NLRP3 inflammasome activation in platelets in response to sepsis

Sepsis is a complex syndrome characterized by organ dysfunction and a dysregulated immune host response to infection. There is currently no effective treatment for sepsis, but platelets have been proposed as a potential therapeutic target for the treatment of sepsis. We hypothesized that the NLRP3 inflammasome is activated in platelets during sepsis and may be associated with multiorgan injury in response to polymicrobial sepsis. Polymicrobial sepsis was induced by cecal ligation and puncture (CLP) in 12‐ to 13‐week‐old male Sprague–Dawley rats. The necrotic cecum was removed at 24 h post‐CLP. At 72 h post‐CLP, activated platelets were significantly increased in CLP versus Sham rats. Colocalization of NLRP3 inflammasome components was observed in platelets from CLP rats at 72 h post‐CLP. Plasma, pulmonary, and renal levels of IL‐1β and IL‐18 were significantly higher in CLP rats compared to Sham controls. Soluble markers of endothelial permeability were increased in CLP versus Sham. Renal and pulmonary histopathology were markedly elevated in CLP rats compared to Sham controls. NLRP3 is activated in platelets in response to CLP and is associated with inflammation, endothelial permeability and multiorgan injury. Our results indicate that activated platelets may play a role to cause multiorgan injury in sepsis and may have therapeutic potential for the treatment of sepsis multiorgan injury.

Abstract 128: Interleukin-17 Mediates Hypertension, Intrauterine Growth Restriction, Cytolytic Natural Killer Cells and Vascular Dysfunction in Pregnant Rats

Preeclampsia is a hypertensive disorder of pregnancy characterized by intrauterine growth restriction (IUGR), vascular dysfunction, and chronic immune activation including increased T H 17s and cytolytic NK cells (NK C ). We recently developed a novel model of preeclampsia in which placental ischemia (PI)-induced T H 17s cause a preeclampsia-like phenotype in pregnant rats characterized by hypertension, IUGR, oxidative stress (ROS), and increased cytolytic NK cells (NK C ). In the current study we investigated a novel role for IL-17, the main cytokine secreted from T H 17s, to directly induce IUGR, NK C activation, and vascular dysfunction in pregnancy. IL-17 (150 pg/day) was chronically infused into a subset of normal pregnant (NP) rats from gestation day (GD) 12-19 (NP+IL-17) via i.p. minipump. On GD 18 carotid catheters were implanted and on GD 19 MAP, fetal weight, placental weight, placental NK C , and NK C -associated proteins were measured and vascular reactivity of uterine arteries was assessed. Data are expressed as mean±SEM. MAP significantly increased from 100±3 mmHg in NP (n=9) to 115±1 mmHg in NP+IL-17 (n=12). Fetal weight significantly decreased from 2.5±0.04 g in NP to 2.3±0.03 g in NP+IL-17 (p<0.05). Placental weight significantly decreased from 0.62±0.02 g in NP to 0.55±0.01 g in NP+IL-17 (p<0.05). Placental ROS significantly increased 1353±337 RLU/min/mg in NP to 2210±180 RLU/min/mg in NP+IL-17 (p<0.05). Placental NK C increased from 2.6±1.6% of the total NK population in NP to 11.3±2.2% in NP+IL-17 (p<0.05). Placental granzyme B increased from 22.7±1.6 pg/mg in NP to 30.2±2 pg/mg in NP+IL-17 (p<0.05). Placental granzyme A increased from 3067±225 pg/mg in NP to 3926±210 pg/mg (p<0.05). Additionally, placental levels of VEGF, an important pro-angiogenic factor secreted by non-cytolytic uterine NK cells significantly decreased from 77.6±6.5 pg/mg in NP to 54.2±3.2 pg/mg in NP+IL-17 (p<0.05). We also observed impaired relaxation of uterine arteries in response to acetylcholine. These data suggest a shift from non-cytolytic NK to NK C cells in the placentas of NP+IL17. In addition to hypertension and ROS, this study demonstrates novel roles for IL-17 to directly mediate IUGR, NK C activation, and endothelial vascular dysfunction during pregnancy.

Activity participation and affect among nursing home residents: support for a behavioural model of depression

One focus of interventions being developed for depression in nursing homes is increasing pleasant events. The conceptual foundation of such interventions requires establishing links among activity levels, depressive symptoms and positive affect. We observed activity and affect among 28 nursing home residents, five-days-a-week for four weeks, and concurrently collected self-reported affect and depression data. Inclusion of intra-individual analyses using random effects models demonstrated considerable individual variability in the relationship between positive affect and activity, although the results broadly supported the association. Participants differed with regard to what types of events were pleasurable and with regard to the relationships among pleasure, interest and activity. Depression levels were related to some of these individual differences. Activity was related primarily to interest rather than pleasure and higher interest was related to fewer depressive symptoms. Our findings emphasize the importance of individually tailoring pleasant events interventions and suggest that prescriptive group activities are unlikely to prove effective as means for improving positive affect.

Simple, novel physical activity maintains proximal femur bone mineral density, and improves muscle strength and balance in sedentary, postmenopausal Caucasian women

A simple, appealing, physical activity program can be prescribed to reduce the risk of falls in sedentary, postmenopausal, independent-living, Caucasian women. Foot stamping, progressively loaded squats, and in-line dancing positively influence proximal femoral bone mineral density, lower extremity strength, and static and dynamic balance.

INTRODUCTION

Foot stamping, squats exercises, and in-line dancing together create a suitable activity program for sedentary, independent-living older women.

METHODS

Forty-five postmenopausal women not taking medications for bone health were randomly assigned to one of three groups. All groups attended one line dance class per week. Two groups additionally performed progressively loaded squats five times per week. One group also performed four foot stamps, twice daily, five times per week. Broadband ultrasound attenuation (BUA), proximal femur (PF) and lumbar spine (LS) bone mineral density (BMD), squats number, and balance variables were measured.

RESULTS

There were no differences within or between groups in baseline and follow-up BUA, PF or LS BMD; however, a strong stamp compliance effect was apparent for BUA (r = 0.73) and PF BMD (r = 0.79). Number of squats (p < 0.01) and single leg stance time (p < 0.01) increased, while timed up and go time decreased (p < 0.01) for all participants.

CONCLUSIONS

Line dancing, particularly in concert with regular squats and foot stamping, is a simple and appealing strategy that may be employed to reduce lower extremity bone loss, and improve lower limb muscle strength and balance, in independent living, otherwise healthy, postmenopausal Caucasian women.

Deep-sea ecology. Developmental arrest in vent worm embryos

Temperature is a key factor in controlling the distribution of marine organisms and is particularly important at hydrothermal vents, where steep thermal gradients are present over a scale of centimetres. The thermophilic worm Alvinella pompejana, which is found at the vents of the East Pacific Rise (2,500-m depth), has an unusually broad thermotolerance (20-80 degrees C) as an adult, but we show here that the temperature range required by the developing embryo is very different from that tolerated by adults. Our results indicate that early embryos may disperse through cold abyssal water in a state of developmental arrest, completing their development only when they encounter water that is warm enough for their growth and survival.

Olanzapine therapy in treatment-resistant psychotic mood disorders: a long-term follow-up study

BACKGROUND

Recent studies suggest a role for the atypical antipsychotic olanzapine in the acute treatment of psychotic mood disorders, but long-term data are unavailable. The purpose of this naturalistic study was to determine the long-term effectiveness and tolerability of olanzapine as add-on therapy in psychotic mood disorders.

METHOD

Hospital records were reviewed for 125 inpatients at the state psychiatric hospital in Buffalo, N.Y., who received at least 6 weeks of add-on olanzapine treatment for psychotic mood disorders (schizoaffective disorders [bipolar and depressive type], bipolar disorders [I, II, and NOS], and major depressive disorder). A group of schizophrenic patients served as a control group (N = 50). Baseline measures, including age, gender, number of hospitalizations in the 2 years prior to olanzapine treatment, concomitant medications, the Clinical Global Impressions scale (CGI), and the Global Assessment of Functioning-Equivalent (GAF-EQ) and Kennedy Axis V psychological impairment, violence, social skills, and activities of daily living subscale scores, were obtained. Follow-up information was obtained from the patients at least 6 months after initiation of olanzapine or by chart review and discussion with the treating psychiatrist. Patients with a diagnosis of psychotic mood disorders were compared with patients with the non-affective psychotic disorder (schizophrenia) on a variety of outcome measures.

RESULTS

Follow-up information was available on 102 patients (82%). Mean follow-up was 15 months; 50 (49%) of the 102 patients remained on olanzapine treatment at follow-up (32 psychotic mood disorder, 18 schizophrenic). The primary reason for discontinuation in both groups was lack of response. Both the psychotic mood disorder and schizophrenic groups had comparable outcomes on the CGI and GAF-EQ. Improvement on the Kennedy Axis V psychological impairment and social skills subscales was seen only in the psychotic mood disorders group (p < .01); both groups showed significant (p < .02) improvement in the violence subscale. Sustained mood-stabilizing effect was evident in only 7/27 (26%) of the psychotic mood disorders patients continuing on add-on olanzapine treatment at follow-up.

CONCLUSION

Lack of response was the primary reason for discontinuation of add-on olanzapine in both groups. Mood symptoms predicted a better response to add-on olanzapine in patients with psychotic mood disorders on selective outcome measures. However, only 26% of the patients with psychotic mood disorders sustained a clinically meaningful mood-stabilizing effect with add-on olanzapine treatment at follow-up.

Larval dispersal potential of the tubeworm Riftia pachyptila at deep-sea hydrothermal vents

Hydrothermal vents are ephemeral because of frequent volcanic and tectonic activities associated with crust formation. Although the larvae of hydrothermal vent fauna can rapidly colonize new vent sites separated by tens to hundreds of kilometres, the mechanisms by which these larvae disperse and recruit are not understood. Here we integrate physiological, developmental and hydrodynamic data to estimate the dispersal potential of larvae of the giant tubeworm Riftia pachyptila. At in situ temperatures and pressures (2 degrees C and 250 atm), we estimate that the metabolic lifespan for a larva of R. pachyptila averages 38 days. In the measured flow regime at a fast-spreading ridge axis (9 degrees 50' N; East Pacific Rise), this lifespan results in potential along-ridge dispersal distances that rarely exceed 100 km. This limited dispersal results not from the physiological performance of the embryos and larvae, but instead from transport limitations imposed by periodic reversals in along-ridge flows and sustained episodes of across-ridge flow. The lifespan presented for these larvae can now be used to predict dispersal under current regimes at other hydrothermal vent sites.

The sagittal band: anatomic and biomechanical study

Forty-eight digits from 12 human adult fresh-frozen and formalin-preserved cadaveric hands were used to study the anatomy and biomechanics of the sagittal band (SB) and to investigate the mechanism of its injury. The SB was observed to be part of a complex retinacular system in proximity to the metacarpophalangeal (MCP) joint collateral ligaments and the palmar plate. Dynamic changes in SB fiber orientation were observed with different positions of the MCP and wrist joints. The fibers were perpendicular (0 degrees ) to the extensor tendon in neutral position, distally angulated 25 degrees at 45 degrees of MCP flexion, and 55 degrees with full flexion. Swan-Ganz catheter measurements were obtained deep to the SB in varying positions of the MCP joint. The average pressure generation was greatest (50 mm Hg) during full MCP joint flexion and least (30 mm Hg) during 45 degrees flexion. When MCP joint radial or ulnar deviation was added the average measurement was greatest (57) in neutral MCP position and least (35 mm Hg) in 45 degrees flexion. Serial sectioning of the ulnar SB produced no extensor tendon instability. Partial proximal but not distal sectioning of the radial SB produced tendon subluxation. Complete sectioning of the radial SB produced tendon dislocation. Wrist flexion increased tendon instability after radial SB sectioning. We conclude that (1) extensor tendon instability following SB disruption is most common in the long finger and least common in the small finger; (2) ulnar instability of the extensor tendon is due to partial or complete radial SB disruption, (3) the degree of extensor tendon instability is determined by the extent of SB disruption, (4) proximal rather than distal SB compromise contributes to extensor tendon instability, (5) great forces are inflicted on the SB while the MCP joint is in full extension or less frequently in full flexion, which may be the mechanism of its injury, and (6) wrist flexion contributes to extensor tendon instability after SB disruption and may exacerbate the severity of its injury.

Larval development of the tropical deep-sea echinoid Aspidodiadema jacobyi: phylogenetic implications

The complete larval development of an echinoid in the family Aspidodiadematidae is described for the first time from in vitro cultures of Aspidodiadema jacobyi, a bathyal species from the Bahamian Slope. Over a period of 5 months, embryos grew from small (98-micron) eggs to very large (3071-micron) and complex planktotrophic echinopluteus larvae. The fully developed larva has five pairs of red-pigmented arms (preoral, anterolateral, postoral, posterodorsal, and posterolateral); fenestrated triangular plates at the bases of fenestrated postoral and posterodorsal arms; a complex dorsal arch; posterodorsal vibratile lobes; a ring of cilia around the region of the preoral and anterolateral arms; and a long, unpaired posterior process containing a fenestrated rod. The presence of a posterior process and posterodorsal arms makes the larva of Aspidodiadema jacobyi much more similar to larvae of irregular urchins in the order Spatangoidea than to other families of the order Diadematoida, to which the family is normally assigned. This unexpected larval form lends support to a recommendation that the Aspidodiadematidae should be either elevated to ordinal status as a sister group of the order Diadematoida, or split off as a sister group of the other families within the order. In either case, if we accept the parsimonious hypothesis that the aboral process and posterodorsal arms were derived only once in the evolutionary history of euechinoids, then the larval data suggest that the Aspidodiadematidae may be very near the node where the irregular and regular euechinoids first diverged.

Light induced larval release of a colonial ascidian

Larval release and photobehavior were studied in the colonial ascidian Polyandrocarpa zorritensis. The test hypothesis was that if larval release is induced by light, then larvae should be attracted to settlement areas where light is sufficient for larval release. Light induced larval release but the time course varied with light intensity. As the intensity of either sunlight or blue-green light decreased (1) the time until the beginning of larval release (latency) became longer, (2) the mean time of larval release increased, and (3) the time interval over which larvae were released increased. The threshold light intensity to induce larval release in blue-green light (8.75x10(12) photons cm(-2) s(-1)) was lower than that in sunlight (3.6x10(13) photons cm(-2) s(-1)). Light induced larval release was not affected by currents up to 15 cm s(-1). Larvae aggregate in light when given a choice between light and dark. This response did not vary with larval age. The lowest light intensity, at which larvae could distinguish between light and dark was 5.0x10(12) photons cm(-2) s(-1) in blue-green light and 2.9x10(14) photons cm(-2) s(-1) in sunlight. Thus, the hypothesis is supported because larvae are attracted to areas where light intensity is sufficient for larval release.

Methane ice worms: Hesiocaeca methanicola colonizing fossil fuel reserves

During a research cruise in July 1997 in the Gulf of Mexico we discovered a gas hydrate approximately 1 m thick and over 2 m in diameter which had recently breached the sea floor at a depth of 540 m. The hydrate surface visible from the submarine was considerably greater than that of any other reported hydrate. Two distinct color bands of hydrate were present in the same mound, and the entire exposed surface of the hydrate was infested (2500 individuals/m2) with 2 to 4 cm-long worms, since described as a new species, Hesiocaeca methanicola, in the polychaete family Hesionidae (Desbruyères and Toulmond 1998). H. methanicola tissue stable isotope values are consistent with a chemo-autotrophic food source. No evidence of chemo-autotrophic symbionts was detected, but geochemical data support the presence of abundant free living bacteria on the hydrate. The activities of the polychaetes, grazing on the hydrate bacteria and supplying oxygen to their habitats, appears to contribute to the dissolution of hydrates in surface sediments.

Epidermal lesions and mortality caused by vibriosis in deep-sea Bahamian echinoids: a laboratory study

When significant mortality of the bathyal spatangoid echinoid Paleopneustes cristatus occurred under laboratory conditions, we investigated the cause and course of the disease by culturing and identifying internal pathogens, then experimentally infecting healthy urchins with isolates of the suspected disease organism. The pathogen was determined to be the gram-negative halophilic bacterium Vibrio alginolyticus. This species was also recovered from frozen post-challenge specimens of P. cristatus and from moribund individuals of Archaeopneustes hystrix, another spatangoid reared under similar in vitro conditions. This is the first experimental study of bacterial disease in any deep-sea invertebrate.

New and emerging therapies for vitiligo

Vitiligo is a common skin disease; however, it still remains a difficult disease to treat. Not all patients respond to current forms of treatment. There are several new treatments, surgical and nonsurgical, and immunologic, that appear to either have higher success rates than past therapies or have potential as future developments for therapy of vitiligo.

Are Echinoderm Egg Size Distributions Bimodal?

Marine invertebrates can be categorized into species that reproduce by producing either large numbers of small, energetically inexpensive eggs that become planktotrophic larvae, or fewer, larger eggs with more yolk and lecithotrophic development (1). The selective advantages of these alternative strategies were considered in a series of simple mathematical models by Vance (2, 3). These models predicted that intermediate egg sizes should have lower reproductive efficiency, and that only extreme egg sizes should be evolutionarily stable (2, 3). Specifytally, Vance's models (2, 3) and later modifications (4-7), predict that eggs of marine invertebrates should have bimodal size distributions, rejecting the contrast between small egg/feeding and large egg/nonfeeding modes of development and the selection against intermediate egg sizes. Evidence for bimodality in egg size distributions is, however, equivocal, with unimodal distributions seen in the majority of comparative studies that are appropriate tests of the hypothesis (8-13). Bimodal distributions have been described only in a few groups of molluscs (4) and asteroid and echinoid echinoderms (14). Here we test the prediction of bimodality in the holothuroid and ophiuroid echinoderms and show that although the natural log-transformed egg size distributions are visually unimodal, the holothurian egg size distribution is statistically composed of two discrete modes. Moreover, reexamination of the asteroid and echinoid egg size distributions (14) with the addition of data from more recent literature confirms that there are two statistical modes in the egg size distributions of these classes. Thus, in the phylum Echinodermata, there is a bimodal egg size distribution three of the four classes in which this prediction can tested.

Ovarian Development in the Class Holothuroidea: a Reassessment of the "Tubule Recruitment Model"

The "tubule recruitment model" for the development of the holothurian gonad was proposed (a) to connect the stages of oogenesis with ovarian morphology in holothurians throughout the reproductive season and (b) to emphasize the potential for the holothurian ovary as a model system for cytological and biochemical study of echinoderm oogenesis. To reassess the evidence for this model, we have examined published accounts and unpublished observations on gonad development in holothurians from both temperate and tropical habitats, in shallow water and in the deep sea. A very limited number of species were found to conform to the predictions of the tubule recruitment model. The patterns of gonad development vary substantially in holothurians, even at the individual level, and with taxonomic position, geographical location, and habitat. The tubule recruitment model can be applied to only a small subset of holothurians, specifically those in the families Stichopodidae and Holothuriidae that have gonad morphology similar to that of Parastichopus californicus. However, the tubule recruitment model is invalid for many other aspidochirotes, and does not have wider applicability within the class Holothuroidea.

Duplex assessment of venous reflux and chronic venous insufficiency: the significance of deep venous reflux

PURPOSE

This study was undertaken to examine the role of superficial and deep venous reflux, as defined by duplex-derived valve closure times (VCTs), in the pathogenesis of chronic venous insufficiency.

METHODS

Between January 1992 and November 1995, 320 patients and 500 legs were evaluated with clinical examinations and duplex scans for potential venous reflux. VCTs were obtained with the cuff deflation technique with the patient in the upright position. Imaging was performed at the saphenofemoral junction, the middle segment of the greater saphenous vein, the lesser saphenous vein, the superficial femoral vein, the profunda femoris vein, and the popliteal vein. Not all patients had all segments examined because tests early in the series did not examine the profunda femoris or lesser saphenous vein and because some patients had previous ligation and stripping or venous thrombosis. VCTs were examined for individual segment reflux, grouped into superficial and deep systems, and then correlated with the clinical stage as defined by the SVS/ISCVS original reporting standards in venous disease. Segment reflux was considered present if the VCT was greater than 0.5 seconds, and system reflux was considered present if the sum of the segments was greater than 1.5 seconds. Between-group differences were analyzed with analysis of variance and post hoc tests where appropriate.

RESULTS

Sixty-nine limbs studied were in class 0, 149 limbs were in class 1, 168 limbs were in class 2, and 114 limbs were in class 3. VCTs in the superficial veins were significantly lower in class 0 than in the other clinical classes. There was no difference in superficial reflux in the symptomatic limbs (classes 1 to 3). Reflux VCTs in the superficial femoral and popliteal veins increased as the clinical symptoms progressed, with a significant increase in class 3 ulcerated limbs when compared with nonuclerated limbs. The incidence of deep venous reflux was 60% in class 3 limbs, compared with 29% in class 2 limbs, whereas the incidence of superficial venous reflux did not differ among the symptomatic limbs. Isolated superficial femoral and popliteal vein reflux was uncommon, even in class 3 limbs, but combined superficial femoral and popliteal vein reflux was found in 53% of class 3 limbs, compared with 18.5% of class 2 limbs.

CONCLUSIONS

Reflux in the deep venous system plays a significant role in the progression of chronic venous insufficiency. Deep system reflux increases as clinical changes become more severe, with significant axial reflux contributing to ulcer formation.

Rapid Arm Movements in Stalked Crinoids

Stalked crinoids in the family Isocrinidae have been observed to wave individual arms actively. Using video cameras mounted on a manned submersible, we studied these movements and investigated the factors that elicit them. Crinoids wave their arms in response to sand or detritus dropped on their crowns, to entanglement in tentacles of adjacent sea anemones, and to contact by small crustaceans that might steal from the food grooves. There was no evidence that arm waving functions in food collection. In most cases, the movements could be attributed directly to mechanical stimulation by some natural stimulus. The rapid effective stroke of an arm flexure is caused by contraction of dorsal longitudinal arm muscles. The slower return stroke results from the elastic recoil of large ligaments near the aboral sides of the arms.

Larval Development (with Observations on Spawning) of the Pencil Urchin Phyllacanthus imperialis: a New Intermediate Larval Form?

Information for understanding the evolutionary shift from feeding to nonfeeding in echinoderm larvae can be gained from species whose larval development pattern appears to be intermediate between these extremes. In this paper we report the development of one such species. The pencil urchin Phyllacanthus imperialis spawned synchronously with the mass spawning of scleractinian corals at Lizard Island, Australia, in two consecutive years. Their large yolky eggs (507 μm diameter) developed into nonfeeding echinopluteus larvae with two pairs of larval arms. The arms were identified as postoral and posterodorsal, which are the first and third pairs in typical echinoplutei. A larval skeleton was present, with skeletal rods extending the length of the arms. Five primary podia of the juvenile rudiment appeared at 2 days of age. Metamorphosis of the larvae and settlement began 4 days after fertilization. Histological examination of 2-day-old larvae revealed the presence of a developing gut, but no mouth opened in what would be the oral region of a typical echinopluteus, or the oral surface of the juvenile rudiment in older larvae. Like other cidaroid larvae, this species showed no evidence of an amniotic invagination. The larva of P. imperialis appears to be a transitional form between the morphology of feeding and nonfeeding echinoid larvae. Traces of the ciliary band in the oral region and the presence of arms typical of the echinopluteus larva indicate its evolutionary past, whereas the large egg size and absence of a mouth hint at its future. This larval form provides insights into developmental changes that occur during the shift from planktotrophy to lecithotrophy in echinoid larvae.

The Michigan Alcoholism Screening Test: false positives in a college student sample

The Michigan Alcoholism Screening Test (MAST), designed and validated by Selzer (1971), is widely used to screen for persons with alcohol problems. The most recent version of the MAST includes the question "Have you ever attended a meeting of Alcoholics Anonymous (AA)?" This question may contribute to false positive identifications, as it does not specify whether attendance is for the subject's own problem drinking. In the current research, 114 college students completed the MAST along with an additional question: "Have you ever attended a meeting of Alcoholics Anonymous because of your own problem drinking?" The results indicated that seven of 114 subjects (6.1%) attained inflated MAST scores because they had attended an Alcoholics Anonymous meeting, but not for their own problem drinking. It is suggested that the wording to the Alcoholics Anonymous question on the MAST be changed to reduce the number of false positive identifications produced by this instrument.

The relative biological effectiveness of fractionated doses of fast neutrons (42 MeVd----Be) for normal tissues in the pig. II. Late effects on cutaneous and subcutaneous tissues

The late effects of irradiation with single and fractionated doses of X rays (250 kV) and fast neutrons (42 MeVd----Bc), on the cutaneous and subcutaneous tissues of the pig, have been evaluated from measurements of changes in relative field length. These were determined at intervals of 26-104 weeks after irradiation. For fractionated irradiation with X rays the average fractions exponent, N, obtained from a log-log plot of iso-effect dose (ED50) against fraction number was 0.41. This was independent of the period of assessment, with no significant indication of a time factor. However, the exponent N did vary with the level of effect and was in the range 0.33-0.51. It was greatest for a greater than or equal to 10% reduction in relative field length. Assuming the validity of the linear quadratic model of cell survival, the alpha/beta ratio was 1.95 Gy. However, this model fitted the data less well for the least severe levels of damage, and for these the alpha/beta ratios were not significantly different from zero. Irradiation with fast neutrons showed a small effect of fractionation for doses given in greater than or equal to 6 fractions compared with a single dose. There was no significant increase in iso-effect dose when the dose was given in 30 fractions compared with 6 fractions. The relative biological effectiveness for late cutaneous and subcutaneous damage for the energy of fast neutrons used did not vary with the period of assessment, i.e. 26-52 weeks compared with 65-104 weeks, and was not significantly different from that previously obtained for ischaemic dermal necrosis, seen after higher doses, at 12-20 weeks after irradiation.

The postoperative follow-up phone call: an essential part of the ambulatory surgery nurse's job

The purpose, content, and connection of the follow-up phone call to quality assurance is described.

Ischaemia reperfusion injury in pedicle skin flaps in the pig: lack of protective effect of SOD and allopurinol

A model of ischaemia and reperfusion was established which consistently achieved a 50% reduction in viable length of random pattern pedicle skin flaps in pigs. Flaps were subjected to two periods of ischaemia and reperfusion. Superoxide dismutase (SOD) in a dose of 3000 mu/kg given intravenously and allopurinol 70 mg/kg/day orally had no effect on viable skin flap length, skin blood flow or histological characteristics of flaps. SOD polymers, which have been used in other species to delay SOD clearance, were found to cause anaphylactoid reactions in pigs.

Depletion of hypothalamic norepinephrine reduces the fever induced by polyriboinosinic acid: polyribocytidylic acid (Poly I:Poly C) in rats

Administration of either Poly I:Poly C (0.05-0.50 micrograms) or norepinephrine (2-8 micrograms) into the anterior hypothalamic area produced a dose-related fever in rats. The fever induced by Poly I:Poly C was attenuated after selective depletion of norepinephrine in the hypothalamus. However, selective depletion of hypothalamic norepinephrine did not affect the fever induced by intrahypothalamic norepinephrine. The data indicate that Poly I:Poly C may act to induce fever through the endogenous release of norepinephrine from the rat's hypothalamus.

Maternal dietary restriction during pregnancy and lactation: effect on digestive organ development in suckling rats

To examine the relative effects of maternal malnutrition during pregnancy and lactation on development of the pancreas and small intestine in suckling pups, rats were restricted to 50% of control (C) intake beginning at day 5 of pregnancy. Immediately after birth, some litters were exchanged such that some C dams were suckling pups born to 50%-restricted dams (C/50) and vice versa (50/C). Other litters were allowed to stay with their own mothers, which received a control or restricted diet as during pregnancy (C/C and 50/50). Pups nurtured by restricted dams had reduced body weights, intestinal lengths, hepatic and pancreatic weights, and specific activities of pancreatic lipase and small intestinal brush border sucrase and maltase. Small intestinal lactase levels were higher in the groups of pups from mothers restricted during lactation. In nearly all cases, the 50/C group was the most severely affected while the C/50 group was intermediate between the C/C and 50/50 groups.

Migration and mortality: the experience of birthplace groups in Australia

"Wide diversity exists in the mortality experience of different birthplace groups in Australia, and this also occurs with respect to their cause of death profiles. Most migrant groups experience lower mortality in Australia than in their country of origin, and most experience lower mortality than the Australian-born population. In the latter case the main [groups] are the Scots, Irish, Poles, South Pacific Islanders, Scandinavian men and North American women. Exceptionally high levels of survival occur among Greeks and Italians in Australia. The lower risk of mortality from heart disease is a principal reason for the deficit between observed and expected deaths of most migrant groups in Australia." The analysis is based on deaths of those aged 15-74 by birthplace, as recorded by the Australian Bureau of Statistics in the years 1980, 1981, and 1982.

Differential mortality of birthplace groups in Australia during 1980-82

"At the 1981 Census, just over one-fifth of Australia's population was born overseas, and this paper examines the mortality experience during 1980-82 of some of the larger birthplace groups with respect to age, duration of residence in Australia and cause of death. One of the main findings is the low mortality of those from Southern Europe, both with respect to total mortality and from many of the major causes of death. In contrast the Australian-born have relatively high mortality from heart disease, respiratory diseases, and from diseases of the genito-urinary system. Mortality differences are generally greatest at the middle adult ages, with convergence at the older ages."

Effect of nutritional rehabilitation on the development of intestinal brush border disaccharidases of postnatally malnourished weanling rats

The reversibility of the effects of postnatal malnutrition on the intestinal brush border enzymes and somatic and intestinal weights were examined using either ad libitum or restricted feedings. Malnutrition was induced in the immediate postnatal period by expanding newborn rat litters to 20 pups/dam. At 21 days of age, malnourished pups exhibited significantly decreased body and intestinal weights as compared to those from control litters. Malnourished pups also had significantly elevated lactase specific activities whereas sucrase and maltase activities were not affected in the proximal small intestine. With subsequent nutritional rehabilitation by an ad libitum (food available 24 h/day) or restricted feeding regimen (food available 2 h/day), body and intestinal weights remained significantly depressed by 56 days in malnourished as compared to control animals. Rats on 2-h feedings consumed approximately 35% of the food consumed by their ad libitum-fed counterparts. Comparison of the ratio of weight gained to the amount of food consumed did not demonstrate a greater food efficiency with any particular feeding pattern. With ad libitum or restricted feedings, lactase specific activity in the proximal segment attained control values by 14 days. Restricted feedings resulted in an apparent elevation of specific activity of sucrase and of maltase, when rats were sacrificed at one chosen time point. Multiple time studies in a 24-h cycle showed that maximal elevations in enzyme activities were associated with feeding time. There were no significant differences in mean specific daily enzyme activities between the two feeding regimens. Restricted feedings show no advantage in enzyme efficiency or in promoting the rate of recovery of the intestine after postnatal malnutrition.

Incidence of ocular abnormalities in patients with sickle hemoglobinopathies

We examined 110 consecutive unselected patients with SS, SC, or Sthal sickle hemoglobinopathies to determine the prevalence of various retinal lesions within each group. The most prevalent retinal abnormality was the black sunburst, occurring in 46% of SS patients, 63% of SC patients, and 37% of Sthal patients. Our data also suggest that retinal lesions become more prevalent up to the fifth decade of life. Included in our series was an eight-year-old SS hemoglobin patient who presented with a dense vitreous hemorrhage secondary to a large salmon patch that had bled into the vitreous, reducing her vision to 20/200.

The binding of copper(II) and zinc(II) to oxidized glutathione

1H and 13C NMR studies of Zn(II) binding to oxidized glutathione (GSSG) in aqueous solution over the pH range 4-11 show that it forms a complex with a 1:1 Zn:GSSG stoichiometry. At pH values between 6 and 11 the metal ligands are the COO- and NH2 groups of the glutamate residues. Below pH 5 the glycine end of the molecule also binds to the metal ions. EPR and visible absorption spectra of Cu(II) GSSG solutions suggest that similar complexes are formed with Cu(II). The solid products obtained from these solutions are shown by analysis and EPR to be primarily binuclear with Cu2GSSG stoichiometry, although the structures depend on the pH and stoichiometry of the solution from which they were obtained.

Effects of varying degrees of chronic dietary restriction in rat dams on reproductive and lactational performance and body composition in dams and their pups

To assess the effects of varying degrees of chronic dietary restriction, rats were fed ad libitum or were restricted to 75%, 50% or 40% of ad libitum intake beginning 28 days prior to breeding and continuing through day 14 of lactation. Pup birth weight did not differ among the groups, but maternal weight gain, net maternal growth, and litter number were proportional to dietary intake. During lactation, maternal weight loss was minimal in all groups and carcass protein proportions remained constant. However, maternal fat stores were mobilized in all groups, with smaller changes in the 50% group. Milk yield was reduced in restricted dams. Despite a partial compensation in milk yield by the 75% group, litter weights were proportional to maternal dietary level. In contrast, rats in the 50% group made no compensation in milk yield. Possible explanations for the discrepancy between milk yield and litter growth are explored.

A study of neonates' differential responses to three voices, as measured by transcutaneous oxymonitor

123 newborn infants were tested for changes in arterial oxygen status as an index of response to three voices, one of these being the maternal voice. Male infants responded more than female infants to their mother's voice, but female infants showed a higher response to the other female voice and the male voice. Black infants of each sex responded more than white infants to the maternal voice and to the other female voice. White female infants responded more than black female infants to the male voice.

Norms for hand grip strength

Norms for hand grip strength of healthy children are presented. Sex and age specific centiles for age 5 to 18 years have been determined using a portable strain gauge dynamometer with an accuracy of 0.5 N. The test group comprised 1417 healthy, urban school children from a middle class suburb of Brisbane. Mean maximum grip strength (of four tests, two with each hand) and mean peak grip strength (best of four tests) were recorded. Mean values of peak grip strength were 10 to 15% higher than the average maximum grip in all age groups. At all ages girls had a reduced grip strength compared with boys and although boys manifested a continual, approximately linear increase in grip strength through all age groups, girls manifested an approximately linear increase up to 13 years after which mean hand grip usually remained constant. By the age of 18 years boys had a mean grip strength some 60% higher than girls. Correlations with height and weight are also presented. "Handedness' influenced grip strength and was most noticeable in children aged over 10 years. The clinical use of hand grip strength centiles for the early indication of neurological and muscular disorders and for following the natural history of neuromuscular disease is discussed.

A new automated approach to high-density facial measurement. Part 1: The image capturing and processing hardware

Hardware used in the capturing and processing of the stereo image for a previously published description of a facial geometric measurement technique is detailed, together with underlying theoretical concepts regulating the selection of the hardware system components. This is the first follow-up paper in an ongoing research project to develop and document in depth a fully automated technique for photogrammetric determination of a Facial Surface Model (FSM), and ultimately to apply the technique in multidisciplinary research.

A product report: Osto-Zyme as an odor eliminator

A product, Osto-Zyme, was clinically tested at our Institute for the elimination of odor. Thirteen clients were chosen by enterostomal therapists to be tested. The product was sprayed directly into pouch, peristomal skin, and into night drainage units. This product proved very effective in the elimination of odor. The manufacturer of Osto-Zyme is the Richard C. Shelton Co., Wright Brothers Branch, Dayton, Ohio.

The effects of preoperative x-irradiation on the survival and blood flow of pedicle skin flaps in the pig

Pedicle skin flaps have been raised from pre-irradiated sites on the flanks of pigs. Radiation treatment was given as a single dose, 6 fractions in 18 days or 30 fractions in 39 days. Surgery was performed at 12, 52 or 104 weeks after irradiation. Control flaps were raised from normal skin on the other flank. The length of flap remaining viable after surgery was shorter in the irradiated than the control flaps. This reduction in flap survival was the same at the three time periods at which it was assessed and for each of the radiation doses selected for the different treatment groups. Clearance rates of an isotope (99mTechnetium) injected intradermally in the distal surviving regions of irradiated and normal flaps were compared. Clearance changes were related to those recorded in normal and irradiated skin before surgery. Isotope clearance in normal flaps was impaired after surgery (days 1-3) but then became faster than in intact skin (days 5-14). A similar pattern of changes was recorded in irradiated flaps only when the pre-operative isotope clearance rates in irradiated skin were similar to that in normal skin (i.e. for all treatment groups at 52 and 104 weeks after treatment). However, when pre-operative clearance was already slower in irradiated than in normal skin (i.e. for a single dose and 6 fraction/18 days after 12 weeks), surgery in the irradiated site did not have the usual effect of slowing the clearance rate.

The isotope clearance technique for measuring skin blood flow

The measurement of skin blood flow using the isotope clearance technique has been investigated in pig skin. The isotope used was technetium-99m; this was shown to be freely diffusible in skin. The volume injected (0.02 to 0.3 ml) did not affect the clearance parameters. Bi-exponential clearance curves were always obtained in normal pig skin. An analysis of what parameters of blood flow are indicated by the two exponents has been made by correlating changes in clearance parameters (animal age and depth of injection) with changes in vascular density and dermal thickness. It is suggested that the fast and slow clearance parameters are derived from clearance by capillaries in the papillary and reticular regions of the dermis respectively. Further evidence in support of this hypothesis was derived from the application of the clearance technique in skin traumatised by surgery (pedicle skin flaps) or x-irradiation. The value of the isotope clearance technique in the measurement of nutrient flow in the dermis is discussed.

The relative biological effectiveness of fast neutrons (42MeVd leads to Be) for early and late normal tissue injury in the pig

Early and late radiation damage has been investigated in a number of normal tissues in the pig after irradiation with single doses of neutrons produced by 42MeV deuterons on beryllium. The results have been compared with data obtained after irradiation with single doses of 250kV X rays. In the skin a low RBE value of approximately 1.2 was obtained for the early (3-9 week) epithelial reaction. For the subsequent dermal vascular response, higher RBE values in the range of 1.35-1.6 were obtained: the RBE decreasing with an increase in the neutron dose. For late skin damage, assessed by the relative reduction in the linear dimensions of an irradiated field, a RBE value of approximately 1.5 was obtained. In the kidney the RBE value, for a neutron dose level (550 cGy) at which renal function was just preserved, was 2.0. A lower value of 1.7 was found for doses resulting in a loss of renal function. The results of 133Xenon clearance studies showed two waves of impaired ventilation function in the irradiated lung. In the acute reaction (3-9 months), at a dose level consistent with just preserving normal ventilation function, the RBE value was less than 1.2. For late lung damage (15-24 months) the RBE value was higher, 1.4. For the rectum, methods are presently only available for assessing acute damage. A RBE of 2.0 was found for neutron doses in the range 350-575 cGy. The RBE values for early endpoints in the skin, lung and gut of the pig are comparable with those published previously for other species, including man. The values for late effects in pig skin and lung were higher than for early damage in those tissues.

The revascularization of pedicle skin flaps in pigs: a functional and morphologic study

Functional and morphologic changes occurring during the revascularization of pedicle flaps have been investigated in the skin of pigs. The skin flaps, 16 cm long by 4 cm wide, were based on a row of segmental vessels arising from the internal mammary artery. Comparative measurements were made in flapped and normal skin. The inherent blood supply in the pedicle of the flap was unable to maintain the whole of the flap in a viable state. Flap viability was ascertained at surgery by the use of the intravital dye Disulphine blue. Injections of the dye after surgery gave a less accurate prediction of viability than when dye was injected prior to surgery. Revascularization between the flap and surrounding skin was evident 3 to 4 days postoperatively at the distal, most hypoxic part of the viable flap. The whole flap had a collateral vascular supply 7 to 10 days after surgery. Isotope clearance studies showed that the greatest functional changes occurred in the distal third of the viable flap, where, after initially slowing, the clearance rate became faster than in normal skin (day 5). Potassium extraction studies indicated similar changes. However, an increase in the red-cell volume on day 1 suggested that vascular shunting was occurring. The results of the morphologic studies indicated a correlation between the number of blood vessels per unit area, the thickness of the dermis, and the recorded functional changes. Seven days after surgery, when isotope clearance rates were very rapid, there was a significant increase in the vascular density and dermal thickness.

The effect of field size on the reaction of pig skin to single doses of X rays

The importance of the size of the treatment area for the response of the skin to radiation has been studied in the pig. The responses of skin areas of 16 cm3 (4 x 4 cm) and 64 cm2 (16 x 4 cm) were compared after single doses of X rays. In the initial 3-9-week period after irradiation the severity of the erythema reaction, which is associated with epidermal call death, was not influenced by the area of skin irradiated. For the later dermal response (10-16 weeks) a similar result was obtained. The dose required to produce dermal necrosis in 50% of the fields treated (ED50) was approximately 2070 cGy for both field sizes. Additional studies have shown that the ED50 for dermal necrosis was not influenced by the age of animals at the time of irradiation. This was despite considerable differences in the vascular density and blood flow in pig skin with increasing age. The apparent contradiction between the results of this experimental study in the pig, which shows no effect of field size, and currently accepted clinical practice is discussed.

High density facial measurement: a new automated approach

A brief summary of research undertaken into facial geometric measurement is furnished, emphasizing the potential of photogrammetric methods. The techniques described solves the long-standing problem of stabilization of the human head for repetitive longitudinal investigations. The basic geometric principles of terrestrial photogrammetry and digital imaging techniques are outlined, as the groundwork for a description of a fully automated method of obtaining a high density geometric delineation of sensitive surfaces by digital methods. The technique is appropriate for any medical purpose dealing with measurement and analysis of soft tissue surfaces, obviating, as it does, the need for head stabilization with its concomitant problems, and also in its provision of a databank capability.