In vivo antiviral activity and pharmacokinetics of (-)-cis-5-fluoro-1-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]cytosine in woodchuck hepatitis virus-infected woodchucks

The (-) enantiomer of cis-5-fluoro-1l-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]cytosine [(-)-FTC)], a substituted oxathiolane compound with anti-hepatitis B virus activity in vitro, was assessed for its efficacy in woodchucks with naturally acquired woodchuck hepatitis virus (WHV) infection. Pharmacokinetics and in vitro anabolism were also determined. (-)-FTC was anabolized to the 5'-triphosphate in a dose-related fashion, reaching a maximum concentration at about 24 h in cultured woodchuck hepatocytes. Following administration of a dose of 10 mg/kg of body weight intraperitoneally (i.p.), the clearance of (-)-FTC from plasma was monoexponential, the terminal half-life was 3.76 +/- 1.4 h, and the systemic clearance was 0.12 +/- 0.06 liters/h/kg. The antiviral efficacy of (-)-FTC in the woodchuck model was assessed by quantitation of serum WHV DNA levels and by WHV particle-associated DNA polymerase activity at two dosages, 30 and 20 mg/kg given i.p. twice daily (b.i.d.), respectively. The level of WHV DNA in serum was reduced 20- to 150-fold (average, 56-fold) in the 30-mg/kg-b.i.d. treatment group and 6- to 49-fold (average, 27-fold) in the 20-mg/kg-b.i.d. treatment group. Viral DNA polymerase levels diminished accordingly. One week after treatment was discontinued, WHV levels returned to pretreatment levels in both studies. These animals were biopsied before and following treatment with 30 mg of (-)-FTC per kg. Their livers were characterized by a mild increase in cytoplasmic lipid levels, but this change was not associated with altered liver enzyme levels. Serum chemistry and hematology results were within the normal ranges for all treated animals. We conclude that (-)-FTC is a potent antihepadnaviral agent and that it has no detectable toxic effects in woodchucks when given for up to 25 days. Further development of (-)-FTC as an anti-hepatitis B virus therapy for patients is warranted.

A description of general health risks in adult liver transplant recipients

The focus of posttransplant care and clinical research has been on the management of rejection and short-term side effects associated with immunosuppressive therapy. Long-term side effects have only recently been recognized as potential health problems in liver transplant recipients. The aim of this pilot study was to determine the feasibility of using the Healthier People Version 4.0 Health Risk Appraisal as a tool for identifying existing and potential risk factors for premature disease and death among asymptomatic liver transplant recipients and to describe health risks in adult liver transplant recipients. The sample consisted of 50 adult first-time liver transplant recipients. It was found that this tool highlights health risks affecting life expectancy and pinpoints risks that an individual can control. It also provides practitioners with information necessary to design appropriate prevention and health promotion strategies to assure better health and quality of life for patients following liver transplantation.

Neutrophil maturation of CD34+ cells from peripheral blood and bone marrow in serum-free culture medium with PIXY321 and granulocyte-colony stimulating factor (G-CSF)

Bone marrow (BM) or peripheral blood (PB) CD34+ cells were cultured for 12 days in serum-free culture medium containing PIXY321 (IL-3/ GM-CSF fusion protein) with or without periodic supplements of granulocyte-colony stimulating factor (G-CSF). The cultures were evaluated at day 12 for total cell proliferation (fold increase from day 0), neutrophil differentiation by flow cytometry, using dual staining with CD15-FITC and CD11b-PE, and morphology using Wright-Giemsa and granule staining. In cultures containing PIXY321 where 6000 U/ml of G-CSF was added days 0 and 6, there was no significant difference (p > or = 0.05) in cell proliferation or the percent of CD15+/CD11b+ cells when compared with cultures with PIXY321 alone. ELISA analysis showed G-CSF levels had declined by 90% after 3 days of culture. Further studies were performed to assess the benefit of supplementing lower concentrations of G-CSF (600 U/ml) at more frequent intervals. A significant increase (p < or = 0.05) in cell proliferation and percent CD15+/CD11b+ was observed when G-CSF was added on days 0, 3, 6, and 9 (every 3 days) as compared with those cultures with PIXY321 alone. CD34+ cell proliferation without G-CSF was 19.6 +/- 4.8-fold, with G-CSF added on days 0 and 6 was 28.7 +/- 6.4-fold, and with G-CSF added on days 0, 3, 6, and 9 was 45.9 +/- 10.6-fold. Percent of CD15+/CD11b+ cells was 19.0 +/- 4.6%, 38.2 +/- 7.2%, and 58.5 +/- 6.5%, respectively, in these cultures. We observed more CD15+/CD11b+ cells, myelocytes/metamyelocytes, and secondary granule staining in cultures with G-CSF added on day, 0, 3, 6, and 9 as compared with cultures with G-CSF added on days 0 and 6 or no G-CSF added. We conclude that PIXY321 and G-CSF act synergistically on the in vitro proliferation and neutrophil differentiation of BM and PB CD34+ cells and that frequent supplements of G-CSF facilitate neutrophil differentiation.

Laparoscopic paraesophageal hernia repair

BACKGROUND

Paraesophageal hernias require surgery to avoid potentially serious complications.

OBJECTIVE

To evaluate paraesophageal hernia repair using the laparoscopic approach.

DESIGN

Case series.

SETTING

University hospital and foregut testing laboratory.

SUBJECTS

Sixty-five consecutive patients (mean age, 63.6 years; range, 26-90 years). Preoperative evaluation included barium esophagogram, endoscopy, esophageal manometry, and 24-hour pH monitoring.

OUTCOME MEASURES

Operative complications, postoperative morbidity, follow-up symptoms (53 patients; mean, 18 months; range, 2-54 months) and barium esophagogram (46 patients).

RESULTS

Fifty-six patients (86%) had a type III hernia and 9 (14%) had a type II hernia. Twenty (65%) of 31 patients who underwent pH monitoring had a positive 24-hour pH score, and 24 (56%) of 43 patients who underwent manometry had an incompetent lower esophageal sphincter. Four patients had a gastric volvulus and 21 patients had more than 50% of their stomach in the chest. All patients underwent hernia reduction, crural repair, and fundoplication (64 Nissen procedures and 1 Toupet procedure). The average duration of surgery was 2 hours. There were 2 conversions: gastric perforation and a difficult dissection because of a large fibrotic sac. Other complications, all managed intraoperatively, were 2 gastric perforations and bleeding in 6 patients. Average length of hospital stay was 2 days (range, 1-23 days). Early re-operation was required in 3 patients: slipped Nissen; small-bowel obstruction due to trocar-site hernia; and organo-axial rotation with gastroduodenal obstruction. Four patients required esophageal dilatation after surgery. Forty-nine of 53 patients available for long-term follow-up were satisfied with the results of surgery. Time to full recovery was 3 weeks (range, 1 week to 2 months). Seven of 46 patients experienced small type I hernias observed on routine follow-up esophagograms.

CONCLUSIONS

Most paraesophageal hernias are type III. A concomitant antireflux procedure is recommended. Paraesophageal hernias can be managed successfully by the laparoscopic route with good outcome.

Pyrrolopyrimidines: novel brain-penetrating antioxidants with neuroprotective activity in brain injury and ischemia models

A novel group of antioxidant compounds, the pyrrolopyrimidines, has been discovered recently. Many of these possess significantly improved oral bioavailability (56-70% in rats), increased efficacy and potency in protecting cultured neurons against iron-induced lipid peroxidative injury and as much as a 5-fold increase in brain uptake compared with the 21-aminosteroid antioxidant compound, tirilazad mesylate (U-74006F), described earlier. They appear to quench lipid peroxidation reactions by electron-donating and/or radical-trapping mechanisms. Several compounds in the series, such as U-101033E and U-104067F, demonstrate greater ability than tirilazad to protect the hippocampal CA1 region in the gerbil transient (5-min) forebrain ischemia model. Delaying treatment until 4 hr after the ischemic insult still results in significant CA1 neuronal protection. U-101033E is still effective in salvaging a portion of the CA1 neuronal population when the ischemic duration is extended to 10 min. In addition, U-101033E has been found to be protective in the context of focal cerebral ischemia, reducing infarct size in the mouse permanent middle cerebral artery occlusion model, in contrast to tirilazad which is minimally effective. These results suggest that antioxidant compounds with improved brain parenchymal penetration are better able to limit certain types of ischemic brain damage than those which are localized in the cerebral microvasculature. However, the activity of U-101033E in improving early post-traumatic recovery in mice subjected to severe concussive head injury is similar to that of tirilazad. Last, the oral bioavailability of many pyrrolopyrimidines suggests that they may be useful for certain chronic neurodegenerative disorders in which lipid peroxidation plays a role.

Metabolic bone disease in very-low-birth-weight infants: assessment, prevention, and treatment by neonatal nurse practitioners

OBJECTIVE

To describe the current practice of neonatal nurse practitioners in assessing skeletal health and preventing and treating metabolic bone disease in very-low-birth-weight infants.

DESIGN

Descriptive, retrospective survey.

PARTICIPANTS

Neonatal nurse practitioners in the continental United States were systematically randomly selected. A 64% response rate was obtained (112).

MAIN OUTCOME MEASURES

Responses to questions about assessing skeletal health and preventing and treating metabolic bone disease in very-low-birth-weight infants.

RESULTS

Current practice of neonatal nurse practitioners includes assessing skeletal health of very-low-birth-weight infants on the 7th (47.3%) or 14th (19.6%) day of life, with subsequent assessments every 7 (63.3%) or 14 (18.8%) days. Neonatal nurse practitioners (85.1%) estimate the incidence of metabolic bone disease at less than 15%. Neonatal nurse practitioners initiate total parenteral nutrition (99%), provide parenteral calcium and phosphorous in ratios of 1.3-1.7:1 (9%), and add powdered fortifier (90.1%) and liquid fortifier (25.2%) to expressed breast milk. All respondents use formulas made for premature infants. Physical therapy is used by 46.8% of neonatal nurse practitioners.

CONCLUSIONS

Neonatal nurse practitioners underestimate the incidence of metabolic bone disease. Parenteral calcium and phosphorous are given but in quantities that differ from the recommended ratio. Most neonatal nurse practitioners use formulas made for premature infants and add powdered fortifier to expressed breast milk. Although physical therapy is prescribed, more research on its effect on bone mineralization is warranted before this practice is recommended without reservation.

Locomotor head-trunk coordination strategies following space flight

During locomotion, angular head movements act in a compensatory fashion to oppose the vertical trunk translation that occurs during each step in the gait cycle. This coordinated strategy between head and trunk motion serves to aid gaze stabilization and perhaps simplifies the sensory coordinate transformation between the head and trunk, allowing efficient descending motor control during locomotion. Following space flight, astronauts often experience oscillopsia during locomotion in addition to postural and gait instabilities, suggesting a possible breakdown in head-trunk coordination. The goal of the present investigation was to determine if exposure to the microgravity environment of space flight induces alteration in head-trunk coordination during locomotion. Astronaut subjects were asked to walk (6.4 km/h, 20 s trials) on a motorized treadmill while visually fixating on a centrally located earthfixed target positioned either 2 m (FAR) or 30 cm (NEAR) from the eyes. In addition, some trials were also performed during periodic visual occlusion. Head and trunk kinematics during locomotion were determined with the aid of a video-based motion analyzing system. We report data collected preflight (10 days prior to launch) and postflight (2 to 4 hours after landing). The coherence between pitch head and vertical trunk movements during gaze fixation of both FAR and NEAR targets was significantly reduced following space flight indicating decreased coordination between the head and trunk during postflight locomotion. Astronauts flying on their first mission showed greater alterations in the frequency spectra of pitch head movements as compared to their more experienced counterparts. These modifications in the efficacy of head movement control may account for the reported disruption in gaze performance during locomotion and may contribute to postflight postural and gait dysfunction.

Attribution of foot bones to sex and population groups

Although cranial and pelvic bones are the preferred skeletal material used by forensic anthropologists to assign unknown individuals to their most probable sex and population (racial) groups, these remains may be unavailable. This paper presents models for classification using metatarsals, proximal pedal phalanges, and the first distal phalanx of the foot. Measurements include lengths and mediolateral and dorsoplantar widths of these foot bones. Four samples of 40 individuals each (black and white males and females) comprise the dataset. Models were developed separately for right and left sides. Three models are provided for each side: a metatarsal model, a proximal phalangeal model, and a combination model involving selected metatarsal and phalangeal measurements. A stepwise discriminant procedure was used for variable selection, with some highly correlated (r > 0.85) variables subsequently removed. The metatarsal models correctly assign approximately 77-84% of individuals to their correct sex and population groups; proximal phalangeal models yield correct assignments in 70-72% of cases, and the combination models give correct classifications in 87% of cases. Models exchanging variables selected from one side for corresponding variables on the other show discriminating power ranging from approximately 67-86%. More conservative "jackknife" estimates give correct assignments in 64-82% of cases. When these models are used for classification of sex alone, 86.2-93.7% ("jackknife" range, 84.3-91.2%) of cases are correctly classified; for race alone, 78.6-96.2% ("jackknife" range, 75.5-92.4%).

Ex vivo expansion of frozen/thawed CD34+ cells isolated from frozen human apheresis products

Human CD34+ cells purified from frozen mobilized peripheral blood apheresis products (n = 7) were studied immediately (freshly isolated) or refrozen and studied after > 30 days storage in liquid nitrogen (refrozen/thawed). The proliferation and differentiation of freshly isolated or refrozen/thawed CD34+ cells were examined after 10 days of serum-supplemented suspension culture with recombinant human hematopoietic growth factors. The proliferative capacity (fold increase) of the refrozen/thawed CD34+ cells (mean +/- SD, 54.3 +/- 34.3) was comparable to the freshly isolated CD34+ cell cultures (49.0 +/- 42.4). Two-color flow cytometry of the CD34+ cultured cell populations, fresh and refrozen/thawed, displayed typical patterns of neutrophil differentiation into CD15/CD11b neutrophil precursors. The colony-forming ability of freshly isolated and refrozen/thawed CD34+ cells showed no significant differences (p > 0.05) in the total number or type of colony-forming units (CFU-GM, CFU-M, BFU-E, CFU-GEMM) obtained. In addition, the cloning efficiencies of freshly isolated (19.5 +/- 7.6%) and refrozen/thawed CD34+ cells (21.9 +/- 12.7%) were comparable (p = 0.366). These data suggest that CD34+ cells enriched from frozen apheresis blood products can be either used immediately or stored in liquid nitrogen and thawed with minimal effect on their ability to proliferate and differentiate in liquid culture.

Enhanced in vitro neurotoxicity of artemisinin derivatives in the presence of haemin

The role of haem in the neurotoxicity of artemisinin derivatives has been studied in vitro by examining neurite outgrowth measured by image analysis and cellular metabolism of the tetrazolium salt MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide) measured spectrophotometrically in the neuroblastoma cell line NB2a, and by examining binding of radiolabelled dihydroartemisinin to NB2a cell and rat brain proteins. In the cases of artemether, dihydroartemisinin, and arteether, haemin (ferriprotoporphyrin IX) significantly increased the dose-related inhibition of neurite outgrowth from differentiating NB2a cells and significantly increased the dose-dependent inhibition of MTT metabolism. Inhibition of neurite outgrowth and metabolism of MTT in the presence or absence of haemin ranged from 72% to 93% and from 27% to 49% at a drug concentration of 300 nM. Haemin also significantly increased the dose-related binding of radiolabelled dihydroartemisinin to proteins from NB2a cells approximately twofold and to rat brain between three- and sixfold. Haemin did not enhance the neurotoxicity of desoxyarteether, a structural analogue of arteether with an ether linkage in the place of the endoperoxide bridge. It is suggested that haemin may catalyse the transformation of these derivatives via an interaction with the endoperoxide bridge of the artemisinin derivative to produce free radicals or electrophilic intermediates that are toxic to neuronal cells.

Effects of the neem tree compounds azadirachtin, salannin, nimbin, and 6-desacetylnimbin on ecdysone 20-monooxygenase activity

The effects of azadirachtin, salannin, nimbin, and 6-desacetylnimbin on ecdysone 20-monooxygenase (E-20-M) activity were examined in three insect species. Homogenates of wandering stage third instar larvae of Drosophila melanogaster, or abdomens from adult female Aedes aegypti, or fat body or midgut from fifth instar larvae of Manduca sexta were incubated with radiolabeled ecdysone and increasing concentrations (from 1 x 10(-8) to 1 x 10(-3) M) of the four compounds isolated from seed kernels of the neem tree, Azadirachta indica. All four neem tree compounds were found to inhibit, in a dose-dependent fashion, the E-20-M activity in three insect species. The concentration of these compounds required to elicit a 50% inhibition of this steroid hydroxylase activity in the three insect species examined ranged from approximately 2 x 10(-5) to 1 x 10(-3).

Risk factors for premature coronary heart disease after successful liver transplantation in adults

As solid-organ transplantation has evolved into a highly effective treatment for end-stage organ disease, the long-term health implications of chronic exposure of recipients to immunosuppressants and other pharmacological agents are becoming more apparent. Coronary heart disease has long been known to plague kidney transplant recipients and more recently has been found to affect heart transplant recipients disproportionately. Coronary heart disease after liver transplantation, however, is less well known. The purpose of this study was to examine risk factors for premature coronary heart disease in asymptomatic adult recipients of liver transplants. Nutrition-related risk factors for coronary heart disease (obesity and hyperlipidemia) were measured in 29 patients before and after liver transplantation. Changes with respect to primary immunosuppression protocol (cyclosporine plus corticosteroid vs tacrolimus plus corticosteroid) were compared. Risk factors that had not been present before transplantation were apparent in both groups by 6 months after transplantation. Although obesity and hyperlipidemia were not found to be independent risk factors for coronary heart disease, they were clinically important when considered in combination. Cyclosporine was associated with significantly higher serum lipid concentrations than was tacrolimus.

Two novel pyrrolopyrimidine lipid peroxidation inhibitors U-101033E and U-104067F protect facial motor neurons following neonatal axotomy

Recent reports suggest that oxygen radical-induced lipid peroxidation plays a role in the retrograde degeneration of motor neurons following facial nerve axotomy in the neonatal rat. The purpose of the present study was to explore this notion further by testing the neuroprotective properties of two novel brain-penetrating, lipid peroxidation inhibitors, U-101033E and U-104067F, in this model of neuronal degeneration. In Experiment 1, 14-day-old rats were pretreated with 3, 10, or 30 mg/kg U-101033E (po) 10 min before right facial nerve axotomy (Day 0) and then posttreated once a day from Day 1 to Day 6, and once every other day from Day 8 to Day 21. Rats were sacrificed 21 days postaxotomy and surviving cholinergic cell bodies were identified using choline acetyltransferase immunocytochemistry. Both 10 and 30 mg/kg U-101033E significantly enhanced motor neuron survival, with survival rates of 65.9-88.9% being noted in comparison to 51.7-62% survival in vehicle controls (P < or = 0.05). Experiment 2 demonstrated a significant neuroprotective effect of 10 and 30 mg/kg U-104067F using the same dosing schedule. Experiment 3 was designed to test whether shorter periods of drug exposure (e.g., 5 or 7 days) would be sufficient to preserve motor neurons in rats treated with 10 mg/kg U-101033E. The results suggested that as little as 5 days of drug treatment is sufficient to enhance motor neuron survival. Finally, Experiment 4 demonstrated an 18-19% increase in motor neuron survival in rats treated with 10 and 30 mg/kg U-104067F for 5 consecutive days postaxotomy. Taken together, the attenuation of motor neuron degeneration by the two pyrrolopyrimidine lipid peroxidation inhibitors, U-101033E and U-104067F, lends support to the notion that lipid peroxidation contributes to the pathogenesis of axotomy-induced neurodegeneration.

Ten years of Orthoclone OKT3 (muromonab-CD3): a review

Many important advances in transplantation have been made during the last decade. The introduction of Orthoclone OKT3 into clinical trials and its subsequent approval by the Food and Drug Administration in 1985 for use as an antirejection agent for renal transplantation were landmarks in the field of clinical transplantation of solid organs. In the decade since the approval of OKT3 for clinical use, much has been learned and written about OKT3. OKT3 now is considered a safe and effective agent for prophylaxis and first-line treatment of acute rejection of solid organ allografts. In this article, the development and use of OKT3 over the last 10 years, as well as the present status and future implications of immune therapy with OKT3, are reviewed.

Osteoporosis prevention in premenopausal women: using a stage model approach to examine the predictors of behavior

The precaution adoption process model was used to examine the predictors of 2 behaviors recommended to reduce the risk of developing osteoporosis: calcium consumption and weight-bearing exercise. A total of 452 premenopausal women completed a mailed questionnaire assessing stage in the precaution adoption process and 12 knowledge and attitudinal variables. Participants were also given an opportunity to request information about osteoporosis. In all, 11 of the 12 knowledge and attitudinal variables were associated with calcium stage; 8 were associated with exercise stage. Information requests were associated with both calcium and exercise stage. Findings provide substantial support for the precaution adoption process model and suggest that the model can be usefully applied in this area to increase understanding of why many women do not practice behaviors that could reduce their risk of developing osteoporosis.

Biochemical comparison of plaque fluid on tooth and acrylic surfaces during a sucrose challenge

Previous studies have investigated variations in dental plaque fluid composition within a single mouth after a sucrose exposure. The purpose of this study was to determine a potential source of calcium and phosphorus in plaque by comparing the pH, calcium and phosphorus concentrations in plaque fluid obtained from an acrylic appliance with samples taken from supragingival tooth surfaces within the same individual after a sucrose challenge. Separate plaque samples from 14 individuals were collected from an acrylic appliance or tooth surfaces within same individual before and 15 min after a 20% sucrose rinse. Each plaque sample was centrifuged and nanolitre samples of plaque fluid were analysed for pH with a pH microelectrode, for total calcium concentration by atomic absorption in a graphite furnace, and for phosphorus concentration by spectrophotometry. There was an increase in the calcium and phosphorus concentration in the plaque after the sucrose challenge and a significant increase in calcium and phosphorus concentrations in the plaque taken from the teeth compared to the acrylic surfaces. The results indicate that the increased total calcium and phosphorus in plaque during a sucrose challenge is probably derived from the demineralization of enamel or extracellular demineralized components.

Physical exercise as an oncology nursing intervention to enhance quality of life

PURPOSE/OBJECTIVES

To examine how physical exercise can enhance the quality of life (QOL) of people with cancer and to provide general guidelines for incorporating exercise into care plans for these patients.

DATA SOURCES

Published and nonpublished medical, nursing, rehabilitation, and physical exercise literature.

DATA SYNTHESIS

Including physical exercise in the care plans of people with cancer can enhance their QOL. The development of an individualized exercise plan for patients with cancer involves screening, assessment, prescription, goal setting, evaluation, and communication. The success of wellness-oriented interventions, such as exercise, can be evaluated with patient diaries, monitoring, and a QOL measurement tool.

CONCLUSIONS

Physical exercise can positively influence all dimensions of life. Nurses must use sound clinical judgment and creativity and collaborate with other healthcare disciplines when prescribing exercise. Established exercise protocols for people with cancer are limited, and further research is needed in this area.

IMPLICATIONS FOR NURSING PRACTICE

Oncology nurses must continue to expand the literature on guidelines and precautions for exercise in oncology populations. Nurses need to use their knowledge of oncology, QOL, and exercise to recommend and encourage the incorporation of physical exercise into the care plans of people with cancer.

Large-scale selection of CD34+ peripheral blood progenitors and expansion of neutrophil precursors for clinical applications

Hematopoietic recovery after high-dose chemotherapy is characterized by an obligate period of neutropenia of approximately 8-10 days. It is postulated that if a pool of neutrophil precursors and progenitors were expanded in vitro and reinfused, the duration of neutropenia may be substantially shortened by these cells capable of providing mature neutrophils within days of reinfusion. In this study, peripheral blood progenitor cell products were obtained from six normal donors mobilized with rhG-CSF and two patients mobilized with cyclophosphamide and rhG-CSF. CD34+ cells were isolated using the Isolex immunomagnetic bead method. A mean of 8.26 x 10(7) CD34+ cells with a mean purity of 74.5% were seeded at a concentration of 1 x 10(5)/ml into a 12 day stroma-free liquid culture using gas-permeable bags. A serum-free growth medium supplemented with PIXY321 was used. On day 7, there was a mean cellular expansion of fourfold, at which time the cells were resuspended at the initial concentration, yielding a mean culture volume of 3L (1-6 L). On day 12, there was an additional mean fold cellular expansion of 10 x, achieving an overall mean fold expansion of 41 +/- 16. Cellular characterization of the expanded cells revealed predominantly neutrophil precursors by morphology (mean 70.1%) and flow cytometric analysis. A mean of 52.3% of the expanded cells expressed CD15. Immunohistochemical staining revealed a mean of 7.1% CD41a+ megakaryocytic progenitors in the final cultured cell product. Detectable CD34+ cells were maintained only in those cultures initiated with greater than 90% CD34+ cells. Colony-forming units-granulocyte-macrophage (CFU-GM) were maintained in the 12 day culture at a level similar to the preculture number, whereas CFU mixed were depleted in all samples. On day 0, there were few CFU clusters (colonies containing fewer than 50 cells) identified, but by day 12, a mean total of 8.3 x 10(6) CFU clusters were identified. On day 12, the expanded cells were harvested and pooled using the Fenwal CS3000 Plus blood cell separator and resuspended in Plasma-Lyte-A with 1% human serum albumin. The mean harvest recovery of expanded progenitors was 91%, with a mean viability of 86%.

Inhibition of lipid peroxidation attenuates axotomy-induced apoptotic degeneration of facial motor neurons in neonatal rats

The purpose of this study was to investigate the role of oxygen radical-induced lipid peroxidative mechanisms in trophic deprivation-induced apoptotic motor neuronal degeneration by testing the ability of the 21-aminosteroid lipid peroxidation inhibitor tirilazad mesylate (U-74006F) to attenuate the retrograde degeneration of facial motor neurons following axotomy in 14-day-old rat pups. On day 0, the right facial nerve of each rat was transected at its point of exit from the stylomastoid foramen. Pups were treated orally with either 10 or 30 mg/kg U-74006F or cyclodextrin vehicle 10 min before axotomy, and post-treated once a day from days 1 to 6, and then once every other day from days 8 to 21. The rats were sacrificed 3 weeks post-transection and the surviving motor neurons, identified through choline acetyltransferase immunocytochemistry, were counted in three regions (planes) in the facial nucleus. In vehicle-treated rats, 56.2% (region A), 50.6% (region B), and 57.4% (region C) of the motor neurons in the ipsilateral facial nucleus survived 21 days following facial nerve axotomy in comparison to the non-axotomized contralateral nucleus (P < 0.0001). Treatment with 10 mg/kg U-74006F significantly enhanced motor neuron survival in regions B and C to 72.8% (P < 0.01) and 66.7% (P < 0.02%), respectively. The 30 mg/kg dose level also increased survival rates to 64.2% (P < 0.02) and 67.9% (P < 0.01), respectively. A second experiment demonstrated that oral dosing with U-74006F (30 mg/kg), when limited to the first 5 days after axotomy, also significantly blunted retrograde degeneration measured at 21 days post-axotomy. The efficacy of the lipid peroxidation inhibitor U-74006F in protecting a portion of the facial motor neuron pool from post-axotomy degeneration suggests that lipid peroxidation may play a mechanistic role in trophic deprivation-induced apoptotic neuronal death.

Attribution of hand bones to sex and population groups

Forensic anthropologists assign sex and population group (race) to individuals on the basis of skeletal remains. While the most useful bones for these determinations are cranial and pelvic, these are not always available. The purpose of this paper is to provide models for classification using metacarpals and hand phalanges. Four samples of 40 individuals each (black and white males and females) form the dataset. Measurements include lengths and radioulnar and dorsopalmar widths of the 19 bones of each hand. The large number of total variables necessitated separate models for metacarpal and phalangeal categories; due to the considerable number of significant differences between corresponding right and left hand variables, separate models were created for right and left sides. A stepwise discriminant procedure was used to select variables, with some highly correlated (r > 0.85) variables subsequently removed. The model for left hand metacarpals has the greatest power of discrimination (89.4%); that for right hand middle phalanges, the least (71.7%). Metacarpals assign approximately 87-89%, proximal phalanges 76-79%, middle phalanges 72-79%, and distal phalanges 81-83% of individuals to their correct sex and population groups. Models exchanging variables selected from one side for corresponding variables on the other show discriminating power ranging from 72.3 to 85.6%. Thus roughly 70-90% of individuals are correctly classified by these models; more conservative "jackknife" estimates yield a success rate of approximately 67-82%. When these models are used for classification of sex alone, 89.9-94.4% ("jackknife" range, 88.7%-94.4%) of cases are correctly classified; for race alone, 80.5-98.1% ("jackknife" range, 77.4-96.9%).

Studies on the influence of pH and pancreatin on 13C-formaldehyde-induced gelatin cross-links using nuclear magnetic resonance

Carbon-13 nuclear magnetic resonance (13C-NMR) and 13C-enriched formaldehyde (13CH2O) were utilized to observe cross-linking in gelatin. Thus, when a 6% solution of gelatin in water was treated with 2000 ppm 13CH2O at 20 degrees C, the 15 hr 13C-NMR spectrum of the crosslinked gel showed peaks representing carbinolamines (methylols) of arginine and lysine, as well as a peak ascribed to a methylene cross-link between arginine and lysine. Similar results were obtained when these cross-linking reactions were conducted using only 100 ppm 13CH2O. When pancreatin (1% w/v) was added to the solution of 6% gelatin cross-linked with 2000 ppm 13CH2O, the gel began to revert to a clear fluid solution. After incubation for 24 hr at 37 degrees C, the 13C-NMR spectrum of this solution confirmed the presence of the methylols of lysine and arginine, and the lysine-arginine cross-link. When 13CH2O (2000 ppm) was added to a 6% solution of gelatin at pH 13.0, the arginine methylol and the lysine-arginine crosslinks were produced. The 13CH2O-induced crosslinking of gelatin at pH 2.0, however, yielded the lysine methylol as the sole product.

Immunocytochemistry and flow cytometry evaluation of human megakaryocytes in fresh samples and cultures of CD34+ cells

Adhering platelets on the cell surface can give misleading results when doing flow cytometry analysis of platelet/megakaryocyte-specific glycoprotein (GP) antigens to enumerate megakaryocytes (MK) in mobilized peripheral blood (PB), apheresis products, or normal bone marrow (BM). For adequate quantification and characterization of human MK, we examined samples with parallel flow cytometry and immunocytochemistry. MK expression of GP IIb/IIIa (CD41a), GP Ib (CD42b), GP IIIa (CD61), CD45, CD33, and CD11b, and their light scatter properties were evaluated. Fresh samples of low density mononuclear cells (MNC) or purified CD34+ cells contained 10-45% of platelet-coated cells. Platelet-coated cells decreased dramatically after several days of incubation in a serum-free medium supplemented with stem cell factor, IL-3, IL-6, and/or GM-CSF. Between d 9-12, flow cytometry detected a distinct CD41a+ MK population, 8.3 +/- 1.3% in BM CD34 cell cultures (n = 7) and 13.1 +/- 2.1% in PB CD34 cell cultures (n = 14), comparable to immunocytochemistry data (7.8 +/- 1.9% and 16.4 +/- 2.6%, respectively). CD41a stained a higher proportion of MK than CD42b or CD61, while CD42b+ or CD61+ cells contained more morphologically mature MK than CD41a+ cells in cultures containing aplastic serum. When fluorescence emission of CD41a was plotted against forward-light scatter (FSC), subpopulations of small and large MK were observed. Such subpopulations overlapped in CD41a intensity and side-light scatter (SSC) property. Most MK co-expressed CD45 (98.8% positive) but not CD33 (80.7% negative) or CD11b (88.9% negative). Our data indicate that flow cytometry can be used effectively to identify MK. However, caution should be taken with samples containing adherent platelets.

Osteoporosis prevention in premenopausal women: using a stage model approach to examine the predictors of behavior

The precaution adoption process model was used to examine the predictors of 2 behaviors recommended to reduce the risk of developing osteoporosis: calcium consumption and weight-bearing exercise. A total of 452 premenopausal women completed a mailed questionnaire assessing stage in the precaution adoption process and 12 knowledge and attitudinal variables. Participants were also given an opportunity to request information about osteoporosis. In all, 11 of the 12 knowledge and attitudinal variables were associated with calcium stage; 8 were associated with exercise stage. Information requests were associated with both calcium and exercise stage. Findings provide substantial support for the precaution adoption process model and suggest that the model can be usefully applied in this area to increase understanding of why many women do not practice behaviors that could reduce their risk of developing osteoporosis.

Protective effects of tirilazad mesylate and metabolite U-89678 against blood-brain barrier damage after subarachnoid hemorrhage and lipid peroxidative neuronal injury

The 21-aminosteroid lipid-peroxidation inhibitor, tirilazad mesylate (U-74006F), recently was shown in a large multinational Phase III clinical trial to decrease mortality and improve neurological recovery in patients 3 months after onset of aneurysmal subarachnoid hemorrhage (SAH). A major tirilazad metabolite in animals and man, U-89678 is formed when the 4-5 double bond in the A-ring is reduced and has been postulated to contribute significantly to tirilazad's neuroprotective effects. In the first experiment of the present study, the authors compared the effects of tirilazad and U-89678 on acute blood-brain barrier (BBB) damage in rats subjected to SAH via injection of 300 microliters of autologous nonheparinized blood under the dura of the left cortex. The rats were treated by intravenous administration of either 0.3 or 1.0 mg/kg of tirilazad or U-89678 10 minutes before and 2 hours after SAH, and BBB damage was quantified according to the extravasation of the protein-bound Evans' blue dye into the injured cortex 3 hours post-SAH. The results revealed that 0.3 and 1.0 mg/kg tirilazad significantly reduced SAH-induced BBB damage 35.2% (p < 0.05) and 60.6% (p < 0.0001), respectively, in comparison to treatment with vehicle. The 0.3- and 1.0-mg/kg doses of U-89678 also decreased injury by 39.1% (p < 0.05) and 21.3% (not significant), respectively. In the second experiment, the investigators assessed the relative abilities of tirilazad and U-89678 to protect cultured neurons from iron-induced lipid peroxidative injury. Fetal mouse spinal cord cells were pretreated with 3, 10, or 30 microM tirilazad or U-89678 for 1 hour and then exposed to 200 microM ferrous ammonium sulfate (FAS) for 40 minutes. Cell viability was measured in terms of the uptake of [3H]alpha-(methyl)-aminoisobutyric acid 45 minutes after the FAS treatment. Both compounds enhanced neuronal survival in a concentration-dependent fashion. Although the two were equally efficacious, U-89678 was slightly more potent than its parent. On the basis of these findings, the authors conclude that the tirilazad metabolite, U-89678, possesses vaso- and neuroprotective properties that are essentially equivalent to the parent 21-aminosteroid. Hence, U-89678 probably contributes to the protective effects of tirilazad in SAH and other insults to the central nervous system.