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PubMed1980

Geographic variation in helminth parasites from the digestive tract of Tennessee raccoons, Procyon lotor.

The stomachs and intestinal tracts of 253 raccoons, Procyon lotor, were examined for helminth parasites. Sixteen species of helminths were found including eight trematodes, two cestodes, five nematodes, and one acanthocephalan. Fourteen of these helminths are new geographic records for the state of Tennessee. Multivariate statistical techniques were used to analyze two-state and multistate character sets. Matrices of correlation among characters were computed and the first three principal components were extracted, accounting for 79.7% and 66.5% of the variation in the respective character sets. Three-dimensional projections of Tennessee's eight geographic localities onto two-state and multistate principal components demonstrated that raccoons in western localities were parasitized most heavily by Atriotaenia procyonis. Mesocestoides variabilis, Gnathostoma procyonis, and Pharyngostomoides procyonis. Parallelorchis diglossus, Euparyphium beaveri. Eurytrema procyonis, Euryhelmis squamala, Molineus barbatus, and Macracanthorhynchus ingens were most common to P. lotor from eastern areas.

Acanthocephala↗
PubMed1996

Ten-year summary of human immunodeficiency virus serology in west Tennessee.

Since the isolation of human immunodeficiency virus (HIV), numerous laboratory tests have been developed to confirm the immunologic response to the virus. In 1991, the state of Tennessee mandated that clinical laboratories performing Western blot analyses for HIV report all new cases of confirmed HIV infection. This report is a summary of HIV confirmed cases evaluated by this facility from 1985 until July 1, 1995. During each year, the laboratory screens approximately 20,000 persons for HIV and all positive screens are confirmed by an FDA-approved Western blot. During the period described, the laboratory has confirmed HIV serologic positivity in 4,096 individuals, principally from Shelby County and surrounding Tennessee counties. Although these data are not complete, they clearly indicate that we have a continuing problem with this infectious disease. Based on the current rate of positive cases seen thus far in 1995, this facility may confirm nearly 900 new cases of HIV infection in this year alone.

Adolescent↗
PubMed1997

A mortality study of employees of the nuclear industry in Oak Ridge, Tennessee.

An analysis was conducted of 27,982 deaths among 106,020 persons employed at four Federal nuclear plants in Oak Ridge, Tennessee, between 1943 and 1985. The main objectives were to extend the evaluation of the health effects of employment in the nuclear industry in Oak Ridge to include most workers who were omitted from earlier studies, to compare the mortality experience of workers among the facilities, to address methodological problems that occur when individuals employed at more than one facility are included in the analysis, and to conduct dose-response analyses for those individuals with potential exposure to external radiation. All-cause mortality and all-cancer mortality were in close agreement with national rates. The only notable excesses occurred for white males for lung cancer [standardized mortality ratio (SMR) = 1.18, 1,849 deaths] and non-malignant respiratory disease (SMR = 1.12, 1,568 deaths). A more detailed analysis revealed substantial differences in death rates among workers at the Oak Ridge plants. Evaluation of internally adjusted log SMRs using Poisson regression showed that workers employed only at Tennessee Eastman Corporation or K-25 and at multiple facilities had higher death rates than similar workers employed only at X-10 or Y-12, and that the differences were primarily due to non-cancer causes. Analysis of selected cancer causes for white males indicated large differences among the workers at the different facilities for lung cancer, leukemia and other lymphatic cancer. Dose-response analyses for external penetrating radiation were limited to a subcohort of 28,347 white males employed at X-10 or Y-12. Their collective recorded dose equivalent was 376 Sv. There was a strong "healthy worker effect" in this subcohort-all-cause SMR = 0.80 (4,786 deaths) and all-cancer SMR = 0.87 (1,134 deaths). Variables included in the analyses were age, birth cohort, a measure of socioeconomic status, length of employment, internal radiation exposure potential and facility. For external radiation dose with a 10-year lag, the excess relative risk was 0.31 per Sv (95% CI = -0.16, 1.01) for all causes and 1.45 per Sv (95% CI = 0.15, 3.48) for all cancer. The estimated excess relative risk for leukemia was negative but imprecisely determined. A preliminary dose adjustment procedure was developed to compensate for missing dose but not other dosimetry errors. Results of the analyses using the adjusted doses suggest that the effect of missing dose is an upward bias in dose-response coefficients and test statistics.

Dose-Response Relationship, Radiation↗
PubMed1997

Hypercalcemia and pulmonary tuberculosis in east Tennessee.

In a study of 83 patients with active pulmonary tuberculosis who were treated in East Tennessee, only three developed hypercalcemia. The incidence of hypercalcemia in East Tennessee is markedly lower than that quoted in earlier studies performed in the United States. The explanation for the infrequent occurrence of elevated serum calcium in our population is probably multifactorial, but does not appear to be related to the selection of antituberculous agents.

Adult↗
PubMed1995

Assessing dental manpower needs in Tennessee.

Using a formula developed by the State of Kentucky and the best data available for the State of Tennessee, it is estimated that this state currently has a slight oversupply of dentists, but that by the turn of the century this will have become a shortage. There is no reason to doubt these estimates except that for confidence in them we will need state-specific data on the supply of dental manpower, the need for dental care, and the demand for dental care. Following the recommendations of the Institute of Medicine and others, the College of Dentistry has initiated the Dental Manpower Project to develop and maintain a database which will allow Tennessee to forecast and monitor trends in the supply of dental personnel and factors affecting need and demand. Hopefully, such an activity will help us avoid mistakes like those made 25 to 30 years ago which resulted in the education of too many dentists nationwide (and in this state) and an unfortunate breach between practitioners and dental education.

Dentistry↗
PubMedDate not supplied

Capillary electrophoresis in court: the landmark decision of the People of Tennessee versus Ware.

Capillary electrophoresis is a versatile and emerging technique. In the fields of law and science, history has been made with the admissibility of CE as a method to evaluate evidence. The extremely low sample requirements, high separation efficiencies, and excellent resolution allow for quantitative techniques from extracted and amplified mitochondrial DNA (mtDNA), which was presented as evidence from hair shafts in the case of The People of Tennessee versus Paul Ware (Tennessee v. Ware). This paper discusses the history of the admissibility of scientific evidence. In 1993, the United States Supreme Court Justices rewrote the rules for admission of scientific evidence under the Federal Rules of Evidence (FRE) in Daubert v. Merrell Dow Pharmaceuticals, Inc. (Daubert) (509 U.S. 597). After rejecting the longstanding requirements under Frye v. United States (Frye), 293 F.1013 (1923), which focused on the conclusions obtained rather than the methodologies employed, Daubert went further in establishing a liberal policy in the FRE favoring the District Court judges to act as gatekeepers, thus admitting well-grounded scientific evidence. Later this year, the Supreme Court will once again review the issue of how the decisions reached in trial courts should be treated by reviewing courts. CE has demonstrated its ability to meet the requisite scientific standards in the court system. The CE evidence presented in Ware led to a felony conviction.

DNA, Mitochondrial↗
PubMed1998

Physicians' experiences with Medicaid managed care: the Tennessee American College of physicians survey on TennCare.

Despite widespread introduction of Medicaid managed care (MMC), physicians have not been surveyed regarding its impact on patient care. This study documented physician experiences with MMC in Tennessee, where a statewide experimental managed care program (TennCare) delivers services through 12 capitated managed care organizations (MCOs). Practicing Tennessee American College of Physician (ACP) members (n = 1,181) were questioned regarding recent experience with the TennCare program, assessment of the program, and suggestions for improvement. The results, derived from 306 physician respondents (response rate 26%), were as expected, based on findings of a prior administrative focus group and independent surveys. Physicians' experiences were similar regardless of practice type. Most physicians rated the TennCare program as either fair (43%) or poor (42%) overall. The majority cited administrative complexity as a major problem that frequently adversely affected patient care. Physician experience suggests that administrative procedures and medication formularies should be streamlined and standardized to improve patient care.

Attitude of Health Personnel↗
PubMed1998

Influenza A--Florida and Tennessee, July-August 1998, and virologic surveillance of influenza, May-August 1998.

During July and August 1998, the state departments of health in Florida and Tennessee each reported an outbreak of influenza. The Florida outbreak occurred in July in two residential homes for children; the Tennessee outbreak occurred in August among members of a family that vacationed together. This report summarizes the investigation of these outbreaks, which were caused by influenza type A(H3N2) viruses, and presents information on influenza isolates received by CDC during May-August 1998, 81% of which were influenza A(H3N2).

Aged↗
PubMed1999

Occurrence of butyltin residues in sediment and mussel tissues from the lower-most Tennessee River and Kentucky Lake, U.S.A.

Surface sediments and mussel samples were collected at six selected locations in the lower-most Tennessee River and Kentucky Lake, U.S.A. and analyzed for butyltin (BT) derivatives. In sediments, total BT concentrations ranged from 6.8 to 356 ng g-1 dry wt. A wide range of concentrations in sediments suggested the presence of localized area of contamination. In mussel tissues, total BT concentrations varied between 26-107 ng g-1 dry wt. BT levels were comparable to the levels reported in mussels from some coastal sites as well as a few freshwater ecosystems. Leaching of tributyltin-containing anti-fouling paints in the ocean-going ships is a source of tributyltin, and discharge of municipal sewage and industrial waste waters in to this watershed may account for the presence of the monobutyltin and dibutyltin derivatives detected in the samples. To our knowledge, this is the first report on the butyltin concentrations in sediment and mussel tissues from the lower-most Tennessee River and Kentucky Lake.

Animals↗
PubMedDate not supplied

The Tennessee Mouse Genome Consortium: identification of ocular mutants.

The Tennessee Mouse Genome Consortium (TMGC) is in its fifth year of a ethylnitrosourea (ENU)-based mutagenesis screen to detect recessive mutations that affect the eye and brain. Each pedigree is tested by various phenotyping domains including the eye, neurohistology, behavior, aging, ethanol, drug, social behavior, auditory, and epilepsy domains. The utilization of a highly efficient breeding protocol and coordination of various universities across Tennessee makes it possible for mice with ENU-induced mutations to be evaluated by nine distinct phenotyping domains within this large-scale project known as the TMGC. Our goal is to create mutant lines that model human diseases and disease syndromes and to make the mutant mice available to the scientific research community. Within the eye domain, mice are screened for anterior and posterior segment abnormalities using slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus photography, eye weight, histology, and immunohistochemistry. As of January 2005, we have screened 958 pedigrees and 4800 mice, excluding those used in mapping studies. We have thus far identified seven pedigrees with primary ocular abnormalities. Six of the mutant pedigrees have retinal or subretinal aberrations, while the remaining pedigree presents with an abnormal eye size. Continued characterization of these mutant mice should in most cases lead to the identification of the mutated gene, as well as provide insight into the function of each gene. Mice from each of these pedigrees of mutant mice are available for distribution to researchers for independent study.

Animals↗
PubMed2000

Chemical composition of fine particles in the Tennessee Valley region.

Fine particles in the atmosphere have elicited new national ambient air quality standards (NAAQS) because of their potential role in health effects and visibility-reducing haze. Since April 1997, Tennessee Valley Authority (TVA) has measured fine particles (PM2.5) in the Tennessee Valley region using prototype Federal Reference Method (FRM) samplers, and results indicate that the new NAAQS annual standard will be difficult to meet in this region. The composition of many of these fine particle samples has been determined using analytical methods for elements, soluble ions, and organic and elemental carbon. The results indicate that about one-third of the measured mass is SO4(-2), one-third is organic aerosol, and the remainder is other materials. The fraction of SO4(-2) is highest at rural sites and during summer conditions, with greater proportions of organic aerosol in urban areas throughout the year. Additional measurements of fine particle mass and composition have been made to obtain the short-term variability of fine mass as it pertains to human exposure. Measurements to account for semi-volatile constituents of fine mass (nitrates, semi-volatile organics) indicate that the FRM may significantly under-measure organic constituents. The potentially controllable anthropogenic fraction of organic aerosols is still largely unknown.

Aerosols↗
PubMedDate not supplied

Effects of bioaccumulation of PCBs on biodiversity and distribution of fish in two creeks in east Tennessee (USA).

The Oak Ridge Reservation, established in Tennessee during World War II as a research, development and process facilities support for the Manhattan Project, released large quantities of organic, inorganic and radionuclear contaminants into the environment. Their effects are particularly evident in aquatic ecosystems, as chemical concentrations in water, and as a disease in biodiversity and species richness. East Fork Poplar Creek and its tributary, Bear Creek flow inside the Reservation and have highly degraded natural habitats, unsatisfactory water quality and impoverished biota. PCB concentrations exceed recommended criteria for aquatic life safety and appear as a primary cause of environment degradation and reduced species richness. An uptake model, FGETS (Food and Gill Exchange of Toxic Substances) was used to analyse fish biodiversity and distribution in the two streams in relation to bioaccumulation of PCB congeners 1254 and 1260. Bioaccumulation of the two polychlorinated biphenyls was estimated in four different species of fish common in Tennessee rivers and streams: Catostomus commersoni, Lepomis macrochirus, Cyprinus carpio and Micropterus salmoides to integrate the available set of data and to evaluate the entity of human impact on these escosystems.

Animals↗
PubMed1998

Tennessee's failed managed care program for mental health and substance abuse services.

In July 1996, Tennessee initiated a managed mental health and substance abuse program called TennCare Partners. This publicly funded "carve-out" experiment started chaotically and soon deteriorated into a crisis. Many patients did not receive care or lost continuity of care, and the traditional "safety net" mental health system nearly disintegrated. This qualitative case study sought to ascertain the impact of the TennCare Partners program. It points out that the program's difficulties stemmed directly from a flawed design that spread funds previously earmarked for severely mentally ill patients across the entire Medicaid population. States contemplating similar reforms should strive to protect vulnerable patients by risk-adjusting capitation payments and by focusing resources on care for severely mentally ill persons. States should also minimize program complexity and ensure the accountability of managed care networks for their patients' behavioral health care needs.

Adult↗
PubMed1996

Mortality of workers at a nuclear materials production plant at Oak Ridge, Tennessee, 1947-1990.

The Y-12 plant at Oak Ridge, Tennessee, produced nuclear materials for the U.S. government's nuclear weapons program beginning in 1943. Workers at Y-12 were exposed to low dose, internal, alpha radiation and external, penetrating radiation, as well as to beryllium, mercury, solvents, and other industrial agents. This paper presents updated results from a long-term mortality study of workers at Y-12 between 1947 and 1974, with follow-up of white men through 1990 and data reported for the first time for women and men of other races. Vital status was determined through searches of the National Death Index and other records, and the workers' mortality was compared to the national population's using standardized mortality ratios (SMRs). Total mortality was low for all Y-12 workers and total cancer mortality was as expected. Among the 6,591 white men, there were 20% more lung cancer deaths than expected (95% confidence interval [CI] 1.04-1.38). Death rates from brain cancer and several lymphopoietic system cancers were also elevated among white men, with SMRs of 1.28 and 1.46. Mortality from cancer of the pancreas, prostate, and kidney was similarly elevated. There was evidence of excess breast cancer among the 1,073 female workers (SMR 1.21, 95% CI 0.60-2.17). Lung cancer mortality among these workers warrants continued surveillance because of the link between internal alpha radiation exposure and this disease, but other agents, notably beryllium, also merit considerations as potential causes of lung cancer. Other cancers and agents should also be investigated as part of a comprehensive study of the health consequences of the production of nuclear weapons.

Adult↗
PubMed1982

Differences in interproximal and occlusal tooth wear among prehistoric Tennessee Indians: implications for masticatory function.

Breadth of the interproximal wear facet between lower P2 and M1 and between lower M1 and M2 was measured in human skeletal samples representing the Archaic, Woodland, and Mississippian periods of Tennessee River Valley prehistory, with the aim of assessing relative magnitudes of applied masticatory forces. When stratified by level of occlusal wear, mean interproximal facet breadth was consistently larger in the Archaic sample than in the Mississippi sample, with the Woodland sample intermediate. An analysis of covariance demonstrated that there was significant (p less than or equal to 0.01) differences in facet size among the three groups even when differencs in crown breadth were taken into account. Similar results were obtained in regressions of facet size on chronological age (Archaic larger than Mississippian at P less than or equal to 0.01). Since rate of occlusal wear appears to be somewhat greater in the Archaic sample than in the later samples, the differences in interproximal wear are probably underestimated. It is suggested that the high levels of interproximal wear in the Archaic are indicative of the large occlusal forces and repetitive chewing required to masticate a diet of seeds, wild plant foods, and small animals, for which prior preparation (e.g., grinding, cooking) was minimal or nonexistent (as indicated by paleofecal samples). The lower amounts of interproximal wear observed in the Woodland and Mississippian samples imply considerable reductions in strenous mastication, perhaps due to the widespread adoption during these period of pottery and the earth oven, together with ethnographically-documented techniques of food preparation that transformed most foods to a soft consistency.

Adolescent↗
PubMed1991

An outbreak of blastomycosis in eastern Tennessee.

Most cases of blastomycosis are sporadic and only nine outbreaks representing a total of 112 cases have previously been reported. Less than half of these have been culture proven cases. Outbreaks have previously occurred in North Carolina, Minnesota, Illinois, Wisconsin and Virginia. We report three culturally confirmed cases of blastomycosis from Elizabethton, Tennessee, who had onset of illness within a one-week span of time. The patients presented with fever, chest pain, weight loss, poor appetite and myalgia. Each initially had a dry cough which became productive of purulent sputum as the illness progressed. Mild hemoptysis occurred during each patient's course. Serologic testing by immunodiffusion and enzyme immunoassay were positive and testing by complement fixation was negative in each case. The diagnosis was made by histopathology on transbronchial biopsy or transthoracic needle aspiration material. Each patient improved on ketoconazole therapy.

Adult↗
PubMed1981

Heavy metal concentrations in the Holston River Basin (Tennessee).

Contamination levels of zinc, cadmium, mercury, copper, lead, and manganese of the major streams in the Holston River Basin in Eastern Tennessee are reported and compared with other waterways. Heavy metal levels are sufficiently high in areas of the Basin to affect the health of aquatic life. The levels of cadmium, copper, manganese, lead and zinc were measured in fish samples from each lake and stream in the Basin and compared to those reported for fish throughout the world. The use of fish to monitor the levels of heavy metals is discussed as an alternative to grab samples of water; mercury levels in fish muscle reflected pollution of a stream, whereas grab samples of water did not.

Animals↗
PubMed1991

2,3,7,8 Tetrachlorodibenzodioxin in fish from the Pigeon River of eastern Tennessee, USA: its toxicity and mutagenicity as revealed by the Ames Salmonella assay.

Levels of 2,3,7,8 tetrachlorodibenzodioxin (TCDD) were determined in both striated muscle (fillets) and whole body extracts of fish specimens harvested during a two-year period (1987-1989) from the Pigeon River (between Hartford and Newport) of Eastern Tennessee (USA). Whole body (wet weight) fish extract levels as high as 117 micrograms/kg body weight and composite fish fillet (wet weight) extract levels as high as 87 micrograms/kg fillet weight were observed. Pure TCDD was found to be highly toxic to the Salmonella typhimurium strains TA97, TA98, and TA100 at dosages which exceeded 825 ng TCDD/ml in the top agar of the Ames Salmonella assay. An 825 ng/ml TCDD dosage was not mutagenic to any of the tested Salmonella strains, either with or without metabolic activation (S9 mix). However, when acidic fish extracts from the Pigeon River were tested for mutagenicity, most of the fish extracts were mutagenic to Salmonella strains TA97, TA98, and TA100. These mutagenic extracts also demonstrated mutagenic dose-response curves. Other chemicals within the extracts as well as synergistic effects may account for the mutagenicity.

Animals↗