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PubMed2000

'Is this what life is going to be like?' The story of a 34 year old man (T) who suffered a severe head injury after a fall.

Imagine this. You don't remember but you fell from a ladder, a distance of 20 ft onto concrete, on Christmas eve whilst cleaning windows. You suffered a severe head injury and emerged from a coma four weeks later yelling and fighting thinking that you are back in the Falklands. After 6 months in a specialist neurological unit, where you were for a majority of the time 'as unhelpful as possible', you are finally discharged home and your rehabilitation is 'complete'. You believed that your body would 'jump out of bed and go home' months ago but 'it did not respond to your orders'. This was the beginning of a 'long and painful journey back to a reasonable life'. Home was not the safe and loving environment that you thought it would be. Everyone was beginning to see that life was not going to be the same again. There was conflict and distress. wife: He was a vibrant, energetic physical man and now he is a shell of himself. All his anger and frustration he feels about his injury he is taking out on us and whilst we all feel compassion and sympathy for him, it's hard to take... The physical problems are easy to deal with but it is the psychological problems that are hardest. son: He has changed alot. He is more short tempered and we can't reason with him. Anything we say is classed as arguing. He won't let us give our views on matters. He's always right.

Accidental Falls↗
PubMedDate not supplied

Blood money: the duty of care to veterans of UK nuclear weapons tests.

Fifty years after the first UK nuclear weapon test at Monte Bello off the north-west coast of Australia in October 1952, this article documents the deliberate and repeated decisions not to provide adequate radiation protection to most of the 40,000 men who participated in the British programme in the 1950s in Australia and Christmas Island, precisely to avoid future liability claims. The evidence lies in the minutes and memoranda of the scientists, doctors and military leaders overseeing these tests. Archival material in the United Kingdom Public Records Office and the National Archives of Australia is, according to senior barristers, sufficient to sustain an allegation of negligence, even by the standards of 50 years ago, against the government of the day and an allegation of cover-up by the current government, faced with potentially huge compensation bills and pension pay-outs for long-term radiation injury to former servicemen. Recent governments have tried to reassure the veterans with epidemiological studies, which are almost inevitably inconclusive. However, pilot studies have now begun on radiobiological tests that may be able to determine whether a particular individual was irradiated significantly 40 or 50 years ago and whether he has subsequently suffered cancers or other ill health because of this radiation burden. The first results from these studies should be available around the time of the fiftieth anniversary of the first UK test.

Environmental Exposure↗
PubMedDate not supplied

Seasonality of vital events in a Pacific Island population.

Analyses of vital data derived from a family record register for the native population of Guam reveal significant variations in births, deaths, and marriages over the period 1901-41. Although lacking marked photoperiod or temperature changes of temperate zones, the tropical island is subject to marked seasonal differences in rainfall characteristic of western Pacific islands. Marital patterns exhibit troughs associated respectively with the Lenten period and with Christmas celebrations. Infant and childhood deaths show close correspondence with rainfall patterns, consistently exceeding expected values during the rainy season (July-November) when conditions are optimal for the spread of communicable and gastrointestinal diseases. Births attain a peak in November, or at the beginning of the more advantageous season for infant health and survival. Seasonality in vital events, reported for many Euroamerican and some African and Asian populations of modern and historical periods, has rarely been documented for native populations of the tropical Pacific. Comparisons of differences in these patterns among different populations in varied environments provide unique opportunities to evaluate causal models of interactions among biological, sociocultural, and physioenvironmental factors.

Delivery, Obstetric↗
PubMed1995

A possible mechanism for the inhibition of ribosomal RNA gene transcription during mitosis.

When cells enter mitosis, RNA synthesis ceases. Yet the RNA polymerase I (pol I) transcription machinery involved in the production of pre-rRNA remains bound to the nucleolus organizing region (NOR), the chromosome site harboring the tandemly repeated rRNA genes. Here we examine whether rDNA transcription units are transiently blocked or "frozen" during mitosis. By using fluorescent in situ hybridization we were unable to detect nascent pre-rRNA chains on the NORs of mouse 3T3 and rat kangaroo PtK2 cells. Appropriate controls showed that our approach was sensitive enough to visualize, at the light microscopic level, individual transcriptionally active rRNA genes both in situ after experimental unfolding of nucleoli and in chromatin spreads ("Miller spreads"). Analysis of the cell cycle-dependent redistribution of transcript-associated components also revealed that most transcripts are released from the rDNA at mitosis. Upon disintegration of the nucleolus during mitosis, U3 small nucleolar RNA (snoRNA) and the nucleolar proteins fibrillarin and nucleolin became dispersed throughout the cytoplasm and were excluded from the NORs. Together, our data rule out the presence of "frozen Christmas-trees" at the mitotic NORs but are compatible with the view that inactive pol I remains on the rDNA. We propose that expression of the rRNA genes is regulated during mitosis at the level of transcription elongation, similarly to what is known for a number of genes transcribed by pol II. Such a mechanism may explain the decondensed state of the NOR chromatin and the immediate transcriptional reactivation of the rRNA genes following mitosis.

Animals↗
PubMedDate not supplied

Locomotion, respiratory physiology, and energetics of amphibious and terrestrial crabs.

The transition from breathing air to breathing water requires physiological and morphological adaptations. The study of crustaceans in transitional habitats provides important information as to the nature of these adaptations. This article addresses the physiology of air breathing in amphibious and terrestrial crabs and their relative locomotor abilities. Potamonautes warreni is an apparently amphibious freshwater crab from southern Africa, Cardisoma hirtipes is an air-breathing gecarcinid crab with some dependency on freshwater, and Gecarcoidea natalis is an obligate air-breathing gecarcinid endemic to Christmas Island in the Indian Ocean. All three species have well-developed lungs but retain gills and show seasonally different activity patterns that, in the gercarcinids, especially G. natalis, include long-distance breeding migrations. The three species were better at breathing air than water, but P. warreni was the best at breathing water. Cardisoma hirtipes is essentially an obligate air breather and appears to experience facultative hypometabolism during immersion. Cardisoma hirtipes has a haemocyanin with a high affinity for O(2) that facilitates loading from air but makes 30% of the Hc bound O(2) inaccessible. The gecarcinids but not P. warreni show increased diffusion limitation for O(2) over the lung during exercise. Gecarcoidea natalis outperforms C. hirtipes by virtue of a unique haemolymph shunt from the lung into the gills. Paradoxically, it is modifications of the gills for aerial O(2) uptake in G. natalis that allow for relatively greater haemolymph oxygenation. Despite showing decreased arterial-venous DeltaPo(2), P. warreni increased the arterial-venous Delta[O(2)] with no recourse to anaerobiosis during 5 min exercise. In the short term, P. warreni is more adept at walking than C. hirtipes. The breeding migrations of C. hirtipes and G. natalis were completely aerobic, but G. natalis walk farther and probably faster. Seasonal changes in underlying metabolism of G. natalis are strongly implied, including variations in hyperglycaemic hormone, variable basal metabolic rates, and a diel alkalosis present only in migrating crabs. The persistent dependence on water for reproduction is a determining factor in the biology of air-breathing crabs. The annual migrations include costs other than locomotion, for example, burrow construction and intermale competition. Estimates of costs that consider walking alone will underestimate the metabolic and stored fuel requirements for successful reproduction.

Animals↗
PubMed2001

What is the optimal medical management of ischaemic heart failure?

Ischaemic heart disease is probably the most important cause of heart failure. All patients with heart failure may benefit from treatment designed to retard progressive ventricular dysfunction and arrhythmias. Patients with heart failure due to ischaemic heart disease may also, theoretically, benefit from treatments designed to relieve ischaemia and prevent coronary occlusion and from revascularisation. However, there is little evidence to show that effective treatments, such as angiotensin converting enzyme (ACE) inhibitors and beta-blockers, exert different effects in patients with heart failure with or without coronary disease. Moreover, there is no evidence that treatment directed specifically at myocardial ischaemia, whether or not symptomatic, or coronary disease alters outcome in patients with heart failure. Some agents, such as aspirin, designed to reduce the risk of coronary occlusion appear ineffective or harmful in patients with heart failure. There is no evidence, yet, that revascularisation improves prognosis in patients with heart failure, even in patients who are demonstrated to have extensive myocardial hibernation. On current evidence, revascularisation should be reserved for the relief of angina. Large-scale, randomised controlled trials are currently underway investigating the role of specific treatments targeted at coronary syndromes in patients who have heart failure. The CHRISTMAS study is investigating the effects of carvedilol in a large cohort of patients with and without hibernating myocardium. The WATCH study is comparing the efficacy of aspirin, clopidogrel and warfarin. The HEART-UK study is assessing the effect of revascularisation on mortality in patients with heart failure and myocardial hibernation. Smaller scale studies are currently assessing the safety and efficacy of statin therapy in patients with heart failure. Only when the results of these and other studies are known will it be possible to come to firm conclusions about whether patients with heart failure and coronary disease should be treated differently from other patients with heart failure due to left ventricular systolic dysfunction.

Adrenergic beta-Antagonists↗
PubMed2005

Temporal variation in deaths related to alcohol intoxication and drinking.

BACKGROUND: Temporal variation in deaths related to alcohol intoxication is examined using two approaches. First, we examine the risk of these deaths during festivals, on the day preceding them, and on the three days that immediately follow them. Second, we assess the weekday variation in deaths, and compare this with survey-based data on weekday variations in drinking. Previously no data existed on the temporal association between intoxication-related deaths and drinking occasions according to the severity of intoxication. METHODS: We used population registration data on 15-69-year-old men and women, linked with the national cause of death register for the years 1987-2001, and the Finnish Drinking Habits Survey carried out in 2000. Intoxication-related deaths were defined on the basis of underlying and contributory causes of death. RESULTS: The largest increased risk of intoxication-related deaths was observed for Midsummer Day [Observed deaths/Expected deaths (O/E) = 2.88 (95% confidence interval 2.48-3.31) for men and O/E = 2.21 (1.43-3.27) for women respectively], Midsummer Eve [O/E = 2.70 (2.32-3.12) and 3.18 (2.23-4.41)], May Day [O/E = 1.80 (1.50-2.16) and 2.65 (1.79-3.79)], Christmas Eve [O/E = 1.58 (1.29-1.91) and 2.21 (1.43-3.27)], and New Year's Day [O/E = 1.48 (1.20-1.80) and 1.77 (1.08-2.74)]. Among men, the increased risk at Midsummer lasted for three consecutive days. The weekday distribution of different levels of intoxication and of intoxication-related deaths was similar, with a clear increase observed on Friday, Sunday, and, particularly, Saturday. CONCLUSIONS: Intoxication-related deaths peak during weekends and around festival days when alcohol is widely consumed in excess. Public awareness of the risks attached to binge drinking should be increased.

Adolescent↗
PubMed2006

Cytokinins in the perianth, carpels, and developing fruit of Helleborus niger L.

Reproductive development in the Christmas rose (Helleborus niger L.) differs from that in commonly investigated model plants in two important aspects: (i) the perianth develops a photosynthetic system, after fertilization, and persists until seed ripening; and (ii) the ripe seed contains an immature embryo which continues to mature off the mother plant. The possible roles of cytokinins in these processes are investigated here by analysing extracts of the perianth and the carpels/maturing fruit prepared during anthesis and four stages of post-floral development. trans-Zeatin, dihydrozeatin, N6-(Delta2-isopentenyl)adenine, and their ribosides were identified by tandem mass spectrometry. Single ion monitoring in the presence of deuterated internal standards demonstrated the additional presence of the corresponding riboside-5'-monophosphates, O-glucosides, and 9-glucosides, and afforded quantitative data on the whole set of endogenous cytokinins. Fruit cytokinins were mostly localized in the seeds. Their overall concentrations increased dramatically during early seed development and remained high for 6-8 weeks, until shortly before seed ripening (the last time point covered in this work). Overall cytokinin levels in the perianth did not change markedly in the period covered, but the level of N6-(Delta2-isopentenyl)adenine-type cytokinins appeared to increase slightly and transiently during the greening phase. The perianths of unpollinated or depistillated flowers, which survived, but did not pass through the complete greening process, contained significantly less cytokinins than observed in fruit-bearing flowers. This suggests that perianth greening requires defined cytokinin levels and supports the role of the developing fruit in their maintenance.

Cytokinins↗
PubMed1980

Studies on prekallikrein of bovine plasma. II. Activation of prekallikrein with proteinases and properties of kallikrein activated by bovine Hageman factor.

Activation of bovine plasma prekallikrein was investigated with several proteinases. Highly purified bovine plasma prekallikrein was rapidly activated to kallikrein [EC 3.4.21.8] by bovine activated Hageman factor, trypsin [EC 3.4.21.4] and Pronase P (proteinases from Streptomyces griseus) and more gradually by papain [EC 3.4.22.2] and ficin [EC 3.4.22.3]. Activation of prekallikrein was also observed with bovine plasmin [EC 3.4.21.7], but not with bovine clotting factors Xa (Stuart factor) [EC 3.4.21.6] and IXa (Christmas factor) or thrombin [EC 3.4.21.5]. Urokinase [EC 3.4.99.26], Reptilase, collagenase [EC 3.4.24.3], elastase [EC 3.4.21.11], alpha-chymotrypsin [EC 3.4.21.1], Nagarse [EC 3.4.21.14], and stem bromelain [EC 3.4.22 4] did not convert prekallikrein to kallikrein. Plasma kallikrein activated to Hageman factor released kinin rapidly from bovine high molecular weight (HMW) kininogen. However, from bovine low molecular weight (LMW) kininogen, liberation of kinin was extremely slow. The kallikrein activity was inhibited by soybean trypsin inhibitor (SBTI), Trasylol, diisopropylfluorophosphate (DFP), and N-alpha-tosyl-L-lysine chloromethylketone (TLCK), but not by egg-white trypsin inhibitor (EWTI), lima bean trypsin inhibitor (LBTI), heparin or hexadimethrine bromide (Polybrene). The kallikrein formed an enzyme-inhibitor complex with SBTI and Trasylol, but not with LBTI. Prekallikrein did not react with SBTI. Prekallikrein consists of a single polypeptide chain of molecular weight about 90,000, as estimated by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. Activation of prekallikrein by Hageman factor was found to involve cleavage of the single peptide bond on the disulfide-bridged polypeptide chain, and no change of molecular weight was observed during the activation. The peptide bond cleaved in prekallikrein by the activation was an Arg-X peptide bond on a disulfide-bridged polypeptide chain.

Animals↗
PubMed1991

Increases in number of REMS and REM density in humans following an intensive learning period.

Animal studies have recently demonstrated that increases in rapid eye movement (REM) sleep and actual number of rapid eye movements (REMs) over normal levels followed successful learning of an avoidance task. These increases persisted for many days following the end of the training sessions. It was hypothesized that similar extended increases in REM sleep parameters would follow an intensive learning task in humans. Senior college students were sleep monitored following the end of their Christmas examinations. Results showed that there was a significant increase in the number of REMs observed following the exams as compared to baseline and control subject values. The number of extra REMs was mot prominent during the fifth REM period of the night. A significantly increased REM density was observed at the fourth REM sleep period of the night. Results support the idea of REM sleep and/or the REMs themselves being involved in long-term memory processing several days after the end of training.

Achievement↗
PubMed2002

Radiation doses to local populations near nuclear weapons test sites worldwide.

Nuclear weapons testing was conducted in the atmosphere at numerous sites worldwide between 1946 and 1980, which resulted in exposures to local populations as a consequence of fallout of radioactive debris. The nuclear tests were conducted by five nations (United States, Soviet Union, United Kingdom, France, and China) primarily at 16 sites. The 16 testing sites, located in nine different countries on five continents (plus Oceania) contributed nearly all of the radioactive materials released to the environment by atmospheric testing; only small amounts were released at a fewother minor testing sites. The 16 sites discussed here are Nevada Test Site, USA (North American continent), Bikini and Enewetak, Marshall Islands (Oceania); Johnston Island, USA (Oceania), Christmas and Malden Island, Kiribati (Oceania); Emu Field, Maralinga, and Monte Bello Islands, Australia (Australian continent); Mururoa and Fangataufa, French Polynesia (Oceania), Reggane, Algeria (Africa), Novaya Zemlya and Kapustin Yar, Russia (Europe), Semipalatinsk, Kazakhstan (Asia), and Lop Nor, China (Asia). There were large differences in the numbers of tests conducted at each location and in the total explosive yields. Those factors, as well as differences in population density, lifestyle, environment, and climate at each site, led to large differences in the doses received by local populations. In general, the tests conducted earliest led to the highest individual and population exposures, although the amount of information available for a few of these sites is insufficient to provide any detailed evaluation of radiation exposures. The most comprehensive information for any site is for the Nevada Test Site. The disparities in available information add difficulty to determining the radiation exposures of local populations at each site. It is the goal of this paper to summarize the available information on external and internal doses received by the public living in the regions near each of the mentioned nuclear test sites as a consequence of local fallout deposition.

Atmosphere↗
PubMed2004

Knock before you enter.

Early on Christmas morning I am suddenly awakened by the high-pitched sound of my pager. It screeches like a smoke alarm, piercing right through to my bones. Although I have become accustomed to the sound, I still feel disoriented when roused from my sleep, and for a moment, feel entirely disoriented.

Community Health Nursing↗
PubMed1985

Breast reduction utilizing the maximally vascularized central breast pedicle.

Experience using a maximally vascularized central breast pedicle to nourish the nipple-areola is presented. The pedicle is designed to incorporate vascular contributions from the lateral thoracic artery, intercostal perforators, internal mammary perforators, and thoracoacromial artery by means of the pectoralis major muscle. The basic technique is as follows: First, the areola is incised and 2-cm-thick skin and subcutaneous flaps are dissected medially, laterally, and superiorly, freeing the entire central breast mound. Second, the breast is reduced in a "Christmas tree" manner, being careful not to narrow the base of the pedicle. Third, excess skin and subcutaneous tissue is excised inferomedially and laterally and the nipple is inset into proper locations. The advantages of this technique are (1) large and small reductions can be done, (2) pedicle length does not appear to be a problem, and (3) the central mound gives the forward projection needed for good contour and good aesthetic results. Sixty-five patients with follow-up to 4 years are presented.

Adult↗
PubMed2003

Secure endoscopic sinus surgery with partial middle turbinate modification: a 16-year long-term outcome report and literature review.

The efficacy of functional endoscopic sinus surgery for the treatment of chronic sinusitis is well established. Two contrasting European techniques were introduced to North America in the 1980s: that espoused by Wigand, which included endoscopic isthmus modification of all sinus ostia and cavities with modification of the middle turbinates, and that developed by Messerklinger, who practiced only minimal opening of the narrow osteomeatal tract at the anterior ethmoid sinus to achieve physiologic reversal of sinus disease. These techniques were additionally modified recently by the introduction of power resection techniques by Setliff and Christmas and stereotactic computer navigation by Anon and Fried. In 1986, after exposure to both original techniques, I developed a middle-ground approach that lies between the extremes of the two European schools. The benefits of this middle-ground multimodal secure technique include a high success rate, maximal safety, and the ability to be performed as an adjunct to any other indicated functional nasal surgery. Since its inception, a key feature of this technique has included partial modification of the bulky inferior portion of the middle turbinates. This has contributed markedly to successful long-term outcome and safety rates.

Endoscopy↗
PubMed1993

The terminal balls characteristic of eukaryotic rRNA transcription units in chromatin spreads are rRNA processing complexes.

When spread chromatin is visualized by electron microscopy, active rRNA genes have a characteristic Christmas tree appearance: From a DNA "trunk" extend closely packed "branches" of nascent transcripts whose ends are decorated with terminal "balls." These terminal balls have been known for more than two decades, are shown in most biology textbooks, and are reported in hundreds of papers, yet their nature has remained elusive. Here, we show that a rRNA-processing signal in the 5'-external transcribed spacer (ETS) of the Xenopus laevis ribosomal primary transcript forms a large, processing-related complex with factors of the Xenopus oocyte, analogous to 5' ETS processing complexes found in other vertebrate cell types. Using mutant rRNA genes, we find that the same rRNA residues are required for this biochemically defined complex formation and for terminal ball formation, analyzed electron microscopically after injection of these cloned genes into Xenopus oocytes. This, plus other presented evidence, implies that rRNA terminal balls in Xenopus, and by inference, also in the multitude of other species where they have been observed, are the ultrastructural visualization of an evolutionarily conserved 5' ETS processing complex that forms on the nascent rRNA.

Animals↗
PubMed2002

Estimating the number of species in a stochastic abundance model.

Consider a stochastic abundance model in which the species arrive in the sample according to independent Poisson processes, where the abundance parameters of the processes follow a gamma distribution. We propose a new estimator of the number of species for this model. The estimator takes the form of the number of duplicated species (i.e., species represented by two or more individuals) divided by an estimated duplication fraction. The duplication fraction is estimated from all frequencies including singleton information. The new estimator is closely related to the sample coverage estimator presented by Chao and Lee (1992, Journal of the American Statistical Association 87, 210-217). We illustrate the procedure using the Malayan butterfly data discussed by Fisher, Corbet, and Williams (1943, Journal of Animal Ecology 12, 42-58) and a 1989 Christmas Bird Count dataset collected in Florida, U.S.A. Simulation studies show that this estimator compares well with maximum likelihood estimators (i.e., empirical Bayes estimators from the Bayesian viewpoint) for which an iterative numerical procedure is needed and may be infeasible.

Animals↗
PubMed1988

High-dose intravenous immunoglobulin and splenectomy for the treatment of HIV-related immune thrombocytopenia in patients with severe haemophilia.

Four patients with severe haemophilia A and one patient with severe Christmas disease developed severe immune thrombocytopenia (platelet count less than 20 x 10(9)/l). All five patients were HIV-antibody positive and one was HIV-antigen positive. Four patients were treated initially with prednisolone, but with only a transient platelet response in three and no response in the fourth. All patients were treated with high dose intravenous immunoglobulin (0.4 g/kg daily for 5 d) resulting in a rise in platelet count in all cases (range 138-300 x 10(9)/l) and then proceeded to splenectomy. Three remain in complete remission after 6-14 months, and one showed a good response with platelet counts ranging from 103 to 187 x 10(9)/l. The fifth patients achieved a normal platelet count for 3 months post-splenectomy, but suffered a relapse with platelet counts ranging from 25 to 108 x 10(9)/l over the next 3 years. However, following a severe Varicella infection 10 months ago, during which he developed a marked transient thrombocytosis, he has also maintained a normal platelet count.

Adolescent↗
PubMed1995

The Albury-Wodonga syndrome. A tale of two cities.

PURPOSE: An epidemic of acutely painful eyes having a seasonal restriction and an apparent response to topical indomethacin, is described. METHODS: From patients seen in a rural private practice, the clinical picture of this acute syndrome and the use of indomethacin drops is described. RESULTS: A favourable response to topical indomethacin in 21 patients is documented. CONCLUSION: Topical indomethacin is worthy of further trial and investigation in the management of the Albury-Wodonga syndrome, harvester's eye, Christmas eye or seasonal corneal ulcer.

Acute Disease↗