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Diet preferences for specific fatty acids and their effect on composition of fat reserves in migratory Red-eyed Vireos (Vireo olivaceous).

Fatty acid composition of body fat in birds often differs between bird species and between seasons, and changes in diet may be responsible for this variation. We tested two related hypotheses using Red-eyed Vireos, a long-distance migratory songbird: (1) birds prefer diets with certain fatty acids, and (2) fatty acid composition of the diet primarily determines the composition of lipid reserves. During paired-choice experiments, vireos preferred semi-synthetic diets with triolein (81% digestive extraction efficiency) over diets with tristearin (54% digestive extraction efficiency) and, in general, ate more when offered diets with unsaturated fats compared to saturated fats. These results demonstrate that vireos can discriminate between diets differing only in fatty acid composition and prefer diets with long-chain unsaturated fatty acids. When vireos were fed one of two diets for 1 month, the primary fatty acids in each diet also predominated in the tissues of birds fed each diet. However, some fatty acids that were absent in the diet occurred in bird tissues (e.g., 22:4, 22:5) suggesting that selective metabolism of fatty acids along with diet composition determine the fatty acid composition of lipid reserves in migratory birds.

Adipose Tissue↗

The effects of nimodipine on regional cerebral blood flow, brain water and electrolyte contents in rats with subarachnoid hemorrhage.

Secondary cerebral ischemic injury is a major cause of mortality and disability from subarachnoid hemorrhage (SAH). In this study, the protective effects of nimodipine were investigated. Rat SAH models were divided into a sham-operated group, a saline-controlled, and a nimodipine-treated group by an endovascular piercing method. Nimodipine, 100 microg/kg BW was injected intraperitoneally 30 minutes before operation and was repeated every 6 hours. Dynamic changes in cortical regional cerebral blood flow (rCBF) using a laser Doppler flow-meter probe, and somatosensory evoked potentials (SEP) were estimated. Brain water content, sodium, potassium and calcium contents at different time points were determined. rCBF, latency of SEP, brain water and electrolyte contents did not statistically change in sham-operated rats. In saline-controlled rats, rCBF decreased immediately after SAH, and stabilized at low levels within 24 hours. The latency of SEP delayed gradually after SAH. Brain water and sodium increased, while potassium decreased at 6 hours and 24 hours. Brain calcium content increased significantly from 1 hour to 24 hours after induction of SAH. Extents of alterations of the above parameters caused by SAH in the nimodipine-treated group were less than those in the saline-controlled group, statistically. In conclusion, nimodipine partly prevents a decrease in cerebral blood supply and attenuates secondary cerebral ischemic injury after SAH.

Animals↗

Pancreatic serous oligocystic adenomas: clinicopathologic features and a comparison with serous microcystic adenomas and mucinous cystic neoplasms.

INTRODUCTION: The preoperative distinction between serous cystic neoplasms (SCNs) and mucinous cystic neoplasms (MCNs) is essential, as all MCNs are considered malignant or potentially malignant and should be surgically resected, whereas SCNs are almost always benign. However, the radiologic distinction between SCNs and MCNs is frequently difficult especially with serous oligocystic adenoma (SOA), a morphologic variant of SCN, as both SOA and MCN appear on cross-sectional imaging as a solitary macrocystic lesion in the pancreas. We reviewed all SOAs managed at our institution to determine if any clinicopathologic features would prove useful for establishing a preoperative diagnosis. METHODS: Over a 15-year period, 64 patients with a pathologically confirmed diagnosis of a pancreatic cystadenoma or cystadenocarcinoma treated at Singapore General Hospital were retrospectively reviewed. There were 27 MCNs and 37 SCNs including 12 SOAs. In addition, 40 cases of SOA previously reported in the literature were reviewed and analyzed together with the 12 patients, making this a series of 52 SOAs. RESULTS: In our experience, SOAs comprised 32.4% of the SCNs, and females predominated (7/12). The median age of the patients was 42.5 years (range 22-74 years), and only 4 of the 12 patients were symptomatic. Most of the cysts were located in the body or tail of the pancreas (9/12), and the median cyst size was 52.5 mm (range 10-190 mm). When the clinicopathologic features of SOAs and serous microcystic adenomas (SMAs) were compared, there was no difference between the patients with SOAs and SMAs in terms of age, sex, presence of symptoms, cyst size, or site of the lesion. However, SOAs occurred in the women less frequently (67.3% vs. 96.3%, P=0.004), were smaller [40 mm (range 10-190 mm) vs. 95 mm (range 25-180 mm), P<0.001], and occurred more commonly in the head of the pancreas [25 (48.1%) vs. 2(7.4%)] compared to MCNs. None of the SOAs were frankly malignant compared to the 29.6% of MCNs that were. CONCLUSIONS: SOAs and SMAs have similar clinicopathologic features. On the other hand, SOAs differ from MCNs by their relatively higher male/female ratio, higher frequency of tumors occurring in the head of the pancreas, and smaller cyst size. Knowledge of these distinguishing clinical features when used in combination with other diagnostic modalities such as endoscopic ultrasonography/fine-needle aspiration will enable clinicians to better differentiate these two pathologic entities preoperatively.

Adult↗

The effects of an acute bout of sleep on running economy and VO2 max.

Synchronized human sleep has been shown to decrease activation of the sympathetic nervous system, resulting in reduced levels of oxygen consumption. This is in direct conflict with sympathetic arousal, which coincides with the initiation of exercise. Although a considerable body of research has investigated the effects of sleep deprivation on exercise performance, the effects of an acute bout of sleep on exercise response have not been previously reported. This question appears relevant considering the occurrence of acute sleep bouts among athletes competing in prolonged multi-event competition (e.g. swimming, track and field). To investigate the effects of an acute bout of sleep on submaximal (running economy) and maximal oxygen consumption, seven male volunteers participated in a continuous, progressive treadmill test to volitional exhaustion immediately following a 1-h bout of sleep (SB) or no sleep (Control). The subjects served as their own controls and the order of trials was randomized. A MANOVA with repeated measures indicated no difference between groups for running economy or VO2 (P < 0.05). However, a significant interaction effect was observed in which SB resulted in greater running economy (lower VO2) through the first two stages of the protocol, while the control treatment yielded a greater economy throughout the remaining stages. While the implications of the findings are uncertain, they may indicate differences in psychological arousal or anxiety as a result of treatments or the possibility of a delayed sympathetic arousal in the early stages of exercise following sleep.

Adolescent↗

Channels for water flow in epithelia: characteristics and regulation.

Pos and Pd, osmotic and diffusive water permeability coefficients of isolated rabbit proximal tubule (PT) cells (expressed per cm2 of real cell membrane area, in microns/sec) are: Pos 396; Pd, 22; Pos/Pd, 18 (control), and after exposure to parachloromercuribenzenesulfonate (pCMBS): Pos, 32; Pd, 10; Pos/Pd, 3. The sulfhydryl reagent dithiothreitol (DTT) reverts pCMBS action. The activation energies (kcal/mol) are Pos, 3.2 (control); 9.2 (pCMBS); Pd, 5.2 (control) and 9.1 (pCMBS). Thus water channels pierce the control plasma membrane and are reversibly closed by pCMBS. High control PT permeabilities are comparable with those of amphibian urinary bladder and collecting tubules (CT) stimulated with antidiuretic hormone (ADH), and low PT (pCMBS) values with those of CT in the resting state, respectively. Transcellular permeability is regulated in PT by the state of sulfhydryl groups and in CT by ADH induced insertion (or, no ADH, suppression) of water channels. In PT (a) large extracellular markers are dragged by water flow indicating extracellular solute-water interaction, (b) transepithelial Pos is much higher than transcellular Pos. Therefore water also flows paracellularly, in addition to the transcellular flow. In PT paracellular permeability is increased if urea in lumen is higher than in blood. It is reduced in the reverse situation. In CT paracellular permeability is virtually zero (resting condition). It may be increased by high lumen urea. Thus, paracellular permeability (which is significant in control PT and zero in CT) can be regulated by changes in the transepithelial urea concentrations. Transcellular permeability depends on the number of channels/cm2 epithelium, their probability of being opened and their individual permeability.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Intragastric intubation: important aspects of the model for administration of ethanol to rat pups during the postnatal period.

One technique for the controlled delivery of ethanol to neonatal rat pups is intragastric intubation. Often, the vehicle used for delivery of ethanol is composed of a nutrient mixture to compensate for decreased suckling or other possible nutritional compromise. This study analyzed the selection of nutrient vehicle, the combination of experimental treatment groups within a litter, and the overall litter size on the growth rate of ethanol-intubated and intubated-control pups, compared with mother-raised control pups. Sprague-Dawley rat pups were raised in litters of 8 or 10, and administered ethanol by intragastric intubation with 20% (v/v) Sustacal or 80% (v/v) Intralipid-II nutrient vehicle. Pups were treated between postnatal days 2 and 10, and body weight was analyzed on day 10. Pups were assigned to a treatment group as either intubated ethanol, intubated control, or nonintubated mother-raised controls. Experimental comparison by statistical analyses was performed to identify the optimal treatment design (mixed treatment groups in a single litter or a single treatment group per litter), the optimal vehicle (Sustacal or Intralipid-II), and the optimal number of pups per litter (8 vs. 10). The analyses demonstrate that the mixing of intubated control, intubated ethanol, and nonintubated mother-raised control treatment groups within a single litter introduced an uncontrolled variable that confounded measurement of ethanol-specific alterations. The sensitivity of treatment groups to inclusion in mixed litters was dependent on the nutrient vehicle and thus nutritional adequacy. Our results suggest that an optimal design was achieved with eight pups per litter. Furthermore, ethanol intubated and intubated control pups grow at a rate identical to parallel litters of eight mother-raised control pups when Intralipid-II is used as nutrient vehicle, and a single treatment group is present in a litter. Optimization of these experimental parameters has provided an excellent neonatal rat model for analysis of specific ethanol effects on brain development during the third trimester.

Animals↗

Lack of effect of 2-chlorodeoxyadenosine therapy in patients with chronic lymphocytic leukemia refractory to fludarabine therapy.

BACKGROUND: Fludarabine and 2-chlorodeoxyadenosine are nucleoside analogues that have proved effective in patients with chronic lymphocytic leukemia (CLL). Although their mechanism of action is thought to be similar, a small number of patients who do not respond to fludarabine do respond to 2-chlorodeoxyadenosine. The extent to which 2-chlorodeoxyadenosine is effective in patients who do not respond to fludarabine is not known, however. METHODS: We treated 28 patients with CLL refractory to fludarabine therapy with a continuous infusion of 2-chlorodeoxyadenosine at a daily dose of 4 mg per square meter of body-surface area for seven days. The treatment could be repeated monthly. The number of treatments ranged from one to five; patients who responded continued to receive treatment until the maximal response was achieved. RESULTS: Two patients (7 percent) had partial remissions, but no patients had complete remissions. One other patient had a substantial response but had residual thrombocytopenia. The rate of response in most affected organs was 20 percent, but anemia or thrombocytopenia rarely improved. Myelosuppression was frequent, and 65 percent of the courses of 2-chlorodeoxyadenosine therapy were accompanied by febrile episodes or infections. Ten patients died within 60 days of starting therapy with 2-chlorodeoxyadenosine; eight deaths were related to infection. The median platelet count at the start of 2-chlorodeoxyadenosine therapy in these 10 patients was 24,000 per cubic millimeter, as compared with 109,000 per cubic millimeter in the other 18 patients. Five patients were alive after a median follow-up of 24 months. CONCLUSIONS: Patients with advanced CLL refractory to fludarabine therapy are unlikely to benefit from treatment with 2-chlorodeoxyadenosine. Although 20 percent of the patients have some response, thrombocytopenia and anemia are rarely corrected and may be made worse by 2-chlorodeoxyadenosine therapy.

Adult↗

Inhibition of copper-associated erythrocyte ghost membrane lipid peroxidation by hepatic cytosolic low molecular weight proteins.

Male weanling Fischer rats were injected ip once daily with either 12.5 mg/kg body weight cupric chloride or 2 ml/kg body weight saline for up to 70 days. As the hepatic cytosolic copper increased in copper-treated rats, copper bound to proteins of different molecular weights; this was determined by gel filtration chromatography. Hepatic cytosolic copper from rats treated with cupric chloride for 14 days eluted in 3 peaks. These included a 150,000 + dalton peak, a 29,000 dalton peak and an 11,000-12,800 dalton peak. In addition to these peaks, hepatic cytosolic copper from rats treated with cupric chloride for greater than or equal to 28 days also eluted in a 4th, but shorter, 6,000-7,000 dalton peak. Hepatic cytosolic copper from saline-treated rats eluted only in a single 29,000 dalton peak. Experiments using an erythrocyte ghost membrane model of copper-associated lipid peroxidation demonstrated that incubation of membranes with protein-bound copper eluted in the 11,000-12,000 dalton peak was associated with less lipid peroxidation than incubation of membranes with cupric chloride or protein-bound copper eluted in the 150,000+ dalton peak. Experimental results suggest that the ability of copper to catalyze lipid peroxidation is significantly reduced by binding with hepatic cytosolic low molecular weight proteins but not by binding with hepatic cytosolic high molecular weight proteins.

Amino Acid Sequence↗

Prolonged survival in chronic myelogenous leukemia after cytogenetic response to interferon-alpha therapy. The Leukemia Service.

OBJECTIVE: To determine whether a cytogenetic response after interferon-alpha therapy in patients with chronic myelogenous leukemia is independently associated with improved survival. DESIGN: Retrospective analysis. PATIENTS: 274 patients with a diagnosis of Philadelphia chromosome-positive chronic myelogenous leukemia in early chronic phase who were treated with interferon-alpha-based programs between 1982 and 1990. INTERVENTION: Therapy with daily subcutaneous interferon-alpha given at 5 x 10(6) U/m2 body surface area (highest dose schedule allowed on studies) or the maximally tolerated lower-dose schedule. RESULTS: Overall, 219 (80%) patients achieved a complete hematologic response and 104 (38%) achieved a major cytogenetic response (< 35% Philadelphia chromosome-positive cells). Estimated median survival was 89 months. Several pretreatment factors were associated with failure to achieve a major cytogenetic response and with worse survival. The existing prognostic models were generally predictive of which patients were likely to achieve a major cytogenetic response (P < or = 0.01) and of survival outcomes (P < or = 0.01). Multivariate analysis identified bone marrow basophilia (P < 0.01) and splenomegaly (P < 0.01) as independent poor prognostic factors for survival. Achievement of a major cytogenetic response, entered as a time-dependent variable while accounting for the other independent factors, was associated with improved survival (P < 0.001). Comparison of survival (dated from 12 months into therapy) with cytogenetic response at 12 months showed that a cytogenetic response was associated with longer survival (P < 0.001). CONCLUSION: Achieving a cytogenetic response with interferon-alpha therapy in patients with chronic myelogenous leukemia was independently associated with improved survival when tested as a time-dependent variable in a multivariate analysis, and this association was confirmed by landmark analysis at 12 months.

Adolescent↗

Randomized, investigator-blinded, multicenter study of gatifloxacin versus amoxicillin/clavulanate treatment of recurrent and nonresponsive otitis media in children.

BACKGROUND: Decreased susceptibility of pathogens to currently used agents for recurrent otitis media has provided the impetus for identifying new antimicrobial options. OBJECTIVE: To compare gatifloxacin with amoxicillin/clavulanate in children with recurrent or nonresponsive acute otitis media (AOM). METHODS: Included in this multicenter randomized trial were 413 patients, ranging in age from 6 months to 7 years, who had recurrent AOM (at least 3 episodes in the previous 6 months or 4 episodes in the previous 12 months) and/or had failed antibiotic therapy for AOM within 14 days of enrollment. Diagnosis required evidence of acute inflammation and otoscopic findings of middle ear effusion; baseline tympanocentesis was optional and encouraged. Children were randomly assigned (2:1) to 10 days of oral therapy with gatifloxacin suspension (10 mg/kg of body weight once daily) or amoxicillin/clavulanate suspension (45/6.4 mg/kg/d in 2 divided doses). RESULTS: : Clinical cure was obtained in 90.2% (222 of 246) of patients in the gatifloxacin group and 84.3% (102 of 121) of those in the amoxicillin/clavulanate group (95% confidence interval, -1.9-12.9) 3-10 days after treatment ended. Gatifloxacin was associated with higher clinical cure rates than was amoxicillin/clavulanate in children younger than 2 years of age (92.0% versus 80.0%, respectively). Cure rates by pretreatment pathogen in the gatifloxacin and amoxicillin/clavulanate groups were 92.1% (35 of 38) versus 88.9% (16 of 18) for Streptococcus pneumoniae infections and 88.2% (30 of 34) versus 92.3% (12 of 13) for Haemophilus influenzae infections, respectively. Sustained clinical cures 3-4 weeks after treatment ended were obtained in 74.4% (183 of 246) of patients treated with gatifloxacin and 72.7% (88 of 121) of those treated with amoxicillin/clavulanate. Adverse events considered drug-related occurred with similar frequency in the 2 groups. Six patients (2.2%) in the gatifloxacin group and 2 patients (1.5%) in the amoxicillin/clavulanate group developed transient symptoms of mild or moderate arthralgia. CONCLUSIONS: In this comparative evaluation of fluoroquinolone therapy in children with AOM, gatifloxacin was similar in clinical efficacy to amoxicillin/clavulanate 45/6.4 mg/kg/d for treatment of recurrent/nonresponsive infections.

Amoxicillin-Potassium Clavulanate Combination↗

Regional myocardial blood flow in left ventricular hypertrophy. An experimental investigation in Newfoundland dogs with congenital subaortic stenosis.

To test the hypothesis that left ventricular hypertrophy (LVH) may predispose the subendocardium to ischemia, we studied regional myocardial blood flow in dogs with the fibrous ring form of subvalvular aortic stenosis and concentric LVH. Radioactive microspheres, 9 +/- 1 mu in diameter, were used. Eleven dogs with LVH (left ventricular body weight ratio of 6.35 +/- 0.46 gm/kg [mean +/- SEM] and peak left ventricular outflow gradient of 51 +/- 7 mm Hg) were compared to 12 normal dogs (left ventricular/body weight ratio of 3.41 +/- 0.12 gm/kg and peak left ventricular outflow gradient of 6 +/- 3 mm Hg). The two groups of dogs were subjected to comparable experimental interventions including (1) tachycardia produced by atrial pacing (221 +/- 4 beats/min), (2) ascending aortic constriction producing systolic hypertension (212 +/- 5 mm Hg), and (3) creation of an aortic-right atrial fistula lowering diastolic blood pressure (38 +/- 3 mm Hg). Basal regional myocardial blood flow was distributed similarly for LVH and normal dogs (endocardial/epicardial ratio = 0.90 +/- 0.05 and 0.94 +/- 0.03, respectively). During experimental interventions, regional blood flow remained equal to all myocardial layers in normal dogs; however, the endocardial/epicardial ratio diminished in LVH dogs during atrial tachycardia to 0.61 +/- 0.08, during systolic hypertension to 0.68 +/- 0.06, and during diastolic hypotension to 0.50 +/- 0.09. When the diastolic/systolic pressure time index ratio (DPTI/SPTI) was less than 0.8, subendocardial ischemia occurred in dogs with LVH (endocardial/epicardial ratio = 0.66 +/- 0.04) but not in normal dogs (endocardial/epicardial ratio = 0.92 +/- 0.03) (p less than 0.0001). Animals with infracoronary obstruction and LVH demonstrate greater susceptibility to development of subendocardial ischemia for identical hemodynamic interventions than do normal animals.

Animals↗

Quantitative changes associated with calving in the levels of bovine immunoglobulins in selected body fluids. I. Changes in the levels of IgA, IgGl and total protein.

Levels of bovine IgA, IgG1 and total protein (TP) were determined in serum, saliva, tears and individual quarter lacteal secretions of six Holstein-Friesian cows sampled from six weeks before to four weeks after parturition. Hierarchal analyses of variance indicated significant variations among weeks, cows and quarters of the udder. A precipitous but non proportional drop in the levels of IgA and IgA1 in lacteal secretions occurred at calving. There was a concomitant increase in IgG1, and decrease in IgA, in serum. Correlation studies supported the concept of selective transport of IgG1 from serum to lacteal secretions in regulated amounts independent of serum IgG1 levels. Changes in the IgG1/TP ratio of serum and lacteal secretions supported the idea of a decrease in the selective transport mechanism. Correlation studies and estimations of secretory IgA (SIgA) in serum suggest that serum IgA is derived from IgA synthesized in secretory tissues. Highly significant correlations between IgA and IgG1 levels in all secretions postpartum suggest that local IgA synthesis and either IgG1 transport or local IgG1 synthesis are initiated by the same stimuli. Although some of the variation in the level reported for IgA and IgG1 in secretions resulted from protein dilution, much of the variation represents physiological differences between individual animals and tissues in the same animal. An IgG2/IgG1 ratio approaching that of serum occurred in a mastitic quarter of one cow. IgA was the principal immunoglobulin in saliva and tears, comprised a greater proportion of the immunoglobulin in milk whey than in prepartum lacteal secretions and was a minor immunoglobulin in bovine serum.

Animals↗

Severe gastroesophageal reflux is associated with reduced carbon monoxide diffusing capacity.

OBJECTIVE: To assess whether severe gastroesophageal reflux (GER) is associated with abnormalities in lung function including measures of lung volume and gas diffusion. METHODS: Data from 147 patients with obesity (body mass index [BMI] range, 31.7 to 70 kg/m(2)) who presented for obesity surgery was analyzed retrospectively. A questionnaire was completed preoperatively that included a history of GER, frequency and severity of symptoms, investigations, and medications used. A history of lung disease, sleep-disordered breathing, and smoking also was obtained. A physician who was blinded to lung function graded GER severity prospectively by the results of pH monitoring and/or gastroscopy, and medication use. Spirometry, lung volumes, and gas transfer were measured preoperatively. RESULTS: Patients with severe GER had reduced levels of the diffusing capacity of the lung for carbon monoxide (DLCO) [21.1 mL/min/mm Hg; 95% confidence interval (CI), 18.9 to 23.2], as measured by CO transfer, compared with those patients without GER (26.3 mL/min/mm Hg; 95% CI, 24.4 to 28.2; p = 0.001). This remained significant after adjusting for age, gender, BMI, and smoking history. Gas transfer corrected for lung volume also was reduced in the group with severe GER (4.6 mL/min/mm Hg per L; 95% CI, 4.3 to 4.9) compared to the group without GER (5.3 mL/min/mm Hg per L; 95% CI, 5.1 to 5.5; p = 0.001). There was no significant difference in other measures of lung function. CONCLUSIONS: Severe GER is associated with an impairment of gas exchange. This may be due to microaspiration of gastric acid or fluid into the airways.

Adult↗

Septohippocampal neurons in the rat septal complex have substantial glial coverage and receive direct contacts from noradrenaline terminals.

The ultrastructure of septohippocampal neurons in the septal complex and their relations with catecholamine, principally noradrenaline, terminals were examined in single thin sections. Projection neurons were identified by retrograde transport of wheat-germ agglutinated apo-horseradish peroxidase conjugated to colloidal gold particles (WAHG) following an injection into the hippocampal formation of anesthetized adult rats. After a 1 day survival, sections through the septal complex were labeled with antibodies to tyrosine hydroxylase (TH) or dopamine-beta-hydroxylase (DBH). By light microscopy, numerous processes with TH- and DBH-immunoreactivity were near neurons containing retrogradely transported WAHG. By electron microscopy, most WAHG was associated with lysosomes, multivesicular and 'sequestration' bodies in the cytoplasm of perikarya and large dendrites. WAHG-labeled perikarya (n = 114) had a large amount of astrocytic coverage (> 60% of surface) and a low amount of terminal coverage (< 25%). WAHG-labeled perikarya and dendrites were either directly contacted by TH- or DBH-labeled terminals or abutted glial processes apposed to TH- or DBH-labeled terminals. Immunoreactivity for TH and DBH was found primarily in axons and axon terminals. The morphology and synaptic associations of TH-labeled terminals was similar to that reported previously. DBH-labeled terminals (n = 314; 0.5 +/- 0.2 microns in diameter) contained numerous small clear vesicles and from 0-4 large, dense-core vesicles. DBH-containing terminals: (1) contacted perikarya and dendrites (58%), 10% of which contained WAHG; (2) were closely apposed to other terminals (7%); or (3) were separated by glial processes (35%). DBH-labeled terminals formed chiefly symmetric synapses on perikarya. However, most DBH-containing terminals formed both asymmetric and symmetric synapses on the shafts of small dendrites, suggesting both excitatory and inhibitory functions for noradrenaline terminals on septal neurons. The results demonstrate that septohippocampal neurons (1) are mostly engulfed by astrocytes and have very little terminal coverage; (2) are both directly contacted (synapses) and indirectly contacted (appositions to apposing astrocytes or axon terminals) by catecholamine, particularly noradrenaline, terminals.

Adrenergic Fibers↗

The effect of changes in dosimetry on cancer mortality risk estimates in the atomic bomb survivors.

In the spring of 1986 the Radiation Effects Research Foundation (RERF) received a new atomic bomb dosimetry system. This report presents the comparisons of leukemia and nonleukemia cancer mortality risk estimates under the old and new dosimetries. In terms of total kerma (essentially whole-body gamma plus neutron exposure), risk estimates for both classes of cancer are 75-85% higher with the new dosimetry. This and other summary comparisons allow for possible nonlinearity at high estimated doses. Changes are also considered in relation to organ doses and assumptions about the relative biological effectiveness (RBE) of neutrons. Without regard to RBE, the risk estimates for total organ dose are essentially unchanged by the dosimetry revision. However, with increasing assumed values of RBE, the estimated low-LET risk decreases much less rapidly under the new dosimetry, due to the smaller neutron component. Thus at an assumed constant RBE of 10, for example, the effect of the dosimetry revision is to increase organ dose risk estimates, relative to those based on the old dosimetry, by 30% for nonleukemia and 80% for leukemia. At an RBE of 20 these increases are 72 and 136%, respectively. A number of other issues are discussed. The city difference in dose is no longer statistically significant, even at an RBE of one. Estimation of RBE is even less feasible with new dosimetry. There is substantial question of the linearity in dose response, in the sense of a leveling off at higher doses. Finally, some indication is given of how risks estimated from this dosimetry and the current data may compare to widely used estimates based largely on the RERF data with the previous dosimetry.

Humans↗

Incidence of cancer of the large bowel in women in relation to reproductive and hormonal factors.

Female resident of King and Pierce Counties (Washington) in whom carcinoma of the colon or rectum was diagnosed during a 15-month period in 1976-77 were interviewed regarding their menstrual and reproductive histories. A random sample of women from the same population was interviewed for comparison. On the average, women with colon cancer had given birth to fewer children than had controls; compared to the incidence of colon cancer in nulliparous women, the incidence in women with 1 or 2 children was reduced by 30%, whereas the incidence in women with 3 or more children was reduced by 50% (P=0.004). No association was present between parity and rectal cancer. Neither contraceptive nor noncontraceptive estrogen use was related to the incidence of colon cancer. Use of oral contraceptives was more common among women with rectal cancer than among controls, but this result could well have arisen by chance (P=0.09). The data were not adequate to determine whether it was the inability to conceive and deliver a child that was related to colon cancer or the failure to undergo the physiologic changes that accompany pregnancy. Nonetheless, the association of low parity with the incidence of colon cancer has now observed several times, in each instance to a moderately strong degree. This observation suggests that events of reproductive life have a bearing on a woman's subsequent risk of developing colon cancer.

Adult↗

Outcomes analysis of laparoscopic resection of pancreatic neoplasms.

BACKGROUND: Experience with laparoscopic resection of pancreatic neoplasms remains limited. The purpose of this study is to critically analyze the indications for and outcomes after laparoscopic resection of pancreatic neoplasms. METHODS: The medical records of all patients undergoing laparoscopic resection of pancreatic neoplasms from July 2000 to February 2006 were reviewed. Data are expressed as mean +/- standard deviation. RESULTS: Laparoscopic pancreatic resection was performed in 22 patients (M:F, 8:14) with a mean age of 56.3 +/- 15.1 years and mean body mass index (BMI) of 26.3 +/- 4.5 kg/m2. Nine patients had undergone previous intra-abdominal surgery. Indications for pancreatic resection were cyst (1), glucagonoma (1), gastrinoma (2), insulinoma (3), metastatic tumor (2), IPMT (4), nonfunctioning neuroendocrine tumor (3), and mucinous/serous cystadenoma (6). Mean tumor size was 2.4 +/- 1.6 cm. Laparoscopic distal pancreatectomy was attempted in 18 patients and completed in 17, and enucleation was performed in 4 patients. Laparoscopic ultrasound (n = 10) and a hand-assisted technique (n = 4) were utilized selectively. Mean operative time was 236 +/- 60 min and mean blood loss was 244 +/- 516 ml. There was one conversion to an open procedure because of bleeding from the splenic vein. The mean postoperative LOS was 4.5 +/- 2.0 days. Seven patients experienced a total of ten postoperative complications, including a urinary tract infection (UTI) (1), lower-extremity deep venous thrombosis (DVT) and pulmonary embolus (1), infected peripancreatic fluid collection (1), pancreatic pseudocyst (1), and pancreatic fistula (6). Five pancreatic fistulas were managed by percutaneous drainage. The reoperation rate was 4.5% and the overall pancreatic-related complication rate was 36.4%. One patient developed pancreatitis and a pseudocyst 5 months postoperatively, which was managed successfully with a pancreatic duct stent. There was no 30-day mortality. CONCLUSIONS: Laparoscopic pancreatic resection is safe and feasible in selected patients with pancreatic neoplasms. With a pancreatic duct leak rate of 27%, this problem remains an area of development for the minimally invasive technique.

Adult↗

Thermal status of saturation divers during operational dives in the North Sea.

The principal aim of the present study was to monitor the core temperature (Tc) of a population of saturation divers conducting routine deep dives at different locations in the United Kingdom sector of the North Sea and to assess whether current dive procedures are adequate in preventing deleterious decreases in Tc. A total of 30 divers, with an average (SD) of 19.3 (6.6) yr of experience as saturation divers, participated in the study. The survey included 59 dives conducted at six locations (Scott Field, Norfra Pipeline, Hudson Field, Pierce Field, Forties Field, and Bruce Field) from four Diver Support Vessels (Rockwater 1, Semi 2, Bar Protector, and Discovery). The depth of the dives monitored ranged from 54 to 160 meters of seawater (msw), and the duration of the dives from 31 min to 7 h 30 min. before each dive, divers were requested to ingest a radio pill and strap a data logger to their abdomen. Upon returning to the chamber within the Diver Support Vessel following a dive, they provided subjective ratings of thermal perception (7 point scale) and thermal comfort (4 point scale) for the period just before, during, and immediately after the dive. In 55 dives, Tc of saturation divers working at depths to 160 msw for up to 6 h with water temperatures ranging from 4 degrees to 6 degrees C increased above the pre-dive core temperature of 37.4 degrees (0.620+/-0.6 degrees C). In four dives there was a decrease in Tc: 2 divers had a 0.2 degrees C fall in Tc, and 2 bellmen had a decrease of 0.4 degrees and 1.0 degrees C. The subjective responses of divers indicated that they were thermally neutral (neither warm nor cold) and comfortable before and immediately after the dives. The current practice of providing thermal protection with hot water suits to saturation divers working in the North Sea is adequate for preventing the risk of hypothermia and maintaining thermal comfort.

Adult↗