Analysis of penicillin-binding protein lb and 2a genes from Streptococcus pneumoniae

Fifty clinical isolates (penicillin MICs, 0.03-8 microg/mL) of Streptococcus pneumoniae were randomly selected from hospitals throughout South Africa, together with seven strains isolated in Hungary (penicillin MICs, 16-32 microg/mL). Penicillin-binding protein (pbp) 1b and 2a genes were amplified by PCR, and the purified DNA was digested with HinfI, StyI, and MseI + DdeI restriction enzymes. The fragments were radioactively end-labeled and separated on polyacrylamide gels, and the DNA fingerprints were visualized following autoradiography. A collection of isolates was further selected for sequence analysis of pbp1b and 2a. DNA fingerprint analysis revealed a uniform profile amongst all isolates for both genes. All isolates revealed a maximum of only seven nucleotide substitutions in their pbp1b genes, resulting in a maximum of three amino acid substitutions in PBP 1B. In the case of the pbp2a gene, up to 13 nucleotide substitutions were observed randomly distributed amongst penicillin-susceptible and resistant isolates, revealing a maximum of five amino acid substitutions in PBP 2A. No amino acid substitutions were found to be common amongst all penicillin-resistant isolates. Transformation experiments with pbp1b and 2a genes isolated from two resistant strains (MICs, 4 and 16 microg/mL) failed to transform pneumococcal strains to increased levels of penicillin resistance. These results show that the pbp1b and 2a genes examined here do not display the typical mosaic gene patterns observed in the pbp2x, 2b, and 1a genes of penicillin-resistant pneumococci. In addition, the transformation studies suggest that PBPs 1B and 2A may not play a role in the development of penicillin resistance in some pneumococci.

A preliminary analysis of psychophysiological variables and nursing performance in situations of increasing criticality

OBJECTIVE

To examine the relationship between psychological, physiological, and performance variables in intensive care unit (ICU) nurses in situations of increasing criticality.

SUBJECTS AND METHODS

Psychophysiological variables and endotracheal suctioning performance were examined in a classroom, a skills laboratory, and an ICU. Situation-specific anxiety (state anxiety) and the predisposition to view situations as threatening (trait anxiety), cognitive appraisal, and heart rate were measured and compared with self-appraisal and a nurse instructor's ratings of suctioning performance. Baseline data were obtained during class on 45 novice ICU nurses.

RESULTS

Twenty-six nurses provided complete data, which included being videotaped and monitored in the classroom, in the skills laboratory performing endotracheal suctioning, and in the ICU during suctioning. High state anxiety significantly predicted poor ICU suctioning performance (P<.04). Nurses high in state and trait anxiety, worry, and heart rate performed poorly compared with less anxious nurses. Nurses in this study who performed best had a mean heart rate of 94 beats/min.

CONCLUSION

Those nurses who are high state anxious, high trait anxious, and worried and who had a faster heart rate performed less well than their more relaxed peers. Nurses with high state anxiety may be at risk for attrition, burnout, medical errors, and poor performance in other ICU nursing tasks.

Cross-reactivity studies of a new group 2 allergen from the dust mite Glycyphagus domesticus, Gly d 2, and group 2 allergens from Dermatophagoides pteronyssinus, Lepidoglyphus destructor, and Tyrophagus putrescentiae with recombinant allergens

BACKGROUND

Dust mites are important inducers of allergic disease. Group 2 allergens are recognized as major allergens in several mite species, including Dermatophagoides pteronyssinus, Lepidoglyphus destructor, and Tyrophagus putrescentiae. No allergens have thus far been characterized on the molecular level from the dust mite Glycyphagus domesticus.

OBJECTIVE

We sought to examine the cross-reactivity among group 2 allergens of G domesticus, L destructor, T putrescentiae, and D pteronyssinus.

METHODS

A group 2 allergen from G domesticus, Gly d 2, was cloned and expressed as a recombinant protein. Cross-reactivity between Gly d 2 and 3 other group 2 allergens, Lep d 2, Tyr p 2, and Der p 2, was studied by using individual sera and a serum pool RAST-positive to G domesticus, L destructor, T putrescentiae, and D pteronyssinus. Recombinant allergens were used as inhibitors of IgE binding in immunoblotting experiments. Molecular modeling on the basis of the Der p 2 structure was carried out for Gly d 2, Lep d 2, and Tyr p 2.

RESULTS

Two cDNAs encoding isoforms of Gly d 2 were isolated, but only the Gly d 2.02 isoform was used in this study. Sixteen of 17 subjects had IgE to Gly d 2. The protein sequence of Gly d 2 revealed 79% identity to Lep d 2 and 46% and 41% identity to Tyr p 2 and Der p 2, respectively. Extensive cross-reactivity was demonstrated among Gly d 2, Lep d 2, and Tyr p 2, but little cross-reactivity was found between these allergens and Der p 2. According to the tertiary structure of Der p 2 and 3-dimensional models of Gly d 2, Lep d 2, and Tyr p 2, differences reside mainly in surface-exposed residues.

CONCLUSION

Gly d 2 showed high sequence homology to Lep d 2. Cross-reactivity was observed between Gly d 2, Lep d 2, and Tyr p 2, but only limited cross-reactivity was demonstrated between these 3 allergens and Der p 2.

Hepatic perfusion parameters in chronic liver disease: dynamic CT measurements correlated with disease severity

OBJECTIVE

The aim of our study was to determine if hepatic perfusion parameters measured with CT change in relation to disease severity in patients with chronic liver disease.

SUBJECTS AND METHODS

Dynamic contrast-enhanced single-section CT scans of the liver were obtained in 40 individuals who included six control subjects, 16 patients with noncirrhotic chronic liver disease, and 18 patients with cirrhosis. Hepatic, aortic, and portal venous time-density curves were fitted to a dual-input one-compartment model to calculate the liver perfusion, arterial fraction, distribution volume, and mean transit time.

RESULTS

Liver perfusion decreased in patients with cirrhosis (67 +/- 23 mL. min(-1). 100 mL(-1) versus 108 +/- 34 mL. min(-1). 100 mL(-1) in control subjects [p = 0.009] and 98 +/- 36 mL. min(-1). 100 mL(-1) in patients with noncirrhotic chronic liver disease [p = 0.003]), and the arterial fraction and the mean transit time increased (41 +/- 27% and 51 +/- 79 sec versus 17 +/- 16% and 16 +/- 5 sec in control subjects, and 19 +/- 6% and 17 +/- 8 sec in patients with noncirrhotic chronic liver disease [p < 0.05]). A significant correlation was seen between these three perfusion parameters and the severity of chronic liver disease based on clinical and biologic data (p < 0.001). No significant change in distribution volume was observed.

CONCLUSION

Hepatic perfusion parameters measured with CT were significantly altered in cirrhosis and correlated with the severity of chronic liver disease.

Trends in frequency and susceptibilities of Candida glabrata bloodstream isolates at a university hospital

The frequency of isolation and antifungal susceptibility patterns to fluconazole and itraconazole were determined for 166 Candida glabrata isolates causing bloodstream infection at a single institution from 1995-2000. Findings demonstrated a trend of increasing resistance to itraconazole among the isolates, but no trend in resistance to fluconazole. The frequency of C. glabrata isolates among all blood culture isolates of Candida spp. causing bloodstream infection remained stable during the study period and ranged from 18-31%.

Synthesis of 4'-O-acetyl-maltose and alpha-D-galactopyranosyl-(1-->4)-D-glucopyranose for biochemical studies of amylose biosynthesis

The chemical synthesis of the title compounds as maltose analogs, in which the non-reducing end is modified by acetylation of the 4'-OH group or by reversing its configuration, is reported. For synthesis of the 4'-O-acetylated analog, beta-maltose was converted into its per-O-benzylated-4',6'-O-benzylidene derivative followed by removal of the benzylidene acetal function and selective silylation at C-6'. Acetylation at C-4' of the obtained silylated compound followed by removal of the benzyl ether protecting groups and subsequent desilylation afforded the desired analog. The other maltose analog was synthesized via the glycosidation reaction between the glycosyl donor, O-(2,3,4,6-tetra-O-benzyl-alpha/beta-D-galactopyranosyl)trichloroacetimidate and the glycosyl acceptor, phenyl 2,3,6-tri-O-benzyl-1-thio-beta-D-glucopyranoside followed by removal of the phenylthio group and debenzylation to provide the desired analog.

Determination of the thermal offset of the Eppley precision spectral pyranometer

Eppley's precision spectral pyranometer (PSP) is used in networks around the world to measure downwelling diffuse and global solar irradiance at the surface of the Earth. In recent years several studies have shown significant discrepancy between irradiances measured by pyranometers and those computed by atmospheric radiative transfer models. Pyranometer measurements have been questioned because observed diffuse irradiances sometimes are below theoretical minimum values for a pure molecular atmosphere, and at night the instruments often produce nonzero signals ranging between +5 and -10 W m(-2). We install thermistor sondes in the body of a PSP as well as on its inner dome to monitor the temperature gradients within the instrument, and we operate a pyrgeometer (PIR) instrument side by side with the PSP. We derive a relationship between the PSP output and thermal radiative exchange by the dome and the detector and a relationship between the PSP output and the PIR thermopile output (net-IR). We determine the true PSP offset by quickly capping the instrument at set time intervals. For a ventilated and shaded PSP, the thermal offset can reach -15 W m(-2) under clear skies, whereas it remains close to zero for low overcast clouds. We estimate the PSP thermal offset by two methods: (1) using the PSP temperatures and (2) using the PIR net-IR signal. The offset computed from the PSP temperatures yields a reliable estimate of the true offset (+/-1 W m(-2)). The offset computed from net-IR is consistent with the true offset at night and under overcast skies but predicts only part of the true range under clear skies.

Event-related fMRI study of response inhibition

Event-related functional magnetic resonance imaging (erfMRI) was employed to measure the hemodynamic response during a Go/No-go task in 16 healthy subjects. The task was designed so that Go and No-go events were equally probable, allowing an unbiased comparison of cerebral activity during these two types of trials. In accordance with prediction, anterior cingulate was active during both the Go and No-go trials, dorsolateral and ventrolateral prefrontal cortex was more active during the No-go trials, while primary motor cortex, supplementary motor area, pre-motor cortex and cerebellum were more active during Go trials. These findings are consistent with the hypothesis that the anterior cingulate cortex is principally engaged in making and monitoring of decisions, while dorsolateral and ventral lateral prefrontal sites play a specific role in response inhibition.

A cytosolic ADP-glucose pyrophosphorylase is a feature of graminaceous endosperms, but not of other starch-storing organs

The occurrence of an extra-plastidial isoform of ADP-glucose (Glc) pyrophosphorylase (AGPase) among starch-storing organs was investigated in two ways. First, the possibility that an extra-plastidial isoform arose during the domestication of cereals was studied by comparing the intracellular distribution of enzyme activity and protein in developing endosperm of noncultivated Hordeum species with that previously reported for cultivated barley (Hordeum vulgare). As in cultivated barley, the AGPase of H. vulgare subsp. spontaneum and Hordeum murinum endosperm is accounted for by a major extra-plastidial and a minor plastidial isoform. Second, the ratio of ADP-Glc to UDP-Glc was used as an indication of the intracellular location of the AGPase activity in a wide range of starch-synthesizing organs. The ratio is expected to be high in organs in which UDP-Glc and ADP-Glc are synthesized primarily in the cytosol, because the reactions catalyzed by AGPase and UDP-Glc pyrophosphorylase will be coupled and close to equilibrium. This study revealed that ADP-Glc contents and the ratio of ADP-Glc to UDP-Glc were higher in developing graminaceous endosperms than in any other starch-storing organs. Taken as a whole the results indicate that an extra-plastidial AGPase is important in ADP-Glc synthesis in graminaceous endosperms, but not in other starch-storing organs.

Thioether-bonded constructs of Fab'gamma and Fc gamma modules utilizing differential reduction of interchain disulfide bonds

We describe a two-stage preparation of chemically engineered Ab constructs, employing as modules Fab'gamma from mAb or rAb, and Fc from human normal IgG1. A multivalent, optionally multispecific F(ab')(n) core is formed in stage one, and one or more Fc modules added in stage two. Examples include bispecific Fab(2)Fc(2) (for simplicity, primes and Greek letters are omitted from names of final constructs) and trivalent Fab(3)Fc(2), which are designed to kill neoplastic cells. An essential element in the construction is the availability of the Fab' in two reduced forms, Fab'(-sulfhydryl (SH))(5) and Fab'-SH. The first is obtained by full reduction of the interchain disulfide bonds (SS) in the F(ab')(2) fragment of IgG. Fab'-SH is obtained by disulfide-interchange reactions on Fab'(-SH)(5), whereby the gamma-light SS is reconstituted, an unusual intrachain SS forms in the gamma-chain hinge, and one hinge SH remains. F(ab')(2) and F(ab')(3) cores are built using partially reduced modules, being given intermodular thioether links that resist reduction. These cores are then fully reduced, making available SH groups for addition of the Fcgamma modules. In the final constructs, all intermodular links embody tandem thioether bonds arising at hinge-region cysteines. Cytotoxic activities of representative constructs, and some enhancements deriving from multiple modules, are assessed. In guinea pigs, catabolism of Fab(2)Fc(2) yielded a t(1/2) similar to that of human IgG1, although the serum Fab(2)Fc(2) revealed some proteolytic breakdown not shown by the IgG1. Immunotherapy of a guinea-pig leukemia confirmed the ability of these constructs to kill target cells in vivo.

Hypergastrinemia promotes adenoma progression in the APC(Min-/+) mouse model of familial adenomatous polyposis

Serum hypergastrinemia promotes the growth of colorectal adenocarcinoma. Some colorectal adenomas express cholecystokinin B/gastrin receptor mRNA, and thus hypergastrinemia may increase progression through the adenoma-carcinoma sequence. This was investigated in the multiple intestinal neoplasia APC(Min-/+) mouse. Serum gastrin levels in APC(Min-/+) mice were elevated 5-6-fold by oral administration of omeprazole (75 mg/kg). Terminal tumor burden was monitored by onset of anemia. A labeling index was generated by immunohistochemical detection of bromodeoxyuridine incorporation. Serum gastrin was neutralized by antigastrin antibodies raised in situ by use of a gastrin immunogen, Gastrimmune. Hypergastrinemia resulted in reduced survival of the APC(Min-/+) mice from a median survival of 13 weeks in the controls to 10 weeks following omeprazole treatment (P < 0.00001, log-rank test). The labeling indices of adenomas from the small and large intestines of omeprazole-treated mice were increased 35 and 29%, respectively (P < 0.05 and P < 0.025, respectively). Gastrimmune immunization reversed both the survival effect and the increased proliferation resulting from serum hypergastrinemia. Hypergastrinemia may promote the progression of existing premalignant colonic lesions by increasing proliferation. Clinical investigations should determine whether this occurs in the human scenario, considering the widespread use of proton pump inhibitors.

A literature review of the consequences of prenatal marihuana exposure. An emerging theme of a deficiency in aspects of executive function

In spite of marihuana being the most widely used illegal drug among women of reproductive age, there is a relative paucity of literature dealing with the neurobehavioral consequences in offspring--particularly the longer-term effects. However, there is a degree of consistency in the limited data, both across cross-sectional reports and longitudinally, where offspring have been followed for a number of years. Two cohort studies fall into the latter category; one involving a low-risk sample and, the other, a high-risk sample. Global IQ is not impacted by prenatal marihuana exposure but aspects of executive function (EF)--in particular, attentional behavior and visual analysis/hypothesis testing--appear to be negatively associated with in utero cannabis exposure in children beyond the toddler stage. This hypothesized influence of prenatal marihuana on EF is examined and discussed relative to effects (or lack of effects) across different ages in the offspring, cannabinoid receptors, and the extant general marihuana and prefrontal literature.

Detection of Penicillin Resistance in Streptococcus pneumoniae by a Seminested PCR Strategy

The first appearance of clinically significant penicillin-resistant Streptococcus pneumoniae (pneumococcus) occurred in 1967 in Australia (1) and penicillin resistant and multiresistant pneumococci have subsequently spread globally and reached high prevalence in many countries (2).

Sequence polymorphisms and antibody binding to the group 2 dust mite allergens

BACKGROUND

The group 2 allergens Der p 2, Der f 2 and Eur m 2 are 14-kD proteins with > 80% sequence identity. Isoforms within each genus have been identified which differ by 3-4 amino acids. The aim of this study was to investigate the importance of these substitutions to antibody binding.

METHODS

Recombinant allergens were expressed and purified from Escherichia coli. ELISA and skin testing were used to evaluate antibody binding. Molecular modeling of the tertiary structure was preformed to examine the location of substitutions.

RESULTS

The three Der f 2 isoforms and two of three of the Der p 2 isoforms reacted with all monoclonal antibodies (mAb). Der p 2.0101, the isoform with aspartate at position 114, bound all mAb except 1D8. Substitution of asparagine for aspartate restored binding of rDer p 2.0101 to mAb 1D8 and increased the correlation coefficient for IgE binding from 0.72 to 0.77. The three Der p 2 isoforms showed comparable skin test reactivity to nDer p 2 and commercial extract. rEur m 2.0101 bound to all mAb except 7A1 and when compared with rDer p 2 for IgE binding, r(2) = of 0.58 (n = 72). Lep d 2 did not react with mAb or with Dermatophagoides spp. allergic sera. Modeling revealed that Eur m 2, Lep d 2 and Tyr p 2 retain the tertiary fold of Der p 2 and the substitutions are on the surface.

CONCLUSIONS

mAb could distinguish isoform substitutions. IgE binding showed a good correlation among all isoforms, thus the recombinant allergens are useful for diagnosis.

Event-related fMRI study of response inhibition

Event-related functional magnetic resonance imaging (erfMRI) was employed to measure the hemodynamic response during a Go/No-go task in 16 healthy subjects. The task was designed so that Go and No-go events were equally probable, allowing an unbiased comparison of cerebral activity during these two types of trials. In accordance with prediction, anterior cingulate was active during both the Go and No-go trials, dorsolateral and ventrolateral prefrontal cortex was more active during the No-go trials, while primary motor cortex, supplementary motor area, pre-motor cortex and cerebellum were more active during Go trials. These findings are consistent with the hypothesis that the anterior cingulate cortex is principally engaged in making and monitoring of decisions, while dorsolateral and ventral lateral prefrontal sites play a specific role in response inhibition.

Gastrin and gastrin receptor activation: an early event in the adenoma-carcinoma sequence

BACKGROUND AND AIMS

Gastrin and the cholecystokinin type B/gastrin receptor (CCKBR) have been shown to be expressed in colorectal adenocarcinoma. Both exogenous and autocrine gastrin have been demonstrated to stimulate growth of colorectal cancer but it is not known if gastrin affects the growth of colonic polyps. The purpose of this study was to determine if gastrin and CCKBR are expressed in human colonic polyps and to determine at which stage of progression this occurs.

METHODS

A range of human colonic polyps was assessed for gastrin and CCKBR gene and protein expression.

RESULTS

Normal colonic mucosa did not express gastrin or CCKBR. Gastrin and CCKBR reverse transcription-polymerase chain reaction products were detected and verified by specific hybridisation with an oligo probe on Southern blots. Gastrin and CCKBR were expressed in 78% and 81% of polyps, respectively. Both genes were coexpressed in 97% of cases. Immunohistochemistry identified progastrin in 91%, glycine extended gastrin 17 in 80%, and amidated gastrin 17 in only 47% of polyps. CCKBR was present in 96% of polyps. Expression of gastrin and CCKBR was seen in all histological types and sizes of polyps.

CONCLUSIONS

This study is the first to show widespread expression of both gastrin and its receptor in colorectal polyps. Their activation occurs early in the adenoma-carcinoma sequence. Gastrin may promote progression through the adenoma-carcinoma sequence.

Non-invasive quantification of liver perfusion with dynamic computed tomography and a dual-input one-compartmental model

Various liver diseases lead to significant alterations of the hepatic microcirculation. Therefore, quantification of hepatic perfusion has the potential to improve the assessment and management of liver diseases. Most methods used to quantify liver perfusion are invasive or controversial. This paper describes and validates a non-invasive method for the quantification of liver perfusion using computed tomography (CT). Dynamic single-section CT of the liver was performed after intravenous bolus administration of a low-molecular-mass iodinated contrast agent. Hepatic, aortic and portal-venous time-density curves were fitted with a dual-input one-compartmental model to calculate liver perfusion. Validation studies consisted of simultaneous measurements of hepatic perfusion with CT and with radiolabelled microspheres in rabbits at rest and after adenosine infusion. The feasibility and reproducibility of the CT method in humans was assessed by three observers in 10 patients without liver disease. In rabbits, significant correlations were observed between perfusion measurements obtained with CT and with microspheres (r=0.92 for total liver perfusion, r=0.81 for arterial perfusion and r=0.85 for portal perfusion). In patients, total liver plasma perfusion measured with CT was 112+/-28 ml.min(-1).100 ml(-1), arterial plasma perfusion was 18+/-12 ml.min(-1).100 ml(-1) and portal plasma perfusion was 93+/-31 ml.min(-1).100 ml(-1). The measurements obtained by the three observers were not significantly different from each other (P>0.1). Our results indicate that dynamic CT combined with a dual-input one-compartmental model provides a valid and reliable method for the non-invasive quantification of perfusion in the normal liver.

Phase I/II study of G17-DT, an anti-gastrin immunogen, in advanced colorectal cancer

Gastrin is a growth factor for colorectal cancer, and therefore, anti-gastrin hormone therapy has a potential role in treatment of this disease. The gastrin immunogen gastrin-17-diphtheria toxoid (G17-DT; Gastrimmune) produces anti-G17 antibodies that have been shown to be effective in the treatment of colorectal carcinoma in preclinical models. Fifty patients with advanced colorectal cancer were treated with G17-DT in a multicenter, sequential group, open label Phase I/II study. Primary injections with two booster doses were given by i.m. injection. The main aim of the study was to assess the safety and efficacy of the production of antigastrin antibodies. Locally developed and standard WHO toxicity measurements with RIA and Scatchard analysis for antibody assessment were used. One center measured tumor response radiologically. Eighty % of patients produced a measurable antibody response. Antibodies of high affinity (median Kd, 0.295 nM; interquartile range, 0.16-0.41 nM) were detected between 4 and 12 weeks after primary injection. The antigen binding capacity was high at 2.8 x 10(-9) M (interquartile range, 5.1 x 10(-10) to 7.25 x 10(-9) M). The treatment was well tolerated with no systemic side effects seen. Myalgia at the injection site was seen in 46% of patients with severe pain caused by the formation of a sterile abscess seen in 14% of patients. The abscesses were all drained under ultrasound guidance, and the patients recovered fully within 6 weeks. No radiological responses were seen, but two patients had stable disease. G17-DT immunization produces anti-G17 antibodies in patients with advanced colorectal cancer. The antibodies were of an affinity high enough to compete with the cholecystokinin B/gastrin receptor for G17 binding with adequate capacity to neutralize postprandial gastrin surges. Additional dose-ranging studies have been performed in patients with gastric cancer using 100- and 200-microg doses of G17-DT formulated without adjuvant and the emulsifier aluminum monostearate. In addition, the effect of immunizing at different time intervals has been determined.

A multidisciplinary study of the 'yips' phenomenon in golf: An exploratory analysis

BACKGROUND

The 'yips' is a psychoneuromuscular impediment affecting execution of the putting stroke in golf. Yips symptoms of jerks, tremors and freezing often occur during tournament golf and may cause performance problems. Yips-affected golfers add approximately 4.7 strokes to their scores for 18 holes of golf, and have more forearm electromyogram activity and higher competitive anxiety than nonaffected golfers in both high and low anxiety putting conditions. The aetiology of the yips is not clear.

OBJECTIVE

To determine whether the yips is a neurological problem exacerbated by anxiety, or whether the behaviour is initiated by anxiety and results in a permanent neuromuscular impediment.

METHODS

In phase I, golf professionals assisted investigators in developing a yips questionnaire that was sent to tournament players (<12 handicap) to establish the prevalence and characteristics of the yips. Phase II measured putting behaviour in scenarios that contribute to the yips response. Four self-reported yips and 3 nonaffected golfers putted 3 scenarios using an uncorrected grip and a standard length putter. Heart rate was superimposed on the videotape and the putter grip was instrumented with strain gauges to measure grip force. Electromyograms and relative putting performance were also measured.

RESULTS

The questionnaire was sent to 2,630 tournament players, of whom 1,031 (39%) responded (986 men and 45 women). Of these, 541 (52%) perceived they experienced the yips compared with 490 (48%) who did not. Yips-affected golfers reported that the most troublesome putts were 3, 4 and 2 feet (0.9, 1.2 and 0.6 metres) from the hole. Fast, downhill, left-to-right breaking putts and tournament play also elicited the yips response. Golfers affected by the yips had a faster mean heart rate, increased electromyogram activity patterns and exerted more grip force than nonrffected golfers and had a poorer putting performance.

CONCLUSIONS

For <10 handicap male golfers and <12 handicap female golfers, the prevalence of the yips is between 32.5% and 47.7%, a high proportion of serious golfers. This high prevalence suggests that medical practitioners need to understand the aetiology of the yips phenomenon so that interventions can be identified and tested for effectiveness in alleviating symptoms. Although previous investigators concluded that the yips is a neuromuscular impediment aggravated but not caused by anxiety, we believe the yips represents a continuum on which 'choking' (anxiety-related) and dystonia symptoms anchor the extremes. The aetiology may well be an interaction of psychoneuromuscular influences. Future research to test the effect of medications such as beta-blockers should assist in better identifying the contributions these factors make to the yips phenomenon.

Co-expression of the Bordetella pertussis leader peptidase I results in enhanced processing and expression of the pertussis toxin S1 subunit in Escherichia coli

Bordetella pertussis is the causative agent of whooping cough. Traditional vaccines against this disease are inherently reactogenic, thus research is currently focussed on the production of less reactive, acellular vaccines. Expression of candidate antigens for these vaccines in Escherichia coli would be preferable, however, several B. pertussis antigens undergo incorrect post-translational processing in E. coli. The leader peptidase gene (lep) of B. pertussis encodes a protein of 294 amino acid residues that shares homology with other prokaryote leader peptidase I sequences. Hydrophilicity analysis based on the predicted amino acid sequence has demonstrated a similar membrane topology to that of E. coli and Salmonella typhimurium leader peptidase I. Co-expression of the B. pertussis lep gene in E. coli strain TOPP2 expressing the pertussis toxin S1 subunit was found to markedly increase the expression and post-translational processing of the S1 protein.

Review article: gastrin and colorectal cancer

The polypeptide hormone gastrin was identified nearly a hundred years ago and its role in the regulation of acid secretion is well established. Gastrin also acts as a growth factor and is trophic for the normal gastric oxyntic mucosa. This growth promoting action has led to the extensive investigation of its role in carcinogenesis, in particular colorectal neoplasia. The relationship between gastrin and colorectal adenocarcinoma has been subject to controversy, however the findings from several recent studies have resulted in a clearer understanding of the mechanism of action of gastrin in this is common cancer. The majority of colorectal cancers produce their own gastrin, which may act in an autocrine manner. The tumour cells also express gastrin/CCKB receptors (and/or a combination of isoforms) which mediate the proliferative action. This locally produced gastrin gives rise to a small increase in systemic gastrin levels. Autocrine gastrin may also have a role in tumour development, as expression occurs early in the adenoma-carcinoma sequence. In addition, several studies using animal models have shown that systemic hypergastrinaemia promotes the proliferation of both normal and neoplastic colonic epithelium. Hyperproliferative colonic epithelium in the presence of hypergastrinaemia has been recorded in humans and a well-designed epidemiological study has demonstrated an increased incidence of colorectal cancer. Gastrin is a potential therapeutic target in the treatment of colorectal cancer and several approaches have been assessed. Receptor antagonists and antisecretory agents have been demonstrated to be ineffectual. Novel methods of inhibition, including the use of anti-gastrin antibodies, are currently being evaluated.

Recombinant allergens for diagnosis and therapy of allergic disease

Many of the problems associated with using natural allergenic products for allergy diagnosis and treatment can be overcome with use of genetically engineered recombinant allergens. Over the past 10 years, the most important allergens from mites, pollens, animal dander, insects, and foods have been cloned, sequenced, and expressed. In many cases the three-dimensional allergen structure has been determined and B-cell and T-cell epitopes have been mapped. These studies show that allergens have diverse biologic functions (they may be enzymes, enzyme inhibitors, lipocalins, or structural proteins) and that as a rule the allergen function is unrelated to its ability to cause IgE antibody responses. High-level expression systems have been developed to produce recombinant allergens in bacteria, yeast, or insect cells. Recombinant allergens show comparable IgE antibody binding to their natural counterparts (where available) and show excellent reactivity on skin testing and in in vitro diagnostic tests. Cocktails of recombinant allergens can be formulated with predetermined and uniform allergen levels, which could replace natural allergens and result in the development of innovative, patient-based tests for allergy diagnosis. Recombinant allergens also offer the exciting possibility of developing new forms of allergen immunotherapy, including the use of hypoallergens, allergens coupled to IgE suppressive adjuvants, and peptide-based therapies. The production of recombinant allergens as defined molecular entities makes it feasible to consider the possibility of developing prophylactic allergen vaccines. The introduction of recombinant allergens in research and in clinical trials should lead to significant improvements in allergy diagnosis and treatment.

Whole brain quantitative CBF, CBV, and MTT measurements using MRI bolus tracking: implementation and application to data acquired from hyperacute stroke patients

A robust whole brain magnetic resonance (MR) bolus tracking technique based on indicator dilution theory, which could quantitatively calculate cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) on a regional basis, was developed and tested. T2*-weighted gradient-echo echoplanar imaging (EPI) volumes were acquired on 40 hyperacute stroke patients after gadolinium diethylene triamine pentaacetic acid (Gd-DTPA) bolus injection. The thalamus, white matter (WM), infarcted area, penumbra, and mirror infarcted and penumbra regions were analyzed. The calculation of the arterial input function (AIF) needed for absolute quantification of CBF, CBV, and MTT was shown to be user independent. The CBF values (ml/min/100 g units) and CBV values (% units, in parentheses) for the thalamus, WM, infarct, mirror infarct, penumbra, and mirror penumbra (averaged over all patients) were 69.8 +/- 22.2 (9.0 +/- 3.0 SD); 28.1 +/- 6.9 (3.9 +/- 1.2); 34.4 +/- 22.4 (7.1 +/- 2.7); 60.3 +/- 20.7 (8.2 +/- 2.3); 50.2 +/- 17.5 (10.4 +/- 2.4); and 64.2 +/- 17.0 (9.5 +/- 2.3), respectively, and the corresponding MTT values (in seconds) were 8.0 +/- 2.1; 8.6 +/- 3.0; 16.1 +/- 8.9; 8.6 +/- 2.9; 13.3 +/- 3.5; and 9.4 +/- 3.2. The infarct and penumbra CBV values were not significantly different from their corresponding mirror values, whereas the CBF and MTT values were (P < 0.01). Quantitative measurements of CBF, CBV, and MTT were calculated on a regional basis on data acquired from hyperacute stroke patients, and the CBF and MTT values showed greater sensitivity to areas with perfusion defects than the CBV values. J. Magn. Reson. Imaging 2000;12:400-410.

H(2)(15)O PET validation of steady-state arterial spin tagging cerebral blood flow measurements in humans

Steady-state arterial spin tagging approaches can provide quantitative images of CBF, but have not been validated in humans. The work presented here compared CBF values measured using steady-state arterial spin tagging with CBF values measured in the same group of human subjects using the H(2)(15)O IV bolus PET method. Blood flow values determined by H(2)(15)O PET were corrected for the known effects of incomplete extraction of water across the blood brain barrier. For a cortical strip ROI, blood flow values determined using arterial spin tagging (64+/-12 cc/100 g/min) were not statistically different from corrected blood flow values determined using H(2)(15)O PET (67+/-13 cc/100 g/min). However, for a central white matter ROI, blood flow values determined using arterial spin tagging were significantly underestimated compared to corrected blood flow values determined using H(2)(15)O PET. This underestimation could be caused by an underestimation of the arterial transit time for white matter regions.

Structures of prevention: a safe-sex/safe-injecting audit of Mount Alexander Shire, a methodological pilot

This paper reports the findings of a methodological pilot project that examined the availability of safe-sex and safe-injecting products in a rural shire in central Victoria. The study mapped the distribution and audited the availability of condoms, water-based lubricants, needles/syringes and needle disposal units to provide baseline data on access to and the availability of products that are directly related to the prevention of the human immunodeficiency virus, sexually transmissible infections and blood-borne viruses. Clear disparities were observed in the availability and pricing of safe sex/safe use materials between regional centres and outlying areas in the Shire. The findings make it clear that an emphasis on overcoming structural impediments to the adoption of safe sex/safe injecting practices is required.

An event-related potential investigation of response inhibition in schizophrenia and psychopathy

BACKGROUND

Schizophrenia and psychopathy are both characterized by impulsive, poorly planned behavior. This behavior may originate from a weak or poorly coordinated response inhibition system. We tested the hypothesis that schizophrenia and psychopathy are associated with abnormal neural processing during the suppression of inappropriate responses.

METHODS

The participants were schizophrenic patients, nonpsychotic psychopaths, and nonpsychotic, nonpsychopathic control subjects (defined by the Hare Psychopathy Checklist-Revised), all incarcerated in a maximum security psychiatric facility. We recorded behavioral responses and event-related potentials (ERPs) during a Go/No Go task.

RESULTS

Schizophrenic patients made more errors of commission than did the nonpsychopathic offenders. As expected, the nonpsychopathic nonpsychotic participants showed greater frontal ERP negativity (N275) to the No Go stimuli than to the Go stimuli. This effect was small in the schizophrenic patients and absent in the psychopaths. For the nonpsychopaths, the P375 ERP component was larger on Go than on No Go trials, a difference that was absent in schizophrenic patients and in the opposite direction in psychopaths.

CONCLUSIONS

These findings support the hypothesis that the neural processes involved in response inhibition are abnormal in both schizophrenia and psychopathy; however, the nature of these processes appears to be different in the two disorders.

Transforming growth factor-alpha-mediated growth pathways in human gastro-intestinal cell lines in relation to the gastrin autocrine pathway

Epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha) increase transcription of the gastrin gene, and the gastrin peptide may be phosphorylated by EGF-stimulated tyrosine kinase. Our aims were to compare EGF/TGF-alpha interactions in 2 human gastro-intestinal cell lines: MGLVA1, with a strong gastrin autocrine pathway, and C170HM2, with a weak pathway. Both cell lines expressed the TGF-alpha gene. MGLVA1 expressed TGF-alpha protein as determined by immuno-cytochemistry, which was absent in C170HM2. Both cell lines expressed the same level of EGF receptors, as assessed by flow cytometry; however, MGLVA1 did not have enhanced in vitro proliferation in response to EGF or TGF-alpha, unlike C170HM2. The basal growth of MGLVA1 was inhibited by anti-sera against TGF-alpha, the EGF receptor and G17. C170HM2 was not inhibited by any of the anti-sera. Neutralisation of TGF-alpha resulted in undetectable cell-associated progastrin levels in MGLVA1 (untreated had 391.7 fmol/5 x 10(6) cells). The progastrin level of C170HM2 remained unaffected. Tyrosine kinase activity, as assessed by phosphopeptide concentration, of unstimulated MGLVA1 was 2.6 times higher than that of C170HM2 in the cell membrane fraction (0.097 compared to 0.037 microg/mg protein, p < 0.001) and 4.8 times higher in the cytosolic fraction (0.269 compared to 0.056 microg/mg protein, p < 0.05). Following treatment with EGF, the phosphopeptide concentration increased in both the membrane and cytosolic fractions of both cell lines. Tyrphostin B42, which inhibits autophosphorylation of the EGF receptor, inhibited the basal growth of MGLVA1 (IC(50) 1.3 microM) and C170HM2 (9.5 microM, p < 0.05 from MGLVA1). Herbimycin, which inhibits pp60(c-src) kinase, reduced the basal growth of MGLVA1 (0.67 microM) but not C170HM2. Immunofluorescence studies confirmed the presence of tyrosine-phosphorylated proteins and pp60(c-src) within the cytoplasm of unstimulated MGLVA1 cells. There was no specific immunofluorescence for either parameter in C170HM2 cells until after treatment with EGF.

[Degree of hemodynamic disturbance at the hyperacute phase of stroke: predictive value of 3D-TOF angiography and the T2 fast-FLAIR sequence]

GOAL

To define during the hyperacute phase of stroke the value of 3D-TOF MR angiography (MRA) and T2 fast-FLAIR sequence for predicting the volume of tissue presenting a hemodynamic disturbance.

MATERIAL

and method: Thirty-five cases of hyperacute stroke located in following territories: middle cerebral artery (MCA) (n=29), anterior choroidal artery (AChoA) (n=5) and watershed (n=1) were retrospectively reviewed. The vascular abnormalities defined on MRA (vessel stenosis or occlusion) or FLAIR sequence (vessel hyperintensity) were classified into 3 groups: normal (I), distal abnormalities (II), abnormalities of the entire arterial territory (III). These results were compared with the volume of tissue showing a prolonged mean transit time (MTT) determined on relative MTT maps calculated from bolus tracking MR perfusion images.

RESULTS

The abnormal volume measured on the MTT map was significantly correlated to the results of the MRA and FLAIR sequence. In the 12 cases of group III defined on the MRA (abnormality from M1), the volume of hemodynamic disturbance was always higher than 100 ml. For the MCA territory, it was not possible to predict the presence of a hemodynamic disturbance in any of the 3 groups defined on the FLAIR sequence and in the groups I and II defined on the MRA. For the AChoA territory, a hemodynamic disturbance was never observed in groups I and II defined either on MRA or FLAIR sequence.

CONCLUSION

When there was no flow within the M1 segment on the MRA, there was always a hemodynamic disturbance larger than 100 ml on the MTT map. In the case of AChoA ischemic lesion, when no vascular abnormality was observed on the MRA or FLAIR images, the MTT map was always normal.

Nature of immobilized antibody layers linked to thioctic acid treated gold surfaces

Utilization of 125I-labeled IgG enables an investigation of protein immobilized to gold electrodes sputter deposited on microporous nylon membranes, including the precise nature of the surface-protein bond (i.e. covalent or non-specific adsorption), physical location of the immobilized protein (i.e. on the surface of the gold electrode or within the pores of the membrane), and the amount of protein immobilized. This is accomplished by comparing the mass of protein immobilized to gold surfaces that have been treated in several different fashions, as well as, deposition of the gold on nylon membranes that have been treated differently. It is shown that these microporous gold electrodes, proposed previously for conducting novel non-separation electrochemical enzyme immunoassays, consist of multiple protein layers non-specifically adsorbed. Approximately, half of the total adsorbed protein is immobilized to the gold surface with the remaining protein bound within the pores on the nylon membrane.

Determinants of substrate specificity of a second non-neuronal secreted acetylcholinesterase from the parasitic nematode Nippostrongylus brasiliensis

We recently reported on a non-neuronal secreted acetylcholinesterase (AChE B) from the nematode parasite Nippostrongylus brasiliensis. Here we describe the primary structure and enzymatic properties of a second secreted variant, termed AChE C after the designation of native AChE isoforms from this parasite. As for the former enzyme, AChE C is truncated at the carboxyl terminus in comparison with the Torpedo AChE, and three of the 14 aromatic residues that line the active site gorge are substituted by nonaromatic residues, corresponding to Tyr70 (Ser), Trp279 (Asn) and Phe288 (Met). A recombinant form of AChE C was highly expressed by Pichia pastoris. The enzyme was monomeric and hydrophilic, and displayed a marked preference for acetylthiocholine as substrate. A double mutation (W302F/W345F, corresponding to positions 290 and 331 in Torpedo) rendered the enzyme 10-fold less sensitive to excess substrate inhibition and two times less susceptible to the bis quaternary inhibitor BW284C51, but did not radically affect substrate specificity or sensitivity to the 'peripheral site' inhibitor propidium iodide. In contrast, a triple mutant (M300G/W302F/W345F) efficiently hydrolysed propionylthiocholine and butyrylthiocholine in addition to acetylthiocholine, while remaining insensitive to the butyrylcholinesterase-specific inhibitor iso-OMPA and displaying a similar profile of excess substrate inhibition as the double mutant. These data highlight a conserved pattern of active site architecture for nematode secreted AChEs characterized to date, and provide an explanation for the substrate specificity that might otherwise appear inconsistent with the primary structure in comparison to other invertebrate AChEs.

When always isn't enough: implications of the late application of condoms for the validity and reliability of self-reported condom use

Condoms are most effective when they are applied before intercourse. This study assessed the prevalence of 'condom cheats'--instances of condom use in which the condom is put on after initial penetration. As part of a prospective study of safer sexual behaviour, 103 heterosexual tertiary students completed a condom use diary over a period of up to 6 months. Of the 464 condoms used by study participants, 13% were put on after initial penetration. Thirty-eight percent of condom users reported at least one instance of late application of a condom. Late application of condoms is common and places individuals at risk of infection with HIV and many other STDs. The widespread practice of this behaviour casts doubt on the validity of self-reports of condom use. Assessments of risk based on self-reported condom use may lead to underestimates of the risk entailed in heterosexual young adults' condom use behaviour, and may also lead to underestimates of condom efficacy.

Whole brain quantitative CBF and CBV measurements using MRI bolus tracking: comparison of methodologies

Three different deconvolution techniques for quantifying cerebral blood flow (CBF) from whole brain T*(2)-weighted bolus tracking images were implemented (parametric Fourier transform P-FT, parametric single value decomposition P-SVD and nonparametric single value decomposition NP-SVD). The techniques were tested on 206 regions from 38 hyperacute stroke patients. In the P-FT and P-SVD techniques, the tissue and arterial concentration time curves were fit to a gamma variate function and the resulting CBF values correlated very well (CBF(P-FT) = 1.02 x CBF(P-SVD), r(2) = 0.96). The NP-SVD CBF values (i.e., original unfitted curves were used) correlated well with the P-FT CBF values only when a sufficient number of time series volumes were acquired to minimize tracer time curve truncation (CBF(P-FT) x 0.92 x CBF(NP-SVD), r(2) = 0.88). The correlation between the fitted CBV and the unfitted CBV values was also maximized in regions with minimal tracer time curve truncation (CBV(fit) = 1.00 x CBV(unfit), r(2) = 0.89). When a sufficient number of time series volumes could not be acquired (due to scanner limitations) to avoid tracer time curve truncation, the P-FT and P-SVD techniques gave more reliable estimates of CBF than the NP-SVD technique.

Three predominant clones identified within penicillin-resistant South African isolates of Streptococcus pneumoniae

The worldwide spread of antibiotic-resistant pneumococcal clones is cause for concern. In South Africa, penicillin-resistant pneumococci are mostly associated with serogroups 6 and 19, therefore, we have analyzed the clonal relationships between resistant isolates of these two serogroups. DNA fingerprinting of penicillin-binding protein genes and arbitrarily-primed PCR, have identified two penicillin-resistant pneumococcal clones of serotype 19A and serotype 6B, and a third multi-resistant serotype 19A clone, of which all three clones are predominant within South Africa's penicillin-resistant pneumococcal population. These clones are represented by strains isolated from hospitals that are widely separated in South Africa. Further studies are required to establish whether these clones have expanded in the rest of Africa or spread to other continents.

Gadolinium-enhanced arterial-phase MR imaging of hypervascular liver tumors: comparison between tailored and fixed scanning delays in the same patients

The purpose of this study was to compare in the same patients tailored and fixed scanning delays during gadolinium-enhanced arterial-phase magnetic resonance imaging of hypervascular liver tumors. Tailored scanning delays were obtained with automated region of interest threshold triggering. A delay of 23 seconds between the start of contrast material injection and imaging was used for fixed delay examinations. Quantitative and qualitative evaluation was performed in 21 patients with normal cardiac function referred for MR assessment of hypervascular liver tumors. In the tailored examinations, the median time delay between the start of contrast material injection and the start of magnetic resonance imaging was 21 seconds (range, 18-34 seconds). The median tumor-to-liver contrast during tailored examinations was 19.1 versus 14.7 during fixed delay examinations. This difference, however, was not significant. Similarly, the enhancement in the aorta, the portal vein, the liver, and the tumor did not differ significantly between examinations performed with tailored and fixed delays. It is concluded that in our group of patients with hypervascular liver tumors and normal cardiac function, no significant improvement in tumor-to-liver contrast and enhancement during the arterial phase was found when gadolinium-enhanced magnetic resonance imaging was performed with a tailored scanning delay rather than with a fixed delay.

Selenate-supplemented nutritional formula increases plasma selenium in hemodialysis patients

OBJECTIVE

The purpose of this study was to determine the short-term effect of feeding selenium-supplemented formulas on the selenium status of end-stage renal disease patients on hemodialysis.

DESIGN AND SETTING

The prospective, randomized, single-blind study of parallel design was conducted at three hemodialysis clinics.

PATIENTS

A total of 79 hemodialysis patients were randomly assigned into one of three groups.

INTERVENTION

Liquid nutritional formula supplemented with either selenite (28 microg Se/8 oz, n = 26), selenate (28 microg Se/8 oz, n = 26), or nonfortified (7 microg Se/8 oz, n = 27) was fed to hemodialysis patients as their sole source of nutrition for 14 days.

MAIN OUTCOME MEASURE

Plasma and red blood cell (RBC) selenium and glutathione peroxidase (GPX) activities were measured in predialysis blood both before (day 1) and after (day 8) a 7-day baseline period, and after subjects received the formula as the sole source of nutrition (approximately 35 kcal/kg/d) for 14 days (day 22).

RESULTS

Selenium intake (Mean +/- SEM, microg/d) was 134 +/- 9, 140 +/- 9, and 35 +/- 2 for patients receiving selenite-, selenate-, or non-supplemented formula, respectively. On day 22, plasma selenium (micromol/L) was greater (P <.032) in the selenate-supplemented group (1.5 +/- 0.1) compared with the nonsupplemented group (1.2 +/- 0.1), but not compared with the selenite-supplemented group (1.4 +/- 0.1). Plasma GPX activity was 44% to 60% that of healthy controls and not different among groups. RBC selenium and GPX activities were within the normal range and were not different among groups.

CONCLUSION

The results of this study indicate that a liquid formula supplemented with selenium as selenate is successful at maintaining selenium concentrations within normal range, as well as significantly increasing plasma selenium levels compared with nonsupplementation.

Generational differences in selenium status of women

In this cross-sectional study of three generations of women, daughters (19-26 yr), mothers (40-58 yr) and maternal grandmothers (67-84 yr) from the same 10 families in central Ohio were studied to determine the effect of life-cycle differences, including estrogen status, on selenium status. Plasma and red blood cell (RBC) selenium and glutathione peroxidase (GPx) activities were determined and typical dietary selenium intakes were calculated from food-frequency questionnaires. Selenium status was lowest in the oldest generation. Plasma selenium of daughters and grandmothers were significantly lower than those of mothers, and plasma GPx and RBC selenium of grandmothers were also lower than those of the mothers. A positive correlation (r = 0.42, p < 0.04) was found between plasma estrogen and plasma selenium concentrations. Selenium intakes of all groups were adequate and no differences in selenium intakes were found among groups. The results of this study indicate that selenium status fluctuates during the female life cycle and is related to estrogen status.

Outcome of an opportunistic infection after polymicrobial peritonitis in an HIV-infected patient treated with peritoneal dialysis

The prevalence of human immuodeficiency virus (HIV)-infected patients with end stage renal disease (ESRD) is likely to increase and many of them will be on peritoneal dialysis as renal replacement therapy. Infectious complications are a major problem associated with peritoneal dialysis (PD). It has been speculated that the HIV-positive peritoneal dialysis population may develop peritonitis more frequently than other peritoneal dialysis patients. We present the complications and unexpected good response to medical management of PD-associated peritonitis in a young HIV-infected black male. He had two unusual and serious infections; the first was a polymicrobial peritonitis which predisposed the patient to an unusual infection caused by Corynebacteria JK for which he was successfully treated without catheter removal.

A model circulatory system for use in undergraduate physiology laboratories

The cardiovascular system is a central topic in physiology classes, yet it is difficult to provide undergraduates with quality laboratory experiences in this area. Thus a model circulatory system was developed to give students hands-on experience with cardiovascular fluid dynamics. This model system can be constructed from readily available materials at a reasonable cost. It has a realistic pressure drop across the different vessels. Using this system, students can investigate the effect that blood volume, vessel compliance, vessel construction, and heart activity have on blood pressure and flow. The system also demonstrates the effect of vessel diameter on resistance and fluid velocity. This model may give students a more concrete, intuitive feel for cardiovascular physiology. Another advantage is that it allows dramatic and easily controlled manipulations with quantitative results. Finally, its simple construction allows students to interchange components, giving them greater flexibility in experimentation.

Same-sex attraction, drug injection and binge drinking among Australian adolescents

OBJECTIVE

To document the prevalence of same-sex attraction among students in years 10 and 12 in Australian Government high schools and to assess the association between same-sex attraction, binge drinking and drug injection.

METHOD

Cross-section survey by anonymous, self-administered questionnaire of 3,387 students in Years 10 and 12 of the Government school system in Australia.

RESULTS

Approximately 6% of respondents reported being currently attracted to members of their own sex. Being attracted to members of the same-sex was associated with more frequent binge drinking among boys and girls, and a three- to four-fold increase in the likelihood of reporting injecting drug use both over the lifetime and within the previous 12 months.

CONCLUSIONS

Adolescents attracted to members of the same-sex report engaging in elevated levels of health-limiting behaviours. There is an urgent need for further research to document the reasons for this. It is recommended that health promotion activities directed at moderating young people's drug and alcohol practices explicitly acknowledge the over-representation of same-sex attracted young people in their target audience.

A comparison of the therapeutic effectiveness of gastrin neutralisation in two human gastric cancer models: relation to endocrine and autocrine/paracrine gastrin mediated growth

BACKGROUND

Gastrin is a growth factor for established tumours.

AIMS

To investigate the therapeutic effect of antibodies, raised against the Gastrimmune immunogen, which neutralise the glycine extended and carboxy amidated forms of gastrin 17 in two human gastric cancer models.

METHODS

MGLVA1 cells (which have a gastrin autocrine/paracrine phenotype) and ST16 cells (which have an endocrine phenotype) were injected into the peritoneal cavity of SCID mice. Peritoneal tumours, ascites, and cachexia formation occurred, with the monitored endpoint being morbidity.

RESULTS

In MGLVA1 cells, intravenous administration of antibodies raised against Gastrimmune increased the 50% median survived by 25% at three different initial cell seeding concentrations (1 x 10(6)-5 x 10(5) per mouse). In ST16 cells, the effect of Gastrimmune induced antibodies on time to morbidity was greatest at the lowest cell seeding concentration (5 x 10(5) cells/mouse) with the 50% median survival increased by 74% and overall survival achieved in 38% of the mice.

CONCLUSIONS

Gastrimmune may have potential therapeutic benefit on gastrin sensitive gastric tumours and may interact with both endocrine and autocrine mediated growth pathways.

Selective drug delivery to the colon using pectin:chitosan:hydroxypropyl methylcellulose film coated tablets

A study has been carried out to assess the potential of pectin:chitosan:hydroxypropyl methylcellulose (HPMC) (P:C:H) films for colonic drug delivery. Radiolabelled (99mTc) tablets were coated with a 3:1:1, P:C:H film and administered to human volunteers. The gastro-intestinal transit of the tablets was assessed by gamma scintigraphy. The results showed that in all cases (n=4), the tablets were able to pass through the stomach and small intestine intact. Break up of the tablets commenced once they were in the colon, due to degradation of the coat by colonic bacteria. The study has highlighted the potential of this coating system for colonic drug delivery.

Women issues in female patients receiving peritoneal dialysis

About 50% of the population receiving peritoneal dialysis (PD) in the United States are women. Nephrologists generally address medical issues related to end-stage renal disease, ie, anemia, hypercholesterolemia, secondary hyperparathyroidism. In female PD patients, specific topics should also be addressed. They include menstruation, birth control methods, osteoporosis, child bearing, postmenopausal hormone replacement and its consequences, screening of gynecological malignancies, sexual problems, and hemoperitoneum. We briefly describe in a multidisciplinary view the management of these issues.

Interaction with amylopectin influences the ability of granule-bound starch synthase I to elongate malto-oligosaccharides

This paper examines the properties in soluble form of two isoforms of starch synthase. One of these, granule-bound starch synthase I (GBSSI), is responsible for the synthesis of amylose inside the amylopectin matrix of the starch granule in vivo. The other, starch synthase II (SSII), is involved in amylopectin synthesis. Both isoforms can use amylopectin and malto-oligosaccharide as substrates in vitro. As well as acting as a substrate for GBSSI, amylopectin acts as an effector of this isoform, increasing the rate at which it elongates malto-oligosaccharides and promoting a processive rather than distributive mode of elongation of these compounds. The affinity of GBSSI for amylopectin as an effector is greater than its affinity for amylopectin as a substrate. The rate and mode of elongation of malto-oligosaccharides by SSII are not influenced by amylopectin. These results suggest that specific interaction with amylopectin in the matrix of the starch granule is a unique property of GBSSI and is critical in determining the nature of its products.