Deep Learning for Synthetic CT from Bone MRI in the Head and Neck

BACKGROUND AND PURPOSE

Bone MR imaging techniques enable visualization of cortical bone without the need for ionizing radiation. Automated conversion of bone MR imaging to synthetic CT is highly desirable for downstream image processing and eventual clinical adoption. Given the complex anatomy and pathology of the head and neck, deep learning models are ideally suited for learning such mapping.

MATERIALS AND METHODS

This was a retrospective study of 39 pediatric and adult patients with bone MR imaging and CT examinations of the head and neck. For each patient, MR imaging and CT data sets were spatially coregistered using multiple-point affine transformation. Paired MR imaging and CT slices were generated for model training, using 4-fold cross-validation. We trained 3 different encoder-decoder models: Light_U-Net (2 million parameters) and VGG-16 U-Net (29 million parameters) without and with transfer learning. Loss functions included mean absolute error, mean squared error, and a weighted average. Performance metrics included Pearson R, mean absolute error, mean squared error, bone precision, and bone recall. We investigated model generalizability by training and validating across different conditions.

RESULTS

The Light_U-Net architecture quantitatively outperformed VGG-16 models. Mean absolute error loss resulted in higher bone precision, while mean squared error yielded higher bone recall. Performance metrics decreased when using training data captured only in a different environment but increased when local training data were augmented with those from different hospitals, vendors, or MR imaging techniques.

CONCLUSIONS

We have optimized a robust deep learning model for conversion of bone MR imaging to synthetic CT, which shows good performance and generalizability when trained on different hospitals, vendors, and MR imaging techniques. This approach shows promise for facilitating downstream image processing and adoption into clinical practice.

Zero TE MRI for Craniofacial Bone Imaging

Zero TE MR imaging is a novel technique that achieves a near-zero time interval between radiofrequency excitation and data acquisition, enabling visualization of short-T2 materials such as cortical bone. Zero TE offers a promising radiation-free alternative to CT with rapid, high-resolution, silent, and artifact-resistant imaging, as well as the potential for "pseudoCT" reconstructions. In this report, we will discuss our preliminary experience with zero TE, including technical principles and a clinical case series demonstrating emerging applications in neuroradiology.

Reducing off target viral delivery in ovarian cancer gene therapy using a protease-activated AAV2 vector platform

Gene therapy is a promising strategy for treating metastatic epithelial ovarian cancer (EOC). However, efficient vector targeting to tumors is difficult and off-target effects can be severely detrimental. Most vector targeting approaches rely on surface receptors overexpressed on some subpopulation of cancer cells. Unfortunately, there is no universally expressed cell surface biomarker for tumor cells. As an alternative, we developed an adeno-associated virus (AAV) based "Provector" whose cellular transduction can be activated by extracellular proteases, such as matrix metalloproteinases (MMP) that are overexpressed in the tumor microenvironments of the most aggressive forms of EOC. In a non-tumor bearing mouse model, the Provector demonstrates efficient de-targeting of healthy tissues, especially the liver, where viral delivery is <1% of AAV2. In an orthotopic HeyA8 tumor model of EOC, the Provector maintains decreased off-target delivery in the liver and other tissues but with no loss in tumor delivery. Notably, approximately 10% of the injected Provector is still detected in the blood at 24 h while >99% of injected AAV2 has been cleared from the blood by 1 h. Furthermore, mouse serum raised against the Provector is 16-fold less able to neutralize Provector transduction compared to AAV2 serum neutralizing AAV2 transduction (1:200 vs 1:3200 serum dilution, respectively). Thus, the Provector appears to generate less neutralizing antibodies than AAV2. Importantly, serum against AAV2 does not neutralize the Provector as well as AAV2, suggesting that pre-existing antibodies against AAV2 would not negate the clinical application of Provectors. Taken together, we present an EOC gene delivery vector platform based on AAV with decreased off-target delivery without loss of on-target specificity, and greater immunological stealth over the traditional AAV2 gene delivery vector.

Role of Tetra Amino Acid Motif Properties on the Function of Protease-Activatable Viral Vectors

Protease-activatable viruses (PAV) based on adeno-associated virus have previously been generated for gene delivery to pathological sites characterized by elevated extracellular proteases. "Peptide locks", composed of a tetra-aspartic acid motif flanked by protease cleavage sequences, were inserted into the virus capsid to inhibit virus-host cell receptor binding and transduction. In the presence of proteases, the peptide locks are cleaved off the capsid, restoring the virus' ability to bind cells and deliver cargo. Although promising, questions remained regarding how the peptide locks prevented cell binding. In particular, it was unclear if the tetra-amino acid (4AA) motif blocks receptor binding via electrostatic repulsion or steric obstruction. To explore this question, we generated a panel of PAVs with lock designs incorporating altered 4AA motifs, each wielding various chemical properties (negative, positive, uncharged polar, and hydrophobic) and characterized the resultant PAV candidates. Notably, all mutants display reduced receptor binding and decreased transduction effciency in the absence of proteases, suggesting simple electrostatics between heparin and the D4 motif do not play an exclusive role in obstructing virus-receptor binding. Even small hydrophobic (A4) and uncharged polar (SGGS) motifs confer a reduction in heparin binding compared to the wild type. Furthermore, both uncharged polar N4 and Q4 mutants (comparable in size to the D4 and E4 motifs respectively, but lacking the negative charge) demonstrate partial ablation of heparin binding. Collectively, these results support a possible dual mechanism of PAV lock operation, where steric hindrance and electrostatics make nonredundant contributions to the disruption of virus-receptor interactions. Finally, because of high virus titer production and superior capsid stability, only the negatively charged 4AA motifs remain viable design choices for PAV construction. Future studies probing the structure-function relationship of PAVs will further expand its promise as a gene delivery vector able to target diseased tissues exhibiting elevated extracellular proteases.

Spectrum of Third Window Abnormalities: Semicircular Canal Dehiscence and Beyond

Third window abnormalities are defects in the integrity of the bony structure of the inner ear, classically producing sound-/pressure-induced vertigo (Tullio and Hennebert signs) and/or a low-frequency air-bone gap by audiometry. Specific anatomic defects include semicircular canal dehiscence, perilabyrinthine fistula, enlarged vestibular aqueduct, dehiscence of the scala vestibuli side of the cochlea, X-linked stapes gusher, and bone dyscrasias. We discuss these various entities and provide key examples from our institutional teaching file with a discussion of symptomatology, temporal bone CT, audiometry, and vestibular-evoked myogenic potentials.

Simvastatin increases osteoblasts and osteogenic proteins in ovariectomized rats

BACKGROUND

Previous reports have indicated that statins could prevent bone loss in ovariectomized (OVX) rats and increase the expressions of osteogenic genes in cultured osteoblasts. In this study, we hypothesized that simvastatin might increase osteoblast number and protein expressions of osteogenic markers localized in bones in concomitance with the prevention of bone loss in OVX rats.

MATERIALS AND METHODS

Fifty-four 3-month-old OVX and sham-operated (SHAM) female Sprague-Dawley rats were used. Simvastatin (10-20 mg kg(-1) day(-1)) was administrated orally for 6 weeks. Trabecular volume, osteoblast number and osteogenic proteins including BMP2, collagen type I and osteocalcin on bone sections obtained from lumbar vertebral body, distal femur and proximal tibia were measured.

RESULTS

The results showed that SHAM rats had significantly less trabecular bone volume and osteoblast number than that of OVX rats 6 weeks after operation. Oral simvastatin treatment (10-20 mg kg(-1) day(-1)) increased bone volume and osteoblast number in the distal femurs, proximal tibiae and vertebrae of OVX rats. Furthermore, the osteoblastic cells with immuno-stained BMP2, collagen type I and osteocalcin in vertebral bones were significantly increased by simvastatin treatment (20 mg kg(-1) day(-1)) in OVX rats.

CONCLUSIONS

This study demonstrates that simvastatin enhances the production of osteogenic proteins in bone and this effect may contribute to the prevention of bone loss in OVX rats.

Non-adiabatic intramolecular and photodissociation dynamics studied by femtosecond time-resolved photoelectron and coincidence imaging spectroscopy

Time-resolved photoelectron spectroscopy (TRPES) is emerging as a useful tool for the study of non-adiabatic dynamics in isolated polyatomic molecules and clusters due to its sensitivity to both electronic and vibrational dynamics. A powerful extension of TRPES, coincidence imaging spectroscopy (CIS), based upon femtosecond time-resolved 3D momentum vector imaging of both photoions and photoelectrons in coincidence, is a new technique for the study of complex dissociative processes. Here we show how these spectroscopies can be used to study both non-adiabatic intramolecular and photodissociation dynamics in polyatomic molecules. Intramolecular dynamics in the alpha, beta-enones acrolein, crotonaldehyde and methyl vinyl ketone are studied using both TRPES and laser-induced fluorescence of HCO(X) product yields. The location of the methyl group is seen to have very dramatic effects on the relative electronic relaxation rates and the HCO(X) yield. Applying both TRPES and CIS to the 200 nm and 209 nm photodissociation of the nitric oxide dimer, (NO)2, we observe the fs time-scale evolution of the excited parent neutral via its photoelectron spectrum and the emergence of the NO(A) photofragment including its energy and angular distributions.

Sexually dimorphic effect of glutamate treatment on cell cycle arrestment of astrocytes from the preoptic area of neonatal rats

Neurotoxicological studies have indicated that L-glutamate exhibits more pronounced effects on the preoptic area (POA) neurons of male rats than on those of females in the neonatal period. However, no information has previously been available as to whether or not such sexual dimorphism also exists for the effects of glutamate on astrocytes from POA. The present paper reports the differential effects of L-glutamate on astrocytes isolated from POA of neonatal male and female rats. The proliferation of astrocytes was measured by methods of cell count and cell cycle analysis. In addition, the activity of Ca(2+)/calmodulin-dependent protein kinase II (CaM kinase II) was assayed to understand its role in the glutamate-induced disturbance of the cell cycle progression of astrocytes. The results revealed that L-glutamate, at doses of 0.5 and 1.0 mM, inhibited the proliferation of astrocytes derived from male rats more severely than those derived from females. The L-glutamate treatment blocked the cell cycle progression and caused an accumulation of cells in the S phase. The activity of CaM kinase II declined more markedly in astrocytes derived from male rats than in those from females after glutamate treatment. These findings suggest that the proliferation of astrocytes derived from POA of neonatal rats can be inhibited in a sexually dimorphic manner by L-glutamate, possibly through blocking the cell cycle progression and partially related to the inactivation of the CaM kinase II.

Cerebral metabolism in major depression and obsessive-compulsive disorder occurring separately and concurrently

BACKGROUND

The frequent comorbidity of major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) suggests a fundamental relationship between them. We sought to determine whether MDD and OCD have unique cerebral metabolic patterns that remain the same when they coexist as when they occur independently.

METHODS

[18F]-fluorodeoxyglucose positron emission tomography (PET) brain scans were obtained on 27 subjects with OCD alone, 27 with MDD alone, 17 with concurrent OCD+MDD, and 17 normal control subjects, all in the untreated state. Regional cerebral glucose metabolism was compared between groups.

RESULTS

Left hippocampal metabolism was significantly lower in subjects with MDD alone and in subjects with concurrent OCD+MDD than in control subjects or subjects with OCD alone. Hippocampal metabolism was negatively correlated with depression severity across all subjects. Thalamic metabolism was significantly elevated in OCD alone and in MDD alone. Subjects with concurrent OCD+MDD had significantly lower metabolism in thalamus, caudate, and hippocampus than subjects with OCD alone.

CONCLUSIONS

Left hippocampal dysfunction was associated with major depressive episodes, regardless of primary diagnosis. Other cerebral metabolic abnormalities found in OCD and MDD occurring separately were not seen when the disorders coexisted. Depressive episodes occurring in OCD patients may be mediated by different basal ganglia-thalamic abnormalities than in primary MDD patients.

Brain metabolic changes associated with symptom factor improvement in major depressive disorder

BACKGROUND

Symptoms of major depressive disorder (MDD) have been linked to regional brain function through imaging studies of symptom provocation in normal control subjects and baseline studies of subjects with MDD. We examined associations between change in depressive symptom factors and change in regional brain metabolism from before to after treatment of MDD.

METHODS

Thirty-nine outpatients with MDD underwent 18F-fluorodeoxyglucose positron emission tomography scanning before and after treatment with either paroxetine or interpersonal psychotherapy. Associations were determined between changes in regional brain metabolism and changes in four Hamilton Depression Rating Scale factors (anxiety/somatization [ANX], psychomotor retardation [PR], cognitive disturbance [COGN], and sleep disturbance) and two corresponding Profile of Mood States subscales (tension [TENS] and fatigue [FATIG]).

RESULTS

Improvement in ANX, PR, TENS, and FATIG factors was associated with decreasing ventral frontal lobe metabolism. Improvement in ANX and TENS was also associated with decreasing ventral anterior cingulate gyrus (AC) and anterior insula activity, whereas improvement in PR was associated with increasing dorsal AC activity. COGN improvement was associated with increasing dorsolateral prefrontal cortex metabolism.

CONCLUSIONS

Brain regions that show significant relationships with symptom provocation in normal control subjects have similar relationships with MDD symptoms as they improve with treatment.

Regional brain metabolic changes in patients with major depression treated with either paroxetine or interpersonal therapy: preliminary findings

BACKGROUND

In functional brain imaging studies of major depressive disorder (MDD), regional abnormalities have been most commonly found in prefrontal cortex, anterior cingulate gyrus, and temporal lobe. We examined baseline regional metabolic abnormalities and metabolic changes from pretreatment to posttreatment in subjects with MDD. We also performed a preliminary comparison of regional changes with 2 distinct forms of treatment (paroxetine and interpersonal psychotherapy).

METHODS

Twenty-four subjects with unipolar MDD and 16 normal control subjects underwent resting F 18 ((18)F) fluorodeoxyglucose positron emission tomography scanning before and after 12 weeks. Between scans, subjects with MDD were treated with either paroxetine or interpersonal psychotherapy (based on patient preference), while controls underwent no treatment.

RESULTS

At baseline, subjects with MDD had higher normalized metabolism than controls in the prefrontal cortex (and caudate and thalamus), and lower metabolism in the temporal lobe. With treatment, subjects with MDD had metabolic changes in the direction of normalization in these regions. After treatment, paroxetine-treated subjects had a greater mean decrease in Hamilton Depression Rating Scale score (61.4%) than did subjects treated with interpersonal psychotherapy (38.0%), but both subgroups showed decreases in normalized prefrontal cortex (paroxetine-treated bilaterally and interpersonal psychotherapy-treated on the right) and left anterior cingulate gyrus metabolism, and increases in normalized left temporal lobe metabolism.

CONCLUSIONS

Subjects with MDD had regional brain metabolic abnormalities at baseline that tended to normalize with treatment. Regional metabolic changes appeared similar with the 2 forms of treatment. These results should be interpreted with caution because of study limitations (small sample size, lack of random assignment to treatment groups, and differential treatment response between treatment subgroups).

Molecular fingerprinting of Mycobacterium tuberculosis strains isolated in Vietnam using IS6110 as probe

SETTING

Northern and Southern areas of Vietnam.

OBJECTIVE

To study the correlation between DNA fingerprinting of 168 Mycobacterium tuberculosis strains isolated from patients with a particular historical past (political separation of Vietnam for 20 years) and data about geographical origin, drug susceptibility, HIV infection and BCG vaccination status.

METHODS

Comparison of restriction fragment length polymorphism (RFLP) patterns produced by Southern hybridization of Pvull-digested chromosomal DNA.

RESULTS

The number of IS6110 copies for the 168 strains ranges from 0 to 23. Strains originating from the North or the South differ strongly with respect to the number of copies of IS6110. Indeed, the strains originating from the north have predominantly from 3 to 14 IS6110 copies while the southern strains have predominantly from 15 to 23 IS6110 copies. Furthermore, strains isolated in the North are dispersed into 6 groups whereas 80% of the strains isolated in the South form a single group. Moreover, the prevalence of drug resistance is higher in strains isolated in the South than in the North. No noticeable correlation is observed between RFLP patterns, drug susceptibility, or HIV infection.

CONCLUSION

The IS6110 fingerprints of 168 M. tuberculosis strains isolated in Vietnam showed a high range of polymorphism. Only a few strains have been found with no IS6110 (1.8%). The differences between the strains from the North and South, having more than six IS6110, suggests that they derived from ancestral strains that would be distinguishable by the number of IS6110 and their transposition sites throughout the genome. The genomic structure of the population of strains from South Vietnam resembles that of the Beijing strain population. This could account for a similar evolution of M. tuberculosis due to a selection by BCG-induced immunity in the two populations.

Relationship of serum lactate dehydrogenase, creatine kinase, aspartate aminotransferase concentrations and severe intraventricular hemorrhage/leukomalacia in very low birth body weight preterm neonates

Estimations of serum enzyme values are widely employed as valuable diagnostic aids in diseases. Most commonly employed enzymes include Aspartate aminotransferase (AST), Lactate dehydrogenase (LDH), and Creatine kinase (CK). The study was designed to determine the relationship of elevated postnatal serum LDH, CK, and AST concentrations within the first day of life and the risk of suffering severe intraventricular hemorrhage (IVH) and/or periventricular leukomalacia (PVL) in VLBW preterm newborns. 81 preterm neonates whose birth body weight < 1500 gm were enrolled. Serums were obtained for measurement within the first postnatal day. Cranial ultrasound scans were performed twice per week after birth until their body weight was above 2300 gm or postconceptional age above 40 weeks. Significant difference was noted in serum LDH and CK concentrations in severe IVH/PVL infants (p < 0.05). No difference was found in serum AST values. Compared with the cut-off values of 1933 IU/L of LDH concentration and 652 IU/L of CK, the predictive values revealed a sensitivity, specificity, negative predictive value and positive predictive value of 76.9%, 89.7%, 95.3% and 58.8%, respectively. In conclusion, higher serum LDH and/or CK concentrations within the first day of life were associated with risk for development of severe IVH/PVL.

Effects of nonsteroidal anti-inflammatory drugs and prostaglandins on osteoblastic functions

It has been reported that nonsteroidal anti-inflammatory drugs (NSAIDs) suppress bone repair and bone remodeling but only mildly inhibit bone mineralization at the earlier stage of the repair process. We proposed that the proliferation and/or the earlier stage of differentiation of osteoblasts may be affected by NSAIDs. This study was designed to investigate whether NSAIDs affect the proliferation and/or differentiation of osteoblasts and whether these effects are prostaglandin (PG) mediated. The effects of PGE1 and PGE2, indomethacin, and ketorolac on thymidine incorporation, cell count, intracellular alkaline phosphatase (ALP) activity, and Type I collagen content in osteoblast-enriched cultures derived from fetal calvaria were evaluated. The results showed that both PGs and NSAIDs inhibited DNA synthesis and cell mitosis in a time- and concentration-dependent manner. However, intracellular ALP activity and Type I collagen content were stimulated at an earlier stage of differentiation in osteoblasts. These results suggested that (i) the inhibitory effect of ketorolac on osteoblastic proliferation contributes to its suppressive effects on bone repair and remodeling in vivo; (ii) PGEs and NSAIDs may be involved in matrix maturation and biologic bone mineralization in the earlier stage of osteoblast differentiation; and (iii) the effects of ketorolac and indomethacin on cell proliferation and differentiation may not be through the inhibition of the synthesis of PGE1 or PGE2.

Characteristics of primary osteoblast culture derived from rat fetal calvaria

Primary osteoblast cultures, which reflect more phenotypic properties of normal osteoblasts than osteoblastic cell lines, can be used as an experimental tool for investigating the osteoblastic functions in vitro. Primary osteoblast cultures were obtained from the parietal bones of calvaria of fetal rats in this study. Differential characteristics of osteoblasts in our culture system were examined and fibroblast cultures were also tested for comparison. We tested the alkaline phosphatase (ALP) and von Kossa stains on osteoblast and fibroblast cultures to examine the expression of ALP and the subsequent matrix mineralization occurred at 2 and 3 weeks after cell confluence respectively. The results showed that osteoblast cultures revealed obvious positive stains of ALP and von Kossa, while fibroblast cultures revealed negative stains, suggesting the osteoblast culture system used in this study reflects the typical phenotypes of primary osteoblasts but not fibroblasts. We tested the ALP activities following various doses of PGE2 or ketorolac treatments in primary osteoblast and fibroblast cultures. The results showed that PGE2 and ketorolac stimulated intracellular ALP activities of osteoblasts in dose dependent fashions, while very low ALP activities were detected in either the control or agents treated cultures of fibroblast. These results suggest that PGE2 may be involved in osteoblastic differentiation and the stimulatory effect of ketorolac on osteoblastic ALP activity may not be PGE2 mediated. The responses of osteoblasts to both agents can be as the characteristics of primary osteoblast derived from rat calvaria.

Effects of elution [correction of eution] conditions on the separation of calpastatin, mu- and m-calpain on DEAE-Sephacel chromatography

A rapid stepwise measurement for the activities of calpastatin and mu- and m-calpains was developed by using 2-stage elution at pH 8.5 and then 7.0. The activities of calpastatin, mu-calpain and m-calpain can be rapidly assayed following the separation on DEAE-Sephacel chromatography by a 2 stage elution with 90 mM NaCl (pH 8.5), and then by 200 and 300 mM NaCl in elution buffer (pH 7.0). No significant differences in the recovery of these proteinases and inhibitor was observed between stepwise gradient and linear gradient methods.

Trial on timing of introduction to solids and food type on infant growth

OBJECTIVE

The optimal time and choice of solid foods to introduce to an infant's diet is unknown. The aim of this randomized trial was to determine whether early versus late introduction of solid foods and commercially prepared versus parent's choice of solid foods affects growth or body composition in the first year.

METHODS

White infants (n = 165) were recruited before 3 months of age and were randomized to receive: 1) commercially prepared solid foods (commercial) from 3 to 12 months, 2) commercially prepared solid foods from 6 to 12 months, 3) parent's choice of solid foods (choice) from 3 to 12 months, or 4) parent's choice of solid foods from 6 to 12 months. Anthropometrics and body composition, using dual energy x-ray absorptiometry, were determined at 3, 6, and 12 months. Three-day diet diaries were completed at 3, 6, 9, and 12 months.

RESULTS

There were no differences in growth or body composition between infants in early versus late introduction groups or commercial versus choice groups at any age. The total energy intake was not different among infants in the early compared with the late group at any age. Infants in the commercial group consumed less protein calories at 9 months (80 +/- 3 kcal/d vs 88 +/- 3 kcal/d) and 12 months 101 +/- 5 kcal/d vs 148 +/- 5 kcal/d), less fat calories at 12 months (263 +/- 10 kcal/d vs 343 +/- 10 kcal/d), and less total calories at 12 months (884 +/- 24 kcal/d vs 1022 +/- 25 kcal/d) compared with the choice group.

CONCLUSION

The early introduction of solid foods to an infant's diet does not alter growth or body composition during the first year of life and results in a displacement of energy intake from formula. Infants consuming commercially prepared foods have a decreased caloric intake from protein and fat; however, despite this difference, there is no effect on growth or body composition.

Effects of ketorolac on bone repair: A radiographic study in modeled demineralized bone matrix grafted rabbits

The effects of ketorolac on bone repair were studied radiographically. The effects of methylprednisolone were also compared. Demineralized bone matrix was grafted into the fractured gap of rabbit's ulna as an experimental bone repair model. The rabbits received ketorolac 2 or 4 mg/kg body weight daily for 6 weeks after transplantation. Serial radiographic studies were performed 2, 4, and 6 weeks after transplantation. Mineralization of grafts and bone union were evaluated as the parameters of bone repair. Comparing the bone repair among groups at individual time points, ketorolac-treated groups showed no statistical differences as compared with the control group in either mineralization or bone union, whereas methylprednisolone significantly suppressed both parameters. However, comparing the mineralization during the healing process in each group, the control group and the group treated with ketorolac 2 mg/kg showed a significant increase during the period from the 2nd to the 4th week of medication, whereas both the group treated with ketorolac 4 mg/kg and the methylprednisolone-treated group showed no significant increase during this period. This poor mineralization of grafted bone in repair process affected by ketorolac suggests that 4 mg/kg of ketorolac might delay the endochondral ossification process during the period from the 2nd to the 4th week of fracture healing.

Gallbladder volume and contractility in term and preterm neonates: normal values and clinical applications in ultrasonography

The aim of this study was to establish the normal values and evaluate associated factors of gallbladder volume and contractility in term and preterm neonates by using ultrasonography. Sonographic measurement of gallbladder volume was performed by using the ellipsoid method in 50 preterm and 46 term infants. We collected data soon after delivery and at 6-h fasting, and at 3-h and 6-h fasting following regular milk feeding. Serial postprandial changes of gallbladder volume and contractility were collected at 15-min intervals for one hour. Gallbladder contraction index (C.I.) was determined as percentage decrement of postprandial size from initial size. Fasting gallbladder volume was larger in term group (p < 0.05). Term neonates more readily showed significant contraction (C.I. > 50%; p < 0.05). In preterm infants significant contraction was clearly observed at postconceptional age > 31 weeks or body weight > 1300 g. The presence of hepatobiliary diseases might be detected by evaluating serial changes of gallbladder volume and contractility under ultrasonography in the neonatal stage.

Low total body bone mineral content and high bone resorption in Korean winter-born versus summer-born newborn infants

Seasonal differences in newborn total body bone mineral content (TBBMC) have not been studied, particularly in relation to alterations in vitamin D status in winter. In vitamin D deficiency bone resorption may be high and bone mineralization low. Bone resorption may be assessed by serum cross-linked carboxyterminal telopeptide of type I collagen (ICTP) measures. Because vitamin D supplements throughout pregnancy are uncommon in Korea, we hypothesized that in Korean winter newborns, TBBMC is low and serum ICTP high from high bone resorption and low 25-hydroxyvitamin D (25-OHD) compared with those in summer newborns. Seventy-one Korean term infants were studied prospectively in summer (July through September, n = 37) versus winter (January through March, n = 34); TBBMC was measured before 3 days of age by dual-energy x-ray absorptiometry. Significant seasonal differences were found: winter newborns had 6% lower TBBMC (least squares means +/- SD; 86.7 +/- 7.7 gm vs 93.9 +/- 7.8 gm, p = 0.0002), lower cord serum 25-OHD (10.7 +/- 8 nm vs 30 +/- 15 nm, p = 0.0001) and 1,25-dihydroxyvitamin D, and higher ICTP (96.4 +/- 20.3 microg/L vs 74.8 +/- 24 microg/L, p = 0.0002) and calcium than summer newborns. TBBMC correlated with serum 25-OHD (r = 0.243, p = 0.047) and inversely with ICTP (r = -0.333, p = 0.008). We suggest that in Korea low maternal vitamin D status in winter results in marked reduction in newborn TBBMC.

Expression of vascular endothelial growth factor in synovial fibroblasts is induced by hypoxia and interleukin 1beta

OBJECTIVE

To study the mechanism by which hypoxia and inflammatory cytokines mediate angiogenesis in the rheumatoid pannus through their effects on the fibroblast-like type B synoviocyte, the major cell type of normal synovia.

METHODS

Fibroblasts were prepared from synovial tissue of healthy and diseased individuals, and cultured in the presence of various stimuli. The expression of vascular endothelial growth factor (VEGF) was assessed by ELISA and reverse transcription polymerase chain reaction.

RESULTS

Unlike normal fibroblasts, synovial fibroblasts from rheumatoid arthritis (RA) and osteoarthritis constitutively secreted significant levels of VEGF, which is known to act directly on endothelial cells. VEGF secretion was further inducible by both hypoxia and interleukin 1beta (IL-1beta) and these increases were additive. In contrast, tumor necrosis factor alpha was unable to induce VEGF expression.

CONCLUSION

Under hypoxia or IL-1 stimulation, conditions common to the inflamed synovium, type B synoviocytes secrete increased levels of VEGF, which is likely to act on nearby endothelia, promoting angiogenesis. The constitutive expression of VEGF in rheumatoid synovial fibroblasts may reflect an altered phenotype involved in the pathology of RA.

Vocal fundamental frequency measures as a reflection of tumor response to chemotherapy in patients with advanced laryngeal cancer

The fundamental frequency (F0) characteristics of 19 male patients with advanced laryngeal cancer, treated with cisplatin-based chemotherapy as part of a Larynx Preservation Protocol (LPP), were measured before each of three cycles of chemotherapy received before definitive radiotherapy (RT). In these select patients, for whom chemotherapy resulted in > or = 50% decrease in the tumor bulk, it was found that mean F0 was essentially unaffected by the disease and did not change over the course of chemotherapy, although the cycle of their treatment could be differentiated by both speaking F0 variability (pitch sigma) and F0 perturbation (jitter). Although these measures failed to distinguish between those patients showing a complete response (CR) (no measurable disease) versus a partial (PR) (residual) tumor response at the primary disease site, the significant changes observed in both groups indicate that frequency variation measures could prove valuable in the documentation of tumor response to nonsurgical therapeutic intervention if the voice is directly affected. Additional assessment of 15 age- and disease-matched patients who showed minimal or no primary response to the chemotherapy showed no significant change in any of the frequency measures after one chemotherapy cycle, suggesting that vocal improvement seen in the successful chemotherapy patients was not due to postbiopsy healing or other systemic influence unassociated with tumor reduction.

Production of biologically active human RelA (p65) in baculovirus-infected insect cells

A recombinant baculovirus was constructed to express a cDNA encoding RelA (p65), a member of the NF-kappa B/Rel family of proteins. Infection of Spodoptera frugiderda insect cells with the recombinant baculovirus resulted in the production of the biologically active protein as measured by immunoblotting using RelA-specific antisera and by electrophoretic mobility shift assays. The recombinant protein bound specifically to an oligonucleotide containing the NF-kappa B consensus motif but not to that containing the unrelated Oct-1 consensus motif. Thus insect cell-derived RelA possess properties similar to the native protein and may be used in physical, biochemical, and pharmacological studies.

Evidence for multiple satellite cell populations and a non-myogenic cell type that is regulated differently in regenerating and growing skeletal muscle

We have performed studies to determine if different populations of satellite cells provide nuclei to growing and regenerating skeletal muscle fibers. Satellite cells were isolated from regenerating or growing anterior tibialis muscles, and their phenotypic properties were compared in vitro. Isolates from regenerating muscle contained 31% satellite cells, and those from control muscle contained 66% satellite cells, as determined by their expression of desmin. Among the desmin-positive satellite cells present from each preparation, two distinct populations of satellite cells were evident. Approximately 28% of satellite cell colonies were composed of only large cells, contained less than 50 cells/colony, and were designated as type 1 colonies. The remainder of satellite cell colonies isolated from either regenerating or control muscles were primarily composed of small cells, contained from 60 to 150 cells/colony, and were designated as type 2 colonies. Despite dramatic differences in the ratio of myogenic to non-myogenic cell types, satellite cells from regenerating and control muscles formed myotubes and expressed myosin heavy chain at similar levels. Treatment of regenerating cultures with dexamethasone resulted in a 16% increase in the number of desmin-positive colonies and dramatically decreased the proliferation of non-myogenic cells. These results suggest that at least two distinct populations of satellite cells can be isolated from regenerating and control skeletal muscles, and that non-myogenic cells are differentially regulated in regenerating versus non-regenerating environments.

Normal serum indices of bone collagen biosynthesis and degradation in small for gestational age infants

Serum carboxyterminal propeptide of type I procollagen (PICP) and cross-linked carboxyterminal telopeptide of type I collagen (ICTP), new markers of bone collagen type I biosynthesis and degradation, have not been studied in small for gestational age (SGA) infants. In an earlier study, we found a lower bone mineral content (BMC) and decreased serum osteocalcin in SGA than in appropriate for gestational age (AGA) infants, supporting the thesis that decreased fetal bone formation is a cause of lower BMC in SGA. In view of the role of insulin-like growth factor-I (IGF-I) in the regulation of collagen type I synthesis and degradation, and low serum IGF-I concentrations in SGA infants, we hypothesized that serum PICP would be lower and serum ICTP would be higher in SGA than in AGA infants, reflecting decreased bone collagen type I biosynthesis or enhancement of bone collagen type I degradation in SGA. We studied 19 term SGA and 38 term AGA infants that were matched specifically 1:2 by gestation and birth month. There were no differences between SGA and AGA infants in serum PICP nor ICTP concentrations. Serum ICTP was correlated with osteocalcin and with PICP in SGA infants but not in AGA infants. Thus, serum biochemical indices of bone collagen type I biosynthesis and degradation in term SGA infants are similar to those in term AGA infants. These findings are not consistent with the thesis of altered fetal bone collagen type I biosynthesis or degradation in SGA. We suggest that the reduced bone mineral content in SGA infants is predominantly related to a lower supply of minerals rather than defective regulation of bone collagen type I metabolism.

Effects of compressive loading on articular cartilage repair of knee joint in rats

Effects of compressive loading on articular cartilage repair was studied. Thirty adolescent Long-Evans rats were used as experiment animals. A full-thickness defect of cartilage was created by drilling with a k-wire, 1.2 mm in diameter, into the weight bearing area of medial femoral condyle of each of bilateral knee joints. Free movement was permitted postoperatively. One leg of each rat received normal weight bearing on knee joint as experiment leg. The contralateral leg was used as the control. The control legs were paw resected to avoid weight bearing on joint cartilages but this did not interfere with the motion of knee joints. The articular cartilage repair was estimated by macroscopic examination and microscopic examination 6 weeks after surgery. Scoring systems were used to evaluate the quantity of repaired tissue in macroscopic examination and the quality of repaired tissue in microscopic examination. The differences of articular cartilage repair affected by compressive loading was analyzed statistically by paired t-test. We concluded that the effects of compressive loading on cartilage repair was to accelerate the metaplasia of repair tissue into hyaline cartilage but not to increase the quantity of repaired tissue.

Changing epidemiology of triplet pregnancy: etiology and outcome over twelve years

Neonates of 34 triplet pregnancies were admitted to our neonatal unit over a twelve-year period (1983 to 1995), with an incidence of 1 out of 812 deliveries. Thirty (88%) of the pregnancies were the result of ovulation induction and artificial fertilization: artificial insemination from husband (n = 3), in vitro fertilization (n = 9), and gamete intra-fallopian transfer (n = 6). All except one had antenatal sonographic diagnosis, 79% in the first trimester. The most common pregnancy-related complication was preterm labor (56%). Twenty-seven (79%) were delivered by cesarean section. There were 101 live births (one stillborn). Mean gestation age was 33.6 +/- 2.94 weeks, mean birthweight 1809 +/- 485 g, with 7 extremely low birthweight (< 1000 g [6.8%]). Neonatal complications included respiratory distress syndrome (12%), intraventricular hemorrhage (8.8%), retinopathy of prematurity (8%), sepsis (3%), severe asphyxia (3%), and omphalopagus conjoined twins (1%). The perinatal and neonatal mortality was 49 per 1000 and 59 per 1000, respectively. The introduction of advanced artificial fertilization techniques and ovulation induction agents resulted in a major increase in multifetal gestations. Early prenatal diagnosis, judicious prolongation of gestation, and planned delivery by cesarean section combined with major improvement in neonatal care by experienced neonatologists has improved survival of triplet neonates.

How sexually permissive are Singaporeans?

This paper presents data on two surveys done in 1989 and 1992 that indicated the attitudes of Singaporeans to sexuality. Both surveys revealed that Singaporeans have sexually conservative attitudes and those who have a lower education, are single, above the age of 40, are Malays/Muslims hold more conservative views.

Antiinflammatory drug effects on bone repair and remodeling in rabbits

Ketorolac and methylprednisolone effects on bone repair were studied. Demineralized bone matrix was used to graft the defects of rabbits' ulnae. Twenty-seven rabbits were divided into 4 groups: Group A (control group; no drug treatment), Group B (treated with ketorolac 2 mg/kg body weight daily), Group C (treated with ketorolac 4 mg/kg body weight daily), and Group D (treated with methylprednisolone 1 mg/kg body weight weekly). Drug treatment was continued for 6 weeks. The biomechanical results indicated methylprednisolone significantly deteriorated the mechanical properties of the grafted ulnae and the contralateral intact ulnae, although the effects were more pronounced in the grafted side. In Group B, there was minimum effect of ketorolac on the bone properties. In Group C, ketorolac significantly decreased the torsional stiffness and energy absorption of the grafted ulnae and also decreased the maximum torque in the intact and the grafted bones. It was concluded that the inhibitory effect of ketorolac on bone repair was dose dependent. In comparing the effects of ketorolac and methylprednisolone, the latter is more pronounced on torsional stiffness, but the effects on maximum torque and energy absorption were similar to ketorolac. The mechanism of the effects of ketorolac needs additional investigation.

[Effect of pinealectomy on N-methyl-D-aspartate-facilitated receptivity in female rats]

The purpose of this study was to examine the effect of pinealectomy and the possible mechanism of the pineal gland on N-methyl-D-aspartate (NMDA)-associated receptivity in female rats. Monosodium L-glutamate (MSG) was used as a neurotoxin to induce hypogonadal status. Long-Evans rats were divided into four groups: (1) control (C), (2) pinealectomized (Px), (3) MSG-treated (MSG) and (4) pinealectomized MSG-treated (Px-MSG). Two injections of MSG were administered on the first and the third days postnatally with a dose of 4 mg/g body weight. Pinealectomy was performed at six weeks of age. In the first part of the experiment, all four groups of rats were ovariectomized at 3.5 months and implanted subcutaneously with a 2mm silastic capsule filled with 20% estradiol benzoate (EB). One week later, the sexual receptivity was estimated by lordosis quotient (LQ) before and ten minutes after 20 mg/kg B.W. NMDA administration. The result shows that NMDA caused a remarkable increase of LQ in control rats, but no significant effect on MSG-treated rats. There was no significant difference between control and Px rats before NMDA administration, but Px rats exhibited higher LQ than control rats after NMDA treatment. In the second part of the experiment, the effect of pinealectomy on releasability of LHRH neurons was examined indirectly by NMDA-evoked LH secretion. The dosage and sampling schedule were chosen by the dose-response and time course of LH response to NMDA, respectively. Serum samples were collected before and ten minutes after NMDA administration. Serum concentration of LH was measured by radioimmunoassay.(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term evaluation of immune status in leprosy patients undergoing multiple drug therapy

A long-term survey of leprosy patients of all clinical types, starting at the time of diagnosis, was carried out to monitor clinical, bacteriological and immunological parameters at regular intervals during multiple drug therapy (MDT). The patients were assigned to two groups for treatment following WHO guidelines: paucibacillary (PB) and multibacillary (MB). Immunoglobulin levels, specific antibodies, skin-test responses to different soluble mycobacterial antigens (new tuberculins), and in vitro proliferative responses to mitogens and to antigens were measured during treatment, as were clinical changes, the bacterial index, and clinical improvement. No exact relations between disease activity and IgM antibody levels, both IgM immunoglobulin and specific IgM antibody to a species-specific antigen (ND-O-BSA), could be seen for MB patients. Changes in in vitro cell-mediated immunity and skin-test response seemed to be more directly related to the bacterial load and could reflect the improvement of bacteriological and clinical parameters during MDT.

Low bone mineral content and high serum osteocalcin and 1,25-dihydroxyvitamin D in summer- versus winter-born newborn infants: an early fetal effect?

Seasonal differences in bone mineral indices have not been studied in newborn infants. In adults, indicators of bone metabolism may show seasonal variations. In postneonatal infants and possibly in adults, vitamin D metabolism shows seasonal variations. We hypothesized that in winter-born infants, the bone mineral content is low and serum osteocalcin is high, related to increased bone turnover and high serum 1,25-dihydroxyvitamin D [1,25(OH)2D]. We studied 246 healthy, term appropriate-for-gestation infants in winter (January through March; 140 children) and summer (July through September; 106 children). The bone mineral content (BMC) of the one-third distal radius was measured before 3 days of age by photon absorptiometry. Significant seasonal differences were found: summer-born infants had significantly lower BMC, higher serum osteocalcin and 1,25(OH)2D, and lower serum total calcium than winter-born infants. Seasonal differences in BMC remained significant after adjusting for race and sex. BMC was not correlated with serum biochemical measures. Thus, summer-born newborn infants have low BMC and high serum osteocalcin and 1,25(OH)2D than winter-born infants; these findings are the opposite of adult findings. We suggest that seasonal effects on fetal bone operate especially in early pregnancy (approximately 6 months before birth) resulting in a "phase effect" and opposite findings from later life.

Seasonal and geographical variations in the growth rate of infants in China receiving increasing dosages of vitamin D supplements

In theory, sunshine exposure is sufficient to maintain normal vitamin D concentrations for the optimal growth of newborn infants. To determine whether season of birth, latitude (north v. south) and increasing dosages of vitamin D supplements would influence the growth rate for the first 6 months of life, 255 healthy fall-and spring-born infants from two northern and two southern cities in China were randomly assigned to receive either 100, 200, or 400 IU of vitamin D a day. The study showed that season of birth and dose of vitamin D did not affect the growth rate of infants born in the same latitude, but a significant difference was found in the gain in length over the 6-month period between infants from the north and infants from the south (P = 0.0001). Regional differences among the Chinese people, other than sunshine exposure, may have influenced the difference in length gain.

Calcium kinetics in lactating women with low and high calcium intakes

Absorption of calcium and its mobilization from bone during lactation are important for delivery of calcium to breast-feeding infants; whether calcium intake offsets bone resorption is not known. We hypothesized that calcium absorption is increased in lactation and greater in women on low calcium diets, resulting in similar rates of bone resorption and accretion. Calcium absorption and kinetic indexes were calculated by using two stable isotopic tracers in 8 women; 6 were studied both during lactation and nonlactation. Women consumed low calcium diets, with half receiving supplemental calcium. Intestinal absorption was related to serum 1,25-dihydroxyvitamin D and did not increase during lactation. Despite decreased urinary calcium excretion during lactation, especially in women with low calcium intake, net balance tended to be lower during lactation. Mean residence time decreased and bone resorption exceeded accretion in almost all lactating women. Calcium need for milk production appears to be met by decreased urinary excretion and increased bone resorption, and not by increased intestinal absorption.

[The mechanism of the pineal gland in inhibiting sexual receptivity of female rats treated with monosodium-L-glutamate: (III). Does it concern with the function of the pituitary gland?]

To elucidate whether pituitary function participates in the effect of the pineal gland on sexual receptivity, monosodium L-glutamate (MSG) was used as a neurotoxin to induce hypogonadal status. Long-Evans rats were divided into four groups: (1) normal control (C), (2) pinealectomized (Px), (3) MSG-treated (MSG) and (4) pinealectomized MSG-treated (Px-MSG). Pinealectomy was performed at six weeks of age. In the first part of the experiment, the sexual receptivity was estimated at the age of 2.5 months by lordosis quotient (LQ). The result indicates that the decline of receptivity by neonatal MSG treatment can be significantly improved by pinealectomy. In the second part of the experiment, the effect of pinealectomy on pituitary function was examined by two tests including (1) post-castrational LH rise and (2) pituitary response to LHRH. Ovariectomy was performed at the age of 2.5 months. Four weeks later three consecutive blood samples were collected at 10 minute intervals for LH radioimmunoassay. Then, three doses of LHRH (100 ng, 250 ng and 500 ng/100 g of body weight) were administered separately at two-week intervals, serum samples were taken before as well as 15 and 60 minutes after LHRH administration. The results showed that there was no significant difference in serum LH levels between Px and control rats after ovariectomy. The LHRH-evoked LH elevation in Px-MSG rats was just the same as that of the MSG rats, although the LH level in MSG rats was lower than in the control rats.(ABSTRACT TRUNCATED AT 250 WORDS)

The facilitatory effect of N-methyl-D-aspartate on sexual receptivity in female rats through GnRH release

The purpose of this study was to examine whether N-methyl-D-aspartate affects the sexual receptivity of female rats. Monosodium L-glutamate was used as a neurotoxin to induce hypogonadal status. Matured normal and monosodium L-glutamate-treated rats were ovariectomized and implanted subcutaneously with estradiol capsules. One week later, lordosis responsiveness was observed before and 10 min after N-methyl-D-aspartate (40 mg/kg of BW, ip) administration. The results showed that N-methyl-D-aspartate caused a remarkable increase of lordosis quotient in control rats but not in monosodium L-glutamate-treated rats. Moreover, the possible action site of N-methyl-D-aspartate in the enhancement of receptivity was evaluated by the post-castrational LH rise, pituitary LH release in response to GnRH, and N-methyl-D-aspartate-evoked GnRH releasability. The results revealed that: (a) serum levels of LH in monosodium L-glutamate-treated rats were lower (p < 0.01) than those of control rats after ovariectomy; (b) there was no significant difference of pituitary LH release responsiveness to GnRH test between two groups; and (c) N-methyl-D-aspartate-evoked LH release in monosodium L-glutamate-treated rats was similar to that in the control rats. In conclusion, N-methyl-D-aspartate may facilitate the sexual receptivity through stimulating GnRH release. The failure of N-methyl-D-aspartate in enhancing receptivity in monosodium L-glutamate-treated rats is probably due to the cellular damage by monosodium L-glutamate on specific areas responsible for lordosis.

[The effects of neonatal monosodium glutamate treatment on sex-odor attractivity and approach behavior in rats]

The neurotoxic effects of monosodium glutamate (MSG) on certain parts of the central nervous system (CNS) and endocrine functions are well documented. MSG-treated rats exhibit stunted growth, obesity and decrease in sexual behavior. The present study was designed to evaluate how neonatal administration of MSG affects sex-odor attractivity and approach behavior, and to investigate factors limiting copulation in MSG-treated rats. In this experiment, subcutaneous injections of MSG (400 mg MSG/ml normal saline/0.1 Kg B.W.) were given to Long-Evans pups on days 1 and 3 after birth, whereas the control groups received normal saline injections of equal volume (1 ml/0.1 kg B.W.). When the rats were 3 months old, sex-odor attractivity and approach behavior were tested. Two points were displayed by MSG-treated rats: (a) attenuated the attractivity of sex-odor. (b) decreased performance of sexual approach to partners. From our results and those of a previous study, we suggest that the deterioration of sex-odor attractivity and approach behavior to partners is attributed to a decline in sexual hormones. Furthermore, we concluded that this decrease in behaviors is to some extent responsible for reduced copulatory behavior.

Reduced serum osteocalcin and 1,25-dihydroxyvitamin D concentrations and low bone mineral content in small for gestational age infants: evidence of decreased bone formation rates

In small for gestational age (SGA) infants, bone mineral content (BMC) is low but the reasons are unclear and the possible relationships between calcium-regulating hormones and BMC have not been studied. We hypothesized that BMC would be lower and concentrations of serum parathyroid hormone and 1,25-dihydroxyvitamin D would be higher at birth in SGA infants than in appropriate for gestational age (AGA) infants. Forty-two term SGA infants and 126 term AGA infants, matched 1:3 specifically by gestation (+/- 1 week) and birth month, were studied prospectively. The BMC of the distal one third of the radius was measured before 3 days of age by photon absorptiometry. The BMC was lower in SGA than in AGA infants. Both SGA and AGA infants had lower BMC in summer or spring than in winter; BMC differences between groups remained significant after adjustment for season (p = 0.0001). Cord serum osteocalcin and 1,25-dihydroxyvitamin D values were lower in SGA than in AGA infants. There were no differences between groups in cord serum levels of intact parathyroid hormone, 25-hydroxyvitamin D, calcium, phosphorus, and magnesium. Relationships were positive between BMC and birth weight and were inverse between BMC and intact parathyroid hormone values. We suggest that reduced uteroplacental blood flow in SGA infants may result in reduced fetal-placental production of 1,25-dihydroxyvitamin D, which results in low BMC and low serum osteocalcin values; fetal serum parathyroid hormone values may be relatively elevated because of reduced placental mineral supply.

A survey of sexual behaviour of Singaporeans

In order to plan education programmes against sexually transmitted diseases (STDs) and HIV infection, a population-based survey on partner relations was conducted on 2,115 Singaporean men and women aged between 15 and 49 years. Of the 605 (60.1%) sexually experienced men and 647 (58.3%) sexually experienced women, 510 (84.3%) men and 644 (99.5%) women were married. Of the marrieds, 465 (76.9%) men and 638 (98.6%) women had their first sexual encounter with the person who was or later became their spouse. Of the sexually experienced men, 97 (16%) engaged in casual sex in the previous year, of which 76 (78.4%) were encounters with commercial sex workers. Of these encounters 55 (72.4%) were unprotected or partially protected by condoms. A history of casual sex in the previous four weeks was given by 18 men, of whom 14 (77.8%) were married. Nine (64.3%) of these married men had sex concurrently with both their wives and commercial workers. Persons at high risk were those who started sexual activity early, unmarried, sexually active men with no or low education, and persons who travelled. Of the sexually experienced respondents, 1,242 (99.2%) had heard about condoms, and 431 (34.4%) were currently using them as contraceptive devices. Attitudes towards condoms and willingness to use them to prevent STDs and HIV infection were favourable. Men were more permissive in their attitudes towards sex. The level of permissiveness in men and women was not corroborated by their reported behaviour, an indication of either under-reporting and/or a disparity between attitude and practice.

Low bone mineral content in summer-born compared with winter-born infants

Possible seasonal differences in newborn bone mineral content (BMC) have not been studied. Adult studies show seasonal variations with lower BMC in winter versus summer. Assuming that BMC variations may relate in part to vitamin D status, we hypothesized that newborn BMC would be lower in winter than summer. BMC of one third distal radius was measured in 55 healthy term newborns using a single beam photon absorptiometer [coefficient of variation (CV) for phantom standard 2.1%]. Infants were enrolled during summer (July-September, 1988) and winter (January-March, 1989) for a longitudinal nutrition study. Contrary to our hypothesis, there was a 12% lower BMC in summer versus winter (mean +/- SD 75.94 +/- 17.42 vs. 86.55 +/- 17.54 mg/cm, respectively; p = 0.035). The difference remained significant after controlling for possible race and gender effects (p = 0.02). We conclude that BMC is lower in summer- compared with winter-born infants. Since any seasonal effects on fetal bone are presumably related to effects through the mother, we speculate that if maternal vitamin D status influences fetal bone mineralization, the effect (possible sunshine deprivation in winter) may operate especially in early pregnancy, thus resulting in lower BMC, evident at birth in summer.

Factors associated with sexually transmitted diseases among prostitutes in Singapore

From June to December 1990, 806 prostitutes registered with the STD programme in Singapore for regular screening for sexually transmitted diseases (STD) were investigated for factors associated with STD incidence in the preceding year. The majority were foreigners (92.7% Malaysians and 3.1% Thais). Anal sex (0.4%) and intravenous drug use (0.9%) were rare. The overall STD incidence rate was 47.7 per 100. None was human immunodeficiency virus (HIV) positive. The crude and age-adjusted risk of STD was found to increase significantly with client load. An inverse relationship between condom use and STD risk was also observed. Mean condom use among clients was reported as 56.1% for spontaneous use and estimated as 75.4% following negotiation for condom use by prostitutes. Although the prostitutes negotiated for condom use with majority of the clients (85.5%) who did not use condoms spontaneously, they were successful with only about half of them (54.4%). Health education should be targeted at clients on the protective effects of condom use and at the prostitutes on skills in negotiating condom use.

Improvement of sexual behavior in aged rats by p-chlorophenylalanine and methysergide

The effects of methysergide, a serotonin antagonist, and p-chlorophenylalanine (PCPA), a serotonin synthesis blocker on the sexual behavior of intact old male rats at 19-23 months of age and female rats at 17-18 months of age were studied. Female rats with prolonged vaginal cornification and a lordosis quotient (LQ) of less than 50%, and male rats displaying no ejaculation were selected as experimental animals. The receptivity of aged female rats, but not the approach behavior to males nor proceptivity was improved by PCPA or methysergide. The LQ of intact aged female rats in non-exit tests was improved by the i.p. administration of 50 mg/kg B.W. of PCPA 2 to 4 hours prior to the sexual behavior test or 3 mg/kg B.W. of methysergide 4 hours prior to the test. Total mount frequency and mount latency of intact aged male rats were improved by the administration of methysergide (3 mg/kg B.W.), while total mount frequency and intromission latency were improved by the administration of PCPA (20 mg/kg B.W. for 4 days). The present results together with the finding from our previous study suggest that the increase of serotonin (5-HT) activity per se plays an important role in the decline of receptivity of aged female rats and the copulatory activity of aged male rats.

Ovarian and circulating levels of oxytocin and arginine vasopressin during the estrous cycle in the rat

Ovarian extracts of Long-Evans rats separated using high performance liquid chromatography (HPLC) were measured by radioimmunoassays (RIAs) for the presence of oxytocin and arginine vasopressin (AVP). The results showed that the ovary contains both, and that they are indistinguishable from the respective standard synthetic peptides. During the estrous cycle, the ovarian content of oxytocin was 10-fold higher (p less than 0.01) in estrus than in the other phases, while AVP was 16- and 25-fold higher (p less than 0.01) in metestrus than in the other phases. In contrast, the plasma levels of oxytocin showed no significant difference among the various phases of the estrous cycle. However, the plasma level of AVP level was significantly higher (p less than 0.01) in diestrus than in other phases. The present study thus strongly supports the hypothesis that both oxytocin and AVP can be produced by the ovary itself in the rat. The possible roles of oxytocin and AVP in the reproductive cycle are discussed.

Prospective study of vitamin D supplementation and rickets in China

To determine whether amounts of vitamin D lower than recommended doses are effective in preventing rickets, 256 term infants from two northern and two southern cities in China were studied in a randomized trial of vitamin D supplementation (100, 200, or 400 IU/day) during the first 6 months of life. Cord blood and 6-month blood samples were collected and radiographs were obtained at 3 to 5 days and at 6 months of age. Cord serum 25-hydroxyvitamin D concentrations were lower in the north than in the south (5 vs 14 ng/ml (12.5 vs 35.0 nmol/L); p less than 0.01). Wrist ossification centers were less likely to be present at birth in the northern children than in the southern children (p = 0.009) and were more likely to be present in infants born in the fall who had higher cord serum concentrations of 25-hydroxyvitamin D (p = 0.04). Serum 25-hydroxyvitamin D concentrations were lower in northern children 6 months of age than in southern children (p = 0.005) and were higher with an increasing supplemental dosage of vitamin D (p less than 0.001), particularly in infants in the north. None of the infants had rickets at 6 months of age. Because of the low serum 25-hydroxyvitamin D concentrations, especially among infants in the north, it may be prudent to supplement the diet with vitamin D at a dose of 400 IU/day.

Low serum calcium and high parathyroid hormone levels in neonates fed 'humanized' cow's milk-based formula

We previously suggested that "late" neonatal hypocalcemia is related to a low calcium-phosphorus ratio of current cow's milk-based formula compared with human milk. However, there are no longitudinal studies of ionized calcium and parathyroid hormone concentrations in neonates receiving formulas with varying Ca/P ratios. Sixty-nine term neonates were studied through 2 weeks of age, and formula-fed neonates were randomized at birth to receive formula with molar ratios of 0.9, 1.2, or 1.4. Serum phosphate concentrations on days 2 and 6 of age were higher, and ionized calcium levels lower on days 6 and 14, in formula-fed vs human milk-fed neonates. Serum intact parathyroid hormone level increased between days 2 and 6 in formula-fed neonates compared with a decrease in human milk-fed neonates. Serum parathyroid hormone level on day 6 correlated with phosphorus intake among formula-fed neonates. No differences were noted in serum mineral or hormone levels among formula-fed groups. We speculate that the lowering of serum ionized calcium concentrations in neonates fed a modern "humanized" cow's milk formula may be a factor in late neonatal hypocalcemia.