of triamcinolone acetonide (TA) has an antiovulatory effect in baboons and humans when it is given at the onset of menstruation. To investigate the effect of TA on the function of the corpus luteum and succeeding menstrual cycles, 40 mg of TA was injected intramuscularly during the postovulatory period (between 1-3 days after ovulation) in ten normal menstruating women. Blood was taken from ovulatory stage to menstruation in each 3 or 4 days during the treated and control cycles, and was determined for LH, FSH, estradiol and progesterone by radioimmunoassay. Suppression of plasma LH (m most subjects) and slight suppression of plasma estradiol (in some subjects) were observed by postovulatory TA injection; however, no suppression of plasma progesterone was observed in 8 out of 10 women. The length of the treated luteal phase was not altered. In the succeeding menstrual cycle (the 2nd cycle), ovulation was not observed in all ten women, and a shortening of menstrual cycle was observed in 7 out of 10 women. In the 3rd cycle, the biphasic basal body temperature pattern (BBT) was observed in 4 out of 10 women, and in the 4th cycle, the biphasic BBT pattern was observed in 8 out of 10 women.These results infer that TA may affect the hypothalamic-pituitary axis, suppress gonadotropin secretion and subsequently impair estrogen secretion from the ovary; however, the possibility is not excluded that TA may directly affect ovarian function and induce de-creased estrogen secretion. Postovulatory TA injection may not suppress luteal function as judged by the plasma level of progesterone and length of the treated luteal phase. However, histological examination of the corpus luteum is necessary for its conclusion. Postovulatory TA injection blocked ovulation in all ten women in the succeeding menstrual cycle. This evidence infers that TA has long activity and/or that succeeding follicular development may commence just after ovulation. Investigations into effects on follicular maturation and ovulation by TA may provide important clues concerning these mechanisms in women.