At the University of California Davis Medical Center, a screening fetal ultrasound examination (level I or II) incorporates a comprehensive segmental evaluation of the fetal heart. This study evaluated the reliability of the fetal ultrasound exam in the detection of abnormal heart anatomy. Our retrospective study reviewed results of 614 antenatal patients that had a screening fetal ultrasound exam. All patients subsequently underwent a detailed targeted fetal cardiac ultrasound exam performed by a pediatric cardiac sonographer and reviewed by a board-certified pediatric cardiologist. Of these 614 patients, 60 fetuses had structural heart disease by the targeted fetal exam. The screening fetal ultrasound exam correctly identified 55 of the 60, with 5 false negatives (8.3% false-negative rate) and 1 false positive (1.7% false-positive rate). Our study suggests that if a screening fetal ultrasound exam incorporates a segmental evaluation of the fetal heart it can reliably detect abnormal heart anatomy. At our institution a targeted fetal cardiac exam is now used to confirm and provide detailed assessment of the heart anatomy when a screening fetal exam is positive for heart disease.

California↗

PubMedDate not supplied

Absent pulmonary valve with tricuspid atresia or severe tricuspid stenosis: report of three cases and review of the literature.

Absence of the pulmonary valve occurs usually in association with tetralogy of Fallot and occasionally with an atrial septal defect or as an isolated lesion. Very rarely it occurs with tricuspid atresia, intact ventricular septum, and dysplasia of the right ventricular free wall and of the ventricular septum. We present the clinical, anatomic, and histologic findings of a new case, and for the first time, the data from two patients with absent pulmonary valve and severe tricuspid stenosis, who exhibited similar histologic findings. We also reviewed the clinical and anatomic data of 24 previously published cases and compared them with the new cases. In all three new cases, the myocardium of the right ventricle was very abnormal. In the two cases with tricuspid stenosis, large segments of myocardium were replaced with sinusoids and fibrous tissue. In the case with tricuspid atresia, the right ventricular free wall contained only fibroelastic tissue. The ventricular septum in all three patients showed asymmetric hypertrophy and in two of the three patients, multiple sinusoids had replaced large segments of myocardial cells. The left ventricular free wall myocardium and the walls of the great arteries were unremarkable. Our data indicate that myocardial depletion involving the right ventricular free wall and the ventricular septum and its replacement by sinusoids and fibroelastic tissue occur not only in cases of absent pulmonary valve with tricuspid atresia but also in cases of absent pulmonary valve with tricuspid stenosis. The degree of myocardial depletion varies and is more severe when the tricuspid valve is atretic.

Fatal Outcome↗

PubMedDate not supplied

Mechanism of protein kinase B activation by insulin/insulin-like growth factor-1 revealed by specific inhibitors of phosphoinositide 3-kinase--significance for diabetes and cancer.

Protein kinase B (PKB) is a member of the second messenger subfamily of protein kinases. The three isoforms of PKB identified have an amino-terminal pleckstrin homology domain, a central kinase domain, and a carboxy-terminal regulatory domain. PKB is the major downstream target of receptor tyrosine kinases that signal via the phosphoinositide (PI) 3-kinase. The crucial role of lipid second messengers in PKB activation has been dissected through the use of the PI 3-kinase-specific inhibitors wortmannin and LY294002. Receptor-activated PI 3-kinase synthesises the lipid second messenger PI-3,4,5-trisphosphate, leading to the recruitment of PKB to the membrane. Membrane attachment of PKB is mediated by its pleckstrin homology domain binding to PI-3,4,5-trisphosphate or PI-3,4-bisphosphate with high affinity. Activation of PKB alpha and beta is then achieved at the plasma membrane by phosphorylation of Thr308/309 in the A-loop of the kinase domain and Ser473/474 in the carboxy-terminal regulatory region, respectively. The upstream kinase that phosphorylates PKB on Thr308, termed PI-dependent protein kinase-1, has been identified and extensively characterised. A candidate for the Ser473/474 kinase, termed the integrin-linked kinase, has been identified recently. Activated PKB is implicated in glucose metabolism, transcriptional control, and in the regulation of apoptosis in many different cell types. Stimulation of PKB activity protects cells from apoptosis by phosphorylation and inactivation of the pro-apoptotic protein BAD. These results could explain why PKB is overexpressed in some ovarian, breast, and pancreatic carcinomas.

Animals↗

PubMedDate not supplied

Multiplanar reconstruction MR image of primary adenoid cystic carcinoma of the central airway: (MPR of central airway adenoid cystic carcinoma).

Multiplanar reconstruction (MPR) is a method that allows free selection of computerized reconstruction images. We reviewed a total of six MPR magnetic resonance (MR) examinations in five cases of adenoid cystic carcinoma of the central airway, which is a rare low-grade malignant tumor. MPR MR provides images either longitudinally or at right angles to the longitudinal axis of the trachea and main bronchi, so it was useful to diagnose tumor extent along airways more precisely and to evaluate therapeutic effects. MPR MR may help in planning therapeutic strategy and in posttherapeutic follow-up.

Adult↗

PubMedDate not supplied

Toward assessing family outcomes of service delivery: validation of a family quality of life survey.

BACKGROUND: The concept of family quality of life (QoL) has emerged as an important outcome of service delivery for individuals with disabilities and their families. The present study describes the process of developing a tool to measure family QoL. METHODS AND RESULTS: A total of 1197 respondents participated in a national field test. Through factor analysis, the survey was refined in several ways: (1) the preliminary 10-domain structure was reduced to a five-domain structure; (2) a total of 41 items were selected for the revised survey; and (3) wordings were clarified. CONCLUSIONS: The implications for future research and practice are discussed.

Adolescent↗

PubMedDate not supplied

Cancer immunotherapy: stress proteins and hyperthermia.

Heat shock proteins (hsps) can induce anti-cancer immune responses by targeting associated tumour antigens to the immune system. Hsps are not merely carriers of antigen but can also induce maturation of dendritic cells (DCs), resulting in a more efficient antigen presentation. However, improvement of hsp-based vaccines is still desirable if one is to realize their full therapeutic potential. Since the immune system consists of different elements functioning together in a highly integrated way, a combination therapy utilizing important immunomodulators together with hsp-based vaccination may improve therapeutic response. Hyperthermia has been shown to have important stimulatory effects on several cellular and organismal endpoints related to the immune system. This review highlights advantages and disadvantages of various ways of using stress proteins in cancer immunotherapy. It also overviews the interaction of hyperthermia with heat shock protein therapy and the related effects on the host's immune response.

Animals↗

PubMedDate not supplied

Personal monitoring instrument for the selective measurement of multiple organic vapors.

Development and laboratory testing of a small instrument capable of recognizing and quantifying multiple organic vapors at low- and sub-ppm concentrations is described. The instrument is slightly larger than a standard personal sampling pump and employs an array of three polymer-coated surface-acoustic-wave microsensors for vapor detection. Vapors are first trapped on a miniature adsorbent preconcentrator housed within the instrument and then thermally desorbed for analysis by the microsensor array. Each measurement cycle requires 5.5 min. The collective responses from the array are stored and then analyzed using pattern recognition methods to yield the identities and concentrations of collected vapors and vapor mixture components. Following initial optimization of instrument operating parameters, calibrations were performed with 16 organic solvent vapors and selected mixtures to establish a response library for each of two identical instruments. Limits of detection < or = 0.1 x threshold limit value were obtained for most vapors. In a series of 90 subsequent exposure tests, vapors were recognized with an error of < 6% (individual vapor challenges) and < 16% (binary mixture challenges) and quantified with an average error of < 10%. Monte Carlo simulations were coupled with pattern recognition analyses to predict the performance for many possible vapor mixtures and sensor combinations. Predicted recognition errors ranged from < 1 to 24%. Performance is shown to depend significantly on the interfacial polymer layers deposited on the sensors in the array and the nature and complexity of the vapor mixtures being analyzed. Results establish the capability of this technology to provide selective multivapor monitoring of personal exposures in workplace environments.

Adsorption↗

PubMedDate not supplied

Carbon monoxide analysis: a comparison of two co-oximeters and headspace gas chromatography.

Three methods (IL-182 Co-Oximeter, IL-282 Co-Oximeter, and headspace gas chromatography) for the analysis of carbon monoxide in postmortem blood were studied and compared using a prepared reference standard, Quantra control materials, and 62 postmortem blood specimens. The methods compared favorably with one another. The linear regression equations for the 62 postmortem blood samples (range = 1.0 to 86% saturation) were: IL-282 vs. IL-182, y = 1.11x - 3.10, r = 0.981; IL-182 vs. GC, y = 0.88x + 2.97, r = 0.973; IL-282 vs. GC, y = 1.00x - 1.24, r = 0.986.

Carbon Monoxide↗

PubMedDate not supplied

delta-9-Tetrahydrocannabinol analysis in forensic blood specimens using capillary column gas chromatography with nitrogen sensitive detection.

A method for the determination of delta-9-tetrahydrocannabinol (THC) in whole blood that employs hexane extraction followed by identification using gas chromatography with nitrogen/phosphorus detection has been developed. The assay is sensitive to 2 ng THC per mL blood and linear to concentrations up to 120 ng/mL (r = 0.998). Precision is demonstrated by coefficients of variation ranging from 3.6 to 9.1% (within run) and 7.1 to 8.0% (between run).

Chromatography, Gas↗

PubMedDate not supplied

Analysis of corticosteroids in urine by HPLC and thermospray LC/MS.

The method for simultaneous determination and confirmation of nine corticosteroids in urine by high-performance liquid chromatography with a diode array detector and thermospray liquid chromatography-mass spectrometry was studied. HPLC was performed on a C18 column with a gradient mobile phase system of water and acetonitrile. The calibration curve was linear from 20 ng/mL to 1.0 micrograms/mL for each corticosteroid, and the detection limit was 10 ng/mL in 5 mL of urine. The extraction recovery of each corticosteroid from the spiked urine was equal to or greater than 85% by liquid-liquid extraction (LLE) at pH 9 using diethyl ether and approximately 79% or more by solid-phase extraction (SPE) with a Sep-Pak C18 cartridge. The mass spectra obtained with the positive ion mode showed protonated molecular species [M + H]+, ammonium adduct ion [M + NH4]+, [MH-60]+, [MH-30]+, and [MH-18]+. The LC/MS detection limits ranged from 10 to 50 ng in the scan mode and from 1 to 5 ng in the selected ion monitoring (SIM) mode.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Quantitative determination of stanozolol and its metabolite in urine by gas chromatography/mass spectrometry.

The amount of stanozolol and 3'-hydroxystanozolol in urine was determined after oral administration of stanozolol. A gas chromatograph/mass selective detector equipped with a capillary column was used for these determinations. The GC/MS was operated in the SIM mode, and m/z 581, 669, and 315 were monitored for stanozolol, 3'-hydroxystanozolol, and calusterone (internal standard), respectively. The detection limit was approximately 1 ng/mL for both steroids. The maximum excretion rate of stanozolol was reached in 8 h and the maximum of 3'-hydroxystanozolol in 19 h. However, only 3% of the administered amount was recovered in urine.

Administration, Oral↗

PubMedDate not supplied

Simultaneous determination of morazone and phenmetrazine in rat plasma and urine using an on-column injection technique with fused-silica capillary column gas chromatography.

The simultaneous determination of morazone and its major metabolite, phenmetrazine, using an on-column injection technique with fused-silica capillary column gas chromatography is described. The on-column injection technique prevents the decomposition of morazone. The limit of quantitation in 0.1 mL of rat plasma for morazone and phenmetrazine is 5 ng/mL and that in 1.0 mL of rat urine is 1 ng/mL. The within run precisions (%CV) at the concentration of 0.5 micrograms/mL are 3.27% for morazone and 3.09% for phenmetrazine.

Analgesics, Opioid↗

PubMedDate not supplied

Study of the metabolism of phenothiazines: determination of N-demethylated phenothiazines in urine.

When phenothiazine drugs (chlorpromazine, promazine, promethazine, propiomazine, propionylpromazine, trifluoperazine and trimeprazine) were reacted with m-chloroperbenzoic acid, N-demethylated phenothiazines were obtained in moderate yield. The mass spectra of the N-demethylated phenothiazines showed either m/z 44 and 72 or m/z 58 as characteristic ions depending on their side chain. The N-demethylated propiomazine was identified as a metabolite of propiomazine from the urine of a rat which was given propiomazine orally.

Animals↗

PubMedDate not supplied

Drug testing at the 10th Asian Games and 24th Seoul Olympic Games.

Drug testing (doping test) procedures in the 1986 10th Asian Olympic Games and 1988 24th Seoul Olympic Games are reported. The International Olympic Committee Medical Commission (IOC-MC) conducted its first doping tests at the 1968 Olympics in Grenoble. With the guidance of the International Olympic Committee (IOC), the Olympic Council of Asia (OCA) introduced doping tests at the 1986 10th Asian Olympic Games in Seoul, Korea, September 21st to October 5th, 1986. 585 samples were tested at the Doping Control Center, Korea Advanced Institute of Science and Technology (DCC/KAIST), for stimulants, narcotics, anabolic steroids, and beta-blockers by gas chromatography/mass spectrometry, high pressure liquid chromatography, and fluorescence polarization immunoassay. These tests covered about 100 different drugs and another 400 as metabolites in addition to pharmacologically related substances. For the Seoul Olympic Games from September 17 to October 2, 1988, the IOC-MC with the DCC/KAIST conducted doping tests on 1601 samples for stimulants, narcotics, beta-blockers, diuretics, and anabolic steroids using GC, HPLC, GC/MSD, GC/MS, LC/MS, and TDx.

Doping in Sports↗