Age and velopharyngeal function during speech production

This investigation was designed to determine if velopharyngeal function during speech production, as reflected in measures of nasal air flow, differs with age in adults. Eighty subjects were studied, 40 women and 40 men, representing four age groups (20-30, 40-50, 60-70, and 80 + years). Results showed no age-related differences in nasal air flow. Sex-related differences in flow were found on productions of nasal consonants only. These findings do not support the suggestion of Hutchinson, Robinson, and Nerbonne (1978) that velopharyngeal function deteriorates with age.

1H magnetic resonance spectroscopy in the investigation of intractable epilepsy

We have been using proton magnetic resonance spectroscopy (1H MRS) in the investigation of adults and children with intractable epilepsy. Spectra were obtained from 2 x 2 x 2 cm cubes in the medial region of the temporal lobe, and were analyzed on the basis of signals from N-acetylaspartate (NAA), creatine+phosphocreatine (Cr), and choline-containing compounds (Cho). In comparison with control subjects, the epilepsy patients as a group show significant reductions in the NAA signal and in the NAA/Cho+Cr ratio, with increases in the Cho and Cr signals. The reduction in NAA is interpreted in terms of neuronal loss or damage, while the increase in Cr and Cho signals may be a reflection of reactive astrocytosis.

Constraints and facilitators to friendships in late late life

This report analyzes friendship patterns of individuals 85 and older, 77% of whom are women. Despite high levels of disability and the loss of age peers, the majority were in frequent contact with friends and still had a close friend. Over 31 months, however, the predictors of friendship involvement changed. At Time 1, mood was most important, but by Time 3, increased disability was most important. Qualitative data describe how the constraints and facilitators lead to changing criteria for friendships in late late life.

Families and support networks among African American oldest-old

This article examines the demographic profile of oldest-old African-Americans who reside in the San Francisco Bay Area. Family life and social support available from adult children, relatives, and friends are explored as they vary by gender. Bivariate analyses indicate that females receive more help from relatives and friends, and males receive more help from immediate family members. Parent and childless respondents were compared for instrumental supports. The childless received support from a variety of helpers, whereas, the parents received help from family or the formal sector. Overall, fewer family members were available to assist the oldest-old with community living, although many were able to redefine relationships and increase the numbers of helpers available to assist them. These findings indicate that the principle of substitution operates among some segments of the older African American population, primarily those who are childless. This pattern was more evident among females than among males.

Differential expectations and realities: race, socioeconomic status and health of the oldest-old

Comparisons by race indicate that African Americans are significantly more disadvantaged than whites in their socioeconomic status. Despite complaints about their situation, however, African Americans report that their situation is better than they had expected. Although they perceive their health as poorer than whites, they are no more disabled functionally, and they have significantly better morale. Within-group correlations find the predictable associations between socioeconomic status and physical, psychological, and social outcomes for both groups. Nevertheless, both qualitative and quantitative data indicate that economic well-being is related to the congruence between expectations and the realities of life in advanced old age, making objective and subjective factors of similar importance.

Introduction: social and cultural diversity of the oldest-old

This introduction describes a volume devoted to a much neglected topic and population, the social and cultural diversity among individuals eighty-five years old and older. Four articles come from the San Francisco 85+

STUDY

1) comparisons by Colleen Johnson between whites and African Americans in socioeconomic status, health, and other outcomes; 2) Barbara Barer's analysis of gender differences in the stressors faced in late-life; 3) Charlotte Perry and Colleen Johnson's examination of the families of oldest-old African Americans; 4) Lillian Troll's analysis of white families. The fifth article by Gloria Clayton on rural/urban differences comes from the Georgia Centenarian STUDY. Finally the volume concludes with a commentary by Leonard Pearlin that places these studies into the broader context of aging research.

Safety of combined oligosaccharide conjugate Haemophilus influenzae type b (HbOC) and whole cell diphtheria-tetanus toxoids-pertussis vaccine in infancy. The Kaiser Permanente Pediatric Vaccine Study Group

The safety of the combined oligosaccharide conjugate Haemophilus influenzae (Hib) type b (HbOC) and whole cell diphtheria-tetanus toxoids-pertussis (DTP) vaccine (Tetramune, HbOC-DTP; Lederle) in infancy was evaluated in 6644 recipients of this vaccine and compared with 3914 recipients of separate injections of whole cell DTP and HbOC vaccines when given as a three dose regimen to infants at 2, 4 and 6 months of age in each group. Of the total number of infants in the study, a subset of 1435 were enrolled into the study and then randomly assigned to receive either the Hib-DPT combined vaccine or the separate components. This subset was used to assess local and systemic side effects which were evaluated utilizing telephone interviews 48 to 72 hours after vaccine. The remaining children in the study population were enrolled in a nonrandomized manner. For these children parents were offered the experimental Hib-DPT vaccine and refusers were given HbOC and DTP. Both of these groups of children as well as the randomized subset described above were used to assess rates of episodes of hospitalization, emergency room utilization and sudden infant death syndrome in HbOC-DTP recipients and children who received HbOC and DTP separately. Immunogenicity was evaluated in 123 children by collection of a single serum sample 30 days after the third dose of HbOC-DTP. The observed immunogenicity was comparable to that observed in other recent studies for HbOC and DTP component antigens. The profile of local and systemic side effects observed was virtually identical to that observed after DTP plus HbOC given separately.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcium intakes of Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites, and non-Hispanic blacks in the United States

OBJECTIVE

To compare dietary calcium intakes from food in Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites, and non-Hispanic blacks aged 11 through 74 years.

DESIGN

Population survey data from the Hispanic Health and Nutrition Examination Survey and the second National Health and Nutrition Examination Survey were used to calculate calcium intake from a single 24-hour recall. These data were compared by age and sex between the five population groups. Food sources of calcium in the three Hispanic groups were also examined using 24-hour recall data.

SUBJECTS

The sample consisted of 11,773 non-Hispanic whites, 1,728 non-Hispanic blacks, 4,739 Mexican Americans, 1,076 Cubans, and 1,835 Puerto Ricans.

MAIN OUTCOME MEASURES

Mean calcium intake, percentage intake of Recommended Dietary Allowance, and, for Hispanics, food sources of calcium.

STATISTICAL ANALYSES

Means were compared within age and sex groups between the five population groups using a t test.

RESULTS

Calcium intakes from food in the three Hispanic groups were similar to intakes of non-Hispanic whites and higher than intakes of non-Hispanic blacks. Although dairy foods were the main sources of calcium for Hispanics, corn tortillas were important calcium sources among Mexican Americans. Women consumed less calcium than the Recommended Dietary Allowance in all age and racial or ethnic groups.

APPLICATIONS

When assessing calcium intakes of the three Hispanic groups, ethnic differences in food sources of calcium need to be considered. Efforts to increase calcium intake in Hispanics also need to account for ethnic differences.

Electromyographic response of peroneal muscles in surgical and nonsurgical injured ankles during sudden inversion

Because the peroneal muscles are thought to act as a safeguard against lateral ankle injury, it is important to study their function. This study was undertaken to electromyographically assess the latency between sudden unexpected ankle inversion and the start of peroneal muscle activity. Three groups participated in the study, including subjects with lateral ankle sprain rehabilitated nonsurgically (N = 7), sprains rehabilitated following surgery (N = 6), and injury-free ankles (N = 11). Peroneal latency was assessed by dropping the subjects into inversion from a special platform. The platform was designed so that either ankle could be inverted to 35 degrees without warning. The ANOVA revealed no significant latency differences (p > .05) between the three groups. The study suggests that bilateral peroneal latency is unaffected by injury. Although it has been thought that healthy muscles provide a defense against ankle sprain, their latency is not permanently affected by ankle injury or by surgery performed to correct defects from injury. It appears that mechanoreceptor impairment may be rehabilitated and that it is not a factor in ankle injury.

Integrating the twelve-step approach with traditional psychotherapy for the treatment of eating disorders

The treatment outcome literature for anorexia nervosa and bulimia indicates that approximately two thirds of patients treated with brief to moderate length interventions have favorable responses. The remaining one third are more difficult to treat and appear to require longer term and more intensive intervention. These patients can usually be characterized as having more severe Axis I and Axis II comorbidity. This manuscript focuses on a longer term treatment program that integrates psychodynamically oriented psychotherapy with a 12-step component. Specific issues that are addressed include the theoretical dilemma between the two models, advantages and disadvantages of adding a 12-step component, and how various subgroups of patients respond to the model. The clinical viability and preliminary impressions regarding outcome with this model are also offered.

Prevalence of high blood cholesterol among US adults. An update based on guidelines from the second report of the National Cholesterol Education Program Adult Treatment Panel

OBJECTIVE

To estimate the current levels and trends in the proportion of US adults with high blood cholesterol based on guidelines from the second report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP II).

DESIGN

Nationally representative cross-sectional surveys.

SETTING/PARTICIPANTS

Data for 7775 participants 20 years of age and older from phase 1 of the third National Health and Nutrition Examination Survey (NHANES III) (data collected from 1988 through 1991) and for 9797 participants 20 through 74 years of age from NHANES II (data collected from 1976 through 1980) were used.

RESULTS

From the data collection period in NHANES II (1976 through 1980) to the period in NHANES III (1988 through 1991), the proportion of adults with high blood cholesterol levels (> or = 240 mg/dL [6.21 mmol bd) fell from 26% to 20%, while the proportion with desirable levels (< 200 mg/dL [5.17 mmol/L]) rose from 44% to 49%. Currently, using the ATP II guidelines and NHANES III data, 40% of all adults 20 years of age and older would require fasting lipoprotein analysis; and 29% of all adults would be candidates for dietary therapy (as compared with 36%, using NHANES II data). Based on 1990 population data, it is estimated that approximately 52 million Americans 20 years of age and older would be candidates for dietary therapy. Assuming that dietary intervention would reduce low-density lipoprotein (LDL) cholesterol levels by 10%, as many as 7% of all adult Americans (approximately 12.7 million) might be candidates for cholesterol-lowering drugs. This estimate reflects approximately 4 million adults with established coronary heart disease, of whom half are aged 65 years and older, and up to 8.7 million adults without established coronary heart disease, of whom up to 3.1 million are aged 65 years and older.

CONCLUSIONS

Substantial progress has been made in reducing the prevalence of high blood cholesterol; yet a large proportion of all adults, approximately 29%, require dietary intervention for high blood cholesterol.

Declining serum total cholesterol levels among US adults. The National Health and Nutrition Examination Surveys

OBJECTIVE

To examine the secular trend in serum total cholesterol levels of the US adult population.

DESIGN

Nationally representative cross-sectional surveys with both an in person interview and a medical examination that included the measurement of blood lipid levels.

SETTING/PARTICIPANTS

Between 6000 and 13,000 adults aged 20 through 74 years examined in each of four separate national surveys during 1960 through 1962, 1971 through 1974, 1976 through 1980, and 1988 through 1991.

RESULTS

Mean serum total cholesterol levels in US adults aged 20 through 74 years have consistently declined over the time period 1960 through 1991. More than half of the decline occurred during the time period 1976 through 1991. This decline occurred across the entire distribution of serum cholesterol levels and in all age-sex groups. High-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels have not changed, suggesting that the decline in total cholesterol levels is due to a decline in low-density lipoprotein cholesterol levels.

CONCLUSIONS

These results document a continuing and substantial decline in serum cholesterol levels among US adults. They suggest that public health programs, designed to reduce cholesterol levels, are proving successful. The observed downward trend in serum cholesterol levels has coincided with a continuing decline in coronary heart disease mortality. These observations suggest that the Healthy People 2000 goal of reducing the mean serum cholesterol level of US adults to no more than 200 mg/dL (5.17 mmol/L) is attainable.

Issues in the long-term evaluation of diet in longitudinal studies

Longitudinal studies are very useful for studying diet/disease relationships. The fundamental components of a longitudinal study are that: 1) data are collected for two or more distinct time periods; 2) the subjects are the same or comparable from one time period to the next; and 3) data are compared between or among time periods in the analysis. A longitudinal study is often assumed to be synonymous with a cohort study, but there are at least four possible definitions for a longitudinal study. While focusing on cohort studies, the paper describes the nature of longitudinal studies, including a discussion of how the different definitions differ from a cohort study and a set of important assumptions necessary to cohort studies. It also highlights some of the major issues associated with such studies, including the selection of a dietary survey methodology; data collection issues in multicultural, multilingual societies; the importance of nutrient databases; measurement error and misclassification in nutrient intake and energy adjustment.

Management of catastrophic neonatal midgut volvulus with a silo and second-look laparotomy

The case of a neonate with midgut volvulus and severe intestinal ischemia extending from the ligament of Treitz to the midtransverse colon is presented. Management consisted of abdominal silo application at the initial exploration to obviate the adverse physiological consequences of increased intraabdominal pressure from reperfusion edema of the intestine. The majority of the intestine was salvaged, and a short segment of ileum was resected. This method of treatment resulted in optimal ventilatory status, renal function, and cardiac performance. The advantages of temporary prosthetic wound coverage in selected cases of midgut volvulus include greater physiologic stability through the avoidance of "intraabdominal hypertension" and the ability to monitor the status of the intestine at the bedside.

The effect of TNFa on bradykinin receptor binding, phosphatidylinositol turnover and cell growth in human A431 epidermoid carcinoma cells

In this study, we examined the effect of TNFa on bradykinin (BK) B2 receptor binding and function in human A431 epidermoid carcinoma cells. [3H]BK binds to a single class of receptors on A431 cells in a saturable and reversible manner. A binding affinity (KD) of 3.0 +/- 0.3 nM (n = 4) and a Bmax of 151 +/- 14 fmols/10(6) cells, representing approximately 90,000 BK receptors per cell, was observed. The rank order of potency for BK agonist peptides indicates that the A431 BK receptor appears to be of the B2 subtype. When A431 cells were incubated with TNFa (10 ng/ml) for 48 h prior to BK binding, a significant decrease in the number of BK receptors compared to control was observed. TNFa did not influence the affinity of BK binding to A431 cells and direct addition of TNFa to the binding assay did not effect BK binding. BK-stimulated IP1 formation appeared to be increased in TNFa treated cells compared to control whereas histamine-stimulated IP1 formation was not influenced. Both control and TNFa treated cells were greater than 95% viable. However, TNFa treated cells were blocked in the G1 phase of the cell cycle resulting in a decrease in DNA synthesis. This may be one mechanism for the TNFa-induced decrease in BK receptors in A431 cells.

Loss of heterozygosity on chromosome 11 in sporadic gastrinomas

Gastrinomas are pancreatic endocrine neoplasms that arise either sporadically or are inherited as part of the multiple endocrine neoplasia type I syndrome (MENI). Loss of heterozygosity (LOH) in the region flanking the MENI gene at chromosome 11q13 has been documented in a few sporadic and familial pancreatic endocrine tumors, but not previously in sporadic gastrinomas. It has therefore been suggested that gastrinomas develop by a mechanism different from other tumors associated with the MENI syndrome. We report LOH on chromosome 11 in 5 of 11 sporadic gastrinomas. Four of these tumors have LOH for markers flanking the MENI region. Molecular evaluation of segments of chromosomes 3, 13, and 17 known to contain cloned or putative tumor suppressor genes fail to show LOH except at one locus in one tumor. These data suggest that a tumor suppressor DNA segment exists at 11q13 that may be involved in the development of sporadic gastrinomas.

Estimation of genetic parameters for wool fiber diameter measures

Genetic and phenotypic correlations and heritability estimates of side, britch, and core diameters; side and britch CV; side and britch diameter difference; and clean fleece weight were investigated using 385 western white-faced ewes produced by 50 sires and maintained at two locations on a selection study. Data were analyzed using analysis of variance procedures, and effects in the final model included breed of sire-selection line combination, sire within breed-selection line, and location. Heritabilities were estimated by paternal half-sib analysis. Sires within breed-selection line represented a significant source of variation for all traits studied. Location had a significant effect on side diameter, side and britch diameter difference, and clean fleece weight. Age of ewe only affected clean fleece weight. Phenotypic and genetic correlations among side, britch, and core diameter measures were high and positive. Phenotypic correlations ranged from .68 to .75 and genetic correlations ranged from .74 to .89. The genetic correlations between side and britch diameter difference and side diameter or core diameter were small (-.16 and .28, respectively). However, there was a stronger genetic correlation between side and britch diameter difference and britch diameter (.55). Heritability of the difference between side and britch diameter was high (.46 +/- .16) and similar to heritability estimates reported for other wool traits. Results of this study indicate that relatively rapid genetic progress through selection for fiber diameter should be possible. In addition, increased uniformity in fiber diameter should be possible through selection for either side and britch diameter difference or side or britch CV.

Effects of skirting on processing characteristics of Targhee wool

Ninety mature Targhee ewes were randomly allocated to nine lots. Lots were randomly assigned to three fleece preparation treatments: 1) nonskirted (control); 2) bellies removed, in which bellies and topknots were removed on the shearing floor; and 3) skirted, in which bellies and topknots were removed and remaining fleece was thrown on a table and lightly skirted. Bellies and topknots composed about 6 to 7% of the fleece weight. An additional 6.6% was removed when fleeces were skirted. Top fiber diameters were not affected (P greater than .10) by skirting. Although not significant (P greater than .10), percentage yield, vegetable content, percentage of noilage, top fiber length, and yellowness indexes tended to be most desirable for skirted lots and least desirable for unskirted lots. Lots with bellies removed were intermediate. Removal of bellies reduced vegetable contamination by 8.4%, with an additional reduction of about .5% by further skirting. Skirting reduced the number of fibers less than 25.4 mm (P less than .10) by 42%. Minimal colored fiber contamination of top was observed. One colored fiber per 15 g of top was detected in two lots of the treatment with bellies removed. All other lots contained no colored fibers. All wools evaluated were well below industry limits set for use in high-quality white or pastel fabrics. All skirted lots of wool evaluated in this study had improved processing characteristics for all processing traits evaluated.

Family functioning in late late life

This study of 150 individuals, 85 years and older, focused on their families and social networks. Using both structured and open-ended questions, we explored the extent to which the family functions as a source of support for the oldest old. The findings indicate that those with children are significantly more active with all relatives, most likely because children link them to grandchildren, great-grandchildren, and their relatives by marriage. For the 30 percent who are childless and unmarried, other relatives are not usually active providers of support, a finding which suggests that the principle of substitution does not operate effectively for this age group. Case studies illustrate the variations in family functioning in the support of their oldest members.

Characterization of Receptors for Substance P in Human Astrocytoma Cells: Radioligand Binding and Inositol Phosphate Formation

UC11 cells, derived from a human astrocytoma, have a high density of functional substance P receptors. Radioligand binding studies were conducted with the highly selective neurokinin-1 receptor ligand [3H][Sar9,Met(O2)11]-substance P. Kinetic binding experiments conducted at 4 degrees C yielded an association rate constant k1 of 1.86 x 10(7) M-1 min-1, a dissociation rate constant k-1 of 0.00478 min-1, and a calculated kinetic KD of 257 pM. Saturation binding experiments yielded average values of KD = 447 +/- 103 pM, Bmax = 862 +/- 93 fmol/mg of protein. This Bmax corresponds to more than 150,000 binding sites/cell. Competition binding experiments with unlabeled [Sar9,Met(O2)11]-substance P yielded average values of KD = 491 +/- 48 pM and Bmax = 912 +/- 67 fmol/mg of protein. In [3H]inositol-labeled cells, substance P induced a robust inositol phosphate formation. Inositol trisphosphate levels increased as much as 20-fold within approximately 15 s of addition of substance P. This inositol trisphosphate formation was transient and had returned to baseline within the first 60-120 s. Inositol monophosphate formation, however, was linear for at least 2 h. Structure activity data on binding and inositol monophosphate formation confirmed the presence of a neurokinin-1 receptor subtype in these cells. Thus, the UC11 cell should be a useful model cell for delineating the physiological role of substance P receptors in astrocytes.

Tumor necrosis factor and interleukin-1 down-regulate receptors for substance P in human astrocytoma cells

This study examined the influence of cytokines on substance P (SP) receptors (NK1 subtype) in the human astrocytoma cell line UC11. Following trypsinization and passage, the density of SP receptors in these cells was rather low but gradually increased several fold over the course of a few days in culture. Frequent replacement of the growth medium enhanced the density of receptors even more, suggesting that growth factors in the culture medium may determine the levels of receptor. Exposure of the cells to sub-nanomolar concentrations of tumor necrosis factor (TNF alpha) or interleukin-1 beta (IL1 beta), but not interleukin-2 or interleukin-6, decreased the density of SP receptors. This was accompanied by a decrease in the ability of SP to stimulate inositolphosphate formation. The ability of histamine to activate inositolphosphate formation was not influenced by the cytokines. The decrease in SP receptor density was readily reversible on washout of the cytokines. The EC50 for TNF alpha was approximately 0.5 ng/ml, the EC50 for IL1 beta was approximately 0.1 ng/ml. Radioligand binding studies with [125I]TNF alpha indicated the presence of a low density of high affinity binding sites for this ligand: Kd = 2.5 +/- 0.6 ng/ml, Bmax = 14.8 +/- 2.7 fmol bound/mg protein (assuming trimeric form of ligand bound). The most likely explanation for the cytokine effect is an inhibition of the synthesis of new receptors.