What color is that urine specimen?
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Color↗
Biomedical subjects
C Cooper
Publications and source records attributed to C Cooper.
Histological, biochemical, and ultrastructural studies on hyperpigmented human skin xenografts.
The mechanisms for hyperpigmentation observed in human cutaneous xenografts placed on athymic nude mice was investigated. Histologic, biochemical, histochemical, and ultrastructural examinations were performed on human skin prior to grafting and at various times ranging from 2 weeks to 30 weeks post-grafting (PG). Hyperpigmentation was macroscopically visible on the graft as early as 4-6 weeks. The number of Dopa-positive melanocytes per unit area was increased at 2 weeks PG and remained elevated until 20 weeks PG. The surface area of the melanocytes, a measure of the activity of the cells, also increased significantly and remained above the pre-grafting size throughout the study. Western blot analysis using tyrosinase specific antibody (alpha Ty-SP) revealed the presence of tyrosinase exclusively in the grafted skin from 2 weeks to 12 weeks PG tested. Histological and ultrastructural observations revealed the presence of numerous dendritic melanocytes, indeterminant clear cells suggestive of Langerhans cells, and dermal melanophages. The results of this study suggest that the observed hyperpigmentation in grafted tissue is caused by an increase in the number of Dopa-positive melanocytes and probably from enhanced melanin production. Extracts of proteins from the xenografts exhibited prominent differences in low and high molecular proteins between pre- and post-grafted skin. Among them, the exclusive appearance of a protein doublet with apparent mw approximately 14 kDa was found in grafted skin, and subsequent studies indicate it has potent effects on melanocyte function.
Animals↗
Determinants of disability in osteoarthritis of the knee.
OBJECTIVES: To evaluate the influences of radiographic severity, quadriceps strength, knee pain, age, and gender on functional ability in patients with osteoarthritis of the knee. METHODS: Equal numbers of knee pain positive and negative respondents to a survey of registrants aged more than 55 years at a general practice were invited to attend for knee radiographs and quadriceps femoris isometric strength estimations. Disability was measured using the Stanford Health Assessment Questionnaire. RESULTS: Complete data were available on 70 men (mean age 72.7 years) and 89 women (mean age 68.1 years); 44% reported knee pain, 48% had radiographic features of osteoarthritis, and 32% reported some degree of disability. Significant correlations were observed between disability and radiographic score, quadriceps strength, and knee pain. Logistic regression analysis, however, showed significant independent contributions from quadriceps strength (odds ratio 0.84 kgF), knee pain (odds ratio 1.67), and age (odds ratio 1.06 per year) only; the radiographic score had no influence on the model. These results were not influenced by confining the analysis to the group with radiographic features of osteoarthritis. CONCLUSIONS: Quadriceps strength, knee pain, and age are more important determinants of functional impairment in elderly subjects than the severity of knee osteoarthritis as assessed radiographically. Strategies designed to optimise muscle strength may have the potential to reduce a vast burden of disability, dependency, and cost.
Age Factors↗
Physical inactivity is an independent risk factor for hip fracture in the elderly.
STUDY OBJECTIVE: To test the hypothesis that physical inactivity is an independent risk factor for hip fracture in the elderly. DESIGN: Population based, case-control study. SETTING: Metropolitan borough of Newcastle upon Tyne. PARTICIPANT: A total of 197 patients aged 50 years and over, resident in Newcastle, and admitted consecutively with a hip fracture, and 382 community controls, matched by age and sex, who had not suffered a hip fracture. MEASUREMENTS AND MAIN RESULTS: Validated methods were used to assess customary physical activity. Information on body build, cigarette smoking, and alcohol consumption was also obtained. Grip strength was measured. Physical inactivity was strongly associated with the risk of hip fracture in men and women. Subjects who did not regularly weight-bear, perform muscle-loading activities such as climbing stairs, and perform productive activities such as gardening, were all more than twice as likely to sustain a hip fracture, when compared with subjects at the higher end of the activity spectrum. These increases in risk remained after adjusting for body mass index, smoking, alcohol consumption, and dependence in daily living activities. CONCLUSIONS: Customary physical inactivity is an independent determinant of hip fracture in the elderly. Strategies to improve the day to day activity of elderly people require urgent exploration.
Activities of Daily Living↗
Delayed contrast enhancement of ascitic fluid on CT: frequency and significance.
OBJECTIVE: Enhancing peritoneal fluid has been described as an uncommon finding resulting from active extravasation of contrast material from the bowel, urinary tract, or blood vessels. We have noted that enhancing peritoneal fluid occurs in other clinical settings. The CT number of ascites frequently increases between initial images obtained during bolus injection of IV contrast material and delayed images obtained after completion of the routine study. The objective of this study was to define the frequency and clinical significance of this phenomenon. SUBJECTS AND METHODS: Fifty patients (32 with malignant disease and 18 with benign disease) with free intraperitoneal fluid were examined with abdominal CT with IV contrast material. Active intraperitoneal bleeding or perforation of the bowel or bladder was not clinically suspected in any patient studied. When intraperitoneal fluid was detected on review of initial dynamic scans, a limited number of delayed scans were obtained also. Significant enhancement was determined by comparing the CT numbers of fluid on dynamic and delayed images. RESULTS: Significant delayed enhancement of intraperitoneal fluid was seen in 54% of patients, with increases averaging 25 H (range, 7-54 H). Parametric analysis indicated enhancement was inversely proportional to the amount of intraperitoneal fluid but independent of the type of IV contrast material (ionic vs nonionic), time delay (range, 10-104 min), clinical history, and serum creatinine and serum albumin levels. Enhancement occurred in both malignant and benign diseases and was more likely when small amounts of ascites were present. CONCLUSION: Enhancement of intraperitoneal fluid is a common and often striking finding on delayed CT scans after administration of IV contrast material. The phenomenon is nonspecific, occurring in a wide spectrum of clinical conditions. Caution should be used in interpreting the significance of high-attenuation intraperitoneal fluid on delayed images to avoid an erroneous diagnosis of active intraperitoneal bleeding or contrast extravasation.
Adult↗
Caring! Nursing's undervalued strength.
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Empathy↗
Fetal growth and autoimmune thyroid disease.
To determine whether fetal and infant growth could influence susceptibility to autoimmune disease in adults, the occurrence of thyroid autoantibodies and autoimmune thyroiditis was studied in 305 women, aged 60-71, born in Hertfordshire and for whom details of birthweight, infant growth, and feeding were routinely recorded. Thyroglobulin autoantibody was detected in 37% of the women, thyroid peroxidase autoantibody in 41%, and autoimmune thyroiditis, defined as biochemical or clinical hypothyroidism in association with thyroid autoantibodies, in 5.6%. The proportion of women with thyroglobulin and thyroid peroxidase autoantibodies fell with increasing birthweight but was not related to weight at 1 year of age or the method of infant feeding. The prevalence of both autoantibodies rose with increasing adult body mass index but fell as the waist to hip ratio increased. These results demonstrate the importance of early environment in determining the susceptibility to autoimmune thyroid disease. The contrasting effects of adult body mass index and waist to hip ratio on antibody prevalence could be explained by their associations with different hormonal environments.
Aged↗
Detection of Toxoplasma gondii antigen-containing immune complexes in the serum of cats.
Enzyme-linked immunosorbent assays for the detection of Toxoplasma gondii antigen-containing IgM immune complexes (T gondii-specific IgM-IC) and IgG immune complexes (T gondii-specific IgG-IC) in the serum of cats were developed. Serum from clinically ill, naturally infected cats; healthy, naturally infected cats; and healthy cats experimentally inoculated with T gondii was assayed. All combinations of T gondii-specific IgM, IgG, antigens, IgM-IC, and IgG-IC were detected in naturally infected and experimentally infected cats. Clinically ill cats and cats with ocular signs of toxoplasmosis were more likely than healthy cats to have T gondii-specific IC in serum. It was concluded that T gondii-specific IC form in the serum of cats, may play a role in clinical disease development, and affect the results of T gondii-specific IgM, IgG, and antigen serologic assays.
Animals↗
Asthma in general practice. Opportunities for recognition and management.
OBJECTIVE: To describe the prevalence of asthma-related symptoms and asthma among patients attending general practitioners. SETTING: Sydney. DESIGN: Cross-sectional survey by written questionnaire. SAMPLE: 1933 patients of 21 general practitioners. RESULTS: 1. Wheeze and asthma were common in patients attending general practitioners; 19 per cent of patients reported recent wheeze, 9 per cent reported recent asthma. 2. Less than half of all patients with recent wheeze (47%) reported having asthma. 3. Recent wheeze without asthma was more common in boys (4.8%) than girls (0%) and more common in men (10%) than women (7%). 4. Although most patients reporting asthma (95%) had had their asthma treated by a doctor, three-quarters of those patients had experienced asthma related symptoms in the previous year. CONCLUSION: Asthma remains under-recognised and under-treated among patients attending general practitioners.
Adolescent↗
The C/EBP family of transcriptional activators is functionally important for Ig VH promoter activity in vivo and in vitro.
We have examined the functional importance of binding sites for C/EBP family members (E sites), in two Ig VH promoters: VH1, a member of the S107 family, and BCL1, a member of the J558 family. Mutation of the E site in the VH1 promoter diminishes transcription in vivo to 59% of wild-type and transcription from the BCL1 promoter in vitro is inhibited to an average of 39% of wild-type by competition with E site oligonucleotides. Purified E site binding proteins from plasmacytoma cells stimulated BCL1 transcription in vitro 2.3-fold. Although five C/EBP family proteins are known which bind the E site, antibody ablation of DNA:protein complexes resolved by electrophoretic mobility shift assays showed that Ig/EBP-1 is the only E site binding protein detectable in early B cell lines; more mature B cells contain Ig/EBP-1 and NF-IL6. We also show by antibody-depletion that Ig/EBP-1 activates the BCL1 promoter in vitro.
Animals↗
Osteoarthritis of the hip: an occupational disease in farmers.
OBJECTIVE: To test the hypothesis that farmers are at high risk of hip osteoarthritis and to investigate possible causes for such a hazard. DESIGN: Cross sectional survey. SETTING: Five rural general practices. SUBJECTS: 167 male farmers aged 60-76 and 83 controls from mainly sedentary jobs. All those without previous hip replacement underwent radiography of the hip. MAIN OUTCOME MEASURES: Hip replacement for osteoarthritis or radiological evidence of hip osteoarthritis. RESULTS: Prevalence of hip osteoarthritis was higher in farmers than controls and especially in those who had farmed for over 10 years (odds ratio 9.3, 95% confidence interval 1.9 to 44.5). The excess could not be attributed to any one type of farming, and heavy lifting seems the likely explanation. CONCLUSIONS: Manual handling in agriculture should be limited where possible. Consideration should be given to making hip osteoarthritis a prescribed industrial disease in farmers. There may be wider implications for the prevention of hip osteoarthritis in the general population.
Age Factors↗
Ankylosing spondylitis in Rochester, Minnesota, 1935-1989. Is the epidemiology changing?
OBJECTIVE: To determine trends in the incidence and clinical presentation of ankylosing spondylitis first diagnosed between 1935 and 1989 among residents of Rochester, Minnesota, and in the survival of the patients. METHODS: Population-based descriptive study. RESULTS: The overall age- and sex-adjusted incidence rate was 7.3 per 100,000 person-years (95% confidence interval 6.1-8.4). The rate tended to decline between 1935 and 1989, but there was little change in the age at symptom onset or diagnosis over the 55-year study period. Overall survival was not decreased up to 28 years following diagnosis. CONCLUSION: These data indicate that there is a constancy in the epidemiologic characteristics of ankylosing spondylitis and suggest that previously study results indicating changes may have been due to biases in patient selection and study design.
Adolescent↗
Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989.
Vertebral fractures are the classic hallmark of osteoporosis, yet little is known of their epidemiology. The incidence of clinically diagnosed vertebral fractures was therefore directly assessed in the predominantly white (European descent) population of Rochester, Minnesota. Altogether, 341 Rochester residents were radiologically diagnosed for the first time with one or more vertebral fractures in the 5 year study period, 1985-1989. The overall age- and sex-adjusted incidence rate was 117 per 100,000 person-years (95% CI, 105 to 130). The age-adjusted rate in women (145 per 100,000 person-years) was almost twice that in men (73 per 100,000 person-years). Of all fractures, 47 (14%) followed severe trauma, 282 (83%) followed moderate or no trauma, and 12 (3%) were pathologic. Incidence rates for fractures following moderate trauma were higher in women than in men and rose steeply with age in both genders. In contrast, fractures following severe trauma were more frequent in men, and their incidence increased less with age. These Rochester rates are greater than those previously reported from studies in Britain and Sweden but lower than the incidence rates extrapolated from a prevalence study in this population.
Adult↗
Is caffeine consumption a risk factor for osteoporosis?
High caffeine consumption has been proposed as a risk factor for osteoporotic fracture, but the evidence associating high caffeine intake with low bone density is inconsistent. We therefore examined the influence of caffeine consumption on bone mineral at six skeletal sites in an age-stratified random sample of white women residing in Rochester, Minnesota. After age adjustment, there was no association between overall caffeine consumption and bone mineral at five of the six sites. In the femoral shaft, however, there was a statistically significant interaction between age and caffeine consumption so that high caffeine intake was associated with slight reductions in bone mineral among elderly subjects but with modestly increased bone mineral at younger ages. When caffeine intake was categorized by source, no consistent influence of coffee, tea, or other caffeinated beverage consumption could be detected on bone mineral. Caffeine intake was, however, positively associated with cigarette smoking and alcohol consumption. After adjusting for age, caffeine consumption was not correlated with biochemical indices of bone turnover, circulating concentrations of estradiol and estrone, or other dietary and musculoskeletal variables. These data suggest that caffeine intake in the range consumed by a representative sample of white women is not an important risk factor for osteoporosis. Among elderly women, however, in whom calcium balance performance is impaired, high caffeine intake may predispose to cortical bone loss from the proximal femur.
Adult↗
Perspective. How many women have osteoporosis?
Osteoporosis is widely viewed as a major public health concern, but the exact magnitude of the problem is uncertain and likely to depend on how the condition is defined. Noninvasive bone mineral measurements can be used to define a state of heightened fracture risk (osteopenia), or the ultimate clinical manifestation of fracture can be assessed (established osteoporosis). If bone mineral measurements more than 2 standard deviations below the mean of young normal women represent osteopenia, then 45% of white women aged 50 years and over have the condition at one or more sites in the hip, spine, or forearm on the basis of population-based data from Rochester, Minnesota. A smaller proportion is affected at each specific skeletal site: 32% have bone mineral values this low in the lumbar spine, 29% in either of two regions in the proximal femur, and 26% in the midradius. Although this overall estimate is substantial, some other serious chronic diseases are almost as common. More importantly, low bone mass is associated with adverse health outcomes, especially fractures. The lifetime risk of any fracture of the hip, spine, or distal forearm is almost 40% in white women and 13% in white men from age 50 years onward. If the enormous costs associated with these fractures are to be reduced, increased attention must be given to the design and implementation of control programs directed at this major health problem.
Adult↗
Secular trends in the incidence of postmenopausal vertebral fractures.
Several studies suggest secular increases in hip fracture incidence through this century, but little is known about such trends for vertebral fracture. We have examined changes in the incidence of clinically ascertained vertebral fractures among Rochester, Minnesota residents aged 35-69 years, that were first diagnosed between 1950 and 1989. Our results indicate no overall increase in incidence over the 40-year period. Categorization of fractures according to the level of preceding trauma, however, revealed a significant increase in the incidence of fractures following moderate trauma among women aged 60-69 years. This increase occurred between 1950 and 1964, and leveled off thereafter. Rates for severe trauma fractures among postmenopausal women, and for vertebral fractures from any cause among younger men and women, remained stable. The rise in moderate trauma fractures in postmenopausal women paralleled that for hip fractures in Rochester and began to plateau at around the same time. It might have resulted from increased diagnosis of vertebral fractures, but the increase in hip fracture incidence is inconsistent with this explanation. An increase in the prevalence of osteoporosis, however, might account for the trend in both types of fractures.
Adult↗