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The introduction, methods, results, and discussion (IMRAD) structure: a fifty-year survey.

BACKGROUND: The scientific article in the health sciences evolved from the letter form and purely descriptive style in the seventeenth century to a very standardized structure in the twentieth century known as introduction, methods, results, and discussion (IMRAD). The pace in which this structure began to be used and when it became the most used standard of today's scientific discourse in the health sciences is not well established. PURPOSE: The purpose of this study is to point out the period in time during which the IMRAD structure was definitively and widely adopted in medical scientific writing. METHODS: In a cross-sectional study, the frequency of articles written under the IMRAD structure was measured from 1935 to 1985 in a randomly selected sample of articles published in four leading journals in internal medicine: the British Medical Journal, JAMA, The Lancet, and the New England Journal of Medicine. RESULTS: The IMRAD structure, in those journals, began to be used in the 1940s. In the 1970s, it reached 80% and, in the 1980s, was the only pattern adopted in original papers. CONCLUSIONS: Although recommended since the beginning of the twentieth century, the IMRAD structure was adopted as a majority only in the 1970s. The influence of other disciplines and the recommendations of editors are among the facts that contributed to authors adhering to it.

Biomedical Research↗

Population variation in the cost and benefit of tolerance and resistance against herbivory in Datura stramonium.

In this study we examine the hypothesis that divergent natural selection produces genetic differentiation among populations in plant defensive strategies (tolerance and resistance) generating adaptive variation in defensive traits against herbivory. Controlled genetic material (paternal half-sib families) from two populations of the annual Datura stramonium genetically differentiated in tolerance and resistance to herbivory were used. This set of paternal half-sib families was planted at both sites of origin and the pattern of genotypic selection acting on tolerance and resistance was determined, as well as the presence and variation in the magnitude of allocational costs of tolerance. Selection analyses support the adaptive differentiation hypothesis. Tolerance was favored at the site with higher average level of tolerance, and resistance was favored at the site with higher average level of resistance. The presence of significant environmentally dependent costs of tolerance was in agreement with site variation in the adaptive value of tolerance. Our results support the expectation that environmentally dependent costs of plant defensive strategies can generate differences among populations in the evolutionary trajectory of defensive traits and promote the existence of a selection mosaic. The pattern of contrasting selection on tolerance suggests that, in some populations of D. stramonium, tolerance may alter the strength of reciprocal coevolution between plant resistance and natural enemies.

Adaptation, Biological↗

[Clinical impact of rib fractures in single and multiple trauma].

In a retrospective study we evaluated the data regarding 126 patients (96 male/30 female) hospitalized with rib fractures between 1986 and 1989. Fifty percent of the subjects had been in a traffic accident. Eighty-five percent of the patients had 2-7 broken ribs. Sixty-two patients suffered from multiple injuries, 40% were men aged less than 40 years. Fifty-six patients were treated by pleural drainage either for hemato- and/or pneumothorax or to prevent intrapleural tension during surgical intervention under endotracheal anesthesia. Thirty-two patients underwent mechanical ventilation for between 1 and 52 days (mean 10 days). In five cases a flail chest was stabilized by ribosteosynthesis to avoid prolonged artificial ventilation. Pain relief by continuous peridural Carbostesin (bupivacaine) administration was given to 31 patients. There was a positive correlation between the incidence of pneumo- and hematothorax and the number of broken ribs. A significant association was found between multiple-injured patients died in hospital; six of them had multiple injuries. The recovery of 44 patients was interrupted by complications, predominantly of pulmonary origin (68%). The pattern and severity of concomitant injuries and interference of complications influenced the length of the hospital stay; pulmonary complications doubled it.

Adolescent↗

Application of functional MRI in epilepsy.

OBJECTIVE: To review the recent development of functional MRI application in epilepsy. DATA SOURCES: Both Chinese and English language literatures were researched using MEDLINE/CD ROM (1996 - 2005) and the Chinese Biomedical Literature Disk (1996 - 2005). STUDY SELECTION: Published articles about functional MRI application and epilepsy were selected. DATA EXTRACTION: Data were mainly extracted from 38 articles which are listed in the reference section of this review. RESULTS: fMRI can be used to localize seizure foci through detecting these cerebral hemodynamic changes produced by epileptiform discharges. EEG-triggered fMRI, which has higher spatial and temporal resolution, helps to detect the spatiotemporal pattern of spike origin and propagation, and define localization of the epileptogenic focus. fMRI is also useful in language and memory cognitive function assessment and presurgical assessment of refractory epilepsy. Atypically distributed cognitive function areas can be detected by fMRI, because of cortical language and memory areas reorganization during long-term epileptic activity in patients with epilepsy. CONCLUSIONS: fMRI technique plays a very important role in cognitive function and presurgical assessment of patients with epilepsy. It is meaningful for understanding pathogenesis of epilepsy.

Cognition↗

Localization of partial epilepsy using magnetic and electric measurements.

Dipole methods applied to brain electric and magnetic fields have made several significant advances in investigation of epilepsy and sensorimotor cortex. The magnetoencephalogram (MEG) and the MEG-electroencephalogram (EEG) combination have contributed substantially. The MEG-EEG combination has shown a mean accuracy of somatosensory evoked response (SER) localization of the central fissure similar to electrocorticography (ECoG), resolution of ambiguity in ECoG of alternative configurations of hand sensorimotor cortex, and resolution of ambiguity of the causes of the difference between EEG and ECoG map patterns. MEG has shown simple dipolar maps of the temporal lobe interictal spike, localization estimates with about 6 mm error, and spatial separation of propagating multiple sources. MEG and EEG have shown a new neocortical propagation pathway in the temporal lobe, noninvasive estimates of the area of the spike focus, and complementary detection sensitivity. Application of spatiotemporal multiple dipole modeling in the simplest field using MEG has given a realistic quantification of spike zones. MEG and EEG have shown simple dipolar patterns for seizure origin, suggesting focality of some frontal seizures, and appears to increase EEG utility. Improved accuracy may result from a combined methodology including MEG and EEG. Dipole methods have potential utility as a noninvasive diagnostic procedure in epilepsy.

Brain Mapping↗

[The structure of the nosogeographic range of opisthorchiasis in the Ob-Irtysh basin].

Results of our own investigations and available data in the literature concerning the epidemiology of opisthorchiasis in Ob-Irtysh river basin have been gathered, and geographic ranging have been established. The prevalence of infection, children's infection rate, the intensity of infection and clinical manifestation rate have been suggested as a criterion for division of territories into areas. 4 degrees of endemia was established: areas with sporadic incidence rate (prevalence is less than 1%); hyperendemic (prevalence 1-10%, intensity of infection 1-20 egg/gr., children's infection and clinical manifestation are absent), mesoendemic (prevalence 10-40%, children's infection rate 1-25%, intensity of infection about 300 egg/gr., clinical manifestation rate about 50%) and hyperendemic area (prevalence above 40%, children's infection rate 25-60%, intensity of infection above 300 egg/gr., clinical manifestation rate about 80%). Original map of pattern of opisthorchiasis distribution area is presented. The decreasing of transmission of O. felineus to periphery of basin is noted.

Age Factors↗

[Psychosocial and clinical predictors of the disease course in patients with cardiac phobia and panic attacks].

Patients suffering from cardiac phobia or neurocirculatory asthenia (also known as cardiac neurosis or effort syndrome) represent a uniform disease group due to the typicality of the signs and symptoms and of the course of the disease; this group should be distinguished from the broad spectrum of cardiovascular disorders. There is close agreement with panic disorder according to DSM III, one of the reasons being that cardiac phobia was originally the model pattern for defining that disorder. In the present prospective study the significance of psychosocial and clinical factors for the prediction of the further course of the disease was studied in 36 patients with cardiac phobia treated on an inpatient basis for the first time, 29 of whom could be followed up by a checkup 2 1/2 years later. The duration of the disease before treatment, as well as difficulties in various social spheres, especially in partnership problems, were found to be variables exercising a particularly strong influence on the course of illness. The variables concerning the marital status and school education were also found to be statistically relevant predictors. Familial stress and the appeal-for-help behaviour of these patients were also recorded. The results of the study point to the importance of psychosocial factors as major coursemodifying factors and underline the need to pay particular attention to this part of the treatment.

Anxiety Disorders↗

Anti-La antibody production by MRL-1pr/1pr mice. Analysis of fine specificity.

In evaluating the origin of autoantibodies, patterns of self-Ag recognition have been interpreted to reflect the relative role of Ag in stimulating a response. Few studies, however, have assessed whether human autoantibodies display patterns of autoantigen recognition similar to those of SLE-prone mice. In previous studies, anti-La antibodies from humans have been shown to bind multiple epitopes on recombinant human La Ag, including immunoreactivity with a large fragment, termed La C, representing the middle portion of the La sequence. We report herein for the first time that MRL-1pr mice also spontaneously produce antibodies to recombinant human La protein and resemble human autoantibodies in their reactivity with La C. To further investigate the fine specificity of this response, we tested for antibody binding to six synthetic La peptides representing sequences within La C. Whereas two of the synthetic La peptides reacted with MRL-1pr sera containing anti-La binding, low reactivity was observed with a large panel of human anti-La sera. Our results therefore show that patterns of La antigen recognition displayed by MRL-1pr antibodies differ from those of human autoantibodies, possibly reflecting differences between mouse and man in the induction of these responses.

Animals↗

Attempts to characterize bovine viral diarrhea virus isolated from cattle after immunization with a contaminated vaccine.

Bovine viral diarrhea virus (BVDV) was isolated from 28 animals with a history of immunization against respiratory disease with a vaccine contaminated with BVDV. The vaccine-derived parental virus strain and the 28 isolates were analyzed using 10 monoclonal antibodies (MAbs) directed against different epitopes and antigenic domains on the major envelope glycoprotein of BVDV. None of the isolates displayed a reaction pattern identical with the parental virus. Instead, seven different reaction patterns (#A-G) emerged. Circumstantial evidence indicated that six of these were vaccine related whereas in one case (pattern #F) the origin of the isolate was unclear. The results indicated that BVDV rapidly changed during animal passages and that the tracing of the vaccine contaminant using Mabs was impossible.

Animals↗

[Vertical and tortional deviations in early strabismus].

The occlusion of one eye may trigger two types of deviation: 1) Heterophorias: the occluded eye deviates towards a horizontal, vertical or torsional abnormal position of rest. Fusion keeps the eyes straight during binocular fixation. 2) Dissociated deviations, horizontal (DHD), vertical (DVD), torsional (DTD): they are found in infantile strabismus. The deviation without fixation is always smaller than the deviation of the occluded eye. The more typical cases are the ones where the position of rest without fixation is an orthoposition. Normal binocular vision is lacking. Most of the time, an alternant neutralisation is found: the occlusion deviation is not the return of the occluded eye to an abnormal position of rest. The deviation is caused by a disequilibrium of binocular retinal stimulations. Horizontal and vertical deviations are easy to study. It is not the case in dissociated torsional deviation (DTD) where the incyclotorsion does not exist when fixation is absent. An indirect proof of extorsion is given by the study of horizontal and vertical deviations determined in the cardinal position of gaze. Extorsion of the globus leeds always to abnormal actions of the recti. This give a typical synoptometer chart which is found in any extorsion whatever its origins: paralysis, alphabetic patterns or infantile strabismus. Dissociated extorsions are always associated with a bilateral elevation in the primary position. Dissociated deviations are found in infantile strabismus with the other dissociations phenomenon such as nystagmus, optokinetic nystagmus asymmetry, fixation in adduction preference (and incyclotorsion).

Accommodation, Ocular↗

Decreasing documentation time using a patient self-assessment tool.

A 1986 audit of 150 randomly selected radiation therapy patient records revealed 147 records containing completed nursing assessment and weekly progress notes. Documentation of care provided was comprehensive, but concern was expressed over the length of time it required--an average of 40 minutes for the patient interview and an additional 20 minutes for documentation. Two strategies were proposed to reduce the amount of time spent in documentation without jeopardizing the detail of information contained in the initial nursing assessment: to pilot a patient self-assessment tool based on our original functional health pattern nursing assessment and to develop a standard flow sheet that contained both frequently used nursing diagnoses and potential interventions. Selected patients completed self-assessment records and discussed them with their primary nurses on the first day of treatment. Based on the pilot data, the forms were modified and revised. In 1987, 50 revised patient self-assessment records were reviewed revealing that both subjective and objective information had improved. Documentation time was reduced and information was more comprehensive.

Health Status↗

A novel marker for basal (stem) cells of mammalian stratified squamous epithelia and squamous cell carcinomas.

We have developed a monoclonal antibody (174H.64) which selectively recognizes antigens shared by the basal cells of mammalian stratified squamous epithelium and squamous cell carcinoma (SCC). Histopathological studies of the frozen tissue sections demonstrated selective binding of this antibody to SCCs of human, bovine, canine, feline, and murine origin. Tumors of other histological types did not show reactivity with the antibody. In well-differentiated SCCs the peripheral layer of the tumor showed preferential binding of the antibody, suggesting that the antigens are associated with the proliferative compartment of the tumor. Studies on normal human tissues showed selective binding of the antibody to the basal layer of stratified squamous epithelia, thymic epithelial cells, and myoepithelial cells around breast ducts, while no antibody binding was observed for the suprabasal layers of stratified epithelia, simple epithelia, or tissues of nonepithelial origin. A similar pattern of antibody binding was also observed for bovine and murine skin with staining of the basal layer. The antigens detected by monoclonal antibody 174H.64 were characterized from cytoskeletal protein extracts of normal human keratinocytes as well as human and bovine SCC tissues by using an immunoblotting technique. The antigens detected in normal human keratinocytes consisted of two major protein bands of approximate molecular weights of 48,000-50,000 and 57,000. In bovine SCC tumor the antigen detected was the Mr 48,000-50,000 band and in the human SCC tumor it was the Mr 57,000 band. A murine lung SCC model was developed with a murine SCC cell line KLN-205. The lung tumor obtained was reactive against the antibody and showed selective staining of the peripheral layer of the tumor containing the stem cell population. The antigens described by monoclonal antibody 174H.64 appear to be molecules associated with the stem cell populations of normal stratified epithelium and squamous cell carcinoma.

Animals↗

[SDS electrophoretic evaluation of salivary protein adsorption to different dental materials].

After different pretreatments of surface the alloys Sipal, Gisadent KCM 83 and Gisadent NCA and the PMME resin Kallocryl A were contaminated with mixed saliva for 1.5 hours. Thereafter, the proteins which could not washed off with water were desorbed from the materials by using a dodecyl sulphate-containing buffer, and analyzed SDS electrophoretically and densitometrically. The pattern of the proteins desorbed reflected a fairly unspecific adsorption of the salivary proteins independent on the kind of the dental material used. Whereas the ranges of the low (10-25 kDa) and the high (greater than 50 kDa) molecular mass polypeptides share nearly equal quotas in the protein pattern of the original saliva, a generally higher portion (68-99%) of the smaller polypeptides was shown among the proteins desorbed from the materials. This effect was especially marked after a shot-peening of alloys and a very high polishing of resin. A somewhat higher percentage of the larger proteins (18-51%) were desorbed from the materials which were pretreated by fine-smoothing or sandblasting.

Adsorption↗

[Study of thyroid function in patients with paroxysmal supraventricular tachycardia].

Twenty-nine patients with paroxysmal supraventricular tachycardias of different origins and clinical pattern were investigated to detect latent thyroid disorders; hyperthyroidism was diagnosed in 2 of those, and hypothyroidism, in 4. Functional thyroid disorders were more common in patients with mitral prolapse and supraventricular tachycardias due to additional conductive pathways (the Wolff-Parkinson-White syndrome) and paroxysmal nodal reciprocal tachycardia, particularly if they were resistant to antiarrhythmic treatment and/or had aggravated thyroid history. It is suggested that thyroid dysfunction is just a triggering factor of arrhythmia since thyrostatic and replacement therapy eliminate paroxysms of tachycardia, while organic pathology of the heart and its conductive network remains unaffected.

Adolescent↗

Subpopulations of microtubules with differential sensitivity to nocodazole: role in the structural organization of the Golgi complex and the lysosomal system.

The role of cytoplasmic microtubules (MTs) in the structural organization of the Golgi complex and the lysosomal system was studied in L929 mouse fibroblasts using a combination of cytochemical and electron microscopic methods. Immunocytochemical staining demonstrated a radiating pattern of MTs, originating in the juxtanuclear region containing the centrioles. The stacks of Golgi cisternae with associated vesicles and tubules (the trans Golgi network), as well as most of the endosomes and lysosomes, were also located in and immediately around this region. Wheat germ agglutinin (WGA) conjugated to horseradish peroxidase (HRP) bound to the plasma membrane at 4 degrees C. After warming to 37 degrees C, the conjugate was rapidly internalized by endocytosis and via small vesicles transferred to endosomes and lysosomes in the juxtanuclear region. Slightly later it was also found in the trans Golgi network. A weaker but otherwise similar staining was obtained if the conjugate was applied to fixed and permeabilized cells. Treatment with 3.0 microM nocodazole induced depolymerization of MTs and rounding up of the cells. At the same time, the Golgi complex was disorganized with dispersion of its stacks of cisternae throughout the cytoplasm and atrophy of the trans Golgi network. The lysosomes gathered around the dispersed cisternal stacks and the endosomes became fewer in number. Moreover, the uptake of WGA-HRP was markedly inhibited. Following withdrawal of the drug, MTs reformed and the structural organization of the cell was again normalized. If the recovery was allowed to take place in the presence of low concentrations of nocodazole (0.03 or 0.15 microM), MTs of short and medium length were formed, the latter showing a curly path. In parallel, a partial or nearly complete normalization of cell morphology occurred. Internalization and transport of WGA-HRP labeled membrane to the lysosomes and the trans Golgi network was also resumed. In contrast, the cells were not able to pass through mitosis in a normal manner and multimicronucleated cells accumulated. Taken together, the findings indicate that L929 cells contain a subset of nocodazole-resistant MTs which play an important role in the structural organization of the cell, especially with regard to the Golgi complex and the lysosomal system. They support recent notions that there exists subpopulations of MTs with different physicochemical properties and functions.

Animals↗

CML-T1: a cell line derived from T-lymphocyte acute phase of chronic myelogenous leukemia.

Most data suggest that malignant transformation in chronic myelogenous leukemia (CML) occurs in hematopoietic stem cell that is the progenitor of myelopoiesis and of B but not T lymphopoiesis. We established a T-lymphoid cell line (CML-T1) from a person with Ph-chromosome-negative CML in acute phase. Evidence of its T-lymphocyte origin includes the pattern cytochemical reactivity, reactivity with anti-T-cell monoclonal antibodies (MoAbs), and rearrangement of the beta-T-cell receptor (TCRB) gene. CML-T1 cells have features of type IV thymocytes. Cytogenetic analyses indicate a 47,XX, del(11), t(6;7)(q23;q24), +mar karyotype. CML-T1 cells exhibit molecular changes typical of CML, including translocation of the ABL protooncogene from chromosome 9 to 22, rearrangement of the BCR gene, and transcription of a chimeric BCR-ABL messenger RNA (mRNA). The ABL insertion on chromosome 22 appears interstitial, similar to other cases of Ph-chromosome-negative CML. These data clearly indicate that T cells can be involved in acute-phase CML. CML-T1 should be useful in studying this process as well as that underlying Ph-chromosome-negative CML.

Adult↗

Diagnostic pathology in the acquired immunodeficiency syndrome. Surgical pathology and cytology experience with 67 patients.

We report the pathologic findings in specimens submitted for histologic and cytologic evaluation from 67 patients with the acquired immunodeficiency syndrome. A wide variety of opportunistic pathogens were identified in 41 patients. Mycobacterium avium-intracellulare evoked only a mild host response: granulomas, if present, were poorly formed. Biopsy specimens showing cytomegalovirus gastroenteritis required sections at multiple levels to demonstrate inclusions. Combined histologic and cytologic evaluation can increase the diagnostic yield in pulmonary and esophageal infections. Kaposi's sarcoma was found in biopsy specimens from 29 patients. Early lesions were often extremely subtle, yet distinct from, benign vascular proliferations in involuted lymph nodes. Malignant lymphoma was diagnosed in ten homosexual men who were suspected of having the acquired immunodeficiency syndrome. The lymphomas were characterized by B-cell origin, a diffuse pattern, frequent extranodal presentations, and an aggressive clinical course with prominent central nervous system involvement.

Acquired Immunodeficiency Syndrome↗

Sequential synergistic effect of interleukin 2 and interferon-gamma on the differentiation of a Tac-antigen-positive B cell line.

The presence of Tac-antigen (Tac-Ag) on human B lymphocytes and its functional significance with regard to the ability of interleukin 2 (IL 2) to modulate B cell differentiation is currently an area of high interest. An Epstein-Barr virus-transformed B cell line (CB) that secretes IgG was 30 to 40% Tac-Ag+ and was used as a model for examining the role of Tac-Ag and IL 2 in B cell differentiation. Recombinant IL 2 alone was found to have a modest but significant effect on CB in enhancing IgG secretion, increasing the plaque-forming cell response from 637 to 1734 at high concentrations (1000 U/ml IL 2) and to 888 at lower concentrations (100 U/ml). In contrast, recombinant interferon-gamma (IFN-gamma) alone had no effect on the differentiation of CB. However, both factors together showed marked synergy in increasing the number of plaque-forming cells to over 3000 by using only 10 U/ml of IFN-gamma and 100 U/ml of IL 2. These two factors were shown to act sequentially in that IL 2 was needed initially, while IFN-gamma was required for the next differentiation step into IgG-secreting cells. The effect of IL 2 on stimulating differentiation was blocked by anti-Tac, indicating that the action of IL 2 is mediated through its Tac-Ag receptor. CB cells were also sorted into Tac+ and Tac- populations and were cultured separately. In 2 wk, both populations reverted to the pattern of the original cell line. Moreover, cell cycle analysis when using double staining procedures indicated that Tac-Ag on the cell surface of CB appears and disappears according to the stage of the cell cycle, and that Tac is most strongly expressed in the S and G2 + M phases. Thus, the present study suggests that certain B cells are capable of responding to sequential stimulation by IL 2 and IFN-gamma with terminal differentiation into Ig-secreting cells, and that the amount of Tac-Ag expression is cell cycle dependent.

Antigens, Surface↗