Genetic Factors Associated With Adverse Pregnancy Outcomes in Chronic Pancreatitis

INTRODUCTION

The effects of genetic factors on pregnancy outcomes in chronic pancreatitis (CP) patients remain unclear. We evaluated the impacts of clinical features and mutations in main CP-susceptibility genes ( SPINK1 , PRSS1 , CTRC , and CFTR ) on pregnancy outcomes in Chinese CP patients.

METHODS

This was a prospective cohort study with 14-year follow-up. The sample comprised female CP patients with documented pregnancy and known genetic backgrounds. Adverse pregnancy outcomes were compared between patients with and without gene mutations. Univariate and multivariate analyses were performed to determine the impact factors for adverse pregnancy outcomes.

RESULTS

Totally, 160 female CP patients with a pregnancy history were enrolled; 59.4% of patients carried pathogenic mutations in CP-susceptibility genes. Adverse pregnancy outcomes occurred in 38 patients (23.8%); the prevalence of adverse outcomes was significantly higher in those harboring gene mutations than those without (30.5% vs 13.8%, P = 0.015). Notably, the rates of preterm delivery (12.6% vs 3.1%, P = 0.036) and abortion (17.9% vs 4.6%, P = 0.013) were remarkably higher in patients with gene mutations (especially SPINK1 mutations) than those without. In multivariate analyses, both CP-susceptibility gene mutations (odds ratio, 2.52; P = 0.033) and SPINK1 mutations (odds ratio, 2.60; P = 0.037) significantly increased the risk of adverse pregnancy outcomes. Acute pain attack during pregnancy was another risk factor for adverse pregnancy outcomes.

DISCUSSION

Pathogenic mutations in CP-susceptibility genes, especially SPINK1 , were independently related to adverse pregnancy outcomes in CP patients. Significant attention should be paid to pregnant females harboring CP-susceptibility gene mutations (ClinicalTrials.gov: NCT06055595).

[Detection of metals and metalloids in the lavage fluid of whole-lung lavage of the cases of pneumoconiosis]

Objective: To detect of the components and concentration of the metals and metalloids in the lavage fluid of whole-lung lavage (WLL) of the cases of pneumoconiosis, and analyze the characteristics, and explore the method to sample and process the samples of bronchoalveolar lavage fluid (BAL) . Methods: The samples of urine and serum of three cases of pneumoconiosis were collected before WLL, and the samples of BAL were collected during the WLL from the left and right lungs according to the sequence of four pressured gas flow and five negative pressure drainage. Each of 10ml original samples of WLL was collected firstly, and the left was centrifuged to acquire all the sediment samples and each of 10 ml samples from the centrifuge clear liquids, The components and concentration of the metals and metalloids in the samples were measured by Inductively Coupled Plasma mass spectrometer (ICP-MS) . Results: The average volume of BAL from unilat-eral lung for 3 patients was 10 758.3±1518 ml, and the average recovery rate was 89.7%. The average dry weight of sediment samples of BAL of three cases of pneumoconiosis was 0.292 gram with the right lung sam-ples slightly higher than the left lung samples. The detectable elements from the samples included Barium (Ba) , Strontium (Sr) , Calcium (Ca) , Magnesium (Mg) , Manganum (Mn) , Ferrum (Fe) , Cuprum (Cu) , Zinc (Zn) , Kalium (K) , Natrium (Na) , Selenium (Se) , Silicon (Si) and Uranium (U) . Each of concentration dis-tributions of these elements were not normal. Except for Cuprum, Selenium and Uranium, the concentrations of the other ten elements in the supernatant samples, mixture samples and sediments samples were statistical-ly different with the nonparametric test of Kruskal-Wallis. The concentrations of Natrium, Kalium and Barium in supernatant samples were higher, while the others in precipitation samples were higher. The concentration of elements in the sample from the right lung was slightly higher than that from the left lung, but there was no statistically significant difference (P>0.05) . There were statistical difference in term of element concentration of precipitates samples before and after pressured gas flow (P<0.05) . The concentration of K、Ca、Mg、Si and Se in se-rum, urine, supernatant and sediment samples had a good correlation. The correlation coefficient of Silicon between serum and precipitation was 0.676 and that between urine and precipitation was 0.524. Conclusion: The concentra-tions of the metals and metalloid in sediment samples were more stable than that of supernatant and mixture samples. The sampling of one-side lung lavage fluid was representative in the detection of metals and metalloid in the BAL. It was the best time for sampling sediment from the BAL after the first pressured gas flow among the WLL.

The effects of licensing and inspection enforcement to reduce tobacco sales to minors in Greater Philadelphia, 1994-1998

This study examined the changes in tobacco sales to minors after active enforcement of merchant compliance to the Synar regulation and the city of Philadelphia Youth Access to Tobacco Ordinance 732. Data for the present study were obtained through Tobacco-free Education and Action Coalition for Health (TEACH) Program in a 5-year, follow-up retail compliance check survey of 1649 stores in 14 cluster areas of Philadelphia, PA. Trend analysis was conducted ofthe sales of tobacco to minors by type of retail outlet, gender, and age of the buyer, and gender, age, and race of the store clerk, and whether restriction policy signs were posted. Analysis indicates that there was a reduction in tobacco sales to minors after implementation of enforcement; sales dropped from 85% in 1994 to 43% in 1998. There were less sales to minors when signs were posted. There were differences in sales if the buyer was asked his or her age and whether the minor was asked to show identification. In addition, the age of the buyer and the brand of cigarettes were associated with sales. Future research should focus on both commercial and social availability and provision of tobacco to minors.

[Experimental research of NNB composite in repairing mandibular defects in rabbits]

OBJECTIVE

To study the effects of artificial bone composite of basic fibroblast growth factor(bFGF) with natural non organic bone(NNB)in repairing mandibular defects in rabbits,in order to provide an ideal bone replacement material for clinic.

METHODS

15mm x 6mm bilateral mandibular periosteum bone defects were made surgically in 30 New Zealand adult rabbits and each defect as an experimental unit. The defects were randomly repaired with composite bone, NNB,fresh autogenous bone at 3,6,12 weeks after surgery according to the total random design, blank control group was stayed. Specimens obtained were evaluated with general observation, X-ray as well as computerized histological microscopic analysis.

RESULTS

New bone formed and calcified earlier in composite bone and the bone area was greater in the same period than that in NNB. The new bone area in composite bone was still smaller than that of autogenous bone at 6 weeks, while at 12 weeks they had no significant differences. The blank defects were not repaired even in the end.

CONCLUSION

Composite bone had sound biocompatibility. It was much better than NNB and can be compared with autogenous bone 12 weeks after operation. So it can be an ideal alternative for bone replacement.

A study of young adults who provide tobacco products to minors

Teens acquire tobacco from social sources. This study examined factors related to young adults providing tobacco products to minors. Variables such as demographics, rate and method of provision, attitudes toward provision, and youth access restriction laws were measured. A sample of 250 college students completed the survey. About 33.2% of those young adults were asked to provide tobacco to minors, and 30.8% of these students provided it. Students in health-related majors were as likely to be approached and to provide tobacco as were nonhealth majors. Males were more likely to be approached and to provide tobacco to minors than were females. Convenience stores and gas stations were the most popular locations. Young adults favored laws that restrict minors from purchasing tobacco, and their intention to give tobacco in the future was the best predictor of providing tobacco to minors.

Barriers to the use of health services by Chinese Americans

This study examined the extent to which cultural, socioeconomic, and systemic factors impeded access to and utilization of health services among a convenience sample of 52 Chinese immigrants living in metropolitan Houston. The subjects, of differing levels of socioeconomic status, were 25 years old or older. Methods used for data collection included participant observation, face-to-face interview, and case study. A semistructured interview instrument with open- and closed-ended questions was administered. A pilot study and expert reviews were conducted for content and face validity. Cultural and socioeconomic factors were found to be strongly associated with access to and utilization of health services. Mainland Chinese and Taiwanese shared similar cultural dilemmas as they sought health care, including communication difficulties, beliefs about health, health care, and illness, and mistrust in Western health care. Although families played important roles in health decisions and choices of services, social class differences also appeared to affect utilization. For example, more affluent Taiwanese than Mainland Chinese were apt to carry health insurance and use Western systems. The findings suggest a need to improve services to the Chinese community through family-centered and community-based approaches adapted to Chinese culture.

Secondary conditions and women with physical disabilities: a descriptive study

OBJECTIVE

To examine secondary conditions and their relationship to life satisfaction in women with physical disabilities.

DESIGN

Survey research.

SETTING

Metropolitan Philadelphia.

PARTICIPANTS

Women aged 18 to 65 years with self-reported functional limitations associated with neurologic, neuromuscular, brain, sensory, arthritic, spinal cord, orthopedic, or other chronic conditions.

MAIN OUTCOME MEASURES

Secondary conditions, health status, functional status, and life satisfaction.

RESULTS

In the past year, an average of 12 +/- 6.1 (SD) secondary conditions were experienced. Fatigue, mobility, physical deconditioning, spasticity, and joint pain were reported most frequently, followed by depression, chronic pain, access problems, weight problems, and isolation. In comparing women with multiple sclerosis (MS) and those with other disabling conditions, women with MS had higher secondary conditions problem index (SCPI) scores for bladder, bowel, and sexual dysfunction than women in the mixed disability group. Other secondary conditions with the highest SCPI scores remained similar. Self-reported emotional health status and SCPI scores were the only significant predictors of life satisfaction.

CONCLUSION

Secondary conditions influence health status and quality of life for women with physical disabilities. Despite differences among disability groups in terms of the type of secondary conditions, common secondary conditions experienced by most women may be amenable to non-disability-specific health promotion programs.

Cross-cultural comparison of health perceptions, concerns, and coping strategies among Asian and Pacific Islander American elders

This article compares the health perceptions, concerns, and coping strategies among elders in two Asian and Pacific Islander American communities. The qualitative comparison is conducted between elder Chamorros of Guam and elder Chinese of the United States, using a focused ethnography for data collection and the grounded theory method for cross-cultural analysis. The health perceptions of these two communities are manifest in two themes: (a) a sense of holism among body, mind, and spirit and (b) an orientation toward others. The health concerns of these two communities include universal experiences of aging, structural elements within the American health care system, and cultural changes impacting health. A significant coping strategy is adaptation to changes while maintaining continuity. Finally, implications for the delivery of culturally appropriate health care services to Asian and Pacific Islander American elders are discussed.

A comparative analysis of perceived risks and substance abuse among ethnic groups

This study examined perceived risks and prevalence of alcohol, tobacco, and illicit drug use among ethnic groups of Whites, Blacks, and Hispanics; compared the extent to which drug use varied among different ethnic groups; explored whether or not there were any age and gender differences in drug use among the ethnic groups; and made implications of the findings. Comparative analyses were conducted by using chi2 to determine the association of independent variables (ethnicity, age, and gender) with the dependent variables (alcohol, tobacco, and illicit drug use) during lifetime, past year, and past month. Data were derived from the 1997 and 1996 National Household Survey on Drug Abuse. Our findings indicated that there are differences in perceived risks and reported use among ethnic groups, as well as in preferences for particular drugs. Whites are the least likely to perceive risks for substance abuse, however, they have the highest prevalence of lifetime drug use of most types of drugs (with the exception of crack cocaine and heroin), as compared with Blacks and Hispanics. The examination of past month categories of drug use shows that Whites had the highest prevalence rates of alcohol and smokeless tobacco use. Hispanics were more likely to binge, and reported higher prevalence of heavy alcohol use. Blacks were more likely than Whites or Hispanics to use crack and heroin in their lifetime. Implications were made for future research and drug prevention in ethnic populations.

[Effects of heat and noise environments on lipid peroxidation erythrocyte membrane in pilots]

OBJECTIVE

To investigate the effects of heat and noise environments on lipid peroxidation of erythrocyte membrane in pilots.

METHOD

Twenty-four pilots and twenty-one ground personnel (control group) served as the subjects. The pilots performed flying in heat and noise environments. Glutathione peroxidase (GSHpx) and malondialdehyde [correction of malondiadehyde] (MDA) levels in erythrocyte membrane were determined before flying (6:00 a.m.), immediately after flying (12:00 a.m.) and 8 hours after flying (8:00 p.m.) respectively with a spectrophotometer.

RESULT

Immediately after flying, GSHpx activity in pilot's erythrocyte membrane decreased significantly as compared with that in control group. Immediately after flying and 8 h after flying, MDA contents in pilots increased significantly as compared with that of control group.

CONCLUSION

Heat and noise environments might induce increase of lipid peroxidation reaction and decrease of antioxidant ability.

Between two worlds: the use of traditional and Western health services by Chinese immigrants

This study examined the use of traditional and Western health services by Chinese immigrants, as well as the cultural and socioeconomic factors affecting health-seeking behaviors and health service utilization patterns among the study population from the perspectives of consumers and Chinese health care providers. Two instruments were used for data collection. The first, a consumer instrument, was designed for interviews of service recipients; the second, a health provider instrument, was designed to elicit information from traditional and Western providers. A few topics in the former instrument were cross-examined from the perspectives of health care providers. The investigation employed a combination of qualitative and quantitative research methods for data collection. Qualitative ethnographic methods used included: (1) participant-observation, (2) face-to-face interview, and (3) case study. To complement the qualitative data, structured quantitative survey were conducted with all selected informants. A total of 105 informants participated in the study: 75 Chinese consumers and 30 Chinese health professionals. The latter group was composed of Western physicians and traditional practitioners. Results revealed several patterns of health-seeking and service utilization behaviors among the Chinese of Houston and Los Angeles. These included high rates of self-treatment and home remedies (balanced diets and other alternative medicines); medium rates of utilization of integrated Western and traditional health services, including travel to country of origin for care; and low rates of exclusive utilization of Western or traditional Chinese treatments.

Effects of high temperature and noise on erythrocyte membrane ATPase activity in pilots during flight

Objective. To determine the effect of heat and noise on erythrocyte membrane ATPase activities in pilots during flying. Method. Twenty-four pilots performing bombing for 3 h (45-53 degrees C, 122-97 dB in the cabin) served as the subjects. 21 ground personnel served as control (27 degrees C in the room). Blood samples were taken from both groups before flying (6:00 a.m.), and immediately (12:00 a.m.) and 8 h (8:00 p.m.) after flying. Na(+)-K+ ATPase, and Ca2(+)-Mg2+ ATPase activities in erythrocyte membrane were determined with colorimetry. Result. The Na(+)-K+ ATPase activity in erythrocyte membrane at 6:00 a.m. in pilots was higher than that in control group at the same time (P<0.01). The Ca2(+)-Mg2+ ATPase activities in erythrocyte membrane at 12:00 a.m. and 8:00 p.m. in pilots were significantly higher, compared with those in control group at the same time (P<0.01). Conclusion. The ATPase values obtained in our study were all within normal range, and the daytime variation of both groups are the same. Exposure of human body to heat and noise for long time may be harmful, the higher ATPase activity is, the more catabolism of ATP will be. ATP exhaustion will lead to Ca2+ overload in erythrocyte thus stiffen the red cell membrane.

HPCPC separation of proteins using polyethylene glycol-potassium phosphate aqueous two-phase

High Performance Centrifugal Partition Chromatography (HPCPC) is a practical and suitable method, particularly on the preparative scale, for the separation of biomolecules such as proteins, enzymes, etc. Aqueous two-phase system is also very attractive for the isolation of biomolecules. Aqueous polymer phase system composed of polyethylene glycol 6000-potassium phosphate has been used for the countercurrent chromatographic separation of bovine serum albumin (BSA) and lysozyme using HPCPC. The separation of BSA and lysozyme under various conditions such as various flow rates, rotational speeds, pH of the solvent, and the retention of stationary phase has been studied in the present investigation. The baseline separation of BSA and lysozyme has been also observed. The results of this study demonstrate that HPCPC is useful for separation of proteins with aqueous two-phase systems.

Native American adolescents' views of fetal alcohol syndrome prevention in schools

Alcohol is the most commonly abused substance among adolescents in the United States. Adolescent females are recognized as one group at risk for giving birth to babies with fetal alcohol syndrome (FAS). Sixth through eighth grade Native Americans were surveyed about their attitudes toward and knowledge of FAS risk factors and prevention strategies. Data revealed that 52% of students drank alcohol prior to the survey. Though sexually active, students lacked knowledge about the relationship between alcohol and FAS. The study revealed 1) limited prevention programs in middle schools and 2) the most influential factor in determining attitudes and decisions about alcohol use was the immediate family. Students felt FAS prevention is an important topic in school health education, noting the important role peers play in teaching and role modeling. Various strategies incorporating music and communication technology such as videotape and computer-assisted interactive tools into prevention materials are discussed.

Purification and chemical modification of porcine bone morphogenetic protein

Implantation of porcine bone morphogenetic protein (pBMP) in the muscle induces differentiation of mesenchymal-type cells and results in endochondral bone formation. pBMP was isolated from porcine demineralized bone matrix and purified by hydroxyapatite chromatography, Sephadex G75 gel filtration, preparative sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), preparative isoelectric focusing (IEF), and chromatofocusing fast protein liquid chromatography (FPLC). Porcine BMP has an MW of 26 K and a range of pI from 4.65 to 4.73 determined by SDS-PAGE and IEF, respectively. Reconstitution with the citrate buffer supernatant fraction enables as little as 50 micrograms of the soluble pBMP fractions to induce osteogenesis in an in vivo assay. Chemical modification studies indicate that the osteoinductive potential of the pBMP molecule depends on tyrosine, carboxyl groups, and disulfide bonds and can be increased by modification of sulfhydryl groups. Modification of arginine and tryptophan has no effect on bioactivity. By pepsin-limited proteolysis, fragments of pBMP with an MW of 6-14 K show definite, although reduced, BMP activity.