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Polyamine cytochemistry. Use of a novel o-phtalaldehyde method for visualizing spermidine and spermine. Comparisons to the formaldehyde-fluorescamine method.

o-Phtalaldehyde (OPT) reacts with a number of biologically important molecules, including the polyamines, spermidine and spermine. By systematically varying reaction conditions with respect to temperature, pH, concentration and length of exposure to the reagent, using both model systems and tissues, we have succeeded in constructing a cytochemical OPT-method specific for spermidine and spermine. The method detects cell types known to contain these polyamines, including growing and neoplastic cells. The staining pattern obtained with the OPT method is identical to that obtained with the formaldehyde-fluorescamine (FF) technique recently shown to be specific for spermidine and spermine. In contrast to the FF technique, the OPT method can be used for staining suspensions of isolated cells and may hence be employed in studies using fluorescence-activated cell sorting (FACS). Preliminary such studies show a pronounced decrease in cellular OPT-induced fluorescence, paralleled by a decrease in content of polyamines, after treatment with the polyamine biosynthesis inhibitor alpha-difluoromethylornithine (alpha DFMO). In contrast, cells simultaneously treated with alpha DFMO + spermidine show pronounced increases in their spermidine content and parallel increases in their OPT-induced fluorescence. Availability of methods selectively demonstrating polyamines at the cellular and subcellular level is expected to aid our understanding of polyamine functions in normal growth and cancer.

Aldehydes↗

Simplified methods for the evaluation of the parameters of the time course of plasma concentration in the one-compartment body model with first-order invasion and first-order drug elimination including methods for ascertaining when such rate constants are equal.

The many limitations in determining the pharmacokinetic parameters of first-order invasion of, and elimination from, the one-compartment body model by the method of residuals or by "feathering" C-t data can be minimized by applying the simplified methods outlined herein. Comparisons of the apparent volumes of distribution, V, calculated on the premises that the Bateman Function represents ka > ke or its converse, ke > ka, i.e., flip-flop, can permit a proper choice of the correct version. Estimation of ke can be obtained by regression of (A0/V)/C(oncentration) on AUCt/C where A0/V is estimable from knowledge of Cmax and tmax since A0/V = Cmax eketmax. The ratio of the magnitude of the rate constant of invasion to that of elimination, m = ka/ke, is related to ketmax by the expression ketmax = ln m/(m - 1) for all possible values of m. A table for the determination of m from values of ketmax is given. When bioavailability, gamma = Ao/Dose, is known or complete, ke and V can be determined from the respective ordinate and abscissa of the intersection of A0/Cmax eketmax and Cl(clearance)/ke, both plotted against arbitrary ke values. The two functions may not intersect at low values of m due to errored C-t values but the ke value when the two curves are closest (kmin) may approximate ke. The intersections of Cmax eketmax and keAUCT (AUCtrap) plotted against variable ke values (Method A) provide estimates of ke from their abscissa values and A/V from their ordinate values when gamma is unknown. Method B appears to give more reliable estimates of ke at the kmin of the difference eketmax/ke - AUCT/Cmax, plotted against ke. Since kmin of this plot is l/tmax when m = 1, the identity of the m as unity underlying the C-t data is indicated when either kmintmax is approximately unity or kmin is practically synonymous with l/tmax. This was clearly shown when 12 constructed m = 1, C-t cases with 10% random error were evaluated by Method B. Better estimates were effected by all procedures when the raw C-t data were smoothed.

Biological Availability↗

The determination of ammonium in Kjeldahl digests using the gas-sensing ammonia electrode. Comparison of the direct method with the known-addition method.

The efficacy of the ammonia electrode for analysis of the nitrogen content of a large series of Kjeldahl digests was investigated. By using this electrode, two methods for the measurement of ammonium concentrations were compared, the direct method and the known-addition method. When the direct method was used, a marked shift in the electrode potential occurred within a few hours, causing errors of 9-17% in the results. When the ammonium concentrations were calculated from the difference in electrode potential before and after addition of a known amount of an ammonium standard solution (known-addition method), it was possible to carry out reproducible measurements and the shift in the electrode potential did not influence the results. In two series of identical samples the coefficient of variation was respectively 1.45% and 0.80%.

Ammonia↗

The vaginal contraceptive diaphragm and the condom--a reevaluation and comparison of two barrier methods with the rhythm method.

The use-effectiveness and continuation rates of two barrier methods of contraception, the diaphragm and condom, were studied during a two-year follow-up in a group of 85 and 98 women, respectively. All were highly motivated. Results were compared to a group of 64 women using the periodic abstinence or rhythm method, i.e. not using any contraceptive. The patients selected the method of contraception they preferred and were instructed in their proper use. Results showed good continuation rates in the groups using a diaphragm and the condom for 2 years, for a total follow-up of 5570 cycles. Pregnancy rate after 24 months of use, as calculated by Pearl's formula, was 2.48 for the diaphragm, 3.21 for the condom, and 5.19 in the rhythm group. No serious side effects or complications occurred in either group. The study demonstrated a fair acceptability and use-effectiveness for barrier contraceptive. We suggest that these harmless and complication-free methods may still be reasonable alternatives for the "modern" methods, the pill and the IUD.

Adolescent↗

A review of the application of propensity score methods yielded increasing use, advantages in specific settings, but not substantially different estimates compared with conventional multivariable methods.

OBJECTIVE: Propensity score (PS) analyses attempt to control for confounding in nonexperimental studies by adjusting for the likelihood that a given patient is exposed. Such analyses have been proposed to address confounding by indication, but there is little empirical evidence that they achieve better control than conventional multivariate outcome modeling. STUDY DESIGN AND METHODS: Using PubMed and Science Citation Index, we assessed the use of propensity scores over time and critically evaluated studies published through 2003. RESULTS: Use of propensity scores increased from a total of 8 reports before 1998 to 71 in 2003. Most of the 177 published studies abstracted assessed medications (N=60) or surgical interventions (N=51), mainly in cardiology and cardiac surgery (N=90). Whether PS methods or conventional outcome models were used to control for confounding had little effect on results in those studies in which such comparison was possible. Only 9 of 69 studies (13%) had an effect estimate that differed by more than 20% from that obtained with a conventional outcome model in all PS analyses presented. CONCLUSIONS: Publication of results based on propensity score methods has increased dramatically, but there is little evidence that these methods yield substantially different estimates compared with conventional multivariable methods.

Bias↗

Catecholamines in urine; an evaluation of alumina-trihydroxyindole methods and a description of an improved method.

A critical assessment of the accuracy and practicability of five alumina-trihydroxyindole methods for the estimation of urinary catecholamines, including our proposed method, was undertaken. The recovery of noradrenaline added to urine obtained by these methods was quantitated against different types of standards, and varied from 22.9 per cent to 104.8 per cent. The major analytical problems (fluorescence suppression and loss of catecholamines during column chromatography) were evaluated and related to the recovery of the respective procedures. The improved method we developed is simple, rapid and reliable. The low fluorescence suppression and column losses of noradrenaline of this method, averaging 2.9 per cent and 5.3 per cent, respectively, resulted in a mean recovery of 92.0 per cent against an external standard. Both the chromatography step and fluorescence development are simple and short, and a batch of ten cases can be completed within 3 hours.

Aluminum↗

Comparison between the photoelectric method and H2 clearance method for measuring cerebrocortical blood flow in cats.

The photoelectric method using carbon black as a nondiffusible tracer of blood was compared with the hydrogen clearance (H2) method in nine anesthetized cats. A photoelectric apparatus and H2 electrode were applied to a small region of the cerebral cortex (left ectosylvian gyrus) for simultaneous measurement of the regional CBF. The values of CBF(H2) and CBF(photoelectric) were 50.7 +/- 19.2 and 52.1 +/- 14.5 ml.100 g-1.min-1, respectively. CBF(H2) and CBF(photoelectric) were found to correlate well (r = 0.588, p less than 0.01) when changes in CBF were induced by CO2 inhalation, exsanguination, hyperventilation, and occlusion of the middle cerebral artery. The correlation between CBF(H2) and CBF(photoelectric) was much better in the case of intraindividual comparisons (r = 0.957, p less than 0.01). In addition to its merits in common with the H2 clearance method, such as handiness, low cost, and strict regionality, the photoelectric method displayed the following advantages: time-to-time measurements of CBF (less than 20 s), immediate display of the microcirculatory flow pattern, and simultaneous monitoring of cerebral blood volume. However, measurements from deep structures of the brain are better performed by the H2 method despite the disadvantage of the use of a potentially explosive gas.

Animals↗

A numerical method for allocating microbial isolates to strain types when characterized by typing methods that are not 100% reproducible.

Many methods for typing microbial strains are not 100% reproducible. This can create problems when deciding whether different groups of isolates are really distinct or represent typing errors or variation of a single strain. Neither hierarchical clustering nor iterative partitioning methods are suited for analysing such data. A novel iterative partitioning method is described which allows for the uncertainty of the typing method in use. Before grouping strains, the maximum dimension of the groups is set based on a previous knowledge of the typing method's reproducibility. Isolates are only allocated to a group if they differ from that group's typical strain type by less than the number of reaction differences required to distinguish between two strains. In a series of Monte Carlo studies the accuracy of strain allocation was found to be very good, even when the two groups were situated close to each other.

Bacteria↗

The back-step method--method for obtaining unbiased population parameter estimates for ordered categorical data.

A significant bias in parameters, estimated with the proportional odds model using the software NONMEM, has been reported. Typically, this bias occurs with ordered categorical data, when most of the observations are found at one extreme of the possible outcomes. The aim of this study was to assess, through simulations, the performance of the Back-Step Method (BSM), a novel approach for obtaining unbiased estimates when the standard approach provides biased estimates. BSM is an iterative method involving sequential simulation-estimation steps. BSM was compared with the standard approach in the analysis of a 4-category ordered variable using the Laplacian method in NONMEM. The bias in parameter estimates and the accuracy of model predictions were determined for the 2 methods on 3 conditions: (1) a nonskewed distribution of the response with low interindividual variability (IIV), (2) a skewed distribution with low IIV, and (3) a skewed distribution with high IIV. An increase in bias with increasing skewness and IIV was shown in parameters estimated using the standard approach in NONMEM. BSM performed without appreciable bias in the estimates under the 3 conditions, and the model predictions were in good agreement with the original data. Each BSM estimation represents a random sample of the population; hence, repeating the BSM estimation reduces the imprecision of the parameter estimates. The BSM is an accurate estimation method when the standard modeling approach in NONMEM gives biased estimates.

Bias↗

A comparison of reference method values for sodium, potassium and chloride with method-dependent assigned values.

The concentrations of sodium, potassium, and chloride in various control sera were determined by reference methods. The reference method values were compared with the corresponding method-dependent assigned values. Sodium: Measurements by flame photometry and ion selective electrodes differed on the whole by less than 1% from the reference method value; determinations by photometry differed, however, by -4.7%. Potassium: The mean bias was -1.2% with flame photometry and -0.4% with ion selective electrodes, whereas nephelometric procedures differed by -1.9 or -4.8%. Chloride: Satisfactory agreement was obtained with values given for ion selective electrodes (-0.3%), for some coulometric procedures (-0.7 and 0.4%), and photometric determinations using mercury rhodanide (-0.5 and +0.7%). Values for mercurimetric titration and for photometric determinations using mercury 2,4,6-tri-(2-pyridyl)-s-triazine differed by + 2.5 and + 1.8%. Proposals concerning the allowable deviation from reference method values are discussed.

Chlorides↗

Epidemiological methods for research with drug misusers: review of methods for studying prevalence and morbidity.

Epidemiological studies of drug misusers have until recently relied on two main forms of sampling: probability and convenience. The former has been used when the aim was simply to estimate the prevalence of the condition and the latter when in depth studies of the characteristics, profiles and behaviour of drug users were required, but each method has its limitations. Probability samples become impracticable when the prevalence of the condition is very low, less than 0.5% for example, or when the condition being studied is a clandestine activity such as illicit drug use. When stratified random samples are used, it may be difficult to obtain a truly representative sample, depending on the quality of the information used to develop the stratification strategy. The main limitation of studies using convenience samples is that the results cannot be generalised to the whole population of drug users due to selection bias and a lack of information concerning the sampling frame. New methods have been developed which aim to overcome some of these difficulties, for example, social network analysis, snowball sampling, capture-recapture techniques, privileged access interviewer method and contact tracing. All these methods have been applied to the study of drug misuse. The various methods are described and examples of their use given, drawn from both the Brazilian and international drug misuse literature.

Epidemiologic Methods↗

Comparison of a computer based method and the classical manual method for radiographic joint space width assessment in hip osteoarthritis.

OBJECTIVE: To compare the intraobserver reliability and the sensitivity to change of 2 techniques evaluating the cartilage breakdown in hip osteoarthritis (OA). METHODS DESIGN: 3 year longitudinal study. PARTICIPANTS: patients with painful hip OA. OUTCOME: coxofemoral joint space width (JSW) at baseline and at 3 year followup was measured on anteroposterior weight-bearing radiographs by 2 methods: a manual method to obtain JSW at the narrowest point (minimal JSW) using a 0.1 mm graduated magnifying glass and a computer based method to obtain minimal and average JSW. STATISTICAL ANALYSIS: Two assessments, at one month interval, of each pair of films; evaluation of the intraobserver reliability using the intraclass coefficient of correlation, and the Bland and Altman approach, obtaining the smallest detectable difference (SDD). For each technique, percentage of progressors was evaluated, i.e., the percentage of patients with change greater than the SDD. Evaluation of sensitivity to change was performed using the standardized response mean (SRM), with 95% CI calculated using the jackknife method. RESULTS: Twenty-five pairs of films were evaluated. There were no statistically significant differences between the 3 analyses in the calculated intraclass coefficients of correlation, percentage of progressors, or SRM. CONCLUSION: These results suggest that both techniques are reliable and sensitive enough to detect changes in a relevant percentage of patients with hip OA after a 3 year followup.

Aged↗

[The determination of oxalate in urine by enzymatic method using oxalate oxidase: comparison between enzymatic and gas-chromatographic methods].

Urinary oxalate is one of the most important constituents of urolithiasis, but the determination of oxalate in urine has not been performed as a routine laboratory examination. We tried to measure oxalate in urine by the enzymatic method with oxalate oxidase. The linearity of the standard curve and reproducibility of this method were confirmed. (Linearity: r = 0.996, S.D./mean: 0.5-3.6%, recovery rate: 99.5 +/- 3.3 (mean +/- S.D.)%) The correlation between this method and gas-chromatographic method was 0.926. The enzymatic method with oxalate oxidase can be utilized for determining the urinary oxalate as a routine laboratory examination.

Chromatography, Gas↗

[Determination of proteins with the Coomassie brilliant blue G 250 method. IV. Use with cerebrospinal fluid proteins and comparative analysis with the biuret and Lowry methods].

The method of Bradford with Coomassie Brillant Blue G 250 for protein assay has been applyed to CSF in comparison with biuret and Lowry's methods. The results of Coomassie method closely agree with Lowry, and are similar to those of biuret. It is suggested to replace the previously used methods for CSF protein assay by the Bradford's method, because it keeps the sensitivity of Lowry and the simplicity of biuret. It adds too the advantage of requiring less time.

Cerebrospinal Fluid Proteins↗

Preincubation of serum aspartate aminotransferase with pyridoxal 5'-phosphate in the SMAC: comparison with revised DuPont aca method and recommended IFCC method.

The method for continuous-flow assay of aspartate aminotransferase with the Technicon SMAC was modified to include preincubation of the serum enzyme with pyridoxal 5'-phosphate, to be consistent with the recommendations of IFCC and the Standards Committee of AACC. Preliminary estimates of the imprecision of the modified method on SMAC gave day-to-day standard deviations of 5.3 U/L at mean of 48 U/L (n = 66) and 6.2 U/L at 155 U/L (n = 61). Added bilirubin, sodium pyruvate, ascorbic acid, and endogenous lipids did not interfere. Comparison of results for 50 samples by this method with those by the manual IFCC method gave y = 1.1113x - 0.3 U/L, Sy/x = 4.4 U/L, and r = 0.997. Similar data are presented for the revised AST method for the DuPont aca discrete analyzer. Clinical data show that AST activities increase by as much as 200% when the serum is preincubated with pyridoxal 5'-phosphate.

Animals↗

Contraceptive methods: do Hispanic adolescents and their family planning care providers think about contraceptive methods the same way?

This article describes how a family planning clinic-based program to prevent repeat pregnancy among Hispanic adolescents in Los Angeles used qualitative research to understand client contraceptive behavior. Background information on Hispanic adolescent reproductive patterns and an overview of paths to motherhood among teen clients are provided to contextualize the results. Participants sorted contraceptive methods on perceived similarities and ranked them on effectiveness, safety, and use-preference. Multidimensional scaling was used to identify and compare conceptual models. Both providers and teens grouped methods by effectiveness and mode of action, but acceptability and ease of method use were also important for teens. Providers found participation a worthwhile educational experience that facilitated self-reflection about their own biases and better understanding of their clients' needs. This method could be applied in many clinical settings where education and counseling are important in treatment and where patients and providers are likely to have different conceptual models regarding therapy.

Adolescent↗

Treatment for lymphedema of the arm--the Casley-Smith method: a noninvasive method produces continued reduction.

BACKGROUND: This paper gives an outline of the Casley-Smith method for the treatment of lymphedema of the arm. It includes a brief summary of the development of manual techniques and the terminology applied to them. METHODS: The four principles of this method are skin care, manual lymphatic drainage, compression in the form of bandaging and/or garments, and exercise. The massage techniques, especially where they differ from other schools, are described in some detail, as are the principles that apply in compression and maintenance of reduction in lymphedema. RESULTS: The results of this method have been analyzed both in Australia and in the United States and are discussed briefly. Mention is made of the benefits of the benzopyrones, which have been used for many years, when added to the above treatment. Both benzopyrones and exercise will produce a continued reduction after the treatment course. They are particularly useful in a less compliant patient. It is stressed that the effect of patient compliance, particularly after treatment, makes a great difference to the ongoing success of the regime. CONCLUSIONS: A comparison is drawn between the efficacy of various current treatments and their cost. This shows that this combined and conservative method of treatment should be considered before recourse to pumps or surgery. The latter seldom achieve the results of decongestive lymphatic drainage, and, in the long term, they are more expensive. Certain preventive measures may be indicated following, e.g., mastectomies. Prevention of the onset of lymphedema is of extreme importance. However, a return to as normal a lifestyle as possible by the patient is also essential. The earlier treatment begins after the onset of lymphedema, the better the prognosis for the patient. Lymphedema can and should be treated.

Aged↗

What is the most appropriate radiologic scoring method for ankylosing spondylitis? A comparison of the available methods based on the Outcome Measures in Rheumatology Clinical Trials filter.

OBJECTIVE: To select the most appropriate radiologic scoring method for the evaluation of radiographic progression in ankylosing spondylitis (AS) in clinical trials. METHODS: The validity of the currently available methods, the Bath Ankylosing Spondylitis Radiology Index (BASRI), the Stoke Ankylosing Spondylitis Spine Score (SASSS), and the modified SASSS (M-SASSS), was tested according to the aspects of the Outcome Measures in Rheumatology Clinical Trials filter: truth, discrimination (reliability and sensitivity to change), and feasibility, using radiographs of 133 patients at 4 different time points (baseline, 1 year, 2 years, and 4 years). One observer scored these sets in chronological order. To assess interobserver reliability, a second observer scored radiographs of 20 patients at the 4 different time points. RESULTS: After 4 years, 9% and 8% of patients showed changes >0 in the sacroiliac (SI) joints and hips, respectively. Independent of the method chosen, approximately 40% of patients showed changes in both the lumbar and cervical spine. Therefore, it was concluded that, for the assessment of progression, SI joints and hips are of minor importance. The intraclass correlation coefficient (ICC) varied from 0.87 to 0.98 and ICCs for intraobserver scores varied from 0.96 to 0.99. Concerning progression scores, only the ICC for the M-SASSS measured after 2 years remained acceptable (0.82). The intraobserver scores for progression after 2 years of followup were an ICC of 0.93 for the BASRI, an ICC of 0.79 for the SASSS, and an ICC of 0.95 for the M-SASSS. Concerning sensitivity to change, it was found that the M-SASSS classified the highest percentage of patients with a change >0. CONCLUSION: The M-SASSS is the most appropriate method by which to score the radiographic progression in AS patients in clinical trials.

Follow-Up Studies↗