Excessive airway narrowing is a cardinal feature of asthma, and results in closure of airways. Therefore, asthmatic patients in whom airway closure occurs relatively early during expiration might be prone to severe asthma attacks. To test this hypothesis, we compared closing volume (CV) and closing capacity (CC) in a group of asthmatic patients with recurrent exacerbations (more than two exacerbations in the previous year; difficult-to-control asthma), consisting of 11 males and two females, aged 20 to 51 yr, with those in a group of equally severely asthmatic controls without recurrent exacerbations (stable asthma) consisting of 13 males and two females aged 18 to 52 yr. Both groups used equivalent doses of inhaled corticosteroids and were matched for sex, age, atopy, postbronchodilator FEV(1), and provocative concentration of methacholine causing a 20% decrease in FEV(1). They were studied during a clinically stable period of their disease. The patients inhaled 400 microg salbutamol via a spacer device, after which TLC and RV were measured by multibreath helium equilibration, together with the slope of Phase 3 (dN(2)), CV, and CC, by single-breath nitrogen washout. CV and CC were expressed as ratios of VC and TLC, respectively, and all data are presented as % predicted (mean +/- SEM). There was no difference in TLC in patients with difficult-to-control asthma and those with stable asthma (106.7 +/- 4.0% predicted versus 101.7 +/- 4.3% predicted, p = 0.40), RV (113.1 +/- 7.8% predicted versus 100.9 +/- 7.1% predicted, p = 0.26), or dN(2) (142.7 +/- 16.3% predicted versus 116.0 +/- 20.2% predicted, p = 0.23). In contrast, CV and CC were increased in the patients with difficult-to-control asthma as compared with the group with stable asthma (CV: 159.5 +/- 26.8% predicted versus 98.8 +/- 12.5% predicted, p = 0.024; CC: 114.0 +/- 6.4% predicted versus 99.9 +/- 3. 6% predicted, p = 0.030). These findings show that asthmatic individuals with recurrent exacerbations have increased CV and CC as compared with equally severely asthmatic but stable controls, even after bronchodilation during well-controlled episodes. The findings imply that airway closure at relatively high lung volumes under clinically stable conditions might be a risk factor for severe exacerbations in asthmatic patients.

Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other object. Lifelong vaginismus occurs when a woman has never been able to have intercourse. A replicated single-case A-B-phase design was used to investigate the effectiveness of therapist-aided exposure for lifelong vaginismus. A baseline period (Phase A) was contrasted with exposure + follow-up (Phase B), using random switching between phases. The main outcome measure (intercourse ability) was assessed daily for 24 weeks. Ten women participated. The exposure consisted of a maximum of three 2-hr sessions during 1 week at a university hospital. The participant performed vaginal penetration exercises on herself, in the presence of a female therapist. Two follow-up sessions were scheduled over a 5-week period. Nine of the 10 participants reported having intercourse after treatment, and in 5 of the 9, intercourse was possible within the 1st week of treatment. The results remained at 1-year follow-up. Furthermore, exposure was successful in decreasing fear and negative penetration beliefs posttreatment and at 3-month and 1-year follow-ups. Therapist-aided exposure appears to be an effective treatment for lifelong vaginismus.

Inc bation of potato t ber tiss e discs on B5 medi m s pplemented with 1-naphtylacetic acid (NAA) led to call s formation, irrespective of the presence of kinetin ; witho t NAA no call s formation occ rred . Inc bation in the presence of abscisic acid (ABA) red ced the increases in fresh weight and dry weight both in call s-forming and in non-call s-forming tiss e. Mitochondrial respiration was lowered by ABA as well . The ind ction of the alternative, CN-resistant pathway was inhibited by the presence of ABA, especially in mitochondria from non-call s-forming tiss e .The in vivo respiration of the call s-forming tiss e was higher than that of the non-call sforming tiss e . Total respiration, cytochrome pathway activity and the capacity of the alternative pathway were all lowered in call s-forming tiss e by treatment with ABA . The in vivo activity of the alternative pathway was low in all tiss e types, especially after ABA-treatment . The slight stim lation by hydroxamates of the oxygen ptake of call s-forming tiss e inc bated on medi m with NAA and ABA indicates the involvement of a hydroxamateactivated peroxidase in the oxygen ptake of this tiss e ; this peroxidase seemed not to participate in the oxygen ptake of the other tiss es types .In non-call s-forming tiss e the oxygen ptake of ABA-treated tiss e was very low and almost completely resistant to the combined addition of inhibitors of both the cytochrome and the alternative pathway, indicating that the in vivo activity of the mitochondria in the oxygen ptake of the tiss e was very low . The possible ca ses for this ABA-effect are disc ssed . In non-call s-forming tiss e the treatment with ABA creates a sit ation which is comparable with that observed in intact potato t bers . This sit ation is characterized by a tiss e respiration lower than that of the isolated mitochondria and an alternative pathway capacity that is low or absent.

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