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[The incidence of arterial hypertension and ischemic heart disease in workers manufacturing nitrogen and phosphorus fertilizers].

Examinations are performed on 120 workers from the plant for nitrogen and 253 workers from the plant for phosphorous fertilizers. For comparison is used a control group of 103 persons having no professional contact with chemical noxa. The measuring of the arterial pressure and assessment of the arterial hypertension rate is performed after the standardised method of the World Health Organization (1984). The probability of ischemic disease of the heart is determined on the basis of the electrocardiographic changes (Minnesota code) and the data of the questionnaire of G. A. Rose (WHO, 1984). The results point out, that the arterial hypertension incidence and that of the ischemic disease of the heart in the exposed workers in both plants is insignificantly higher than that of the controls. There is no effect of the specialized length of service on the dissemination of the registered cardio-vascular diseases. The data of the carried out investigation show no presence of heightened risk of arterial hypertension and ischemic heart disease in workers from the nitrogen and phosphorous fertilizers production.

Adult

[Color velocity imaging for diagnosis in kidney transplants. Methods for interpretation of color coding].

Colour velocity imaging is a new technique in the field of colour-coded sonographic flow measurement. It measures blood flow directly by analysing ultrasound pulses' running time and has advantages over colour Doppler systems. Colour velocity imaging's colour code detects changes in arterial blood flow. Therefore it can be used in the diagnosis of kidney allografts in the same way as duplex ultrasound. Using the presented methods of colour interpretation, sensitivity of 66.6-100% and specificity of 72.7-91.7% are attained. Thus colour velocity imaging combines the attributes of duplex ultrasound and colour Doppler ultrasound.

Blood Flow Velocity

Coding clinical information: analysis of clinicians using computerized coding.

Data are presented of a controlled experiment with a computerized browsing and encoding tool. Eighteen practicing clinicians extracted medical concepts from two narrative exercise cases using two approaches, traditional and computer-assisted use of ICD-9. Our results indicate that by using a computerized coding tool the completeness of coding can be improved by up to 55%, that by enforcing mandatory as opposed to optional modifier codes results in lower rates of incomplete coding (0 and 55%, respectively), higher rates of correct coding (41 to 92%) and no change in incorrect code, and that manual coding takes twice as long than coding with the help of the computerized coding tool. Clinicians need 59% more time for processing the whole set of codes than is suggested by the sum of individual codes. We conclude that the use of a computerized coding tool can save time and result in higher quality codes. However, the real time spent on coding may be underestimated when looking at individual coding times, instead of the whole task of processing a clinical scenario.

Disease

[Incidence and regression of sudden infant death in Austria. Is the change in the SIDS incidence real or virtual?].

After the rise in incidence of the sudden infant death syndrome (SIDS) in the 1980s to a peak of 1.7/1000 live births in Austria in 1988, the SIDS rate more than halved to 0.79/1000 live births in 1994. This trend can be regarded as typical of the epidemiology of SIDS in most Western countries. It is commonly interpreted as a result of preventive measures. However, the decline in incidence of SIDS started several years before systematic preventive activities were undertaken in Austria. Graphical presentation shows that the dynamics of SIDS does not affect the almost linear decline in postneonatal mortality over the past 25 years, as would be expected from the fact that SIDS is the most important cause of death in the postneonatal period. A comparative analysis of trends of postneonatal SIDS and non-SIDS mortality reveals that in Austria the increase of SIDS was accompanied by a rapid fall of non-SIDS mortality, whereas, on the contrary, the decline of SIDS went along with relative increase of non-SIDS mortality. Changing awareness of coroners and forensic pathologists of SIDS, with the resultant changes in frequency and performance of postmortem examinations, and changes in coding practices of causes of death should be taken into consideration as determinants of SIDS incidence before interpreting trends as resulting from public health interventions.

Austria

Death certification by doctors in non-metropolitan Victoria.

OBJECTIVE: To examine the completeness and accuracy of death certification by general practitioners, specialists and resident medical officers (RMOs) in non-metropolitan Victoria. DESIGN: An examination of the death certificates written by a representative sample of community and hospital doctors and comparison with the clinical history. SETTING: The Ballarat statistical district. RESULTS: Eighteen percent of the death certificates at initial assessment, were unsatisfactory (the percentage for those written by RMOs were significantly higher). After review of the clinical record, 27% of certificates were found to inaccurately represent the cause of death, (again the percentage for RMOs was higher) Eighteen percent of certificates required a change of code. CONCLUSION: Monitoring the health of the public relies in part on information gained from death certificates. It is thus of concern that such a high percentage of death certificates are inaccurate to the extent that they are incorrectly coded. Consideration should be given to new educational initiatives and to the promotion of the existing toll free telephone advice service to doctors.

Death Certificates

[Trends in average life expectancy in the Saxony Free State--results of a cause of death-specific table analysis].

We conducted a specific table analysis on mortality causes that was mainly oriented on the lines of the chapters of ICD-9 to explore the average life expectancy for the population in Saxony particularly since 1988. The drop in average life expectancy of males observed since 1990 can be fully explained only for those around 18 years of age by "accidents" as the cause of death. Between 30 and 55 years of age there were additional losses of average life expectancy via the mortality causes "diseases of the digestive tract", "neoplasms" and "psychiatric diseases". The significance of neoplasms and of psychiatric diseases is receeding in respect of the average life expectancy. In 1991 there was an increase in the incidence of suicide in the age bracket around 51 years in males. Seen on an overall scale across all age brackets the development of the suicide rate has increased average life expectancy. Significant average life expectancy increase developed in the range of death causes due to embryonic or congenital damage as well as cardiovascular diseases, diseases of the respiratory system and infectious diseases. As far as the female population is concerned, only accidents and diseases of the digestive tract had a negative effect on average life expectancy in 1990 and 1991 whereas the negative effect exercised by the mortality cause "neoplasms" is systematically flattening out. There are excessive gains in life expectancy in respect of cardiovascular diseases, clearly in the range of embryonal and congenital diseases and remarkably in respect of suicide. How many of these specific differentiations of causes of death are due to changes in coding, has not yet been assessed. Leaving aside the unnatural causes of death these figures point to a marked influence of improved medical care on average life expectancy.

Adolescent

Colour coding in the cerebral cortex: the responses of wavelength-selective and colour-coded cells in monkey visual cortex to changes in wavelength composition.

The reaction of wavelength-selective (WL), wavelength-opponent (WLO) and colour-coded (CO) cells in monkey visual cortex to changes in the wavelength composition of the light reflected from the area in their receptive fields was studied, using multicoloured displays. Wavelength-selective and wavelength-opponent cells were found to be very sensitive to changes in the wavelength composition of the light reflected from the areas in their receptive fields, irrespective of their perceived natural and void colours. Changes in the wavelength composition of the light reflected from surrounding areas did not affect their responses. They were also sensitive to the order in which lights of various wavelengths illuminated the areas in their receptive fields. Colour-coded cells were not affected by changes in the wavelength composition nor were they sensitive to the sequence with which the area in their receptive fields was illuminated by lights of different wavelengths. However, they required that the display, with the area of their preferred colour in their receptive fields, be trichromatically illuminated. This and other evidence suggested that such cells were sensitive not only to the illumination of the area in their receptive fields, but of surrounding areas as well. This evidence reinforces further the distinction between wavelength-selective and colour-coded cells and leads to the conclusion that one function of the wavelength-selective cells must be to register the changes in wavelength composition which occur throughout the day.

Animals

Structural studies of the lysozyme coded by the pneumococcal phage Cp-1. Conformational changes induced by choline.

The CPL-1 lysozyme coded by the pneumococcal phage Cp-1 has been overproduced in Escherichia coli under the control of a modified lipoprotein lactose promoter. This result has provided the conditions to analyse the CPL-1 secondary structure by circular dichroism (CD). The CD spectra recorded in the far-ultraviolet region showed, at neutral pH, two minima at 210 nm and 230 nm and a shoulder at 217 nm, whereas two bands at 260 nm and 295 nm were observed in the near-ultraviolet region. It has been estimated, by using the CDPROT program, that the protein is composed of 19% alpha-helix, 32% beta-sheet, 28% beta-turn and 21% random coil. Minor changes in the CD spectra were detected either when the pH was varied over 6-10 or when the ionic strength was increased to 1 M NaCl. Choline, a well known modulator of the enzyme activity that is present in the pneumococcal cell wall, induced remarkable changes in the intensities of the bands at 210, 230 and 295 nm, with the appearance of an unusual positive band at 225 nm. The conformational change was reversible and correlated with the competitive inhibitory effect of choline on the lysozyme activity, supporting, by a new and direct experimental approach, the basic role of choline in the recognition of the cell wall substrate. The analyses of the secondary structure prediction and the CD data reported here are compatible with the two-domain structure of CPL-1 reinforce our hypothesis that the C-terminal region is directly involved in the binding of the enzyme to the pneumococcal teichoic and lipoteichoic acids.

Amino Acid Sequence

[Study on the principles of base change in 4-fold degenerate sites of protein coding genes].

The relationship of transition and transversion of base change in 4-fold degenerate sites of coding genes of 6 proteins, which showed 70% homology in wmposition investigated. Taking into account of the effects of base composition on base substitution, it was found that the transition-transversion bias was evident but not as pronounced as in mitochondrial DNA. Comparison of different kinds of transition or transversion indicated that they happened with rather equal vate, with 0.65-0.73 for different kinds of transversion and 0.99 for A-G transition assuming that T-C transition was 1. The causes for transition-transversion bias is discussed and it is proposed that mutagens may play a role in it.

Animals

Mutations in the helper component protease gene of zucchini yellow mosaic virus affect its ability to mediate aphid transmissibility.

The nucleotide sequence of the helper component protease (HC-Pro) genes of three zucchini yellow mosaic virus (ZYMV) strains has been compared with that of a helper-deficient strain of ZYMV-HC. The comparisons revealed three unique deduced amino acid differences. Two of these mutations were located in regions which are conserved in other potyviruses. The role of these mutations in aphid transmissibility was examined by exchanging DNA fragments of part of the deficient HC-Pro gene with the respective section within the gene of the infectious full-length clone of the aphid-transmissible ZYMV. The first exchange included two of the three mutations, the first coding for a change from Asp to Gly (in a non-conserved region) and the second coding for a change from Arg to Ile [within the Phe-Arg-Asp-Lys (FRNK) conserved box]. This exchange resulted in a reduced transmission (20.6% for the mutated virus compared with 57.4% in the normal ZYMV when acquired from plants and 37.2% compared with 83.1%, respectively, when acquired from membranes). The second exchange incorporated a single mutation [conferring a change from Thr to Ala within the Pro-Thr-Lys (PTK) conserved box]. This single mutation resulted in almost total loss of HC activity in aphid transmission both from plants and from membranes. The Lys residue in the conserved Lys-Ile-Thr-Cys (KITC) box, which is related to loss of HC activity in potato virus Y, tobacco vein mottling virus and in the Michigan strain of ZYMV, is unchanged in the helper-deficient ZYMV. It is therefore proposed that more than one site in HC-Pro may be functionally related to aphid transmissibility. The possible reasons for the role of these mutations in helper activity in aphid transmission of ZYMV are discussed.

Amino Acid Sequence

Health care reform: managed competition and beyond.

Since the election, the health care reform debate has focused on three broad features: implementation of managed competition, changes in the tax treatment of health insurance, and the imposition of budget caps or targets. The basic element of managed competition is the creation of sponsors who act as collective purchasing agents for large groups of individuals. One of the potentially most politically difficult issues in implementing any health care reform proposal is likely to be defining the minimum standard benefit package. It will determine the costs society bears, the income of providers, the health of many individuals, and the attributes of a workable health care reform package. Managed competition is intended to foster competition among health plans on the basis of cost and quality. The measures of quality actually employed in the health care system will determine in large part the incentives faced by insurers, providers, and consumers. The problem of adverse selection is potentially the most important issue in reforming the health insurance market. If individuals can opt not to purchase health benefits, poorer risks will be more likely to purchase health insurance than good risks, and at minimum the price of these benefits will be higher than would otherwise be the case. Managed competition requires that individuals share at least some of the financial consequences of their choices among health plans. As a result, most managed competition proposals change the tax code by limiting the exclusion of employer contributions to health insurance from worker's taxable income. Changing the health insurance market, mandating employer health benefits, and changing the tax code may have significant effects on the health care delivery system, but they are unlikely to reduce health care cost inflation in the near term. One of the proposals for restraining the growth in health care costs is the imposition of a budget on the amount spent on health care services. The combination of the constraints placed on federal governmental action by the budget and the significant political problems involved in reaching a consensus on the important elements of health care reform may limit the ability of the federal government to implement national health care reform in the near term. As a result, individual states may be encouraged by the federal government to continue to experiment with their own health reform programs.

Budgets

The genetic code in mitochondria and chloroplasts.

The universal genetic code is used without changes in chloroplasts and in mitochondria of green plants. Non-plant mitochondria use codes that include changes from the universal code. Chloroplasts use 31 anticodons in translating the code; a number smaller than that used by bacteria, because chloroplasts have eliminated 10 CNN anticodons that are found in bacteria. Green plant mitochondria (mt) obtain some tRNAs from the cytosol, and genes for some other tRNAs have been acquired from chloroplast DNA. The code in non-plant mt differs from the universal code in the following usages found in various organisms: UGA for Trp, AUA for Met, AGR for Ser and stop, AAA for Asn, CUN for Thr, and possibly UAA for Tyr. CGN codons are not used by Torulopsis yeast mt. Non-plant mt, e.g. in vertebrates, may use a minimum of 22 anticodons for complete translation of mRNA sequences. The following possible causes are regarded as contributing to changes in the non-plant mt: directional mutation pressure, genomic economization, changes in charging specificity of tRNAs, loss of release factor RF2, changes in RF1, changes in anticodons, loss of lysidine-forming enzyme system, and disappearance of codons from coding sequences.

Animal Population Groups

Molecular characterization of three mutations in katG affecting the activity of hydroperoxidase I of Escherichia coli.

Hydroperoxidase I (HPI) of Escherichia coli is a bifunctional enzyme exhibiting both catalase and peroxidase activities. Mutants lacking appreciable HPI have been generated using nitrosoguanidine and the gene encoding HPI, katG, has been cloned from three of these mutants using either classical probing methods or polymerase chain reaction amplification. The mutant genes were sequenced and the changes from wild-type sequence identified. Two mutants contained G to A changes in the coding strand, resulting in glycine to aspartate changes at residues 119 (katG15) and 314 (katG16) in the deduced amino acid sequence of the protein. A third mutant contained a C to T change resulting in a leucine to phenylalanine change at residue 139 (katG14). The Phe139-, Asp119-, and Asp314-containing mutants exhibited 13, less than 1, and 18%, respectively, of the wild-type catalase specific activity and 43, 4, and 45% of the wild-type peroxidase specific activity. All mutant enzymes bound less protoheme IX than the wild-type enzyme. The sensitivities of the mutant enzymes to the inhibitors hydroxylamine, azide, and cyanide and the activators imidazole and Tris were similar to those of the wild-type enzyme. The mutant enzymes were more sensitive to high temperature and to beta-mercaptoethanol than the wild-type enzyme. The pH profiles of the mutant catalases were unchanged from the wild-type enzyme.

Base Sequence

[Ethics in nursing].

Synopsis about the evolution of moral principles adopted by brazilian nursing since 1923 to nowadays. It indicates a metaphysical, abstract and spiritual tendencies in the codes of 1958 and 1975, and a change in the code of 1993, which searches to observe valuables of historic form and based on material conditions of existence.

Brazil

Levels of translatable mRNA coding for rat liver glucokinase.

Changes in the level of translatable mRNA coding for glucokinase under different physiological conditions were determined using a reticulocyte lysate translation system and immunoprecipitation. Poly(A+) RNA isolated from livers of rats fed a high carbohydrate diet displayed a 10-fold increase in glucokinase template activity when compared to starved rats. Livers from streptozotocin-induced diabetic rats had only 9% of the glucokinase template activity displayed by controls. Administration of insulin to diabetic rats produced an increase in the level of mRNA coding for glucokinase within 20 min and reached a maximum 13-fold increase 1 h following insulin treatment. Under all experimental conditions examined, changes in the level of glucokinase mRNA were accompanied by similar changes in direction and magnitude of enzyme activity and the relative rate of synthesis of the enzyme in vivo. In addition, the developmental appearance of glucokinase activity at the 16th day following birth was accompanied by a corresponding increase in the amount of glucokinase mRNA. Thus, it appears that dietary, hormonal, and developmental changes in the activity of glucokinase arise as the result of changes in the amount of functional mRNA coding for the enzyme.

Animals

Partial nucleotide sequence of South American yellow fever virus strain 1899/81: structural proteins and NS1.

We have partially cloned and sequenced the genome of a Peruvian yellow fever virus isolate (1899/81) and compared the nucleotide and deduced amino acid sequences of this strain with the previously published sequence of the West African yellow fever virus strain Asibi. In the 3594 base region sequenced, which contains the structural genes (C, M, E), all but the 72 3'-terminal nucleotides of the NS1 gene and 108 nucleotides of the 5' non-coding region, 515 nucleotide substitutions were detected. Nucleotide divergence was lowest in the 5' non-coding region, 2.8%, compared with an average rate of 14.7% in the coding regions. Over 91% of the 512 nucleotide changes in the coding region were silent; 44 amino acid substitutions resulted. The capsid protein was the least conserved, whereas the M protein was the most highly conserved (6.7% and 1.3% divergence, respectively). The envelope protein had 18 amino acid changes (3.7% divergence), one of which created an additional site for potential glycosylation of the 1899/81 virus. NS1 protein divergence (3.9%) was similar to that seen in the E protein. Of the 44 amino acid substitutions found, 34 (77%) were conservative. The highest number of nonconservative differences occurred in the envelope glycoprotein. These changes may significantly affect the antigenic and biological functions of the viruses.

Amino Acid Sequence

Ischemia induces changes in the level of mRNAs coding for stress protein 71 and creatine kinase M.

Hyperthermia, hypoxia, and other conditions induce the appearance of heat shock or stress proteins in cells. We have previously shown that in the ischemic dog myocardium the level of a messenger RNA (mRNA) coding for a protein with migration characteristics similar to heat shock/stress protein 71 increases. Using a human heat-shock protein (hHSP) 70 genomic clone and anti-HSP70 antibodies as probes, we demonstrate in this report that heart stress protein (SP) 71 mRNA and its translational products (71 kDa polypeptides) are members of the stress protein family. In rabbit hearts, the ischemia-induced mRNAs translate into three isoforms with different isoelectric points (6.0, 6.1, and 6.15), in contrast to dog heart mRNA that translates into a protein with a pI of 5.8. The levels of SP71 mRNA in the dog and rabbit ischemic myocardium increased by sixfold and 18-fold, respectively. In the same samples, the levels of creatine kinase M mRNA decreased by about 40%, whereas those of myosin heavy chain mRNA remain unaltered. Our comparative analysis of three different mRNAs indicates that ischemia manifests its effects by differentially changing the levels of specific mRNAs coding for proteins with separate and distinct roles in the cell.

Animals

[A method for the quantitative evaluation of the probability of ischemic heart disease in epidemiological research on workers exposed to harmful effects].

A method for quantitative evaluation of the probability for ischaemic disease of the heart in epidemiological studies is recommended and the state of risk is determined by riskogram, including 3 parts: 1. Assessment of the electrocardiographic changes after Minnesota code. 2. Integral quantitative interpretation of ECG-changes with the data from the Rose test. 3. Classified quantitative assessment of the probability for ischaemic disease of the heart. The quantitative interpretation of the probability for ischaemic disease of the heart allows the use of various statistical methods, mathematical models and computer processing of data, received at the epidemiological studies. By tracing the dependences "dose-effect" and "dose-response" the maximum admissible duration of the length of service could be predicted in specific conditions of professional exposure, in order to prevent injury of the cardiovascular system from harmful industrial factors.

Bulgaria