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[Study on dynamic changes of body mass index for adults in Henan Province].

To analysis the dynamic changes of body mass index (BMI) of adults, and provide basis for health research and policy-making, using the random cluster sampling, a total of 480 households (urban 80, suburban 80, county neighboring communities 80, rural 240) in 24 different sites were selected. The adults of selected households were subjects. Data on height, body weight and household income etc were collected in autumn of every surveying year. The results showed that the rates of BMI < 18.5 cut-off point declined with years, they were 7.3% and 3.5% in 1989 and 2000 respectively. The rates of overweight and obesity showed a steadily increasing tendency, rose up sharply from 10.7% in 1989 to 25.2% in 2000, about 1.5% higher each year. The percentage of overweight and obesity altogether in 2000 ranked as urban 33.3%, county 31.7%, suburban 24.6%, and rural 21.4%. It suggested that the percentage of overweight and obesity increased quickly, have accounted for big part in population, and should be listed as one of major public health issues.

Adult↗

The importance of being big.

The ultimate stem cell, the oocyte, is frequently very large. For example, Drosophila and Xenopus oocytes are approximately 10(5) times larger than normal somatic cells. Importantly, once the large oocytes are fertilized, the resulting embryonic cells proliferate rapidly. Moreover, these divisions occur in the absence of cell growth and are not governed by normal cell cycle controls. Observations suggest that mitogens and cell growth signals modulate proliferation by upregulating G1-phase cyclins, which in turn promote cell division. Like embryonic cells, the proliferation of cancer cells is largely independent of mitogens and growth factors. This occurs, in part, because many proteins that are known to modulate G1-phase cyclin activity are frequently mutated in cancer cells. Interestingly, we have found that both the expression and the activity of G1-phase cyclins is modulated by growth rate and cell size in yeast. These and other data suggest that proliferative capacity correlates with cell size. Thus, a major goal of our laboratory is to use yeast to investigate the relationship between proliferation rate, G1-phase cyclins, growth rate, and cell size. The elucidation of this relationship will help clarify the role of cell size in promoting proliferation in both normal and cancer cells.

Cell Proliferation↗

Fluorescence polarization assay for endothelin-converting enzymes.

The conversion of big endothelin to endothelin by alpha-chymotrypsin was determined by following its single Trp fluorescence polarization. This provides a novel, simple, fast, and sensitive identifying assay in the search for a native endothelin-converting enzyme.

Amino Acid Sequence↗

[Advance directives in the prehospital setting -- emergency physicians' attitudes].

OBJECTIVE: The German physician based emergency medical system (EMS) might confront physicians with advance directives in the field. A multi-question survey was used to evaluate emergency physicians' experience with advance directives in the prehospital setting and to assess their attitudes towards forms and statements of advance directives. METHODS: A questionnaire was mailed to the members of the Association of Emergency Physicians of Northern Germany ("AGNN"), an interest group of emergency physicians, in 2001. RESULTS: 511 emergency physicians (50,4 % of the AGNN members) filled in the questionnaire completely and sent it back for evaluation. 75 % of the participants were working as emergency physicians at present, 72 % had emergency experiences of more than 5 years. One third had previously dealt with advance directives in the prehospital setting. 77 % of these physicians thought advance directives generally helpful. Nevertheless 88 % based their management on the context of the individual circumstances (e. g. emergency conditions, underlying diseases, expected prognosis), only 7 % said they would always exactly follow the statements of the directive. In the view of the emergency physicians the advance directive should contain information on cardiopulmonary resuscitation (CPR: 88 %), intensive care-treatment (75 %) and preclinical emergency treatment (55 %). Information on underlying diseases (87 %) and a legal substitute (84 %) should be contained as well. As formal requirements, 47 % of the physicians wanted the family doctor to be involved, 49 % desired a notary authenticity confirmation, additionally or solely. Pragmatically, the advance directive should be kept with the personal documents (84 %). A regular reconfirmation was deemed necessary (twice to once a year: 64 %). The current legal situation was regarded as unclear by 81 % of the emergency physicians, 85 % favored a unique, officially authorized type of directive. CONCLUSION: The high number of returned questionnaires shows the importance of the topic "advance directives" for emergency physicians. Despite some practical and legal problems, a big majority of the experienced emergency physicians in this survey thought the advance directives in the prehospital setting to be helpful. A clear statement on resuscitation as well as simplification of the many existing types of directives are the most essential requirements demanded by the emergency physicians. A solution could be the creation of an extra "emergency advance directive".

Attitude of Health Personnel↗

Significance of fixation of the vertebral column for spinal cord injury experiments.

STUDY DESIGN: Thoracic spinal cord transections were performed in adult rats. The animals were divided into two groups, with or without internal fixation of the involved vertebral column. Histologic and immunohistochemical studies were performed to compare the effect of internal fixation of the vertebral column. OBJECTIVES: To find out the aspects and extent of beneficial effects of vertebral column fixation for spinal cord repair. SUMMARY OF BACKGROUND DATA: Vertebral column fixation is a routine procedure in clinical spinal cord surgery. Paradoxically, most, if not all, animal spinal cord experiments seem to have ignored the importance of vertebral column fixation. During trunk movements, the vertebral column flexes to different directions, accompanied by bending of the spinal cord. Following spinal cord lesions, with frequent bending of the cord there will be repeated bleeding, inflammation, and other pathologic processes at the lesion site. Thus, the healing process will be hampered. The severity of the damages that will be brought about by bending of the cord is, to a certain degree, unpredictable. There will be rather big individual variations in injury and repair among the same type of experiments, rendering quantification and conclusion difficult. METHODS: Adult Sprague-Dawley rats were used. The thoracic spinal cord was transected. Strong stainless steel wires were used for internal fixation of the vertebral column. The histology of the horizontal sections of the spinal cord segment, which included the lesion site, was examined at the 14th postoperative day. The volumes of the secondary degeneration and meningeal scar, the gap between the borders of the proximal and distal stumps of the transected spinal cord, the thickness of the meningeal scar, the astrocytic reaction, and the abundance of regenerating nerve fibers at the lesion site were compared between the vertebral column fixed and nonfixed groups. Whenever possible, the results were evaluated quantitatively. RESULTS: In all these aspects, the internally fixed group was consistently far better than the unfixed group. The quantitative analyses were as follows (fixed/unfixed): 1)volume of secondary degeneration: 1.07 +/- 0.20/1.81 +/- 0.43 mm3 (P < 0.01); 2) volume of meningeal scar: 2.38 +/- 0.55/4.34 +/- 1.40 mm3 (P < 0.05); 3) distance between cord stumps: 1.38 +/- 0.34/2.35 +/- 0.79 mm (P < 0.05); 4) the mean thinnest dimension of the meningeal scar: 0.90 +/- 0.43/1.98 +/- 0.85 mm (P < 0.05). CONCLUSION: Vertebral column fixation is a crucial procedure for spinal cord animal experiments.

Animals↗

[Treatment approach for substernal and intrathoracic goiter. Personal experience].

The retrospective analysis of 489 cases of substernal and intrathoracic goiters among 4122 patients undergoing surgical treatment between 1984 and 1996 due to various thyroid gland diseases including clinical data, surgical technics and early postoperative complications was performed. The surgical procedures of substernal and intrathoracic goiter amounted to 11.9% of all thyroid gland surgery. In 468 (95.5%) patients goiter was situated substernally, in 22 (4.5%) intrathoracicaly. The mean age and time of goiter growth in that location exceeded over 10 years the location of goiter within the neck. In preoperative examination the X-ray of chest and trachea were essential. Routine ultrasonography and thyroid gland scyntigraphy were scarcely helpful as the retrosternal and mediastinal region were often omitted. The jugular access was dominant (98.6%), sternotomy was performed in 1.4% of cases due to big disproportion between size of the goiter and size of the upper inlet into the chest. The surgical complications, similarly as in goiter within the neck (no cases of pneumothorax were observed), included the single-side paresis of recurrent laryngeal nerve in 3.7% of patients, in 0.2% hypoparathyroidism, in 1% bleeding requiring reoperation and in 0.2% esophageal fistula (self-healed). The surgical treatment of retrosternal and intramediastineal goiter was safe and a total number of complications was comparable to that one in a group of patients under-going surgery due to goiter within the neck. Most of surgical procedures was possible to perform using the jugular access. In a small number of cases because of difficulties related to the anatomical conditions the access was reached through the oblong sternotomy.

Adolescent↗

Fully synthetic immunogens. Part III. Synthesis of hinge-peptide/gastrin conjugates and their immunological properties.

As core molecule for the multiple attachment of antigenic peptides we have selected the human IgG1 hinge fragment 225-232/225'-232'. Two types of conjugates of this double-chain bis-cystinyl hinge-peptide were prepared i) by linking its C-termini to [NIe15]-human-little-gastrin-[2,17] and ii) by elongating the resulting hinge-peptide/[NIe15]-little-gastrin-[2-17] conjugate at the two N-termini with the human big-gastrin sequence 1-14 to produce the big-gastrin-[1-14]/hinge-peptide/little-gastrin-[2-17] conjugate. For the synthesis of these peptide structures both the route via the preformed double-chain bis-cystinyl peptide and the route via suitably protected monomeric bis-cysteinyl peptides were used. For the latter approach advantage was taken of the previous observation about the preferred oxidation of the bis-cysteinyl hinge-peptide 225-232 to the dimer in parallel alignment. Both synthetic routes led to identical products. Immunization experiments in guinea pigs with the synthetic hybrids led to surprisingly strong immune responses with anti-little-gastrin antibody titers comparable to those induced by the iso-1-cytochrome c/little-gastrin-[2-17] conjugate as carrier-hapten system. These findings show that the two gastrin constructs are fully competent immunogens. Additionally, the gastrin receptor-like specificity of the antibodies indicates that both the synthetic hybrids and the cytochrome c conjugate allow for expression of a little-gastrin-specific conformational epitope similar to the bioactive structure of this hormone. The usefulness of such synthetic hybrids is further confirmed by the observation that the bivalent immunogen, containing both the little-gastrin 2-17 and the big-gastrin 1-14 sequence, is capable of inducing an immune response against both antigenic sequences, although with different efficiency. These results fully confirm our expectations.

Amino Acid Sequence↗

Regional differences in endothelin converting enzyme activity in rat brain: inhibition by phosphoramidon and EDTA.

1. It has been demonstrated previously that conversion of big endothelin-1 (bET-1) to endothelin-1 (ET-1) is inhibited in vitro and in vivo by phosphoramidon. In addition, ET-1 binding sites and mRNA have been shown within the brain. Here we expand upon our previous observation that rat brain contains phosphoramidon-inhibitable endothelin converting enzyme (ECE) and show that this activity is not uniformly distributed throughout the brain. 2. ECE activity was detected by a bioassay which depended upon the 10,000 fold difference in potency between bET-1 and ET-1 as stimulants of guanosine 3':5'-cyclic monophosphate (cyclic GMP) accumulation in kidney epithelial (PK1) cells of the pig. Data were confirmed by specific enzyme-linked immunosorbent assay (ELISA) employing antibody directed against ET-1/3(17-21). 3. Following homogenization of the whole brain and ultracentrifugation the 100,000 g pellet contained greater than 4 times more ECE activity than the cytosol. Washing of the pellet with KCl (1 M) and extraction with the detergent CHAPS (20 mM) revealed a phosphoramidon-inhibitable ECE within the residual particulate fraction (nominally classified as the cytoskeletal fraction). Phosphoramidon (IC50, approx. 5 microM) or EDTA inhibited the conversion of bET-1 to ET-1 by the cytoskeletal fraction of rat brain by more than 60%.2+ 4. Following dissection of rat brain into olfactory bulb, cerebral cortex, striatum, hippocampus, cerebellum, midbrain (including thalamus), hypothalamus and medulla oblongata (including pons) the greatest ECE was detected in the hypothalamus and medulla oblongata.After fractionation, the ECE-activities in the cytoskeletal fractions prepared from the hypothalamus or medulla oblongata were inhibited concentration-dependently by phosphoramidon or EDTA, with maximum inhibitions of>80% and >70%, respectively.5. These data show that rat brain contains a phosphoramidon- and EDTA-inhibitable ECE which maybe similar to that present in endothelial cells. The localization of this enzyme correlates with published reports of immunoreactive-ET-l, ET-1-binding sites, and messenger RNA for ET-1 in the rat brain, and suggests the presence of the entire synthetic pathway for ET-1.

Animals↗

In vivo and in vitro comparisons of biological activities of bovine, ovine and rat CRF (corticotrophin-releasing factor).

The biological activity of partially purified bovine hypothalamic CRF (corticotrophin- releasing factor) was compared to those of synthetic CRFs (ovine, rat) sauvagine and vasopressin in vivo and in vitro. ACTH-primed hypophysectomized rats with heterotopically transplanted pituitaries and medial basal hypothalamic ablation (H-T + MBHA ), and intact rats pre-treated with chlorpromazine, morphine and Nembutal (C-M-N) were used for in vivo CRF assays. Perifused rat adenohypophyseal fragments were employed for in vitro studies. CRF-A (void volume fractions, 'big' CRF) and CRF-B (Kav = 0.583) purified from bovine hypophyseal stalk, synthetic ovine and rat CRF, and sauvagine all induced significant stimulation of ACTH and/or corticosterone secretion in these systems. Synthetic ovine and rat CRF and sauvagine showed comparable CRF potency. The CRF dose-response slopes for bovine CRF were somewhat steeper than those for ovine CRF or sauvagine in the in vitro system. Vasopressin had the least steep dose-response slope. Intravenous bolus administration of ovine CRF caused a more prolonged (greater than 20 min) elevation of plasma ACTH compared to a relatively short duration after bovine CRF-A. These data suggest that bovine hypothalamus contains substance(s) which exhibits different CRF characteristics from those of ovine CRF.

Adrenocorticotropic Hormone↗

[The survey of quality of life among aging population in the rural areas of Guangdong].

In order to investigate the quality of life in 1008 cases of elderly people living in rural areas, Kaipin and Boluo counties in Guangdong Province. Data was collected by cluster stratification and random selection, 96.64% of them were independently managing their activities of daily life with 78.08% lived by themselves. In a self-evaluation questionnaire on health status, 36.31% perceived good, 52.8% moderate and 10.42% bad with 56.05% having had history of chronic illnesses. Arthritis and chronic headache, appeared to take the first and second place 38.8% showed satisfaction about the current medical condition with, 45.7% moderate and 9.1% un-satisfaction. 23.81% of them felt the degree of satisfaction to their life was good, 65.97% moderate and 9.82% poor. Since the proportion of elderly in the rural areas was big, and most elderly could manage their lives in late years because they had engaged in physical labor in the past, the general health condition was bad which led to poor quality of life. It is suggested that more medical care be provided to elderly living in the countryside to improve their quality of life.

Aged↗

Contacts of general practitioners with illegal immigrants.

AIMS: Violence and economic hardship cause many people to go to industrialized countries, often without obtaining a residence permit. The aim of this study is to gain insight into the factors that determine the occurrence of contacts in primary health care with such illegal immigrants. METHODS: Data were analysed on contacts with illegal immigrants from a national survey among Dutch general practitioners (GPs) (n = 1,148; response: 62%). RESULTS: GPs reported that they have on average 0.74 patient contacts with an illegal immigrant per week (95% CI: 0.56-0.92). This probably includes some over-reporting. Contacts are more likely in practices and communities that comprise more non-Dutch-born people and more (patients with) typically urban health problems. Working experience and demography of the GP are not independently associated with the occurrence of contacts. CONCLUSIONS: Contacts of Dutch GPs with illegal immigrants mostly occur in the deprived areas of the big cities.

Adult↗

[Evaluation of the prevalence of osteoporosis in a population of women living in Krakow based on densitometric measurements of the forearm].

Osteoporosis is considered a civilization disease, affecting populations living in big cities. It is detected in 10 percent of population and in 30 percent women over fifty. We tried to estimate prevalence of osteoporosis in people living in Kraków. For estimation purposes, 1000 people living in Kraków more than 40 years were chosen. 325 persons came to our Department for examination, 232 of which were women. All patient filled a special questionnaire on pathological changes in skeletal system and risk factor of osteoporosis. Densitometric measurements of nondominant forearm using Osteometer DTX 100 were performed in all patients. For osteoporosis criteria level of T-score less than -2.5 was taken. Because of lack of Polish reference data for densitometric measurements our data were compared to WHO data, concerning prevalence of osteoporosis in white women. Compared to WHO data, a higher frequency of osteoporosis was found in women living in Kraków more than 40 years.

Adult↗

Biosynthesis of human endothelins in transformants expressing cDNAs for human prepro-endothelins.

To understand the biosynthesis of the human ET family, three kinds of cloned cDNA for human prepro-endothelin-1 (prepro-ET-1), prepro-ET-2, and prepro-ET-3 were stably expressed in Chinese hamster ovary cells (CHO-K1). Immunoreactive (ir-) ET polypeptides in the culture media of the transformants were purified by reverse-phase high-performance liquid chromatography (HPLC) coupled with sandwich-type enzyme immunoassay (EIA). Amino acid sequencing and FAB mass spectrometry of the purified ir-ET polypeptides revealed the presence of human big ET-1 (1-38), big ET-2 (1-38), and big ET-3 (1-41)NH2 as intermediate forms. These results directly revealed the biosynthetic pathways of three human ETs at the peptide level.

Amino Acid Sequence↗

Two-point water-fat imaging with partially-opposed-phase (POP) acquisition: an asymmetric Dixon method.

A novel two-point water-fat imaging method is introduced. In addition to the in-phase acquisition, water and fat magnetization vectors are sampled at partially-opposed-phase (POP) rather than exactly antiparallel as in the original Dixon method. This asymmetric sampling encodes more valuable phase information for identifying water and fat. From the magnitudes of the two complex images, a big and a small chemical component are first robustly obtained pixel by pixel and then used to form two possible error phasor candidates. The true error phasor is extracted from the two error phasor candidates through a simple procedure of regional iterative phasor extraction (RIPE). Finally, least-squares solutions of water and fat are obtained after the extracted error phasor is smoothed and removed from the complex images. For noise behavior, the effective number of signal averages NSA* is typically in the range of 1.87-1.96, very close to the maximum possible value of 2. Compared to earlier approaches, the proposed method is more efficient in data acquisition and straightforward in processing, and the final results are more robust. At both 1.5T and 0.3T, well separated and identified in vivo water and fat images covering a broad range of anatomical regions have been obtained, supporting the clinical utility of the method.

Adipose Tissue↗

Nascent microglia in the developing brain.

Nascent microglia cells in the developing brain were studied by morphological, cytochemical, and autoradiographic methods. These cells are a well differentiated population, characterized by the presence of an activated nucleus, numerous ribosomes, a well developed Golgi system and associated structures including clear vesicles, dense granules, and membrane-bound polymorphous structures. Big clear vacuoles in the cytoplasm are a constant feature; filaments and microtubules are found in variable numbers. Finger-like projections and invaginations of the plasma membrane are usually found. The identification of these cells with the classical microglial cells stained by Rio Hortega's method was made by reconstruction of 20 cells using serial sections. These cells show strong NADPH dehydrogenase, ATPase, and acid phosphatase activities, in addition to nonspecific esterase activity which is inhibited by sodium fluoride. Transfusion of labeled bone marrow cells from a donor showed labeled cells only in those areas in which nascent microglia cells are more abundant. Taken together, these data suggest an exogenous, most probably monocytic, origin of nascent microglia. New studies with membrane markers are, however, needed for providing better characterization of these cells.

Animals↗

Reactive microglia in the developing brain.

Reactive microglia in the developing brain after stab wound was studied by morphological, cytochemical, and autoradiographic methods. Morphologically, early reactive cells are of the "M" cell type (Matthews 1974). They show an activated nucleus, cytoplasm rich in ribosomes with wide Golgi complex and variable numbers of lipid inclusions. Big clear vacuoles are found in many of these cells. Microtubules not associated with centrioles and filaments may or may not be present. Junctional complexes of the zonula or puncta adherentia types are occasionally found. Strong NADPH dehydrogenase, weak NADH dehydrogenase, strong ATPase, and strong acid phosphatase, in addition to nonspecific esterase activities were demonstrated in many reactive cells. Intravenous infusion of labelled bone marrow cells from a donor showed labelled macrophages and labelled perivascular cells at the site of injury. Intracerebral injection of a small dose of tritiated thymidine at the time of injury resulted in the appearance of labelled macrophages in the following days. These data suggest that many of the reactive cells have an exogenous, more probably monocytic, origin; but a certain amount of endogenous cells also act as macrophages in brain injuries.

Animals↗

Multihospital system membership and patient treatments, expenditures, and outcomes.

OBJECTIVE: To determine the relationship between hospital membership in systems and the treatments, expenditures, and outcomes of patients. DATA SOURCES: The Medicare Provider Analysis and Review dataset, for data on Medicare patients admitted to general medical-surgical hospitals between 1985 and 1998 with a diagnosis of acute myocardial infarction (AMI); the American Hospital Association Annual Survey, for data on hospitals. STUDY DESIGN: A multivariate regression analysis. An observation is a fee-for-service Medicare AMI patient admitted to a study hospital. Dependent variables include patient transfers, catheterizations, angioplasties or bypass surgeries, 90-day mortality, and Medicare expenditures. Independent variables include system participation, other admission hospital and patient traits, and hospital and year fixed effects. The five-part system definition incorporates the size and location of the index admission hospital and the size and distance of its partners. PRINCIPAL FINDINGS: While the effects of multihospital system membership on patients are in general limited, patients initially admitted to small rural system hospitals that have big partners within 100 miles experience lower mortality rates than patients initially admitted to independent hospitals. Regression results show that to the extent system hospital patients experience differences in treatments and outcomes relative to patients of independent hospitals, these differences remain even after controlling for the admission hospital's capacity to provide cardiac services. CONCLUSIONS: Multihospital system participation may affect AMI patient treatment and outcomes through factors other than cardiac service offerings. Additional investigation into the nature of these factors is warranted.

Aged↗

Radioimmunoassay of endothelin in human plasma.

A specific and sensitive radioimmunoassay (RIA) for determination of endothelin-1 (ET-1) in human plasma has been developed. Antibodies were raised in rabbits using synthetic ET-1 conjugated to thyroglobulin as immunogen. The antibodies obtained were used at a final dilution of 1:300,000 yielding maximum binding of 61.7 +/- 3.0% (mean +/- 1 SD, n = 20) of 125I-ET-1. The ID50 (inhibitory dose 50%) was 4.5 +/- 0.6 fmol/100 microliters (mean +/- 1 SD, n = 20). The sensitivity of the RIA was 0.33 fmol/100 microliters standard solution. No cross reactivity was observed with endothelin-3, big-endothelin-1, atrial natriuretic factor, angiotensin I or angiotensin II. The cross-reactivity with endothelin-2 was 100%. Endothelin was extracted from acidified plasma with Sep-pak C18 cartridges and recovery of ET-1 added to normal plasma was 70.9 +/- 10.3% (mean +/- 1 SD, n = 12). The concentration of ET-1 in plasma from normal subjects was 1.5 +/- 0.4 pmol/l (mean +/- 1 SD, n = 11) ranging from 1.0 to 2.2 pmol/1. Extracts of normal human plasma subjected to high performance liquid chromatography on a reverse phase C18 column showed one peak of immunoreactivity co-eluting with the standard for ET-1. From these data it is concluded that the immunoreactive material measured in normal plasma with the present RIA is identical to ET-1.

Animals↗