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Measuring trends in optometric practice: a study in Oregon.

BACKGROUND: Considerable change has occurred in the United States, over the past several years, broadening the scope of optometry to include the treatment of ocular disease. This change has received a great deal of "press", however little has been done to measure actual trends occurring in the practice of optometry. A study was undertaken in 1991 to establish an accurate profile of optometric practice in the state of Oregon including trends over the past five years and those projected into the next five years. METHODS: A sampling of all optometrist (465) in the state was done early in 1991, query being made as to five years back (1986) and five years ahead (1996) relative to various practice characteristics. The return rate was 51%. RESULTS: It was found that general examinations, spectacles, and contact lenses are services offered by, essentially, every office. However, there is considerable variation, office-to-office, on all other services. Projections into the next five years forecast increased services in contact lenses, vision therapy, and the management/treatment of ocular disease. As to technology, trends indicate greater use of auto-refractors, auto-keratometers, automated visual fields, and binocular indirect opthalmoscopy. CONCLUSIONS: Optometrists in Oregon are optimistic on the projected growth of particular services. While this outlook seems to be based on an existing patient base in most areas of care, it appears to assume that projected treatment privileges will attract a new and expanded base of patients relative to ocular disease.

Humans↗

Distribution of hypertension and renal disease in Oregon.

Expecting to find agreement between the geographic distribution of hypertension and renal disease, we developed regional mortality rates for 1950-72 and prevalence rates for a Selective Service cohort born in 1939-41 and examined during 1957-69. For this purpose the State's counties were grouped into eight geographically homogeneous regions. The general decline in hypertension mortality was most pronounced in Portland, Oregon's major urban center. However, the decline halted during 1968-72 in the southern Cascade region which has become an area of relatively higher risk within the State. During these 23 years nephritis mortality fell, kidney infection mortality was stable, and both syndromes showed peak mortality in other, different regions of the State. The geographic pattern of hypertension prevalence among the draftee cohort resembled the 1963-67 hypertension mortality pattern, but more recent morbidity data are needed to confirm the southern Cascade region's recent change to a high-risk area. Of 529 draftees with diagnosed hypertension, only 35 percent of the cases were previously known, only 7 percent has had any previous treatment, and only 7 percent were associated with known renal conditions. Among 521 registrants with a history of renal disorders, the prevalence of hypertension was increased for all categories of renal disease but was significantly high only for those with a history of glomerulonephritis. To date in Oregon we have found no evidence that renal disorders are major determinants of hypertension morbidity or mortality.

Adolescent↗

African tick-bite fever among international travelers--Oregon, 1998.

In May 1998, the Oregon Health Division received a report from a local physician that nine persons developed annular skin lesions accompanied by influenza-like symptoms within 8 days of leaving southern Africa. All nine persons were members of a 34-person group from Oregon that traveled to Swaziland in April 1998 to participate in a 3-week humanitarian construction project. This report describes two cases of African tick-bite fever (ATBF) diagnosed in this group and underscores the importance of pretravel counseling about vectorborne illnesses and post-travel recognition of imported rickettsial diseases.

Adult↗

Lee v. State of Oregon.

HELD: Oregon's Death with Dignity Act, Measure 16, which legalizes physician-assisted suicide for certain terminally ill persons, violates the equal protection clause of the fourteenth amendment to the United States Constitution. Measure 16 fails to withstand even the lowest level of judicial scrutiny because the disparate treatment afforded the class of terminally ill persons does not further any legitimate state interest.

Adult↗

EILATox-Oregon Workshop: blind study evaluation of Vitotox test with genotoxic and cytotoxic sample library.

In order to assess the robustness, sensitivity and specificity of a recently developed Vitotox test, 17 blind coded chemicals and three environmental water samples were tested at the EILATox-Oregon Workshop using the Thermo Electron Vitotox kit. The Vitotox test is a rapid geno- and cytotoxicity test using standard 96- or 384-well microtitre plates. The genotoxicity test is based on two genetically modified Salmonella typhimurium strains containing bacterial luciferase operon from Vibrio fisheri under the SOS inducible promoter. The SOS system is an inducible network in Escherichia coli that responds to DNA damage and activates DNA repair. The Vitotox genotoxicity test bacteria strain carries bacterial luciferase genes under the control of SOS inducible promoter and therefore any DNA damage inside the cells induces the production of bacterial luciferase. The luciferase expression is then followed with a microtitre plate luminometer for 3 h after mixing different dilutions of sample with the test bacteria. The genotoxicity index is calculated for each dilution and the genotoxicity of the sample is interpreted based on kinetic time curves and genotoxicity vs concentration/dilution curves. Cytotoxicity of the sample is determined simultaneously with another test strain containing the same luciferase operon controlled by the constitutive promoter. This bacterium produces constant bioluminescence and any decrease of the bioluminescence production is used as a marker for cytotoxicity. As a miniaturized microtitre plate assay the Vitotox test requires a very small quantity of the sample material. The samples used in the workshop were diluted 1 : 10 or 1 : 100 before testing. Genotoxicity and cytotoxicity data were collected at dilutions of 1 : 10-1 : 2000. When the samples of the EILATox-Oregon Workshop were tested using the Vitotox test, four coded chemicals out of 17 were determined to be genotoxic. Seven chemicals and one environmental sample were found to be cytotoxic. Three chemical samples were found to be both geno- and cytotoxic.

Aliivibrio fischeri↗

Detection of bioavailable heavy metals in EILATox-Oregon samples using whole-cell luminescent bacterial sensors in suspension or immobilized onto fibre-optic tips.

At the EILATox-Oregon Workshop, nine luminescent whole-cell bacterial sensors were used for the determination of bioavailable metals in blind samples (17 synthetic and 3 environmental). A non-inducible luminescent control strain was used to determine sample matrix effects and bacterial toxicity. Whole-cell bacterial sensors capable of determining arsenic, inorganic mercury and its organic derivatives, cadmium, lead or copper were used in suspensions and a bacterial sensor for the detection of inorganic mercury was immobilized onto fibre-optic tips using calcium alginate. Bioavailable amounts of metals were estimated using calibration plots, that were constructed to determine the range of metals giving rise to a linear relationship between luminescence and the amount of metals present in the standard solutions. EILATox-Oregon sample 5, which contained 74 mg l(-1) of Hg, gave a significant response with both formats of the mercury sensor. The bioavailable amounts of mercury according to the measurement of bacterial sensor in suspension and immobilized onto a fibre-optic tip were 76 and 93 mg l(-1), respectively. The bacterial sensor for arsenic and copper showed a response with sample 6 (58 mg l(-1) of As) and sample 8 (400 mg l(-1) of metham sodium), respectively. This study showed that the bacterial sensors in suspension or immobilized onto optical fibres are capable of quantifying bioavailable metals from unknown samples. The measurement protocol of bacterial sensors is simple and possible to perform in the field. Moreover, the samples do not need any pretreatment before analysis. Construction and characterization of the strain for the detection of bioavailable copper are described.

Biological Availability↗

Toxicity detection from EILATox-Oregon Workshop samples by using kinetic photobacteria measurement: the Flash method.

The Flash test, which can be used to measure the toxicity from clear, turbid and coloured samples with identical protocol, was used in the EILATox-Oregon Workshop. During the workshop, 17 synthetic samples and three environmental samples were tested. In the Flash method the photobacteria Vibrio fischeri are initially dispensed on top of the sample and the light output of the bioluminescence reaction is recorded at a rate of several readings per second. The change in the light production was measured at two points: 30 s and 30 min after exposure at room temperature. Toxicity calculations were done by using either the peak height of the sample or the peak height of the control sample (maximum signal at 0-2 s). When the peak height of the sample is used as a reference, the colour and turbidity effect of solid particles are taken into account throughout the whole measurement period. In the EILATox-Oregon Workshop toxicity was seen in samples 1 (chlordimeform), 4 (phosdrin), 5 (HgCl(2)), 6 (sodium arsenite), 8 (metham sodium), 12 (p-chlorophenol), 14 (sodium selenite) and 17 (MNNG). Only samples 1, 4 and 12 showed different ec(50) values between different calculations of toxicity. The ec(50) values were calculated and compared with the ec(50) values of Microtox derived from the literature. The Flash test will not replace the standardized photobacteria test, but is the advanced version of it and is needed when the sample matrix is complex and when speed and low costs are required.

Biosensing Techniques↗

Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon Sudden Unexpected Death Study.

OBJECTIVES: We sought to evaluate the contribution of left ventricular (LV) dysfunction toward occurrence of sudden cardiac death (SCD) in the general population, and to identify distinguishing characteristics of SCD in the absence of LV dysfunction. BACKGROUND: Patients who manifest warning symptoms and signs are more likely to undergo evaluation before SCD. Although prevalence of LV dysfunction in this subgroup may overestimate the prevalence in overall SCD, this is the only means of assessment in the general population. METHODS: All cases of SCD in Multnomah County, Oregon (population 660,486; 2002 to 2004) were prospectively ascertained in the ongoing Oregon Sudden Unexpected Death Study. We retrospectively assessed LV ejection fraction (LVEF) among subjects who underwent evaluation of LV function before SCD (normal: > or =55%; mildly to moderately reduced: 36% to 54%; and severely reduced: < or =35%). Of a total of 714 SCD cases (annual incidence 54 per 100,000), LV function was assessed in 121 (17%). RESULTS: The LVEF was severely reduced in 36 patients (30%), mildly to moderately reduced in 27 (22%), and normal in 58 (48%). Patients with normal LVEF were distinguishable by younger age (66 +/- 15 years vs. 74 +/- 10 years; p = 0.001), higher proportion of females (47% vs. 27%; p = 0.025), higher prevalence of seizure disorder (14% vs. 0%; p = 0.002), and lower prevalence of established coronary artery disease (50% vs. 81%; p < 0.001). CONCLUSIONS: In this community-wide study, only one-third of the evaluated SCD cases had severe LV dysfunction meeting current criteria for prophylactic cardioverter-defibrillator implantation. The SCD cases with normal LV function had several distinguishing clinical characteristics. These findings support the aggressive development of alternative screening methods to enhance identification of patients at risk.

Aged↗

Alexa and Oregon Green dyes as fluorescence anisotropy probes for measuring protein-protein and protein-nucleic acid interactions.

The fluorescence properties of Alexa 488, Oregon Green 488, and Oregon Green 514 (Molecular Probes (Eugene, OR)) are compared when conjugated to biomolecules and as model compounds free in solution. We show that these relatively new, green fluorescence probes are excellent probes for investigation of the thermodynamics of protein-protein and protein-nucleic acid interactions by fluorescence anisotropy. Unlike fluorescein, the emission of these dyes has minimal pH dependence near neutrality and is significantly less susceptible to photobleaching. Steady-state and time-resolved fluorescence anisotropy data are compared for two interacting proteins of different size and for the association of a transcription factor with a DNA oligonucleotide containing a specific binding site. The temperature dependence of the fluorescence lifetimes of the probes is reported, and the effects of molecular size and probe motion on steady-state anisotropy data are discussed. The critical interplay among correlation time, fluorescence lifetime, and the observed steady-state anisotropy is evaluated.

Binding Sites↗

Negative-tension instability of scroll waves and winfree turbulence in the oregonator model.

Excitable media support self-organized scroll waves which can be unstable and give rise to three-dimensional wave chaos. Winfree turbulence of scroll waves results from the negative-tension instability of scroll waves; it plays an important role in the cardiac tissue where it may lead to ventricular fibrillation. By numerical simulations of the Oregonator model, we show that this instability and, thus, the Winfree turbulence may also be observed in the Belousov-Zhabotinsky reaction. The region in the parameter space, where the instability takes place, is determined, and a relationship between the negative-tension instability and the meandering behavior of spiral waves is found. The application of global periodic forcing to control such turbulence in the Oregonator model is discussed.

Journal Article↗

Increase in the resistance to the Bacillus thuringiensis supernatant effect in a Drosophila melanogaster wild type Oregon R line.

We report here the genetical and X chromosome rDNA molecular study of two Drosophila melanogaster Oregon R lines. These lines differ extensively in the degree of resistance of the females both to the lethal effect of an increased temperature and to that of Bacillus thuringiensis beta-exotoxin, which is an inhibitor of the nucleolar RNA polymerase. The 3B line, whose females are resistant, came from an Oregon R population subjected over several generations to increased temperature, 28 degrees C or over, while the other line is derived from the initial stock. Twofold variation was observed in the total number of ribosomal genes between the two lines. This variation applied to most ribosomal units, including the active ones. Variations among X chromosome rDNA content in a wild type population have thus been revealed using tests of resistance to the Bacillus thuringiensis beta-exotoxin. Additive variations in specific unit types between the two lines indicate that modifications to the rDNA content are not rare events.

Adenosine↗

X chromosome variations of Bacillus thuringiensis supernatant resistance and ribosomal DNA content in Drosophila melanogaster wild-type Oregon R lines.

We have used the supernatant of Bacillus thuringiensis cultures to follow variations of the ribosomal DNA content in a wild-type Oregon R line of Drosophila melanogaster. These variations are revealed by differences in the degree of resistance to the lethal effect of the supernatant added in the culture medium. Different X chromosomes, all originated from the same X chromosome, confer different degrees of resistance. Increases and reductions in the number of the X ribosomal DNA transcriptional units have been found and are correlated with variations in the degree of supernatant resistance. However, no significant variations in X rDNA content were observed between the initial line and this line tested 20 generations later. These results show that the X rDNA is subjected to frequent modifications that must be essentially complementary and thus originate from reciprocal molecular events. Variations of resistance have been observed in the absence of recombination between homologous chromosomes; this is in agreement with the hypothesis that unequal recombinations between sister chromatids are largely involved in the variations of the X ribosomal DNA in Oregon R wild-type strains.

Adenosine↗

Carbon and oxygen isotope ratios of ecosystem respiration along an Oregon conifer transect: preliminary observations based on small-flask sampling.

Isotope ratio analyses of atmospheric CO(2) at natural abundance have significant potential for contributing to our understanding of photosynthetic and respiration processes in forest ecosystems. Recent advances in isotope ratio mass spectrometry allow for rapid, on-line analysis of small volumes of CO(2) in air, and open new research opportunities at the ecophysiological, whole-organism, and atmospheric levels. Among the immediate applications are the carbon and oxygen isotope ratio analyses of carbon dioxide in atmospheric air. Routine analysis of carbon dioxide in air volumes of approximately 50-300 &mgr;l is accomplished by linking a commercially available, trace gas condenser and gas chromatograph to an isotope ratio mass spectrometer operated in continuous-flow mode. Samples collected in the field are stored in either gas-tight syringes or 100-ml flasks. The small sample volume required makes it possible to subsample the air in flasks for CO(2) and then to sample the remaining air volume for the analysis of the isotopic composition of either methane or nitrous oxide. Reliable delta(13)C and delta(18)O values can be obtained from samples collected and stored for 1-3 days. Longer-term storage, on the order of weeks, is possible for delta(13)C measurements without drift in the isotope ratio signal, and should also be possible for delta(18)O measurements. When linked with an infrared gas analyzer, pump and flask sampling system, it is feasible to sample CO(2) extensively in remote forest locations. The air-sampling system was used to measure the isotope ratios of atmospheric CO(2) and to conduct a regression analysis of the relationship between these two parameters. From the regression, we calculated the delta(13)C of ecosystem respiration of four coniferous ecosystems along a precipitation gradient in central Oregon. The ecosystems along the coast-to-interior Oregon (OTTER) gradient are dominated by spruce-hemlock forests at the wet, coastal sites (> 200 cm precipitation annually) to juniper woodlands (20 cm precipitation) at the interior, dry end of the transect. The delta(13)C values of ecosystem respiration along this transect differed by only 1.3 per thousand (range of -25.2 to -23.9 per thousand ) during August at the peak of the summer drought. Following autumn rains in September, the delta(13)C of ecosystem respiration in the four stands decreased; overall the difference in the carbon isotope ratio of ecosystem respiration among sites increased to 3.9 per thousand (-26.8 to -22.9 per thousand ).

Journal Article↗

Genetic structure of desert ground squirrels over a 20-degree-latitude transect from Oregon through the Baja California peninsula.

The genetic structure of populations over a wide geographical area should reflect the demographic and evolutionary processes that have shaped a species across its range. We examined the population genetic structure of antelope ground squirrels (Ammospermophilus leucurus) across the complex of North American deserts from the Great Basin of Oregon to the cape region of the Baja California peninsula. We sampled 73 individuals from 13 major localities over this 2500-km transect, from 43 to 22 degrees north. Our molecular phylogeographical analysis of 555 bp of the mitochondrial cytochrome b gene and 510 bp of the control region revealed great genetic uniformity in a single clade that extends from Oregon to central Baja California. A second distinct clade occupies the southern half of the peninsula. The minimal geographical structure of the northern clade, its low haplotype diversity and the distribution of pairwise differences between haplotypes suggest a rapid northward expansion of the population that must have followed a northward desert habitat shift associated with the most recent Quaternary climate warming and glacial retreat. The higher haplotype diversity within the southern clade and distribution of pairwise differences between haplotypes suggest that the southern clade has a longer, more stable history associated with a southern peninsular refugium. This system, as observed, reflects both historical and contemporary ecological and evolutionary responses to physical environmental gradients within genetically homogeneous populations.

Animals↗

Isolation of Non-O1 Vibrio cholerae Serovars from Oregon Coastal Environments.

Water, sediment, and shellfish from three Oregon estuaries were cultured for pathogenic Vibrio species. Non-O1 serovars of V. cholerae were the most common pathogenic Vibrio species recovered. Non-O1 V. cholerae were isolated from all three estuaries sampled, covering an area of about 170 miles along the Oregon coast. Non-O1 V. cholerae were isolated from water and sediment, but not shellfish, at temperatures ranging from 11 to 19 degrees C and salinities of 2.3 to 26 per thousand. Sixteen isolates representing 12 different non-O1 serovars were identified, while four non-O1 V. cholerae isolates failed to react with any of the 54 antisera tested. These results indicate that non-O1 V. cholerae serovars can be found over a large geographic area and under a variety of environmental conditions. These organisms are apparently an autochthonous component of these estuarine microbial communities.

Journal Article↗

The effect of physician-controlled health insurance. U.S. v. Oregon State Medical Society.

The trial record in an antitrust case against the Oregon State Medical Society, finally decided in 1952, was examined to reconstruct the behavior of a competitive market for health insurance coverage. Health insurers, called "hospital associations," were found to have engaged individually in cost-control efforts similar to, but possibly more aggressive than, today's utilization review under professional sponsorship. The subsequent disappearance of these insurer-initiated cost controls in Oregon is traced to the medical society's organization of a competing Blue Shield plan as a model of insurer conduct and to a simultaneous boycott by physicians of the hospital associations as long as they persisted in questioning doctors' practices. Some modern parallels are noted, and the advantages of fostering privately sponsored cost-control efforts are suggested.

Hospitals↗

Nitrate removal effectiveness of a riparian buffer along a small agricultural stream in western Oregon.

The Willamette Valley of Oregon has extensive areas of poorly drained, commercial grass seed lands. Little is know about the ability of riparian areas in these settings to reduce nitrate in water draining from grass seed fields. We established two study sites with similar soils and hydrology but contrasting riparian vegetation along an intermittent stream that drains perennial ryegrass (Lolium perenne L.) fields in the Willamette Valley of western Oregon. We installed a series of nested piezometers along three transects at each site to examine NO3-N in shallow ground water in grass seed fields and riparian areas. Results showed that a noncultivated riparian zone comprised of grasses and herbaceous vegetation significantly reduced NO3-N concentrations of shallow ground water moving from grass seed fields. Darcy's law-based estimates of shallow ground water flow through riparian zone A/E horizons revealed that this water flowpath could account for only a very small percentage of the streamflow. Even though there is great potential for NO3-N to be reduced as water moves through the noncultivated riparian zone with grass-herbaceous vegetation, the potential was not fully realized because only a small proportion of the stream flow interacts with riparian zone soils. Consequently, effective NO3-N water quality management in poorly drained landscapes similar to the study watershed is primarily dependent on implementation of sound agricultural practices within grass seed fields and is less influenced by riparian zone vegetation. Wise fertilizer application rates and timing are key management tools to reduce export of NO3-N in stream waters.

Agriculture↗

Old Dad Chiro comes to Portland: rediscovering DD in Oregon, 1908-10.

This paper sketches Palmer's Portland period, and relies upon five issues of DD's periodical, the Chiropractor's Adjuster, to supplement traditional sources. The early activities of the D.D. Palmer College of Chiropractic are reviewed, and Palmer's travels throughout the region are noted. Old Dad Chiro's widespread influence in the profession is apparent from the diverse correspondence reprinted in his magazine, including letters from chiropractors in at least 22 states. During his Portland years his intent to "adjust" the "mistaken" ideas of chiropractors and his anger at son BJ became plainly and painfully evident. The founder's activities in Portland gave impetus to chiropractic education in the Northwest, and his schools' successor, the Oregon Peerless College of Chiropractic & Neuropathy, continued to operate for several years until its merger with another forerunner of today's Western States Chiropractic College. Most importantly, Palmer's stay in Oregon saw perhaps the first publication of his final theories of chiropractic, and gave rise to his classic text, The Chiropractor's Adjuster: the Science, Art and Philosophy of Chiropractic.

Chiropractic↗