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RNA quality and gene expression analysis of ovarian tumor tissue undergoing repeated thaw-freezing.

Gene expression profiles evaluated by microarray-based quantization of RNA are used in studies of differential diagnosis and prognosis in cancer. RNA of good quality is mandatory for this evaluation. The RNA most often comes from tumor banks with limited amount of tissue, and the tissue often undergoes repeated thawing and freezing. We evaluated the influence of repeated division of tumor samples at room temperature, on RNA quality and quantity, in addition to the gene expression profile. Sixteen ovarian tumor samples were divided in three aliquots each, undergoing respectively one, two, and three thaw-freeze cycles. RNA from each aliquot was extracted on the day of division, and quantity and quality were evaluated. RNA from all three aliquots of four tumor samples underwent microarray analysis on Affymetrix Human Genome U133A 2.0 arrays. Microarray data were evaluated using both unsupervised, and supervised multivariate statistical methods, reliability analysis, as well as verification using published gene lists in ovarian cancer studies. RNA quality and quantity did not change during the division procedure and microarray data showed insignificant difference in gene expression. Tumor samples from tumor banks can be frozen and thawed at least three times without compromising the RNA integrity and genetic expression profile.

Cryopreservation↗

Sleepiness and driving: the experience of U.K. car drivers.

This paper presents the results of a postal questionnaire survey of just over 4600 male drivers aimed at exploring the relationship between accidents and daytime sleepiness. Drivers in this survey provided details of the accidents they had experienced in the last 3 years, and identified those factors they thought had contributed to their accidents. In addition to the normal demographic and exposure variables, drivers completed the Epworth scale measuring daytime sleepiness. Drivers also reported whether they had felt close to falling asleep whilst driving during the past 12 months and whether the car they drove most was privately or company owned. The analysis of this data has identified the characteristics of tiredness-related accidents. The probability of feeling close to falling asleep at the wheel has been related to demographic variables and the Epworth score using a logistic model. Drivers reported that ca 7% of accident involvements were associated with tiredness (ca 9-10% of accidents). The accident liability of the drivers has been evaluated using a multivariate statistical model; for some drivers, accident liability is shown to be sensitive to daytime sleepiness.

Accidents, Traffic↗

Association of cancer prevention-related nutrition knowledge, beliefs, and attitudes to cancer prevention dietary behavior.

OBJECTIVE: To examine the relationship of cancer prevention-related nutrition knowledge, beliefs, and attitudes to cancer prevention dietary behavior. SUBJECTS/SETTING: Noninstitutionalized US adults aged 18 years and older. METHODS: Data collected in the 1992 National Health Interview Survey Cancer Epidemiology Supplement were analyzed. The supplement included questions to ascertain knowledge, beliefs, and attitudes and a food frequency questionnaire to ascertain nutrient intake. STATISTICS: Multivariate linear regression modeling was conducted to assess the hypothesized relationships. RESULTS: After adjustment for relevant covariates (age, sex, education, total energy, perceived barriers to eating a more healthful diet), knowledge and belief constructs were predictive of dietary behavior. Specifically, fat, fiber, and fruit and vegetable intakes more closely approximated dietary recommendations for persons with more cancer-prevention knowledge. The strength of the associations between these constructs and dietary behavior varied in some cases according to level of education and perceived barriers to eating a healthful diet. Of the perceived barriers to eating a healthful diet, perceived ease of eating a healthful diet was most strongly and consistently predictive of intake. CONCLUSIONS: Research findings challenge dietetics practitioners to design diet- and health-promotion programs and activities that not only educate the public about the importance of diet to health, but also address barriers to dietary change.

Adult↗

Risk factors for coronary artery disease in families of young men with myocardial infarction.

Familial clustering of coronary artery disease (CAD) and familial influences on various clinical and metabolic risk factors were investigated in 85 male survivors of acute myocardial infarction younger than 45 years. The study also involved 85 age-matched men randomly selected from the general population and the first-degree relatives of both patients and control subjects. Presence of CAD was assessed by an angina questionnaire and from rest and exercise electrocardiograms. There was an apparent aggregation of premature CAD in 38% of the case families. A familial clustering of hyperlipoproteinemia was present in 58% of the case families and 15% of the control families. Systemic hypertension and cigarette smoking also were clustered in the case families. Multivariate statistical analyses of clinical and metabolic risk indicators in patients with and without a family history of CAD and in control subjects indicated that familial aggregation of CAD is independently related to MI at a young age. Degree and extent of coronary atheromatosis and number and severity of hemodynamically significant stenoses did not differ between young patients with and without a familial aggregation of CAD. The absence of a relation between the family history and severity of CAD implies that other underlying mechanisms are involved.

Adult↗

Comparison of the classification ability of the electrocardiogram and vectorcardiogram.

Controversy exists over the classification ability of the standard 12-lead electrocardiogram (EGG) and the vectorcardiogram (VCG). In this study the diagnostic information content and classification performance of the ECG and VCG were examined using multivariate statistical techniques and a large validated data base of 3,266 cases. Logistic classification models were developed to differentiate between 7 diagnostic entities: normal (n = 538), left (n = 557), right (n = 323) and biventricular (n = 437) hypertrophy, and anterior (n = 390), inferior (n = 657) and combined (n = 364) myocardial infarction. The models were obtained from a learning sample (n = 2,446) using an optimal set of computer derived ECG and VCG measurements. They were subsequently applied to a test sample (n = 820). In the learning sample, the discrimination models resulted in a total correct classification rate of 69.6% for the ECG and 69.4% for the VCG. The total accuracy rate was slightly lower in the test set: 66.3% for the ECG and 67.1% for the VCG. The combined use of the best ECG and VCG variables did not increase total diagnostic accuracy. When cases with biventricular hypertrophy and combined infarction were deleted, accuracy rates of more than 80% were achieved for both lead systems. Differences in the classification rates for the subgroups were not statistically significant. Thus, the conventional 12-lead ECG is as good as the VCG for the differential diagnosis of 7 main entities, provided identical procedures are used in the design of the classifiers.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomegaly↗

Does the chronic fatigue syndrome involve the autonomic nervous system?

PURPOSE: To investigate the role of the autonomic nervous system in the symptoms of patients with chronic fatigue syndrome (CFS) and delineate the pathogenesis of the orthostatic Intolerance and predisposition to neurally mediated syncope reported in this patient group. PATIENTS AND METHODS: Twenty-three CFS patients and controls performed a battery of autonomic function tests. The CFS patients completed questionnaires pertaining to autonomic and CFS symptoms, their level of physical activity, and premorbid and coexisting psychiatric disorders. The relationship between autonomic test results, cardiovascular deconditioning, and psychiatric disorders was examined with multivariate statistics and the evidence that autonomic changes seen in CFS might be secondary to a postviral, idiopathic autonomic neuropathy was explored. RESULTS: The CFS subjects had a significant increase in baseline (P < 0.01) and maximum heart rate (HR) on standing and tilting (both P < 0.0001). Tests of parasympathetic nervous system function (the expiratory inspiratory ratio, P < 0.005; maximum minus minimum HR difference, P < 0.05), were significantly less in the CFS group as were measures of sympathetic nervous system function (systolic blood pressure decrease with tilting, P < 0.01; diastolic blood pressure decrease with tilting, P < 0.05; and the systolic blood pressure decrease during phase II of a Valsalva maneuver, P < 0.05). Twenty-five percent of CFS subjects had a positive tilt table test. The physical activity index was a significant predictor of autonomic test results (resting, sitting, standing, and tilted HR, P < 0.05 to P < 0.009); and the blood pressure decrease in phase II of the Valvalsa maneuver, P < 0.05) whereas premorbid and coexistent psychiatric conditions were not. The onset of autonomic symptoms occurred within 4 weeks of a viral infection in 46% of patients-a temporal pattern that is consistent with a postviral, idiopathic autonomic neuropathy. CONCLUSION: Patients with CFS show alterations in measures of sympathetic and parasympathetic nervous system function. These results, which provide the physiological basis for the orthostatic intolerance and other symptoms of autonomic function in this patient group, may be explained by cardiovascular deconditioning, a postviral idiopathic autonomic neuropathy, or both.

Adult↗

The presence or absence of fetal breathing movements as a predictor of outcome in preterm labor.

The presence or absence of fetal breathing movements may be helpful in differentiating between true and false preterm labor. We attempted to demonstrate the clinical utility of this simple ultrasonic observation in predicting short-term delivery outcome during suspected preterm labor. A total of 50 pregnancies between 26 and 34 weeks' gestation with presumed preterm labor were observed in a prospective manner. During 20 minutes of observation with real-time ultrasound at the time of admission, fetal breathing movements were observed in 33 patients and considered absent in the remaining 17 patients. In those pregnancies with absent fetal breathing movements, true labor with subsequent delivery occurred in 16 patients. Of the 33 pregnancies with fetal breathing movements present, 29 continued for greater than 48 hours. It appears that the absence of fetal breathing movement is a reliable indicator of imminent preterm delivery, irrespective of fetal membrane status (p less than 0.0001). The observed mean sensitivity and specificity of this phenomenon in predicting short-term delivery outcome are 96.6% +/- 3.3% (mean +/- SD) and 80.0% +/- 8.9%, respectively. A multivariant statistical model based on the frequency of contractions, white blood cell counts, initial cervical examination results, and premature rupture of membranes could successfully predict delivery outcome in 40% to 75% of cases. The addition of fetal breathing movement analysis to the model allowed for the correct prediction of outcome in 90% of the cases.

Delivery, Obstetric↗

Prediction of mandibular growth rotation evaluated from a longitudinal implant sample.

The aim of this study was to estimate the possibility of predicting the direction and the amount of growth rotation of the mandible on the basis of morphologic criteria observed on a single profile radiograph at pubertal age. The difficulty in such an analysis is due to the fact that the actual growth rotation cannot be evaluated from radiographs by measurements at outer bony contours subjected to remodeling. The sample consisted of twenty-one persons in whom the actual mandibular growth rotation was determined from metallic implants over a 6-year period at around the time of puberty. Morphologic features from the first profile radiograph could therefore be compared with the observed growth changes over the study period and their predicting values calculated. A total of forty-four morphologic variables were employed and the data were analyzed by multivariate statistical methods. For each person, the variables which, alone and in combination, showed the highest predictive value with respect to total mandibular growth rotation are specified. The four variables which, in combination, gave the best prognostic estimate (86%) of mandibular growth rotation in this sample are (1) mandibular inclination, represented by three alternatives--(a) Index I (proportion between posterior and anterior facial height, (b) lower gonial angle (GOL), (c) inclination of lower border (NSL-ML1); (2) intermolar angle (MOLs-MOLi); (3) shape of lower border (ML1-ML2); and (4) inclination of symphysis (CTL-NSL). The statistical analysis was based on a sample of extreme cases. In children with a more normal growth pattern, these features may be less developed. The concordance between the predicted and the observed growth changes is illustrated graphically for each person.

Adolescent↗

Tall cell papillary thyroid cancer: incidence and prognosis.

BACKGROUND: The tall cell variant (TCV) of papillary thyroid cancer is reported to have a poor prognosis. This study examines the incidence and end result of surgical treatment of TCV. METHODS: In this study, 240 thyroid cancers treated over a 23-year period at two hospital centers are reviewed. A total of 153 patients with papillary cancer were available for follow-up. All microscopic slides were re-examined. RESULTS: Of the total 183 papillary cancers, 19 (10.4%) were TCV. The remainder were usual papillary or other papillary cancer variants. Patient age, tumor size, lymph node and soft-tissue involvement, recurrence, and death rates were evaluated. Multivariate statistical analysis disclosed that TCV histology, as well as age and tumor size, were significant predictors of recurrence. CONCLUSION: Despite a high rate of recurrence in TCV cases over age 50 (6/9), there were no recurrent TCVs in cases under age 50 (0/8). Pathologists and surgeons must develop an increased awareness of this entity and implications for more radical treatment in the older age group.

Adult↗

Algorithm for assessing renal dysfunction risk in critically ill trauma patients receiving aminoglycosides.

A recent retrospective study proposed that the following screening criteria be used in identifying critically ill trauma patients receiving aminoglycosides who are at significant risk to develop renal dysfunction: (1) post-admission shock, (2) minimum serum concentration more than 2 mg/L, and (3) diagnosis of septicemia. The major purpose of the present study was to validate these criteria and design a corresponding algorithm for clinical use. All patients admitted to a trauma intensive care unit and receiving an aminoglycosides was also studied. All patients studied over a 7-month period. A control group not receiving aminoglycosides was also studied. All patients were evaluated for the presence of renal dysfunction (i.e., serum creatinine increase greater than or equal to 0.5 mg/dL). Univariate and multivariate statistical analyses were used to compare potential associated risk factors. The overall renal dysfunction incidence was 10% in the treatment patients (n = 93) versus 5% in the control patients (n = 199) (p = 0.13). Sensitivity and specificity of the screening criteria were 67% and 92%, respectively. The predictive values of a positive and negative test relative to correctly labeling patients at high risk or low risk to develop renal dysfunction were 46% and 96%, respectively. Major risk factors associated with renal dysfunction in the treatment group were post-admission shock, minimum serum concentration more than 2 mg/L, and liver dysfunction. Use of three major risk factors has excellent predictive value in identifying severely traumatized patients at low risk for developing renal dysfunction while receiving aminoglycosides. The modest predictive value of a positive test results in conservative management of patients by avoidance of aminoglycosides, i.e., use of alternative antimicrobial agents.

Acute Kidney Injury↗

[Intensive care unit hospitalization after colorectal surgery].

OBJECTIVE: Intensive care units (ICU) support critically ill patients during the perioperative period. Few studies exist focusing on ICU hospitalisation after colorectal surgery. The objective of the study was to 1) detect predictive factors of mortality and length of stay in ICU after colorectal procedures, and 2) compare the autonomy status of the patients before and 30 days after their ICU stay. PATIENTS AND METHODS: This study followed a prospective non randomized cohort in our colorectal surgery unit. During a period of one year (January 1st to December 31th, 2000) 351 colorectal procedures were performed and 54 patients were admitted to ICU after surgery. For each patient, 37 parameters were collected on a standardized register. Predictive factors of mortality (30 days after the procedure) and ICU stay (up to 3 days) were studied by univariate and multivariate statistical analysis. Self autonomy before surgery and 30 days after was also investigated. RESULTS: "Multiple-intervention" was the only independent factor influencing mortality. Both "low autonomy status before surgery" and "pulmonary comorbidity" increased the length of stay. Regarding the 48 survivors, 45 (94%) recovered the same autonomy index as in the preoperative period 30 days after the procedure. CONCLUSION: This study highlights the poor predictive factors influencing mortality during or after ICU stay following colorectal surgery, and emphasizes two preoperative parameters increasing the length of stay up to 3 days. This should guide the informations given to the patients families. Finally, this study confirms the good quality of self-sufficiency after ICU stay even for a long time (over 3 days).

Adult↗

Prediction of walking function in stroke patients with initial lower extremity paralysis: the Copenhagen Stroke Study.

OBJECTIVES: The majority of stroke patients with initial leg paralysis do not regain independent walking. We characterize the minority who, despite initial leg paralysis, regained independent walking. DESIGN: Consecutive and community based. SETTING: A stroke unit receiving all stroke patients from a well-defined community. PATIENTS: A total of 859 acute stroke patients; 157 (15%) initially had leg paralysis. MAIN OUTCOME MEASURES: Scandinavian Stroke Scale (SSS) and Barthel index (BI) on admission and weekly during rehabilitation. Univariate and multivariate statistics were considered. RESULTS: Of the 157 patients with initial leg paralysis, 84 (60%) died; 73 (40%) survived. Fifteen (21%) survivors regained walking function (the walking group), and 58 (79%) did not (the nonwalking group). The BI on admission was the only factor of significant predictive value (p < .03). Mean admission BI was 50 in the walking group versus 3 in the nonwalking group (p < .001). Age, gender, lesion size, total SSS score, and comorbidity had no predictive value. Within the first week, the walking group gained 3.2 points in the SSS subscore for leg strength versus 0.5 points in the nonwalking group (p < .02). CONCLUSION: Only 10% of stroke patients with initial leg paralysis regained independent walking. In these patients, BI on admission was high and leg strength improved quickly in the first week.

Aged↗

The P3 auditory event-related brain potential indexes major personality traits.

BACKGROUND: The amplitude of the auditory P3 event-related potential is reduced in patients with axes I and II disorders. Data regarding P3 amplitude and normal personality traits in healthy individuals have been inconsistent, however, although more extreme variants of dimensional traits such as neuroticism and extraversion are associated with psychiatric morbidity. METHODS: Male subjects (n = 18) recruited from the community completed the NEO Five-Factor Inventory, which consists of five scales: Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness. P3 potentials were generated using an auditory discrimination paradigm to which a third, novel stimulus was added. Partial least squares analysis, a multivariate statistical procedure, was used to test the relationship, in both stimulus conditions, between P3 amplitude at six electrode sites and the five personality dimensions. RESULTS: P3 amplitude across conditions and sites was positively related to Extraversion, Openness, Agreeableness, and Conscientiousness and negatively related to Neuroticism. CONCLUSIONS: Previous studies have shown that both reduced P3 amplitude and a high Neuroticism/low Extraversion-Openness-Agreeableness-Conscientiousness trait pattern are associated with the presence of, and risk for, substantial psychiatric morbidity. Our results suggest that processes indexed by auditory P3 amplitude are related to these broad personality dimensions in healthy individuals.

Adult↗

Variations of the three-dimensional structure of the Escherichia coli ribosome in the range of overlap views. An application of the methods of multicone and local single-cone three-dimensional reconstruction.

Electron microscopic techniques are among the most important tools for obtaining structural information of biological specimens. However, the three-dimensional (3D) structural analysis of asymmetrical specimens that do not form crystalline sheets has traditionally presented serious methodological obstacles to its accomplishment. One of the fundamental questions to be addressed in this type of structural study is in what way, and to what degree, does the 3D structural conformation depend on the orientation of the specimen with respect to the electron microscopic support films. As a step in studying this problem, we have analyzed the variations of the 3D structure of the Escherichia coli 70S monosome by performing four different 3D reconstructions of the 70S monosome from subsets of images in the so-called overlap range of views. These subsets were selected according to a multivariate statistical analysis performed on the total population of overlap-range specimen images. A certain amount of structural variability exists among the 3D reconstructions, although many of the main morphological characteristics, as the relative orientation between the ribosomal subunits, remain unchanged. We have also generalized the random conical reconstruction technique (Radermacher, M., T. Wagenknecht, A. Verschoor, and J. Frank. 1987. J. Microsc. 146: 113-136) to include those cases where the specimen exhibits a rocking behavior with respect to the support. The resulting Multicone Reconstruction Technique has been applied to computer-generated images as well as the E. coli 70S monosome images from part of the overlap range of views.

Analysis of Variance↗

Increase in plasma levels of secretory type II phospholipase A(2) in patients with coronary spastic angina.

OBJECTIVE: Plasma levels of sPLA(2) were increased in various chronic inflammatory diseases including coronary artery disease. Lipid products mediated through PLA(2) have been shown to induce impairment of endothelium-dependent dilation, contraction of smooth muscle and proliferation of smooth muscle cells, all of which might lead to coronary spasm. Thus, this study investigated whether plasma levels of secretory non-pancreatic type II phospholipase A(2) (sPLA(2)) may be increased in patients with coronary spastic angina, considering the possible link of sPLA(2) with pathogenesis of coronary artery spasm. METHODS: Plasma levels of sPLA(2) in peripheral circulation, in coronary sinus and in aortic root were measured in 57 patients with coronary spastic angina, 46 patients with stable effort angina and 53 control patients by radioimmunoassay. RESULTS: The peripheral plasma levels of sPLA(2) were increased in patients with coronary spastic angina compared with control patients. In multivariate statistical analysis, the increase in sPLA(2) levels was a significant risk for the presence of coronary spasm independent of other risk factors including C-reactive protein levels. The coronary sinus-arterial difference of plasma sPLA(2) levels, reflecting sPLA(2) released into the coronary circulation, was increased during coronary spasm induced by the intracoronary infusion of acetylcholine in patients with coronary spastic angina, but it remained unchanged both during the acetylcholine infusion and during myocardial ischemia provoked by rapid atrial pacing in patients with stable effort angina and in control patients. CONCLUSION: The increase in peripheral plasma levels of sPLA(2) is a significant risk factor for the presence of coronary spasm and it may possibly reflect inflammatory activity in spasm coronary arteries.

Acetylcholine↗

Earthworm species of the genus Eisenia can be phenotypically differentiated by metabolic profiling.

The universality of low molecular weight metabolites allows rapid and straightforward investigation of the biochemistry of genetically uncharacterised species. Thus ex vivo metabolic profiling in combination with multivariate data analysis (metabonomics) offers great potential in comparative biology. Here we present the first use of high resolution nuclear magnetic resonance (NMR) spectroscopy to distinguish closely related animal species via their metabolic phenotype (metabotype). We have profiled the three Eisenia (Oligochaeta, Lumbricidae) species Eisenia fetida, Eisenia andrei and Eisenia veneta using tissue extracts and coelomic fluid analysis. The low molecular weight biochemical profiles of tissue extracts were highly conserved for all three species, with E. fetida and E. andrei being more similar to each other than to E. veneta. However the metabolic profiles of the coelomic fluid of the different species were highly distinctive - the NMR spectra allowed unequivocal identification of species. Multivariate statistics were also used to quantify these spectral differences and to enable simplified graphical visualisation of species similarity. These results show that two morphologically undistinguishable species (E. fetida and E. andrei) differ markedly in their biochemical profiles despite apparently occupying the same ecological niche, and indicate that metabolic phenotype profiling can be used as a powerful functional genomics tool.

Animals↗

Mapping flexible protein domains at subnanometer resolution with the atomic force microscope.

The mapping of flexible protein domains with the atomic force microscope is reviewed. Examples discussed are the bacteriorhodopsin from Halobacterium salinarum, the head-tail-connector from phage phi29, and the hexagonally packed intermediate layer from Deinococcus radiodurans which all were recorded in physiological buffer solution. All three proteins undergo reversible structural changes that are reflected in standard deviation maps calculated from aligned topographs of individual protein complexes. Depending on the lateral resolution (up to 0.8 nm) flexible surface regions can ultimately be correlated with individual polypeptide loops. In addition, multivariate statistical classification revealed the major conformations of the protein surface.

Bacterial Proteins↗

Role of laparoscopic salpingostomy in the treatment of hydrosalpinx.

OBJECTIVE: To determine pregnancy rates after laparoscopic salpingostomy in occlusive distal tubal disease. To evaluate the relative impact of various historical, physical, and operative factors on pregnancy outcome using a multivariate statistical analysis. DESIGN: Prospective cohort. SETTING: University-affiliated tertiary care infertility clinic. PATIENT(S): One hundred thirty-nine infertile women with occlusive distal tube disease. INTERVENTION(S): Laparoscopic salpingostomy. MAIN OUTCOME MEASURE(S): The occurrence of intrauterine (IUP) and ectopic pregnancy (EP). RESULT(S): The overall IUP and EP rates were 24.5% and 16.5%, respectively. Analysis of historical variables, assessed independently, demonstrated a significantly higher IUP rate with a positive history of gonorrhea and a significantly higher EP rate with a positive history of pelvic inflammatory disease, lack of history of intrauterine device (IUD) usage, or the performance of a bilateral procedure. The logistic regression model to predict intrauterine pregnancy had an overall predictive value of 77.5% and included the following significant variables: secondary infertility, positive history of gonorrhea, and the operative finding of moderate periadnexal adhesions. The logistic regression model to predict ectopic pregnancy had an overall predictive value of 89.0% and included the following significant variables: previous ectopic pregnancy, negative history of IUD use, positive history of PID, a bilateral procedure, and perihepatic adhesions. CONCLUSION(S): Operative laparoscopy may be effective for the correction of hydrosalpinges in selected patients. The probability of achieving an intrauterine or an ectopic pregnancy can be predicted based on combinations of significant variables.

Adult↗