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Glucocorticoids upregulate the high affinity receptors for vasoactive intestinal peptide (VIP) on human mononuclear leucocytes in vitro.

Glucocorticoids were shown to induce a time- and dose-dependent increment of specific [125I]VIP-binding on human mononuclear leucocytes in culture. Cortisol (0.5 microM) increased specific [125I]VIP-binding to 132% of control after 48 h preincubation, to 162% after 96 h, and to 175% after 144 h. Dexamethasone (0.5 microM) increased specific [125I]VIP-binding to 140%, 194% and 210% after the same time periods. Analysis of the binding data revealed an increase in Bmax to 119% by cortisol (0.5 microM, 48 h) and to 194% by dexamethasone (0.5 microM, 48 h), and no change in Kd for the high affinity receptor after preincubation. The number of low affinity binding sites for VIP was also increased by glucocorticoids. However, in contrast to the high affinity receptor, low affinity binding sites were initially downregulated in culture, and glucocorticoids induced a restitution to number and affinity close to those obtained for freshly isolated leucocytes. This increase in low affinity binding sites was blocked by actinomycin D, in contrast to the high affinity receptor upregulation which was independent of de novo protein synthesis. Furthermore, corresponding to the glucocorticoid induced high affinity receptor upregulation, an increase in VIP stimulated cyclic AMP production was observed. The results of this study suggest that leucocyte responsiveness to VIP can be influenced by glucocorticoids.

Cyclic AMP↗

Process surveillance: auditing infection control policies and procedures.

The infection control team in a university hospital designed, implemented, and evaluated a program to audit infection control policies. Process surveillance techniques of observation and monitoring were used during surveys of patient care areas to evaluate infection control practices. Nineteen unit surveys have been completed in a 2-year period. Analysis of the program has demonstrated it to be an effective method to determine compliance with infection control policies.

Communicable Disease Control↗

Vibration sensitivity recovery after a second course of acrylamide intoxication.

Five monkeys were trained to report detection of vibration or an electrical stimulus. Three of them had been dosed previously with acrylamide administered orally until toxic signs appeared, and were then allowed to recover. Approximately 30 weeks after the end of the first dosing course, they were dosed a second time with 10 mg/kg/day of acrylamide, 5 days a week, to mimic the dosage regimen of the first dosing period. Two monkeys received vehicle, as in the first dosing period. Vibration sensitivity was reduced in the exposed monkeys to an extent comparable to the first dosing period. Analysis of covariance showed that the rate of recovery from a second exposure to acrylamide was comparable to the rate of recovery from the first exposure. Vibration sensitivity appears useful as a monitoring tool to follow the time course of acrylamide-induced peripheral nerve dysfunction.

Acrylamides↗

A pilot study on the effects of Aroclor 1254 ingestion by rhesus and cynomolgus monkeys as a model for human ingestion of PCBs.

A pilot study using female cynomolgus (Macaca fascicularis) and female rhesus (Macaca mulatta) monkeys was conducted to study the effects of chronic ingestion of polychlorinated biphenyls (PCBs). Four control and four treated monkeys of each species received an apple juice-gelatin mixture containing 0 and 280 micrograms Aroclor 1254/kg body weight/day, respectively, 5 days/wk. The cynomolgus monkeys, which were mature monkeys with a poor breeding history, were treated for approximately 55 wk, while the rhesus monkeys, which were just attaining sexual maturity, were treated for approximately 120 wk. After 38 wk on test, the treated and control rhesus monkeys were mated with untreated males. The clinical signs resulting from the Aroclor 1254 ingestion were similar for both species, and the time of onset after initiation of treatment was not appreciably different between the two species. Several treatment and interspecies differences were found with regard to the haematological and serum biochemistry parameters monitored, but age differences between the two species may have contributed to these findings. Periodic analysis of adipose tissue, blood and faecal specimens for PCBs suggested that the rhesus monkey retained more of the ingested PCB than did the cynomolgus monkey. Following mating, all of the treated rhesus monkeys aborted within 30-60 days after becoming pregnant, while all of the control monkeys had viable offspring.

Abortion, Spontaneous↗

Hyperlexia: a variant of aphasia or dyslexia.

We report five patients with hyperlexia who presented for evaluation in the Learning Disabilities Clinic at the Medical College of Georgia over a two year period. Analysis of the data from the neurologic and neuropsychologic evaluations indicates that the primary and essential cognitive deficit in these children is a disorder in speech and language involving a severe deficit in their ability to comprehend language whether it be spoken or written, as opposed to a dyslexia syndrome involving only recognition and/or comprehension of written language. This finding is in contrast to the Nosology of Disorders of Higher Cerebral Function proposed by the Child Neurology Society which views hyperlexia as a variant of the language disorder subtype of dyslexia.

Aphasia↗

Lessons from the catastrophic antiphospholipid syndrome (CAPS) registry.

Although less than 1% of patients with the antiphospholipid syndrome (APS) develop the catastrophic variant, its potentially lethal outcome emphasizes its importance in clinical medicine today. However, the rarity of this variant makes it extraordinarily difficult to study in any systematic way. In order to put together all the published case reports as well as the new diagnosed cases from all over the world, an international registry of patients with catastrophic APS ("CAPS Registry") was created in 2000 by the European Forum on Antiphospholipid Antibodies. Currently, it documents the entire clinical, laboratory and therapeutic data of more than 300 patients whose data has been fully registered. This registry can be freely consulted at the Internet (www.med.ub.es/MIMMUN/FORUM/CAPS.HTM) and it is expected that the periodical analysis of these data will allow us to increase our knowledge of this condition.

Antiphospholipid Syndrome↗

Structural investigation of a water-soluble glucan from an edible mushroom, Astraeus hygrometricus.

A water-soluble glucan, Fraction I, was isolated from the aqueous extract of the fruit bodies of the mushroom Astraeus hygrometricus. On the basis of total hydrolysis, methylation analysis, periodate oxidation, and NMR studies ((1)H, (13)C, 2D-COSY, TOCSY, NOESY, and HSQC), the structure of the repeating unit of the glucan is determined as:This glucan shows strong splenocyte activation.

Agaricales↗

Structural investigation of a polysaccharide (Fr. II) isolated from the aqueous extract of an edible mushroom, Pleurotus sajor-caju.

A water-soluble polysaccharide, (Fr. II) isolated from aqueous extract of an edible mushroom Pleurotus sajor-caju, was found to consist of D-glucose, D-galactose, and D-mannose in a molar proportion of 1:1:1. Compositional analysis, methylation analysis, periodate oxidation study, partial hydrolysis, and NMR experiments ((1)H, (13)C, 2D-COSY, TOCSY, NOESY, HSQC, and HMBC) revealed the presence of the following repeating unit in the polysaccharide: [formula: see text]

Carbohydrate Sequence↗

Chemical analysis of a new (1-->3)-, (1-->6)-branched glucan from an edible mushroom, Pleurotus florida.

A glucan that was soluble in aqueous sodium chloride was isolated from the aqueous extract of the fruiting bodies of Pleurotus florida. On the basis of total hydrolysis, methylation analysis, periodate oxidation, Smith degradation, and NMR studies (1H, 13C, TOCSY, DQF-COSY, NOESY, and HSQC), the structure of the repeating unit of the polysaccharide is established as: This glucan stimulates the phagocytic activity of macrophages.

Carbohydrate Sequence↗

A beta-D-glucan isolated from the fruiting bodies of Hericium erinaceus and its aqueous conformation.

HEP3, a beta-D-glucan slightly soluble in water, was isolated from the alkaline extract of the fruiting bodies of Hericium erinaceus. Its chemical structure was investigated by methylation analysis, periodate oxidation, Smith degradation and by IR and NMR spectroscopy. It was shown to have a main chain composed of beta-(1-->3)-linked D-glucopyranosyl residues, with single unit glucosyl branches attached to O-6 of every third backbone residue. Viscometry and Congo red reaction indicated that HEP3 has a highly ordered hydrogen-bond dependent conformation in aqueous solution, which collapses in strong alkaline solution.

Carbohydrate Conformation↗

Isolation and structural elucidation of a water-soluble polysaccharide (PS-I) of a wild edible mushroom, Termitomyces striatus.

A heteropolysaccharide (PS-I), isolated from the hot aqueous extract of an edible mushroom, Termitomyces striatus, is composed of d-glucose, d-galactose, d-mannose and l-fucose in a molar ratio 2:1:1:1. Structural investigation of the native as well as the Smith-degraded polysaccharide was carried out using methylation analysis, periodate oxidation studies and 1D and 2D NMR spectroscopy, and the repeating unit of the polysaccharide is established as follows: [carbohydrate structure: see text]

Agaricales↗

The structure of a polysaccharide from Fraction-II of an edible mushroom, Pleurotus florida.

A water-soluble polysaccharide was isolated from Fraction-II of the aqueous extract of the fruit bodies of the mushroom, Pleurotus florida. Compositional analysis, methylation analysis, periodate oxidation study, Smith degradation, and NMR studies (1H, 13C, DQF-COSY, TOCSY, NOESY, HSQC, and HMBC) revealed the presence of the following repeating unit in the polysaccharide: [structure: see text].

Carbohydrate Sequence↗

Structural analysis of water-soluble glucans from the root of Angelica sinensis (Oliv.) Diels.

Two water-soluble glucans (designated APS-1cI and APS-1cII) were extracted from the roots of Angelica sinensis (Oliv.) Diels and further purified by anion-exchange and gel-filtration chromatography. Their molecular weights were determined to be 1.7 x 10(5) and 3.9 x 10(4)Da, respectively. The structures of the purified glucans were investigated by a combination of chemical and instrumental analysis, such as methylation analysis, periodate oxidation, GC-MS, as well as FTIR and NMR spectroscopy ((1)H, (13)C, H-H COSY, HSQC, HMBC, TOCSY and NOESY). The data obtained indicated that APS-1cI was a linear alpha-glucan composed of only (1-->6)-alpha-D-Glcp, and APS-1cII had a repeating unit consisting of (1-->4)-alpha-D-Glcp and (1-->6)-alpha-D-Glcp in a molar ratio of 4:1. Such glucans isolated from A. sinensis (Oliv.) Diels have not been previously reported.

Angelica sinensis↗

Verification films: a study of the daily and weekly reproducibility of breast patient set-up in the START trial.

AIMS: Verification of patient position in radiotherapy by the use of portal images is a current practice in most radiotherapy departments. All patients within the Standardisation of Breast Radiotherapy Trial (START) were required to have on-treatment verification images. Measurements of maximum lung and breast depth from these were used to provide details for the case-report forms. This study was undertaken to validate these measurements, assess the reproducibility of patients' set-up within the START trial and to compare reproducibility on a day-to-day basis with reproducibility over a longer period. Analysis also included a subjective assessment of image quality. MATERIALS AND METHODS: Fifty-three patients from 29 departments were studied. Some centres used electronic portal imaging and others used film. Where film verification was the method of choice, information was collected about the type of film and cassette used. RESULTS: The correlation coefficients for inter- and intra-observer variability of breast and lung depth were 0.99. Comparing maximum breast depth on weekly and daily images, the median per cent standard deviation of breast depth was 4% and 3%, respectively. The mean standard deviation of breast depth for all patients, which gives an indication of the individual patient variability, was 5.5 +/- 2.2 mm for weekly and 3.9 +/- 1.5 mm for daily measurements. For lung depth, mean standard deviation was 6.8 +/- 2.5 mm for weekly and 6.8 +/- 2.8 mm for daily measurements. Images taken using Kodak X-omat V film were inferior to those taken with films in corresponding cassettes. CONCLUSION: Differences between lung depth measured in simulator and on the treatment unit were evident for many patients. There was little difference in the standard deviations of breast and lung depth for daily and weekly verification films on the treatment machine.

Breast Neoplasms↗

Reproductive health, the Arab world and the internet: usage patterns of an Arabic-language emergency contraception web site.

Emergency contraception (EC) has the potential to reduce significantly the incidence of unintended pregnancy worldwide. In May 2003, the first Arabic-language web site dedicated to disseminating information about and increasing awareness of EC was launched. This paper examines patterns of web site use and user profiles over a 19-month period. Analysis of use shows that the Arabic web site users are interested in different aspects of EC than the English web site users, suggesting the importance of creating culturally specific content when adapting and translating health education materials. Arabic web site users demonstrate significant interest in general reproductive health issues not specific to EC, suggesting a need for greater availability of Arabic-language health education resources through the Internet.

Arab World↗

Time and frequency domain analyses of heart rate variability in patients with epilepsy.

Heart rate variability (HRV) is a useful tool for the detection of sympathetic-parasympathetic balance of autonomic nervous system in patients at risk of sudden death (SD). SD is more common in patients with epilepsy and the exact mechanisms of SD are unknown. Autonomic nervous system involvement in patients with epilepsy has rarely been studied and has shown conflicting results. Our purpose was to determine if HRV showed any changes in patients with epilepsy in comparison with normal population. A short period analysis of HRV was performed for both the frequency and time domain in 43 epilepsy patients who had generalized tonic-clonic seizures (GTCS) and who were not taking any medications and also in 43 age and sex matched controls. In the time domain analysis, patients displayed higher SDNN (standard deviation of all R-R intervals), SDANN (standard deviation of mean NN intervals in 5 min recordings) and HRV triangular index than did healthy subjects (p < 0.0001). Patients tended to display higher pNN50 (number of R-R intervals differed by > 50 ms from adjacent interval divided by the total number of all R-R intervals) and RMSSD (root-mean-square of successive differences) values than did healthy subjects, but the differences were not statistically significant (p > 0.05). In the frequency domain analysis, the spectral measures of HRV showed a reduction of high frequency (HF) values (is a marker of parasympathetic activity) and an increase of low frequency (LF) values (is a measure of sympathetic activity); as a result, the ratio between low and high frequencies (LF/HF) was significantly increased (p < 0.0001, p < 0.0001 and p < 0.001, respectively). Our data suggests an increase in the sympathetic control of the heart rate in epilepsy patients who have GTCS. This increased sympathetic activity could play a key role in the development of ventricular tachyarrhythmias in patients with epilepsy and may be related to the higher incidence of sudden death in this disorder as compared to controls.

Adult↗

Effects of physicochemical surface characteristics of Listeria monocytogenes strains on attachment to glass.

Seven strains of Listeria monocytogenes frequently involved in foodborne disease (epidemic strains) and 14 sporadic strains were examined to compare the attachment and subsequent biofilm growth on glass slides at 37 degrees C. Epidemic strains at 3 h incubation had significantly higher attachment values than sporadic strains (P<0.001), but subsequent biofilm growth over 24 h was not dependent on initial attachment. To better understand this phenomenon, the surface hydrophobicity and charge, as well as the extracellular carbohydrate content of the 21 L. monocytogenes strains were studied to determine if these surface characteristics had an effect on bacterial attachment to glass. Hydrophobicity was measured by the bacterial adherence to hydrocarbon (BATH) and polystyrene adherence methods. Hydrophobicity values obtained with the BATH method were linearly correlated with those from the polystyrene adherence method (r=0.64, P<0.001), but no correlation was found between hydrophobicity and bacterial attachment to glass. Hydrophobicity and surface charge measured as electrophoretic mobility (EM) were correlated (r=0.77, P<0.001); however, there was no correlation between the degree of attachment and surface charge. Colorimetric measurements of the total extracellular carbohydrates revealed that attached cells produced significantly (P<0.05) higher levels than planktonic cells after a 3 h time period. Analysis of co-variance (Nested ANCOVA) furthermore demonstrated that total carbohydrates produced by planktonic cells had a significant positive effect on 24 h biofilm growth (P=0.006). This is the first report to indicate that the ability of a L. monocytogenes strain to produce high levels of extracellular carbohydrates may increase its ability to form a biofilm. Genetic studies targeting carbohydrate synthesis pathways of L. monocytogenes will be required to fully understand the importance of this observation.

Analysis of Variance↗

A randomized, controlled trial of C0- Vs C2-guided therapeutic drug monitoring of cyclosporine in stable heart transplant patients.

BACKGROUND: Cyclosporine monitoring using 2-hour post-dose samples (C2) is thought to be more efficacious than using pre-dose levels (C0) in managing immunosuppression for transplant patients. We evaluated the effect of C2 monitoring on cyclosporine dose and clinical parameters in stable heart transplant patients. METHODS: 125 stable heart transplant patients were randomized to C0 or C2 monitoring of cyclosporine levels for a period of six months. All patients had both C0 and C2 samples taken, and clinicians were blinded to one of the samples depending on randomization. The primary endpoint was the relative change in cyclosporine (Neoral) dose during the study period and secondary endpoints were change in creatine clearance, mortality, infection, and acute rejection. RESULTS: There was a significant decrease in the cyclosporine dose for the C2 group as compared with the C0 group (-11 mg/day and -26 mg/day respectively, p = 0.0025). No proven rejection episodes occurred in either group and there was no significant difference in the incidence of infection (C0 6, C2 10; p = 0.14), the change in renal function (change in creatine clearance C(0) +0.54 ml/min; C2 -0.16 ml/min; p = 0.61), the number of blood tests or dose adjustments between groups over the study period. Analysis of the blinded samples revealed that the reduction of cyclosporine dose in the C2 group could not be accounted for by reduced immunosuppression . CONCLUSION: C2 monitoring allows a significant cyclosporine dose reduction without compromising patient outcome in stable heart transplant patients. Further studies are required to ascertain whether this dose reduction can be translated into clinical benefit.

Aged↗