A Case of Emphysematous Cystitis

Emphysematous cystitis (EC) is an uncommon but potentially life-threatening urinary tract infection. Diagnostic difficulty exists because of the variable presentations. We report the case of a 73-year-old woman who presented with diarrhoea and malaise, and emphysematous cystitis was revealed on the abdominal X-ray. As she was treated for EC, the diarrhoea and the radiographic abnormalities of EC also resolved. The evaluation and management of this complicated urinary tract infection are discussed.

A Case Series of Puffer Fish Poisoning

Puffer fish poisoning caused by tetrodotoxin, a potent neurotoxin, is uncommon in Hong Kong. We report a total of seven cases of puffer fish poisoning with different levels of severity. Two of them developed respiratory distress and subsequently required endotracheal intubation and respiratory support while the others presented with numbness and mild weakness. Most of them experienced perioral numbness as the first symptom. The mean time of symptoms onset was approximately 94 minutes. All of our patients survived the intoxication.

A Case of Slow-Release Potassium Chloride Overdose

An 86-year-old gentleman was brought to the emergency department after a massive overdose of slow-release potassium chloride and indapamide. The initial serum potassium was 6.8 mmol/L. His abdominal X-ray did not reveal any radio-opaque drugs. Whole bowel irrigation was commenced shortly after presentation. There was no rebound of hyperkalaemia and his stay in the acute hospital was short. Slow-release potassium overdose is uncommonly reported in the medical literature; such poisoning in the elderly has not been reported. Previous case reports are summarised and the management of this uncommon poisoning is discussed.

IL-21 Signaling in Immunity

IL-21 is a type I cytokine produced by T cells and natural killer T cells that has pleiotropic actions on a wide range of immune and non-immune cell types. Since its discovery in 2000, extensive studies on the biological actions of IL-21 have been performed in vitro and in vivo. Recent reports describing patients with primary immunodeficiency caused by mutations of IL21 or IL21R have further deepened our knowledge of the role of this cytokine in host defense. Elucidation of the molecular mechanisms that mediate IL-21's actions has provided the rationale for targeting IL-21 and IL-21 downstream mediators for therapeutic purposes. The use of next-generation sequencing technology has provided further insights into the complexity of IL-21 signaling and has identified transcription factors and co-factors involved in mediating the actions of this cytokine. In this review, we discuss recent advances in the biology and signaling of IL-21 and how this knowledge can be potentially translated into clinical settings.

Cutting Edge: IL-1 Receptor Signaling is Critical for the Development of Autoimmune Uveitis

IL-1β is a proinflammatory cytokine important for local and systemic immunity. However, aberrant production of this cytokine is implicated in pathogenic mechanisms of a number of inflammatory diseases, including Behçet's disease and age-related macular degeneration. In this study, we report the increased secretion of IL-1β in the retina by neutrophils, macrophages, and dendritic cells during ocular inflammation and show that loss of IL-1R signaling confers protection from experimental autoimmune uveitis. Moreover, the amelioration of experimental autoimmune uveitis in Il1r-deficient mice was associated with reduced infiltration of inflammatory cells into the retina and decreased numbers of uveitogenic Th17 cells that mediate uveitis. These findings indicate the possible utility of IL-1R-blocking agents for the treatment of ocular inflammatory diseases.

The cytokines IL-21 and GM-CSF have opposing regulatory roles in the apoptosis of conventional dendritic cells

Interleukin-21 (IL-21) has broad actions on T and B cells, but its actions in innate immunity are poorly understood. Here we show that IL-21 induced apoptosis of conventional dendritic cells (cDCs) via STAT3 and Bim, and this was inhibited by granulocyte-macrophage colony-stimulating factor (GM-CSF). ChIP-Seq analysis revealed genome-wide binding competition between GM-CSF-induced STAT5 and IL-21-induced STAT3. Expression of IL-21 in vivo decreased cDC numbers, and this was prevented by GM-CSF. Moreover, repetitive α-galactosylceramide injection of mice induced IL-21 but decreased GM-CSF production by natural killer T (NKT) cells, correlating with decreased cDC numbers. Furthermore, adoptive transfer of wild-type CD4+ T cells caused more severe colitis with increased DCs and interferon-γ (IFN-γ)-producing CD4+ T cells in Il21r(-/-)Rag2(-/-) mice (which lack T cells and have IL-21-unresponsive DCs) than in Rag2(-/-) mice. Thus, IL-21 and GM-CSF exhibit cross-regulatory actions on gene regulation and apoptosis, regulating cDC numbers and thereby the magnitude of the immune response.

IL-21 promotes the pathologic immune response to pneumovirus infection

IL-21 is a cytokine with pleiotropic actions, promoting terminal differentiation of B cells, increased Ig production, and the development of Th17 and T follicular helper cells. IL-21 is also implicated in the development of autoimmune disease and has antitumor activity. In this study, we investigated the role of IL-21 in host defense to pneumonia virus of mice (PVM), which initiates an infection in mice resembling that of respiratory syncytial virus disease in humans. We found that PVM-infected mice expressed IL-21 in lung CD4(+) T cells. Following infection, Il21r(-/-) mice exhibited less lung infiltration by neutrophils than did wild-type (WT) mice and correspondingly had lower levels of the chemokine CXCL1 in bronchoalveolar lavage fluid and lung parenchyma. CD8(+), CD4(+), and γδ T cell numbers were also lower in the lungs of PVM-infected Il21r(-/-) mice than in infected WT mice, with normal Th17 cytokines but diminished IL-6 production in PVM-infected Il21r(-/-) mice. Strikingly, Il21r(-/-) mice had enhanced survival following PVM infection, and moreover, treatment of WT mice with soluble IL-21R-Fc fusion protein enhanced their survival. These data reveal that IL-21 promotes the pathogenic inflammatory effect of PVM and indicate that manipulating IL-21 signaling may represent an immunomodulatory strategy for controlling PVM and potentially other respiratory virus infections.

Synergistic role of diacylglycerol kinases α and ζ in T cell development and self-tolerance (137.37)

Signal for the T cell receptor (TCR) plays critical roles in T cell development and function. TCR signaling can induce positive or negative selection of thymocytes, induces activation or anergy of mature T cells, and induce conventional T cell activation or regulatory T cells to suppress immune function. The mechanisms that modulate TCR signaling to direct these distinct outcomes have been poorly understood. Diacylglycerol (DAG) kinases (DGKs) are a family of enzymes that convert DAG to phosphatidic acid (PA) through phosphorylation. In mammals, ten DGK isoforms have been identified. Using both a gain of function and a loss of function approaches, we have found that DGK ( and ( are important regulators for T cells. Enhanced DGK activity inhibits TCR signaling and T cell maturation. Deficiency of either DGK( or ( causes T cells hyperresponsive to TCR stimulation and resistant to anergy induction. Loss of both DGK( and ( in mice results in impairment of positive selection, spontaneous T cell activation, impairment of regulatory T cell function, and autoimmunity. We further demonstrate that DGKs function both as signal terminator by inhibiting DAG-mediated signaling and as signaling initiator by generating PA.

Diacylglycerol kinases in immune cell function and self-tolerance

Both diacylglycerol (DAG) and phosphatidic acid (PA) are important second messengers involved in signal transduction from many immune cell receptors and can be generated and metabolized through multiple mechanisms. Recent studies indicate that diacylglycerol kinases (DGKs), the enzymes that catalyze phosphorylation of DAG to produce PA, play critical roles in regulating the functions of multiple immune cell lineages. In T cells, two DGK isoforms, alpha and zeta, inhibit DAG-mediated signaling following T-cell receptor engagement and prevent T-cell hyperactivation. DGK alpha and zeta synergistically promote T-cell anergy and are critical for T-cell tolerance. In mast cells, DGKzeta plays differential roles in their activation by promoting degranulation but attenuating cytokine production following engagement of the high affinity receptor for immunoglobulin E. In dendritic cells and macrophages, DGKzeta positively regulates Toll-like receptor-induced proinflammatory cytokine production through its product PA and is critical for host defense against Toxoplasma gondii infection. These studies demonstrate pivotal roles of DGKs in regulating immune cell function by acting both as signal terminator and initiator.

1,25-Dihydroxyvitamin D3 induces biphasic NF-κB responses during HL-60 leukemia cells differentiation through protein induction and PI3K/Akt-dependent phosphorylation/degradation of IκB

1,25-dihydroxyvitamin D(3) (VD(3)) induces differentiation in a number of leukemia cell lines and under various conditions is able to either stimulate or inhibit nuclear factor kappa B (NF-kappaB) activity. Here we report a time-dependent biphasic regulation of NF-kappaB in VD(3)-treated HL-60 leukemia cells. After VD(3) treatment there was an early approximately 4 h suppression and a late 8-72 h prolonged reactivation of NF-kappaB. The reactivation of NF-kappaB was concomitant with increased IKK activities, IKK-mediated IkappaBalpha phosphorylation, p65 phosphorylation at residues S276 and S536, p65 nuclear translocation and p65 recruitment to the NF-kappaB/vitamin D responsive element promoters. In parallel with NF-kappaB stimulation, there was an up-regulation of NF-kappaB controlled inflammatory and anti-apoptotic genes such as TNFalpha, IL-1beta and Bcl-xL. VD(3)-triggered reactivation of NF-kappaB was associated with PI3K/Akt phosphorylation. PI3K/Akt antagonists suppressed VD(3)-stimulated IkappaBalpha phosphorylation as well as NF-kappaB-controlled gene expression. The early approximately 4 h VD(3)-mediated NF-kappaB suppression coincided with a prolonged increase of IkappaBalpha protein which require de novo protein synthesis, lasted for as least 72 h and was insensitive to MAPK, IKK or PI3K/Akt inhibitors. Our data suggest a novel biphasic regulation of NF-kappaB in VD(3)-treated leukemia cells and our results may have provided the first molecular explanation for the contradictory observations reported on VD(3)-mediated immune-regulation.

Neuroprotective potential of ceftriaxone in in vitro models of stroke

Astrocytic glutamate transporters are considered an important target for neuroprotective therapies as the function of these transporters is abnormal in stroke and other neurological disorders associated with excitotoxicity. Recently, Rothstein et al., [Rothstein JD, Patel S, Regan MR, Haenggeli C, Huang YH, Bergles DE, Jin L, Dykes Hoberg M, Vidensky S, Chung DS, Toan SV, Bruijn LI, Su ZZ, Gupta P, Fisher PB (2005) Beta-lactam antibiotics offer neuroprotection by increasing glutamate transporter expression. Nature 433:73-77] reported that beta-lactam antibiotics (including ceftriaxone, which easily crosses the blood-brain barrier) increase glutamate transporter 1 (GLT-1) expression and reduce cell death resulting from oxygen-glucose deprivation (OGD) in dissociated embryonic cortical cultures. To determine whether a similar neuroprotective mechanism operates in more mature neurons, which show a different pattern of response to ischemia than primary cultures, we exposed acute hippocampal slices obtained from rats treated with ceftriaxone for 5 days (200 mg/kg; i.p.) to OGD. Whole-cell patch clamp recording of glutamate-induced N-methyl-d-aspartate (NMDA) currents from CA1 pyramidal neurons showed a larger potentiation of these currents after application of 15 microM dl-threo-beta-benzyloxyaspartic acid (TBOA; a potent blocker of glutamate transporters) in ceftriaxone-injected animals than in untreated animals, indicating increased glutamate transporter activity. Western blot analysis did not reveal GLT-1 upregulation in the hippocampus. Delay to OGD-induced hypoxic spreading depression (HSD) recorded in slices obtained from ceftriaxone-treated rats was longer (6.3+/-0.2 vs. 5.2+/-0.2 min; P<0.001) than that in the control group, demonstrating a neuroprotective action of the antibiotic in this model. The effect of ceftriaxone was also tested in organotypic hippocampal slices obtained from P7-9 rats (>14 days in vitro). OGD or glutamate (3.5-5.0 mM) damaged CA1 pyramidal neurons as assessed by propidium iodide (PI) fluorescence. Similar damage was observed after pre-treatment with ceftriaxone (10-200 microM; 5 days) and ceftriaxone exposure did not result in GLT-1 upregulation as assayed by Western blot. Treatment of slice cultures with dibutyryl cAMP (100-250 microM; 5 days) increased GLT-1 expression but did not reduce cell damage induced by OGD or glutamate. Thus we confirm the neuroprotective effect of antibiotic exposure on OGD-induced injury, but suggest that this action is related to independent modulation of transporter activity rather than to the level of GLT-1 protein expression. In addition, our results indicate that the protective effects of beta-lactam antibiotics are highly dependent on the experimental model.

Schisandrol A from Schisandra chinensis reverses P-glycoprotein-mediated multidrug resistance by affecting Pgp-substrate complexes

Recent studies have shown that dibenzocyclooctadiene lignans may reverse P-glycoprotein-mediated multidrug resistance (Pgp-MDR) in cancer cells; however, the mechanism of action remains unknown. Through screening of herbs, we found that schisandrol A (SCH) isolated from Fructus Schisandrae (the dried fruit of Schisandra chinensis (Turcz.) Baill.) sensitized Pgp-MDR HepG2-DR cells by interfering with the function of Pgp-substrate complexes. In Pgp-MDR cells, SCH enhanced the cytotoxicity of cancer drugs that are Pgp substrates and restored vinblastine-induced G2/M arrest without lowering Pgp expression. SCH increased cellular retention of Pgp substrates such as rhodamine 123. In Pgp-overexpressing membrane preparations, SCH stimulated basal Pgp-ATPase thus showing some substrate-like function. However, SCH was not a competitive inhibitor for verapamil or progesterone and decreased their Km. In the presence of substrates, SCH decreased the reactivity between Pgp and the monoclonal antibody UIC-2 which is normally increased with active substrate-Pgp complexes. The labeling of active Pgp transport sites by [125I]-iodoarylazidoprazosin was partially blocked by SCH. SCH did not affect the activity of the mutant Pgp F983A suggesting that SCH acted differently than the thioxanthene type of Pgp allosteric inhibitors. Our results suggest that SCH acts by affecting the normal formation and functioning of the Pgp-substrate complexes.

Magnolol suppresses NF-kappaB activation and NF-kappaB regulated gene expression through inhibition of IkappaB kinase activation

The mis-regulation of nuclear factor-kappa B (NF-kappaB) signal pathway is involved in a variety of inflammatory diseases that leds to the production of inflammatory mediators. Our studies using human U937 promonocytes cells suggested that magnolol, a low molecular weight lignan isolated from the medicinal plant Magnolia officinalis, differentially down-regulated the pharmacologically induced expression of NF-kappaB-regulated inflammatory gene products MMP-9, IL-8, MCP-1, MIP-1alpha, TNF-alpha. Pre-treatment of magnolol blocked TNF-alpha-induced NF-kappaB activation in different cell types as evidenced by EMSA. Magnolol did not directly affect the binding of p65/p50 heterodimer to DNA. Immunoblot analysis demonstrated that magnolol inhibited the TNF-alpha-stimulated phosphorylation and degradation of the cytosolic NF-kappaB inhibitor IkappaBalpha and the effects were dose-dependent. Mechanistically, a non-radioactive IkappaB kinases (IKK) assay using immunoprecipitated IKKs protein demonstrated that magnolol inhibited both intrinsic and TNF-alpha-stimulated IKK activity, thus suggesting a critical role of magnolol in abrogating the phosphorylation and degradation of IkappaBalpha. The involvement of IKK was further verified in a HeLa cell NF-kappaB-dependent luciferase reporter system. In this system magnolol suppressed luciferase expression stimulated by TNF-alpha and by the transient transfection and expression of NIK (NF-kappaB-inducing kinase), wild type IKKbeta, constitutively active IKKalpha and IKKbeta, or the p65 subunit. Magnolol was also found to inhibit the nuclear translocation and phosphorylation of p65 subunit of NF-kappaB. In line with the observation that NF-kappaB activation may up-regulate anti-apoptotic genes, it was shown in U937 cells that magnolol enhanced TNF-alpha-induced apoptotic cell death. Our results suggest that magnolol or its derivatives may have potential anti-inflammatory actions through IKK inactivation.

Triptolide induces Bcl-2 cleavage and mitochondria dependent apoptosis in p53-deficient HL-60 cells

Triptolide, a bioactive component of the Chinese medicinal herb Tripterygium wilfordii Hook F., induces p53-mediated apoptosis in cancer cells. This study demonstrated that triptolide activated an alternative p53-independent apoptotic pathway in HL-60 cells. In the absence of an intact p53 and without changing Bax level, at nM range triptolide induced apoptosis with concomitant DNA fragmentation, S phase cell cycle arrest, mitochondrial cytochrome c release and the activation of caspases. Besides, both caspases 8 and 9 were activated and the simultaneous inhibition of both was required to completely block triptolide's apoptotic effect. Importantly, triptolide induced the appearance of a truncated 23kD Bcl-2 which was inhibited by the general caspase inhibitor Z-VAD-FMK. In the MCF-7 cells that possessed the wild type p53 but lacked caspases 3, triptolide induced cell death with an increase in p53 but Bcl-2 remained unaltered. On the other hand, transfected cells overexpressing the 28kD Bcl-2 became more resistant to triptolide and upon triptolide treatment accumulated in the G(1) instead of S phase. After 36h treatment, triptolide activated JNK pathways, at the same time inactivated the ERK and p38 pathways. However, SP600125, a specific JNK inhibitor, could not inhibit the triptolide-mediated cleavage of caspase 3, indicated that activation of JNK might not be related to the apoptotic effects of triptolide. Our data suggest that in the absence of an intact p53 and without altering Bax level triptolide induces apoptosis activates a positive amplification loop involving caspase-mediated Bcl-2 cleavage/activation, mitochondrial cytochrome c release and further activation of caspases.

Gomisin A alters substrate interaction and reverses P-glycoprotein-mediated multidrug resistance in HepG2-DR cells

Through an extensive herbal drug screening program, we found that gomisin A, a dibenzocyclooctadiene compound isolated from Schisandra chinensis, reversed multidrug resistance (MDR) in Pgp-overexpressing HepG2-DR cells. Gomisin A was relatively non-toxic but without altering Pgp expression, it restored the cytotoxic actions of anticancer drugs such as vinblastine and doxorubicin that are Pgp substrates but may act by different mechanisms. Several lines of evidence suggest that gomisin A alters Pgp-substrate interaction but itself is neither a Pgp substrate nor competitive inhibitor. (1) First unlike Pgp substrates gomisin A inhibited the basal Pgp-associated ATPase (Pgp-ATPase) activity. (2) The cytotoxicity of gomisin A was not affected by Pgp competitive inhibitors such as verapamil. (3) Gomisin A acted as an uncompetitive inhibitor for Pgp-ATPase activity stimulated by the transport substrates verapamil and progesterone. (4) On the inhibition of rhodamine-123 efflux the effects of gomisin A and the competitive inhibitor verapamil were additive, so were the effects of gomisin A and the ATPase inhibitor vanadate. (5) Binding of transport substrates with Pgp would result in a Pgp conformational change favoring UIC-2 antibody reactivity but gomisin A impeded UIC-2 binding. (6) Photocrosslinking of Pgp with its transport substrate [125I]iodoarylazidoprazosin was inhibited by gomisin A in a concentration-dependent manner. Taken together our results suggest that gomisin A may bind to Pgp simultaneously with substrates and alters Pgp-substrate interaction.

Honokiol inhibits TNF-α-stimulated NF-κB activation and NF-κB-regulated gene expression through suppression of IKK activation

Honokiol, a small molecular weight lignan originally isolated from Magnolia officinalis, shows anti-angiogenic, anti-invasive and anti-proliferative activities in a variety of cancers. In this study, we investigated whether honokiol affects the transcription factor nuclear factor-kappa B (NF-kappaB) which controls a large number of genes involved in angiogenesis, metastasis and cell survival. We observed that the tumor necrosis factor-alpha (TNF-alpha)-induced NF-kappaB activation was blocked by honokiol in four different cancer cell lines as evidenced by EMSA. Honokiol did not directly affect the NF-kappaB-DNA binding. Immunoblot experiments demonstrated that honokiol inhibited the TNF-alpha-stimulated phosphorylation and degradation of the cytosolic NF-kappaB inhibitor IkappaBalpha. Furthermore, honokiol suppressed the intrinsic and TNF-alpha-stimulated upstream IkappaB kinases (IKKs) activities measured by a non-radioactive kinase assay using immunoprecipitated IKKs, suggesting a critical role of honokiol in abrogating the phosphorylation and degradation of IkappaBalpha. In a HeLa cell NF-kappaB-dependent luciferase reporter system, honokiol suppressed luciferase expression stimulated by TNF-alpha and by the transient transfection and expression of NIK (NF-kappaB-inducing kinase), wild type IKKbeta, constitutively active IKKalpha and IKKbeta, or the p65 subunit. Honokiol was also found to inhibit the nuclear translocation and phosphorylation of p65 subunit of NF-kappaB. RT-PCR results showed that honokiol suppressed NF-kappaB-regulated inflammatory and carcinogenic gene products including MMP-9, TNF-alpha, IL-8, ICAM-1 and MCP-1. In line with the observation that NF-kappaB activation may up-regulate anti-apoptotic genes, it was shown that honokiol enhanced TNF-alpha-induced apoptotic cell death. In summary, our results demonstrate that honokiol suppresses NF-kappaB activation and NF-kappaB-regulated gene expression through the inhibition of IKKs, which provides a possible mechanism for its anti-tumor actions.

Reversal of P-glycoprotein-mediated multidrug resistance by Alisol B 23-acetate

Herbal drugs were screened for their activity in reversing multidrug resistance (MDR) in P-glycoprotein (P-gp) over-expressing cancer cells. Through bio-assay guided fractionation an active compound was isolated from Rhizoma Alismatis, the underground part of Alisma orientale and the chemical structure of the isolate compound was confirmed by HPLC, LC-MS and NMR as Alisol B 23-acetate (ABA). ABA restored the sensitivity of MDR cell lines HepG2-DR and K562-DR to anti-tumor agents that have different modes of action but are all P-gp substrates. It restored the activity of vinblastine, a P-gp substrate, in causing G2/M arrest in MDR cells. In a dose-dependent manner, ABA increased doxorubicin accumulation and slowed down the efflux of rhodamin-123 from MDR cells. ABA inhibited the photoaffinity labeling of P-gp by [125I]iodoarylazidoprazosin and stimulated the ATPase activity of P-gp in a concentration-dependent manner, suggesting that it could be a transporter substrate for P-gp. In addition, ABA was also a partial non-competitive inhibitor of P-gp when verapamil was used as a substrate. Our results suggest that ABA may be a potential MDR reversal agent and could serve as a lead compound in the development of novel drugs.

Betulinic acid enhances 1alpha,25-dihydroxyvitamin D3-induced differentiation in human HL-60 promyelocytic leukemia cells

Betulinic acid (BA) is a pentacyclic triterpene found in a number of medicinal plants and has been shown to cause apoptosis in a number of cell lines. We report here that BA may also have an effect on HL-60 cell differentiation. BA was cytotoxic to HL-60 cells with an IC50 of 5.7 microM after a 72-h treatment. Flow cytometry analysis showed that after exposure to 1-12 microM of BA for 72 h, approximately 10% of viable cells were in the sub-G1, presumably apoptotic, phase. At the same time differentiation was induced in approximately 10% (at 1 microM BA) to a maximum of 20% (at 6 microM BA) of cells as judged by the NBT-reduction test, and the expression of membrane markers CD11b and CD14. On the other hand, at 1 and 5 nM, 1alpha,25-dihydroxyvitamin D3 (DHD3) induced differentiation in approximately 10 and 70% of cells, respectively. At 1 nM DHD3, the addition of 1 microM BA increased differentiated cells from 10 to 43% and with 3 microM BA the increase was to 80%. BA also enhanced the effects of DHD3 in the expansion of the G1 cell population with a concomitant decrease of S phase cells. The effects of DHD3 and BA on CD11b and CD14 expression were inhibited by PD98059, a MEK inhibitor. Our results suggest that BA may enhance the effect of DHD3 in inducing mitogen-activated protein kinase kinase/extracellular signal-regulated protein kinase-mediated HL-60 cell differentiation.

Effect of organic waste amendments on degradation of PAHs in soil using thermophillic composting

The feasibility of using various types of organic wastes including pig manure, sewage sludge, and soybean refuse for remediation of soil spiked with phenanthrene, anthracene and pyrene (PAHs) was evaluated through batch-scale composting reactors. The most active degradation of PAHs occurred between day 4 to 30 and maximum removal at the end of composting accounted for 90% of the initial concentrations of the three PAH compounds. Among the three PAHs, degradation of pyrene in the composting mass was relatively slow as indicated by a longer lag period than that of phenanthrene and anthracene. This corresponded well with the high molecular weight and log K(ow) values of pyrene. The organic amendments were effective in enhancing the degradation of PAHs, and pig manure amendment exhibited a slightly higher removal efficiency than sewage sludge and soybean refuse. A decrease in total organic matter in all treatments indicated that the decomposition process occurred. Toxicity test with cress seed germination was evaluated and no phytotoxicity was noted after 21 days of composting. This preliminary study positively supports that pig manure is an effective organic additive for bioremediation of PAH-contaminated soil using composting as a treatment technology.

Pig manure as a co-composting material for biodegradation of PAH-contaminated soil

Pig manure at three different ratios of 12.5%, 25% and 50% (w/w dry weight basis) was amended with a soil spiked with 100 mg kg(-1) each of three polycyclic aromatic hydrocarbons (phenanthrene, anthracene, and pyrene) to investigate its effect on the biodegradation of these PAHs in a bench-scale composting system. An increase in pig manure amendment was effective in enhancing the amounts of soluble organic carbon, ammoniacal nitrogen, and soluble phosphorous in the composting mass. It could also increase the populations of total thermophilic and mesophilic bacteria as well as PAH-degrading bacteria, but this pattern was restricted only to the early stage of the composting process. High amounts of pig manure in the composting mass reduced the seed germination or root growth of cress seeds, but the composting process was effective in reducing the phytotoxic effects of the compost. Amendment of pig manure was beneficial to PAH removal during composting treatment and maximum removal rate at the end of composting accounted for 90% of the initial concentrations of PAHs. A pig manure application rate of 25% showed the most efficient removal of 3-ringed PAHs (phenanthrene and anthracene), while no significant difference in pyrene removal for those receiving 25 or 50% pig manure amendment. Taking into consideration the effects of pig manure on seed germination and available nutrients in the composting mass, this study suggested that a pig manure amendment of 25%, i.e., 3:1 ratio of contaminated soil: pig manure, is recommended to co-compost with PAH-contaminated soil.

A three-factor model of trait anger: dimensions of affect, behavior, and cognition

The structure of trait anger was tested in a study of 24 self-report scales. Exploratory factor analyses in an undergraduate sample (N = 457) yielded a two-factor model (comprising cynicism and aggression) and a three-factor model (representing angry emotions, aggressive behaviors, and cynicism). Subsequent evaluations, including confirmatory factor analyses, indicated that the three-factor model provided the best characterization of the trait anger domain. The three-factor solution was consistent with an "ABC" conceptualization of trait anger, consisting of the dimensions of affect, behavior, and cognition. The three factors showed strikingly different associations with the Big Five personality traits. Angry Affect was most strongly related to Neuroticism, whereas Behavioral Aggression was associated with low Agreeableness. Cynical Cognition represented a blend of neurotic and disagreeable characteristics. Modest mean-level differences were observed between the genders for each factor.

Increased responses of glucagon and glucose production to hypoglycemia with intraperitoneal versus subcutaneous insulin treatment

The study aim was to investigate the effect of the route of insulin treatment on the glucagon and glucose production (GP) responses to hypoglycemia in the diabetic rat. Experiments were performed in 4 groups of rats: (1) streptozotocin (STZ)-induced diabetic, untreated (D, n = 7), (2) diabetic treated with subcutaneous insulin (DSC, n = 8), (3) diabetic treated with intraperitoneal insulin (DIP, n = 6), and (4) normal control (N, n = 10). Slow-release insulin implants were used in DSC and DIP rats for 10 to 14 days (3 U/d). A hyperinsulinemic (120 pmol x kg(-1) x min(-1) insulin)-hypoglycemic (glycemia = 2.5 +/- 0.1 mmol/L) clamp following an isoglycemic basal period was performed in 5-hour fasted rats. Basal plasma glucose was normalized in both DSC and DIP rats; however, in DSC but not DIP rats, glucose normalization required peripheral hyperinsulinemia. Tracer-determined GP, which was elevated in D rats, was completely normalized in DIP but only partially corrected in DSC rats. Basal glucagon levels were similar in all groups. During hypoglycemia, GP was suppressed in D rats (delta, -28.9 +/- 5.0 micromol x kg(-1) x min(-1), moderately increased in DSC rats (delta, 6.1 +/- 5.6, P < .01 v D), but markedly increased in DIP and N rats (delta, 34.5 +/- 4.5 for DIP and 16.8 +/- 2.8 for N; P < .01 vD, P < .05 for DIP v DSC or N). Plasma glucagon increased 6-fold in N (945 +/- 129 pg/mL), only doubled in D (424 +/- 54), and tripled in DSC (588 +/- 83), but increased 5-fold in DIP rats (1,031 +/- 75, P < .05 v D and DSC). We conclude that in STZ-diabetic rats, (1) intraperitoneal but not subcutaneous insulin treatment normalizes basal GP, and (2) intraperitoneal insulin treatment as compared with subcutaneous treatment alleviates peripheral hyperinsulinemia and results in increased glucagon and GP responses to hypoglycemia.

The contraceptive self-efficacy scale: analysis in four samples

Previous research has established a relationship between contraceptive self-efficacy (CSE), as measured by the 18-item CSE scale, and young women's contraceptive behavior. In this paper, the authors continue to explore the scale and its relationship to contraceptive behavior with four diverse samples to establish generalizability and to set guidelines for use of the scale. A series of correlational analyses were conducted with each sample. A pattern of low correlations among CSE items across samples emerged, indicating that use of the total item set separately as the basis for CSE was warranted. Zero-order and partial correlations revealed which CSE items were correlated with contraceptive behavior as well as which items explained unique variance in contraceptive behavior for each sample. Regression analyses showed that CSE was significantly predictive of contraceptive behavior for all samples. These results are discussed in terms of scale properties and use in research and clinical settings. Educational implications are formulated as well.

The short-term natural history of irritable bowel syndrome: a time-series analysis

Although researchers have studied irritable bowel syndrome (IBS), including its physiological and psychological characteristics and treatments' effectiveness, basic descriptive information about IBS has been limited to lists of symptoms and explanations of what IBS is not. The purpose of the present study is to describe how core IBS symptoms vary over time. Twenty-five subjects (17 females, 8 males), who were not receiving treatment for IBS, rated the severity of their IBS symptoms daily for 8 weeks. Four symptoms' (abdominal pain, abdominal tenderness, constipation and diarrhea) ratings were slimmed to create a primary IBS symptom score. The data were detrended, then a time-series analysis was performed. Many subjects' IBS severity was predictable over more than one day, and symptoms tended to occur in clusters rather than randomly. Anxiety and depression were slightly to moderately correlated with IBS variables, but virtually all of these correlations were nonsignificant.

Gay men's safer sex behavior: an integration of three models

This cross-sectional study explored gay men's sexual risk behavior from the perspective of three popular conceptual models, the health belief model, the theory of reasoned action, and social cognitive theory. Data were collected from sexually active gay men via anonymous questionnaire containing questions about sexual behavior and items related to the constructs comprising the three models. Using structural equation modeling techniques (LISREL 8), self-reported condom use was examined from the perspective of each theory. The results suggested that a substantial part of the variance in unprotected anal intercourse could be explained by conceptually analogous constructs common to these models. These constructs referred to the cognitive-affective reactions toward condoms and to the social context of using condoms. An additional variable unique to social cognitive theory, self-efficacy, added to the explained variance in the criterion above and beyond the variables that were common to the models. Relevant variables from the three theories were integrated into an expanded self-efficacy model.

The prediction of accurate contraceptive use from attitudes and knowledge

A framework of the relationship between knowledge, attitudes, and behavior was described in the context of couple's use of birth control. It was hypothesized that when knowledge of behavioral enactment is present, attitudes and beliefs about susceptibility to pregnancy will be predictive of accurate use of the diaphragm. Respondents were 111 women who participated in a three-wave panel design focusing on diaphragm use. Analyses indicated that the level of knowledge about what a woman should do to use the diaphragm correctly was high. Correct knowledge, however, did not translate into accurate behavior. Motivational factors focusing on attitudes, perceived susceptibility to pregnancy, and normative factors were also relevant.

Relationship of trait anger to resting blood pressure: a meta-analysis

A series of meta-analyses were conducted to assess whether anger is related to essential hypertension. The present review also considered the relevance of the distinction between anger experience and anger expression, the effect of participant selection bias, and the white-coat hypertension effect for the anger-blood pressure (BP) association. Anger experience was correlated with elevated BP, but the relationship was small and highly variable. When positive effects emerged, both participant selection and the reliability of BP measurement posed interpretational problems. Persons high in anger are not merely exhibiting elevated BP in response to testing, so a white-coat effect is not evident. Being labeled as hypertensive may contribute to higher anger scores, however. The review suggests lines of future research concerning associations between trait anger and blood pressure.

Relationship of trait anger to resting blood pressure: a meta-analysis

A series of meta-analyses were conducted to assess whether anger is related to essential hypertension. The present review also considered the relevance of the distinction between anger experience and anger expression, the effect of participant selection bias, and the white-coat hypertension effect for the anger-blood pressure (BP) association. Anger experience was correlated with elevated BP, but the relationship was small and highly variable. When positive effects emerged, both participant selection and the reliability of BP measurement posed interpretational problems. Persons high in anger are not merely exhibiting elevated BP in response to testing, so a white-coat effect is not evident. Being labeled as hypertensive may contribute to higher anger scores, however. The review suggests lines of future research concerning associations between trait anger and blood pressure.

A multilevel data-analytic approach for evaluation of relationships between daily life stressors and symptomatology: patients with irritable bowel syndrome

Four statistical strategies were used to evaluate whether occurrence of daily stressors increases lower gastrointestinal (GI) symptoms in irritable bowel syndrome (IBS) patients. Across-subject concurrent correlations between weekly stress and symptoms were positive but casually ambiguous and obscured between- and within-subject and occasion relationships. Multiple regressions assessing (weekly and daily) relations showed that prior symptoms predicted subsequent symptoms but that prior and concurrent daily stress had no consistent effects. Idiographic correlations also showed little evidence for a relationship between stress and symptoms. Daily stress did not appear to increase GI symptoms in IBS patients on a general basis. Daily recording methodology, in conjunction with within-subject analytic strategies, is proposed as an innovative approach to examine relations between stress and physical symptomatology.

A multilevel data-analytic approach for evaluation of relationships between daily life stressors and symptomatology: patients with irritable bowel syndrome

Four statistical strategies were used to evaluate whether occurrence of daily stressors increases lower gastrointestinal (GI) symptoms in irritable bowel syndrome (IBS) patients. Across-subject concurrent correlations between weekly stress and symptoms were positive but casually ambiguous and obscured between- and within-subject and occasion relationships. Multiple regressions assessing (weekly and daily) relations showed that prior symptoms predicted subsequent symptoms but that prior and concurrent daily stress had no consistent effects. Idiographic correlations also showed little evidence for a relationship between stress and symptoms. Daily stress did not appear to increase GI symptoms in IBS patients on a general basis. Daily recording methodology, in conjunction with within-subject analytic strategies, is proposed as an innovative approach to examine relations between stress and physical symptomatology.

Long-term monitoring of psychosocial stress and symptomatology in inflammatory bowel disease

Eleven subjects with inflammatory bowel disease (IBD) participated in a longterm self-monitoring investigation of the relationship between psychosocial stress and IBD symptomatology. Two measurement instruments, the IBD Symptom Diary and the Psychosocial Stress Diary, were completed by each subject for 7 consecutive days each month for one year. Pooled time-series analysis of the influence of daily stress on IBD activity revealed a significant effect. A positive concurrent relationship was found between both daily and monthly psychosocial stress and IBD activity. Investigations of temporal relationship among variables revealed a negative effect of previous month stress on IBD. Results suggest a monthly rebound effect whereby IBD symptom severity is negatively responsive to the severity of the previous month stress. The effects of stress upon IBD were not found to be modified by behavioral coping strategies. These results support the prevailing impression that psychosocial stress contributes to the clinical course of IBD, and specifically suggest an influential role of daily and monthly stress. A pattern matching IBD's characteristic waxing and waning clinical course emerges when the association between stress and IBD is examined from a monthly viewpoint. Refinement of our knowledge of the IBD-stress model calls for replication and explanation of the monthly rebound effect as well as investigations into type of stressor and coping strategy that may influence IBD activity.

Condom use: a self-efficacy model

A survey of heterosexually active college students gathered information about condom use, self-efficacy (SE), outcome expectancies, sexual attitudes, peer group influences, acquired immunodeficiency syndrome (AIDS) knowledge, and perceived vulnerability to AIDS. On the basis of A. Bandura's (1986) social-cognitive theory, a structural model with SE as the central mediator was formulated and evaluated with LISREL. This model explained 46% of the variance in condom use from judgments of SE and effects attributable to peers and 53% of the variance in SE from outcome expectancies and peer group influences. Sexual attitudes, AIDS knowledge, and perceived vulnerability did not predict condom use. Most students were well-informed about human immunodeficiency virus (HIV) transmission but reported not feeling at risk, even though many engaged in risky sexual behavior.

The relationship between trait hostility and cardiovascular reactivity: a quantitative review and analysis

Results of a series of meta-analyses indicated that high and low scorers on most trait hostility measures do not consistently differ in blood pressure or heart rate reactivity to traditional laboratory stressors. The few significant effects were modest in size, and instances of hyporeactivity were found. When stressors were classified as provocative versus nonprovocative, in accord with Trait x Situation approaches, however, Potential for Hostility-Interpersonal Style was predictive of exaggerated systolic and diastolic blood pressure responses and the Cook-Medley Hostility Inventory was predictive of diastolic blood pressure responses to provocative stressors. Hence, the next generation of studies of the hostility-reactivity hypothesis should emphasize interpersonal stressors. Alternative mechanisms for the disease consequences of hostility should also be examined, however, because the available evidence indicates that the hyperreactivity hypothesis is unlikely to furnish a complete explanation for the association between hostility and heart disease.

Condom use: a self-efficacy model

A survey of heterosexually active college students gathered information about condom use, self-efficacy (SE), outcome expectancies, sexual attitudes, peer group influences, acquired immunodeficiency syndrome (AIDS) knowledge, and perceived vulnerability to AIDS. On the basis of A. Bandura's (1986) social-cognitive theory, a structural model with SE as the central mediator was formulated and evaluated with LISREL. This model explained 46% of the variance in condom use from judgments of SE and effects attributable to peers and 53% of the variance in SE from outcome expectancies and peer group influences. Sexual attitudes, AIDS knowledge, and perceived vulnerability did not predict condom use. Most students were well-informed about human immunodeficiency virus (HIV) transmission but reported not feeling at risk, even though many engaged in risky sexual behavior.

Multiple role juggling and daily mood states in working mothers: an experience sampling study

The effects of multiple role juggling (i.e., simultaneously attending to demands of different roles) on daily mood states of employed mothers were examined. Ss completed activity and mood questionnaires 8 times a day for 8 days. Multiple role juggling had immediate negative effects on task enjoyment and mood. However, contrast effects and habituation to role juggling occurred when mood and satisfaction were examined over time. Furthermore, mood states tended to spill over from one episode to the next within a day, but contrast effects were found across days. These results reflect the complex nature of psychological adjustment to multiple role occupancy.

The Detection and Interpretation of Interaction Effects Between Continuous Variables in Multiple Regression

issues in the detection and interpretation of interaction effects between quantitative variables in multiple regression analysis are discussed. Recent articles by Cronbach (1987) and Dunlap and Kemery (1987) suggested the use of two transformations to reduce "problems" of multicollinearity. These transformations are discussed in the context of the conditional nature of multiple regression with product terms. It is argued that although additive transformations do not affect the overall test of statistical interaction, they do affect the interpretational value of regression coefficients. Factors other than multicollinearity that may account for failures to observe interaction effects are noted.

Effects of sensory and procedural information on coping with stressful medical procedures and pain: a meta-analysis

A meta-analysis of studies on preparation for medical procedures and pain evaluated the relative effects of sensory; procedural, and combined sensory-procedural preoperational information on coping outcomes. Results indicated that, in contrast to sensory information, procedural information provided no significant benefits over control group instruction. Combined sensory-procedural preparation, however, yielded the strongest and most consistent benefits in terms of reducing negative affect, pain reports, and other-rated distress. The meta-analytic results are consistent with the dual process preparation hypothesis, which proposes that the information combination is optimal because procedural details provide a map of specific events while sensory information facilitates their interpretation as nonthreatening. It is concluded that a combined preparation is the preferred clinical option.

The relation between Type A behavior and chronic emotional distress: A meta-analysis

A meta-analysis was conducted of studies examining the relation between Type A behavior and chronic emotional distress as measured by standard psychological scales. Aggregating across all studies, the average effect size was .27, indicating a positive association between Type A and chronic dysphoria; however, there was considerable variability in the size of the relation among studies. Partitioning by Type A measure revealed that Structured Interview-assessed Type A was unrelated to chronic dysphoric emotions; however, most of the self-report measures of Type A behavior were moderately correlated with upset. The Framingham Type A Scale and the Bortner Scale showed the strongest relations. Thus, contrary to the traditional view, Type A measured by self-report does have some emotional concomitants, although they are not in the pathological range. Also discussed are how the results bear on the proposal that the maladjusted personality confers coronary risk, the implications for reported associations between Type A and illness complaints, and for the study of the Type A as a social psychological construct.

Effects of sensory and procedural information on coping with stressful medical procedures and pain: A meta-analysis

A meta-analysis of studies on preparation for medical procedures and pain evaluated the relative effects of sensory; procedural, and combined sensory-procedural preoperational information on coping outcomes. Results indicated that, in contrast to sensory information, procedural information provided no significant benefits over control group instruction. Combined sensory-procedural preparation, however, yielded the strongest and most consistent benefits in terms of reducing negative affect, pain reports, and other-rated distress. The meta-analytic results are consistent with the dual process preparation hypothesis, which proposes that the information combination is optimal because procedural details provide a map of specific events while sensory information facilitates their interpretation as nonthreatening. It is concluded that a combined preparation is the preferred clinical option.

In search of the false-uniqueness phenomenon: fear and estimates of social consensus

An examination of the social perception literature yields little evidence for the false-uniqueness phenomenon (Valins & Nisbett, 1972), the perception that one's attributes are more unique than is the case. In contrast, the tendency for individuals to project their own characteristics onto other people and assume that more people are like themselves is a robust phenomenon. One reason researchers may not have found false uniqueness is that they have not looked at the accuracy of consensus estimates. A close look at the results of Tabachnik, Crocker, and Alloy (1983) and Sanders and Mullen (1983), who did assess accuracy, suggests that people possessing undesirable attributes over-estimate consensus, whereas people holding desirable attributes underestimate consensus. The latter pattern is a form of false uniqueness. In this study we looked at the accuracy of social consensus estimates in the context of psychological fears. A sample of subjects filled out an abbreviated version of a fear survey and made estimates of consensus. The results showed that both high- and low-fear respondents overestimated the incidence of high fear among their peers, but high-fear subjects were more inaccurate in their estimates. A false-uniqueness effect was found on the part of low-fear subjects, as they tended to underestimate the incidence of low fear among their peers. These findings are consistent with a motivational interpretation that emphasizes the individual's need to justify or normalize stigmatized behavior and to bolster perceived self-competence.

In search of the false-uniqueness phenomenon: Fear and estimates of social consensus

An examination of the social perception literature yields little evidence for the false-uniqueness phenomenon (Valins & Nisbett, 1972), the perception that one's attributes are more unique than is the case. In contrast, the tendency for individuals to project their own characteristics onto other people and assume that more people are like themselves is a robust phenomenon. One reason researchers may not have found false uniqueness is that they have not looked at the accuracy of consensus estimates. A close look at the results of Tabachnik, Crocker, and Alloy (1983) and Sanders and Mullen (1983), who did assess accuracy, suggests that people possessing undesirable attributes over-estimate consensus, whereas people holding desirable attributes underestimate consensus. The latter pattern is a form of false uniqueness. In this study we looked at the accuracy of social consensus estimates in the context of psychological fears. A sample of subjects filled out an abbreviated version of a fear survey and made estimates of consensus. The results showed that both high- and low-fear respondents overestimated the incidence of high fear among their peers, but high-fear subjects were more inaccurate in their estimates. A false-uniqueness effect was found on the part of low-fear subjects, as they tended to underestimate the incidence of low fear among their peers. These findings are consistent with a motivational interpretation that emphasizes the individual's need to justify or normalize stigmatized behavior and to bolster perceived self-competence.