FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Kumar, A Zou, LL Yuan, XQ Long, Y Yang, K AF Kumar, A Zou, LL Yuan, XQ Long, Y Yang, K TI N-methyl-D-aspartate receptors: Transient loss of NR1/NR2A/NR2B subunits after traumatic brain injury in a rodent model SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE N-methyl-D-aspartate receptor; hippocampus; brain injury; memory; rodent model ID CORTICAL IMPACT INJURY; NMDA RECEPTORS; RAT-BRAIN; MEDIATED REGULATION; CALPAIN ACTIVATION; MESSENGER-RNA; EXPRESSION; MEMORY; CELLS; NR1 AB Hippocampal N-methyl-D-aspartate (NMDA) receptor subunits, by virtue of their involvement in excitotoxic injury as well as memory association, may play an important role in the pathophysiologic mechanisms of traumatic brain injury (TBI). In this study, temporal changes in NMDA receptor subunit (NR1, NR2A, and NR2B) levels in rat hippocampus after TBI were investigated by Western blot and mRNA expression levels by RT-PCR methods. Sprague-Dawley rats (250-350 g) were employed, and a controlled cortical impact injury device was used to produce the TBI in rodents. At different postinjury time points (2, 6, 12, 24, and 48 hr), the rat hippocampi were dissected out for protein and RNA preparation. Western blot analysis revealed significant decreases of NR1, NR2A, and NR2B subunit proteins at 6 and 12 hr postinjury in rat hippocampus. Complete recovery of NR1, NR2A, and NR2B subunit protein to the levels of sham controls was observed at 24 hr postinjury. However, RT-PCR analysis did not show any significant change in the mRNA levels at 2, 6, and 12 hr postinjury in comparison with sham controls, suggesting nontranscriptional change in the levels of these subunits. Thus, TBI can produce transient degradation of NMDA receptor subunits in the hippocampus, which might contribute to temporary memory impairment after injury. (C) 2002 Wiley-Liss, Inc. C1 Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA. Baylor Coll Med, Ctr Cell & Gene Therapy, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Neurol Care Line, Houston, TX USA. RP Yang, K (reprint author), Baylor Coll Med, Dept Neurosurg, 1 Baylor Plaza, Houston, TX 77030 USA. FU NINDS NIH HHS [R01-NS35502-04] NR 25 TC 42 Z9 70 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD MAR 15 PY 2002 VL 67 IS 6 BP 781 EP 786 DI 10.1002/jnr.10181 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 526ZC UT WOS:000174158700010 PM 11891792 ER PT J AU Littner, M Hirshkowitz, M Davila, D Anderson, WM Kushida, CA Woodson, T Johnson, SF Wise, MS AF Littner, M Hirshkowitz, M Davila, D Anderson, WM Kushida, CA Woodson, T Johnson, SF Wise, MS TI Practice parameters for the use of auto-titrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome SO SLEEP LA English DT Article DE obstructive sleep apnea; continuous positive airway pressure; CPAP; sleep-disordered breathing; auto-titrating; APAP ID SNORING DETECTION; CPAP TITRATION AB Continuous positive airway pressure (CPAP) is used to treat patients with the obstructive sleep apnea syndrome (OSAS). The current standard is for an attendant technician to titrate CPAP during full polysomnography to obtain a fixed single pressure. The patient uses CPAP nightly at this fixed single pressure. Recently, devices using new technology that automatically titrate positive airway pressure (APAP) have become available. Such devices continually adjust pressure, as needed, to maintain airway patency (APAP titration). These adjustments can be made with or without attendant technician intervention. Data obtained during APAP titration can be used to provide a fixed single pressure for subsequent treatment. Alternatively, APAP devices can be used in self-adjusting mode for treatment (APAP treatment). A task force of the Standards of Practice Committee of the American Academy of Sleep Medicine reviewed the available literature. Based on this review, the Standards of Practice Committee developed these practice parameters as a guide to the appropriate use of APAP Recommendations are as follows: 1) A diagnosis of OSAS must be established by an acceptable method. 2) APAP titration and APAP treatment are not currently recommended for patients with congestive heart failure, significant lung disease (e.g., chronic obstructive pulmonary disease), daytime hypoxemia and respiratory failure from any cause, or prominent nocturnal desaturation other than from OSA (e.g., obesity hypoventilation syndrome). In addition, patients who do not snore (either due to palate surgery or naturally) should not be titrated with an APAP device that relies on vibration or sound in the device's algorithm. 3) APAP devices are not currently recommended for split-night studies since none of the reviewed research studies examined this issue. 4) Certain APAP devices may be used during attended titration to identify by polysomnography a single pressure for use with standard CPAP for treatment of OSA. 5) Once an initial successful attended CPAP or APAP titration has been determined by polysomnography, certain APAP devices may be used in the self-adjusting mode for unattended treatment of patients with OSA. 6) Use of unattended APAP to either initially determine pressures for fixed CPAP or for self-adjusting APAP treatment in CPAP naive patients is not currently established. 7) Patients being treated with fixed CPAP on the basis of APAP titration or being treated with APAP must be followed to determine treatment effectiveness and safety, and 8) a re-evaluation and, if necessary, a standard attended CPAP titration should be performed if symptoms do not resolve or the CPAP or APAP treatment otherwise appears to lack efficacy. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Sepulveda, CA USA. Baylor Coll Med, Houston VAMC Sleep Disorders & Res, Houston, TX 77030 USA. Baptist Med Ctr, Little Rock, AR USA. Univ S Florida, Coll Med, Tampa, FL 33620 USA. Stanford Univ, Ctr Excellence Sleep Disorders, Stanford, CA 94305 USA. Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Milwaukee, WI 53226 USA. St Patricks Hosp, Sleep Ctr, Missoula, MT USA. Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. RP Littner, M (reprint author), VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. NR 28 TC 98 Z9 102 U1 0 U2 5 PU AMER ACAD SLEEP MEDICINE PI ROCHESTER PA 6301 BANDEL RD, STE 101, ROCHESTER, MN 55901 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAR 15 PY 2002 VL 25 IS 2 BP 143 EP 147 PG 5 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 528ZK UT WOS:000174275400003 PM 11902424 ER PT J AU Lewis, JH Schonlau, M Munoz, JA Asch, SM Rosen, MR Yang, H Escarce, JJ AF Lewis, JH Schonlau, M Munoz, JA Asch, SM Rosen, MR Yang, H Escarce, JJ TI Compliance among pharmacies in California with a prescription-drug discount program for Medicare beneficiaries SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID IMPACT AB Background: Several states have developed prescription-drug discount programs for Medicare beneficiaries. In California, Senate Bill 393, enacted in 1999, requires pharmacies participating in the state Medicaid program (Medi-Cal) to charge customers who present a Medicare card amounts based on Medi-Cal rates. Because Medicare beneficiaries may not be accustomed to presenting their Medicare cards at pharmacies, we assessed the compliance of pharmacies with Senate Bill 393. Methods: Fifteen Medicare beneficiaries who received special training and acted as ``standardized patients'' visited a random sample of pharmacies in the San Francisco Bay area and Los Angeles County in April and May 2001. According to a script, they asked for the prices of three commonly prescribed drugs: rofecoxib, sertraline, and atorvastatin. The script enabled us to determine whether and when, during their interactions with pharmacists or salespeople, the discounts specified in Senate Bill 393 were offered. Pharmacies at which the appropriate discounts were offered were considered compliant. Results: The patients completed visits to 494 pharmacies. Seventy-five percent of the pharmacies complied with the prescription-drug discount program; at only 45 percent, however, was the discount offered before it was specifically requested. The discount was offered at 91 percent of pharmacies that were part of a chain, as compared with 58 percent of independent pharmacies (P<0.001). Compliance was higher in the San Francisco Bay area than in Los Angeles County (84 percent vs. 72 percent, P=0.004) and was higher in high-income than low-income neighborhoods (81 percent vs. 69 percent, P=0.002). A Medicare beneficiary taking all three drugs would have saved an average of $55.70 per month as compared with retail prices (a savings of 20 percent). Conclusions: Discounts required under California's prescription-drug discount program for Medicare beneficiaries offer substantial savings. Many patients, however, especially those who use independent pharmacies or who live in low-income neighborhoods, may not receive the discounts. (N Engl J Med 2002;346:830-5.) Copyright (C) 2002 Massachusetts Medical Society. C1 RAND Corp, Hlth, Santa Monica, CA 90407 USA. Greater Los Angeles Vet Affairs Hlth Care Syst, Los Angeles, CA USA. RP Lewis, JH (reprint author), RAND Corp, Hlth, 1700 Main St, Santa Monica, CA 90407 USA. NR 21 TC 4 Z9 4 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC/NEJM PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAR 14 PY 2002 VL 346 IS 11 BP 830 EP 835 DI 10.1056/NEJMsa122601 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 529YM UT WOS:000174328900007 PM 11893795 ER PT J AU Williams, JW Noel, PH Cordes, JA Ramirez, G Pignone, M AF Williams, JW Noel, PH Cordes, JA Ramirez, G Pignone, M TI Is this patient clinically depressed? SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID DSM-III-R; RANDOMIZED CONTROLLED TRIAL; DIAGNOSING MENTAL-DISORDERS; CASE-FINDING INSTRUMENTS; PRIMARY-CARE; MAJOR DEPRESSION; MEDICAL OUTPATIENTS; COLLABORATIVE MANAGEMENT; TREATMENT GUIDELINES; LIKELIHOOD RATIOS AB Context Depressive disorders are highly prevalent in the general population, but recognition and accurate diagnosis are made difficult by the lack of a simple confirmatory test. Objective To review the accuracy and precision of depression questionnaires and the clinical examination for diagnosing clinical depression. Data Sources We searched the English-language literature from 1970 through July 2000 using MEDLINE, a specialized registry of depression trials, and bibliographies of selected articles. Study Selection Case-finding studies were included if they used depression questionnaires with easy to average literacy requirements, evaluated at least 100 primary care patients, and compared questionnaire results with accepted diagnostic criteria for major depression. Eleven questionnaires, ranging in length from 1 to 30 questions, were assessed in 28 published studies. Reliability studies for the clinical examination required criterion-based diagnoses made by at least 2 clinicians who interviewed the patient or reviewed a taped examination. Fourteen studies evaluated interrater reliability. Data Extraction Pairs of authors independently reviewed articles. For case-finding studies, quality assessment addressed sample size and whether patients were selected consecutively or randomly, the criterion standard was administered and interpreted independently of and blind to the results of the case-finding instrument, and the proportion of persons receiving the criterion standard assessment was less than or more than 50% of those approached for criterion standard assessment. For reliability studies, quality assessment addressed whether key patient characteristics were described, the interviewers collected clinical history independently, and diagnoses were made blinded to other clinicians' evaluations. Data Synthesis In case-finding studies, average questionnaire administration times ranged from less than 1 minute to 5 minutes. The median likelihood ratio positive for major depression was 3.3 (range, 2.3-12.2) and the median likelihood ratio negative was 0.19 (range, 0.14-0.35). No significant differences between questionnaires were found. For mental health care professionals using a semistructured interview, agreement was substantial to almost perfect for major depression (kappa=0.64-0.93), Non-standardized interviews yielded somewhat lower agreement (kappa=0.55-0.74). A single study showed that primary care clinicians using a semistructured interview have high agreement with mental health care professionals (kappa=0.71). Conclusions Multiple, practical questionnaires with reasonable performance characteristics are available to help clinicians identify and diagnose patients with major depression. Diagnostic confirmation by mental health care professionals using a clinical interview or by primary care physicians using a semistructured interview can be made with high reliability. C1 S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio Evidence Based Practice Ctr, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. Univ N Carolina, Dept Med, Chapel Hill, NC USA. RTI UNC Evidence Based Practice Ctr, Chapel Hill, NC USA. RP Williams, JW (reprint author), Dept Vet Affairs Med Ctr, Ctr Hlth Serv Res Primary Care, HSR&D, 508 Fulton St,Bldg 6, Durham, NC 27705 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 NR 97 TC 198 Z9 202 U1 5 U2 9 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 6 PY 2002 VL 287 IS 9 BP 1160 EP 1170 DI 10.1001/jama.287.9.1160 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 527KV UT WOS:000174186000032 PM 11879114 ER PT J AU Sun, W Chen, FH Esmallian, F Sarma, JS Wetzel, GT Klitzner, TS Singh, BN AF Sun, W Chen, FH Esmallian, F Sarma, JS Wetzel, GT Klitzner, TS Singh, BN TI Acute effects of dronedarone on the potassium currents in human atrial cells SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract C1 VA Greater LA Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2002 VL 39 IS 5 SU A BP 105A EP 105A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 526AR UT WOS:000174106700457 ER PT J AU Sonel, AF Shalaby, A McConnell, JP Hogan, S Feldman, AM AF Sonel, AF Shalaby, A McConnell, JP Hogan, S Feldman, AM TI Detectable troponin T level predicts high mortality in patients with heart failure undergoing internal defibrillator implantation SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract C1 Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Mayo Clin, Rochester, MN USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2002 VL 39 IS 5 SU A BP 159A EP 159A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 526AR UT WOS:000174106700706 ER PT J AU Schafhalter-Zoppoth, I Gray, MO Teerlink, JR AF Schafhalter-Zoppoth, I Gray, MO Teerlink, JR TI Endothelin antagonism with bosentan, a dual receptor blocker, normalizes dysregulated transforming growth factor beta signaling pathways in rats with chronic heart failure SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RI Teerlink, John/D-2986-2012 NR 0 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2002 VL 39 IS 5 SU A BP 168A EP 168A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 526AR UT WOS:000174106700745 ER PT J AU Schafhalter-Zoppoth, I Teerlink, JR AF Schafhalter-Zoppoth, I Teerlink, JR TI Endothelin antagonism with bosentan improves myocardial mechanics and ventricular remodeling in rats with chronic heart failure SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract C1 Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94143 USA. RI Teerlink, John/D-2986-2012 NR 0 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2002 VL 39 IS 5 SU A BP 171A EP 171A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 526AR UT WOS:000174106700758 ER PT J AU Sonel, AF Whittle, J Kelley, M Wilensky, RL AF Sonel, AF Whittle, J Kelley, M Wilensky, RL TI Is there still a role for physician assessment in the emergency department in the era of novel cardiac markers? SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract C1 Univ Penn, Philadelphia, PA 19104 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2002 VL 39 IS 5 SU A BP 316A EP 316A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 526AR UT WOS:000174106701419 ER PT J AU Ansari, MN Shlipak, MG Heidenreich, PA Massie, BM AF Ansari, MN Shlipak, MG Heidenreich, PA Massie, BM TI Strategies to improve guideline adherence: A randomized clinical trial SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2002 VL 39 IS 5 SU A BP 453A EP 453A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 526AR UT WOS:000174106702037 ER PT J AU Samaha, FF Klugherz, BD Wilensky, RL Locallo, AR Williams, M Kimmel, SE AF Samaha, FF Klugherz, BD Wilensky, RL Locallo, AR Williams, M Kimmel, SE TI Prediction rule for insignificant coronary artery disease in patients being considered for elective coronary angiography SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract C1 Univ Penn, Med Ctr, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2002 VL 39 IS 5 SU A BP 454A EP 454A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 526AR UT WOS:000174106702043 ER PT J AU Sonel, AF Whittle, J Good, CB Kelley, M AF Sonel, AF Whittle, J Good, CB Kelley, M TI Prediction of risk in patients with unstable angina and non-ST elevation myocardial infarction: A prospective comparison of the new ACC/AHA guidelines and physician predicted risk SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract C1 Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2002 VL 39 IS 5 SU A BP 457A EP 457A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 526AR UT WOS:000174106702056 ER PT J AU Shanafelt, TD Bradley, KA Wipf, JE Back, AL AF Shanafelt, TD Bradley, KA Wipf, JE Back, AL TI Burnout and self-reported patient care in an internal medicine residency program SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID EMERGENCY PHYSICIANS; ALCOHOL-CONSUMPTION; NATIONAL SURVEY; HOUSE OFFICERS; DEPRESSION; DISTRESS; STRESS; SATISFACTION; MANAGEMENT; QUESTIONS AB Background: Burnout is a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Little is known about burnout in residents or its relationship to patient care. Objective: To determine the prevalence of burnout in medical residents and explore its relationship to self-reported patient care practices. Design: Cross-sectional study using an anonymous, mailed survey. Setting: University-based residency program in Seattle, Washington. Participants: 115 internal medicine residents. Measurements: Burnout was measured by using the Maslach Burnout Inventory and was defined as scores in the high range for medical professionals on the depersonalization or emotional exhaustion subscales. Five questions developed for this study assessed self-reported patient care practices that suggested suboptimal care (for example, "I did not fully discuss treatment options or answer a patient's questions" or "I made ... errors that were not due to a lack of knowledge or inexperience"). Depression and at-risk alcohol use were assessed by using validated screening questionnaires. Results: Of 115 (76%) responding residents, 87 (76%) met the criteria for burnout. Compared with non-burned-out residents, burned-out residents were significantly more likely to self-report providing at least one type of suboptimal patient care at least monthly (53% vs. 21%; P=0.004). In multivariate analyses, burnout-but not sex, depression, or at-risk alcohol use-was strongly associated with self-report of one or more suboptimal patient care practices at least monthly (odds ratio, 8.3 [95% Cl, 2.6 to 26.5]). When each domain of burnout was evaluated separately, only a high score for depersonalization was associated with self-reported suboptimal patient care practices (in a dose-response relationship). Conclusion: Burnout was common among resident physicians and was associated with self-reported suboptimal patient care practices. C1 Univ Washington, Vet Affairs NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98195 USA. RP Back, AL (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way S-111, Seattle, WA 98108 USA. FU NIAAA NIH HHS [K23AA00313] NR 45 TC 651 Z9 673 U1 12 U2 69 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD MAR 5 PY 2002 VL 136 IS 5 BP 358 EP 367 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 525VT UT WOS:000174095300003 PM 11874308 ER PT J AU Kampman, KM Volpicelli, JR Mulvaney, F Rukstalis, M Alterman, AI Pettinati, H Weinrieb, RM O'Brien, CP AF Kampman, KM Volpicelli, JR Mulvaney, F Rukstalis, M Alterman, AI Pettinati, H Weinrieb, RM O'Brien, CP TI Cocaine withdrawal severity and urine toxicology results from treatment entry predict outcome in medication trials for cocaine dependence SO ADDICTIVE BEHAVIORS LA English DT Article DE cocaine withdrawal; clinical trial; treatment outcome ID PSYCHOTHERAPY; ABSTINENCE; ABUSERS; PHARMACOTHERAPY; ATTRITION AB Both cocaine withdrawal symptoms, measured by an instrument called the Cocaine Selective Severity Assessment (CSSA), and urine toxicology results obtained at the start of treatment have been shown to predict treatment outcome in outpatient cocaine dependence treatment. This study further evaluates the predictive validity of the CSSA and urine toxicology results, alone and in combination. Subjects included 76 cocaine-dependent individuals who participated in 7-week, outpatient, pilot medication trials for cocaine dependence. Predictor variables included CSSA scores and results from a urine toxicology screen obtained on the first day of medication treatment. Successful outcome was defined as 3 continuous weeks of self-reported abstinence from cocaine confirmed by urine toxicology screens. Predictive validity was assessed by logistic regression analysis. Both the urine toxicology screen and the CSSA scores were significant predictors of 3 weeks of continuous abstinence from cocaine, and the inclusion of both variables significantly improved the predictive validity of either variable alone. Urine toxicology results and CSSA scores obtained at treatment entry are useful predictors of outcome in outpatient cocaine dependence treatment. (C) 2001 Elsevier Science Ltd. All rights reserved. C1 Univ Penn, Treatment Res Ctr, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Kampman, KM (reprint author), Univ Penn, Treatment Res Ctr, Sch Med, Dept Psychiat, 3900 Chestnut St, Philadelphia, PA 19104 USA. FU NIDA NIH HHS [K20 DA00238, Y01 DA30012] NR 21 TC 51 Z9 51 U1 1 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4603 J9 ADDICT BEHAV JI Addict. Behav. PD MAR-APR PY 2002 VL 27 IS 2 BP 251 EP 260 DI 10.1016/S0306-4603(01)00171-X PG 10 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 504UL UT WOS:000172874200008 PM 11817766 ER PT J AU Voland, P Weeks, DL Vaira, D Prinz, C Sachs, G AF Voland, P Weeks, DL Vaira, D Prinz, C Sachs, G TI Specific identification of three low molecular weight membrane-associated antigens of Helicobacter pylori SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID SEROLOGICAL ASSESSMENT; CAMPYLOBACTER-JEJUNI; ERADICATION THERAPY; PROTEIN; SEQUENCE; ADHESIN; EXPRESSION; DIAGNOSIS; INFECTION; GENE AB Background: A large number of Helicobacter pylori proteins are antigenic, but antibodies to these proteins persist in spite of the eradication of the infection. Methods and results: The analysis of sera from H. pylori-infected and non-infected patients, before and 3 and 5 months after eradication, showed that the antibody response against unknown H. pylori antigens at 32, 30, 22 and 14 kDa in sodium dodecylsulphate polyacrylamide gel electrophoresis decreased by greater than or equal to 60% at 3 months and greater than or equal to 70% at 5 months after treatment. Two-dimensional gel electrophoresis and mass spectrometry allowed the identification of eight proteins at these positions: neuraminyl-lactose-binding haemagglutinin precursor, 3-oxoadipate CoA-transferase subunit A. elongation factor P. peptidoglycan-associated lipoprotein precursor, hypothetical protein HP0596, adhesin-thiol peroxidase, 50S ribosomal protein L7/L12 and subunit b' of the F-0 ATP synthase. Three of these eight. expressed as recombinant proteins (32 kDa neuraminyl-lactose-binding haemagglutinin precursor, 30 kDa peptidoglycan-associated lipoprotein precursor and 22 kDa hypothetical protein HP0596), reacted specifically with sera from infected patients, while the 14 kDa 50S ribosomal protein L7/L12 cross-reacted with one out of live sera from H. pylori-negative patients. The other recombinant proteins did not show significant immunoreactivity. Conclusions: Four low molecular weight antigens were identified by these methods. three of which were specific. Immunoreaction with these three proteins (neuraminyl-lactose-binding haemagglutinin precursor, peptidoglycan-associated lipoprotein precursor and hypothetical protein HP0596) could provide a serological assessment not only of H. pylori infection, but also of eradication. C1 VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Tech Univ Munich, Dept Med 2, D-8000 Munich, Germany. Univ Calif Los Angeles, Dept Physiol, Los Angeles, CA 90024 USA. St Orsola Hosp, Bologna, Italy. RP Sachs, G (reprint author), VA Greater Los Angeles Hlth Care Syst, Bldg 113,Rm 324,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK46917, DK53462, DK41301] NR 23 TC 28 Z9 29 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD MAR PY 2002 VL 16 IS 3 BP 533 EP 544 DI 10.1046/j.1365-2036.2002.01221.x PG 12 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 531PH UT WOS:000174423800024 PM 11876708 ER PT J AU Dominitz, JA Young, JCC Boyko, EJ AF Dominitz, JA Young, JCC Boyko, EJ TI Outcomes of infants born to mothers with inflammatory bowel disease: A population-based cohort study SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID CARE UTILIZATION INDEX; CROHNS-DISEASE; ULCERATIVE-COLITIS; OLMSTED COUNTY; PRETERM BIRTH; PREGNANCY; WOMEN; FERTILITY; SULPHASALAZINE; MESALAZINE AB OBJECTIVE: Limited population-based data on inflammatory bowel disease (IBD) and pregnancy outcomes exist. The purpose of this study is to determine the association between maternal IBD status and adverse pregnancy outcomes. METHODS: Using computerized birth records of infants born to mothers with Crohn's disease (CD) or ulcerative colitis (UC) and mothers without diagnoses of IBD (no-IBD) in Washington State, we performed a cross-sectional retrospective study to determine gestational age, birth weight, and congenital malformations. RESULTS: Preterm delivery was seen in 15.2% of CD births, 10.4% of UC births, and 7.2% of no-LBD births. Low birth weight was found in 16.8% of CD births, 7.6% of UC births, and 5.3% of no-IBD births. Smallness for gestational age was present in 15.2% of CD births, 10.5% of UC births, and 6.9% of no-IBD births. Only CD births were at significantly increased risk of preterm delivery (p < 0.0025), low birth weight (p < 0.001), and smallness for gestational age (p < 0.001). Congenital malformations were more commonly recorded in UC births than in controls (7.9% vs 1.7%, p < 0.001), whereas 3.4% of CD births had malformations recorded. Using multivariable logistic regression, CD births were more likely to be preterm (odds ratio [OR] 2.3, 95% Cl = 1.4-3.8) and have low birth weights (OR 3.6, CI = 2.2-5.9) and smallness for gestational age (OR 2.3, Cl = 1.3-3.9). UC births were more likely to have congenital malformations reported (OR = 3.8, CI = 1.5-9.8). CONCLUSIONS: Maternal IBD is associated with increased odds of preterm delivery, low birth weight, smallness for gestational age (CD), and reporting of congenital malformations (UC). (Am J Gastroenterol 2002;97:641-648. (C) 2002 by Am. Coll. of Gastroenterology). C1 VA Puget Sound Hlth Care Syst, Seattle Epidemiol Res & Informat Ctr, Seattle Div Gastro 111S, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Hlth Serv Res & Dev, Seattle, WA 98195 USA. Childrens Hosp Reg Med Ctr, Dept Pediat, Div Gen Pediat, Seattle, WA USA. RP Dominitz, JA (reprint author), VA Puget Sound Hlth Care Syst, Seattle Epidemiol Res & Informat Ctr, Seattle Div Gastro 111S, 1660 S Columbian Way, Seattle, WA 98108 USA. OI Dominitz, Jason/0000-0002-8070-7086; Boyko, Edward/0000-0002-3695-192X FU BHP HRSA HHS [5 T32 PE10002] NR 53 TC 132 Z9 134 U1 2 U2 9 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD MAR PY 2002 VL 97 IS 3 BP 641 EP 648 AR PII S0002-9270(01)04105-3 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 532JA UT WOS:000174469700022 PM 11926208 ER PT J AU Sultzer, DL AF Sultzer, DL TI Neuroimaging: Mapping psychosis in Alzheimer's disease. SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Meeting Abstract C1 Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAR-APR PY 2002 VL 10 IS 2 SU 1 BP 19 EP 19 PG 1 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 538CB UT WOS:000174795500053 ER PT J AU Samuels, SC Evers, M Lantz, M Datto, CJ Snowden, M Cohen, CI Katz, IR AF Samuels, SC Evers, M Lantz, M Datto, CJ Snowden, M Cohen, CI Katz, IR TI Depression in demented nursing home aged: Optimizing recognition and treatment. SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Meeting Abstract C1 Bronx Vet Adm Med Ctr, Bronx, NY USA. Mt Sinai Sch Med, New York, NY USA. Jewish Home & Hosp, New York, NY USA. Univ Penn, Philadelphia, PA 19104 USA. Suny Downstate Med Ctr, Brooklyn, NY 11203 USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAR-APR PY 2002 VL 10 IS 2 SU 1 BP 42 EP 43 PG 2 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 538CB UT WOS:000174795500123 ER PT J AU Lantz, M Samuels, SC Evers, M Marin, DB Purohit, D Khan, K Haroutunian, VH AF Lantz, M Samuels, SC Evers, M Marin, DB Purohit, D Khan, K Haroutunian, VH TI Depression screening in the nursing home results in documentation changes. SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Meeting Abstract C1 Jewish Home & Hosp, New York, NY USA. Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAR-APR PY 2002 VL 10 IS 2 SU 1 BP 43 EP 44 PG 2 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 538CB UT WOS:000174795500125 ER PT J AU Mulsant, BH Pollock, BG Kirshner, M Shen, C Dodge, H Ganguli, M AF Mulsant, BH Pollock, BG Kirshner, M Shen, C Dodge, H Ganguli, M TI Serum anticholinergic activity in a community-based geriatric sample: Relationship with cognitive performance. SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Meeting Abstract C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA 15260 USA. RI Ganguli, Mary/A-3638-2013; MORAN, CATHERINE/C-9539-2015 NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAR-APR PY 2002 VL 10 IS 2 SU 1 BP 58 EP 58 PG 1 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 538CB UT WOS:000174795500136 ER PT J AU Mulsant, BH Houck, PH Gildengers, AG Dew, MA Pollock, BB Miller, MD Stack, JA Mazumdar, S Reynolds, CF AF Mulsant, BH Houck, PH Gildengers, AG Dew, MA Pollock, BB Miller, MD Stack, JA Mazumdar, S Reynolds, CF TI What is the optimal duration of an acute antidepressant trial when treating geriatric depression? SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Meeting Abstract C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAR-APR PY 2002 VL 10 IS 2 SU 1 BP 75 EP 75 PG 1 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 538CB UT WOS:000174795500163 ER PT J AU Shores, MM Peskind, ER Wilkinson, CW Raskind, MA AF Shores, MM Peskind, ER Wilkinson, CW Raskind, MA TI Differential response of plasma norepinephrine to antidepressants in Alzheimer's disease and aging. SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Meeting Abstract C1 VA Puget Sound, GRECC, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAR-APR PY 2002 VL 10 IS 2 SU 1 BP 91 EP 92 PG 2 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 538CB UT WOS:000174795500201 ER PT J AU Berg, AO Allan, JD Frame, PS Homer, CJ Johnson, MS Klein, JD Lieu, TA Mulrow, CD Murphy, AL Orleans, CT Peipert, JF Pender, NJ Siu, AL Teutsch, SM Westhoff, C Woolf, SH AF Berg, AO Allan, JD Frame, PS Homer, CJ Johnson, MS Klein, JD Lieu, TA Mulrow, CD Murphy, AL Orleans, CT Peipert, JF Pender, NJ Siu, AL Teutsch, SM Westhoff, C Woolf, SH TI Aspirin for the primary prevention of cardiovascular events: Recommendations and rationale SO AMERICAN JOURNAL OF NURSING LA English DT Article ID DISEASE; RISK C1 Univ Washington, Dept Family Med, Seattle, WA 98195 USA. Univ Texas, Hlth Sci Ctr, Sch Nursing, San Antonio, TX USA. Univ Rochester, Sch Med, Rochester, NY USA. Tri Cty Family Med, Cohocton, NY USA. Natl Initiat Childrens Healthcare Qual, Boston, MA USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Family Med, Newark, NJ 07103 USA. Harvard Pilgrim Hlth Care, Dept Ambulatory Care & Prevent, Boston, MA USA. Harvard Univ, Sch Med, Boston, MA USA. Univ Texas, Hlth Sci Ctr, Audie L Murphy Mem Vet Hosp, San Antonio, TX USA. Robert Wood Johnson Fdn, Princeton, NJ 08540 USA. Women & Infants Hosp Rhode Isl, Providence, RI 02908 USA. Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA. Mt Sinai Sch Med, Div Gen Internal Med, New York, NY USA. Mt Sinai Sch Med, Primary Care & Med Serv Care Ctr, New York, NY USA. Mt Sinai Med Ctr, New York, NY 10029 USA. Merck & Co Inc, Outcomes Res & Management, W Point, PA USA. Columbia Univ Coll Phys & Surg, Dept Obstet & Gynecol, New York, NY 10032 USA. Virginia Commonwealth Univ Med Coll Virginia, Dept Family Practice, Fairfax, VA USA. RP Berg, AO (reprint author), Care Of Atkins D, Agcy Healthcare Res & Qual, Ctr Practice & Technol Assessment, 6010 Execut Blvd,Suite 300, Rockville, MD 20852 USA. NR 16 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-936X J9 AM J NURS JI Am. J. Nurs. PD MAR PY 2002 VL 102 IS 3 BP 67 EP + PG 3 WC Nursing SC Nursing GA 531HR UT WOS:000174410400030 ER PT J AU Barbour, LA Shao, JH Qiao, LP Pulawa, LK Jensen, DR Bartke, A Garrity, M Draznin, B Friedman, JE AF Barbour, LA Shao, JH Qiao, LP Pulawa, LK Jensen, DR Bartke, A Garrity, M Draznin, B Friedman, JE TI Human placental growth hormone causes severe insulin resistance in transgenic mice SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article DE placental growth hormone; pregnancy; insulin resistance; gestational diabetes ID GESTATIONAL DIABETES-MELLITUS; GLUCOSE-TRANSPORTER PROTEIN; TYROSINE PHOSPHORYLATION; SKELETAL-MUSCLE; FETAL GROWTH; OBESE WOMEN; EXPRESSION; PREGNANCY; METABOLISM; LACTOGEN AB OBJECTIVE: The insulin resistance of pregnancy is considered to be mediated by human placental lactogen, but the metabolic effects of human placental growth hormone have not been well defined. Our aim was to evaluate the effect of placental growth hormone on insulin sensitivity in vivo using transgenic mice that overexpress the human placental growth hormone gene. STUDY DESIGN: Glucose and insulin tolerance tests were performed on 6 transgenic mice that overexpressed the human placental growth hormone variant gene and 6 normal littermate controls. The body composition of the mice was assessed by dual-energy radiograph absorptiometry, and free fatty acid levels were measured as a marker of lipolysis. RESULTS: The human placental growth hormone levels in the transgenic mice were comparable to those attained in the third trimester of pregnancy. These mice were nearly twice as heavy as the control mice, and their body composition differed by a significant increase in bone density and a small decrease in percentage of body fat. Fasting insulin levels in the transgenic mice that overexpressed placental growth hormone were approximately 4-fold higher than the control mice (1.57 +/- 0.22 ng/mL vs 0.38 +/- 0.07 ng/mL; P <.001) and 7 times higher 30 minutes after glucose stimulation (4.17 +/- 0.54 ng/mL vs 0.62 +/- 0.10 ng/mL; P <.0001) with no significant difference in either fasting or postchallenge glucose levels. Insulin sensitivity was markedly decreased in the transgenic mice, as demonstrated by an insignificant decline in glucose levels after insulin injection compared with the control mice, which demonstrated more than a 65% reduction in glucose levels (P <.001). CONCLUSION: Human placental growth hormone causes insulin resistance as manifested by fasting and postprandial hyperinsulinemia and minimal glucose lowering in response to insulin injection. Human placental growth hormone is a highly likely candidate to mediate the insulin resistance of pregnancy. C1 Univ Colorado, Hlth Sci Ctr, Dept Med Obstet & Gynecol, Boulder, CO 80309 USA. Univ Colorado, Hlth Sci Ctr, Dept Pediat, Boulder, CO 80309 USA. So Illinois Univ, Sch Med, Dept Physiol, Chicago, IL 60680 USA. Denver Vet Affais Med Ctr, Div Endocrinol, Denver, CO USA. RP Barbour, LA (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Med Obstet & Gynecol, Boulder, CO 80309 USA. RI Bartke, Andzej/D-6640-2017 OI Bartke, Andzej/0000-0002-2569-557X FU PHS HHS [11089] NR 25 TC 81 Z9 85 U1 0 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD MAR PY 2002 VL 186 IS 3 BP 512 EP 517 DI 10.1067/mob.2002.121256 PG 6 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 533WD UT WOS:000174552500030 PM 11904616 ER PT J AU Beil, M Leser, J Lutz, MP Gukovskaya, A Seufferlein, T Lynch, G Pandol, SJ Adler, G AF Beil, M Leser, J Lutz, MP Gukovskaya, A Seufferlein, T Lynch, G Pandol, SJ Adler, G TI Caspase 8-mediated cleavage of plectin precedes F-actin breakdown in acinar cells during pancreatitis SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE cholecystokinin; cytoskeleton; pancreas; secretion ID INTERMEDIATE FILAMENTS; EPIDERMOLYSIS-BULLOSA; MUSCULAR-DYSTROPHY; ENZYME ACTIVATION; CYTOSKELETON; APOPTOSIS; ORGANIZATION; BINDING; KINASE; IDENTIFICATION AB Pancreatic acinar cells depend on the integrity of the cytoskeleton for regulated secretion. Stimulation of isolated rat pancreatic acini with the secretagogue CCK serves as a model for human acute edematous pancreatitis. It induces the breakdown of the actin filament system (F-actin) with the consecutive inhibition of secretion and premature activation of digestive enzymes. However, the mechanisms that regulate F-actin breakdown are largely unknown. Plectin is a versatile cytolinker protein regulating F-actin dynamics in fibroblasts. It was recently demonstrated that plectin is a substrate of caspase 8. In pancreatic acinar cells, plectin strongly colocalizes with apical and basolateral F-actin. Supramaximal secretory stimulation of acini with CCK leads to a rapid redistribution and activation of caspase 8, followed by degradation of plectin that in turn precedes the F-actin breakdown. Inhibition of caspase 8 before CCK hyperstimulation prevents plectin cleavage, stabilizes F-actin morphology, and reverses the inhibition of secretion. Thus we propose that the caspase 8-mediated degradation of plectin represents a critical biochemical event during CCK-induced secretory blockade and cell injury. C1 Univ Ulm, Dept Internal Med 1, D-89070 Ulm, Germany. Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Adler, G (reprint author), Univ Ulm, Dept Internal Med 1, D-89070 Ulm, Germany. OI Lutz, Manfred/0000-0003-1989-4553 NR 52 TC 34 Z9 35 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD MAR PY 2002 VL 282 IS 3 BP G450 EP G460 DI 10.1152/ajpgi.00042.2001 PG 11 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 525UE UT WOS:000174091800007 PM 11841995 ER PT J AU Holschneider, DP Scremin, OU Roos, KP Chialvo, DR Chen, K Shih, JC AF Holschneider, DP Scremin, OU Roos, KP Chialvo, DR Chen, K Shih, JC TI Increased baroreceptor response in mice deficient in monoamine oxidase A and B SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE arterial baroreceptor reflex; serotonin; norepinephrine; phenylethylamine; dopamine; blood pressure; heart rate; sympathetic nervous system ID NUCLEUS-TRACTUS-SOLITARIUS; SPONTANEOUSLY HYPERTENSIVE RATS; AUTONOMIC NERVOUS-SYSTEM; BLOOD-PRESSURE RESPONSE; HEART-RATE; CONSCIOUS RABBITS; BAROREFLEX CONTROL; TRANSGENIC MICE; REFLEX; RECEPTORS AB The recent development of mice doubly deficient for monoamine oxidase A and B (MAO-A/B, respectively) has raised questions about the impact of these mutations on cardiovascular function, in so far as these animals demonstrate increased tissue levels of the vasoactive amines serotonin, norepinephrine, dopamine, and phenylethylamine. We recorded femoral arterial pressures and electrocardiograms in adult MAO-A/B-deficient mice during halothane-nitrous oxide anesthesia as well as 30 min postoperatively. During both anesthesia and recovery, systolic, diastolic, and mean arterial pressures were 10-15 mmHg lower in MAO-A/B-deficient mice compared with normal controls (P < 0.01). Mutants also showed a greater baroreceptor-mediated reduction in heart rate in response to hypertension after intravenous pulses of phenylephrine or angiotensin II. Tachycardia elicited in response to hypotension after nitroprusside was greater in mutants than in controls. Heart rate responsiveness to changes in arterial pressure was abolished after administration of glycopyrrolate, with no differences in this phenomenon noted between genotypes. These data suggest that prevention of hypertension may occur in chronic states of catecholaminergic/indoleaminergic excess by increased gain of the baroreflex. C1 Univ So Calif, Dept Psychiat & Behav Sci, Keck Sch Med, Los Angeles, CA 90089 USA. Univ So Calif, Dept Neurol, Keck Sch Med, Los Angeles, CA 90089 USA. Univ So Calif, Dept Cell & Neurobiol, Keck Sch Med, Los Angeles, CA 90089 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Physiol, Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Cardiovasc Res Lab, Sch Med, Los Angeles, CA 90024 USA. Rockefeller Univ, Ctr Studies Phys & Biol, New York, NY 10021 USA. Univ So Calif, Sch Pharm, Dept Mol Pharmacol & Toxicol, Los Angeles, CA 90089 USA. RP Holschneider, DP (reprint author), Univ So Calif, Keck Sch Med, LAC USC Hosp, Dept Psychiat, 1200 N State St,Rm 10-621, Los Angeles, CA 90033 USA. RI Chialvo, Dante/A-4658-2009 OI Chialvo, Dante/0000-0002-1038-3637 FU NIMH NIH HHS [R37 MH-39085, R01 MH-37020, KO5 MH-00796, R01 MH-NS-62148] NR 50 TC 11 Z9 12 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD MAR PY 2002 VL 282 IS 3 BP H964 EP H972 PG 9 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 520JT UT WOS:000173779300023 PM 11834493 ER PT J AU Nagami, GT AF Nagami, GT TI Enhanced ammonia secretion by proximal tubules from mice receiving NH(4)Cl: role of angiotensin II SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE transport; ammoniagenesis; acid-base physiology; losartan; ammonium chloride ID METABOLIC-ACIDOSIS; PERFUSED INVITRO; RAT; TRANSPORT; KIDNEY; BASE AB Acidosis and angiotensin II (ANG II) stimulate ammonia production and transport by the proximal tubule. We examined the effect of short-term (18 h) in vivo acid loading with NH(4)Cl on ammonia production and secretion rates by mouse S2 proximal tubule segments microperfused in vitro with or without ANG II in the luminal microperfusion solution. S2 tubules from NH(4)Cl-treated mice displayed higher rates of luminal ammonia secretion compared with those from control mice. The adaptive increase in ammonia secretion in NH(4)Cl-treated mice was eliminated when losartan was coadministered in vivo with NH(4)Cl. Ammonia secretion rates from both NH(4)Cl-treated and control mice were largely inhibited by amiloride. Addition of ANG II to the microperfusion solution enhanced ammonia secretion and production rates to a greater extent in tubules from NH(4)Cl-treated mice compared with those from controls, and the stimulatory effects of ANG II were blocked by losartan. These results demonstrate that a short-term acid challenge induces an adaptive increase in ammonia secretion by the proximal tubule and suggest that ANG II plays an important role in the adaptive enhancement of ammonia secretion that is observed with short-term acid challenges. C1 Vet Affairs Greater Los Angeles Healthcare Syst W, Med Serv, Nephrol Sect 111L, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst W, Res Serv, Nephrol Sect 111L, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. RP Nagami, GT (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst W, Med Serv, Nephrol Sect 111L, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM gnagami@ucla.edu NR 30 TC 19 Z9 20 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD MAR PY 2002 VL 282 IS 3 BP F472 EP F477 PG 6 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 520JQ UT WOS:000173779100012 PM 11832428 ER PT J AU Yoder, BK Tousson, A Millican, L Wu, JH Bugg, CE Schafer, JA Balkovetz, DF AF Yoder, BK Tousson, A Millican, L Wu, JH Bugg, CE Schafer, JA Balkovetz, DF TI Polaris, a protein disrupted in orpk mutant mice, is required for assembly of renal cilium SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE Tg737; ciliogenesis; cell line; polycystic kidney disease; Madin-Darby canine kidney cells; Oak Ridge Polycystic Kidney ID POLYCYSTIC KIDNEY-DISEASE; CELL-CELL ADHESION; INTRAFLAGELLAR TRANSPORT IFT; CAENORHABDITIS-ELEGANS; EPITHELIAL-CELLS; C-ELEGANS; CPK GENE; MOUSE; MUTATION; MEMBRANE AB Cilia are organelles that play diverse roles, from fluid movement to sensory reception. Polaris, a protein associated with cystic kidney disease in Tg737(orpk) mice, functions in a ciliogenic pathway. Here, we explore the role of polaris in primary cilia on Madin-Darby canine kidney cells. The results indicate that polaris localization and solubility change dramatically during cilia formation. These changes correlate with the formation of basal bodies and large protein rafts at the apical surface of the epithelia. A cortical collecting duct cell line has been derived from mice with a mutation in the Tg737 gene. These cells do not develop normal cilia, which can be corrected by reexpression of the wild-type Tg737 gene. These data suggest that the primary cilia are important for normal renal function and/or development and that the ciliary defect may be a contributing factor to the cystic disease in Tg737(orpk) mice. Further characterization of these cells will be important in elucidating the physiological role of renal cilia and in determining their relationship to cystic disease. C1 Univ Alabama, Dept Cell Biol, Birmingham, AL 35294 USA. Univ Alabama, High Resolut Imaging Facil, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Surg, Birmingham, AL 35294 USA. Univ Alabama, Dept Physiol & Biophys, Birmingham, AL 35294 USA. Univ Alabama, Birmingham Vet Affairs Med Ctr, Birmingham, AL 35294 USA. RP Yoder, BK (reprint author), Univ Alabama, Dept Cell Biol, 1530 3rd Ave S,MCLM652, Birmingham, AL 35294 USA. EM Byoder@uab.edu FU NIDDK NIH HHS [1RO1-DK-55007-01] NR 57 TC 116 Z9 120 U1 0 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD MAR PY 2002 VL 282 IS 3 BP F541 EP F552 PG 12 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 520JQ UT WOS:000173779100021 PM 11832437 ER PT J AU Pollock, BG Mulsant, BH Rosen, J Sweet, RA Mazumdar, S Bharucha, A Marin, R Jacob, NJ Huber, KA Kastango, KB Chew, ML AF Pollock, BG Mulsant, BH Rosen, J Sweet, RA Mazumdar, S Bharucha, A Marin, R Jacob, NJ Huber, KA Kastango, KB Chew, ML TI Comparison of citalopram, perphenazine, and placebo for the acute treatment of psychosis and behavioral disturbances in hospitalized, demented patients SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 14th Annual Meeting of the American-Association-for-Geriatric-Psychiatry CY FEB 23-26, 2001 CL SAN FRANCISCO, CALIFORNIA SP Amer Assoc Geriatr Psychiat ID ALZHEIMERS-DISEASE; DOUBLE-BLIND; NEUROLEPTIC TREATMENT; CLINICIAN; SEROTONIN; DIAGNOSIS; AGITATION; TRIAL; AD AB Objective: Until recently, conventional antipsychotics were the standard pharmacotherapy for psychosis and behavioral disturbances associated with dementia. This double-blind, placebo-controlled study compared the acute efficacy of the selective serotonin reuptake inhibitor citalopram and the neuroleptic perphenazine with placebo for the treatment of psychosis and behavioral disturbances in nondepressed patients with dementia. Method: Eighty-five hospitalized patients with at least one moderate to severe target symptom (aggression, agitation, hostility, suspiciousness, hallucinations, or delusions) were randomly assigned to receive either citalopram, perphenazine, or placebo under double-blind conditions for up to 17 days. Results: Patients treated with citalopram or perphenazine showed statistically significant improvement on several Neurobehavioral Rating Scale factor scores. Compared to those receiving placebo, only patients treated with citalopram showed significantly greater improvement in their total Neurobehavioral Rating Scale score as well as in the scores for the agitation/aggression and lability/tension factors. Side effect scores were similar among the three treatment groups. Conclusions: Citalopram was found to be more efficacious than placebo in the short-term hospital treatment of psychotic symptoms and behavioral disturbances in nondepressed, demented patients. C1 Univ Pittsburgh, Sch Med, Geriatr Psychopharmacol Program, Acad Div Geriatr & Neuropsychiat,Dept Psychiat, Pittsburgh, PA USA. VA Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Pollock, BG (reprint author), Western Psychiat Inst & Clin, Geriatr Psychopharmacol Program, 3811 OHara St, Pittsburgh, PA 15213 USA. FU NCRR NIH HHS [RR-00056]; NIMH NIH HHS [MH-01509, MH-01613, MH-52247, MH-55106, MH-59666] NR 32 TC 159 Z9 164 U1 0 U2 6 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD MAR PY 2002 VL 159 IS 3 BP 460 EP 465 DI 10.1176/appi.ajp.159.3.460 PG 6 WC Psychiatry SC Psychiatry GA 527KZ UT WOS:000174186400019 PM 11870012 ER PT J AU Malcolm, R Myrick, H Roberts, J Wang, W Anton, RF AF Malcolm, R Myrick, H Roberts, J Wang, W Anton, RF TI The differential effects of medication on mood, sleep disturbance, and work ability in outpatient alcohol detoxification SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID ADMISSION PREDICTS RELAPSE; WITHDRAWAL SYNDROME; INPATIENT ALCOHOLICS; SEIZURES; ANXIETY; CARBAMAZEPINE; PREVENTION; DIAGNOSIS AB A double-blind, randomized controlled trial of patients (n = 136) meeting DSM-IV criteria for alcohol withdrawal and stratified based on detoxification history were treated with carbamazepine or lorazepam for 5 days on a fixed dose tapering schedule. Mood symptoms improved for all subjects regardless of medication or detoxification history. There was a significant main effect favoring carbamazepine in reducing anxiety (p = 0.0007). Anxiety was highest in those individuals who had multiple previous detoxifications (p = 0.02). Visual analog measures of sleep quality indicated a statistically significant main effect of medication on sleep that again favored carbamazepine (p = 0.0186). Visual analog rating of perceived ability to return to work was decreased in individuals who had multiple previous detoxifications (p = 0.025). In this study of outpatients with mild to moderate alcohol withdrawal, carbamazepine was superior to lorazepam in reducing anxiety and improving sleep. C1 Med Univ S Carolina, Alcohol Res Ctr, Charleston, SC 29425 USA. Ralph H Johnson VAMC, Charleston, SC USA. Univ Maryland, Dept Measurements Stat & Evaluat, College Pk, MD USA. RP Malcolm, R (reprint author), Med Univ S Carolina, Alcohol Res Ctr, 67 President St, Charleston, SC 29425 USA. FU NIAAA NIH HHS [AA10761] NR 42 TC 32 Z9 35 U1 3 U2 5 PU BRUNNER-ROUTLEDGE PI PHILADELPHIA PA 325 CHESTNUT ST, 8TH FL, PHILADELPHIA, PA 19106 USA SN 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD SPR PY 2002 VL 11 IS 2 BP 141 EP 150 DI 10.1080/10550490290087910 PG 10 WC Substance Abuse SC Substance Abuse GA 551KX UT WOS:000175561800006 PM 12028744 ER PT J AU Hirakura, Y Carreras, I Sipe, JD Kagan, BL AF Hirakura, Y Carreras, I Sipe, JD Kagan, BL TI Channel formation by serum amyloid A: a potential mechanism for amyloid pathogenesis and host defense SO AMYLOID-JOURNAL OF PROTEIN FOLDING DISORDERS LA English DT Article DE acute phase reactants; inflammation; cytotoxicity; pores; membranes ID VOLTAGE-DEPENDENT CHANNELS; HIGH-DENSITY-LIPOPROTEIN; LIPID BILAYER-MEMBRANES; PRION PROTEIN-FRAGMENT; C-REACTIVE PROTEIN; ACUTE-PHASE; CONGO-RED; ANTIMICROBIAL PEPTIDES; BETA-PROTEIN; A PROTEIN AB Serum amyloid A (SAA) is a family of closely, related apolipoproteins associated with high density lipoprotein (HDL). Subclasses of SAA isoforms are differentially expressed constitutively, and during inflammation. During states of infection or inflammation, levels of HDL bound, acute phase isoforms of SAA rise as much as 1000-fold in the serum, suggesting that it might play a role in host defense. Following recurrent or chronic inflammation, an N-terminal peptide fragment of SAA known as amyloid A (AA) assembles into fibrils causing extensive damage to spleen, liver, and kidney, and rapidly, progressing to death. In the present paper, we report the novel finding that a recombinant acute phase isoform variant of human SAA1.1 (SAAp) readily forms ion-channels in planar lipid bilayer membranes at physiologic concentrations. These channels are voltage-independent, poorly selective, and are relatively, long-lived This type of channel would place a severe metabolic strain on various kinds of cells. Expression of human SAA1.1 in bacteria induces lysis of bacterial cells, while expression of the constitutive isoform (human SAA4) does not. Secondary structural analysis of the SAA isoforms indicates a strong hydrophobicity of the N-terminal of the acute phase isoform relative to the constitutive SAA4 isoform, which may be responsible for the bactericidal activity of the former, in keeping with the notion that SAA1 targets cell membranes and forms channels in them Channel formation may thus be related to a host defense role of acute phase SAA isoforms and may, also be the mechanism of end organ damage in AA and other amyloidoses. C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat, Inst Neuropsychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Mental Retardat Res Ctr, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Boston Univ, Sch Med, Dept Biochem, Boston, MA 02118 USA. RP Kagan, BL (reprint author), Univ Calif Los Angeles, Sch Med, Dept Psychiat, Inst Neuropsychiat, 760 Westwood Pl, Los Angeles, CA 90024 USA. FU NIMH NIH HHS [MH 01174] NR 63 TC 58 Z9 60 U1 0 U2 5 PU PARTHENON PUBLISHING GROUP PI LANCASTER PA RICHMOND HOUSE, WHITE CROSS, SOUTH ROAD, LANCASTER LA1 4XQ, ENGLAND SN 1350-6129 J9 AMYLOID JI Amyloid-J. Protein Fold. Disord. PD MAR PY 2002 VL 9 IS 1 BP 13 EP 23 DI 10.3109/13506120209072440 PG 11 WC Biochemistry & Molecular Biology; Medicine, General & Internal; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; General & Internal Medicine; Research & Experimental Medicine GA 549FB UT WOS:000175432900002 PM 12000193 ER PT J AU Young, IA Burns, SP Little, JW AF Young, IA Burns, SP Little, JW TI Sudden onset of cervical spondylotic myelopathy during sleep: A case report SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Spinal-Injury-Association CY APR 14-16, 2000 CL CHICAGO, ILLINOIS SP Amer Spinal Injury Assoc DE case report; quadriplegia; rehabilitation; spinal cord injuries; spinal osteophytosis; spinal stenosis ID SPINAL-CORD INFARCTION; QUADRIPLEGIA; INJURY AB Cervical spondylotic myelopathy is a common cause of compressive spinal cord dysfunction. The typical course involves either a gradual or an episodic increase in symptoms and neurologic deficits, with impairment evolving over a period of months to years. Acute neurologic deterioration in conjunction with cervical spondylosis has been described almost exclusively in traumatic situations such as disk herniation. We report a case of an acute, nontraumatic onset of tetraplegia in association with cervical spondylosis. A 56-year-old man developed tetraplegia during a 1-hour nap, with loss of volitional control of his extremities, impaired sensation below the C3 dermatome, and increased muscle tone. Magnetic resonance imaging of the cervical spine revealed canal stenosis and increased T2 signal within the cord. This case report describes the rehabilitation course for this patient and reviews the clinical spectrum of onset and progression of cervical spondylotic myelopathy. C1 Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, Seattle, WA USA. RP Burns, SP (reprint author), VA Puget Sound, SCI Serv 128, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 25 TC 7 Z9 7 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD MAR PY 2002 VL 83 IS 3 BP 427 EP 429 DI 10.1053/apmr.2002.29621 PG 3 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 529AM UT WOS:000174277900021 PM 11887127 ER PT J AU Oates, JC Reilly, CM Crosby, MB Gilkeson, GS AF Oates, JC Reilly, CM Crosby, MB Gilkeson, GS TI Peroxisome proliferator-activated receptor gamma agonists - Potential use for treating chronic inflammatory diseases SO ARTHRITIS AND RHEUMATISM LA English DT Review ID NITRIC-OXIDE SYNTHASE; NECROSIS-FACTOR-ALPHA; PPAR-GAMMA; 15-DEOXY-DELTA(12,14)-PROSTAGLANDIN J(2); INSULIN-RESISTANCE; IN-VITRO; NUCLEAR RECEPTORS; GENE-EXPRESSION; INHIBIT; CELLS C1 Med Univ S Carolina, Div Rheumatol & Immunol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Med Res Serv, Charleston, SC USA. RP Oates, JC (reprint author), Med Univ S Carolina, Div Rheumatol & Immunol, 96 Jonathan Lucas St,Suite 912, Charleston, SC 29425 USA. FU NIAMS NIH HHS [AR-40837, R01 AR047451]; NIGMS NIH HHS [GM08716] NR 65 TC 25 Z9 31 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0004-3591 J9 ARTHRITIS RHEUM JI Arthritis Rheum. PD MAR PY 2002 VL 46 IS 3 BP 598 EP 605 DI 10.1002/art.10052 PG 8 WC Rheumatology SC Rheumatology GA 531HD UT WOS:000174409200006 PM 11920394 ER PT J AU Solomon, CS Goalstone, ML AF Solomon, CS Goalstone, ML TI Dominant negative alpha-subunit of FTase inhibits effects of insulin and IGF-I in MCF-7 cells SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE farnesyltransferase; insulin; geranylgeranyltransferase I; dominant negative alpha-subunit; MCF-7 cells ID FARNESYL-PROTEIN TRANSFERASE; BREAST-CANCER CELLS; SMOOTH-MUSCLE CELLS; GROWTH-FACTOR-I; MOLECULAR MECHANISMS; P21 RAS; FARNESYLTRANSFERASE; HYPERINSULINEMIA; POTENTIATION; ACTIVATION AB We recently designed a dominant negative (DN) farnesyltransferase (FTase)/geranyl-gerahyltransferase I (GGTase I) alpha-subunit that when expressed in vascular smooth muscle cells decreased insulin-stimulated phosphorylation of FTase, FTase activity, amounts of farnesylated p21Ras, DNA synthesis, and cell migration. Currently, we explored the inhibitory effects of DN FTase/GGTase I alpha-subunit in MCF-7 cells on IGF-1- and insulin-stimulated DNA synthesis and cell proliferation. Expression of the DN FTase/GGTase I alpha-subunit completely blocked IGF-1- and insulin-stimulated BrdU incorporation and cell count. DN FTase/GGTase I alpha-subunit inhibited insulin-stimulated phosphorylation of FTase/GGTase I alpha-subunit, FTase and GGTase I activity, and prenylation of p21Ras and RhoA. Expression of DN FTase/GGTase I alpha-subunit diminished IGF-1- and insulin-stimulated phosphorylation of ERK (extracellular signal-regulated kinase), but had no effect on IGF-1- and insulin-stimulated phosphorylation of Akt. Taken together, these data suggest that DN FTase/GGTase I alpha-subunit can assuage the mitogenic effects of IGF-1 and insulin on MCF-7 breast cancer cells. C1 Denver VA Med Ctr, Res Serv, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. RP Goalstone, ML (reprint author), Denver VA Med Ctr, Res Serv, 111H,1055 Clermont St, Denver, CO 80220 USA. NR 46 TC 8 Z9 8 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD MAR 1 PY 2002 VL 291 IS 3 BP 458 EP 465 DI 10.1006/bbrc.2002.6471 PG 8 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 527TD UT WOS:000174202700005 PM 11855811 ER PT J AU Bradham, WS Bozkurt, B Gunasinghe, H Mann, D Spinale, FG AF Bradham, WS Bozkurt, B Gunasinghe, H Mann, D Spinale, FG TI Tumor necrosis factor-alpha and myocardial remodeling in progression of heart failure: a current perspective SO CARDIOVASCULAR RESEARCH LA English DT Review DE cytokines; extracellular matrix; heart failure; remodeling ID MATRIX-METALLOPROTEINASE ACTIVITY; VENTRICULAR EJECTION FRACTION; ADULT FELINE MYOCARDIUM; SMOOTH-MUSCLE CELLS; FAILING HUMAN HEART; DILATED CARDIOMYOPATHY; CIRCULATING LEVELS; TRANSGENIC MICE; INFLAMMATORY CYTOKINES; SIGNAL-TRANSDUCTION AB A milestone in the progression of congestive heart failure (CHF) is myocardial remodeling. Left ventricular (LV) remodeling during the progression of CHF is accompanied by changes in the structure of the myocardial extracellular matrix. Recent clinical and experimental studies have noted that increased release of tumor necrosis factor alpha (TNF-alpha) can contribute to LV myocardial remodeling. Experimental studies have noted that the induction of TNF-alpha can result in LV dilation and proceed to LV pump dysfunction. The biological effects of TNF-alpha are mediated through TNF receptors that are present on all nucleated cells in the heart. TNF receptor activation can induce a number of cellular and molecular events which contribute to LV remodeling in CHF, and include changes in myocyte size and viability and alterations in myocardial structure/composition. In vitro studies have demonstrated that TNF receptor activation can cause the induction of a proteolytic system. This proteolytic system, the matrix metalloproteinases (MMPs), is upregulated in models of LV dysfunction and possesses the capacity to degrade a wide variety of extracellular matrix components. Therefore, one pathway by which TNF-alpha can influence LV myocardial remodeling is through the induction of a specific portfolio of MMP species. Future basic and clinical studies which directly alter TNF receptor activity and measure myocarddial MMP species and the relation to LV remodeling will provide new insight into this disease process and future therapeutic modalities. (C) 2002 Elsevier Science BY All rights reserved. C1 Med Univ S Carolina, Charleston, SC 29425 USA. Houston VAMC, Winters Ctr Heart Failure Res, Cardiol Sect, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. RP Spinale, FG (reprint author), Med Univ S Carolina, Room 625,Strom Thurmond Res Bldg,770 MUSC Complex, Charleston, SC 29425 USA. OI Mann, Douglas /0000-0002-2516-0145 NR 82 TC 95 Z9 117 U1 0 U2 5 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0008-6363 J9 CARDIOVASC RES JI Cardiovasc. Res. PD MAR PY 2002 VL 53 IS 4 BP 822 EP 830 AR PII S0008-6363(01)00503-X DI 10.1016/S0008-6363(01)00503-X PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 547DB UT WOS:000175316800004 PM 11922892 ER PT J AU Cohen, AJ Belinsky, S Franklin, W Beard, S AF Cohen, AJ Belinsky, S Franklin, W Beard, S TI Molecular and Physiologic evidence for 5 ' CpG island methylation of the endothelin B receptor gene in lung cancer SO CHEST LA English DT Article; Proceedings Paper CT 44th Annual Thomas L Petty Aspen Lung Conference CY JUN 06-09, 2001 CL ASPEN, COLORADO C1 Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Div Pulm Sci & Crit Care Med, Denver, CO 80220 USA. Lovelace Res Inst, Albuquerque, NM USA. RP Cohen, AJ (reprint author), Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Div Pulm Sci & Crit Care Med, 1055 Clermont Ave,Resp 111A, Denver, CO 80220 USA. NR 0 TC 8 Z9 8 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAR PY 2002 VL 121 IS 3 SU S BP 27S EP 28S DI 10.1378/chest.121.3_suppl.27S-a PG 2 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 532NH UT WOS:000174481400016 PM 11893663 ER PT J AU Evans, C Kheradmand, F Corry, D Tuvim, M Densmore, C Waldrep, C Knight, V Dickey, B AF Evans, C Kheradmand, F Corry, D Tuvim, M Densmore, C Waldrep, C Knight, V Dickey, B TI Gene therapy of mucus hypersecretion in experimental asthma SO CHEST LA English DT Article; Proceedings Paper CT 44th Annual Thomas L Petty Aspen Lung Conference CY JUN 06-09, 2001 CL ASPEN, COLORADO C1 Baylor Coll Med, Houston, TX USA. Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Dickey, B (reprint author), Houston Vet Affairs Med Ctr, MS 151 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 1 TC 1 Z9 1 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAR PY 2002 VL 121 IS 3 SU S BP 90S EP 91S DI 10.1378/chest.121.3_suppl.90S-a PG 2 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 532NH UT WOS:000174481400071 PM 11893719 ER PT J AU Ito, A Buenafe, AC Matejuk, A Zamora, A Silverman, M Dwyer, J Vandenbark, AA Offner, H AF Ito, A Buenafe, AC Matejuk, A Zamora, A Silverman, M Dwyer, J Vandenbark, AA Offner, H TI Estrogen inhibits systemic T cell expression of TNF-alpha and recruitment of TNF-alpha(+) T cells and macrophages into the CNS of mice developing experimental encephalomyelitis SO CLINICAL IMMUNOLOGY LA English DT Article DE EAE; CNS; T cells; macrophages; 17 beta-estradiol; TNF-alpha ID EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; CENTRAL-NERVOUS-SYSTEM; DELAYED-TYPE HYPERSENSITIVITY; TUMOR-NECROSIS-FACTOR; COLLAGEN-INDUCED ARTHRITIS; MULTIPLE-SCLEROSIS; INFLAMMATORY RESPONSES; ESTRADIOL SUPPRESSION; BETA-ESTRADIOL AB Estrogen treatment has been found to have suppressive activity in several models of autoimmunity. To investigate the mechanism of 17beta-estradiol (E2) suppression of experimental autoimmune encephalomyelitis, we evaluated E2 effects on TNF-alpha expression in the central nervous system (CNS) and spleen of C57BL/6 mice immunized with MOG 35-55/CFA. Kinetic analysis demonstrated that E2 treatment drastically decreased the recruitment of total inflammatory cells as well as TNF-alpha(+) macrophages and T cells into the CNS at disease onset. In contrast, E2 had only moderate effects on the relatively high constitutive TNF-alpha expression by resident CNS microglial cells. E2 treatment also had profound inhibitory effects on expression of TNF-alpha by splenic CD4(+) T cells, including those responsive to MOG 35-55 peptide. We propose that the mechanism of E2 protection may involve both systemic inhibition of TNF-alpha expression and local (CNS) recruitment of inflammatory cells, with modest effects on TNF-alpha expression by resident CNS microglial cells. (C) 2002 Elsevier Science (USA). C1 Portland VA Med Ctr, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Polish Acad Sci, L Hirszfeld Inst Immunol & Expt Therapy, Wroclaw, Poland. Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97201 USA. RP Offner, H (reprint author), Portland VA Med Ctr, R&D-31,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. FU NIAID NIH HHS [AI42376]; NINDS NIH HHS [NS23444] NR 40 TC 41 Z9 44 U1 0 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PD MAR PY 2002 VL 102 IS 3 BP 275 EP 282 DI 10.1006/clim.2001.5175 PG 8 WC Immunology SC Immunology GA 534MV UT WOS:000174590900008 PM 11890714 ER PT J AU McHorney, CA Robbins, J Lomax, K Rosenbek, JC Chignell, K Kramer, AE Bricker, DE AF McHorney, CA Robbins, J Lomax, K Rosenbek, JC Chignell, K Kramer, AE Bricker, DE TI The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity SO DYSPHAGIA LA English DT Article DE deglutition; deglutition disorders ID IMPROVING HEALTH-CARE; GENERAL-PRACTICE CARE; PREPAID GROUP PLAN; QUALITY-OF-LIFE; MOS SHORT-FORM; MEDICAL OUTCOMES; PATIENT SATISFACTION; CONCEPTUAL-FRAMEWORK; DEPRESSED-PATIENTS; CATEGORICAL-DATA AB Advances in the measurement of swallowing physiologic parameters have been clinician-driven, as has the development of intervention techniques to modify swallowing pathophysiology. However, a critical element to determining the success of such efforts will be established by the patients themselves. We conceptualized, developed, and validated the SWAL-QOL, a 93-item quality-of-life and quality-of-care outcomes tool for dysphagia researchers and clinicians. With 93 items, the SWAL-QOL was too long for practical and routine use in clinical research and practice. We used an array of psychometric techniques to reduce the 93-item instrument into two patient-centered outcomes tools: (1) the SWAL-QOL, a 44-item tool that assesses ten quality-of-life concepts, and (2) the SWAL-CARE, a 15-item tool that assesses quality of care and patient satisfaction. All scales exhibit excellent internal-consistency reliability and short-term reproducibility. The scales differentiate normal swallowers from patients with oropharyngeal dysphagia and are sensitive to differences in the severity of dysphagia as clinically defined. It is intended that the standardization and publication of the SWAL-QOL and the SWAL-CARE will facilitate their use in clinical research and clinical practice to better understand treatment effectiveness as a critical step toward improving patients' quality of life and quality of care. C1 Regenstrief Inst Hlth Care, Indianapolis, IN 46202 USA. Indiana Univ, Sch Med, Dept Internal Med & Geriatr, Richard L Roudebush Vet Affairs Med Ctr, Indianapolis, IN USA. Indiana Univ, Ctr Aging Res, Indianapolis, IN USA. William S Middleton Mem Vet Adm Med Ctr, Sch Med, Madison, WI USA. Univ Kentucky, Sanders Brown Ctr Aging, PhD Program Gerontol, Louisville, KY USA. Univ Florida, Dept Communicat Disorders, Gainesville, FL USA. Univ Wisconsin, Sch Med, Dept Surg, Madison, WI USA. ACHOICE, Milwaukee, WI USA. Univ Wisconsin Hosp & Clin, Madison, WI 53792 USA. NW Mem Hosp, Chicago, IL 60611 USA. RP McHorney, CA (reprint author), Regenstrief Inst Hlth Care, 1050 Wishard Blvd,RG,6th Floor, Indianapolis, IN 46202 USA. NR 87 TC 169 Z9 188 U1 2 U2 16 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0179-051X J9 DYSPHAGIA JI Dysphagia PD SPR PY 2002 VL 17 IS 2 BP 97 EP 114 DI 10.1007/s00455-001-0109-1 PG 18 WC Otorhinolaryngology SC Otorhinolaryngology GA 534XU UT WOS:000174615700002 PM 11956835 ER PT J AU Sohn, EH Wolden-Hanson, T Matsumoto, AM AF Sohn, EH Wolden-Hanson, T Matsumoto, AM TI Testosterone (T)-induced changes in arcuate nucleus cocaine-amphetamine-regulated transcript and NPY mRNA are attenuated in old compared to young male brown Norway rats: Contribution of T to age-related changes in cocaine-amphetamine-regulated transcript and NPY gene expression SO ENDOCRINOLOGY LA English DT Article ID NEUROPEPTIDE-Y; MESSENGER-RNA; BODY-COMPOSITION; ANATOMICAL DISTRIBUTION; INSITU HYBRIDIZATION; HYPOTHALAMIC CART; FEEDING-BEHAVIOR; FOOD-INTAKE; IN-VITRO; LEPTIN AB The age-related decrease in serum T levels is associated with impairments in food intake and weight regulation and alterations in brain peptides that regulate energy balance. To test the hypothesis that reduced T levels contribute to altered hypothalamic cocaine-amphetamine-regulated transcript (CART) and NPY gene expression, the mRNA content of these neuropeptides was measured by in situ hybridization in sham-operated (intact), castrated, and T-replaced castrated young and old male Brown Norway rats. T levels in T-replaced young and old rats were similar to those in intact young animals. Compared with castrated rats, arcuate nucleus CART mRNA was lower and NPY mRNA was higher in both young and old T-replaced castrated animals, suggesting reciprocal regulation of these peptides by T; these T-induced changes were localized primarily in the rostral arcuate and were markedly attenuated in old animals. Compared with intact animals, paraventricular nucleus CART mRNA was lower in castrated animals and similar in T-replaced young and old rats. We conclude that hypothalamic CART and NPY neurons remain responsive to T regulation in old rats, albeit less so than in young animals, suggesting that the age-related reduction of T contributes in part to altered brain neuropeptide gene expression favoring anorexia and wasting with aging. C1 Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Sch Med, Div Gerontol & Geriatr Med, Dept Med, Seattle, WA 98108 USA. Univ Washington, Sch Med, Populat Ctr Res Reprod, Seattle, WA 98108 USA. RP Matsumoto, AM (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, S-182-GRECC,1660 S Columbian Way, Seattle, WA 98108 USA. FU NICHD NIH HHS [P50-HD-12629] NR 50 TC 40 Z9 40 U1 0 U2 1 PU ENDOCRINE SOC PI BETHESDA PA 4350 EAST WEST HIGHWAY SUITE 500, BETHESDA, MD 20814-4110 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD MAR PY 2002 VL 143 IS 3 BP 954 EP 963 DI 10.1210/en.143.3.954 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 524WA UT WOS:000174034800026 PM 11861518 ER PT J AU Langton, JE Brent, GA AF Langton, JE Brent, GA TI Nonthyroidal illness syndrome: evaluation of thyroid function in sick patients SO ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA LA English DT Article ID TUMOR-NECROSIS-FACTOR; TYPE-3 IODOTHYRONINE DEIODINASE; SERUM THYROXINE CONCENTRATION; EUTHYROID SYNDROME; RECEPTOR COACTIVATORS; HOSPITALIZED-PATIENTS; FREE TRIIODOTHYRONINE; HORMONE METABOLISM; THYROTROPIN ASSAY; BINDING GLOBULIN AB Changes in thyroid function in the setting of systemic illness, surgery, or fasting are referred to as nonthyroidal illness syndrome (also called "sick euthyroid syndrome"). Nonthyroidal illness influences thyroid hormone production and action at multiple levels including the hypothalamic-pituitary-thyroid axis, thyroid hormone transport, and metabolism. This article reviews the pathophysiology of these changes and the influence on interpretation of thyroid function tests. Guidelines are provided for the assessment of thyroid function in sick patients and the options for treatment. C1 VA Greater Los Angeles Healthcare Syst, Dept Med, Div Endocrinol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. RP Brent, GA (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Med, Div Endocrinol, 11301 Wilshire Blvd, Los Angeles, CA USA. FU NIDDK NIH HHS [DK43714] NR 65 TC 20 Z9 23 U1 1 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-8529 J9 ENDOCRIN METAB CLIN JI Endocrinol. Metabol. Clin. North Amer. PD MAR PY 2002 VL 31 IS 1 BP 159 EP + AR PII S0889-8529(01)00008-1 DI 10.1016/S0889-8529(01)00008-1 PG 15 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 557RX UT WOS:000175922900010 PM 12055987 ER PT J AU Pahlavani, MA Vargas, DA Evans, TR Shu, JH Nelson, JF AF Pahlavani, MA Vargas, DA Evans, TR Shu, JH Nelson, JF TI Melatonin fails to modulate immune parameters influenced by calorie restriction in aging Fischer 344 rats SO EXPERIMENTAL BIOLOGY AND MEDICINE LA English DT Article DE melatonin; caloric restriction; immunomodulation; aging; rat ID INDUCED LYMPHOCYTE-PROLIFERATION; T-CELL PROLIFERATION; PINEAL-GLAND; OPIATERGIC MECHANISM; DIETARY RESTRICTION; ANTIBODY-RESPONSE; GENE-EXPRESSION; F344 RATS; MICE; SPLEEN AB The aim of this study was to determine if long-term treatment with melatonin (MEL), a purported anti-aging agent, was as effective as calorie restriction (CR) in modulating immune parameters in aging Fischer 344 male rats. Splenic lymphocytes were isolated from 17-month-old rats that, beginning at 6 weeks of age, were treated with MEL (4 or 16 mug/ml in drinking water) and from 17-month-old rats fed ad libitum (AL) or rats fed a CR diet (55% of AL intake). The number of splenic T cell populations and T cell subsets was measured by flow cytometry, the proliferative response of splenocytes to Concanavalin A (Con A) and lipopolysaccharide (LPS) was measured by [H-3]thymidine incorporation, and the induction of cytokine production (IL-2 and IFN-gamma) was measured by ELISA assay. In addition, the level of the natural killer (NK) cell activity was assessed by fluorimetric assay. CR rats had a higher number of lymphocytes expressing the naive T cell marker (CD3 OX22) than AL rats (P < 0.05). CR rats also showed greater induction of proliferative response, IL-2 and IFN-γ levels following Con A simulation, and NK cell activity than AL rats (P < 0.05). MEL-treated rats did not differ from AL rats in any of these parameters or in any other measurement. These results indicate that MEL treatment is unable to modulate immune function in a manner comparable with that of CR. C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Pahlavani, MA (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, GRECC 182, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. FU NIA NIH HHS [AG14088, AG00677, AG14932] NR 45 TC 9 Z9 10 U1 0 U2 0 PU SOC EXPERIMENTAL BIOLOGY MEDICINE PI MAYWOOD PA 195 WEST SPRING VALLEY AVE, MAYWOOD, NJ 07607-1727 USA SN 1535-3702 J9 EXP BIOL MED JI Exp. Biol. Med. PD MAR PY 2002 VL 227 IS 3 BP 201 EP 207 PG 7 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 522VM UT WOS:000173917700008 PM 11856819 ER PT J AU Dulai, GS AF Dulai, GS TI Surveying the case for surveillance SO GASTROENTEROLOGY LA English DT Editorial Material ID BARRETTS-ESOPHAGUS; CANCER RISK; ADENOCARCINOMA; DYSPLASIA; DIAGNOSIS; PATTERNS; PROGRAM; IMPACT C1 VA Greater Los Angeles Healtcare Syst, Ctr Study Digest Healthcare Qual & Outcomes, CURE Digest Dis Res Ctr, Los Angeles, CA USA. RP Dulai, GS (reprint author), VA Greater Los Angeles Healtcare Syst, Ctr Study Digest Healthcare Qual & Outcomes, CURE Digest Dis Res Ctr, Los Angeles, CA USA. FU NCRR NIH HHS [1K23 RR DK 00198-01] NR 26 TC 22 Z9 22 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD MAR PY 2002 VL 122 IS 3 BP 820 EP 823 DI 10.1053/gast.2002.32093 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 525EY UT WOS:000174056900030 PM 11875016 ER PT J AU Dulai, GS Gralnek, IM Oei, TT Chang, D Alofaituli, G Gornbein, J Kahn, K AF Dulai, GS Gralnek, IM Oei, TT Chang, D Alofaituli, G Gornbein, J Kahn, K TI Utilization of health care resources for low-risk patients with acute, nonvariceal upper GI hemorrhage: an historical cohort study SO GASTROINTESTINAL ENDOSCOPY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Society-for-Gastrointestinal-Endoscopy CY MAY 21-24, 2000 CL SAN DIEGO, CALIFORNIA SP Amer Soc Gastrointestinal Endoscopy ID UPPER GASTROINTESTINAL HEMORRHAGE; PEPTIC-ULCER HEMORRHAGE; OUTPATIENT MANAGEMENT; EARLY DISCHARGE; HOSPITALIZATION; ENDOSCOPY; SAFETY; TRIAL AB Background: Adults hospitalized with acute, nonvariceal upper GI hemorrhage can be accurately stratified according to their risk of subsequent adverse outcomes by using the Rockall score. Low-risk patients (Rockall score: 2) may be candidates for early discharge. Methods: Cases were identified with ICD-9-CM codes for calendar years 1997 and 1998. Medical record data to determine patient Rockall risk score, health care resource utilization, and adverse outcomes were abstracted with standardized forms. Results: Fifty-three of 175 (30%) cases had Rockall scores less than or equal to2. As predicted, those patients with Rockall scores less than or equal to2 had a low risk of adverse outcomes with only 2 of 53 (4%) meeting criteria for recurrent bleeding as defined by the "Rebleed" variable, and no mortality. These low-risk patients had a mean hospital stay of 2.6 +/- 2.1 days; 49% were admitted to an intermediate or intensive care unit bed and 57% were given H-2 receptor antagonists intravenously. Conclusions: The proportion of patients admitted with acute, nonvariceal, upper GI hemorrhage with Rockall Scores less than or equal to2 was substantial. Adverse outcomes were rare. In contrast, the level of health care resource utilization appeared high. The Rockall score has potential as a clinically based concurrent decision rule to improve the quality of care by finding those patients less likely to require intensive health care services. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, CURE Digest Res Ctr, Ctr Study Digest Healthcare Qual & Outcomes, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA 90073 USA. RP Gralnek, IM (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, CURE Digest Res Ctr, Ctr Study Digest Healthcare Qual & Outcomes, Bldg 115,Room 318,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 25 TC 31 Z9 31 U1 0 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD MAR PY 2002 VL 55 IS 3 BP 321 EP 327 DI 10.1067/mge.2002.121880 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 528KY UT WOS:000174244000003 PM 11868003 ER PT J AU El-Serag, HB Mason, AC Petersen, N Key, CR AF El-Serag, HB Mason, AC Petersen, N Key, CR TI Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA SO GUT LA English DT Article ID HELICOBACTER-PYLORI INFECTION; GASTROESOPHAGEAL REFLUX DISEASE; BARRETTS-ESOPHAGUS; INTESTINAL METAPLASIA; RISING INCIDENCE; PEPTIC-ULCER; ALCOHOL-USE; CANCER; PREVALENCE; TOBACCO AB Background and aims: It has been suggested that gastric cardia adenocarcinoma (GCA) is a distinct entity from oesophageal adenocarcinoma (OA). We examined several epidemiological features of GCA and OA in the USA to elucidate differences/similarities between these malignancies. Methods: Using the database of Surveillance, Epidemiology, and End Results (SEER) program, we examined incidence rates for temporal changes, and ethnic and age distributions, and performed birth cohort analyses for cases with morphologically and histologically confirmed OA or GCA. Results: The age adjusted incidence rates of OA rose progressively, reaching 1.8 per 100 000 (95% confidence interval 1.7-1.9) during 1987-1991 and 2.5 per 100 000 (2.3-2.6) during 1992-1996. In 1992-1996, Whites were affected five times more than Blacks, and men eight times more than women. A significant increase in incidence occurred among younger persons aged 45-65 years. Irrespective of age, OA was characterised by higher incidence rates among more recent birth cohorts: a 40% increase in incidence for each five year increase in the date of birth-a "birth cohort effect". On the other hand, the incidence rates of GCA reached their highest level of 3.3 per 100 000 (3.2-3.4) in 1987-1991 and subsequently declined during 1992-1996 to 3.1 per 100 000 (3.0-3.3). Whites were affected twice more than blacks and men five times more than women. Most patients with GCA were older than 60 years with no increase among younger persons and no birth cohort effect (p=0.99). Conclusion: Several significant epidemiological differences exist between OA and GCA. These differences suggest that these two malignancies are separate entities with different risk factors. C1 Houston Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Univ New Mexico, Albuquerque, NM 87131 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr, Gastroenterol Sect, 152,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 31 TC 169 Z9 173 U1 0 U2 1 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD MAR PY 2002 VL 50 IS 3 BP 368 EP 372 DI 10.1136/gut.50.3.368 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 524FZ UT WOS:000174003600017 PM 11839716 ER PT J AU Martinez, M Lopez-Ribot, JL Kirkpatrick, WR Bachmann, SP Perea, S Ruesga, MT Patterson, TF AF Martinez, M Lopez-Ribot, JL Kirkpatrick, WR Bachmann, SP Perea, S Ruesga, MT Patterson, TF TI Heterogeneous mechanisms of azole resistance in Candida albicans clinical isolates from an HIV-infected patient on continuous fluconazole therapy for oropharyngeal candidosis SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; AMINO-ACID SUBSTITUTIONS; ANTIFUNGAL AGENTS; DRUG-RESISTANCE; IN-VITRO; LANOSTEROL 14-ALPHA-DEMETHYLASE; REDUCED AFFINITY; CHROMOGENIC AGAR; SUSCEPTIBILITY; CONTRIBUTE AB Molecular mechanisms of azole resistance in Candida albicans include alterations in the target enzyme and increased efflux of drug, but the impact of specific treatment regimens on resistance has not been established. A patient with advanced AIDS was enrolled in a longitudinal study to receive continuous oral fluconazole (FLU) 200 mg/day for the treatment of oropharyngeal candidosis (OPC). Oral cultures were obtained at time of enrolment, during episodes of OPC and quarterly for surveillance. The patient had five symptomatic relapses on continuous FLU during 43 months. All OPC episodes were successfully treated with increasing doses of FLU although increased FLU MICs were detected for C. albicans isolates with progression of time. DNA-typing techniques demonstrated that resistance developed in a persistent strain of C. albicans. Both FLU-resistant and isogenic isolates with reduced susceptibility were detected in the same clinical samples through multiple episodes. Analysis of molecular mechanisms of resistance revealed overexpression of MDR and CDR genes encoding efflux pumps (but not ERG11) in isolates with decreased FLU susceptibility. In addition, the presence of the G464S amino acid substitution in their lanosterol demethylase, affecting its affinity for FLU, was also detected. However, other isogenic, but FLU-susceptible isolates recovered from the same samples did not harbour the mutation, indicating micro-evolution of yeast populations within the oral cavity. In this patient, the continuous antifungal pressure exerted by FLU resulted in development of resistance of multifactorial nature. Despite their clonal origin, different subpopulations of C. albicans demonstrated distinct resistance mechanisms, including concomitant presence and absence of functional point mutations in ERG11 genes. C1 Univ Texas, Hlth Sci Ctr, S Texas Ctr Biol Med, Dept Med,Div Infect Dis, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX USA. Univ Basque Country, Fac Med & Odontol, Dept Microbiol Immunol & Parasitol, Lejona, Vizcaya, Spain. RP Lopez-Ribot, JL (reprint author), Univ Texas, Hlth Sci Ctr, S Texas Ctr Biol Med, Dept Med,Div Infect Dis, San Antonio, TX 78284 USA. EM ribot@uthsesa.edu RI Lopez-Ribot, Jose/D-2048-2010 FU NCRR NIH HHS [M01 RR 01346]; NIAID NIH HHS [R20 AI 42401]; NIDCR NIH HHS [5R01 DE 11381-04A2] NR 42 TC 29 Z9 39 U1 0 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD MAR PY 2002 VL 49 IS 3 BP 515 EP 524 DI 10.1093/jac/49.3.515 PG 10 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 530QF UT WOS:000174369900011 PM 11864952 ER PT J AU Levine, S Gregory, C Nguyen, T Shrager, J Kaiser, L Rubinstein, N Dudley, G AF Levine, S Gregory, C Nguyen, T Shrager, J Kaiser, L Rubinstein, N Dudley, G TI Bioenergetic adaptation of individual human diaphragmatic myofibers to severe COPD SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE chronic obstructive pulmonary disease; human diaphragm; succinate dehydrogenase; calcium-activated myosin ATPase; mitochondrial oxidative capacity; diaphragmatic fatigue; muscle fatigue ID OBSTRUCTIVE PULMONARY-DISEASE; ELASTASE-INDUCED EMPHYSEMA; SKELETAL-MUSCLE FIBERS; MYOSIN HEAVY-CHAINS; SPINAL-CORD INJURY; ATPASE ACTIVITY; NORMAL MEN; SUCCINATE-DEHYDROGENASE; MULTIPLE-SCLEROSIS; CRURAL DIAPHRAGM AB To assess the effect of severe chronic obstructive pulmonary disease (COPD) on the ability of human diaphragmatic myofibers to aerobically generate ATP relative to ATP utilization, we obtained biopsy specimens of the costal diaphragm from seven patients with severe COPD (mean +/- SE; age 56 +/- 1 yr; forced expiratory volume in 1 s 23 +/- 2% predicted; residual volume 267 +/- 30% predicted) and seven age-matched control subjects. We categorized all fibers in these biopsies by using standard techniques, and we carried out the following quantitative histochemical measurements by microdensitometry: 1) succinate dehydrogenase (SDH) activity as an indicator of mitochondrial oxidative capacity and 2) calcium-activated myosin ATPase (mATPase) activity, the ATPase that represents a major portion of ATP consumption by contracting muscle. We noted the following: 1) COPD diaphragms had a larger proportion of type I fibers, a lesser proportion of type IIax fibers, and the same proportion of type IIa fibers as controls. 2) SDH activities of each of the fiber types were higher in COPD than control diaphragms (P < 0.0001); the mean increases expressed as percent of control values) in types I, IIa, and IIax were 84, 114, and 130%, respectively. 3) COPD elicited no change in mATPase activity of type I and IIa fibers, but mATPase decreased in type IIax fibers (P = 0.02).4) Mitochondrial oxidative capacity relative to ATP demand (i.e., SDH/ mATPase) was higher (P = 0.03) in each of the fiber types in COPD diaphragms than in controls. These results demonstrate that severe COPD elicits an increase in aerobic ATP generating capacity relative to ATP utilization in all diaphragmatic fiber types as well as the previously described fast-to-slow fiber type transformation (Levine S, Kaiser L, Leferovich J, and Tikunov B, N Engl J Med 337: 1799-1806, 1997). C1 Vet Affairs Med Ctr, Med Serv, Philadelphia, PA 19004 USA. Vet Affairs Med Ctr, Surg Serv, Philadelphia, PA 19004 USA. Vet Affairs Med Ctr, Res Serv, Philadelphia, PA 19004 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Surg, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Cell & Dev Biol, Philadelphia, PA 19104 USA. Univ Georgia, Dept Exercise Sci, Athens, GA 30602 USA. RP Levine, S (reprint author), Vet Affairs Med Ctr, Med Serv, Univ & Woodland Ave, Philadelphia, PA 19004 USA. NR 53 TC 82 Z9 87 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD MAR PY 2002 VL 92 IS 3 BP 1205 EP 1213 DI 10.1152/japplphysiol.00116.2001 PG 9 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 523NF UT WOS:000173960100042 PM 11842060 ER PT J AU Faulkner, KG Orwoll, E AF Faulkner, KG Orwoll, E TI Implications in the use of T-scores for the diagnosis of osteoporosis in men SO JOURNAL OF CLINICAL DENSITOMETRY LA English DT Article DE T-scores; men; osteoporosis; normative data; WHO criteria ID BONE-DENSITY; FRACTURE RISK; WOMEN AB Osteoporosis is recognized as a disorder of both men and women. However, the World Health Organization's (WHO) definition of osteoporosis (a bone mineral density [BMD] T-score of -2.5 or less) was formulated for use with postmenopausal women only. In the absence of a BMD-based definition for male osteoporosis, the WHO definition is often applied to men as well. Several important questions exist when considering the use of T-scores in men. First, is the WHO definition appropriate for men? What is the impact of using a -2.5 criteria, in terms of the number of men that would be identified as osteoporotic? When calculating T-scores in men, should male or female young normal values be used? Can the same T-score criteria be used for all skeletal sites and technologies? To address these questions, osteoporosis prevalence estimates for men aged 50 yr and over were generated using WHO methods and manufacturer normative data from dual-energy x-ray absorptiometry (DXA), quantitative computed tomography (QCT), and ultrasound. Estimates were determined for several skeletal sites and technologies using both male and female young normal values. Prevalence estimates were compared to published fracture risk estimates. Mean T-scores declined with acre at all measurement sites. Discrepancies were found between the different skeletal sites and techniques, similar to the previously reported differences in women. A -2.5 criterion (based on young normal males or females) appeared to underestimate the prevalence of osteoporosis, except for QCT, which seemed to overestimate risk. Depending on the technique used, 0 to 12.5 million US men 50 yr of age and older would be classified as osteoporotic using or the WHO definition. T-Scores based on male norms were less discordant across skeletal sites than female-based T-scores. Male-based T-scores between -1.8 and -2.3 using DXA and ultrasound and -3.1 for QCT provided osteoporosis prevalence estimates that approximated the likelihood of common fractures in men 50 and over. We conclude that the use of single T-score-based criterion for the diagnosis of osteoporosis in men has many potential difficulties. BMD measurement techniques provide discrepant estimates of prevalence and may underestimate the size of the male population at risk for fracture. Based on available normative data, a -2.5 criterion underestimates osteoporosis prevalence in men, whether based on male or female norms. Prospective studies are needed to further refinement to the BMD definition of osteoporosis in men. C1 Synarc, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. RP Faulkner, KG (reprint author), 726 Heartland Trail, Madison, WI 53717 USA. OI Orwoll, Eric/0000-0002-8520-7355 NR 15 TC 44 Z9 44 U1 0 U2 2 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 1094-6950 J9 J CLIN DENSITOM JI J. Clin. Densitom. PD SPR PY 2002 VL 5 IS 1 BP 87 EP 93 DI 10.1385/JCD:5:1:087 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 542UB UT WOS:000175061700012 PM 11940733 ER PT J AU McElroy, SL Frye, MA Suppes, T Dhavale, D Keck, PE Leverich, GS Altshuler, L Denicoff, KD Nolen, WA Kupka, R Grunze, H Walden, J Post, RM AF McElroy, SL Frye, MA Suppes, T Dhavale, D Keck, PE Leverich, GS Altshuler, L Denicoff, KD Nolen, WA Kupka, R Grunze, H Walden, J Post, RM TI Correlates of overweight and obesity in 644 patients with bipolar disorder SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID MAJOR DEPRESSIVE DISORDER; BODY-WEIGHT GAIN; EATING DISORDER; PREVALENCE; LITHIUM; MECHANISMS; MANAGEMENT; ENDOCRINE; WOMEN AB Objective: Overweight and obesity are common clinical problems encountered in the treatment of bipolar disorder. We therefore assessed the prevalence and clinical correlates of overweight, obesity, and extreme obesity in 644 bipolar patients. Method: 644 outpatients with DSM-IV bipolar disorder in the Stanley Foundation Bipolar Treatment Outcomes Network were evaluated with structured diagnostic interviews and clinician- and self-administered questionnaires to determine bipolar disorder diagnoses, demographic and historical illness characteristics, comorbid Axis I diagnoses, medical histories, health habits, and body mass indices (BMIs). Results: Fifty-eight percent of the patients with bipolar disorder were overweight, 21% were obese, and 5% were extremely obese. American patients had significantly higher mean (p < .0001) BMIs and significantly higher rates of obesity (p < .001) and extreme obesity (p < .001) than European patients. Significant associations (p:.001) were found between over-weight, obesity, and extreme obesity and gender, age, income level, comorbid binge-eating disorder, hypertension, arthritis, diabetes mellitus, exercise habits, and coffee consumption. Current BMI and weight were each correlated with the number of weight gain-associated psycho-tropics to which patients had been exposed. Multinomial logistic regression (adjusted for site and eating disorder diagnosis and corrected for multiple comparisons) showed that (1) overweight was significantly associated with male gender and hypertension (p < .001), (2) obesity was significantly associated with hypertension (p < .001), and (3) extreme obesity was significantly associated with hypertension and arthritis (p < .001). Conclusion: Overweight, obesity, and extreme obesity were common in this group of bipolar patients, although it was unclear that their prevalence rates were truly elevated, because overweight and obesity are increasingly common public health problems among the general population. Correlates of overweight and obesity in bipolar disorder include patient and treatment variables such as gender, geographical location, comorbid binge-eating disorder, age, income level, degree of exposure to weight gain-associated psychotropics, medical disorders associated with obesity, and health habits. C1 Univ Cincinnati, Coll Med, Biol Psychiat Program, Dept Psychiat,Stanley Fdn Bipolar Treatment Outco, Cincinnati, OH 45267 USA. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. W Los Angeles VA Med Ctr, Los Angeles, CA USA. Univ Texas, SW Med Ctr, Dallas, TX USA. NIMH, Biol Psychiat Branch, Bethesda, MD 20892 USA. Univ Utrecht, Med Ctr, Utrecht, Netherlands. Altrecht Inst Mental Hlth Care, Utrecht, Netherlands. LMU Univ Hosp, Dept Psychiat, Munich, Germany. Univ Hosp, Dept Psychiat, Freiburg, Germany. RP McElroy, SL (reprint author), Univ Cincinnati, Coll Med, Biol Psychiat Program, Dept Psychiat,Stanley Fdn Bipolar Treatment Outco, POB 670559,231 Albert Sabin Way, Cincinnati, OH 45267 USA. RI Nolen, Willem/E-9006-2014 NR 43 TC 214 Z9 218 U1 4 U2 12 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD MAR PY 2002 VL 63 IS 3 BP 207 EP 213 PG 7 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 534WU UT WOS:000174613400006 PM 11926719 ER PT J AU Wirshing, DA Boyd, JA Pierre, JM Saunders, CS Wirshing, WC Azizian, K Patel, KR Ashcraft, JC Darmandjian, H Feusner, J AF Wirshing, DA Boyd, JA Pierre, JM Saunders, CS Wirshing, WC Azizian, K Patel, KR Ashcraft, JC Darmandjian, H Feusner, J TI Delusions associated with quetiapine-related weight redistribution SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Letter ID ADIPOSE-TISSUE; PSEUDOCYESIS; PREGNANCY; GAIN C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. Univ So Calif, Sch Pharm, Los Angeles, CA USA. RP Wirshing, DA (reprint author), VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RI Feusner, Jamie/K-2312-2012 OI Feusner, Jamie/0000-0002-0391-345X NR 12 TC 2 Z9 3 U1 2 U2 2 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD MAR PY 2002 VL 63 IS 3 BP 247 EP 248 PG 2 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 534WU UT WOS:000174613400014 PM 11926726 ER PT J AU Friedlander, AH Garrett, N Norman, D AF Friedlander, AH Garrett, N Norman, D TI Prevalence of atheromas on panographs of patients with type 2 diabetes. SO JOURNAL OF DENTAL RESEARCH LA English DT Meeting Abstract C1 VA Greater Los Angeles, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU INT AMER ASSOC DENTAL RESEARCHI A D R/A A D R PI ALEXANDRIA PA 1619 DUKE ST, ALEXANDRIA, VA 22314-3406 USA SN 0022-0345 J9 J DENT RES JI J. Dent. Res. PD MAR PY 2002 VL 81 SI SI MA 3992 BP A488 EP A488 PG 1 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 559KE UT WOS:000176024703958 ER PT J AU Mayfield, JA Caps, MT Boyko, EJ Ahroni, JH Smith, DG AF Mayfield, JA Caps, MT Boyko, EJ Ahroni, JH Smith, DG TI Relationship of medial arterial calcinosis to autonomic neuropathy and adverse outcomes in a diabetic veteran population SO JOURNAL OF DIABETES AND ITS COMPLICATIONS LA English DT Article DE autonomic neuropathy; medial arterial calcinosis; ulceration; amputation; mortality ID FOOT ULCERATION; FOLLOW-UP; CALCIFICATION; NIDDM; PREDICTORS; DIAGNOSIS; MELLITUS; TESTS; RISK AB Statement of the problem: Medial arterial calcinosis (MAC) is associated with neuropathy, amputation, and mortality through an unknown mechanism. We hypothesized that MAC was a marker of autonomic neuropathy rather than a risk factor and that the outcomes were due to autonomic neuropathy. Methods: All subjects in an ongoing prospective study of diabetic foot conditions in a diabetic veteran cohort who received a foot radiograph between 11/7/90 and 11/5/93 were included. Autonomic neuropathy measured as either heart rate variability with timed respiration or postural hypotension. A logistic model predicted the presence of MAC at baseline and Cox proportional models assessed the relative contribution of autonomic neuropathy and traditional risk factors for the outcomes of ulceration, amputation, and death. Results: MAC was identified in 181 subjects, no MAC in 253 subjects, and 39 were excluded due to disagreement between observers. Both measures of autonomic neuropathy were independent predictors of MAC at baseline, even after adjustment for vibration sensation loss in a logistic model. MAC was associated with an increased risk for ulceration (hazards ratio. HR: 2.1, 95% confidence intervals, CI, 1.4-3.1), amputation (HR 3.3, 95% CI 1.5-7.4), and mortality (HR 1.6, 95% CI 1.1-2.2). The addition of either autonomic measure of neuropathy did not change the MAC HR or significantly improved the fit of the model. Conclusions: Our hypothesis that the excess mortality, amputation, and ulceration in persons with MAC could be explained by autonomic neuropathy measured as postural hypotension or heart rate variability with measured respiration was not supported. (C) 2002 Elsevier Science Inc. All rights reserved. C1 Univ Washington, Seattle ERIC VA Puget Sound, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Res & Dev Serv, Seattle, WA USA. Univ Washington, Dept Vasc Surg, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Surg Serv, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Nursing, Dept Biobehav Nursing & Hlth Syst, Seattle, WA 98195 USA. Univ Washington, Dept Orthoped Surg, Seattle, WA 98195 USA. RP Boyko, EJ (reprint author), Univ Washington, Seattle ERIC VA Puget Sound, S-111 GIMC,1660 S Columbian Way, Seattle, WA 98108 USA. OI Boyko, Edward/0000-0002-3695-192X NR 30 TC 10 Z9 10 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1056-8727 J9 J DIABETES COMPLICAT JI J. Diabetes Complications PD MAR-APR PY 2002 VL 16 IS 2 BP 165 EP 171 AR PII S1056-8727(01)00178-7 DI 10.1016/S1056-8727(01)00178-7 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 537RD UT WOS:000174772500006 PM 12039400 ER PT J AU Reiner, B Siegel, E Scanlon, M AF Reiner, B Siegel, E Scanlon, M TI Changes in technologist productivity with implementation of an enterprisewide PACS SO JOURNAL OF DIGITAL IMAGING LA English DT Article DE picture archival and communications system; technologist productivity ID FILMLESS AB The purpose of this report is to determine what effect filmless operation has on technologist productivity when compared with traditional film-based operation. Retrospective data on technologist productivity was collected from the study institution before and after implementation of PACS using workload reports and payroll records. Departmentwide technologist productivity was defined as the number of examinations per full-time equivalent (exams/FTE) and correlated with local and nationwide standards operating in traditional film-based operations. During film-based operation, technologist productivity was comparable between the study institution and nationwide standards, allowing for the unique examination volumes and modality mix. After implementation of a large-scale PACS, technologist productivity was found to increase 34% above that of national standards and 48% that of the local control site, Implementation of an enterprisewide PACS offers the potential to significantly improve departmentwide technologist productivity when compared with traditional film-based operation. C1 Univ Maryland, Sch Med, Dept Radiol, Baltimore, MD 21201 USA. Vet Affairs Med Ctr, Dept Radiol, Philadelphia, PA USA. RP Reiner, B (reprint author), Dept Diagnost Radiol, 10 N Greene St, Baltimore, MD 21201 USA. NR 18 TC 14 Z9 14 U1 0 U2 1 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0897-1889 J9 J DIGIT IMAGING JI J. Digit. Imaging PD MAR PY 2002 VL 15 IS 1 BP 22 EP 26 DI 10.1007/s10278-002-0999-y PG 5 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 569YR UT WOS:000176631300004 PM 12134211 ER PT J AU Vig, EK Brodkin, KI Raugi, GJ Gladstone, H AF Vig, EK Brodkin, KI Raugi, GJ Gladstone, H TI Blue rubber bleb nevus syndrome in a patient with ataxia and dementia SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY, 2000 CL NASHVILLE, TENNESSEE SP Amer Geriatr Soc ID NATURAL-HISTORY; CAVERNOUS ANGIOMAS; MALFORMATIONS; INVOLVEMENT; KRIT1 AB Blue rubber bleb nevus syndrome (BRBNS), an uncommon disorder characterized by cavernous hemangiomas, most often of the skin and gastrointestinal tract, is usually diagnosed during childhood and young adulthood. We made this diagnosis in an octogenarian referred to a geriatric medicine clinic because of concerns about his ability to live independently. Ataxia, dementia, focal neurologic signs, and bluish/purplish vascular nodules on his lips, buccal mucosa, tongue, chest, and neck were noted on physical examination. Magnetic resonance imaging (MRI) revealed an old left parietal infarction, multiple cavernous hemangiomas most densely concentrated in the subcortical structures and cerebellum, and areas of hemosiderin deposition. Skin biopsy findings were consistent with hemangioma. The physical examination, MRI, and skin biopsy made a diagnosis of BRBNS likely. The patient's ataxia, dementia, and other neurologic signs can be explained by previous hemorrhage from the vascular malformations in his brain. Blue rubber bleb nevus syndrome is an uncommon cause of a relatively common geriatric syndrome presentation. C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Calif Los Angeles, Dept Med, Sch Med, Div Dermatol, Los Angeles, CA USA. Univ Washington, Harborview Med Ctr, Div Gerontol & Geriatric, Seattle, WA 98104 USA. Univ Washington, Harborview Med Ctr, Div Dermatol, Dept Med, Seattle, WA 98104 USA. RP Vig, EK (reprint author), Univ Washington, Harborview Med Ctr, Div Gerontol & Geriatric, 325 9Th Ave,Box 359755, Seattle, WA 98104 USA. NR 19 TC 5 Z9 7 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD SPR PY 2002 VL 15 IS 1 BP 7 EP 11 DI 10.1177/089198870201500102 PG 5 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 532GT UT WOS:000174466500002 PM 11936246 ER PT J AU Harwood, DG Sultzer, DL AF Harwood, DG Sultzer, DL TI "Life is not worth living": Hopelessness in Alzheimer's disease SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article ID NEUROBEHAVIORAL RATING-SCALE; MINI-MENTAL-STATE; VASCULAR DEMENTIA; ELDERLY SUBJECTS; MEMORY DEFICIT; CORNELL SCALE; DEPRESSION; DIAGNOSIS; SUICIDE; RELIABILITY AB This study investigated the prevalence and clinical correlates of hopelessness among 91 patients diagnosed with probable Alzheimer's disease (AD) according to National Institute of Neurological Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria. Hopeless ideation was measured with Item 3 on the Hamilton Depression Rating Scale (Suicide), which inquires specifically whether the patient thinks "life is not worth living." The results showed that hopelessness was present in 10% (n = 9) of the sample. Patients with these cognitions evidenced greater psychological symptoms of mood disturbance and more insight into their cognitive and functional impairments. Unrelated factors included age, education, Mini-Mental State Examination score, neurovegetative signs of depression, affective expressions of depression, agitation/disinhibition, and psychosis. Although indifference is frequent in AD, these results indicate that thoughts of hopelessness are also a common phenomenon, occurring in approximately 10% of our probable AD cohort. These thoughts appear to be related to the subjective expressions of depression and anxiety rather than the neurovegetative or affective signs and are more prominent among patients with greater deficit awareness. C1 VA Greater Los Angeles Healthcare Syst, Mental Hlth Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Neuropsychiat Inst & Hosp, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Sultzer, DL (reprint author), W Los Angeles VA Healthcare Ctr, 11301 Wilshire Blvd,3 South,116AF, Los Angeles, CA 90073 USA. FU NIMH NIH HHS [MH00910, MH56031] NR 45 TC 16 Z9 17 U1 2 U2 5 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD SPR PY 2002 VL 15 IS 1 BP 38 EP 43 DI 10.1177/089198870201500108 PG 6 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 532GT UT WOS:000174466500008 PM 11936242 ER PT J AU Berfield, AK Abrass, CK AF Berfield, AK Abrass, CK TI IGF-1 induces foam cell formation in rat glomerular mesangial cells SO JOURNAL OF HISTOCHEMISTRY & CYTOCHEMISTRY LA English DT Article DE mesangial cell; IGF-1; atherosclerosis; lipids; glomerulosclerosis; phagocytosis ID GROWTH-FACTOR-I; LOW-DENSITY-LIPOPROTEIN; SCAVENGER RECEPTOR; INSULIN; CHOLESTEROL; BINDING; CULTURE; ENDOCYTOSIS; NEPHROPATHY; EXPRESSION AB When rat glomerular mesangial cells (MCs) are cultured with IGF-1 they accumulate intracellular lipid and take on foam cell morphology. These changes were characterized by electron microscopy and Nile red staining. To define the mechanism responsible for IGF-1-mediated lipid uptake, MCs were evaluated for endocytosis, scavenger receptor activity, and receptor-mediated uptake by the LDL receptor. Lipid accumulation was markedly increased when MCs were cultured with IGF. The primary route of uptake was through enhanced endocytosis. Lipid-laden MCs have decreased phagocytic capacity and disrupted cytoskeletons. These data show that IGF-1 induces MC to take on a foam cell morphology and that lipid-laden MCs have impaired phagocytic function. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Abrass, CK (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 111A,1660 S Columbian Way, Seattle, WA 98108 USA. NR 42 TC 13 Z9 14 U1 0 U2 0 PU HISTOCHEMICAL SOC INC PI SEATTLE PA UNIV WASHINGTON, DEPT BIOSTRUCTURE, BOX 357420, SEATTLE, WA 98195 USA SN 0022-1554 J9 J HISTOCHEM CYTOCHEM JI J. Histochem. Cytochem. PD MAR PY 2002 VL 50 IS 3 BP 395 EP 403 PG 9 WC Cell Biology SC Cell Biology GA 525GR UT WOS:000174061000010 PM 11850441 ER PT J AU Mann, MB Wu, SJ Rostamkhani, M Tourtellotte, W MacMurray, JP Comings, DE AF Mann, MB Wu, SJ Rostamkhani, M Tourtellotte, W MacMurray, JP Comings, DE TI Association between the phenylethanolamine N-methyltransferase gene and multiple sclerosis SO JOURNAL OF NEUROIMMUNOLOGY LA English DT Article DE multiple sclerosis; PNMT; norepinephrine; epinephrine; SNP ID MULTIVARIATE-ANALYSIS; CONDUCT DISORDER; SUSCEPTIBILITY; SCREEN; TWINS; LOCI; PNMT; ENCEPHALOMYELITIS; DISEASE; LINKAGE AB Phenylethanolamine N-methyltransferase (PNMT), the terminal enzyme of the catecholamine biosynthesis pathway, catalyzes the conversion of norepinephrine (NE) to epinephrine (EPI). PNMT is a candidate gene for multiple sclerosis (MS) for two reasons. PNMT is known to map to a region identified in two genome screens for MS and it directly regulates the amounts of NE and EPI, both of which play a significant role in the modulation of the innate immune response. The frequencies of two promoter polymorphisms of the PNMT gene showed genetic association in a case-control study of 108 patients with MS and 774 ethnically and age-matched control subjects. In subjects with MS, significant differences in the frequency of the GG genotype at the G - 387A marker and the AA genotype at the G - 182A marker were observed. Additionally, when both markers were combined and evaluated, highly significant differences between the polymorphism distributions in patients with MS and control subjects were detected. The data suggest that these promoter polymorphisms of the PNMT gene, both independently and cumulatively, show association with MS. (C) 2002 Elsevier Science B.V. All rights reserved. C1 MGI Appl Genomics, Dept Genomics, Long Beach, CA USA. Los Angeles Vet Affairs Med Ctr, Dept Neurol, Los Angeles, CA USA. Calif State Polytech Univ Pomona, Dept Biol Sci, Pomona, CA 91768 USA. City Hope Natl Med Ctr, Dept Med Genet, Duarte, CA 91010 USA. RP Mann, MB (reprint author), Case Western Reserve Univ, Sch Med, Dept Genet, Cleveland, OH 44106 USA. OI Mann, Michael/0000-0002-7515-6515 NR 31 TC 12 Z9 14 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-5728 J9 J NEUROIMMUNOL JI J. Neuroimmunol. PD MAR PY 2002 VL 124 IS 1-2 BP 101 EP 105 AR PII S0165-5728(02)00009-7 DI 10.1016/S0165-5728(02)00009-7 PG 5 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 536EW UT WOS:000174688600013 PM 11958827 ER PT J AU Hurley, RA Reneman, L Taber, KH AF Hurley, RA Reneman, L Taber, KH TI Ecstasy in the brain: A model for neuroimaging SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID MDMA ECSTASY; 3,4-METHYLENEDIOXYMETHAMPHETAMINE MDMA; SEROTONIN NEUROTOXICITY; EMISSION-TOMOGRAPHY; USERS; TRANSPORTER; INGESTION; NEURONS; MEMORY; DRUG C1 Baylor Coll Med, Dept Radiol, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Herbert J Frensley Ctr Imaging Res, Houston, TX 77030 USA. Acad Med Ctr, Sch Neurosci, Amsterdam, Netherlands. RP Taber, KH (reprint author), Baylor Coll Med, Dept Radiol, 1 Baylor Plaza, Houston, TX 77030 USA. NR 31 TC 9 Z9 9 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SPR PY 2002 VL 14 IS 2 BP 125 EP 129 DI 10.1176/appi.neuropsych.14.2.125 PG 5 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 555JB UT WOS:000175790000001 PM 11983786 ER PT J AU Lim, GT Mendez, MF Bronstein, YL Jouben-Steele, L Vinters, HV AF Lim, GT Mendez, MF Bronstein, YL Jouben-Steele, L Vinters, HV TI Clinicopathologic case report: Akinetic mutism with findings of white matter hyperintensity SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID FRONTAL-SUBCORTICAL CIRCUITS; VASCULAR DEMENTIA; BINSWANGERS-DISEASE; MAGNETIC-RESONANCE; LEUKO-ARAIOSIS; ALZHEIMERS-DISEASE; OXYGEN-METABOLISM; LESIONS; DIAGNOSIS; MRI C1 Univ Calif Los Angeles, Med Ctr, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Med Ctr, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Med Ctr, Dept Pathol & Lab Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Med Ctr, Brain Res Inst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Med Ctr, Inst Neuropsychiat, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 44 TC 2 Z9 2 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SPR PY 2002 VL 14 IS 2 BP 214 EP 221 DI 10.1176/appi.neuropsych.14.2.214 PG 8 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 555JB UT WOS:000175790000014 PM 11983799 ER PT J AU Blake, DJ Bodine, C AF Blake, DJ Bodine, C TI An overview of assistive technology for persons with multiple sclerosis SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Review ID DYSFUNCTION AB Multiple sclerosis (MS) is a progressive neurologic disease clinically characterized by episodes of focal disorder of the cranial nerves, spinal cord, and the brain. MS affects a significant number of young adults, and they most often face a future of progressive functional losses as more of their central nervous system and cranial nerves are affected. As the disease progresses, they have new impairments with accompanying limitations in activities, restrictions to their participation in life, and compromised quality of life. Assistive technology includes any item that is used to maintain or improve functional capabilities. The rehabilitation healthcare provider has many opportunities to intervene with assistive technologies to decrease activity limitations and participation restrictions. The purpose of this article is to (1) review the impairments and associated activity limitations and participations restrictions experienced by persons with MS, (2) provide an overview of high- and low-tech assistive technologies appropriate for persons with MS, (3) discuss funding opportunities for assistive technologies, (4) review cur-rent studies of assistive technology used for persons with MS and discuss future research directions, and (5) consider assistive technology as an intervention for disability prevention. C1 Denver Vet Affairs Med Ctr, Phys Med Serv, Denver, CO 80220 USA. Denver Vet Affairs Med Ctr, Rehabil Serv, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Rehabil Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Assist Technol Partners, Denver, CO 80218 USA. RP Blake, DJ (reprint author), Denver Vet Affairs Med Ctr, Phys Med Serv, Denver, CO 80220 USA. NR 28 TC 18 Z9 19 U1 0 U2 6 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD MAR-APR PY 2002 VL 39 IS 2 BP 299 EP 312 PG 14 WC Rehabilitation SC Rehabilitation GA 556RR UT WOS:000175863200014 PM 12051472 ER PT J AU Weeks, WB Yano, EM Rubenstein, LV AF Weeks, WB Yano, EM Rubenstein, LV TI Primary care practice management in rural and urban veterans health administration settings SO JOURNAL OF RURAL HEALTH LA English DT Article; Proceedings Paper CT Annual Meeting of the Veterans-Administration-Health-Services-Research-and-Deveolpment-Service (HSR&D) CY FEB, 2001 CL WASHINGTON, D.C. ID ACCESS; VA AB Limited access to specialty care in rural settings may result in more expectations of primary care providers and a higher demand for primary care. The authors used survey and administrative data from 1999 from the Veterans Health Administration (VHA) to compare primary care practice management and performance in 19 rural to 103 urban VHA hospitals nationally. Rural VHA hospitals were smaller, less likely to be academically affiliated, and had fewer integrated specialty care services. Primary care providers in rural settings were more likely to manage specialty care services, provide continuity across patient care settings, and have complete responsibility for a broader range of services. However, rural hospitals had more staff per patient allocated to primary care than did urban hospitals. Patients in rural settings received comparable quality care to those in urban settings, and they appeared to be more satisfied with the care they received. Within the VHA system, primary care providers in rural settings provided a broader range of services than those in urban ones. This increased breadth may be attributable to the lack of availability of integrated specialty care services in rural settings. Because of this broader range of responsibilities, the provision of primary care in rural settings may require higher staffing patterns and may be inherently more costly than in urban settings; therefore, researchers should be cautious when comparing primary care expenditures across rural and urban settings. C1 Vet Adm Med Ctr, White River Jct, VT USA. VA Greater Los Angeles Healthcare Syst, Vet Affairs Greater Los Angeles Hlth Serv Res & D, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA 90406 USA. RP Weeks, WB (reprint author), Vet Adm Med Ctr, 111Q, White River Jct, VT USA. RI Weeks, William/G-7436-2014 NR 16 TC 23 Z9 23 U1 0 U2 0 PU NATL RURAL HEALTH ASSOC PI KANSAS CITY PA ONE WEST ARMOUR BLVD, STE 301, KANSAS CITY, MO 64111 USA SN 0890-765X J9 J RURAL HEALTH JI J. Rural Health PD SPR PY 2002 VL 18 IS 2 BP 298 EP 303 DI 10.1111/j.1748-0361.2002.tb00890.x PG 6 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 588GN UT WOS:000177693900005 PM 12135150 ER PT J AU Baer, JS AF Baer, JS TI Student factors: Understanding individual variation in college drinking SO JOURNAL OF STUDIES ON ALCOHOL LA English DT Review ID ALCOHOL-RELATED PROBLEMS; HEAVY DRINKING; OUTCOME EXPECTANCIES; SENSATION SEEKING; SOCIAL-CONTEXT; GAME PARTICIPATION; GENDER DIFFERENCES; ANXIETY DISORDERS; YOUNG ADULTHOOD; BINGE DRINKING AB Objective: Research on individual differences in drinking rates and associated problems among college students is reviewed. Method: Studies are included if completed within U.S, college and university samples and found in published scientific literature as identified by several searches of national databases. Results. The resulting review suggests first that the extant literature is large and varied in quality, as most studies use questionnaire responses from samples of convenience in cross-sectional designs. Evidence from studies of college samples does consistently suggest that alcohol is consumed for several different purposes for different psychological effects in different contexts. A pattern Of impulsivity sensation seeking is strongly related to increased drinking among students. This pattern is supported by research into personality, drinking motives, alcohol expectancies anti drinking contexts. A second pattern of drinking associated with negative emotional states is also documented. Some long-term consequences of this second pattern have been described. Social processes appear especially important for drinking in many college venues and may contribute to individual differences in drinking more than enduring personality differences, Conclusions. Future research efforts should test interactive and mediating models of multiple risk factors and address developmental processes. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. RP Baer, JS (reprint author), VA Puget Sound Hlth Care Syst, S-116-ATC,1660 S Columbian Way, Seattle, WA 98108 USA. NR 105 TC 54 Z9 56 U1 4 U2 16 PU ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV PI PISCATAWAY PA C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA SN 0096-882X J9 J STUD ALCOHOL JI J. Stud. Alcohol PD MAR PY 2002 SU 14 BP 40 EP 53 PG 14 WC Substance Abuse; Psychology SC Substance Abuse; Psychology GA 548KN UT WOS:000175387300005 ER PT J AU Terpenning, M Shay, K AF Terpenning, M Shay, K TI Oral health is cost-effective to maintain but costly to ignore SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Editorial Material ID HOME-ACQUIRED PNEUMONIA; GRAM-NEGATIVE BACILLI; ASPIRATION PNEUMONIA; ANTIMICROBIAL AGENTS; DENTAL PLAQUE; COLONIZATION C1 Univ Michigan, Sch Med, Ann Arbor VA Hlth Care Syst, Dept Med,Div Geriatr Med, Ann Arbor, MI 48109 USA. Univ Michigan, Sch Med,Ann Arbor GRECC,Dept Periodont, US Dept Vet Affairs,Ann Arbor VA Hlth Care Syst, Geriatr & Extended Care Serv Line,Vet Integrated, Ann Arbor, MI USA. RP Terpenning, M (reprint author), Univ Michigan, Sch Med, Ann Arbor VA Hlth Care Syst, Dept Med,Div Geriatr Med, Ann Arbor, MI 48109 USA. NR 29 TC 24 Z9 24 U1 0 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD MAR PY 2002 VL 50 IS 3 BP 584 EP 585 DI 10.1046/j.1532-5415.2002.50131.x PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 528TU UT WOS:000174260000028 PM 11943061 ER PT J AU Poggioli, GJ DeBiasi, RL Bickel, R Jotte, R Spalding, A Johnson, GL Tyler, KL AF Poggioli, GJ DeBiasi, RL Bickel, R Jotte, R Spalding, A Johnson, GL Tyler, KL TI Reovirus-induced alterations in gene expression related to cell cycle regulation SO JOURNAL OF VIROLOGY LA English DT Article ID PROTEIN PHOSPHATASE 2A; VIRUS TYPE-1 VPR; SPINDLE CHECKPOINT FUNCTION; POLO-LIKE KINASES; DNA-DAMAGE; RETINOBLASTOMA PROTEIN; ATAXIA-TELANGIECTASIA; NUCLEAR AUTOANTIGEN; INDUCED APOPTOSIS; DEPENDENT KINASE AB Mammalian reovirus infection results in perturbation of host cell cycle progression. Since reovirus infection is known to activate cellular transcription factors, we investigated alterations in cell cycle-retated gene expression following HEK293 cell infection by using the Affymetrix U95A microarray. Serotype 3 reovirus infection results in differential expression of 10 genes classified as encoding proteins that function at the G(1)-to-S transition, 11 genes classified as encoding proteins that function at G(2)-to-M transition, and 4 genes classified as encoding proteins that function at the mitotic spindle checkpoint. Serotype I reovirus infection results in differential expression of four genes classified as encoding proteins that function at the G(1)-to-S transition and three genes classified as encoding proteins that function at G(2)-to-M transition but does not alter any genes classified as encoding proteins that function at the mitotic spindle checkpoint. We have previously shown that serotype 3, but not serotype 1, reovirus infection induces a G(2)-to-M transition arrest resulting from an inhibition of cdc2 kinase activity. Of the differentially expressed genes encoding proteins regulating the G(2)-to-M transition, chk1, wee1, and GADD45 are known to inhibit cdc2 kinase activity. A hypothetical model describing serotype 3 reovirus-induced inhibition of cdc2 kinase is presented, and reovirus-induced perturbations of the G(1)-to-S, G(2)-to-M, and mitotic spindle checkpoints are discussed. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol B 182, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pediat, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Hematol & Oncol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Microbiol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Immunol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Neurol Serv, Denver, CO 80220 USA. Natl Jewish Ctr Immunol & Resp Med, Program Mol Signal Transduct, Denver, CO 80206 USA. Natl Jewish Ctr Immunol & Resp Med, Div Basic Sci, Denver, CO 80206 USA. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol B 182, 4200 E 9th Ave, Denver, CO 80262 USA. OI Tyler, Kenneth/0000-0003-3294-5888 FU NIA NIH HHS [AG14071] NR 87 TC 24 Z9 27 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD MAR PY 2002 VL 76 IS 6 BP 2585 EP 2594 DI 10.1128/JVI.76.6.2585-2594.2002 PG 10 WC Virology SC Virology GA 524YA UT WOS:000174039400001 PM 11861824 ER PT J AU Reilly, CM Farrelly, LW Viti, D Redmond, ST Hutchison, F Ruiz, P Manning, P Connor, J Gilkeson, GS AF Reilly, CM Farrelly, LW Viti, D Redmond, ST Hutchison, F Ruiz, P Manning, P Connor, J Gilkeson, GS TI Modulation of renal disease in MRL/lpr mice by pharmacologic inhibition of inducible nitric oxide synthase SO KIDNEY INTERNATIONAL LA English DT Article; Proceedings Paper CT Meeting of the Nephrology-Society-of-Nephrology-Forefronts-in-Nephrology on Nitric Oxide and Renal Inflammation CY AUG 02-05, 2001 CL ST JOHN COLL, CAMBRIDGE, ENGLAND SP Int Soc Nephrol Forefronts Nephrol HO ST JOHN COLL DE lupus; rodent; autoantibody; inflammation; nitric oxide ID MRL-LPR/LPR MICE; MESANGIAL CELLS; L-ARGININE; NEPHROTOXIC NEPHRITIS; AUTOIMMUNE-DISEASE; LUPUS NEPHRITIS; IMMUNE INJURY; MESSENGER-RNA; NO SYNTHASE; GLOMERULONEPHRITIS AB Background. MRL-MPJFas(lpr) (MRL/lpr) mice spontaneously develop lupus-like disease characterized by immune complex glomerulonephritis and overproduction of nitric oxide (NO). Blocking NO production pharmacologically by a non-specific nitric oxide synthase (NOS) inhibitor ameliorated renal disease in MRL/lpr mice while genetically deficient inducible NOS (iNOS) mice developed proliferative glomerulonephritis similar to wild-type controls. Methods. To clarify the role of iNOS in the pathogenesis of nephritis in MRL/lpr mice, we treated mice with two different NOS inhibitors. Either NI-monomethyl-L-arginine (L-NMMA), a nonspecific NOS inhibitor, Or L-N-6-(1-iminoethyl)lysine (L-NIL), an iNOS specific inhibitor, was administered in the drinking water from 10 through 22 weeks of age with disease progression monitored over time. Control mice received water alone. Results. Both L-NMMA and L-NIL blocked NO production effectively in MRL/lpr mice. As expected, neither L-NNMA nor L-NIL had an effect on antibody production, immune complex deposition or complement activation. Although both NOS inhibitors decreased protein excretion, L-NMMA was more effective than L-NIL. Pathologic renal disease was significantly decreased at 19 weeks in both treatment groups. At 22 weeks the L-NIL treated mice, but not the L-NMMA mice, had significantly reduced renal disease scores compared to controls. Conclusion. These results indicate that specific inhibition of iNOS blocks the development of pathologic renal disease in MRL/lpr mice. C1 Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Med Res Ctr, Charleston, SC USA. Univ Miami, Sch Med, Dept Pathol, Miami, FL USA. Pharmacia Corp, St Louis, MO USA. RP Reilly, CM (reprint author), Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, 96 Jonathon Lucas St,Suite 912,POB 250623, Charleston, SC 29425 USA. FU NIAMS NIH HHS [R01 AR 45499] NR 52 TC 46 Z9 47 U1 0 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD MAR PY 2002 VL 61 IS 3 BP 839 EP 846 DI 10.1046/j.1523-1755.2002.00230.x PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 523NB UT WOS:000173959600012 PM 11849435 ER PT J AU Namazie, A Alavi, S Olopade, OI Pauletti, G Aghamohammadi, N Aghamohammadi, M Gornbein, JA Calcaterra, TC Slamon, DJ Wang, MB Srivatsan, ES AF Namazie, A Alavi, S Olopade, OI Pauletti, G Aghamohammadi, N Aghamohammadi, M Gornbein, JA Calcaterra, TC Slamon, DJ Wang, MB Srivatsan, ES TI Cyclin D1 amplification and p16(MTS1/CDK4I) deletion correlate with poor prognosis in head and neck tumors SO LARYNGOSCOPE LA English DT Article DE head and neck tumors; cyclin D1; p16; fluorescence in situ hybridization ID SQUAMOUS-CELL CARCINOMA; IN-SITU HYBRIDIZATION; CHROMOSOME 11Q13 AMPLIFICATION; HUMAN BREAST-CANCER; GENE AMPLIFICATION; IMMUNOHISTOCHEMICAL DETECTION; P16(INK4A) EXPRESSION; P16/CDKN2 GENE; LUNG-CANCER; RB PROTEIN AB Objectives/Hypothesis: Cyclin D1, a cell cycle regulator localized to chromosome 11q13, is amplified in several human tumors including head and neck squamous cell carcinoma (HNSCC). Amplification and/or overexpression of cyclin D1 have been correlated to a poor prognosis. Deletion of the p16 gene, localized to 9p21, has also been observed in a significant proportion of HNSCC. The p16 gene regulates cyclin D1-CDK4 activity and prevents retinoblastoma tumor suppressor gene phosphorylation, thereby downregulating cellular proliferation. Detection of cyclin D1 amplification and p16 deletion using a simple and sensitive method will be valuable for the development of effective treatment modalities for head and neck cancer. Study Design: We have used fluorescence in situ hybridization (FISH) to study cyclin D1 amplification and p16 gene deletion in head and neck tumors. Both single- and dual-color FISH were performed. Methods: Paraffin-embedded tissues from 103 patients with HNSCC were analyzed using genomic DNA probes for cyclin D1 and p16. Dual-color FISH was performed with chromosome 11 or 9 centromeric probes as a control. Twenty-eight of these samples were analyzed for p16 expression by immunohistochemistry. Results: Cyclin D1 amplification was observed in 30% (31/103) of patients, and p16 deletion in 52% (54/103). Lack of p16 expression was observed in 64% (18/28) of patients. There was a good correlation between the deletion of p16 sequences and the loss of p16 expression (P = .008). Amplification of cyclin D1 had a statistically significant association with recurrence, distant metastasis, and survival at 36 months. There was a significant association between p16 deletion and the development of distant metastases. Cyclin D1 amplification and p16 deletion together correlated with recurrence, distant metastasis, and survival. Conclusions: We demonstrate that FISH is a simple and sensitive method for detecting cyclin D1 amplification and p16 deletion in head and neck cancer. Our results suggest that these two genetic aberrations together portend a poorer outcome than either of the abnormalities alone in head and neck cancer. C1 Univ Calif Los Angeles, Sch Med, Div Head & Neck Surg, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Div Hematol Oncol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Div Biomath, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst, Surg Serv, Dept Surg, Los Angeles, CA 90073 USA. Univ Chicago, Med Ctr, Div Hematol Oncol, Chicago, IL 60637 USA. RP Srivatsan, ES (reprint author), VA Greater Los Angeles Hlth Care Syst, Surg Serv, Dept Surg, 10H2,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 41 TC 90 Z9 104 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0023-852X J9 LARYNGOSCOPE JI Laryngoscope PD MAR PY 2002 VL 112 IS 3 BP 472 EP 481 DI 10.1097/00005537-200203000-00013 PG 10 WC Medicine, Research & Experimental; Otorhinolaryngology SC Research & Experimental Medicine; Otorhinolaryngology GA 530BP UT WOS:000174336000013 PM 12148857 ER PT J AU Kilbourne, AM Andersen, RM Asch, S Nakazono, T Crystal, S Stein, M Gifford, AL Bing, EG Bozzette, SA Shapiro, MF Cunningham, WE AF Kilbourne, AM Andersen, RM Asch, S Nakazono, T Crystal, S Stein, M Gifford, AL Bing, EG Bozzette, SA Shapiro, MF Cunningham, WE TI Response to symptoms among a US national probability sample of adults infected with human immunodeficiency virus SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Article ID QUALITY-OF-LIFE; LOW-PREVALENCE DISEASES; HEALTH-SERVICE USE; HIV-INFECTION; AIDS PATIENTS; UNITED-STATES; MEDICAL-CARE; ACCESS; COST; VALIDITY AB Previous studies concerning disparities in Human Immunodeficiency Virus (HIV) services use among vulnerable groups did not control for specific clinical need for care such as symptom events. Using the Andersen Behavioral Model of Health Services Use, the authors determined whether minorities, women, and the less educated (vulnerable groups) were less likely to receive care for HIV symptoms. Persons enrolled in the HIV Cost and Services Utilization Study were asked whether they received care for their most bothersome symptom. Surprisingly, minorities and women were no more likely to go without care than other groups. Those with Medicaid, Medicare, private health maintenance organization (HMO) insurance, or no insurance were less likely to receive care for symptoms than those with private-non-HMO insurance. Vulnerable groups were no less likely to use services for HIV-related symptoms when need for care was considered. However, disparities may exist for symptom-specific care among HIV infected persons covered by public or HMO insurance. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Rutgers State Univ, Piscataway, NJ 08855 USA. Brown Univ, Providence, RI 02912 USA. VA San Diego Healthcare Syst, San Diego, CA USA. Charles R Drew Univ Med & Sci, Los Angeles, CA 90059 USA. RP Kilbourne, AM (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. FU AHRQ HHS [U01HS08578]; NIAAA NIH HHS [U24AA11899-04]; NIMH NIH HHS [MH-19127] NR 38 TC 13 Z9 13 U1 4 U2 7 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 J9 MED CARE RES REV JI Med. Care Res. Rev. PD MAR PY 2002 VL 59 IS 1 BP 36 EP 58 DI 10.1177/1077558702059001002 PG 23 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 522TW UT WOS:000173913900002 PM 11877878 ER PT J AU Washington, DL Harada, ND Villa, VM Damron-Rodriguez, J Dhanani, S Shon, H Makinodan, T AF Washington, DL Harada, ND Villa, VM Damron-Rodriguez, J Dhanani, S Shon, H Makinodan, T TI Racial variations in Department of Veterans Affairs ambulatory care use and unmet health care needs SO MILITARY MEDICINE LA English DT Article ID MEDICAL-CARE; CARDIOVASCULAR PROCEDURES; ETHNIC-DIFFERENCES; BEHAVIORAL-MODEL; ACCESS; SYSTEM; DISPARITIES; SURVIVAL; SERVICES AB Our objective was to describe racial/ethnic variations in Department of Veterans Affairs (VA) ambulatory care use and its association with the presence of unmet health care needs. Using the 1992 National Survey of Veterans, we examined race/ ethnicity and unmet health care need for ambulatory care users of VA and non-VA facilities. Black and Hispanic veterans were more likely to report any VA use. In unadjusted analyses, American Indian/Eskimo, Hispanic, and black veterans were 4.4, 2.5, and 1.9 times more likely, respectively, than white veterans to report an inability to get needed care. Adjusting for VA ambulatory care use diminished the disparity in inability to get needed care between American Indian/Eskimo or Hispanic veterans and white veterans and eliminated the disparity between black and white veterans. Our findings support the VA's role as a medical safety net provider and suggest that VA ambulatory care use is effective in mitigating health-re ate racial disparities for some veterans. Additional facilitators for reducing unmet need should be explored. C1 VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Policy & Social Res, Los Angeles, CA 90095 USA. RP Washington, DL (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Med, 11301 Wilshire Blvd,111G, Los Angeles, CA 90073 USA. NR 23 TC 30 Z9 30 U1 1 U2 1 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD MAR PY 2002 VL 167 IS 3 BP 235 EP 241 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 653DP UT WOS:000181420200013 PM 11901574 ER PT J AU Grant, GA Britz, GW Goodkin, R Jarvik, JG Maravilla, K Kliot, M AF Grant, GA Britz, GW Goodkin, R Jarvik, JG Maravilla, K Kliot, M TI The utility of magnetic resonance imaging in evaluating peripheral nerve disorders SO MUSCLE & NERVE LA English DT Review DE magnetic resonance imaging (MRI); neurography; neuropathy; nerve injury; peripheral nerve ID CARPAL-TUNNEL SYNDROME; MEDIAN NERVE; INTRAOPERATIVE FINDINGS; NORMAL ANATOMY; SHEATH TUMORS; MR; NEUROGRAPHY; WRIST; DIAGNOSIS; COMPRESSION AB The evaluation of peripheral nerve injuries has traditionally relied primarily on information gained from the clinical history, physical examination, and electrodiagnostic testing. Taken together, all of this clinical and diagnostic information often allows one to determine the location and severity of the underlying peripheral nerve problem. However, it may not be sufficient in diagnosing a focal entrapment neuropathy superimposed upon a more generalized peripheral neuropathy; localizing a focal lesion along a long segment of nerve which may be difficult to assess accurately with electrodiagnostic studies; distinguishing early between an axonotmetic grade of injury, which can recover through axonal regeneration, and a neurotmetic grade which cannot and therefore may benefit from a surgical exploration and repair procedure; and noninvasively diagnosing and determining the surgical resectability of peripheral nerve mass lesions such as tumors. The goal of this review is to illustrate how standard and evolving magnetic resonance imaging techniques can provide additional information in dealing with some of these problems. (C) 2002 Wiley Periodicals, Inc. C1 Univ Washington, Sch Med, Dept Neurol Surg, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Radiol, Sect Neuroradiol, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Hlth Serv, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Kliot, M (reprint author), Univ Washington, Sch Med, Dept Neurol Surg, 1959 NE Pacific St,Box 356470, Seattle, WA 98195 USA. FU NINDS NIH HHS [T32NS-07144-15] NR 81 TC 95 Z9 98 U1 1 U2 4 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0148-639X J9 MUSCLE NERVE JI Muscle Nerve PD MAR PY 2002 VL 25 IS 3 BP 314 EP 331 DI 10.1002/mus.10013 PG 18 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 526ZK UT WOS:000174159400002 PM 11870709 ER PT J AU Taub, E Uswatte, G Elbert, T AF Taub, E Uswatte, G Elbert, T TI New treatments in neurorehabilitation founded on basic research SO NATURE REVIEWS NEUROSCIENCE LA English DT Review ID INDUCED MOVEMENT THERAPY; BODY-WEIGHT SUPPORT; STROKE PATIENTS; SOMATOSENSORY CORTEX; PHYSICAL-THERAPY; MOTOR RECOVERY; LEARNED NONUSE; REHABILITATION; PLASTICITY; ADULT AB Recent discoveries about how the central nervous system responds to injury and how patients reacquire lost behaviours by training have yielded promising new therapies for neurorehabilitation. Until recently, this field had been largely static, but the current melding of basic behavioural science with neuroscience promises entirely new approaches to improving behavioural, perceptual and cognitive capabilities after neurological damage. Studies of phenomena such as cortical reorganization after a lesion, central nervous system repair, and the substantial enhancement of extremity use and linguistic function by behavioural therapy, support this emerging view. The ongoing changes in rehabilitation strategies might well amount to an impending paradigm shift in this field. C1 Univ Alabama Birmingham, Birmingham Vet Affairs Med Ctr, Birmingham, AL 35294 USA. Univ Alabama Birmingham, Dept Psychol, Birmingham, AL 35294 USA. Univ Konstanz, Dept Psychol, D-78457 Constance, Germany. RP Taub, E (reprint author), Univ Alabama Birmingham, Birmingham Vet Affairs Med Ctr, CPM 712,1530 3rd Ave S, Birmingham, AL 35294 USA. EM etaub@uab.edu RI Elbert, Thomas/C-8556-2009; Uswatte, Gitendra/C-4913-2009 NR 91 TC 348 Z9 364 U1 4 U2 47 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1471-003X EI 1471-0048 J9 NAT REV NEUROSCI JI Nat. Rev. Neurosci. PD MAR PY 2002 VL 3 IS 3 BP 228 EP 236 DI 10.1038/nrn754 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 527VD UT WOS:000174207900018 PM 11994754 ER PT J AU Horner, MD Hamner, MB AF Horner, MD Hamner, MB TI Neurocognitive functioning in posttraumatic stress disorder SO NEUROPSYCHOLOGY REVIEW LA English DT Article DE neuropsychology; cognition; posttraumatic stress disorder ID POSITRON-EMISSION-TOMOGRAPHY; SHORT-TERM-MEMORY; COMBAT VETERANS; HIPPOCAMPAL VOLUME; SEXUAL ABUSE; ADULT SURVIVORS; KOREAN CONFLICT; POW SURVIVORS; DEFICITS; ATTENTION AB This paper reviews the literature on performance on standard neuropsychological tests among individuals with posttraumatic stress disorder (PTSD). Of 19 studies, 16 reported impairment of attention or immediate memory (or both); however, most of these studies included PTSD patients with significant psychiatric comorbidity, so that the extent to which the observed deficits are specifically attributable to PTSD remains unclear. Other potential confounds, including medical illness, substance abuse, and motivational factors, further preclude definitive conclusions at present. Results of structural and functional neuroimaging studies of PTSD are also summarized. Two studies have reported correlations between hippocampal volume and cognitive findings in PTSD patients; functional studies have indicated specific findings in limbic regions, although the relationship of these results to neuropsychological performance remains to be explored. C1 Ralph H Johnson VA Med Ctr, Mental Hlth Serv 116, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. RP Horner, MD (reprint author), Ralph H Johnson VA Med Ctr, Mental Hlth Serv 116, 109 Bee St, Charleston, SC 29401 USA. NR 57 TC 75 Z9 80 U1 4 U2 19 PU CONSULTANTS BUREAU PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1040-7308 J9 NEUROPSYCHOL REV JI Neuropsychol. Rev. PD MAR PY 2002 VL 12 IS 1 BP 15 EP 30 AR UNSP 1040-7308/02/0300-0015/0 DI 10.1023/A:1015439106231 PG 16 WC Psychology, Clinical; Neurosciences SC Psychology; Neurosciences & Neurology GA 566AF UT WOS:000176402700002 PM 12090717 ER PT J AU Aslam, N Bernardini, J Fried, L Piraino, B AF Aslam, N Bernardini, J Fried, L Piraino, B TI Large body mass index does not predict short-term survival in peritoneal dialysis patients SO PERITONEAL DIALYSIS INTERNATIONAL LA English DT Article DE body mass index; patient survival; technique survival ID HEMODIALYSIS-PATIENTS; MORTALITY; SIZE AB Objective: Higher than normal body mass index (BMI) is associated with an increased risk of death in the general population. We examined the effect of higher than normal BMI on patient and technique survival in peritoneal dialysis patients (PD), controlling for comorbidity, initial albumin, dialysate-to-plasma ratio of creatinine (D/P-Cr), and initial urea clearance (Kt/V). Design: Registry database. Settings: Four dialysis centers. Patients: Incident PD patients. Methods: All data were collected prospectively. Demographics, BMI, serum albumin, D/P-Cr, and comorbidity using the Charlson Comorbidity Index (CCI) were determined at the start of PD. 104 patients with a high BMI (> 27) were matched to a control group of 104 patients with normal BMI (20 - 27) for age, gender, presence of diabetes, and CCI. Patient and technique survival were compared using Cox proportional hazards model. Main Outcome Measures: Patient and technique survival. Results. The groups were of similar age (56.1 vs 56.7 years), sex (60% males in both groups), race (Caucasian 80% vs 86%), presence of diabetes (40% vs 37%), CCI score (5.4 in both groups), initial albumin (3.6 vs 3.5 g/dL), and D/P-Cr (0.65 in both groups). Kaplan-Meier survival analysis showed similar 2-year patient survival between large BMI (> 27) and control (20 - 27) groups (76.6% vs 76.1%). Two-year technique survival was also similar between the two groups (59.7% vs 66.8%). With Cox proportional hazards analysis, BMI was not a predictor of patient mortality or technique survival when controlling for initial albumin, D/P-Cr, and initial Kt/V. Conclusions: We conclude that a BMI above normal is not associated with any increased or decreased risk of death in patients on PD for 2 years. C1 Univ Pittsburgh, Sch Med, Renal & Elect Div, Pittsburgh, PA 15261 USA. VA Pittsburgh Hlth Care Syst, Renal Div, Pittsburgh, PA USA. RP Aslam, N (reprint author), Univ Pittsburgh, Sch Med, Renal & Elect Div, A907 Scaife Hall 3550 Terrace St, Pittsburgh, PA 15261 USA. OI Piraino, Beth/0000-0001-5061-0841 NR 14 TC 62 Z9 62 U1 0 U2 0 PU MULTIMED INC PI TORONTO PA 66 MARTIN ST, TORONTO, ON L9T 2R2, CANADA SN 0896-8608 J9 PERITON DIALYSIS INT JI Perit. Dial. Int. PD MAR-APR PY 2002 VL 22 IS 2 BP 191 EP 196 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 542ZW UT WOS:000175076700005 PM 11990403 ER PT J AU Johnson, WB Huwe, JM AF Johnson, WB Huwe, JM TI Toward a typology of mentorship dysfunction in graduate school SO PSYCHOTHERAPY LA English DT Article ID MENTORING RELATIONSHIPS; PROTEGE RELATIONSHIPS; CLINICAL-PSYCHOLOGY; ETHICAL ISSUES; EDUCATION; PERCEPTIONS; STUDENTS; EXPERIENCES; FACULTY; TEACHER AB Researchers, writers, and practitioners of mentoring relationships have traditionally avoided discussion of the dark and dysfunctional side of mentoring. Student-faculty mentorships in graduate settings are sometimes characterized by dysfunction stemming from such varied sources as faulty matching, boundary violations, incompetence, conflict, and cross-gender or cross-race concerns. In this article, a typology of dysfunctional graduate school mentorships is offered for the purpose of bolstering theory development, research and both departmental and individual prevention efforts. The article concludes with several strategic recommendations for both graduate program administrators and individual faculty members who find themselves in problem mentorships with graduate students. C1 USN Acad, Dept Leadership Eth & Law, Annapolis, MD 21402 USA. Portland Vet Affairs Med Ctr, Dept Psychol, Portland, OR USA. RP Johnson, WB (reprint author), USN Acad, Dept Leadership Eth & Law, Luce Hall,Stop 7B, Annapolis, MD 21402 USA. EM johnsonb@usna.edu NR 45 TC 28 Z9 29 U1 0 U2 4 PU AMER PSYCHOLOGICAL ASSOC, DIV PSYCHOTHERAPY PI CORAL GABLES PA 1390 SOUTH DIXIE HIGHWAY, STE 2222, CORAL GABLES, FL 33146-2946 USA SN 0033-3204 J9 PSYCHOTHERAPY JI Psychotherapy PD SPR PY 2002 VL 39 IS 1 BP 44 EP 55 DI 10.1037//0033-3204.39.1.44 PG 12 WC Psychology, Clinical SC Psychology GA 906OA UT WOS:000227650300005 ER PT J AU Asch, SM Sa'adah, MG Lopez, R Kokkinis, A Richwald, GA Rhew, DC AF Asch, SM Sa'adah, MG Lopez, R Kokkinis, A Richwald, GA Rhew, DC TI Comparing quality of care for sexually transmitted diseases in specialized and general clinics SO PUBLIC HEALTH REPORTS LA English DT Article ID HOSPITAL EXPERIENCE; PHYSICIANS; AIDS; MORTALITY; PERFORMANCE; GUIDELINES; PATIENT AB Objective. The objective of this study was to compare quality of care for patients with sexually transmitted diseases (STDs) in specialized vs. general clinics. Methods. The authors conducted a retrospective chart review evaluating compliance with a set of STD-related process of care quality indicators for adult patients seen in six Los Angeles County clinics (two STD specialized clinics and four general medical clinics). Results. Thirty-two quality indicators were selected using a modified Delphi process. From March 1, 1996, to June 31, 1996, there were 205 STD-related visits to the two specialized STD clinics and 373 STD-related visits to the four general medical clinics. For patients with "classic" STDs (those for which sexual contact is the primary means of transmission), STD clinics achieved greater compliance than general medical clinics on 14 quality indicators, while general medical clinics achieved greater compliance on 4 indicators. Conclusion. STD clinics provide better overall STD care than general medical clinics. Possible explanations include differences in clinician experience with STD patients and greater use of standardized protocol sheets. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Sexually Transmitted Dis Program, Dept Hlth Serv Publ Hlth, Los Angeles, CA USA. Zynx Hlth Inc, Cedars Sinai Dept Med, Beverly Hills, CA USA. Zynx Hlth Inc, Hlth Serv Res, Beverly Hills, CA USA. RP Asch, SM (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd 111G, Los Angeles, CA 90073 USA. NR 17 TC 13 Z9 13 U1 0 U2 0 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPERINTENDENT DOCUMENTS,, WASHINGTON, DC 20402-9325 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD MAR-APR PY 2002 VL 117 IS 2 BP 157 EP 163 DI 10.1093/phr/117.2.157 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 605MC UT WOS:000178680800008 PM 12357000 ER PT J AU Shekelle, PG AF Shekelle, PG TI Why don't physicians enthusiastically support quality improvement programmes? SO QUALITY & SAFETY IN HEALTH CARE LA English DT Editorial Material AB Resistance of physicians to clinical governance will continue until they can see how a real programme works operationally and a measurable leap in quality is achieved. In the absence of a role model, the opportunity exists for the NHS to fund primary care groups/trusts to develop a model that can be seen to work. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Shekelle, PG (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 1 TC 25 Z9 25 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1475-3898 J9 QUAL SAF HEALTH CARE JI Qual. Saf. Health Care PD MAR PY 2002 VL 11 IS 1 BP 6 EP 6 DI 10.1136/qhc.11.1.6 PG 1 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 551KM UT WOS:000175560900005 PM 12078372 ER PT J AU Freedman, R Adler, LE Olincy, A Waldo, MC Ross, RG Stevens, KE Leonard, S AF Freedman, R Adler, LE Olincy, A Waldo, MC Ross, RG Stevens, KE Leonard, S TI Input dysfunction, schizotypy, and genetic models of schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article; Proceedings Paper CT NATO Advanced Research Workshop on Schizophrenia and Schizotypy held in Honor of Peter Venables CY MAR 24-27, 2001 CL TUSCANY, ITALY DE schizophrenia; schizotypy; inhibition; hippocampus; auditory-evoked potential; catecholamines; nicotinic receptors; genetic linkage; human chromosome 15 ID ALPHA-BUNGAROTOXIN-BINDING; P50 SUPPRESSION; SUSCEPTIBILITY LOCUS; NICOTINIC RECEPTORS; GATING DEFICITS; NO EVIDENCE; LINKAGE; SMOKING; CLOZAPINE; BRAIN AB Peter Venables proposed that an input dysfunction. which causes the brain to lose its ability to control the flood of sensors information into its higher level processing areas, might be an important pathophysiological mechanism in schizophrenia. The hypothesis was part of his general belief that even the most severe psychopathology arises from aberrations in normal brain psychophysiology, Neurobiological and genetic investigations based on his initial observations include the demonstration that diminished inhibition of the auditory-evoked response to repeated stimuli is a genetically determined deficit, linked to one of the chromosomal loci that is also responsible for the part of the genetically transmitted risk for schizophrenia. Increasing evidence that schizophrenia is a multigenetic illness prompts reconsideration of the nature of schizotypy. Individual genes that convey part of the risk for schizophrenia may be quite common in the general population and cause relatively subtle changes in psychophysiology, Thus, as predicted by Venables, the substrates of schizotypy and schizophrenia may arise from variants in normal brain function, (C) 2002 Elsevier Science B.V. All rights reserved. C1 Denver Vet Affairs Med Ctr, Dept Psychiat & Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80262 USA. RP Freedman, R (reprint author), Denver Vet Affairs Med Ctr, Dept Psychiat & Pharmacol, Campus Box C-268-71,4200 E 9th Ave, Denver, CO 80262 USA. NR 42 TC 21 Z9 21 U1 1 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD MAR 1 PY 2002 VL 54 IS 1-2 SI SI BP 25 EP 32 AR PII S0920-9964(01)00348-6 DI 10.1016/S0920-9964(01)00348-6 PG 8 WC Psychiatry SC Psychiatry GA 529ND UT WOS:000174304800004 PM 11853975 ER PT J AU Buchsbaum, MS Nenadic, I Hazlett, EA Spiegel-Cohen, J Fleischman, MB Akhavan, A Silverman, JM Siever, LJ AF Buchsbaum, MS Nenadic, I Hazlett, EA Spiegel-Cohen, J Fleischman, MB Akhavan, A Silverman, JM Siever, LJ TI Differential metabolic rates in prefrontal and temporal Brodmann areas in schizophrenia and schizotypal personality disorder SO SCHIZOPHRENIA RESEARCH LA English DT Article; Proceedings Paper CT NATO Advanced Research Workshop on Schizophrenia and Schizotypy held in Honor of Peter Venables CY MAR 24-27, 2001 CL TUSCANY, ITALY DE positron emission tomography (PET); magnetic resonance imaging (MRI); frontal lobe; temporal lobe ID VERBAL-LEARNING TASK; CEREBRAL BLOOD-FLOW; VENTRICULAR VOLUME; MRI; PET; SHAPE; SIZE; ABNORMALITIES; PERFORMANCE; INTERVIEW AB In an exploration of the schizophrenia spectrum, we compared cortical metabolic rates in unmedicated patients with schizophrenia and schizotypal personality disorder (SPD) with findings in age- and sex-matched normal volunteers. Coregistered magnetic resonance imaging (MRI) and positron emission tomography (PET) scans were obtained in 27 schizophrenic, 13 SPD, and 32 normal volunteers who performed a serial verbal learning test during tracer uptake. A template of Brodmann areas derived from a whole brain histological section atlas was used to analyze PET findings. Significantly lower metabolic rates were found in prefrontal areas 44-46 in schizophrenic patients than in normal volunteers. SPD patients did not differ from normal volunteers in most lateral frontal regions, but they had values intermediate between those of normal volunteers and schizophrenic patients in lateral temporal regions. SPD patients showed higher than normal metabolic rates in both medial frontal and medial temporal areas. Metabolic rates in Brodmann area 10 were distinctly higher in SPD patients than in either normal volunteers or schizophrenic patients. (C) 2002 Elsevier Science B.V. All rights reserved. C1 CUNY Mt Sinai Sch Med, Dept Psychiat, Neurosci PET Lab, New York, NY 10029 USA. Klinikum Friedrich Schiller Univ, Hans Berger Kliniken, Psychiat Klin, Jena, Germany. Bronx Vet Affairs Med Ctr, Psychiat Serv, Bronx, NY 10468 USA. RP Buchsbaum, MS (reprint author), CUNY Mt Sinai Sch Med, Dept Psychiat, Neurosci PET Lab, Box 1505,1 Gustave L Levy Pl, New York, NY 10029 USA. FU NIMH NIH HHS [MH 40071, MH 56460, MH 56489, MH 60023] NR 38 TC 71 Z9 72 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD MAR 1 PY 2002 VL 54 IS 1-2 SI SI BP 141 EP 150 AR PII S0920-9964(01)00361-9 DI 10.1016/S0920-9964(01)00361-9 PG 10 WC Psychiatry SC Psychiatry GA 529ND UT WOS:000174304800017 PM 11853988 ER PT J AU Nordyke, RJ Peabody, JW AF Nordyke, RJ Peabody, JW TI Market reforms and public incentives: finding a balance in the Republic of Macedonia SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE private care; reform; primary care; Eastern Europe ID HEALTH-CARE; EASTERN-EUROPE; PRIVATIZATION; BULGARIA; STATE AB The Republic of Macedonia is undertaking sweeping reforms of its health sector. Funded by a World Bank credit, the reforms seek to improve the efficiency and quality of primary health care (PHC) by significantly strengthening the role of the market in health care provision. On the supply-side, one of the key reform proposals is to implement a capitation payment system for PHC physicians. By placing individual physicians on productivity-based contracts, these reforms will effectively marketize all PHC provision. In addition, the Ministry of Health is considering the sale or concessions of public PHC clinics to private groups, indicating the government's commitment to marketization of health care provision. Macedonia is in a unique position to develop a new role for the private sector in PHC provision. The private provision of outpatient care was legalized soon after independence in 1991; private physicians now account for nearly 10% of all physicians and 22% of PHC physicians. If the reforms are fully realized, all PHC physicians-over 40% of all physicians-will be financially responsible for their clinical practices. This study draws on Macedonia's experience with limited development of private outpatient care starting in 1991 and the reform proposals for PHC, finding a network of policies and procedures throughout the health sector that negatively impact private and public sector provision, An assessment of the effects that this greater policy environment has on private sector provision identifies opportunities to strategically enhance the reforms. With respect to established market economies, the study finds justification for a greater role for government intervention in private health markets in transition economies. In addition to micro-level payment incentives and administrative controls, marketization in Central and Eastern Europe requires an examination of insurance contracting procedures, quality assurance practices, public clinic ownership, referral practices, hospital privileges, and capital investment policies. (C) 2002 Elsevier Science Ltd. All rights reserved. C1 RAND Corp, Santa Monica, CA 90407 USA. Univ Calif San Francisco, Inst Global Hlth, San Francisco, CA 94105 USA. Univ Calif Los Angeles, Sch Publ Hlth, San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Univ So Calif, Sch Policy Planning & Dev, Int Publ Policy & Management Program, Los Angeles, CA 90089 USA. RP Nordyke, RJ (reprint author), RAND Corp, 1700 Main St,MS 14-A, Santa Monica, CA 90407 USA. NR 53 TC 6 Z9 6 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD MAR PY 2002 VL 54 IS 6 BP 939 EP 953 AR PII S0277-9536(01)00067-3 DI 10.1016/S0277-9536(01)00067-3 PG 15 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 532KC UT WOS:000174473100008 PM 11996027 ER PT J AU Oliveria, SA Lapuerta, P McCarthy, BD L'Italien, GJ Berlowitz, DR Asch, SM AF Oliveria, SA Lapuerta, P McCarthy, BD L'Italien, GJ Berlowitz, DR Asch, SM TI Physician-related barriers to the effective management of uncontrolled hypertension SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID BLOOD-PRESSURE CONTROL; INNER-CITY; CARE; HEALTH; POPULATION; PATIENT; TRIAL; RECOMMENDATIONS; PRACTITIONERS; MEDICATIONS AB Background: Primary care physicians may not be aggressive enough with the management of hypertension. The purpose of this study was to identify barriers to primary care physicians' willingness to increase the intensity of treatment among patients with uncontrolled hypertension. Methods: Descriptive survey study. We sampled patient visits in a large midwestern health system to identify patients with uncontrolled hypertension. The treating primary care physicians were asked to complete a survey about the patient visit with a copy of the office notes attached to the survey (patient visits, n=270; response rate, 86%). Results: Pharmacologic therapy was initiated or changed at only 38% of visits, despite documented hypertension for at least 6 months before the patients' most recent visit. The most frequently cited reason for no initiation or change in therapy was related to the primary care physicians being satisfied with the blood pressure (BP) value (satisfactory BP response, 30%; satisfactory diastolic BP response, 16%; only borderline hypertension, 10%). At 93% of these visits, systolic BP values were 140 mm Hg or higher, which is above the cut point recommended by Sixth Report of the joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines, and 35% were 150 mm. Hg or higher. On average, physicians reported that 150 mm Hg was the lowest systolic BP at which they would recommend pharmacologic treatment to patients, compared with 91 mm Hg for diastolic BP. Conclusions: Our findings suggest that an important reason why physicians do not treat hypertension more aggressively is that they are willing to accept an elevated systolic BP in their patients. This has an important impact on public health because of the positive association between systolic BP and cardiovascular disease. C1 Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA. Cornell Univ & Med, Weill Med Coll, Ithaca, NY 14853 USA. Bristol Myers Squibb Co, Pharmaceut Res Inst, Princeton, NJ USA. Henry Ford Hlth Syst, Detroit, MI USA. Ctr Hlth Qual Outcomes & Econ Res, Bedford, England. Bedford VA Hosp, Bedford, England. Boston Univ, Sch Med, Boston, MA USA. Univ Calif Los Angeles, W Los Angeles Vet Adm Med Ctr, Los Angeles, CA USA. RAND, Santa Monica, CA USA. RP Oliveria, SA (reprint author), Mem Sloan Kettering Canc Ctr, 1275 York Ave Box 99, New York, NY 10021 USA. NR 56 TC 310 Z9 318 U1 0 U2 11 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD FEB 25 PY 2002 VL 162 IS 4 BP 413 EP 420 DI 10.1001/archinte.162.4.413 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 521RF UT WOS:000173854800006 PM 11863473 ER PT J AU Wu, SV Rozengurt, N Yang, M Young, SH Sinnett-Smith, J Rozengurt, E AF Wu, SV Rozengurt, N Yang, M Young, SH Sinnett-Smith, J Rozengurt, E TI Expression of bitter taste receptors of the T2R family in the gastrointestinal tract and enteroendocrine STC-1 cells SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article DE stomach; intestine; gustducin; transducin ID SIGNALING MECHANISMS; GUSTDUCIN; TRANSDUCTION; ACTIVATION; RESPONSES AB Although a role for the gastric and intestinal mucosa in molecular sensing has been known for decades, the initial molecular recognition events that sense the chemical composition of the luminal contents has remained elusive. Here we identified putative taste receptor gene transcripts in the gastrointestinal tract. Our results, using reverse transcriptase-PCR, demonstrate the presence of transcripts corresponding to multiple members of the T2R family of bitter taste receptors in the antral and fundic gastric mucosa as well as in. the lining of the duodenum. In addition, cDNA clones of T2R receptors were detected in a rat gastric endocrine cell cDNA library, suggesting that these receptors are expressed, at least partly, in enteroendocrine cells. Accordingly, expression of multiple T2R receptors also was found in STC-1 cells, an enteroendocrine cell line. The expression of alpha subunits of G proteins implicated in intracellular taste signal transduction, namely Galphagust, and Galphat-2, also was demonstrated in the gastrointestinal mucosa as well as in STC-1 cells, as revealed by reverse transcriptase-PCR and DNA sequencing, immunohistochemistry, and Western blotting. Furthermore, addition of compounds widely used in bitter taste signaling (e.g., denatonium, phenylthiocarbamide, 6-n-propil-2-thiouracil, and cycloheximide) to STC-1 cells promoted a rapid increase in intracellular Ca2+ concentration. These results demonstrate the expression of bitter taste receptors of the T2R family in the mouse and rat gastrointestinal tract. C1 Univ Calif Los Angeles, Div Digest Dis,Ctr Ulcer Res & Educ,Digest Dis Re, Unit Signal Transduct & Gastrointestinal Canc,Sch, Dept Med,Sch Med,Vet Adm Greater Los Angeles Hea, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Ctr Ulcer Res & Educ,Sch Med, Digest Dis Res Ctr,Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Inst Mol Biol, Los Angeles, CA 90095 USA. RP Rozengurt, E (reprint author), Univ Calif Los Angeles, Div Digest Dis,Ctr Ulcer Res & Educ,Digest Dis Re, Unit Signal Transduct & Gastrointestinal Canc,Sch, Dept Med,Sch Med,Vet Adm Greater Los Angeles Hea, Los Angeles, CA 90095 USA. FU NIDDK NIH HHS [DK55003, DK17294, DK56930, R01 DK055003, R01 DK056930] NR 21 TC 261 Z9 289 U1 2 U2 11 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD FEB 19 PY 2002 VL 99 IS 4 BP 2392 EP 2397 DI 10.1073/pnas.04261769 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 524UK UT WOS:000174031100114 PM 11854532 ER PT J AU Alvarez, B Carbo, N Lopez-Soriano, J Drivdahl, RH Busquets, S Lopez-Soriano, FJ Argiles, JM Quinn, LS AF Alvarez, B Carbo, N Lopez-Soriano, J Drivdahl, RH Busquets, S Lopez-Soriano, FJ Argiles, JM Quinn, LS TI Effects of interleukin-15 (IL-15) on adipose tissue mass in rodent obesity models: evidence for direct IL-15 action on adipose tissue SO BIOCHIMICA ET BIOPHYSICA ACTA-GENERAL SUBJECTS LA English DT Article DE interleukin-15; white adipose tissue; Zucker rat; ob/ob mouse; obesity ID TUMOR-NECROSIS-FACTOR; LIPOPROTEIN-LIPASE; FACTOR-ALPHA; BETA-CHAIN; RECEPTOR; CLONING; MUSCLE; PROTEIN; CELLS AB Interleukin-15 (IL-15) is a proinflammatory cytokine with multifunctional effects outside the immune system. Previous studies have indicated that treatment of normal rats with IL-15 reduces white adipose tissue (WAT) mass, but it was unclear if these effects were direct or indirect. In the present study, the effects of IL-15 on WAT mass and lipid metabolism were studied in two genetic models of obesity: the leptin receptor-negative falfa Zucker rat and the leptin-deficient ob/ob mouse. Lean Zucker rats, lean (+/+), and obese mice (ob/ob) responded to IL-15 with reductions in WAT mass and lipoprotein lipase activity (LPL), with no decreases in food intake. In contrast, falfk Zucker rats did not respond to IL-15 administration by any of the above measures of fat mass or lipid metabolism. In addition, ribonuclease protection assays (RPAs) were used to demonstrate that all three subunits (gammac, beta and alpha) of the IL-15 receptor complex are expressed by rat and mouse WAT, suggesting that the effects of IL-15 on adipose tissue metabolism could be direct. Additionally, the fal fa rats expressed 84% lower levels of the gammac signaling receptor subunit than lean Zucker rats, suggesting this decrease may play a role in the lack of adipose tissue response to IL-15 in the falfa genotype and lending further support for a direct action of IL-15 on adipose tissue. (C) 2002 Elsevier Science B.V. All rights reserved. C1 Univ Barcelona, Fac Biol, Canc Res Grp, Dept Bioquim & Biol Mol, E-08071 Barcelona, Spain. VA Puget Sound Hlth Care Syst, Res Serv, Tacoma, WA USA. Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Tacoma, WA USA. Univ Washington, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. RP Argiles, JM (reprint author), Univ Barcelona, Fac Biol, Canc Res Grp, Dept Bioquim & Biol Mol, Diagonal 645, E-08071 Barcelona, Spain. EM argiles@porthos.bio.ub.es; quinnl@u.washington.edu NR 20 TC 54 Z9 56 U1 2 U2 9 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0304-4165 J9 BBA-GEN SUBJECTS JI Biochim. Biophys. Acta-Gen. Subj. PD FEB 15 PY 2002 VL 1570 IS 1 BP 33 EP 37 AR PII S0304-4165(02)00148-4 DI 10.1016/S0304-4165(02)00148-4 PG 5 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 545LW UT WOS:000175219800005 PM 11960686 ER PT J AU Revankar, SG Patterson, JE Sutton, DA Pullen, R Rinaldi, MG AF Revankar, SG Patterson, JE Sutton, DA Pullen, R Rinaldi, MG TI Disseminated phaeohyphomycosis: Review of an emerging mycosis SO CLINICAL INFECTIOUS DISEASES LA English DT Review ID IN-VITRO ACTIVITY; SCEDOSPORIUM-PROLIFICANS INFECTION; FATAL DISSEMINATED INFECTION; 1ST CASE-REPORT; EXOPHIALA-DERMATITIDIS; CURVULARIA-LUNATA; MYCELIOPHTHORA-THERMOPHILA; VORICONAZOLE UK-109,496; AUREOBASIDIUM-PULLULANS; SCYTALIDIUM-DIMIDIATUM AB Disseminated phaeohyphomycosis is an uncommon infection caused by dematiaceous fungi, although the number of case reports about this infection has been increasing in recent years. A total of 72 cases are reviewed. Scedosporium prolificans is by far the most common cause. The presence of melanin in their cell walls may be a virulence factor for these fungi. The primary risk factor is decreased host immunity, although cases in apparently immunocompetent patients have been reported. Eosinophilia was seen in 11% of cases. Endocarditis is mostly reported on bioprosthetic valves, particularly those of porcine origin. The outcome of antifungal therapy remains poor, with an overall mortality rate of 79%. Special precautions taken for immunocompromised patients may help prevent exposure to fungi during the patients' period of greatest risk. The development of newer antifungal agents and combination therapy may hold promise in improving the management of these devastating infections in the future. C1 Vet Adm Med Ctr, Div Infect Dis 111D, Dallas, TX 75216 USA. Univ Texas, SW Med Ctr, Dept Med, Dallas, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP Revankar, SG (reprint author), Vet Adm Med Ctr, Div Infect Dis 111D, 4500 S Lancaster Rd, Dallas, TX 75216 USA. NR 92 TC 212 Z9 218 U1 2 U2 6 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD FEB 15 PY 2002 VL 34 IS 4 BP 467 EP 476 DI 10.1086/338636 PG 10 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 514UD UT WOS:000173458700007 PM 11797173 ER PT J AU Li, W Nadelman, C Gratch, NS Li, WQ Chen, M Kasahara, N Woodley, DT AF Li, W Nadelman, C Gratch, NS Li, WQ Chen, M Kasahara, N Woodley, DT TI An important role for protein kinase C-delta in human keratinocyte migration on dermal collagen SO EXPERIMENTAL CELL RESEARCH LA English DT Article ID ATP BINDING MUTANT; TYROSINE PHOSPHORYLATION; PKC-DELTA; CELLS; GROWTH; EXPRESSION; ACTIVATION; ALPHA; OVEREXPRESSION; PROLIFERATION AB Migration of human keratinocytes plays a critical role in the re-epithelialization of human skin wounds, the process by which the wound bed is resurfaced and closed by keratinocytes as it forms a new epidermis. While the importance of ECM components and serum factors in the regulation of keratinocytes motility is well established, the intracellular signaling mechanisms remain fragmentary. In this study, we investigated the role of protein kinase Cdelta (PKCdelta) signaling in the promotion of human keratinocyte migration by a collagen matrix and bovine pituitary extract. We found that pharmacological inhibition of the PKCdelta pathway completely blocks migration. Using a lentivirus-based vector system, which offers more than 90% gene transduction efficiency to human keratinocytes, we show that the kinase-defective mutant of PKCdelta (K376R) dramatically inhibits human keratinocyte migration. Furthermore, PKCdelta is activated in migrating human keratinocytes. These observations indicate for the first time that the PKCdelta pathway plays an important role in the control of human keratinocyte migration. m (C) 2002 Elsevier Science (USA). C1 Univ So Calif, Keck Sch Med, Dept Med, Div Dermatol, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Norris Canc Ctr, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Inst Med Genet, Los Angeles, CA 90033 USA. Greater Los Angeles Vet Adm Hlth Syst, Los Angeles, CA USA. Georgetown Univ, Med Ctr, Vincent T Lombardi Canc Res Ctr, Washington, DC 20007 USA. RP Li, W (reprint author), Univ So Calif, Keck Sch Med, Dept Med, Div Dermatol, Los Angeles, CA 90033 USA. FU NCI NIH HHS [R01 CA65567-05]; NIAMS NIH HHS [R01 AR46538-01] NR 37 TC 15 Z9 16 U1 0 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0014-4827 J9 EXP CELL RES JI Exp. Cell Res. PD FEB 15 PY 2002 VL 273 IS 2 BP 219 EP 228 DI 10.1006/excr.2001.5422 PG 10 WC Oncology; Cell Biology SC Oncology; Cell Biology GA 524JL UT WOS:000174009400011 PM 11822877 ER PT J AU Tsukamoto, H AF Tsukamoto, H TI Iron regulation of hepatic macrophage TNF alpha expression SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Review DE NF-kappa B; redox regulation; Kupffer cells; iron chelator; alcoholic liver disease; free radicals ID TUMOR-NECROSIS-FACTOR; NF-KAPPA-B; INDUCED LIVER-INJURY; NITRIC-OXIDE; ACTIVATED MACROPHAGES; LIPID-PEROXIDATION; MOLECULAR MECHANISMS; FERRITIN SYNTHESIS; INTERFERON-GAMMA; CYTO-TOXICITY AB Sustained TNFalpha induction is central to the pathogenesis of chronic liver disease including alcoholic liver disease (ALD). However, molecular understanding of this abnormality at the cellular level remains elusive. Redox regulation of NF-kappaB is critical in the transcriptional control of TNFa expression. Evidence supports that increased iron storage in hepatic macrophages (HM) is causally associated with accentuated and sustained NF-kappaB activation in these cells in ALD. Treatment of cultured HM with a lipophilic iron chelator (deferiprone) abrogates LPS-induced NF-kappaB activation. HM from an animal model of ALD have increased nonheme iron content accompanied by increased generation of EPR-detected radicals, NF-kappaB activation, and TNFa induction, all of which are normalized by ex vivo treatment of the cells with deferiprone. A moderate increase in the nonheme iron content in HM by erythrophagocytosis, promotes subsequent LPS-stimulated NF-kappaB activation in a hemeoxygenase-dependent manner. Recent evidence also suggests a role of intracellular low molecular weight iron in the early signal transduction for LPS-mediated NF-kappaB activation. (C) 2002 Elsevier Science Inc. C1 Univ So Calif, Keck Sch Med, Res Ctr Liver Dis, Los Angeles, CA 90089 USA. Univ So Calif, UCLA Res Ctr Alcohol Liver & Pancreat Dis, Los Angeles, CA 90089 USA. Greater Los Angeles VA Hlth Care Syst, Los Angeles, CA USA. RP Tsukamoto, H (reprint author), Univ So Calif, Keck Sch Med, Res Ctr Liver Dis, 1333 San Pablo St,MMR-402, Los Angeles, CA 90089 USA. FU NIAAA NIH HHS [R37AA06603, P50AA19999]; NIDDK NIH HHS [P30DK48522] NR 51 TC 28 Z9 29 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PD FEB 15 PY 2002 VL 32 IS 4 BP 309 EP 313 AR PII S0891-5849(01)00772-9 DI 10.1016/S0891-5849(01)00772-9 PG 5 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 522YU UT WOS:000173925200002 PM 11841920 ER PT J AU Turley, EA Noble, PW Bourguignon, LYW AF Turley, EA Noble, PW Bourguignon, LYW TI Signaling properties of hyaluronan receptors SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Review ID ENDOTHELIAL-CELL PROLIFERATION; TYROSINE KINASE-ACTIVITY; MEDIATED MOTILITY RHAMM; BINDING PROTEIN; EXTRACELLULAR-MATRIX; MOUSE MACROPHAGES; EPITHELIAL-CELLS; MULTIPLE-MYELOMA; CD44; ACID C1 Univ Western Ontario, London Reg Canc Ctr, London, ON N6A 4L6, Canada. Yale Univ, Sch Med, Pulm & Crit Care Sect, New Haven, CT 06520 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94121 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. RP Turley, EA (reprint author), Univ Western Ontario, London Reg Canc Ctr, 790 Commissioners Rd E, London, ON N6A 4L6, Canada. NR 83 TC 609 Z9 631 U1 8 U2 61 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD FEB 15 PY 2002 VL 277 IS 7 BP 4589 EP 4592 DI 10.1074/jbc.R100038200 PG 4 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 523NX UT WOS:000173962900005 PM 11717317 ER PT J AU Barnett, PG Chen, S Boden, WE Chow, B Every, NR Lavori, PW Hlatky, MA AF Barnett, PG Chen, S Boden, WE Chow, B Every, NR Lavori, PW Hlatky, MA TI Cost-effectiveness of a conservative, ischemia-guided management strategy after non-Q-wave myocardial infarction - Results of a randomized trial SO CIRCULATION LA English DT Article DE cost-benefit analysis; myocardial infarction; angiography; tests ID CORONARY ANGIOGRAPHY; UNSTABLE ANGINA; CARE COSTS; OUTCOMES; SURGERY; VA AB Background-Use of coronary angiography after myocardial infarction has been controversial, with some physicians advocating routine use and others advocating selective use only after documentation of residual myocardial ischemia. The effects of these strategies on economic outcomes have not been established. Methods and Results-We analyzed data from a randomized, controlled clinical trial conducted in 17 Department of Veterans Affairs hospitals that enrolled 876 clinically uncomplicated patients 24 to 72 hours after an acute non-Q-wave myocardial infarction. The routine invasive strategy included early coronary angiography with revascularization based on established guidelines. The conservative, ischemia-guided strategy included noninvasive testing with radionuclide ventriculography and exercise thallium scintigraphy, followed by coronary angiography in patients with objective evidence of myocardial ischemia. We measured the cost of hospitalization and outpatient visits and tests during follow-up and calculated the incremental cost-effectiveness ratio. The conservative, ischemia-guided strategy had lower costs than the routine invasive strategy, both during the initial hospitalization ($14 733 versus $19 256, P<0.001) and after a mean follow-up of 1.9 years ($39 707 versus $41 893, P=0.04). The hazard ratio for death was 0.72 (confidence limits, 0.51 to 1.01) in the conservative strategy. The conservative strategy had lower costs and better outcomes in 76% of 1000 bootstrap replications, and a cost-effectiveness ratio below $50 000 per year of life added in 96% of replications. Conclusions-A conservative, ischemia-guided strategy of selective coronary angiography and revascularization for patients who develop objective evidence of recurrent ischemia is more cost-effective than a strategy of routine coronary angiography after uncomplicated non-Q-wave myocardial infarction. C1 Stanford Univ, Sch Med, Stanford, CA 94305 USA. VA Palo Alto Hlth Care Syst, Palo Alto, CA USA. Syracuse VA Med Ctr, Syracuse, NY USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Hlatky, MA (reprint author), Stanford Univ, Sch Med, HRP Redwood Bldg,Room 150, Stanford, CA 94305 USA. NR 21 TC 30 Z9 32 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 12 PY 2002 VL 105 IS 6 BP 680 EP 684 DI 10.1161/hc0602.103584 PG 5 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 522YM UT WOS:000173924600015 PM 11839621 ER PT J AU Quinn, J Moore, M Benson, DF Clark, CM Doody, R Jagust, W Knopman, D Kaye, JA AF Quinn, J Moore, M Benson, DF Clark, CM Doody, R Jagust, W Knopman, D Kaye, JA TI A Videotaped CIBIC for dementia patients - Validity and reliability in a simulated clinical trial SO NEUROLOGY LA English DT Article ID ALZHEIMERS-DISEASE; GLOBAL CHANGE; RATING-SCALE; DOUBLE-BLIND; DRUG TRIALS; TACRINE; MULTICENTER; IMPRESSION AB Background: The global impression of a clinician is an Food and Drug Administration-mandated primary outcome measure for clinical trials in dementia. Reliability and validity of these measures are not well established. Methods: A videotaped version of the Clinician's Interview Based Impression-of Change (CIBIC) was evaluated. Raters were informed that the videotaped interviews were taken at baseline and 6 to 12 months later, when in fact half of the interviews were shown in reverse order. Ratings on "true order" interviews were compared with ratings on "reverse order" interviews. In addition, ratings by neurologists experienced in dementia were compared with those of less experienced raters. Results: Inter-rater reliability of the neurologists was poor when measured by absolute agreement on a 7-point scale (kappa = 0.18). With a less stringent 3-point scale (better, worse, or unchanged), inter-rater reliability was significantly better for the true order videos (kappa = 0.51) than for the reversed order videos (kappa = 0.12). Validity also was reduced in the reverse order group: neurologists rated 90% of subjects correctly in the "true order" group and 63% correctly in the "reversed order" group. The inter-rater reliability of the neurologists was greater than the less experienced raters, but the validity of the neurologists' ratings was only marginally better. Conclusions: The reliability and validity of the videotape CIBIC are reasonable when patients follow the expected course of gradual decline, but are poor when patients appear to improve. These findings suggest that global assessments should be modified as outcome measures in clinical trials with patients with dementia. C1 Portland Vet Affairs Med Ctr, Dept Neurol, Portland, OR 97201 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Univ Calif Davis, Dept Neurol, Davis, CA 95616 USA. Mayo Clin, Dept Neurol, Rochester, MN USA. RP Quinn, J (reprint author), Portland Vet Affairs Med Ctr, Dept Neurol, P3 R&D,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. OI Kaye, Jeffrey/0000-0002-9971-3478 FU NIA NIH HHS [AG 08017] NR 24 TC 31 Z9 31 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD FEB 12 PY 2002 VL 58 IS 3 BP 433 EP 437 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 520FT UT WOS:000173770900018 PM 11839844 ER PT J AU Muller, JG Isomatsu, Y Koushik, SV O'Quinn, M Xu, L Kappler, CS Hapke, E Zile, MR Conway, SJ Menick, DR AF Muller, JG Isomatsu, Y Koushik, SV O'Quinn, M Xu, L Kappler, CS Hapke, E Zile, MR Conway, SJ Menick, DR TI Cardiac-specific expression and hypertrophic upregulation of the feline Na+-Ca2+ exchanger gene H1-promoter in a transgenic mouse model SO CIRCULATION RESEARCH LA English DT Article DE Na+-Ca2+ exchanger; pressure-overload hypertrophy; transgenic mice ID SODIUM-CALCIUM EXCHANGER; HUMAN VENTRICULAR MYOCYTES; FAILING HUMAN HEART; NA-CA EXCHANGE; SARCOPLASMIC-RETICULUM; NA+/CA2+ EXCHANGER; HUMAN MYOCARDIUM; NCX1; CONTRACTION; RELAXATION AB The NCX1 gene contains three promoters (H1, K1, and Br1), and as a result of alternative promoter usage and alternative splicing, there are multiple tissue-specific variants of the Na+-Ca2+ exchanger. We have proposed that for NCX1, the H1 promoter regulates expression in the heart, the K1 promoter regulates expression in the kidney, and the Br1 promoter regulates expression in the brain as well as low-level ubiquitous expression. Here, using a transgenic mouse model, we test the role of the DNA region including -1831 to 67 by of intron 1, encompassing exon H1 of the feline NCX1 gene (NCX1H1). The NCX1H1 promoter was sufficient for driving the normal spatiotemporal pattern of NCX1 expression in cardiac development. The luciferase reporter gene was expressed in a heart-restricted pattern both in early embryos (embryonic days 8 to 14) and in later embryos (after embryonic day 14), when NCX1 is also expressed in other tissues. In the adult, no luciferase activity was detected in the kidney, liver, spleen, uterus, or skeletal muscle; minimal activity was detected in the brain; and very high levels of luciferase expression were detected in the heart. Transverse aortic constriction-operated mice showed significantly increased left ventricular mass after 7 days. In addition, there was a 2-fold upregulation of NCX1H1 promoter activity in the left ventricle in animals after 7 days of pressure overload compared with both control and sham-operated animals. This work demonstrates that the NCX1H1 promoter directs cardiac-specific expression of the exchanger in both the embryo and adult and is also sufficient for the upregulation of NCX1 in response to pressure overload. C1 Med Univ S Carolina, Gazes Cardiac Res Inst, Charleston, SC 29425 USA. Med Univ S Carolina, Div Cardiol, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs, Charleston, SC USA. Med Coll Georgia, Inst Mol Med & Genet, Augusta, GA 30912 USA. RP Menick, DR (reprint author), Med Univ S Carolina, Gazes Cardiac Res Inst, 114 Doughty St,Room 203,POB 250773, Charleston, SC 29425 USA. FU NHLBI NIH HHS [HL-60714, HL-60104, HL-48788] NR 37 TC 24 Z9 25 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7330 J9 CIRC RES JI Circ.Res. PD FEB 8 PY 2002 VL 90 IS 2 BP 158 EP 164 DI 10.1161/hh0202.103231 PG 7 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Hematology GA 521CT UT WOS:000173821800010 PM 11834708 ER PT J AU Clinton, JM Chansky, HA Odell, DD Zielinska-Kwiatkowska, A Hickstein, DD Yang, L AF Clinton, JM Chansky, HA Odell, DD Zielinska-Kwiatkowska, A Hickstein, DD Yang, L TI Characterization and expression of the human gene encoding two translocation liposarcoma protein-associated serine-arginine (TASR) proteins SO GENE LA English DT Article DE U12-type intron; retroposition; alternative splicing; RNA-binding protein ID SPLICE SITES; RNA; TRANSCRIPTION; SPECIFICITY; RETROPOSONS; SEQUENCES; INTERACTS; INTRONS; FAMILY AB Translocation liposarcoma protein (TLS)-associated serine-arginine (TASR)-1 and -2 are two newly identified serine-arginine splicing factors. Our recent studies suggest that disruption of TASR-mediated pre-mRNA splicing is involved in the pathogenesis of human leukemia and sarcomas. The mRNA transcripts for TASR-1 and -2 share an identical sequence at the 5' untranslated region (5' UTR) and in part of the coding region; however the other regions of the transcripts diverge from each other and it was not clear whether the differences resulted from alternative splicing or transcription from two distinct genes. Here we describe the assignment of both TASR cDNAs to the same 16 kb DNA segment located on chromosome 1. Despite the presence of at least three retroposed products of TASR-1 mRNA in the human genome, only the 16 kb structural TASR gene on chromosome 1 is actively transcribed. In addition, multiple polyadenylation sites and a rare U12-type intron were found within the TASR gene. Transcription initiation site of the TASR gene was determined by primer extension; analysis of the TASR promoter revealed that it lacks the TATA box but contains a GC-rich sequence. When cloned into a luciferase reporter and transfected into human cells, the TASR promoter construct generated luciferase activity that was at least 2000 fold greater than the promoterless plasmid. Northern blot analysis showed that at least five different TASR-1 and -2 transcripts are expressed in a broad range of human tissues. (C) 2002 Elsevier Science B.V. All rights reserved. C1 Univ Washington, Sch Med, Dept Orthoped & Sports Med, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. NCI, Dept Expt Transplantat & Immunol, Bethesda, MD 20892 USA. RP Yang, L (reprint author), Univ Washington, Sch Med, Dept Orthoped & Sports Med, 1660 S Columbian Way GMR 151, Seattle, WA 98108 USA. NR 21 TC 8 Z9 10 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-1119 J9 GENE JI Gene PD FEB 6 PY 2002 VL 284 IS 1-2 BP 141 EP 147 AR PII S0378-1119(02)00382-7 DI 10.1016/S0378-1119(02)00382-7 PG 7 WC Genetics & Heredity SC Genetics & Heredity GA 534QN UT WOS:000174598100014 PM 11891055 ER PT J AU Hussein, MR Wood, GS AF Hussein, MR Wood, GS TI Building bridges in cancer - Mismatch repair and microsatellite instability SO AMERICAN JOURNAL OF DERMATOPATHOLOGY LA English DT Review DE mismatch repair; microsatellite instability; high-frequency microsatellite instability; low-frequency microsatellite instability; microsatellite stable ID NONPOLYPOSIS COLORECTAL-CANCER; SPORADIC GASTRIC CARCINOMAS; SQUAMOUS-CELL CARCINOMA; HMLH1 PROMOTER; COLON-CANCER; DNA-REPAIR; P16 GENE; ENDOMETRIAL CARCINOMAS; ALTERED EXPRESSION; HYPERMETHYLATION AB Mismatch repair (MMR) defects and microsatellite instability (MSI) are two genetic alterations that have been documented in a wide variety of human cancers, including some that involve the skin. Available evidence indicates that these two features are sometimes directly related, although their connection seems to he indirect or nonexistent in other instances. The purposes, of this review are to summarize the variable relations between MMR and MSI as deduced from analysis of a diverse array of human neoplasms and to give brief insights as to the other molecular mechanisms potentially involved in the maintenance of genomic stability. C1 Univ Wisconsin, Dept Med Dermatol, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Wood, GS (reprint author), Univ Wisconsin, Dept Med Dermatol, Madison, WI 53705 USA. FU NIAMS NIH HHS [AR02136] NR 96 TC 13 Z9 15 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0193-1091 J9 AM J DERMATOPATH JI Am. J. Dermatopathol. PD FEB PY 2002 VL 24 IS 1 BP 76 EP 81 DI 10.1097/00000372-200202000-00016 PG 6 WC Dermatology SC Dermatology GA 517HY UT WOS:000173606100016 PM 11803288 ER PT J AU Oberley, TD AF Oberley, TD TI Oxidative damage and cancer SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Editorial Material ID MANGANESE SUPEROXIDE-DISMUTASE; RENAL-CELL CARCINOMA; ANTIOXIDANT ENZYMES; FERRIC NITRILOTRIACETATE; 4-HYDROXY-2-NONENAL-MODIFIED PROTEINS; IMMUNOGOLD ANALYSIS; BREAST-CANCER; RATS; KIDNEY; LOCALIZATION C1 Univ Wisconsin, Sch Med, Dept Pathol & Lab Med, Madison, WI USA. Vet Adm Hosp, Madison, WI USA. RP Oberley, TD (reprint author), William S Middleton Mem Vet Adm Med Ctr, Dept Pathol & Lab Med, 2500 Overlook Terrace,Room A-35, Madison, WI 53705 USA. NR 44 TC 114 Z9 125 U1 0 U2 2 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 0002-9440 J9 AM J PATHOL JI Am. J. Pathol. PD FEB PY 2002 VL 160 IS 2 BP 403 EP 408 DI 10.1016/S0002-9440(10)64857-2 PG 6 WC Pathology SC Pathology GA 519NZ UT WOS:000173733500002 PM 11839558 ER PT J AU Schultz, D Su, XF Wei, CC Bishop, SP Powell, P Hankes, GH Dillon, AR Rynders, P Spinale, FG Walcott, G Ideker, R Dell'Italia, LJ AF Schultz, D Su, XF Wei, CC Bishop, SP Powell, P Hankes, GH Dillon, AR Rynders, P Spinale, FG Walcott, G Ideker, R Dell'Italia, LJ TI Downregulation of ANG II receptor is associated with compensated pressure-overload hypertrophy in the young dog SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE angiotensin II; hypertrophy; angiotensin II receptors; arrhythmias ID RENIN-ANGIOTENSIN SYSTEM; LEFT-VENTRICULAR HYPERTROPHY; NITRIC-OXIDE SYNTHASE; INDUCED HEART-FAILURE; MYOCARDIAL-INFARCTION; MOLECULAR-CLONING; CONVERTING ENZYME; CARDIAC FIBROSIS; GENE-EXPRESSION; DOWN-REGULATION AB We studied the gradual onset of pressure overload (PO) induced by a mildly constricting aortic band in 8-wk-old puppies (n = 8) that increased to 98 +/- 11 mmHg at 9 mo. Left ventricular (LV) weight/body weight was increased in PO versus sham-operated littermate controls [8.11 +/- 0.60 (SE) vs. 4.46 +/- 0.38 g/kg, P < 0.001]. LV end-diastolic diameter, diastolic pressure, and fractional shortening did not differ in PO versus control dogs. There were no inducible arrhythmias in response to an aggressive electrophysiological stimulation protocol in PO dogs. Furthermore, isolated cardiomyocyte function did not differ between control and PO dogs. LV angiotensin II (ANG II) levels were increased (68 +/- 12 vs. 20 +/- 5 pg/g, P < 0.01) as steady-state ANG II type 1 (AT(1)) receptor mRNA was decreased 40% and endothelial nitric oxide synthase mRNA levels were increased 2.5-fold in PO versus control dogs (P < 0.05). Total ANG II receptor binding sites of freshly prepared cardiac membranes demonstrated no difference in the dissociation constant, but there was a 60% decrease in maximum binding (B-max) in PO versus control dogs (P < 0.01). LV ANG II levels correlated negatively with AT(1) receptor mRNA levels (r = -0.75, P < 0.01) and total AT(1) receptor B-max (r = -0.77, P < 0.02). These results suggest that LV ANG II negatively regulates AT(1) receptor expression and that this is an adaptive response to chronic PO before the onset of myocardial failure in the young dog. C1 Univ Alabama, Dept Med, Div Cardiovasc Dis, Birmingham, AL 35294 USA. Univ Alabama, Birmingham Vet Affairs Med Ctr, Birmingham, AL 35294 USA. Univ Alabama, Dept Pathol, Birmingham, AL 35294 USA. Auburn Univ, Coll Vet Med, Auburn, AL 36849 USA. Emory Univ, Atlanta, GA 30322 USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Dell'Italia, LJ (reprint author), Univ Alabama, Dept Med, Div Cardiol, MCLM 834, 1530 3rd Ave S, Birmingham, AL 35295 USA. NR 43 TC 8 Z9 9 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD FEB PY 2002 VL 282 IS 2 BP H749 EP H756 PG 8 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 514BR UT WOS:000173416900043 PM 11788426 ER PT J AU Ricono, JM Arar, M Choudhury, GG Abboud, HE AF Ricono, JM Arar, M Choudhury, GG Abboud, HE TI Effect of platelet-derived growth factor isoforms in rat metanephric mesenchymal cells SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE kidney; development; mesangial cell; signal transduction ID FACTOR RECEPTOR-BETA; SIGNAL-TRANSDUCTION; MESANGIAL CELLS; DNA-SYNTHESIS; KINASE; CHEMOTAXIS; PROTEIN; MIGRATION; KIDNEY; ALPHA AB Platelet-derived growth factor (PDGF) B-chain or PDGF beta-receptor-deficient mice lack mesangial cells. To explore potential mechanisms for failure of PDGF A-chain to rescue mesangial cell phenotype, we investigated the biological effects and signaling pathways of PDGF AA and PDGF BB in metanephric mesenchymal (MM) cells isolated from rat kidney. PDGF AA caused modest cell migration but had no effect on DNA synthesis, unlike PDGF BB, which potently stimulated migration and DNA synthesis. PDGF AA and PDGF BB significantly increased the activities of phosphatidylinositol 3-kinase (PI 3-K) and mitogen-activated protein kinase (MAPK). PDGF BB was more potent than PDGF AA in activating PI 3-K or MAPK in these cells. Pretreatment of MM cells with the MAPK kinase (MEK) inhibitor PD-098059 abrogated PDGF BB-induced DNA synthesis, whereas the PI 3-K inhibitor wortmannin had a very modest inhibitory effect on DNA synthesis (approximately Delta20%). On the other hand, wortmannin completely blocked PDGF AA- and PDGF BB-induced migration, whereas PD-098059 had a modest inhibitory effect on cell migration. These data demonstrate that activation of MAPK is necessary for the mitogenic effect of PDGF BB, whereas PI 3-K is required for the chemotactic effect of PDGF AA and PDGF BB. Although PDGF AA stimulates PI 3-K and MAPK activity, it is not mitogenic and only modestly chemotactic. Collectively, the data may have implications related to the failure of PDGF AA to rescue mesangial cell phenotype in PDGF B-chain or PDGF-beta-receptor deficiency. C1 Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pediat, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Inst Biotechnol, Dept Mol Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Abboud, HE (reprint author), Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med, MC 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM abboud@uthscsa.edu FU NIDDK NIH HHS [DK-55815, DK-33665] NR 25 TC 12 Z9 12 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD FEB PY 2002 VL 282 IS 2 BP F211 EP F219 PG 9 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 512XD UT WOS:000173348100004 PM 11788434 ER PT J AU Edgerton, EA Duan, NH Seidel, JS Asch, S AF Edgerton, EA Duan, NH Seidel, JS Asch, S TI Predictors of seat-belt use among school-aged children in two low-income Hispanic communities SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE child; Hispanic Americans; motor vehicles; seat belts ID INJURY SEVERITY AB Objectives: To examine the prevalence of seat belt use among school-aged children in low-income Hispanic communities. Methods: We conducted unobtrusive observations of school-aged children (aged 5 to 12 years) traveling to and from nine elementary schools in two communities. We documented vehicle type, and belted status and seating position of children, driver, and other passengers. Results are presented as percentages with 95% confidence intervals (CIs). Results: We observed 3651 children, of which restraint use could be determined for 2741. Overall, 29% of children were using seat belts. By seating location, 58% were in the front seat with 40% belted, and 42% were in the back seat with 14% belted. Children were most likely to be restrained when traveling in the front seat (40.0%, CI=37.6-42.5); traveling with a belted driver (42.4%, CI=40.0-44.8); or traveling without additional passengers (40.3%, CI=37.0-43.7). Conclusions. Seat belt use among children from this Study population was below the national average and was alarmingly low among children in the back scat. While traveling, being belted in the back seat provides the most protection in a collision. Prevention efforts need to be based on an understanding of the barriers to restraint use for children traveling in the back seat. C1 Univ Calif Los Angeles, Harbor Med Ctr, Div Gen & Emergency Pediat, Torrance, CA 90509 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. Vet Adm Greater Los Angeles, Res Serv, Los Angeles, CA USA. RP Edgerton, EA (reprint author), Childrens Natl Med Ctr, MPII,111 Michigan Ave NW, Washington, DC 20010 USA. NR 26 TC 7 Z9 8 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD FEB PY 2002 VL 22 IS 2 BP 113 EP 116 AR PII S0749-3797(01)00411-1 DI 10.1016/S0749-3797(01)00412-3 PG 4 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 529VR UT WOS:000174322100007 PM 11818181 ER PT J AU Martins, D Tareen, N Norris, KC AF Martins, D Tareen, N Norris, KC TI The epidemiology of end-stage renal disease among African Americans SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Article DE epidemiology; renal disease; end-stage renal disease (ESRD); African Americans; hypertension; diabetes ID NUTRITION EXAMINATION SURVEY; HIV-ASSOCIATED NEPHROPATHY; 3RD NATIONAL-HEALTH; BLOOD-PRESSURE CONTROL; HYPERTENSIVE NEPHROSCLEROSIS; DIABETES-MELLITUS; RACIAL-DIFFERENCES; RISK; METAANALYSIS; PROGRESSION AB Although disparities in outcomes among African Americans compared with whites with respect to cardiovascular disease, cancer, diabetes, infant mortality, and other health standards have been well-described, these disparities are most dramatic with respect to kidney diseases. End-stage renal disease (ESRD) occurs almost 4 times more commonly in African Americans than in their white counterparts. These disparate rates of kidney disease may be caused by the complex interplay of genetic, environmental, cultural, and socioeconomic factors. African Americans are particularly vulnerable to the deleterious renal effects of hypertension and may require more aggressive blood pressure control than whites to accrue benefit with respect to preservation of renal function. Diabetes, the leading cause of ESRD in the United States, is another important factor in the excess renal morbidity and mortality of African Americans because of its prevalence in this population. Other renal diseases, especially those associated with HIV/AIDS, are also much more likely to affect African Americans than other American population subgroups. A more thorough understanding of the epidemiology of renal diseases in African Americans and the cultural, social, and biological differences that underlie racial disparities in prevalence of renal disease will be essential to the design of effective public health strategies for prevention and treatment of this burdensome problem. C1 Charles R Drew Univ Med & Sci, Dept Internal Med, Los Angeles, CA 90059 USA. Univ Calif Los Angeles, Sch Med, Dept Internal Med, Los Angeles, CA 90024 USA. W Los Angeles Vet Adm Med Ctr, Los Angeles, CA USA. RP Norris, KC (reprint author), Charles R Drew Univ Med & Sci, Dept Internal Med, 12021 S Wilmington, Los Angeles, CA 90059 USA. FU NCRR NIH HHS [P20-RR11145, G12-RR03026] NR 43 TC 57 Z9 59 U1 1 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-9629 EI 1538-2990 J9 AM J MED SCI JI Am. J. Med. Sci. PD FEB PY 2002 VL 323 IS 2 BP 65 EP 71 DI 10.1097/00000441-200202000-00002 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 520ND UT WOS:000173787200002 PM 11863081 ER PT J AU Novis, DA Renner, S Friedberg, R Walsh, MK Saladino, AJ AF Novis, DA Renner, S Friedberg, R Walsh, MK Saladino, AJ TI Quality indicators of blood utilization - Three college of American Pathologists Q-Probes studies of 12 288 404 red blood cell units in 1639 hospitals SO ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE LA English DT Article ID ORDER SCHEDULE; INSTITUTIONS AB Objectives To determine the normative rates of blood unit crossmatched to transfused (C:T) ratios, red blood cell (RBC) unit wastage, and RBC unit expiration that exist in hospital communities throughout the United States, and to examine hospital blood bank practices associated with more desirable (lower) rates. Design In 3 separate studies, participants in the College of American Pathologists Q-Probes laboratory quality improvement program collected data retrospectively on the number of transfusion crossmatches performed in their institutions and the number of RBC-containing units that were transfused into patients, the number of units that expired (outdated) prior to being utilized, and the number that were wasted due to mishandling. Participants also completed questionnaires describing their hospitals' and blood banks' laboratory and transfusion practices. Setting and Participants One thousand six hundred thirty-nine public and private institutions, well more than 80% of which were known to be located in the United States. Main Outcome Measures Quality indicators of blood utilization (namely, the C:T ratio, the rate of RBC unit expiration, and the rate of RBC unit wastage). Results Participants submitted data on 12 288 404 RBC unit transfusions. The C:T ratios were 1.5 or less in the top-performing 10% of participating institutions (90th percentile and above), 1.8 to 1.9 in the midrange of participating institutions (50th percentile), and 2.4 or greater in the bottom-performing 10% of participating institutions (10th percentile and below). Red blood cell unit expiration rates were 0.1% or less at the 90th percentile and above, 0.3% to 0.9% at the 50th percentile, and 3.5% or greater at the 10th percentile and below. Red blood cell unit wastage rates were 0.1% or less at the 90th percentile and above, 0.1% to 0.4% at the 50th percentile, and 0.7% or greater at the 10th percentile and below. Depending on which quality indicator was examined, lower values (ie, better performances) were found in institutions that had fewer than 200 hospital beds, no teaching programs, no on-site full-time medical directors of transfusion services, did not utilize maximum surgical blood order schedules, set C:T threshold goals of 2.0 or less, monitored categories of health care workers responsible for RBC wastage, monitored requests for RBC components by transfusion indication, did not accept short-dated units from blood distribution centers, and if they did accept short-dated units, were allowed to return those units to the distribution centers. Conclusions Hospital blood bank personnel can achieve C:T ratios below 2.0, RBC unit expiration rates below 1.0%, and RBC unit wastage rates below 0.5%. Lower C:T ratios and/or RBC unit expiration rates were associated with blood bank personnel setting C:T thresholds of 2.0 or less, monitoring requests for blood components by transfusion indication criteria, monitoring categories of health care workers responsible for blood wastage, not accepting short-dated units from blood distribution centers, and if short-dated units were accepted, being allowed to return those units to the blood distribution center. These practices were not associated with lower blood wastage rates. C1 Wentworth Douglass Hosp, Dept Pathol, Dover, NH 03820 USA. Vet Adm Greater Los Angeles Healthcare Syst, Dept Pathol, Los Angeles, CA USA. Univ Alabama, Birmingham Vet Adm Med Ctr, Birmingham, AL USA. Coll Amer Pathologists, Northfield, IL USA. Dept Vet Affairs Med Ctr, Ft Howard, MD USA. RP Novis, DA (reprint author), Wentworth Douglass Hosp, Dept Pathol, Dover, NH 03820 USA. NR 15 TC 32 Z9 32 U1 0 U2 1 PU COLLEGE AMER PATHOLOGISTS PI NORTHFIELD PA C/O KIMBERLY GACKI, 325 WAUKEGAN RD, NORTHFIELD, IL 60093-2750 USA SN 0003-9985 J9 ARCH PATHOL LAB MED JI Arch. Pathol. Lab. Med. PD FEB PY 2002 VL 126 IS 2 BP 150 EP 156 PG 7 WC Medical Laboratory Technology; Medicine, Research & Experimental; Pathology SC Medical Laboratory Technology; Research & Experimental Medicine; Pathology GA 520NA UT WOS:000173786900005 PM 11825109 ER PT J AU Cooper, RA Thorman, T Cooper, R Dvorznak, MJ Fitzgerald, SG Ammer, W Song-Feng, G Boninger, ML AF Cooper, RA Thorman, T Cooper, R Dvorznak, MJ Fitzgerald, SG Ammer, W Song-Feng, G Boninger, ML TI Driving characteristics of electric-powered wheelchair users: How far, fast, and often do people drive? SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE community action; rehabilitation; wheelchairs ID DISABLED-CHILDREN AB Objectives: To determine the driving characteristics of electric-powered wheelchair users during unrestricted community activities and to compare the activity levels among an active group and a group of regular users. Design: Multisite engineering evaluation of electric-powered wheelchair driving activity during unrestricted community mobility. Setting: Data were collected in the communities of Pittsburgh, PA, and the National Veterans Wheelchair Games (NVWG) in San Antonio, TX. Participants: Seventeen people participated, all of whom used electric-powered wheelchairs as their primary means of mobility. Intervention: Each subject was asked standarized questions about self and wheelchair use. Data logger and sensor installed on wheelchair. Data downloaded from logger. Main Outcome Measures: Speed, distance traveled, and the time that each subject's personal wheelchair was being driven were recorded for 24hr/d over approximately 5 days for each subject by using a custom-built data logger. Results: The NVWG group traveled faster than the Pittsburgh group, but this difference was only statistically significant on the first day. The NVWG group was more likely to travel longer than the Pittsburgh group with significant differences seen in day 4 (P = .03) and day 5 (P = .05). Total distance traveled during the 5-day period and average distance traveled per day were also significantly different between the groups (P = .02 for both 5-day distance and daily distance), with the NVWG group traveling longer (17.164 +/- 8708m) when compared with the Pittsburgh group (8335 +/- 7074m) over the 5-day period. Both distance traveled and speed increased during afternoon and evening hours. The maximum distance traveled by any Subject for each hour across the 2 groups was used to create the theoretic maximum distance day, which resulted in 7970m of driving. Conclusion: Drivers of electric-powered wheelchairs are most active during the afternoon and evening hours. Over the 5-day period of this study, there was little Variation in the speed or distance driven per day. The Subjects participating in the NVWG were more active than their Counterparts during a typical week at home. The maximum theoretic distance that a wheelchair user in our group would travel is less than 8km. The range of current electric-powered wheelchairs appears adequate. if not generous. for the subjects in our study. C1 VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs 151R1, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs 151R1, 7180 Highland Dr, Pittsburgh, PA 15206 USA. OI Boninger, Michael/0000-0001-6966-919X NR 14 TC 52 Z9 52 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD FEB PY 2002 VL 83 IS 2 BP 250 EP 255 DI 10.1053/apmr.2002.28020 PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 519DP UT WOS:000173709900018 PM 11833031 ER PT J AU Stein, CM Olson, JM Gray-McGuire, C Bruner, GR Harley, JB Moser, KL AF Stein, CM Olson, JM Gray-McGuire, C Bruner, GR Harley, JB Moser, KL TI Increased prevalence of renal disease in systemic lupus erythematosus families with affected male relatives SO ARTHRITIS AND RHEUMATISM LA English DT Article ID SIB-PAIR FAMILIES; CLINICAL MANIFESTATIONS; SUSCEPTIBILITY GENES; LABORATORY FEATURES; COMPLEMENT; SUBSETS; LINKAGE; GENDER; MICE; RACE AB Objective. To distinguish familial differences from sex-related differences in the clinical manifestations of systemic lupus erythematosus (SLE). Methods. A total of 372 affected individuals from 160 multiplex SLE pedigrees were analyzed. Twenty-five of these pedigrees contained at least 1 affected male relative. Comparisons of the presence of each of the 11 1982 American College of Rheumatology criteria for SLE were made between female family members with affected male relatives and those without affected male relatives, using Fisher's exact tests. Results. The presence of renal disease was significantly increased in female family members with an affected male relative when compared with those with no affected male relative (68% and 43%, respectively; P = 0.002). This trend remained after stratifying by race and was most pronounced in European Americans. A familial basis for differences in hematologic and immunologic manifestations was also suggested, while arthritis and dermatologic features appeared to be most influenced by sex. Conclusion. Our results demonstrate that the increased prevalence of renal disease previously reported in men with SLE is, in large part, a familial rather than sex-based difference, at least in multiplex SLE families. Distinguishing familial from sex-related differences may facilitate efforts to understand the genetic and hormonal factors that underlie this complex autoimmune disease. C1 Univ Minnesota, Dept Med, Rheumat & Autoimmune Dis Div, Minneapolis, MN 55455 USA. Case Western Reserve Univ, Cleveland, OH 44106 USA. Univ Oklahoma, Hlth Sci Ctr, Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. RP Moser, KL (reprint author), Univ Minnesota, Dept Med, Rheumat & Autoimmune Dis Div, 6-122 BSBE Bldg,312 Church St SE, Minneapolis, MN 55455 USA. OI Stein, Catherine/0000-0002-9763-5023 FU NCRR NIH HHS [RR-03655]; NHGRI NIH HHS [HG-01577]; NHLBI NIH HHS [HL-07567]; NIAID NIH HHS [AI-24717, AI-31584]; NIAMS NIH HHS [AR-42460, AR-45231] NR 52 TC 19 Z9 19 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0004-3591 J9 ARTHRITIS RHEUM JI Arthritis Rheum. PD FEB PY 2002 VL 46 IS 2 BP 428 EP 435 DI 10.1002/art.10105 PG 8 WC Rheumatology SC Rheumatology GA 520MN UT WOS:000173785800017 PM 11840445 ER PT J AU Orces, CH del Rincon, I Abel, MP Escalante, A AF Orces, CH del Rincon, I Abel, MP Escalante, A TI The number of deformed joints as a surrogate measure of damage in rheumatoid arthritis SO ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH LA English DT Article DE rheumatoid arthritis; joint damage; joint deformity; joint counts ID PRELIMINARY CORE SET; CLINICAL-TRIALS; DISABILITY; COUNTS; HLA-DRB1; ALLELES; DISEASE; MOTION; SCALE; SCORE AB Objective, To evaluate the reliability and validity of the number of deformed joints (NDJ) as a surrogate measure of joint damage in rheumatoid arthritis (RA). Methods. We tested interrater reliability and validity in determining the NDJ as a surrogate for joint damage in consecutive patients with RA. We rated each of 48 joints as normal or abnormal in terms of alignment and range of motion, and expressed the results as the total number of deformed joints. We compared the NDJ with the severity of damage on a plain radiograph of the hands, scored using Sharp's technique, as the gold standard measure of joint damage. We also compared the correlation between the NDJ and radiographic joint damage, on the one hand, and disease duration, performance-based measures of physical function, and the self-reported level of disability. Results. The interrater reliability of the NDJ was excellent, with an intraclass correlation among four examiners of 0.94. To assess validity of the NDJ, we studied 273 RA patients from 5 clinical settings. Their average NDJ was 14 (range 0-43), and their average Sharp's score for joint space narrowing and erosions combined was 106 (range 4-309). The NDJ and the total Sharp's score were highly correlated (r = 0.83). Both measures were correlated to a similar degree with disease duration (r = 0.51 for each measure), grip strength (r = -0.49 for NDJ, and r = -0.51 for Sharp's score), walking velocity (r = -0.44 for NDJ, and r = -0.45 for Sharp's score), the timed button test (r = -0.62 for NDJ, and r = -0.57 for Sharp's score), and the Modified Health Assessment Questionnaire (r = 0.38 for NDJ, and r = 0.38 for Sharp's score). Both the Sharp's score and the NDJ worsened significantly in 38 patients for whom 1-2 year followup data were available. Conclusion. The NDJ is reliable and is strongly associated with the standard measure of joint damage in RA. Because it is easily performed in a clinical setting, it could be used as an economical surrogate of joint damage in studies of the long-term outcome of RA. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. S Texas Vet Adm Hlth Syst, San Antonio, TX USA. Wilford Hall USAF Med Ctr, San Antonio, TX 78236 USA. RP Escalante, A (reprint author), Univ Texas, Hlth Sci Ctr, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NCRR NIH HHS [M01-RR-01346]; NHLBI NIH HHS [K23-HL-004481]; NIAMS NIH HHS [K24-AR-47530]; NICHD NIH HHS [R01-HD-37151] NR 29 TC 41 Z9 42 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0004-3591 J9 ARTHRIT RHEUM-ARTHR JI Arthritis Rheum-Arthritis Care Res. PD FEB PY 2002 VL 47 IS 1 BP 67 EP 72 DI 10.1002/art1.10160 PG 6 WC Rheumatology SC Rheumatology GA 520VU UT WOS:000173803700011 PM 11932880 ER PT J AU Zamora, A Matejuk, A Silverman, M Vandenbark, AA Offner, H AF Zamora, A Matejuk, A Silverman, M Vandenbark, AA Offner, H TI Inhibitory effects of incomplete Freund's aduvant on experimental autoimmune encephalomyelitis SO AUTOIMMUNITY LA English DT Article DE IFA; EAE; gamma INF; IL10; MBP Ac1-11 ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; BV8S2 TRANSGENIC MICE; GUINEA-PIG; T-CELLS; ADJUVANT; PROTEIN; SUPPRESSION; PROTECTION; INDUCTION; ANTIGEN AB Freund's incomplete adjuvant (IFA), an aqueous/oil emulsion that is widely used in combination with antigenic proteins and peptides to induce tolerance, is considered to be immunologically inert. However, sporadic reports indicate that IFA may itself have inhibitory proper-ties on induction of adjuvant induced arthritis and spontaneous diabetes. In the current study, the effects of IFA/saline were evaluated on the induction of experimental autoimmune encephalomyelitis (EAE) in three different strains of mice, IFA/saline given i.p. in two doses of > 100 mul 10 days apart were found to inhibit EAE induction to varying degrees in all three strains of mice in a dose dependent fashion. The IFA/saline injections inhibited both mitogen and antigen-induced T cell proliferation, induced elevated secretion of IFN-gamma and IL-10 by neuroantigen specific T cells, and reduced expression of cytokines. chemokines, and chemokine receptors of CNS-infiltrating mononuclear cells. These data demonstrate for the first time a direct inhibitory effect of IFA/saline on EAE. and re-emphasize the need to Properly control experiments using IFA to induce antigen-specific tolerance. C1 Portland VA Med Ctr, Neuroimmunol Res R&D 31, Portland, OR 97201 USA. RP Offner, H (reprint author), Portland VA Med Ctr, Neuroimmunol Res R&D 31, 3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. FU NIAID NIH HHS [AI42376]; NINDS NIH HHS [NS23221, NS23444] NR 15 TC 8 Z9 8 U1 1 U2 2 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK,, ABINGDON OX14 4RN, OXON, ENGLAND SN 0891-6934 J9 AUTOIMMUNITY JI Autoimmunity PD FEB PY 2002 VL 35 IS 1 BP 21 EP 28 DI 10.1080/08916930290005873 PG 8 WC Immunology SC Immunology GA 525DR UT WOS:000174053900003 PM 11908703 ER PT J AU Lyamin, OI Mukhametov, LM Siegel, JM Nazarenko, EA Polyakova, IG Shpak, OV AF Lyamin, OI Mukhametov, LM Siegel, JM Nazarenko, EA Polyakova, IG Shpak, OV TI Unihemispheric slow wave sleep and the state of the eyes in a white whale SO BEHAVIOURAL BRAIN RESEARCH LA English DT Article DE unihemispheric sleep; slow wave sleep; unilateral eye closure; eye state; Beluga; white whale; Cetaceans ID DOLPHINS AB We recorded electroencephalogram (EEG) and simultaneously documented the state of both eyelids during sleep and wakefulness in a sub-adult male white whale over a 4-day-period. We showed that the white whale was the fifth species of Cetaceans, which exhibits unihemispheric slow wave sleep. We found that the eye contralateral to the sleeping hemisphere in this whale was usually closed (right eye, 52% of the total sleep time in the contralateral hemisphere; left eye, 40%) or in an intermediate state (31 and 46%, respectively) while the ipsilateral eye was typically open (89 and 80%). Episodes of bilateral eye closure in this whale occupied less than 2% of the observation time and were usually recorded during waking (49% of the bilateral eye closure time) or low amplitude sleep (48%) and rarely in high amplitude sleep (3%). In spite of the evident overall relationship between the sleeping hemisphere and eye state, EEG and eye position in this whale could be independent over short time periods (less than 1 min). Therefore, eye state alone may not accurately reflect sleep state in Cetaceans. Our data support the idea that unihemispheric sleep allows Cetaceans to monitor the environment. (C) 2002 Elsevier Science B.V. All rights reserved. C1 Severtsov Inst Ecol & Evolut, Moscow 117071, Russia. Univ Calif Los Angeles, Sch Med, Dept Psychiat, North Hills, CA 91343 USA. RP Lyamin, OI (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Sleep Res 151A3, 16111 Plummer St, North Hills, CA 91343 USA. FU NINDS NIH HHS [NS32819] NR 17 TC 43 Z9 44 U1 6 U2 23 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0166-4328 J9 BEHAV BRAIN RES JI Behav. Brain Res. PD FEB 1 PY 2002 VL 129 IS 1-2 BP 125 EP 129 AR PII S0166-4328(01)00346-1 DI 10.1016/S0166-4328(01)00346-1 PG 5 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 521KL UT WOS:000173839100014 PM 11809503 ER PT J AU Furst, BA Champion, KM Pierre, JM Wirshing, DA Wirshing, WC AF Furst, BA Champion, KM Pierre, JM Wirshing, DA Wirshing, WC TI Possible association of QTc interval prolongation with co-administration of quetiapine and lovastatin SO BIOLOGICAL PSYCHIATRY LA English DT Article DE quetiapine; lovastatin; QTc prolongation; schizophrenia; dyslipidemia; weight ID REDUCTASE INHIBITORS; PHARMACOKINETICS AB Background: QTc interval prolongation can occur as a result of treatment with both conventional and novel antipsychotic medications and is of clinical concern because of its association with the potentially fatal ventricular arrhythmia, torsade de pointes. Methods: One case is described in which a patient with schizophrenia, who was being treated for dyslipidemia, developed a prolonged QTc interval while taking quetiapine and lovastatin. Results: QTc returned to baseline when the lovastatin dose was reduced. Conclusions: QTc prolongation associated with antipsychotic medication occurs in a dose-dependent manner. We therefore hypothesize that the addition of lovastatin caused an increase in plasma quetiapine levels through competitive inhibition of the cytochrome P-450 (CYP) isoenzyme 3A4. Our case highlights the potential for a drug interaction between quetiapine and lovastatin leading to QTc prolongation during the management of dysipidemia inpatients with schizophrenia. Biol Psychiatry 2002,51: 264-265 (C) 2002 Society of Biological Psychiatry. C1 VA Greater Los Angles Healthcare Syst, Dept Psychiat, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Wirshing, DA (reprint author), VA Greater Los Angles Healthcare Syst, Dept Psychiat, 11301 Wilshire Blvd,Bldg 210,Room 15 B151H, Los Angeles, CA 90073 USA. NR 11 TC 24 Z9 25 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD FEB 1 PY 2002 VL 51 IS 3 BP 264 EP 265 DI 10.1016/S0006-3223(01)01333-6 PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 520YH UT WOS:000173811000009 PM 11839370 ER PT J AU Wang, H Jiang, XH Yang, F Chapman, GB Durante, W Sibinga, NES Schafer, AI AF Wang, H Jiang, XH Yang, F Chapman, GB Durante, W Sibinga, NES Schafer, AI TI Cyclin A transcriptional suppression is the major mechanism mediating homocysteine-induced endothelial cell growth inhibition SO BLOOD LA English DT Article ID SMOOTH-MUSCLE CELLS; CHRONIC-RENAL-FAILURE; MAP KINASE CASCADE; BRAIN-TUMOR CELLS; VASCULAR-DISEASE; DOWN-REGULATION; RISK FACTOR; S-ADENOSYLHOMOCYSTEINE; A GENE; CORONARY ATHEROSCLEROSIS AB Previously, it was reported that homocysteine (Hcy) specifically inhibits the growth of endothelial cells (ECs), suppresses Ras/mitogen-activated protein (MAP) signaling, and arrests cell growth at the G(1)/S transition of the cell cycle. The present study investigated the molecular mechanisms underlying this cell-cycle effect. Results showed that clinically relevant concentrations (50 muM) of Hcy significantly inhibited the expression of cyclin A messenger RNA (mRNA) in ECs in a dose- and time-dependent manner. G(1)/S-associated molecules that might account for this block were not changed, because Hcy did not affect mRNA and protein expression of cyclin D1 and cyclin E. Cyclin D1- and E-associated kinase activities were unchanged. In contrast, cyclin A-associated kinase activity and CDK2 kinase activity were markedly suppressed. Nuclear run-on assay demonstrated that Hcy decreased the transcription rate of the cyclin A gene but had no effect on the half-life of cyclin A mRNA. In transient transfection experiments, Hcy significantly inhibited cyclin A promoter activity in endothelial cells, but not in vascular smooth muscle cells. Finally, adenovirus-transduced cyclin A expression restored EC growth inhibition and overcame the S phase block imposed by Hcy. Taken together, these findings indicate that cyclin A is a critical functional target of Hcy-mediated EC growth inhibition. (C) 2002 by The American Society of Hematology. C1 Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. Rice Univ, Baylor Coll Med, Dept Bioengn, Dept Med, Houston, TX 77251 USA. Rice Univ, Baylor Coll Med, Dept Bioengn, Dept Pharmacol, Houston, TX 77251 USA. Albert Einstein Coll Med, New York, NY USA. RP Wang, H (reprint author), Baylor Coll Med, VA Med Ctr, 2002 Holcombe Ave 109-129, Houston, TX 77030 USA. FU NHLBI NIH HHS [HL-62467, HL-59976] NR 69 TC 40 Z9 43 U1 0 U2 1 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD FEB 1 PY 2002 VL 99 IS 3 BP 939 EP 945 PG 7 WC Hematology SC Hematology GA 515ZQ UT WOS:000173527000030 PM 11806997 ER PT J AU Keith, RL Miller, YE Hoshikawa, Y Moore, MD Gesell, TL Gao, BF Malkinson, AM Golpon, HA Nemenoff, RA Geraci, MW AF Keith, RL Miller, YE Hoshikawa, Y Moore, MD Gesell, TL Gao, BF Malkinson, AM Golpon, HA Nemenoff, RA Geraci, MW TI Manipulation of pulmonary prostacyclin synthase expression prevents murine lung cancer SO CANCER RESEARCH LA English DT Article ID CONTINUOUS INTRAVENOUS EPOPROSTENOL; BUTYLATED HYDROXYTOLUENE; BETA-CAROTENE; CARDIOVASCULAR-DISEASE; COLORECTAL-CANCER; TRANSGENIC MICE; ORGAN-CULTURE; ASPIRIN USE; VITAMIN-A; A/J MICE AB Inhibition of cyclooxygenase (COX) activity decreases eicosanoid production and prevents lung cancer in animal models. Prostaglandin (PG) I-2 (PGI(2) prostacyclin) is a PGH(2) metabolite with anti-inflammatory, antiproliferative, and antimetastatic properties. The instability of PGI(2) has limited its evaluation in animal models of cancer. We hypothesized that pulmonary overexpression of prostacyclin synthase may prevent the development of murine lung tumors. Transgenic mice with selective pulmonary prostacyclin synthase overexpression were exposed to two distinct carcinogenesis protocols: an initiation/promotion model and a simple carcinogen model. The transgenic mice exhibited significantly reduced lung tumor multiplicity (tumor number) in proportion to transgene expression, a dose-response effect. Moreover, the highest expressing mice demonstrated reduced tumor incidence. To investigate the mechanism for protection, we evaluated PG levels and inflammatory responses. At the time of sacrifice following one carcinogenesis model, the transgenics exhibited only an increase in 6-keto-PGF(1alpha), not a decrease in PGE(2). Thus, elevated PGI(2) levels and not decreased PGE(2) levels appear to be necessary for the chemopreventive effects. When exposed to a single dose of butylated hydroxytoluene, transgenic mice exhibited a survival advantage; however, reduction in alveolar inflammatory response was not observed. These studies demonstrate that manipulation of PG metabolism downstream from COX produces even more profound lung cancer reduction than COX inhibition alone and could be the basis for new approaches to understanding the pathogenesis and prevention of lung cancer. C1 Univ Colorado, Hlth Sci Ctr, Div Pulm Sci & Crit Care Med, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmaceut Sci, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Denver VA Med Ctr, Dept Med, Div Pulm Sci & Crit Care Med, Denver, CO 80220 USA. RP Geraci, MW (reprint author), Univ Colorado, Hlth Sci Ctr, Div Pulm Sci & Crit Care Med, Dept Med, 4200 E 9th Ave,Campos Box C-272, Denver, CO 80262 USA. FU NCI NIH HHS [P50 CA 58187, CA 33497]; NHLBI NIH HHS [HL-43180, HL-03001]; NIDDK NIH HHS [DK-39902] NR 43 TC 81 Z9 81 U1 0 U2 1 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD FEB 1 PY 2002 VL 62 IS 3 BP 734 EP 740 PG 7 WC Oncology SC Oncology GA 519TB UT WOS:000173740600020 PM 11830527 ER PT J AU Levine, SM Sako, EY AF Levine, SM Sako, EY TI Waiting to make the weight for lung transplantation SO CHEST LA English DT Editorial Material ID BODY-MASS INDEX; PREOPERATIVE OBESITY; SURVIVAL; MORTALITY C1 Univ Texas, Hlth Sci Ctr, Lung Transplant Program, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Audie L Murphy Mem Vet Hosp Div, San Antonio, TX USA. RP Levine, SM (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div, Pulm Sect, 111E,7400 Merton Minter Blvd, San Antonio, TX 78229 USA. NR 16 TC 1 Z9 1 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD FEB PY 2002 VL 121 IS 2 BP 317 EP 320 DI 10.1378/chest.121.2.317 PG 4 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 521JJ UT WOS:000173836600003 PM 11834634 ER PT J AU Sorenson, SM Moradzadeh, E Bakhda, R AF Sorenson, SM Moradzadeh, E Bakhda, R TI Repeated infections in a 68-year-old man SO CHEST LA English DT Article C1 Univ Calif Los Angeles, Sch Med, Dept Radiol, Los Angeles, CA 90095 USA. W Los Angeles Vet Adm Med Ctr, Los Angeles, CA USA. RP Sorenson, SM (reprint author), Univ Calif Los Angeles, Sch Med, Dept Radiol, 10833 Le Conte Ave, Los Angeles, CA 90095 USA. NR 6 TC 3 Z9 4 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD FEB PY 2002 VL 121 IS 2 BP 644 EP 646 DI 10.1378/chest.121.2.644 PG 3 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 521JJ UT WOS:000173836600052 PM 11834683 ER PT J AU Basile, JN AF Basile, JN TI Halting the progression of heart failure: Finding the optimal combination therapy SO CLEVELAND CLINIC JOURNAL OF MEDICINE LA English DT Article ID HYPERTENSION; CAPTOPRIL; MORTALITY; LOSARTAN; ELITE AB Finding the optimal combination of drugs in the correct dosages, which requires careful monitoring over time, is key to slowing the disease process and prolonging life. For most patients, treating heart failure involves correcting underlying left ventricular dysfunction, thereby slowing the remodeling process. C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29403 USA. RP Basile, JN (reprint author), Med Univ S Carolina, Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29403 USA. NR 18 TC 0 Z9 0 U1 0 U2 0 PU CLEVELAND CLINIC PI CLEVELAND PA 9500 EUCLID AVE, CLEVELAND, OH 44106 USA SN 0891-1150 J9 CLEV CLIN J MED JI Clevel. Clin. J. Med. PD FEB PY 2002 VL 69 IS 2 BP 104 EP + PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 523ER UT WOS:000173941500001 PM 11990640 ER PT J AU Gregor, SM Perell, KL Rushatakankovit, S Miyamoto, E Muffoletto, R Gregor, RJ AF Gregor, SM Perell, KL Rushatakankovit, S Miyamoto, E Muffoletto, R Gregor, RJ TI Lower extremity general muscle moment patterns in healthy individuals during recumbent cycling SO CLINICAL BIOMECHANICS LA English DT Article DE recumbent; cycling; biomechanics; general muscle moment; rehabilitation; lower extremity ID PARADOX AB Objective. The purpose of this study was to compare lower extremity generalized muscle moments across two workloads during recumbent bicycling in younger and older healthy adults. Design. The study design was a comparative investigation of cycling patterns. Background. Biomechanical data regarding muscle activation, kinematic, and kinetic patterns have been presented for upright cycling, but only a few studies have evaluated biomechanical patterns during the alternative configuration of recumbent cycling, Methods. Twenty-four healthy adults, classified by age into two different groups, tinder 35 and over 50 years of age, rode a recumbent bicycle at a constant cadence (60-65 rpm) and at two different resistances (0.5 and 1.0 kg m) while kinematic and kinetic data were recorded. General muscle moments were calculated using joint kinematic and kinetic data via inverse dynamic equations. Results. The ankle general muscle moment remained plantar flexor throughout the pedaling cycle; the knee general muscle moment remained flexor throughout the cycle, except during the power phase of the higher workload where an extensor general muscle moment was observed; and the hip general muscle moment was extensor with a transient flexor general muscle moment period during the recovery phase. Increased workload led to increases in ankle plantar flexor and knee extensor general muscle moment magnitudes, but no changes at the hip. Age had no effect on general muscle moment magnitudes or patterns. Conclusions. Configurational differences between the upright and recumbent bicycle do not affect patterns, but the total output requirements do affect the magnitudes of the general muscle moments. C1 VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, PM&R Gait Lab 117G, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Mt St Marys Coll, Los Angeles, CA USA. Georgia Inst Technol, Atlanta, GA 30332 USA. RP Perell, KL (reprint author), VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, PM&R Gait Lab 117G, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 11 TC 23 Z9 23 U1 1 U2 8 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0268-0033 J9 CLIN BIOMECH JI Clin. Biomech. PD FEB PY 2002 VL 17 IS 2 BP 123 EP 129 AR PII S0268-0033(01)00112-7 DI 10.1016/S0268-0033(01)00112-7 PG 7 WC Engineering, Biomedical; Orthopedics; Sport Sciences SC Engineering; Orthopedics; Sport Sciences GA 527PD UT WOS:000174193700006 PM 11832262 ER PT J AU Anderson, F Game, BA Atchley, D Xu, MF Lopes-Virella, MF Huang, Y AF Anderson, F Game, BA Atchley, D Xu, MF Lopes-Virella, MF Huang, Y TI IFN-gamma pretreatment augments immune complex-induced matrix metalloproteinase-1 expression in U937 histiocytes SO CLINICAL IMMUNOLOGY LA English DT Article DE IFN-gamma; LDL; metalloproteinase; immune complex ID COLLAGEN GENE-EXPRESSION; ACUTE CORONARY SYNDROMES; ATHEROSCLEROTIC PLAQUES; INTERFERON-GAMMA; OXIDIZED LDL; MURINE MACROPHAGES; LYMPHOCYTES-T; ACTIVATION; CELLS; LOCALIZATION AB We reported recently that immune complexes (ICs) induced matrix metalloproteinase-1 (AMP-1) expression in U937 histiocytes. The present study was undertaken to determine the effect of pretreatment of U937 cells with interferon-gamma (IFN-gamma) on IC-induced MMP-1 expression. Our flow cytometry studies showed that IFN-gamma upregulated the surface expression of FcgammaRI, but not FcgammaRII. Results also showed that pretreatment of the cells with IFN-gamma augmented LDL-containing IC (LDL-10-induced NRKP-1 secretion in a dose- and time-dependent manner. Furthermore, Northern blot analysis revealed that IFN-gamma pretreatment led to a marked increase in MMP-1 mRNA. Finally, we demonstrated that PD98059 was able to block LDL-IC-induced MMP-1 secretion, regardless of whether the cells were pretreated with IFN-gamma or not, suggesting that IFN-gamma pretreatment did not alter the essential role of the ERR signaling pathway in LDL-IC-induced MMP-1 expression. In conclusion, the present study has demonstrated that IFN-gamma pretreatment augments LDL-IC-induced AMP-1 expression in U937 cells, thus elucidating an immune mechanism potentially involved in plaque destabilization. (C) 2002 Elsevier Science (USA). C1 Med Univ S Carolina, Dept Med, Ralph H Johnson Vet Adm Med Ctr, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29403 USA. RP Huang, Y (reprint author), Med Univ S Carolina, Dept Med, Ralph H Johnson Vet Adm Med Ctr, 114 Doughty St, Charleston, SC 29403 USA. NR 35 TC 7 Z9 7 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PD FEB PY 2002 VL 102 IS 2 BP 200 EP 207 DI 10.1006/clim.2001.5161 PG 8 WC Immunology SC Immunology GA 527PB UT WOS:000174193500012 PM 11846463 ER PT J AU Siegle, GJ Ingram, RE Matt, GE AF Siegle, GJ Ingram, RE Matt, GE TI Affective interference: An explanation for negative attention biases in dysphoria? SO COGNITIVE THERAPY AND RESEARCH LA English DT Article DE depression; information processing; attention; rumination ID AFFECTIVE WORDS; DEPRESSED MOOD; MEMORY; INFORMATION; ANXIETY; TASK; STIMULI; TIME AB Research suggests that individuals with features of depression pay excessive attention to negative information. Yet, it is unclear what aspects of negative information are attended to by these individuals. Different answers to this question suggest different roles for attention in the onset and maintenance of depressive states. This study investigated aspects of emotional information to which college students with and without features of depression attend. Research participants completed an affective lexical decision task and an affective valence identification task. Dysphoric individuals were slow to identify the emotional valence of positive information and nonemotional aspects of negative information (the lexicality of negative words), but were not slow to identify the emotional valence of negative words. An "affective-interference" hypothesis is advanced to explain these results. Dysphoric individuals are proposed to attend to the emotional content of negative information at the expense of attending to other aspects of the information. Results are related to theories of ruminative coping with depression. C1 Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Pittsburgh, PA 15213 USA. VA Pittsburgh Healtcare Syst, Pittsburgh, PA 15213 USA. San Diego State Univ, San Diego, CA USA. RP Siegle, GJ (reprint author), Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, 2811 O Hara St, Pittsburgh, PA 15213 USA. NR 43 TC 49 Z9 51 U1 2 U2 17 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0147-5916 J9 COGNITIVE THER RES JI Cogn. Ther. Res. PD FEB PY 2002 VL 26 IS 1 BP 73 EP 87 AR UNSP 0147-5916/02/0200-0073/0 DI 10.1023/A:1013893705009 PG 15 WC Psychology, Clinical SC Psychology GA 522KX UT WOS:000173896100005 ER PT J AU Eisenberg, JNS Wade, TJ Charles, S Vu, M Hubbard, A Wright, CC Levy, D Jensen, P Colford, JM AF Eisenberg, JNS Wade, TJ Charles, S Vu, M Hubbard, A Wright, CC Levy, D Jensen, P Colford, JM TI Risk factors in HIV-associated diarrhoeal disease: the role of drinking water, medication and immune status SO EPIDEMIOLOGY AND INFECTION LA English DT Article ID CRYPTOSPORIDIUM INFECTION; OUTBREAK; AIDS; CONSUMPTION AB In a cross-sectional survey of 226 HIV-infected men, we examined the occurrence of diarrhoea and its relationship to drinking water consumption patterns, risk behaviours, immune status and medication use. Diarrhoea was reported by 47% of the respondents. Neither drinking boiled nor filtered water was significantly associated with diarrhoea (OR = 0.5 [0.2 1.6], 1.2 [0.6, 2.5] respectively), whereas those that drank bottled water were at risk for diarrhoea (OR = 3.0 [1.1, 7.8]). Overall, 47% always or often used at least one water treatment. Of the 37% who were very concerned about drinking water, 62% had diarrhoea, 70% always or often used at least one water treatment. An increase in CD4 count was protective only for those with a low risk of diarrhoea associated with medication (OR = 0.6 [0.5, 0.9]). A 30% attributable risk to diarrhoea was estimated for those with high medication risk compared to those with low medication risk. The significant association between concern with drinking water and diarrhoea as well as between concern with drinking water and water treatment suggests awareness that drinking water is a potential transmission pathway for diarrhoeal disease. At the same time we found that a significant portion of diarrhoea was associated with other sources not related to drinking water such as medication usage. C1 Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA. Univ Calif Berkeley, Ctr Occupational & Environm Hlth, Berkeley, CA 94720 USA. San Francisco Vet Adm Med Ctr, San Francisco, CA 94121 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Eisenberg, JNS (reprint author), Univ Calif Berkeley, Sch Publ Hlth, 140 Warren Hall MC 7360, Berkeley, CA 94720 USA. FU ODCDC CDC HHS [UR2/CCU916252-02] NR 19 TC 11 Z9 13 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0950-2688 J9 EPIDEMIOL INFECT JI Epidemiol. Infect. PD FEB PY 2002 VL 128 IS 1 BP 73 EP 81 DI 10.1017/S0950268801006252 PG 9 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 540CG UT WOS:000174910400010 PM 11895094 ER PT J AU Licht, EA Jacobsen, RH Fujikawa, DG AF Licht, EA Jacobsen, RH Fujikawa, DG TI Chronically impaired frontal lobe function from subclinical Epileptiform discharges SO EPILEPSY & BEHAVIOR LA English DT Article DE cognitive deficits; subclinical epileptiform discharges; frontal lobe deficits; subclinical seizures ID EEG DISCHARGES; INTELLIGENCE; EPILEPSY; SEIZURES AB Subclinical epileptiform discharges (SEDs) are a common occurrence on electroencephalograms (EEGs). Their potential for acutely disrupting cognitive functions has been well documented, but detailed studies of cognitive performance by patients with chronic exposure to disruptive SEDs have been lacking and scant data have been available to guide treatment decisions or to assist in predicting recovery. We identified a patient with frequent frontotemporally (FT) predominant SEDs and monitored cognitive performance over time with periodic neuropsychological testing and EEGs. Over a 16-year period, Full Scale 10 rose 23 points and Verbal IQ rose 30 as SEDs were suppressed. Severity of impairment, reflected by the marked increase in cognitive performance overtime, was not predicted by his appearance and performance on routine tests of cognitive functions in the clinic. Quantitating total SED duration per EEG provided an objective marker to track severity over time. The cumulative effects of chronic exposure to disruptive SEDs may create a sustained "cognitive burden" or encephalopathic state that persists even in the absence of ongoing discharges. (C) 2002 Elsevier Science (USA). C1 VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Dept Neurol, Sepulveda, CA 91343 USA. VA Greater Los Angeles Healthcare Syst, Nursing Home Care Unit, Dept Neurol, Sepulveda, CA 91343 USA. VA Greater Los Angeles Healthcare Syst, Nursing Home Care Unit, Dept Mental Hlth, Sepulveda, CA 91343 USA. VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Dept Mental Hlth, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. RP Fujikawa, DG (reprint author), Dept Vet Affairs, Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Neurol Dept 127, 16111 Plummer St, Sepulveda, CA 91343 USA. NR 10 TC 11 Z9 11 U1 0 U2 1 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1525-5050 J9 EPILEPSY BEHAV JI Epilepsy Behav. PD FEB PY 2002 VL 3 IS 1 BP 96 EP 100 DI 10.1006/ebeh.2001.0312 PG 5 WC Behavioral Sciences; Clinical Neurology; Psychiatry SC Behavioral Sciences; Neurosciences & Neurology; Psychiatry GA 553ML UT WOS:000175679500015 ER PT J AU Sugawara, M Sugawara, Y Wen, K Giulivi, C AF Sugawara, M Sugawara, Y Wen, K Giulivi, C TI Generation of oxygen free radicals in thyroid cells and inhibition of thyroid peroxidase SO EXPERIMENTAL BIOLOGY AND MEDICINE LA English DT Article DE thyroid peroxidase; superoxide; hydrogen peroxide; quinones; thyroid cells ID HYDROGEN-PEROXIDE; NADPH OXIDASE; SUPEROXIDE-DISMUTASE; IRREVERSIBLE INACTIVATION; PLASMA-MEMBRANE; HUMAN-TISSUES; PORCINE; MECHANISM; FOLLICLES; H2O2 AB We examined whether superoxide (O-2(-)) IS produced as a precursor of hydrogen peroxide (H2O2) in cultured thyroid cells using the cytochrome c method and the electron paramagnetic resonance (EPR) method. No O-2(-) or its related radicals was detected in thyroid cells under the physiological condition. The presence of quinone, 2,3-dimethoxy-1-naphthoquinone (DMNQ), or 2-methyl-1,4-naphthoquinone (menadione), in the medium produced O-2(-) and hydroxyl radicals (OH.); the amount of H2O2 generation was also increased. Incubation of follicles with DMNQ or menadione inhibited iodine organification (a step of thyroid hormone formation) and its catalytic enzyme, thyroid peroxidase (TPO). This inhibition should be caused by reactive oxygen species because the two quinones, particularly DMNQ, exert their effect through the generation of reactive oxygen species. It is speculated that the site-specific inactivation of TPO might have occurred at the heme-linked histidine residue of the TPO molecule, a critical amino acid for enzyme activity because OH. (vicious free radicals) can be formed at the iron-linked amino acid. TPO mRNA level and electrophoretic mobility of TPO were not inhibited by quinones. Our study suggests that thyroid H2O2 IS produced by divalent reduction of oxygen without O-2(-) generation. If thyroid cells happen to be exposed to significant amount of reactive oxygen species, TPO and subsequent thyroid hormone formation are inhibited. C1 W Los Angeles Vet Affairs, Div Endocrinol & Metab, Med Ctr 111M, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Univ So Calif, Sch Pharm, Dept Mol Pharmacol & Toxicol, Los Angeles, CA 90033 USA. RP Sugawara, M (reprint author), W Los Angeles Vet Affairs, Div Endocrinol & Metab, Med Ctr 111M, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Giulivi, Cecilia/C-4015-2012 OI Giulivi, Cecilia/0000-0003-1033-7435 NR 30 TC 29 Z9 33 U1 0 U2 1 PU SOC EXPERIMENTAL BIOLOGY MEDICINE PI MAYWOOD PA 195 WEST SPRING VALLEY AVE, MAYWOOD, NJ 07607-1727 USA SN 1535-3702 J9 EXP BIOL MED JI Exp. Biol. Med. PD FEB PY 2002 VL 227 IS 2 BP 141 EP 146 PG 6 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 514JV UT WOS:000173436500009 PM 11815678 ER PT J AU Ledoux, WR Hillstrom, HJ AF Ledoux, WR Hillstrom, HJ TI The distributed plantar vertical force of neutrally aligned and pes planus feet SO GAIT & POSTURE LA English DT Article DE ground reaction force; gait; flat foot; pes planus ID HALLUX-VALGUS; FOOT; RELIABILITY AB The distributed vertical ground reaction forces were determined for a normative population and contrasted with data from subjects with flat feet. Nineteen asymptomatic subjects, 11 with a neutrally aligned foot type (normal arch) and 8 with a pes planus foot type (low arch), were studied as they walked barefoot across a pressure plate. The pressure plate data were converted to force values at seven locations (subhallucal, five submetatarsal and subcalcaneal) on the plantar aspect of the foot. The distributed loading pattern of the plantar soft tissue throughout the stance phase of gait was determined. Pes planus feet had significantly more force at the subhallucal area with no difference seen under the other areas. These data are indicative of aberrant first ray mechanics in pes planus feet. Published by Elsevier Science B.V. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Dept Orthopaed & Sports Med, RR&D Ctr Excellence Limb Loss Prevent & Prosthet, Seattle, WA 98108 USA. Temple Univ, Sch Podiat Med, Gait Study Ctr, Philadelphia, PA 19107 USA. RP Ledoux, WR (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Orthopaed & Sports Med, RR&D Ctr Excellence Limb Loss Prevent & Prosthet, 1660 S Columbian Way,MS 151, Seattle, WA 98108 USA. RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 NR 26 TC 65 Z9 72 U1 4 U2 7 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0966-6362 J9 GAIT POSTURE JI Gait Posture PD FEB PY 2002 VL 15 IS 1 BP 1 EP 9 AR PII S0966-6362(01)00165-5 DI 10.1016/S0966-6362(01)00165-5 PG 9 WC Neurosciences; Orthopedics; Sport Sciences SC Neurosciences & Neurology; Orthopedics; Sport Sciences GA 571JV UT WOS:000176715000001 PM 11809575 ER PT J AU Sontag, SJ Schnell, TG Chejfec, G AF Sontag, SJ Schnell, TG Chejfec, G TI Barrett's esophagus and neoplasia: Data from the Bayreuth Barrett's archive - Reply SO GASTROENTEROLOGY LA English DT Letter C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. RP Sontag, SJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD FEB PY 2002 VL 122 IS 2 BP 590 EP 591 DI 10.1016/S0016-5085(02)80337-7 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 517QK UT WOS:000173621200041 ER PT J AU Gunter-Hunt, G Mahoney, JE Sieger, CE AF Gunter-Hunt, G Mahoney, JE Sieger, CE TI A comparison of state advance directive documents SO GERONTOLOGIST LA English DT Article DE end-of-life treatment decisions; advance decision making; medical ethics ID SELF-DETERMINATION ACT; SUPPORT INTERVENTION; NURSING-HOME; PREFERENCES; CARE; LIFE; END; DECISIONS; SURROGATE AB Purpose: Advance directive (AD) documents are based on state-specific statutes and vary in terms of content. These differences can create confusion and inconsistencies resulting in a possible failure to honor the health care wishes of people who execute health care documents for one state and receive health care in another state. The purpose of this study was to compare similarities and differences in the content of state AD documents. Design and Methods: AD documents for 50 states and the District of Columbia posted on the Partnership for Caring website were reviewed. States and regions of the country were compared for type or types of documents used and issues included in AD documents. Results: Three states had statutory living will documents only; however, these states did allow for appointment of a health care agent for limited end-of-life decisions. Three states had statutory durable power of attorney for health care documents only, 32 had both statutory living will and durable power of attorney for health care documents, and 13 had statutory forms which combine both types of directive in one document (advance health care directives). Of 8 identified key issues, those addressed by at least 90% of states were designation of a proxy, personal instructions for care, general life-sustaining measures, and terminal illness. When document types were compared, advance health care directive documents included more of the key issues than did living will or durable power of attorney for health care documents (p < .001). Implications: This variability suggests a need for national dialogue to standardize some provisions of AD documents. C1 William S Middleton Mem Vet Adm Med Ctr, Res Educ & Clin Ctr, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Dept Med, Madison, WI USA. Partnership Caring Inc, New York, NY USA. RP Gunter-Hunt, G (reprint author), William S Middleton Mem Vet Adm Med Ctr, Res Educ & Clin Ctr, 2500 Overlook Terrace, Madison, WI 53705 USA. NR 22 TC 15 Z9 15 U1 1 U2 4 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD FEB PY 2002 VL 42 IS 1 BP 51 EP 60 PG 10 WC Gerontology SC Geriatrics & Gerontology GA 520TQ UT WOS:000173797800006 PM 11815699 ER PT J AU Pfutzer, R Myers, E Applebaum-Shapiro, S Finch, R Ellis, I Neoptolemos, J Kant, JA Whitcomb, DC AF Pfutzer, R Myers, E Applebaum-Shapiro, S Finch, R Ellis, I Neoptolemos, J Kant, JA Whitcomb, DC TI Novel cationic trypsinogen (PRSS1) N29T and R122C mutations cause autosomal dominant hereditary pancreatitis SO GUT LA English DT Article; Proceedings Paper CT Digestive Disease Week/102nd Annual Meeting of the American-Gastroenterological-Association CY MAY 20-23, 2001 CL ATLANTA, GEORGIA SP Amer Gastroenterol Assoc ID GENE AB Hereditary pancreatitis (HP) is usually caused by mutations In the cationic trypsinogen (PRSS1) gene, especially R122H or N291. We sequenced the PRSS1 gene in the proband of families without these common mutations. Novel R122C and N29T mutations were detected in independent families that segregated with the disease in an autosomal dominant fashion. The R122C mutation eliminates the arginine autolysis site as with R122H mutations. The N29T mutation may also enhance intrapancreatic trypsin activity as has been demonstrated in vitro. Identification of these new mutations requires special attention as commonly used detection methods may fail. C1 Univ Pittsburgh, Dept Med, Pittsburgh, PA 15101 USA. Univ Pittsburgh, Dept Human Genet, Pittsburgh, PA USA. Univ Pittsburgh, Dept Physiol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Cell Biol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Ctr Genom Sci, Pittsburgh, PA USA. VA Pittsburgh Hlt Care Syst, Div Gastroenterol, Pittsburgh, PA USA. Univ Liverpool, Dept Surg, Liverpool L69 3BX, Merseyside, England. Univ Pittsburgh, Dept Pathol, Pittsburgh, PA USA. RP Whitcomb, DC (reprint author), Univ Pittsburgh, Dept Med, 571 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15101 USA. RI Neoptolemos, John/G-4488-2010 FU NIAAA NIH HHS [AA10855]; NIDDK NIH HHS [R01 DK054709] NR 6 TC 59 Z9 60 U1 1 U2 2 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD FEB PY 2002 VL 50 IS 2 BP 271 EP 272 DI 10.1136/gut.50.2.271 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 514BQ UT WOS:000173416800025 PM 11788572 ER PT J AU Volberding, PA AF Volberding, PA TI Navigating emerging challenges to long-term HIV therapy SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Editorial Material C1 San Francisco Vet Affairs Med Ctr, Med Serv, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Volberding, PA (reprint author), San Francisco Vet Affairs Med Ctr, Med Serv, 4150 Clement St,VAMC 111, San Francisco, CA 94121 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD FEB 1 PY 2002 VL 29 SU 1 BP S1 EP S1 PG 1 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 523MU UT WOS:000173958500001 ER PT J AU Kirkpatrick, WR Perea, S Coco, BJ Patterson, TF AF Kirkpatrick, WR Perea, S Coco, BJ Patterson, TF TI Efficacy of ravuconazole (BMS-207147) in a guinea pig model of disseminated aspergillosis SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article; Proceedings Paper CT 101st General Meeting of the American-Society-for-Microbiology CY MAY, 2001 CL ORLANDO, FLORIDA SP Ameri Soc Microbiol ID EXPERIMENTAL INVASIVE ASPERGILLOSIS; IN-VITRO; AMPHOTERICIN-B; ORAL TRIAZOLE; ITRACONAZOLE; VORICONAZOLE; FUMIGATUS; ER-30346; SPECTRUM AB Ravuconazole (BMS-207147, ER-30346), an oral triazole, was evaluated in an immunosuppressed temporarily neutropenic guinea pig model of invasive aspergillosis. In this model, guinea pigs were immunosuppressed with triamcinolone 20 mg/kg sc od beginning 4 days before challenge and made neutropenic with cyclophosphamide 300 mg/kg ip 1 day before challenge. Treatments of ravuconazole 5, 10 and 25 mg/kg po od were compared with itraconazole 2.5 and 5.0 mg/kg po bd and amphotericin B 1.25 mg/kg ip od. Treatment began 24 h after lethal intravenous challenge with Aspergillus fumigatus and continued for 5 days. Mortality occurred in eight of eight untreated control animals versus none of eight treated with ravuconazole 5 or 10 mg/kg/day or itraconazole 10 mg/kg/day. Mortality occurred in one of eight animals treated with ravuconazole 25 mg/kg/day, one of eight with amphotericin B and two of eight treated with itraconazole 5 mg/kg/day. Compared with controls, each of the antifungals examined significantly reduced the tissue burden in liver and brain, although only the highest doses of the azole drugs and amphotericin B significantly reduced tissue burden in the kidney. All three doses of ravuconazole improved survival and also reduced the tissue burden of Aspergillus. In this model of invasive aspergillosis, ravuconazole showed significant activity and may be a useful compound in human disease. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX 78284 USA. RP Kirkpatrick, WR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, 7703 Floyd Curl Dr,Mail Code 7881, San Antonio, TX 78229 USA. NR 19 TC 28 Z9 29 U1 0 U2 3 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD FEB PY 2002 VL 49 IS 2 BP 353 EP 357 DI 10.1093/jac/49.2.353 PG 5 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 523NE UT WOS:000173960000019 PM 11815579 ER PT J AU Yamaguchi, DT Huang, J Ma, DF Wang, PKC AF Yamaguchi, DT Huang, J Ma, DF Wang, PKC TI Inhibition of gap junction intercellular communication by extremely low-frequency electromagnetic fields in osteoblast-like models is dependent on cell differentiation SO JOURNAL OF CELLULAR PHYSIOLOGY LA English DT Article ID COMBINED MAGNETIC-FIELDS; DOUBLE-BLIND TRIAL; BONE-CELLS; PARATHYROID-HORMONE; BIOLOGICAL-SYSTEMS; CALCIUM; CULTURE; MC3T3-E1; INVITRO; PERMEABILITY AB Electromagnetic fields have been used to augment the healing of fractures because of its ability to increase new bone formation. The mechanism of flow electromagnetic fields can promote new bone formation is unknown, although the interaction of electromagnetic fields with components of the plasma membrane of cells has been hypothesized to occur in bone cells. Gap junctions occur among bone forming cells, the osteoblasts, and have been hypothesized to play a role in new bone formation. Thus it was investigated whether extremely low-frequency (ELF) magnetic fields alter gap junction intercellular communication in the preosteoblastic model, MC3T3-E1, and the well-differentiated osteoblastic model, ROS 17/2.8. ELF magnetic field exposure systems were designed to be used for all inverted microscope stage and for a tissue culture incubator. Using these systems, it was found that magnetic fields over a frequency range from 30 to 120 Hz and field intensities LIP to 12.5 G dose dependently decreased gap junction intercellular communication in MC3T3-E1 cells during their proliferative phase of development. The total amount of connexin 43 protein and the distribution of connexin 43 gap junction protein between cytoplasmic and plasma membrane pools were unaltered by treatment with ELF magnetic fields. Cytosolic calcium ([Ca2+](i)) which can inhibit gap junction communication, was not altered by magnetic field exposure. Identical exposure conditions did not affect gap junction communication in the ROS 17/2.8 cell line and when MC3T3-E1 cells were more differentiated. Thus ELF magnetic fields may affect only less differentiated or preosteoblasts and not fully differentiated osteoblasts. Consequently, electromagnetic fields may aid in the repair of bone by effects exerted only on osteoprogenitor or pre-osteoblasts. J. Cell. Physiol. 190: 180-188, 2002. (C) 2002 Wiley-Liss, Inc. C1 VAMC, Res Serv, Los Angeles, CA USA. VAMC, Geriatr Res Educ & Clin Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Elect Engn, Los Angeles, CA USA. RP Yamaguchi, DT (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv 151, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 43 TC 23 Z9 32 U1 0 U2 3 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0021-9541 J9 J CELL PHYSIOL JI J. Cell. Physiol. PD FEB PY 2002 VL 190 IS 2 BP 180 EP 188 DI 10.1002/JCP.10047 PG 9 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 508NP UT WOS:000173095600004 PM 11807822 ER PT J AU Tang, SJ Tran, T Memmesheimer, C Pandol, S Aranda, R Pisegna, JR Jensen, DM AF Tang, SJ Tran, T Memmesheimer, C Pandol, S Aranda, R Pisegna, JR Jensen, DM TI Paraesophageal hernia repair and deep vein thrombosis SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Letter ID LAPAROSCOPIC REPAIR; HIATUS-HERNIA; SURGERY; FUNDOPLICATION; MANAGEMENT; SAC C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Div Digest Dis, Los Angeles, CA 90073 USA. RP Tang, SJ (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Div Digest Dis, Los Angeles, CA 90073 USA. NR 29 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD FEB PY 2002 VL 34 IS 2 BP 187 EP 188 DI 10.1097/00004836-200202000-00017 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 513DJ UT WOS:000173362400017 PM 11782617 ER PT J AU Taylor, F Raskind, MA AF Taylor, F Raskind, MA TI The alpha 1-adrenergic antagonist prazosin improves sleep and nightmares in civilian trauma posttraumatic stress disorder SO JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY LA English DT Article ID LOCUS-COERULEUS; MODULATION; PTSD; ACTIVATION; MECHANISM; NEURONS AB Heightened noradrenergic reactivity may be a contributing factor in the pathophysiology of post-traumatic stress disorder (PTSD). Prazosin is an alpha(1)-adrenoceptor antagonist commonly used as an antihypertensive agent. Because (alpha(1)-adrenergic activity has been associated with fear and startle responses, a drug that blocks central alpha(1)-adrenergic activity may be useful in the treatment of PTSD symptoms. An outpatient who had been exposed to civilian trauma and had subsequent chronic refractory PTSD was thus prescribed prazosin. The marked reduction in PTSD symptoms, particularly sleep and nightmares, prompted the following open-label feasibility trial. Five outpatients with non-combat-related PTSD were consecutively identified and received prazosin in a 6-week open-label trial. In each case, the prazosin doses were slowly increased until optimal benefit was achieved. Change was assessed with the Clinician-Administered PTSD Scale for DSM-IV, One Week Symptom Version (CAPS-SX), the Clinical Global Impression of Change Scale (CGIC), and the Clinical Impression of Change-Nightmares (CIC-Nightmares) score. All five patients experienced moderate to marked improvement on the CGIC. The CAPS-SX PTSD nightmare and sleep PTSD categories showed at least a four-point reduction of those symptoms. All patients reported at least moderate improvement on the CIC-Nightmare score. Optimal doses of prazosin ranged from 1 to 4 mg/day. The drug was reasonably tolerated, and there were no drug discontinuations. These preliminary findings provide a rationale for blind placebo-controlled efficacy trials of the alpha(1)-antagonist prazosin for PTSD. C1 Rainier Associates, Tacoma, WA 98467 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, NW Network VA Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. RP Taylor, F (reprint author), Rainier Associates, 5909 Orchard W, Tacoma, WA 98467 USA. NR 16 TC 88 Z9 89 U1 1 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-0749 J9 J CLIN PSYCHOPHARM JI J. Clin. Psychopharmacol. PD FEB PY 2002 VL 22 IS 1 BP 82 EP 85 DI 10.1097/00004714-200202000-00013 PG 4 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 514TM UT WOS:000173457200013 PM 11799347 ER PT J AU Metlay, JP Shea, JA Crossette, LB Asch, DA AF Metlay, JP Shea, JA Crossette, LB Asch, DA TI Tensions in antibiotic prescribing - Pitting social concerns against the interests of individual patients SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 24th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 02-05, 2001 CL SAN DIEGO, CALIFORNIA SP Soc Gen Internal Med DE antibiotics; drug utilization; physician's practice patterns; drug resistance, microbial; pneumonia ID COMMUNITY-ACQUIRED PNEUMONIA; ANTIMICROBIAL RESISTANCE; STREPTOCOCCUS-PNEUMONIAE; LIFE-SUPPORT; MAIL SURVEYS; GUIDELINES; MANAGEMENT; FLUOROQUINOLONES; EPIDEMIOLOGY; WITHDRAW AB BACKGROUND: To reduce the prevalence of antibiotic-resistant bacteria in the community, physicians must optimize their use of antibiotics. However, optimal use from the perspective of the community (reserving newer agents for future use) is not always consistent with optimal use from the perspective of the individual patient (prescribing newer, broader agents). OBJECTIVES: To identify preferred patterns of antibiotic prescribing for patients with community-acquired pneumonia (CAP), measure explicit attitudes toward antibiotics and antibiotic resistance, and determine the relationship between these prescribing patterns and attitudes. DESIGN. Cross-sectional anonymous mail survey. PARTICIPANTS: National random sample of 400 generalist physicians (general internal medicine and family practice) and 429 Infectious diseases specialists. MEASUREMENTS: Rank ordering of antibiotic preferences for a hypothetical outpatient with CAP and reasons for antibiotic selection. Endorsement of attitudes regarding antibiotic prescribing decisions and resistance. RESULTS: Both generalists and infectious diseases specialists were more likely to prefer newer, broader drugs for the treatment of CAP compared to older agents still recommended by national guidelines. Physicians rated the issue of contributing to antibiotic resistance lowest among 7 determinants of their choices. CONCLUSIONS: Despite national guidelines and increasing public awareness, the public health concern of contributing to the problem of antibiotic resistance does not exert a strong impact on physician prescribing decisions for CAP. Future efforts to optimize antibiotic prescribing decisions will need to consider options for increasing the impact of public health issues on the patient-oriented decisions of individual physicians. C1 Univ Penn, Sch Med, Dept Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Metlay, JP (reprint author), Univ Penn, Sch Med, Dept Med, Div Gen Internal Med, 712 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. NR 28 TC 63 Z9 64 U1 1 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD FEB PY 2002 VL 17 IS 2 BP 87 EP 94 DI 10.1046/j.1525-1497.2002.10711.x PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 543UG UT WOS:000175119100001 PM 11841523 ER PT J AU Kilbourne, AM Herndon, B Andersen, RM Wenzel, SL Gelberg, L AF Kilbourne, AM Herndon, B Andersen, RM Wenzel, SL Gelberg, L TI Psychiatric symptoms, health services, and HIV risk factors among homeless women SO JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED LA English DT Article DE homeless; HIV; mental disorders; health services ID MENTALLY-ILL; MEDICAL-CARE; LOS-ANGELES; ANAL SEX; BEHAVIORS; PREDICTORS; ACCESS; ADULTS; MEN; PERCEPTIONS AB The authors determined whether psychiatric symptoms and lack of health and/or social services contacts were associated with HIV risk behaviors among a probability sample of homeless women. Women were interviewed regarding socioeconomic indicators, psychiatric symptoms, health and/or social services contacts, and past-year HIV risk behaviors. Overall, 8 percent of the women injected drugs, 64 percent engaged in unprotected sex, and 22 percent traded sex. Multiple logistic regression results revealed that substance abuse was positively associated with injection drug use and trading sex. Homeless women with case managers were less likely to inject drugs. Although barriers to obtaining drug treatment were associated with trading sex, women attending self-help meetings for substance abuse were also more likely to trade sex. Homeless women who are substance abusers are vulnerable to HIV risk behaviors. Risk reduction interventions for homeless women should be implemented through substance abuse and intensive case management programs. C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Calif Los Angeles, Sch Publ Hlth, Hlth Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Family Med, Los Angeles, CA 90024 USA. RP Kilbourne, AM (reprint author), Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. FU AHRQ HHS [R01 HS08323]; NIMH NIH HHS [MH-19127] NR 38 TC 30 Z9 31 U1 1 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1049-2089 J9 J HEALTH CARE POOR U JI J. Health Care Poor Underserved PD FEB PY 2002 VL 13 IS 1 BP 49 EP 65 DI 10.1177/10492080222148610 PG 17 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 514BC UT WOS:000173415400005 PM 11836913 ER PT J AU Nash, JD Burgess, DS Talbert, RL AF Nash, JD Burgess, DS Talbert, RL TI Effect of fluvastatin and pravastatin, HMG-CoA reductase inhibitors, on fluconazole activity against Candida albicans SO JOURNAL OF MEDICAL MICROBIOLOGY LA English DT Article ID AMPHOTERICIN-B; ITRACONAZOLE; PHARMACODYNAMICS; PHARMACOKINETICS; INFECTIONS AB Synergy between fluvastatin, at clinically unachievable concentrations, and fluconazole against Candida albicans has been reported. The purpose of the present study was to evaluate the in-vitro activity of fluconazole alone and in combination with clinically achievable concentrations of pravastatin and fluvastatin against C albicans. In-vitro susceptibility and synergy testing were performed against clinical isolates of C albicans with fluconazole, pravastatin and fluvastatin. Both checkerboard method and time-kill studies were performed. MICs for fluconazole ranged from 0.5 (susceptible) to >256 mg/L (resistant) at 24 h. All isolates had MICs >2 mg/L for both statins. No synergy or antagonism was observed with fluconazole in combination with either agent against any isolate of C. albicans by the checkerboard assay or time-kill studies. Clinically achievable concentrations of pravastatin and fluvastatin did not affect the invitro activity of fluconazole against C. albicans. C1 Univ Texas, Coll Pharm, Austin, TX 78712 USA. Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Burgess, DS (reprint author), Univ Texas, Coll Pharm, Austin, TX 78712 USA. NR 12 TC 23 Z9 24 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-2615 J9 J MED MICROBIOL JI J. Med. Microbiol. PD FEB PY 2002 VL 51 IS 2 BP 105 EP 109 PG 5 WC Microbiology SC Microbiology GA 520LU UT WOS:000173784000003 PM 11863260 ER PT J AU Plumbley, JA Fan, HX Eagan, PA Ehsan, A Schnitzer, B Gulley, ML AF Plumbley, JA Fan, HX Eagan, PA Ehsan, A Schnitzer, B Gulley, ML TI Lymphoid tissues from patients with infectious mononucleosis lack monoclonal B and T cells SO JOURNAL OF MOLECULAR DIAGNOSTICS LA English DT Article ID EPSTEIN-BARR-VIRUS; HUMAN-IMMUNODEFICIENCY-VIRUS; NON-HODGKINS-LYMPHOMAS; LYMPHOPROLIFERATIVE DISORDERS; HEMOPHAGOCYTIC SYNDROME; MOLECULAR PATHOLOGY; GENE REARRANGEMENTS; CLONAL EXPANSIONS; LOW-GRADE; DISEASE AB In typical cases of infectious mononucleosis (IM), lymphoid tissue is rarely submitted for pathological examination. When lymphoid tissues from IM cases are examined, the histological appearance of IM may be difficult to distinguish from malignant lymphoma. The purpose of this study was to address the utility of clinical molecular assays for T and B cell clonality in distinguishing IM from lymphoid malignancy. DNA was recovered from paraffin-embedded archival lymphoid tissues of 18 cases of IM and 13 control cases representing other reactive lymphoid hyperplasias. T cell receptor gamma (TCR-gamma) and immunoglobulin heavy chain (IgH) gene rearrangements were assayed using our standard clinical polymerase chain reaction procedures targeting each of the four functional variable (V) families and the three joining 0) families of the TCR-gamma gene, and framework III of the IgH gene, respectively. In 17 of 18 cases of IM, no monoclonal T or B cell populations were detectable. One case, the only spleen specimen in the study, had an oligoclonal pattern of TCR-gamma rearrangements. The control cases representing other reactive hyperplasias also lacked monoclonality. The assays used were sensitive to clonal populations as small as 5% of cells. In this case series, no monoclonal lymphoid populations were identified in any case of IM. This finding suggests that molecular studies are useful in distinguishing IM from lymphoidneoplasms. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Keesler Hosp, Med Def Grp 81, Keesler AFB, MS USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. Univ Michigan, Med Ctr, Ann Arbor, MI USA. RP Gulley, ML (reprint author), Univ N Carolina, Dept Pathol, 101 Manning Dr,Brinkhouse Bullitt Bldg, Chapel Hill, NC 27599 USA. NR 28 TC 10 Z9 12 U1 0 U2 0 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 1525-1578 J9 J MOL DIAGN JI J. Mol. Diagn. PD FEB PY 2002 VL 4 IS 1 BP 37 EP 43 DI 10.1016/S1525-1578(10)60678-2 PG 7 WC Pathology SC Pathology GA 561LC UT WOS:000176141300004 PM 11826186 ER PT J AU Yang, J Lam, EWN Hammad, HM Oberley, TD Oberley, LW AF Yang, J Lam, EWN Hammad, HM Oberley, TD Oberley, LW TI Antioxidant enzyme levels in oral squamous cell carcinoma and normal human oral epithelium SO JOURNAL OF ORAL PATHOLOGY & MEDICINE LA English DT Article DE antioxidant enzymes; immunohistochemistry; oral squamous cell carcinoma ID MANGANESE SUPEROXIDE-DISMUTASE; GLUTATHIONE-S-TRANSFERASE; SYRIAN-HAMSTER TISSUES; IMMUNOHISTOCHEMICAL LOCALIZATION; KIDNEY DEVELOPMENT; GENE-TRANSFER; GLIOMA-CELLS; OVEREXPRESSION; IMMUNOLOCALIZATION; CARCINOGENESIS AB Background. The antioxidant enzymes (manganese- and copper-zinc-containing superoxide dismutases, catalast and glutathione peroxidase) limit cell injury induced by reactive oxygen species. The purpose of the study was to determine whether human oral squamous cell carcinomas have altered antioxidant enzyme levels. This study is the first to undertake this task in human oral mucosa and squamous cell carcinoma. Methods: Semiquantitative immunohistochemistry was used to examine 26 archived oral squamous cell carcinoma biopsies. Fourteen well-differentiated and 12 poorly differentiated tumors were examined, as were 12 specimens of oral mucosa. All sections were reviewed by two oral and maxillofacial pathologists, and image analysis of the immunostained sections was performed using NIH Image. Antioxidant enzyme staining intensities were compared in the different groups by Duncan's multiple range test. Results: In general, mucosal basal cells displayed lower antioxidant enzyme levels than spinous cells, and primary tumor cells displayed lower antioxidant enzyme staining intensities than did their normal cell counterparts. Moreover, poorly differentiated tumor cells showed lower antioxidant enzyme staining intensities than well-differentiated tumor cells. Manganese-containing superoxide dismutase staining intensities were, however, higher in well-differentiated oral squamous cell carcinomas than their normal cells of origin. Conclusions: Detection of antioxidant enzymes may be a useful future marker in the molecular diagnosis of the oral cancer. Moreover, it may be possible to not only monitor the effectiveness of chemopreventitive and therapeutic strategies in oral cancer using these enzymes, but to monitor tumor recurrence. C1 Temple Univ, Sch Dent, Dept Oral Med, Philadelphia, PA 19104 USA. Univ Alberta, Dept Dent, Edmonton, AB, Canada. Jordan Univ Sci & Technol, Fac Dent, Irbid, Jordan. William S Middleton Mem Vet Adm Med Ctr, Pathol Serv, Madison, WI USA. Univ Iowa, Coll Med, Dept Radiat Oncol, Free Rad & Radiat Biol Grad Program, Iowa City, IA USA. RP Yang, J (reprint author), Temple Univ, Sch Dent, Dept Oral Med, 3223 N Broad St, Philadelphia, PA 19104 USA. EM jyang@dental.temple.edu FU NIDCR NIH HHS [P50 DE 10758] NR 23 TC 58 Z9 60 U1 1 U2 3 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0904-2512 J9 J ORAL PATHOL MED JI J. Oral Pathol. Med. PD FEB PY 2002 VL 31 IS 2 BP 71 EP 77 DI 10.1034/j.1600-0714.2002.310202.x PG 7 WC Dentistry, Oral Surgery & Medicine; Pathology SC Dentistry, Oral Surgery & Medicine; Pathology GA 529LV UT WOS:000174301700002 PM 11896826 ER PT J AU Strack, S Kinder, BN AF Strack, S Kinder, BN TI Special series: Personality autobiographies - Introduction SO JOURNAL OF PERSONALITY ASSESSMENT LA English DT Editorial Material C1 US Dept Vet Affairs, Psychol Serv 116B, Ctr Ambulatory Care, Los Angeles, CA 90012 USA. Univ S Florida, Dept Psychol, Tampa, FL 33620 USA. RP Strack, S (reprint author), US Dept Vet Affairs, Psychol Serv 116B, Ctr Ambulatory Care, 351 E Temple St, Los Angeles, CA 90012 USA. NR 9 TC 2 Z9 2 U1 0 U2 0 PU LAWRENCE ERLBAUM ASSOC INC PI MAHWAH PA 10 INDUSTRIAL AVE, MAHWAH, NJ 07430-2262 USA SN 0022-3891 J9 J PERS ASSESS JI J. Pers. Assess. PD FEB PY 2002 VL 78 IS 1 BP 1 EP 3 DI 10.1207/S15327752JPA7801_01 PG 3 WC Psychology, Clinical; Psychology, Social SC Psychology GA 531TM UT WOS:000174433400001 PM 11936203 ER PT J AU Schlesinger, N Detry, MA Holland, BK Baker, DG Beutler, AM Rull, M Hoffman, BI Schumacher, HR AF Schlesinger, N Detry, MA Holland, BK Baker, DG Beutler, AM Rull, M Hoffman, BI Schumacher, HR TI Local ice therapy during bouts of acute gouty arthritis SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE gout; cold; inflammation; treatment ID COLD; HEAT; TEMPERATURE; URATE AB Objective. To evaluate the effect of local application of ice on duration and severity of acute gouty arthritis. Methods. Nineteen patients with acute gout were enrolled and randomized into 2 groups. Group A (n = 10) received topical ice therapy, oral prednisone 30 mg PO tapered to 0 over 6 days and colchicine 0.6 mg/day. Group B was the control group (n = 9), given the same regimen but without the ice therapy. The patients were followed for one week. Results. The mean reduction in pain for those patients treated with ice therapy was 7.75 cm (on 10 cm visual analog scale) with standard deviation 2.58 compared with 4.42 cm (+/- SD 2.96) for the control group. Using a Wilcoxon rank-sum test there was a significant difference (p = 0.021) in pain reduction between the ice therapy and control groups. Joint circumference and synovial fluid volume also tended to be more effectively reduced after one week of therapy in the ice group compared with controls, but these did not achieve statistical significance. Conclusion. The group treated with ice had a significantly greater reduction in pain compared with the control group. Although the clinical improvement was impressive, due to the small sample size we could not show statistically significant improvement in all the variables that tended to suggest that effect was more than simply analgesic. Cold applications may be a useful adjunct to treatment of acute gouty arthritis. C1 Vet Affairs Med Ctr, Arthrit Immunol Ctr, Philadelphia, PA USA. Univ Penn, Sch Med, Div Rheumatol, Philadelphia, PA 19104 USA. Univ Texas, MD Anderson Canc Ctr, Dept Epidemiol, Houston, TX 77030 USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Prevent Med, Newark, NJ 07103 USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Med, Rheumatol Sect, Newark, NJ 07103 USA. Allegheny Univ Hosp, Div Rheumatol, Dept Med, Philadelphia, PA USA. RP Schlesinger, N (reprint author), 68 Hart Dr, W Orange, NJ 07052 USA. NR 10 TC 53 Z9 57 U1 1 U2 4 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD FEB PY 2002 VL 29 IS 2 BP 331 EP 334 PG 4 WC Rheumatology SC Rheumatology GA 517PC UT WOS:000173618300022 PM 11838852 ER PT J AU Rashad, SM Abdelaty, EM Rooney, J Schumacher, R AF Rashad, SM Abdelaty, EM Rooney, J Schumacher, R TI Acute inflammation at the site of calcinosis in limited cutaneous scleroderma SO JOURNAL OF RHEUMATOLOGY LA English DT Letter ID ACUTE CALCIFIC PERIARTHRITIS C1 Univ Penn, Sch Med, Dept Med, Div Rheumatol, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Rashad, SM (reprint author), Univ Penn, Sch Med, Dept Med, Div Rheumatol, Philadelphia, PA 19104 USA. NR 15 TC 2 Z9 2 U1 0 U2 0 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD FEB PY 2002 VL 29 IS 2 BP 402 EP 403 PG 2 WC Rheumatology SC Rheumatology GA 517PC UT WOS:000173618300041 PM 11838868 ER PT J AU Small, GW McDonnell, DD Brooks, RL Papadopoulos, G AF Small, GW McDonnell, DD Brooks, RL Papadopoulos, G TI The impact of symptom severity on the cost of Alzheimer's disease SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE Alzheimer's disease; cost of illness; caregivers; disease progression ID PLACEBO-CONTROLLED TRIAL; MANAGED CARE; DOUBLE-BLIND; DONEPEZIL; CAREGIVERS; DEMENTIA; AD; GALANTAMINE; PATTERNS; PROGRAM AB OBJECTIVES: To examine the economic impact of Alzheimer's disease (AD) as the disease progresses on patients' medical costs and caregivers' productivity. DESIGN: A 12-page, self-administered mail survey, fielded in November 1999. SETTING: Households with AD caregivers, selected from a nationwide (U.S.) consumer database. PARTICIPANTS: One thousand seven hundred fifteen caregivers of noninstitutionalized AD patients. MEASUREMENTS: Disease progression was measured using a scale of symptom frequency and measures of instrumental and physical functioning. Cost components included hospital days, physician visits, and emergency room visits. Lost productivity was assessed using hours per week that caregivers provided care and the number of days that they missed from work because of caregiving. RESULTS: The direct costs of caring for AD patients for 6 months totaled $3,129, whereas the indirect costs were $26,080. Patients with more-frequent symptoms used all healthcare resources, including the hospital, emergency room, and physicians, more often than those with less-frequent symptoms. Those with lower levels of physical and instrumental functioning also used the hospital and physicians more often than those with higher levels of physical and instrumental functioning. Caregivers of these more severely impaired patients spent more hours providing care and reported missing more work than those caring for higher-functioning patients. These relationships remained after controlling for potentially confounding factors. CONCLUSIONS: This large study of patients at all stages of AD shows that the direct and indirect costs of AD are considerably lower for patients with fewer symptoms. Longitudinal studies will determine the impact on the overall cost of care of interventions that reduce symptoms and maintain patients at earlier stages of the disease. C1 Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Ctr Aging, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Alzheimers Dis Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Consumer Hlth Sci, Princeton, NJ USA. Janssen Pharmaceut Prod LP, Titusville, NJ USA. RP Small, GW (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, 88-201,760 Westwood Plaza, Los Angeles, CA 90024 USA. OI McDonnell, Diana/0000-0003-3044-3147 NR 32 TC 65 Z9 65 U1 4 U2 8 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD FEB PY 2002 VL 50 IS 2 BP 321 EP 327 DI 10.1046/j.1532-5415.2002.50065.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 520EL UT WOS:000173767600015 PM 12028215 ER PT J AU Ahmed, A Allman, RM DeLong, JF AF Ahmed, A Allman, RM DeLong, JF TI Inappropriate use of digoxin in older hospitalized heart failure patients SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID PAROXYSMAL ATRIAL-FIBRILLATION; CONVERTING ENZYME-INHIBITORS; SINUS RHYTHM; VENTRICULAR RATE; GENERAL-PRACTICE; ELDERLY PATIENTS; DIGITALIS; MANAGEMENT; TRIAL; PRESCRIPTION AB Background. Older adults are more likely to suffer from the adverse effects of digoxin. Studies have described the inappropriate use of digoxin in various populations, The objective of this study was to determine the correlates of inappropriate digoxin use in older heart failure patients. Methods. We studied older hospitalized heart failure patients with documented left ventricular (LV) function evaluation and electrocardiography. Digoxin use was considered inappropriate if patients had preserved LV systolic function (ejection fraction greater than or equal to40%) or if they had no atrial fibrillation (AF). We compared baseline patient characteristics by indication for digoxin and tested statistical significance using Pearson's chi-square analysis and Student's t tests. using logistic regression, we determined the correlates of inappropriate use and initiation of digoxin. Results. Subjects (N = 603) had a mean age of 79 (+/-7) years; 59% were women, and 18% were African American. A total of 376 patients (62%) were discharged on dioxin, and 223 (37%) had no indication for its use. Half of the patients without an indication for digoxin received the drug. Of 132 patients without an indication and not already on digoxin, 38 (29%) were initiated on it. After adjustment for various patient and care characteristics, prior digoxin use (adjusted odds ratio [OR] 11.47, 95% confidence internal [CI] 5.72-23.02) and pulse greater than or equal to100/min (adjusted OR 2.33, 95% CI 1.10-4.94) were associated with inappropriate digoxin use. Pulse greater than or equal to100/min was also associated with inappropriate initiation of the drug (adjusted OR 2.95. 95% CI 1.28-6.78). Conclusions. Inappropriate use of dioxin was common and was associated with prior use. Tachycardia was associated with inappropriate use and initiation. Electrocardiography and echocardiography should be performed in all older heart failure patients. Digoxin therapy should not be initiated or continued in patients without any evidence of LV systolic dysfunction or chronic AF. C1 Univ Alabama, Sch Med, Dept Med, Div Gerontol & Geriatr Med, Birmingham, AL 35200 USA. Univ Alabama, Sch Publ Hlth, Dept Epidemiol & Int Hlth, Birmingham, AL 35294 USA. Univ Alabama, Ctr Aging, Birmingham, AL USA. Birmingham VA Med Ctr, Sect Geriatr, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham Atlanta Geratr Res Educ & Clin Ctr, Birmingham, AL USA. Alabama Qual Assurance Fdn, Birmingham, AL USA. RP Ahmed, A (reprint author), Univ Alabama, Sch Med, Dept Med, Div Gerontol & Geriatr Med, Birmingham, AL 35200 USA. RI Ahmed, Ali/A-2934-2008 OI Ahmed, Ali/0000-0002-6832-6424 NR 52 TC 10 Z9 10 U1 0 U2 0 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD FEB PY 2002 VL 57 IS 2 BP M138 EP M143 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 523ZP UT WOS:000173987700014 PM 11818435 ER PT J AU Matsumoto, AM AF Matsumoto, AM TI Andropause: Clinical implications of the decline in serum testosterone levels with aging in men SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Review ID BONE-MINERAL DENSITY; BENIGN PROSTATIC HYPERPLASIA; FOLLICLE-STIMULATING-HORMONE; ANDROGEN RECEPTOR GENE; CORONARY-ARTERY DISEASE; AGE-RELATED-CHANGES; PITUITARY-GONADAL FUNCTION; HEALTHY OLDER MEN; LEAN BODY-MASS; IDIOPATHIC HYPOGONADOTROPIC HYPOGONADISM C1 Univ Washington, Sch Med, Populat Ctr Res Reprod,Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Clin Res Unit, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. RP Matsumoto, AM (reprint author), VA Puget Sound Hlth Care Syst, Clin Res Unit, Ctr Geriatr Res Educ & Clin, 1660 S Columbia Way,S-182-GRECC, Seattle, WA 98108 USA. FU NICHD NIH HHS [HD12629] NR 475 TC 239 Z9 245 U1 4 U2 11 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD FEB PY 2002 VL 57 IS 2 BP M76 EP M99 PG 24 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 523ZP UT WOS:000173987700006 PM 11818427 ER PT J AU Petersen, LA AF Petersen, LA TI Racial differences in trust - Reaping what we have sown? SO MEDICAL CARE LA English DT Editorial Material ID AFRICAN-AMERICAN CHURCHES; MANAGED CARE; MEDICAL-RESEARCH; HEALTH-CARE; PHYSICIANS; INTERVENTION; ATTITUDES; VIEWS; WHITE; RACE C1 Houston Vet Affairs Med Ctr, Hlth Serv Res & Dev 152, Houston Ctr Qual Care & Utilizat Studies, Hlt Serv Res & Dev Ctr Excellence, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. RP Petersen, LA (reprint author), Houston Vet Affairs Med Ctr, Hlth Serv Res & Dev 152, Houston Ctr Qual Care & Utilizat Studies, Hlt Serv Res & Dev Ctr Excellence, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 31 TC 32 Z9 32 U1 3 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 2002 VL 40 IS 2 BP 81 EP 84 DI 10.1097/00005650-200202000-00002 PG 4 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 517DB UT WOS:000173594900002 PM 11802080 ER PT J AU Reker, DM Rosen, AK Hoenig, H Berlowitz, DR Laughlin, J Anderson, L Marshall, CR Rittman, M AF Reker, DM Rosen, AK Hoenig, H Berlowitz, DR Laughlin, J Anderson, L Marshall, CR Rittman, M TI The hazards of stroke case selection using administrative data SO MEDICAL CARE LA English DT Article DE stroke; risk adjustment; mortality ID ICD-9-CM; MORTALITY AB BACKGROUND. Administrative data and ICD-9-CM diagnostic codes are frequently used in research efforts to evaluate risk adjusted patient outcomes, particularly mortality. Varying ICD-9-CM sampling algorithms have been used to identify stroke patients. OBJECTIVES. This study evaluates the effects of different sampling strategies (one high sensitivity and one high specificity) on modeling stroke mortality as a performance indicator. RESEARCH DESIGN. Risk adjustment models were developed for two stroke cohorts identified using differing ICD-9-CM algorithms. Standard mortality ratios were calculated in a validation sample as network performance measures and compared across the two stroke samples. SUBJECTS. VHA inpatients with stroke during years 1997 (model development) and 1998 (model validation) were selected from the Patient Treatment File based on cerebrovascular diagnostic codes. MEASURES. Patient mortality within 30 days of admission. RESULTS. The model development and validation for each stroke sampling method produced consistent results: c-statistics 0.74 to 0.75, R-2 0.07 to 0.09, concordance 73% to 74%. However, ranking differences in network performance varied by 5 or more positions for 7 of the 22 patient networks. CONCLUSIONS. These findings highlight a potential problem when using administrative data to assess stroke mortality. In the absence of an agreed upon definition of stroke patients, results of provider profiling will vary depending on the ICD-9 algorithm used. C1 Vet Adm Med Ctr, Kansas City, MO 64128 USA. Univ Kansas, Med Ctr, Ctr Aging, Kansas City, KS 66103 USA. Bedford VA Med Ctr, Bedford, MA USA. Duke Univ, Med Ctr, Durham VA Med Ctr, Durham, NC USA. Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. Denver VA Med Ctr, Denver, CO USA. Memphis VA Med Ctr, Memphis, TN USA. Bay Pines VA Med Ctr, Bay Pines, FL USA. Gainesville VA Med Ctr, Gainesville, FL USA. RP Reker, DM (reprint author), Vet Adm Med Ctr, Res 151,4801 Linwood Blvd, Kansas City, MO 64128 USA. FU NIA NIH HHS [P60AG 14635-02, P60AG-11268] NR 12 TC 36 Z9 36 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 2002 VL 40 IS 2 BP 96 EP 104 DI 10.1097/00005650-200202000-00004 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 517DB UT WOS:000173594900004 PM 11802082 ER PT J AU Parchman, ML Pugh, JA Noel, PH Larme, AC AF Parchman, ML Pugh, JA Noel, PH Larme, AC TI Continuity of care, self-management behaviors, and glucose control in patients with type 2 diabetes SO MEDICAL CARE LA English DT Article DE continuity of patient care; diabetes mellitus; self care ID PROVIDER CONTINUITY; REGULAR EXERCISE; ATTITUDES; BARRIERS; IMPACT; TRIAL; SITE AB BACKGROUND. The influence of continuity of care on outcomes of care for patients with type 2 diabetes is poorly understood. OBJECTIVE. To examine the relationships between continuity, glucose control, and advancement through stages of change for self-management behaviors. DESIGN. Prospective cohort study. SETTING. Five community health centers on the Texas-Mexico border. SUBJECTS. A random sample of 256 adults, :18 years of age and older with an established diagnosis of type 2 diabetes. MEASURES. Stage of change for diet and exercise were assessed during two patient interviews, averaging 18.9 months apart. Phlebotomy was performed at each interview to measure glycosolated hemoglobin (HbA,c). Medical records were abstracted for ambulatory care utilization. A continuity score was calculated based on the number of visits and number of providers seen. RESULTS. Patients who advanced one or more stages of change for diet had higher levels of continuity. As continuity improved, the change in HbA,c was smaller. (r = -0.25; P <0.001) This relationship remained significant after controlling for number of visits, months since diagnosis, number of days in the study, duration of diabetes, and advancement in stage of change for diet. Advancement through stage of change for diet explained a significant amount of the variance in the relationship between continuity and HbA(1C) (t test = -11.33; P <0.01). CONCLUSIONS. Continuity of care with a primary care provider is associated with better glucose control among patients with type 2 diabetes. This relationship appears to be mediated by changes in patient behavior regarding diet. C1 Univ Texas, Hlth Sci Ctr, Dept Family & Community Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst,VERDICT, Audie L Murphy Div,VA Hlth Serv Res Ctr Excellenc, San Antonio, TX 78229 USA. RP Parchman, ML (reprint author), Univ Texas, Hlth Sci Ctr, Dept Family & Community Med, 7703 Floyd Curl Dr,MSC 7795, San Antonio, TX 78229 USA. OI Pugh, Jacqueline/0000-0003-4933-141X; Parchman, Michael/0000-0001-7129-2889 FU PHS HHS [H507397] NR 32 TC 88 Z9 92 U1 3 U2 17 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 2002 VL 40 IS 2 BP 137 EP 144 DI 10.1097/00005650-200202000-00008 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 517DB UT WOS:000173594900008 PM 11802086 ER PT J AU Corbitt, J Hagerty, T Fernandez, E Morgan, WW Strong, R AF Corbitt, J Hagerty, T Fernandez, E Morgan, WW Strong, R TI Transcriptional and post-transcriptional regulation of tyrosine hydroxylase messenger RNA in PC12 cells during persistent stimulation by VIP and PACAP38: differential regulation by protein kinase A and protein kinase C-dependent pathways SO NEUROPEPTIDES LA English DT Article ID CYCLASE-ACTIVATING POLYPEPTIDE; SUPERIOR CERVICAL-GANGLION; ADRENAL CHROMAFFIN CELLS; GENE-EXPRESSION; SHORT-TERM; COLD STRESS; LONG-TERM; NERVOUS-SYSTEM; PC-12 CELLS; I RECEPTORS AB VIP and PACAP38 are closely related peptides that are released in the adrenal gland and sympathetic ganglia and regulate catecholamine synthesis and release. We used PC12 cells as a model system to examine receptor and second messenger pathways by which each peptide stimulates transcriptional and post-transcriptional mechanisms that regulate the level of the mRNA for tyrosine hydroxylase (TH), the rate-limiting enzymatic step in catecholamine synthesis. Concentration-response studies revealed that PACAP38 had both greater efficacy and potency than VIP. The specific PAC1 receptor antagonist PACAP[6-38] blocked the effects of each peptide on TH mRNA content while the PACAP/VIP type II receptor antagonist (N-AC-Tyr(1)-D-Phe(2))-GRF-(1-29)-NH2 was without effect. At equipotent concentrations, each peptide stimulated a transient increase in TH gene transcription lasting less than 3 h. Continuous VIP treatment stimulated a transient increase in TH mRNA lasting less than 24 h. In contrast, continuous exposure to PACAP38 stimulated a stable increase in TH mRNA that persisted for 2 days in the absence of elevated transcription, pointing to different post-transcriptional effects of the two peptides. PACAP38 alone had no effect on the magnitude of TH gene transcription or TH mRNA in A126-1B2 PKA-deficient PC12 cells. However, when combined with dexamethasone, PACAP38 produced a synergistic increase in TH mRNA in the absence of PACAP38-stimulated TH gene transcription. In contrast, VIP had no effect on either TH mRNA content or TH gene transcription in this model. PACAP38, but not VIP, stimulated PKC activity. Calphostin C antagonized the effect of PACAP38 on the persistent post-transcriptional elevation in TH mRNA. Thus, the results support the conclusion that VIP and PACAP38 each stimulate PAC1 receptors to increase TH gene transcription through a PKA-controlled pathway, but their divergent post-transcriptional effects result at least partly from differing abilities to stimulate PKC. (C) 2002 Elsevier Science Ltd. All rights reserved. C1 Audie L Murphy Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. RP Strong, R (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, Geriat Res Educ & Clin Ctr 182, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. FU NIDDK NIH HHS [DK 52543] NR 58 TC 23 Z9 23 U1 0 U2 0 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0143-4179 J9 NEUROPEPTIDES JI Neuropeptides PD FEB PY 2002 VL 36 IS 1 BP 34 EP 45 DI 10.1054/npep.2002.0885 PG 12 WC Endocrinology & Metabolism; Neurosciences SC Endocrinology & Metabolism; Neurosciences & Neurology GA 580NR UT WOS:000177241100005 PM 12147212 ER PT J AU Yang, H AF Yang, H TI Central and peripheral regulation of gastric acid secretion by peptide YY SO PEPTIDES LA English DT Review ID DORSAL VAGAL COMPLEX; ENTEROCHROMAFFIN-LIKE CELLS; THYROTROPIN-RELEASING-HORMONE; NUCLEUS-TRACTUS-SOLITARIUS; NEUROPEPTIDE-Y; PANCREATIC-POLYPEPTIDE; RAT-BRAIN; RAPHE PALLIDUS; TRH ANALOG; GASTROINTESTINAL-TRACT AB Peptide YY (PYY) released postprandially from the ileum and colon displays a potent inhibition of cephalic and gastric phases of gastric acid secretion through both central and peripheral mechanisms. To modulate vagal regulation of gastric functions, circulating PYY enters the brain through the area postrema and the nucleus of the solitary tract. where it exerts a stimulatory action through PYY-preferring Y1-like receptors, and an inhibitory action through Y2 receptors. In the gastric mucosa, PYY binds to Y1 receptors in the enterochromaffin-like cells to inhibit gastrin-stimulated histamine release and calcium signaling via a pertussis toxin-sensitive pathway. (C) 2002 Elsevier Science Inc. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Inst Brain Res, Los Angeles, CA 90073 USA. RP Yang, H (reprint author), VA Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Bldg 115,Rm 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 105 TC 29 Z9 29 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD FEB PY 2002 VL 23 IS 2 BP 349 EP 358 AR PII S0196-9781(01)00611-8 DI 10.1016/S0196-9781(01)00611-8 PG 10 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 522QD UT WOS:000173907700011 PM 11825649 ER PT J AU Aravagiri, M Marder, SR AF Aravagiri, M Marder, SR TI Brain, plasma and tissue pharmacokinetics of risperidone and 9-hydroxyrisperidone after separate oral administration to rats SO PSYCHOPHARMACOLOGY LA English DT Article DE risperidone; 9-hydroxyrisperidone; pharmacokinetics; rat; oral dose; plasma; brain; tissue; LC-MS-MS ID RECEPTOR OCCUPANCY; METABOLISM; EXCRETION; 5-HT2; D-2 AB Rationale: Following an oral dose of risperidone (RSP), concentrations of its major metabolite 9-hydroxyrisperidone (9-OHRSP) were high in plasma and tissues but disproportionately lower in the brain compared to RSP, indicating that 9-OHRSP may have different pharmacokinetic properties. Objectives: To investigate non-compartmental pharmacokinetics of RSP and 9-OHRSP in plasma, brain and other tissues after separate administration of a single oral dose of 6 mg/kg RSP and 9-OHRSP to rats. Methods: Plasma, brain, liver, lung, kidney and spleen tissues were collected at pre-dose and at 0.5, 1, 2, 5, 6, 12, 24, 36 and 48 h post-dose, homogenized in saline and assayed for RSP and 9-OHRSP using a sensitive and specific liquid chromatography tandem mass spectrometry method. Results: The concentrationtime curve of RSP and 9-OHRSP showed that they were readily absorbed and followed a multiphase elimination pattern. The terminal elimination half-life (t(1/2)) of RSP after the RSP dose was longest in the liver (17.6 h) and shortest in the spleen (1.2 h). The t(1/2) of 9-OHRSP after the RSP dose was shorter in plasma (3.4 h) and other tissues (similar to8-11 h) than that for RSP but it was longer in the spleen. However, the t(1/2) of 9-OHRSP after the 9-OHRSP dose was shorter in most tissues as compared to the t(1/2) of 9-OHRSP after the RSP dose. The area under the concentration-time curve (AUC) of RSP and 9-OHRSP was 6-67 times higher in the plasma and tissues than in the brain. AUCs of 9-OHRSP in tissues after the RSP close were 2-5 times higher than those for RSP, except in the brain, where AUCs of RSP and 9-OHRSP were similar. Conclusion: Pharmacokinetics of 9-OHRSP in many tissues were different after RSP and 9-OHRSP doses. The reason for disproportionate brain levels of 9-OHRSP is not clear. The overall exposure to active drug in the brain as represented by AUC was similar after the RSP and 9-OHRSP doses and the 9-OHRSP is probably an equal contributor to the pharmacological actions of RSP. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Psychopharmacol Unit, Los Angeles, CA 90073 USA. RP Aravagiri, M (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Psychopharmacol Unit, Bldg 210,15,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 22 TC 33 Z9 35 U1 0 U2 3 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0033-3158 J9 PSYCHOPHARMACOLOGY JI Psychopharmacology PD FEB PY 2002 VL 159 IS 4 BP 424 EP 431 DI 10.1007/s00213-001-0933-x PG 8 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 528KC UT WOS:000174242100010 PM 11823895 ER PT J AU Hung, PW Paik, DS Napel, S Yee, J Jeffrey, RB Steinauer-Gebauer, A Min, J Jathavedam, A Beaulieu, CF AF Hung, PW Paik, DS Napel, S Yee, J Jeffrey, RB Steinauer-Gebauer, A Min, J Jathavedam, A Beaulieu, CF TI Quantification of distention in CT colonography: Development and validation of three computer algorithms SO RADIOLOGY LA English DT Article DE colon, CT; computers, diagnostic aid; computed tomography (CT), computer programs; computed tomography (CT), image processing; phantoms ID VIRTUAL COLONOSCOPY; COLORECTAL POLYPS; DISPLAY MODES; HELICAL CT; GLUCAGON; COLON AB Three bowel distention-measuring algorithms for use at computed tomographic (CT) colonography were developed, validated in phantoms, and applied to a human CT colonographic data set. The three algorithms are the cross-sectional area method, the moving spheres method, and the segmental volume method. Each algorithm effectively quantified distention, but accuracy varied between methods. Clinical feasibility was demonstrated. Depending on the desired spatial resolution and accuracy, each algorithm can quantitatively depict colonic diameter in CT colonography. C1 Stanford Univ, Med Ctr, Dept Radiol, Stanford, CA 94305 USA. Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA. Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. San Francisco Vet Adm Med Ctr, San Francisco, CA USA. NYU, Sch Med, Dept Radiol, New York, NY USA. RP Beaulieu, CF (reprint author), Stanford Univ, Med Ctr, Dept Radiol, MC 5105,300 Pasteur Dr, Stanford, CA 94305 USA. FU NCI NIH HHS [R01 CA72023] NR 27 TC 9 Z9 9 U1 0 U2 3 PU RADIOLOGICAL SOC NORTH AMERICA PI OAK BROOK PA 820 JORIE BLVD, OAK BROOK, IL 60523 USA SN 0033-8419 J9 RADIOLOGY JI Radiology PD FEB PY 2002 VL 222 IS 2 BP 543 EP 554 DI 10.1148/radiol.2222010600 PG 12 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 515NQ UT WOS:000173502500035 PM 11818626 ER PT J AU Howard, VJ Sides, EG Newman, GC Cohen, SN Howard, G Malinow, MR Toole, JF AF Howard, VJ Sides, EG Newman, GC Cohen, SN Howard, G Malinow, MR Toole, JF CA Stability Plasma Homocysteine Acut TI Changes in plasma homocyst(e)ine in the acute phase after stroke SO STROKE LA English DT Article DE homocyst(e)ine; stroke, acute; stroke, ischemic ID ACUTE MYOCARDIAL-INFARCTION; TOTAL HOMOCYSTEINE LEVELS; CARDIOVASCULAR-DISEASE; ISCHEMIC STROKE; RISK FACTOR; FOLIC-ACID AB Background and Purpose-Elevated plasma homocyst(e)ine [H(e)] concentration has been associated with an increased risk of stroke. Although the literature suggests that H(e) increases from the acute to the convalescent phase after a stroke, it is not known whether H(e) changes within the acute period. Methods-A prospective, multicenter study was conducted to examine changes in H(e) during the 2 weeks after an incident stroke. Blood samples were collected at days 1, 3, 5, 7, and between 10 and 14 days after the stroke. Results-Seventy-six participants (51 men) were enrolled from 9 sites from February 1997 through June 1998. Mean age was 65.6 years, and subjects had at least two H(e) measurements. The estimated mean H(e) level at baseline was 11.3+/-0.5 mumol/L, which increased consistently to a mean of 12.0+/-0.05, 12.4+/-0.5, 13.3+/-0.5, and 13.7+/-0.7 mumol/L at days 3, 5, 7, and 10 to 14, respectively. The magnitude of the change in H(e) was not affected by age, sex, smoking status, alcohol use, history of hypertension or diabetes, or Rankin Scale Score. Conclusions-These data suggest that the clinical interpretation of H(e) after stroke and the eligibility for clinical trials assessing treatment for elevated H(e) levels require an adjustment in time since stroke to properly interpret the observed H(e) levels. C1 Univ Alabama, Dept Epidemiol & Int Hlth, Birmingham, AL 35294 USA. Univ Alabama, Dept Biostat, Birmingham, AL 35294 USA. Wake Forest Univ, Bowman Gray Sch Med, Dept Neurol, Ctr Stroke Res, Winston Salem, NC 27103 USA. SUNY Stony Brook, Dept Neurol, Stony Brook, NY 11794 USA. Cedars Sinai Med Ctr, Div Neurol, Los Angeles, CA 90048 USA. W Los Angeles Vet Affairs Healthcare Ctr, Dept Neurol, Los Angeles, CA USA. Oregon Reg Primate Res Ctr, Beaverton, OR 97006 USA. RP Howard, VJ (reprint author), Univ Alabama, Dept Epidemiol & Int Hlth, 1530 3rd Ave S,RPHB 210F, Birmingham, AL 35294 USA. FU NINDS NIH HHS [R01 NS34447] NR 32 TC 63 Z9 67 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD FEB PY 2002 VL 33 IS 2 BP 473 EP 478 DI 10.1161/hs0202.103069 PG 6 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 518AX UT WOS:000173644900010 PM 11823655 ER PT J AU Xu, JM Kogai, T Brent, GA Hershman, JM AF Xu, JM Kogai, T Brent, GA Hershman, JM TI A GC box in the human sodium iodide symporter gene promoter is essential for full activity SO THYROID LA English DT Article ID THYROID TRANSCRIPTION FACTOR; HUMAN NA+/I SYMPORTER; CANCER CELL-LINE; SODIUM/IODIDE-SYMPORTER; MESSENGER-RNA; FACTOR-I; EXPRESSION; THERAPY; CLONING; TUMORS AB We previously reported that the human sodium iodide symporter (hNIS) 5-flanking region between -603 and -415 is essential for full expression. In this study, we further localized sequences within this region required for the basal expression of the hNIS promoter and identified a functional GC box. Activity of the hNIS promoter was assessed by transient transfection of luciferase reporter gene constructs with progressive 5' deletions into the human papillary thyroid cancer cell line BHP 2-7. Deletion from -603 to -535 enhanced promoter activity, further deletion to -469 decreased promoter activity, and deletion to -415 nearly abolished promoter activity. The DNA sequence within this critical 55 bp region from -469 to -415 contains a GC box. Introduction of mutations into the GC box of the deletion constructs -603, -535 and -469 decreased promoter activity in both thyroid cells (BHP 2-7 and rat thyroid cell FRTL-5) and nonthyroid cells (human prostate cancer cell LNCaP-2 and human breast cancer cell MCF-7). The magnitude of reduction for the - 603 mutation construct was significantly greater than that for the -469 mutation construct in thyroid cells compared to nonthyroid cells. In vitro transcription using nuclear extracts isolated from HeLa cells was reduced from DNA templates with the GC box mutation and nearly abolished from templates with 5' deletion to -415. Identification of proteins interacting with the GC box was performed by gel retardation assays with or without Sp1 specific antibodies. Sp1 and an "Sp1-like" protein bound to the wild-type GC box sequence but not to the GC box mutant. In summary, the GC box is a positive regulatory element in the hNIS basal promoter. C1 VA Greater Los Angeles Healthcare Syst, Div Endocrinol & Metab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. RP Hershman, JM (reprint author), VA Greater Los Angeles Healthcare Syst, Div Endocrinol 111D, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Ain, Kenneth/A-5179-2012 OI Ain, Kenneth/0000-0002-2668-934X NR 31 TC 8 Z9 8 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1050-7256 J9 THYROID JI Thyroid PD FEB PY 2002 VL 12 IS 2 BP 107 EP 114 DI 10.1089/105072502753522338 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 530GU UT WOS:000174350600004 PM 11916279 ER PT J AU Fukata, S Miyauchi, A Kuma, K Sugawara, M AF Fukata, S Miyauchi, A Kuma, K Sugawara, M TI Acute suppurative thyroiditis caused by an infected piriform sinus fistula with thyrotoxicosis SO THYROID LA English DT Article; Proceedings Paper CT 71st Annual Meeting of the American-Thyroid-Association CY SEP 16-20, 1998 CL PORTLAND, OREGON SP Amer Thyroid Assoc ID BODY AB We report herein an unusual case of thyrotoxicosis caused by acute suppurative thyroiditis (AST) infected through a piriform sinus fistula (PSF). A 28-year-old man presented with pain over the thyroid gland and elevated serum thyroid hormone levels, a picture similar to subacute thyroiditis. A fine-needle aspiration biopsy from the left lobe showed neutrophil. infiltration, and culture from the aspirate grew anaerobic peptostreptococcus. A neck computed tomography (CT) scan showed an abscess in the thyroid gland, and barium swallow revealed the presence of PSF. Appropriate antibiotic treatment ameliorated his symptoms of infection, followed by normalization of thyroid function. Three months later, he underwent fistulectomy and partial left lobectomy. The end of the PSF track was found in the left thyroid lobe. Thus infection of the thyroid gland through the infected PSF was likely the cause of supprative thyroiditis. The unusual clinical features of AST in this patient include the presence of severe thyrotoxicosis, relatively late onset (28-years-old) of infection despite the presence of congenital PSF, and the lack of acute inflammatory signs on the overlying skin of the thyroid gland. It is important to recognize this type of AST, since fistulectomy is required to prevent recurrent AST. C1 Kuma Hosp, Chuo Ku, Kobe, Hyogo 6500011, Japan. Univ Calif Los Angeles, Sch Med, W Los Angeles Vet Affairs Med Ctr, Dept Endocrinol & Metab, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Internal Med, Los Angeles, CA USA. RP Fukata, S (reprint author), Kuma Hosp, Chuo Ku, 8-2-35 Shimoyamate Dori, Kobe, Hyogo 6500011, Japan. NR 13 TC 15 Z9 20 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1050-7256 J9 THYROID JI Thyroid PD FEB PY 2002 VL 12 IS 2 BP 175 EP 178 DI 10.1089/105072502753522428 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 530GU UT WOS:000174350600013 PM 11916288 ER PT J AU Jones, HA Metz, JM Devine, P Hahn, SM Whittington, R AF Jones, HA Metz, JM Devine, P Hahn, SM Whittington, R TI Rates of unconventional medical therapy use in patients with prostate cancer: Standard history versus directed questions SO UROLOGY LA English DT Article ID COMPLEMENTARY THERAPIES; CONTROLLED TRIAL; UNITED-STATES; PC-SPES; CARCINOMA; PATTERNS; SUPPLEMENTATION; PREVALENCE; LYCOPENE AB Objectives. The use of unconventional medical therapies (UMTs) in the general population has increased dramatically in the past decade. Studies have estimated that 9% to 64% of patients with cancer use UMTs, and many do not disclose this information to their physicians. This study was designed to evaluate the rates of UMT use by patients with prostate cancer revealed by standard versus directed questioning and to identify demographic markers that may predict use. Methods. A prospective study of 287 consecutive patients with cancer presenting to the Department of Radiation Oncology was performed. The prostate cancer population was 29% (84 of 287) of the total cancer patient population. Each patient underwent the standard history interview, including questions regarding prescription and over-the-counter medication. At the completion of the standard history interview, patients were then asked a set of directed questions regarding the use of UMTs. Results. Of the 84 patients with prostate cancer, 31 (37%) used unconventional therapies. The standard history revealed that 6 (19%) of 31 used UMTs, and directed questioning revealed an additional 25 patients (81%) used UMTs in the study population (P < 0.001). Of those using UMTs, 65% used megavitamins, 49% used herbal remedies, 13% used meditation or guided imagery, and 20% used nonherbal natural supplements. Conclusions. UMT use is prevalent among patients with prostate cancer. Some of these treatments may have a potential biologic impact on tumor behavior, therapeutic endpoints, and measured prostate-specific antigen values. The use of directed questioning during the patient evaluation significantly increases the physician's ability to identify patients with prostate cancer using UMTs. UROLOGY 59: 272-276, 2002. (C) 2002, Elsevier Science Inc. C1 Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA USA. Univ Penn, Sch Med, Dept Radiat Oncol, Philadelphia, PA 19104 USA. RP Jones, HA (reprint author), Hosp Univ Penn, Dept Radiat Oncol, 2 Donner,3400 Spruce St, Philadelphia, PA 19104 USA. NR 21 TC 24 Z9 24 U1 3 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0090-4295 J9 UROLOGY JI UROLOGY PD FEB PY 2002 VL 59 IS 2 BP 272 EP 276 DI 10.1016/S0090-4295(01)01491-1 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 520QQ UT WOS:000173792900022 PM 11834401 ER PT J AU Carlsson, B Singh, BN Temciuc, M Nilsson, S Li, YL Mellin, C Malm, J AF Carlsson, B Singh, BN Temciuc, M Nilsson, S Li, YL Mellin, C Malm, J TI Synthesis and preliminary characterization of a novel antiarrhythmic compound (KB130015) with an improved toxicity profile compared with amiodarone SO JOURNAL OF MEDICINAL CHEMISTRY LA English DT Article ID FUNCTIONAL FULL LENGTH; HIGH-LEVEL EXPRESSION; CEREBRAL-CORTEX; CARDIAC MUSCLE; CELLS; RECEPTOR; BINDING; GENE; AGENTS; DRUGS AB Recent developments in antiarrhythmic therapy have indicated that the best approach to pharmacologically controlling supraventricular arrhythmias and life-threatening ventricular tachyarrhythmias is by prolonging cardiac repolarization rather than by blocking conduction. In this context, amiodarone has emerged as the most potent compound, but its universal use has been limited by its toxicity profile. There are data to suggest that an important component of amiodarones antiarrhythmic action might be mediated via inhibition of thyroid hormone action in the heart. Therefore, a new series of carboxymethoxybenzoyl and benzyl derivatives of benzofuran has been prepared and evaluated as thyroid hormone receptor antagonists. Within this series, 2-methyl-3-(3,5-diiodo-4-carboxymethoxybenzyl)benzofuran KB130015 (7) was found to reveal the most promising in vitro data. It inhibits the binding of I-125-T-3 to the human thyroid hormone receptors (hThR) alpha(1) and beta(1). T-3-Antagonism was confirmed in reporter cell assays employing CHOKl cells (Chinese hamster ovary cells) stably transfected with hThRalpha(1) or hThRbeta(1) and an alkaline phosphatase reporter gene downstream a thyroid response element. The derived IC50 values were 2.2 muM for hThRalpha(1) and 4.1 muM for hThRbeta(1). Compound 7 was selected for further characterization of chronic effects on ventricular papillary muscle by transmembrane electrophysiology after daily intraperitoneal injection of the ligand (40 mg/kg body weight) in guinea pigs. Compound 7 was found to prolong the action potential duration at 90% (APD(90)) repolarization time (219 +/- 22 ms, control: 186 +/- 9 ms, p < 0.01) without exhibiting any reverse-rate dependency of action in a manner similar to that of amiodarone. In general, preliminary tolerance experiments with 7 demonstrated an improved safety profile compared to that of amiodarone. In summary, 7 appears to be less toxic than amiodarone while maintaining its electrophysiologic properties consistent with antiarrhythmic activity. Its potential antiarrhythmic actions warrant further investigations. C1 Karolinska Inst, Novum, Karo Bio AB, S-14157 Huddinge, Sweden. W Los Angeles Vet Affairs Med Ctr, Cardiol Sect 111E, Los Angeles, CA 90073 USA. Ideon, Synthelec AB, S-22370 Lund, Sweden. RP Malm, J (reprint author), Karolinska Inst, Novum, Karo Bio AB, S-14157 Huddinge, Sweden. NR 34 TC 91 Z9 93 U1 1 U2 3 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0022-2623 J9 J MED CHEM JI J. Med. Chem. PD JAN 31 PY 2002 VL 45 IS 3 BP 623 EP 630 DI 10.1021/jm001126+ PG 8 WC Chemistry, Medicinal SC Pharmacology & Pharmacy GA 517MZ UT WOS:000173615600008 PM 11806713 ER PT J AU Kalechstein, AD Newton, TF Leavengood, AH AF Kalechstein, AD Newton, TF Leavengood, AH TI Apathy syndrome in cocaine dependence SO PSYCHIATRY RESEARCH LA English DT Article DE abstinence; depression; Neuropsychiatric Inventory Apathy Subscale; Beck Depression Inventory ID HIV-1 INFECTION; DEPRESSION; ABSTINENCE; WITHDRAWAL; SYMPTOMS; ADDICTS; SLEEP; MOOD AB The cocaine abstinence syndrome has been associated with a range of symptoms, including apathy and depression. Although initial studies reported high prevalence rates of 'apathy/amotivation' and depression, validated rating scales of apathy were not then available. Using a validated measure of apathy, we hypothesized that newly abstinent cocaine-dependent subjects would report increased apathy compared with non-cocaine-using control subjects. Furthermore, because apathy and depression are dissociable in other neuropsychiatric syndromes, we examined whether they were dissociable in recently abstinent cocaine-dependent subjects. Following 4 days of monitored abstinence, cocaine-dependent subjects (n = 11) and non-drug-using control subjects (n = 19) were administered standardized tests of apathy and depression. Cocaine-dependent subjects had elevated scores on the apathy rating scale compared with the control group, but the groups did not differ in ratings of depression. These data suggest that apathy is present during the initial phases of abstinence for a subset of cocaine-dependent individuals. This group may benefit from targeted pharmacological intervention. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Calif Los Angeles, Sch Med, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. W Los Angeles Vet Adm Med Ctr, Psychiat Serv, Los Angeles, CA 90073 USA. RP Kalechstein, AD (reprint author), Univ Calif Los Angeles, Sch Med, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, 760 Westwood Plaza,A7-372, Los Angeles, CA 90024 USA. OI newton, thomas/0000-0002-3198-5901 FU NIDA NIH HHS [DA98095, DA00388, DA07272, DA50038] NR 18 TC 14 Z9 14 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0165-1781 J9 PSYCHIAT RES JI Psychiatry Res. PD JAN 31 PY 2002 VL 109 IS 1 BP 97 EP 100 AR PII S0165-1781(01)00354-7 DI 10.1016/S0165-1781(01)00354-7 PG 4 WC Psychiatry SC Psychiatry GA 525TN UT WOS:000174087200012 PM 11850056 ER PT J AU Alvarez, B Quinn, LS Busquets, S Quiles, MT Lopez-Soriano, FJ Argiles, JM AF Alvarez, B Quinn, LS Busquets, S Quiles, MT Lopez-Soriano, FJ Argiles, JM TI Tumor necrosis factor-alpha exerts interleukin-6-dependent and -independent effects on cultured skeletal muscle cells SO BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH LA English DT Article DE tumor necrosis factor alpha; skeletal muscle; interleukin-6; cytokine ID CANCER CACHEXIA; EXPRESSION; PROTEIN; MYOGENESIS; CYTOKINES; UBIQUITIN; TNF AB In vivo studies have shown that cancer-associated skeletal muscle wasting (cachexia) is mediated by two cytokines, tumor necrosis factor-alpha (TNF) and interleukin-6 (IL-6). It has been unclear from these studies whether TNF exerts direct effects on skeletal muscle and/or whether these effects are mediated via IL-6. Previous studies from our laboratory have shown that TNF induces IL-6 mRNA expression in cultured skeletal muscle cells. To further investigate the relationship between TNF and IL-6. the effects of TNF and IL-6 on protein and DNA dynamics in murine C2C12 skeletal myotube cultures were determined. At 1000 U/ml. TNF induced 30% increases in protein and DNA content. The effects of TNF on protein accumulation were inhibited by aphidicolin, an inhibitor of DNA synthesis. IL-6 mimicked the effects of TNF on C2C12 cultures. inducing a 32% increase in protein accumulation and a 71% increase in the rate of protein synthesis. IL-6 also decreased expression of mRNA for several proteolytic system components, including ubiquitin 2.4 kb (51%) and 1.2 kb (63%). cathepsin B (39%) and m-calpain (47%), indicating that IL-6 acts on both protein synthesis and degradation. Incubation of murine C2C12 myotube cultures with TNF (1000 U/ml) in the presence of a polyclonal mouse anti-IL-6 antibody resulted in an abolishment of the effects of TNF on protein synthesis. but did not inhibit TNF-induced stimulation of DNA synthesis. These findings indicate that the effects of TNF on muscle protein synthesis are mediated by IL-6, but that TNF exerts IL-6-independent effects on proliferation of marine skeletal myoblasts. (C) 2002 Elsevier Science B.V. All rights reserved. C1 Univ Barcelona, Fac Biol, Canc Res Grp, Dept Bioquim & Biol Mol, Barcelona 08028, Spain. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Amer Lake Div, Tacoma, WA 98493 USA. Hosp Gen Valle Hebron, Barcelona, Spain. RP Argiles, JM (reprint author), Univ Barcelona, Fac Biol, Canc Res Grp, Dept Bioquim & Biol Mol, Diagonal 645, Barcelona 08028, Spain. NR 21 TC 44 Z9 45 U1 0 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-4889 J9 BBA-MOL CELL RES JI Biochim. Biophys. Acta-Mol. Cell Res. PD JAN 30 PY 2002 VL 1542 IS 1-3 BP 66 EP 72 AR PII S0167-4889(01)00167-7 DI 10.1016/S0167-4889(01)00167-7 PG 7 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 525AA UT WOS:000174044000007 PM 11853880 ER PT J AU Alvarez, B Busquets, S Lopez-Soriano, FJ Argiles, JM AF Alvarez, B Busquets, S Lopez-Soriano, FJ Argiles, JM TI TNF-alpha modulates cytokine and cytokine receptors in C2C12 myotubes SO CANCER LETTERS LA English DT Article DE tumour necrosis factor-alpha; skeletal muscle; cachexia; cytokines ID TUMOR-NECROSIS-FACTOR; SKELETAL-MUSCLE; CANCER CACHEXIA; PROTEIN-TURNOVER; INTERLEUKIN-6; EXPRESSION; RATS; INVOLVEMENT; SEPSIS; INDUCE AB Incubation of C2C12 differentiated myotubes in the presence of 1000 units/ml (100 ng/ml) of recombinant murine tumor necrosis factor-alpha (TNF-alpha) for up 6 h caused an important increase in mRNA content of the cytokine (10-fold at 6 h). The levels of expression of the two cytokine receptors were not changed by the cytokine at short-time intervals, but 48 h of treatment resulted in a decreased expression of TNFR1 (33%). Interestingly, the presence of the cytokine resulted in significant increases in mRNA content for the catabolic pro-inflammatory cytokines IL-6 (17-fold) and IFN-gamma (8-fold). Similarly, TNF-alpha also caused a moderate increased expression of different anti-inflammatory cytokines such as IL-9 (104%), IL-10 (24%) and IL-15 (47%). The results suggest that other cytokines may be involved in mediating TNF-a action in skeletal muscle and that anti-inflammatory cytokines may be released as a counter-regulatory mechanism. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Barcelona, Fac Biol, Dept Bioquim & Biol Mol, Canc Res Grp, E-08028 Barcelona, Spain. VA Puget Sound Hlth Care Syst, Amer Lake Div, Geriatr Res Educ & Clin Ctr, Tacoma, WA 98493 USA. RP Argiles, JM (reprint author), Univ Barcelona, Fac Biol, Dept Bioquim & Biol Mol, Canc Res Grp, Diagonal 645, E-08028 Barcelona, Spain. NR 20 TC 23 Z9 23 U1 0 U2 6 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0304-3835 J9 CANCER LETT JI Cancer Lett. PD JAN 25 PY 2002 VL 175 IS 2 BP 181 EP 185 DI 10.1016/S0304-3835(01)00717-0 PG 5 WC Oncology SC Oncology GA 511DX UT WOS:000173250300009 PM 11741746 ER PT J AU Saunders, PR Maillot, C Million, M Tache, Y AF Saunders, PR Maillot, C Million, M Tache, Y TI Peripheral corticotropin-releasing factor induces diarrhea in rats: role of CRF1 receptor in fecal watery excretion SO EUROPEAN JOURNAL OF PHARMACOLOGY LA English DT Article DE CRF (corticotropin-releasing factor); diarrhea; CRF1 receptor; CP-154,526; colon; fecal output ID IRRITABLE-BOWEL-SYNDROME; SMALL-INTESTINE; GUINEA-PIG; HORMONE; ANTAGONIST; STRESS; MOTILITY; CELLS AB Systemic injection of corticotropin-releasing factor (CRF) stimulates colonic secretory and motor functions, and CRF receptors play a role in stress-related alterations of colonic functions. Stress has also been reported to induce diarrhea and we investigated if peripheral injection of CRF can mimic this response in conscious rats. Intravenous (i.v.) injection of CRF (3, 10 or 30 mug/kg) caused diarrhea in 13%, 63% and 75% of rats, respectively, and dose dependently increased the fecal fluid content by 5.1-, 8.6- and 10.8-fold, while the dried solid weight was increased by 5.2-, 4.9- and 5.8-fold, respectively, compared to the i.v. saline group. CRF actions were rapid in onset and blocked by the CRF1 receptor, antagonist CP-154,526 (butyl-[2,5-dimethyl-7-(2,4,6-trimethylphenyl)-7H-pyrrolo[2,3-d]pyrimidin-4-yl]ethylamine). These results demonstrate that peripheral CRF induces watery diarrhea, primarily through the activation of CRF1 receptor suggesting a possible role for these pathways in colonic responses to stress. (C) 2002 Published by Elsevier Science B.V. C1 Vet Affairs Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Dept Med,Digest Dis Div, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Inst Brain Res, Los Angeles, CA 90073 USA. RP Saunders, PR (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Dept Med,Digest Dis Div, Bldg 115,Rm 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-41301, DK-57238, DK-57238-01A1S1] NR 26 TC 60 Z9 61 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0014-2999 J9 EUR J PHARMACOL JI Eur. J. Pharmacol. PD JAN 25 PY 2002 VL 435 IS 2-3 BP 231 EP 235 DI 10.1016/S0014-2999(01)01574-6 PG 5 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 520QU UT WOS:000173793200015 PM 11821031 ER PT J AU Lyamin, OI Mukhametov, LM Chetyrbok, IS Vassiliev, AV AF Lyamin, OI Mukhametov, LM Chetyrbok, IS Vassiliev, AV TI Sleep and wakefulness in the southern sea lion SO BEHAVIOURAL BRAIN RESEARCH LA English DT Article DE slow wave sleep; paradoxical sleep; interhemispheric EEG asymmetry; southern sea lion; otariidae; pinnipeds ID OTARIA-FLAVESCENS; PAGOPHILUS-GROENLANDICA; ELEPHANT SEALS; BEHAVIOR; PATTERNS; DOLPHINS; BYRONIA; PUPS; EEG AB We recorded an electroencephalogram from the two hemispheres, a neck musculature electromyogram, an electrooculogram, and respiratory acts during sleep and wakefulness on land in three 1-year-old sea lion females for 3 or 4 consecutive days. On average active wakefulness (AW) occupied 20.4 +/- 2.0% of the 24-h period; quiet wakefulness (QW) 54.9 +/- 2.5%; slow wave sleep (SWS) 15.0 +/- 2.5% and paradoxical sleep (PS) 9.7 +/- 2.0%. Between 30 and 50% (average 39.1 +/- 3.4%) of total sleep time was spent in PS. From 8 to 31 episodes of PS were recorded per day (average 17 +/- 6 per day), with the longest episode lasting 20 m in (average 5.6 +/- 0.5 min). Episodes of interhemispheric EEG asymmetry accounted for 5.5 +/- 1.3% of total SWS time. Respiratory pauses in these animals varied in QW between 4 and 36 s (average 15.7 +/- 0.4 s), in SWS between 11 and 37 s (20.9 +/- 0.6 s) and in PS between 2 and 69 s (15.0 +/- 1.5 s). AW, QW, SWS and PS were approximately equally distributed between light (07:00-19:00) and dark time (19:00-07:00). The low amount of SWS with interhemispheric EEG asymmetry, the high proportion of PS in total sleep time and the nearly even distribution of sleep and wakefulness over the 24-h period could be both species-specific features and/or ontogenetic characteristics of the animals studied. (C) 2002 Elsevier Science B.V. All rights reserved. C1 Russian Acad Sci, Severtsov Inst Ecol & Evolut, Moscow 117071, Russia. RP Lyamin, OI (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Sleep Res 151A3, 16111 Plummer St, North Hills, CA 91343 USA. NR 42 TC 13 Z9 13 U1 2 U2 5 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0166-4328 J9 BEHAV BRAIN RES JI Behav. Brain Res. PD JAN 22 PY 2002 VL 128 IS 2 BP 129 EP 138 AR PII S0166-4328(01)00317-5 DI 10.1016/S0166-4328(01)00317-5 PG 10 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 522NJ UT WOS:000173903200003 PM 11796158 ER PT J AU Chang, A Tourtellotte, WW Rudick, R Trapp, BD AF Chang, A Tourtellotte, WW Rudick, R Trapp, BD TI Premyelinating oligodendrocytes in chronic lesions of multiple sclerosis SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID RAT OPTIC-NERVE; GLIAL PROGENITOR-CELL; PDGF ALPHA-RECEPTOR; ADULT HUMAN CNS; NG2 PROTEOGLYCAN; PRECURSOR CELLS; SPINAL-CORD; REMYELINATION; SURVIVAL; BRAIN AB Background: Multiple sclerosis is an inflammatory disease of the central nervous system that destroys myelin, oligodendrocytes, and axons. Since most of the lesions of multiple sclerosis are not remyelinated, enhancement of remyelination is a possible therapeutic strategy that could perhaps be achieved with the transplantation of oligodendrocyte-producing cells into the lesions. We investigated the frequency distribution and configuration of oligodendrocytes in chronic lesions of multiple sclerosis to determine whether these factors limit remyelination. Methods: Forty-eight chronic lesions obtained at autopsy from 10 patients with multiple sclerosis were examined immunocytochemically for oligodendrocytes and oligodendrocyte progenitor cells. Using confocal microscopy, we examined the three-dimensional relations between axons and the processes of premyelinating oligodendrocytes. Results: Thirty-four of the 48 chronic lesions of multiple sclerosis contained oligodendrocytes with multiple extended processes that associated with demyelinated axons but failed to myelinate them. These axons were dystrophic and contained multiple swellings. In some regions, the densities of premyelinating oligodendrocytes (25 per square millimeter of tissue) were similar to those in the developing rodent brain (23 per square millimeter). In the patients with disease of long duration (more than 20 years), there were fewer lesions with premyelinating oligodendrocytes (P<0.001). Conclusions: Premyelinating oligodendrocytes are present in chronic lesions of multiple sclerosis, so remyelination is not limited by an absence of oligodendrocyte progenitors or their failure to generate oligodendrocytes. Our findings suggest that in the chronic lesions of multiple sclerosis, the axons are not receptive for remyelination. Understanding the cellular interactions between premyelinating oligodendrocytes, axons, and the microenvironment of lesions of multiple sclerosis may lead to effective strategies for enhancing remyelination. (N Engl J Med 2002;346:165-73.) Copyright (C) 2002 Massachusetts Medical Society. C1 Cleveland Clin Fdn, Lerner Res Inst, Dept Neurosci, NC30, Cleveland, OH 44195 USA. Cleveland Clin Fdn, Mellen Ctr Multiple Sclerosis, Cleveland, OH 44195 USA. W Los Angeles Vet Affairs Med Ctr, Dept Neurol, Los Angeles, CA 90073 USA. RP Trapp, BD (reprint author), Cleveland Clin Fdn, Lerner Res Inst, Dept Neurosci, NC30, 9500 Euclid Ave, Cleveland, OH 44195 USA. FU NINDS NIH HHS [P01 NS38667, R01 NS35058] NR 38 TC 505 Z9 520 U1 5 U2 24 PU MASSACHUSETTS MEDICAL SOC/NEJM PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JAN 17 PY 2002 VL 346 IS 3 BP 165 EP 173 DI 10.1056/NEJMoa010994 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 511NZ UT WOS:000173273600004 PM 11796850 ER PT J AU Morrison, DA Sethi, G Sacks, J Henderson, W Grover, F Sedlis, S Esposito, R Ramanathan, KB Weiman, D Talley, J Saucedo, J Antakli, T Paramesh, V Pett, S Vernon, S Birjiniuk, V Welt, F Krucoff, M Wolfe, W Lucke, JC Mediratta, S Booth, D Barbiere, C Lewis, D AF Morrison, DA Sethi, G Sacks, J Henderson, W Grover, F Sedlis, S Esposito, R Ramanathan, KB Weiman, D Talley, J Saucedo, J Antakli, T Paramesh, V Pett, S Vernon, S Birjiniuk, V Welt, F Krucoff, M Wolfe, W Lucke, JC Mediratta, S Booth, D Barbiere, C Lewis, D CA Investigators Dept Vet Affairs Coo AWESOME TI Percutaneous coronary coronary bypass graft intervention versus surgery for patients with medically refractory myocardial ischemia and risk factors for adverse outcomes with bypass - The VA AWESOME Multicenter Registry: Comparison with the randomized clinical trial SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID REVASCULARIZATION INVESTIGATION BARI; ANGIOPLASTY; DISEASE; METAANALYSIS AB OBJECTIVES This study was designed to compare the three-year survival after percutaneous coronary intervention (PCI) or coronary artery, by-pass graft surgery (CABG) in physician-directed and patient-choice registries with the Angina With Extremely Serious Operative Mortality Evaluation (AWESOME) randomized trial results. BACKGROUND The AWESOME multicenter randomized trial and registry compared the long-term survival after PCI and CABG for the treatment of patients with medically refractory myocardial ischemia and at least one additional risk factor for adverse outcome with CABG. The randomized trial demonstrated comparable three-year survival. METHODS Over a five-year period (1995 to 2000), 2,431 patients with medically, refractory myocardial ischemia and at least one of five risk factors (prior heart surgery, myocardial infarction within seven days, left ventricular ejection fraction <0.35, age >70 years, intra-aortic balloon required to stabilize) were identified. By physician consensus, 1,650 patients formed a physician-directed registry assigned to CABG (692), PCI (651) or further medical therapy (307), and 781 were angiographically eligible for random allocation; 454 of these patients constitute the randomized trial, and the remaining 327 constitute a patient choice registry. Survival for CABG and PCI was compared using Kaplan-Meier curves and log-rank tests. RESULTS The CABG and PCI 36-month survival rates for randomized patients were 79% and 80%, respectively. The CABG and PCI 36-month survival rates were both 76% for the physician-directed subgroup; comparable survival rates for the patient-choice subgroup were 80% and 89%, respectively. None of the global log-rank tests for survival demonstrated significant differences. CONCLUSIONS Both registries support the randomized trial conclusion: PCI is an alternative to CABG for some medically refractory high-risk patients. (C) 2002 by the American College of Cardiology. C1 Vet Adm Med Ctr, Cardiac Catheterizat Lab, Tucson, AZ 85723 USA. Edward Hines Jr Vet Adm Hosp, CSPCC, Hines, IL 60141 USA. Denver VA Med Ctr, Denver, CO USA. New York VA Med Ctr, New York, NY USA. Memphis VA Med Ctr, Memphis, TN USA. Little Rock VA Med Ctr, Little Rock, AR USA. Albuquerque VA Med Ctr, Albuquerque, NM USA. W Roxbury VA Med Ctr, W Roxbury, MA USA. Durham VA Med Ctr, Durham, NC USA. Asheville VA Med Ctr, Asheville, NC USA. Lexington VA Med Ctr, Lexington, KY USA. Kansas City VA Med Ctr, Kansas City, KS USA. RP Morrison, DA (reprint author), Vet Adm Med Ctr, Cardiac Catheterizat Lab, 111C,3601 S 6th Ave, Tucson, AZ 85723 USA. NR 22 TC 36 Z9 37 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD JAN 16 PY 2002 VL 39 IS 2 BP 266 EP 273 DI 10.1016/S0735-1097(01)01720-X PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 511EZ UT WOS:000173252800013 PM 11788218 ER PT J AU Zareparsi, S Camicioli, R Sexton, G Bird, T Swanson, P Kaye, J Nutt, J Payami, H AF Zareparsi, S Camicioli, R Sexton, G Bird, T Swanson, P Kaye, J Nutt, J Payami, H TI Age at onset of Parkinson disease and apolipoprotein E genotypes SO AMERICAN JOURNAL OF MEDICAL GENETICS LA English DT Article DE Parkinson disease; apolipoprotein E genotypes; onset age of Parkinson disease ID ALZHEIMERS-DISEASE; EPSILON-4 ALLELE; E POLYMORPHISM; E GENE; DEMENTIA; FREQUENCY; METAANALYSIS; ASSOCIATION; RELATIVES; RISK AB Several lines of evidence suggest that the variable age at onset of Parkinson disease (PD) is likely influenced by genes. The apolipoprotein E (APOE) gene is associated with onset of Alzheimer disease, and possibly other neurodegenerative disorders. APOE has been investigated in relation to onset of PD, but results have been inconsistent. The aim of the present study was to determine if APOE genotypes are associated with onset age of PD, using a patient population large enough to assure sufficient power. We studied 521 unrelated Caucasian patients with idiopathic PD from movement disorder clinics in Oregon and Washington. Genotyping and statistical analyses were carried out using standard methods. Age at onset, of PD was significantly earlier in patients with the epsilon3epsilon4/epsilon4epsilon4 genotype than in patients with the epsilon3epsilon3 genotype (56.1 +/- 10.9 vs. 59.6 +/- 11.0, P = 0.003). The significantly earlier onset of PD was not influenced by the possible effects of recruitment site, family history and gender. The effect of the epsilon2epsilon3 genotype on onset of PD differed between the two recruitment sites. There was a trend for earlier onset of PD in epsilon2epsilon3 patients than in epsilon3epsilon3 patients only in the Oregon sample. In conclusion, APOE is associated with age at onset of PD. (C) 2001 Wiley-Liss, Inc. C1 Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Vet Affaire Puget Sound Hlth Care Syst, Seattle, WA USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Zareparsi, S (reprint author), Oregon Hlth Sci Univ, Dept Neurol, 3181 SW Sam Jackson Pk Rd,CR-131, Portland, OR 97201 USA. OI Kaye, Jeffrey/0000-0002-9971-3478; Camicioli, Richard/0000-0003-2977-8660 FU NCRR NIH HHS [5M01 RR00334]; NIA NIH HHS [AG08017]; NINDS NIH HHS [NS36960] NR 37 TC 43 Z9 44 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0148-7299 J9 AM J MED GENET JI Am. J. Med. Genet. PD JAN 15 PY 2002 VL 107 IS 2 BP 156 EP 161 DI 10.1002/ajmg.10111 PG 6 WC Genetics & Heredity SC Genetics & Heredity GA 508NZ UT WOS:000173096500013 PM 11807891 ER PT J AU Berg, AO Allan, JD Frame, PS Homer, CJ Johnson, MS Klein, JD Lieu, TA Mulrow, CD Orleans, CT Peipert, JF Pender, NJ Siu, AL Teutsch, SM Westhoff, C Woolf, SH AF Berg, AO Allan, JD Frame, PS Homer, CJ Johnson, MS Klein, JD Lieu, TA Mulrow, CD Orleans, CT Peipert, JF Pender, NJ Siu, AL Teutsch, SM Westhoff, C Woolf, SH CA US Preventive Serv Task Force TI Aspirin for the primary prevention of cardiovascular events: Recommendation and rationale SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material ID LOW-DOSE ASPIRIN; RANDOMIZED TRIAL; DISEASE; RISK AB This statement summarizes the recommendation of the third U.S. Preventive Services Task Force (USPSTF) for aspirin for the primary prevention of cardiovascular events, as well as the supporting scientific evidence. The complete information on which this statement is based, including evidence tables and references, can be found in a companion article in this issue. Copies of this document, the summary of the evidence, and the systematic evidence review can be obtained through the USPSTF Web site (www.ahrq.gov/clinic/uspstfix.htm) and in print: through the Agency for Healthcare Research and Quality Publications Clearinghouse (800-358-9295). C1 Univ Washington, Seattle, WA 98195 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78284 USA. TriCty Family Med, Cohocton, NY USA. Univ Rochester, Sch Med, Rochester, NY 14627 USA. Natl Initiat Childrens Healthcare Qual, Boston, MA USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Newark, NJ 07103 USA. Harvard Univ, Pilgrim Hlth Care, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA 02115 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. Robert Wood Johnson Fdn, Princeton, NJ 08540 USA. Women & Infants Hosp Rhode Isl, Providence, RI 02908 USA. Univ Michigan, Ann Arbor, MI 48109 USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. Mt Sinai Med Ctr, New York, NY 10029 USA. Merck & Co Inc, W Point, PA USA. Columbia Univ Coll Phys & Surg, New York, NY 10032 USA. Virginia Commonwealth Univ, Med Coll Virginia, Fairfax, VA USA. RP Berg, AO (reprint author), Univ Washington, Seattle, WA 98195 USA. NR 16 TC 206 Z9 212 U1 0 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JAN 15 PY 2002 VL 136 IS 2 BP 157 EP 160 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 512PZ UT WOS:000173333900010 ER PT J AU An, JB Lichtenstein, AK Brent, G Rettig, MB AF An, JB Lichtenstein, AK Brent, G Rettig, MB TI The Kaposi sarcoma-associated herpesvirus (KSHV) induces cellular interleukin 6 expression: role of the KSHV latency-associated nuclear antigen and the AP1 response element SO BLOOD LA English DT Article ID MULTICENTRIC CASTLEMANS-DISEASE; HUMAN-IMMUNODEFICIENCY-VIRUS; EFFUSION LYMPHOMA-CELLS; BLOOD MONONUCLEAR-CELLS; DNA-SEQUENCES; PERIPHERAL-BLOOD; GENE-EXPRESSION; ENDOTHELIAL-CELLS; GROWTH-FACTOR; HUMAN-HERPESVIRUS-8 AB Cellular interleukin 6 (IL-6) is an important growth factor for Kaposi sarcoma-associated herpesvirus (KSHV)-associated neoplasms, which include human immunodeficiency virus (HIV)-related and -unrelated cases of Kaposi sarcoma (KS), primary effusion lymphoma (PEL), and multicentric Castleman disease (MCD). Increased IL-6 levels are found in tissues affected with these diseases, and KSHV exists in a latent state in the majority of virally infected cells. In addition, acute infection with KSHV up-regulates IL-6 expression in endothelial cells. Thus, the hypothesis was considered that a latent KSHV gene product up-regulates IL-6 expression. To evaluate this hypothesis, the KSHV latency-associated nuclear antigen (LANA) was expressed in human embryonal kidney 293 cells and a bone marrow stromal cell line. LANA up-regulates IL-6 expression by inducing transcription from the IL-6 promoter, and the AP1 response element within the IL-6 promoter is necessary for and mediates IL-6 up-regulation by LANA. Thus, LANA may play a key pathophysiologic role in KSHV-associated neoplasms by functioning to up-regulate expression of IL-6. (Blood. 2002;99:649-654) (C) 2002 by The American Society of Hematology. C1 VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. RP Rettig, MB (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Med, 11301 Wilshire Blvd,Bldg 304,Rm E1-108, Los Angeles, CA 90073 USA. NR 37 TC 72 Z9 74 U1 0 U2 1 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD JAN 15 PY 2002 VL 99 IS 2 BP 649 EP 654 DI 10.1182/blood.V99.2.649 PG 6 WC Hematology SC Hematology GA 510PF UT WOS:000173215900034 PM 11781250 ER PT J AU Yuan, C Zhang, SX Polissar, NL Echelard, D Ortiz, G Davis, JW Ellington, E Ferguson, MS Hatsukami, TS AF Yuan, C Zhang, SX Polissar, NL Echelard, D Ortiz, G Davis, JW Ellington, E Ferguson, MS Hatsukami, TS TI Identification of fibrous cap rupture with magnetic resonance imaging is highly associated with recent transient ischemic attack or stroke SO CIRCULATION LA English DT Article DE magnetic resonance imaging; atherosclerosis; carotid arteries; stroke ID ATHEROSCLEROTIC PLAQUE RUPTURE; IN-VIVO; NMR; THROMBOSIS; DISRUPTION; MICROSCOPY; CARTILAGE; STENOSIS; CONTRAST; GRADIENT AB Background-High-resolution MRI has been shown to be capable of distinguishing intact, thick fibrous caps from thin and ruptured caps in human carotid atherosclerosis in vivo. The aim of this study was to determine whether MRI identification of fibrous cap thinning or rupture is associated with a history of recent transient ischemic attack (TIA) or stroke. Methods and Results-Fifty-three consecutive patients (mean age, 71 years; 49 male) scheduled for carotid endarterectomy were recruited after obtaining informed consent. Twenty-eight subjects had a recent history of TIA or stroke on the side appropriate to the index carotid lesion, and 25 were asymptomatic. Preoperative carotid MRI was performed in a 1.5-T GE Signa scanner that generated T-1-, PD-, and T-2-weighted and three-dimensional time-of-flight images. Using previously reported MRI criteria, the fibrous cap was categorized as intact-thick, intact-thin, or ruptured for each carotid plaque by blinded review. There was a strong and statistically significant trend showing a higher percentage of symptomatic patients for ruptured caps (70%) compared with thick caps (9%) (P=0.001 Mann-Whitney test for cap status versus symptoms). Compared with patients with thick fibrous caps, patients with ruptured caps were 23 times more likely to have had a recent TIA or stroke (95% CI=3, 210). Conclusions-MRI identification of a ruptured fibrous cap is highly associated with a recent history of TIA or stroke. Ongoing prospective studies will determine the predictive value fibrous cap characteristics, as visualized by MRI, for risk of subsequent ischemic events. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Mt Whisper Light Stat Consulting, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Surg & Perioperat Care, Seattle, WA USA. RP Yuan, C (reprint author), Univ Washington, Dept Radiol, Box 357115,1959 NE Pacific Ave, Seattle, WA 98195 USA. FU NHLBI NIH HHS [R01 HL56874, R01 HL60213] NR 31 TC 252 Z9 287 U1 1 U2 13 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JAN 15 PY 2002 VL 105 IS 2 BP 181 EP 185 DI 10.1161/hc0202.102121 PG 5 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 512NR UT WOS:000173330900025 PM 11790698 ER PT J AU Neuzil, KM Zhu, YW Griffin, MR Edwards, KM Thompson, JM Tollefson, SJ Wright, PF AF Neuzil, KM Zhu, YW Griffin, MR Edwards, KM Thompson, JM Tollefson, SJ Wright, PF TI Burden of interpandemic influenza in children younger than 5 years: A 25-year prospective study SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID RESPIRATORY SYNCYTIAL VIRUS; OTITIS-MEDIA; PANDEMIC INFLUENZA; HEALTHY INFANTS; DAY-CARE; A-VIRUS; INFECTION; VACCINE; EPIDEMIOLOGY; DISEASE AB Many respiratory viruses cause morbidity in young children, but a licensed vaccine and effective oral therapy are available only for influenzavirus. To determine the incidence of laboratory-confirmed influenza illness, we prospectively followed up 1665 healthy children aged, 5 years who were enrolled in the Vanderbilt Vaccine Clinic at some point from 1974 through 1999. Viral cultures were obtained when the children presented with clinical illness. The isolation of influenzavirus was associated with an estimated 95 health care visits for children with symptoms of influenza, 46 episodes of acute otitis media, and 8 episodes of lower respiratory tract disease per 1000 children yearly. Rates of acute otitis media and lower respiratory tract disease were highest among children aged, <2 years. Hospitalizations associated with culture-positive influenza occurred at an annual rate of 3-4 per 1000 children aged, <2 years. Influenza is associated with substantial morbidity in otherwise healthy children aged, <5 years. C1 Univ Washington, Sch Med, Dept Med, Div Infect Dis, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Vanderbilt Univ, Sch Med, Dept Prevent Med, Nashville, TN 37212 USA. Vanderbilt Univ, Sch Med, Dept Med, Nashville, TN 37212 USA. Vanderbilt Univ, Sch Med, Dept Pediat, Div Infect Dis, Nashville, TN 37212 USA. RP Neuzil, KM (reprint author), Med Serv 111, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIAID NIH HHS [N01-AI-05050, N01-AI-64298]; ODCDC CDC HHS [UR6/CCU417579] NR 38 TC 302 Z9 327 U1 1 U2 8 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JAN 15 PY 2002 VL 185 IS 2 BP 147 EP 152 DI 10.1086/338363 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 508LX UT WOS:000173091300002 PM 11807687 ER PT J AU Alam, MN Gong, H Alam, T Jaganath, R McGinty, D Szymusiak, R AF Alam, MN Gong, H Alam, T Jaganath, R McGinty, D Szymusiak, R TI Sleep-waking discharge patterns of neurons recorded in the rat perifornical lateral hypothalamic area SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID MELANIN-CONCENTRATING HORMONE; LOCUS-COERULEUS NEURONS; DORSAL RAPHE NEURONS; EYE-MOVEMENT SLEEP; OREXIN-A; FEEDING-BEHAVIOR; NEUROPEPTIDE-Y; BRAIN; NARCOLEPSY; AROUSAL AB The perifornical lateral hypothalamic area (PF-LHA) has been implicated in the control of several waking behaviours, including feeding, motor activity and arousal. Several cell types are located in the PF-LHA, including projection neurons that contain the hypocretin peptides (also known as orexins). Recent findings suggest that hypocretin neurons are involved in sleep-wake regulation. Loss of hypocretin neurons in the human disorder narcolepsy is associated with excessive somnolence, cataplexy and increased propensity for rapid eye movement (REM) sleep. However, the relationship of PF-LHA neuronal activity to different arousal states is unknown. We recorded neuronal activity in the PF-LHA of rats during natural sleep and waking. Neuronal discharge rates were calculated during active waking (waking accompanied by movement), quiet waking, non-REM sleep and REM sleep. Fifty-six of 106 neurons (53 %) were classified as wake/REM-related. These neurons exhibited peak discharge rates during waking and REM sleep and reduced discharge rates during non-REM sleep. Wake-related neurons (38 %) exhibited reduced discharge rates during both non-REM and REM sleep when compared to that during waking. Wake-related neurons exhibited significantly higher discharge rates during active waking than during quiet waking. The discharge of wake-related neurons was positively correlated with muscle activity across all sleep-waking states. Recording sites were located within the hypocretin-immunoreactive neuronal field of the PF-LHA, Although the neurotransmitter phenotype of recorded cells was not determined, the prevalence of neurons with wake-related discharge patterns is consistent with the hypothesis that the PF-LHA participates in the regulation of arousal, muscle activity and sleep-waking states. C1 VA Greater Los Angeles Healthcare Syst, Res Serv, North Hills, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Psychol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA 90024 USA. RP Szymusiak, R (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv, 151A3,16111 Plummer St, North Hills, CA 91343 USA. FU NHLBI NIH HHS [HL60296, P50 HL060296]; NIMH NIH HHS [R01 MH047480, MH47480, MH61354] NR 45 TC 114 Z9 117 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD JAN 15 PY 2002 VL 538 IS 2 BP 619 EP 631 DI 10.1013/jphysiol.2001.12888 PG 13 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 522DW UT WOS:000173881300022 PM 11790824 ER PT J AU Arita, S Nagai, T Ochiai, M Sakamoto, Y Shevlin, LA Smith, CV Mullen, Y AF Arita, S Nagai, T Ochiai, M Sakamoto, Y Shevlin, LA Smith, CV Mullen, Y TI Prevention of primary nonfunction of canine islet autografts by treatment with pravastatin SO TRANSPLANTATION LA English DT Article ID LIVER-TRANSPLANTATION; MEVALONATE PATHWAY; REJECTION; ALLOGRAFTS; SURVIVAL; RAT; 15-DEOXYSPERGUALIN; ISOGRAFTS; MICE AB Background. Nonspecific inflammation is the primary cause of early islet graft loss. We have shown in mice that pravastatin, a 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor, prevents primary nonfunction of islet isografts by reducing inflammatory reactions at the graft site. This study was designed to test the effectiveness of this agent in a large animal model, dogs, by transplanting autologous islets. Methods. After total pancreatectomy, islets were isolated by using a two-step digestion method, followed by discontinuous gradient centrifugation on EuroFicoll. A known number of freshly isolated islets were immediately transplanted back into the same dog via the portal vein. Results. First, we determined the minimal islet number required to reverse diabetes by transplanting 3,000-10,000 IEQ/kg with no additional treatment. The number was found to be 4,000 IEQ/kg, and islets less than 4,000 IEQ/kg consistently failed. To test the effect of pravastatin, 3,000 IEQ/kg were transplanted into dogs that either received no further treatment or were treated daily with 20 mg/kg of pravastatin from days -2 to 14. Without pravastatin, this number of islets lowered blood glucose only transiently, and all four of these dogs became hyperglycemic within 1 week. In contrast, four of the five dogs treated with pravastatin became normoglycemic (<150 mg/dL) and maintained this level during the observation period of 12 weeks (P<0.05). Postprandial plasma glucose and insulin levels returned to normal, and K values of intravenous glucose tolerance tests were significantly higher in pravastatin-treated dogs than in controls (P<0.04 at week 2 and P<0.01 at week 4). Conclusion. Peritransplant pravastatin treatment reduced the number of autologous islets required to reverse diabetes in totally pancreatectomized dogs. These results suggest that pravastatin may also facilitate better islet graft survival and function in clinical transplantation. C1 Univ Calif Los Angeles, Sch Med, Islet Transplant Program, Dept Surg, Los Angeles, CA 90073 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Mullen, Y (reprint author), City Hope Natl Med Ctr, 1500 E Duarte Rd, Duarte, CA 91010 USA. NR 29 TC 26 Z9 26 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0041-1337 J9 TRANSPLANTATION JI Transplantation PD JAN 15 PY 2002 VL 73 IS 1 BP 7 EP 12 DI 10.1097/00007890-200201150-00003 PG 6 WC Immunology; Surgery; Transplantation SC Immunology; Surgery; Transplantation GA 515FJ UT WOS:000173484500003 PM 11792971 ER PT J AU Yehuda, R AF Yehuda, R TI Current concepts - Post-traumatic stress disorder SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Review ID HOLOCAUST SURVIVORS; DEPRESSED-PATIENTS; VIETNAM VETERANS; COMBAT VETERANS; PLASMA-CORTISOL; PTSD; NOREPINEPHRINE; SUPPRESSION; EXPOSURE; SYMPTOMS C1 Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Mt Sinai Sch Med, Div Traumat Stress Studies, New York, NY USA. RP Yehuda, R (reprint author), Bronx Vet Affairs Med Ctr, 130 Kingsbridge Rd, Bronx, NY 10468 USA. NR 55 TC 575 Z9 598 U1 15 U2 96 PU MASSACHUSETTS MEDICAL SOC/NEJM PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JAN 10 PY 2002 VL 346 IS 2 BP 108 EP 114 DI 10.1056/NEJMra012941 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 509EM UT WOS:000173133400007 PM 11784878 ER PT J AU Silverman, JM Smith, CJ Schmeidler, J Hollander, E Lawlor, BA Fitzgerald, M Buxbaum, JD Delaney, K Galvin, P AF Silverman, JM Smith, CJ Schmeidler, J Hollander, E Lawlor, BA Fitzgerald, M Buxbaum, JD Delaney, K Galvin, P CA Autism Genetic Res Excange Consort TI Symptom domains in autism and related conditions: Evidence for familiality SO AMERICAN JOURNAL OF MEDICAL GENETICS LA English DT Article DE autism spectrum; heterogeneity; genetics; affected sibling pairs; multiplex siblingships; broader affected phenotype; asperger disorder ID PERVASIVE DEVELOPMENTAL DISORDERS; FAMILY HISTORY; INDIVIDUALS; PHENOTYPE; TWIN; PARENTS AB Heterogeneity in autism impairs efforts to localize and identify the genes underlying this disorder. As autism comprises severe but variable deficits and traits in three symptom domains (social interaction, communication, and repetitive behaviors) and shows variability in the presence and emergence of useful phrase speech, different genetic factors may be associated with each. The affected cases (n = 457) in multiply affected siblingships (n = 212), including a proband with autism and one or more siblings with either autism or marked deficits in autism symptom domains, were assessed using the Autism Diagnostic Interview, Revised. Symptom domain scores and language features were examined to determine their similarity within siblingships. The variance within siblingships was reduced for the repetitive behavior domain and for delays in and the presence of useful phrase speech. These features and the nonverbal communication subdomain provided evidence of familiality when we considered only the diagnosis of autism to define multiply affected siblingships (cases: n = 289; siblingships: n = 136). In addition, the same familial features identified also appeared familial for those with autism-related conditions. Finally, the level of severity of almost all of the familial features varied within multiplex siblingships independently. The features identified as familial replicate the combined set suggested in earlier, smaller studies. Furthermore, the familiality of these features extend to related conditions of milder severity than autism and appear to be independent. Making distinctions among families by the severity of these features may be useful for identifying more genetically homogeneous subgroups in studies targeted at genes for specific autism-related symptom domains. (C) 2001 Wiley-Liss, Inc. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Adm Med Ctr, Psychiat Serv, Bronx, NY USA. St Jamess & St Patricks Hosp, Dept Psychiat Elderly, Dublin, Ireland. Univ Dublin Trinity Coll, Dept Psychiat, Dublin 2, Ireland. RP Silverman, JM (reprint author), Mt Sinai Sch Med, Dept Psychiat, Box 1230,1 Gustave L Levy Pl, New York, NY 10029 USA. OI Buxbaum, Joseph/0000-0001-8898-8313 NR 25 TC 85 Z9 87 U1 3 U2 13 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0148-7299 J9 AM J MED GENET JI Am. J. Med. Genet. PD JAN 8 PY 2002 VL 114 IS 1 SI SI BP 64 EP 73 DI 10.1002/ajmg.10048 PG 10 WC Genetics & Heredity SC Genetics & Heredity GA 509EP UT WOS:000173133600011 PM 11840508 ER PT J AU Phan, J Pesaran, T Davis, RC Reue, K AF Phan, J Pesaran, T Davis, RC Reue, K TI The Diet1 locus confers protection against hypercholesterolemia through enhanced bile acid metabolism SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID NUCLEAR RECEPTOR LXR; CHOLESTEROL 7-ALPHA-HYDROXYLASE EXPRESSION; DENSITY-LIPOPROTEIN CHOLESTEROL; BILIARY LIPID SECRETION; TRANSGENIC MICE; BIOSYNTHESIS; GENE; TRANSPORT; LIVER; HOMEOSTASIS AB The C57BL,/6ByJ (B6By) mouse strain is resistant to diet-induced hypercholesterolemia and atherosclerosis, despite its near genetic identity with the atherosclerosis-susceptible C57BL/6J (B6J) strain. We previously identified a genetic locus, Diet1, which is responsible for the resistant phenotype in B6By mice. To investigate the function of Diet1, we compared mRNA expression profiles in the liver of B6By and B6J mice fed an atherogenic diet using a DNA microarray. These studies revealed elevated expression levels in B6By liver for key bile acid synthesis proteins, including cholesterol 7alpha-hydroxylase and sterol-27-hydroxylase, and the oxysterol nuclear receptor liver X receptor alpha. Expression levels for several other genes involved in bile acid metabolism were subsequently found to differ between B6By and B6J mice, including the bile acid receptor farnesoid X receptor, oxysterol 7alpha-hydroxylase, sterol-12alpha-hydroxylase, and hepatic bile acid transporters on both sinusoidal and canalicular membranes. The overall expression profile of the B6By strain suggests a higher rate of bile acid synthesis and transport in these mice. Consistent with this interpretation, fecal bile acid excretion is increased 2-fold in B6By mice, and bile acid levels in blood and urine are elevated 3- and 18-fold, respectively. Genetic analysis of serum bile acid levels revealed co-segregation with Diet1, indicating that this locus is likely responsible for both increased bile acid excretion and resistance to hypercholesterolemia in B6By mice. C1 Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. RP Reue, K (reprint author), Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 113,Rm 312, Los Angeles, CA 90073 USA. FU NHLBI NIH HHS [HL58627, HL28481] NR 53 TC 16 Z9 17 U1 0 U2 3 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JAN 4 PY 2002 VL 277 IS 1 BP 469 EP 477 DI 10.1074/jbc.M107107200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 508KU UT WOS:000173087900063 PM 11682476 ER PT J AU Yang, L Xia, L Wu, DY Wang, HB Chansky, HA Schubach, WH Hickstein, DD Zhang, Y AF Yang, L Xia, L Wu, DY Wang, HB Chansky, HA Schubach, WH Hickstein, DD Zhang, Y TI Molecular cloning of ESET, a novel histone H3-specific methyltransferase that interacts with ERG transcription factor SO ONCOGENE LA English DT Article DE histone methyltransferase; ESET; ERG ID HUMAN MYELOID-LEUKEMIA; EWINGS-SARCOMA; CHROMOSOMAL TRANSLOCATION; EWS-ERG; GENE; PROTEINS; DOMAIN; FAMILY; RNA; METHYLATION AB The ets-related gene erg encodes a transcription factor that is implicated in the control of cell growth and differentiation. To identify interacting partners of ERG, we screened a yeast two-hybrid cDNA library constructed from mouse hematopoietic cells using the N-terminal region of ERG as a bait. We isolated a 4.6 kb full-length mouse cDNA encoding a 1307-amino acid protein migrating as a 180 kD band, which was termed ESET (ERG-associated protein with SET domain). ESET is 92% identical to the human protein SETDB1 (SET domain, bifurcated 1). The interaction between ESET and ERG was supported by in vitro pull-down using glutathione S-transferase (GST) fusion protein, by transfection and co-immunoprecipitation experiments, and by association of endogenous SETDB1 with ERG. Since ESET possesses evolutionarily conserved SET, preSET, and postSET domains implicated in histone methylation, we tested the ability of ESET to methylate core histones. The results of these studies demonstrated that ESET is a histone H3-specific methyltransferase, and that mutations within ESET abolished its methyltransferase activity. Together, these findings raise the possibility that transcription factor ERG may participate in transcriptional regulation through ESET-mediated histone methylation. C1 Univ N Carolina, Lineberger Comprehens Canc Ctr, Dept Biochem & Biophys, Chapel Hill, NC 27599 USA. NCI, Dept Expt Transplantat & Immunol, Bethesda, MD 20892 USA. Univ Washington, Dept Med Oncol, Seattle, WA 98108 USA. Univ Washington, Dept Orthoped, Seattle, WA 98108 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. RP Zhang, Y (reprint author), Univ N Carolina, Lineberger Comprehens Canc Ctr, Dept Biochem & Biophys, Chapel Hill, NC 27599 USA. FU NIGMS NIH HHS [GM63067-01] NR 30 TC 145 Z9 151 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0950-9232 J9 ONCOGENE JI Oncogene PD JAN 3 PY 2002 VL 21 IS 1 BP 148 EP 152 DI 10.1038/sj.onc.1204998 PG 5 WC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity GA 505AD UT WOS:000172887800015 PM 11791185 ER PT J AU Zhou, X Potoka, DA Boyle, P Nadler, EP McGinnis, K Ford, HR AF Zhou, X Potoka, DA Boyle, P Nadler, EP McGinnis, K Ford, HR TI Aminoguanidine renders inducible nitric oxide synthase knockout mice more susceptible to Salmonella typhimurium infection SO FEMS MICROBIOLOGY LETTERS LA English DT Article DE aminoguinidine; iNOS knockout mouse; Salmonella typhimurium ID NADPH PHAGOCYTE OXIDASE; IN-VIVO; PERITONEAL-MACROPHAGES; ANTIMICROBIAL ACTIONS; MECHANISM; IMMUNOSUPPRESSION AB Aminoguanidine (AG), a nitric oxide synthase (NOS) inhibitor, has been widely used to study the role of inducible NOS (iNOS) in host defense against infections caused by various pathogens including Salmonella typhimurium. iNOS has been reported to play an important role in host defense against S. typhimurium infection both in vitro and in vivo. In this report we show those AG treatment lead to weight loss in both wild-type and NOS knockout mice, and rendered them more susceptible to Salmonella infection. These results suggest that AG may have side effects other than the inhibition or iNOS, and that data obtained from studies using AG should be interpreted with caution. (C) 2002 Published by Elsevier Science B.V. on behalf of the Federation of European Microbiological Societies. C1 Childrens Hosp Pittsburgh, Dept Surg, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Serv Res, Pittsburgh, PA USA. RP Zhou, X (reprint author), Univ Maryland, Sch Med, Ctr Vaccine Dev, Baltimore, MD 21201 USA. FU NIAID NIH HHS [R01-AI-14032] NR 16 TC 9 Z9 9 U1 1 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-1097 J9 FEMS MICROBIOL LETT JI FEMS Microbiol. Lett. PD JAN 2 PY 2002 VL 206 IS 1 BP 93 EP 97 DI 10.1111/j.1574-6968.2002.tb10992.x PG 5 WC Microbiology SC Microbiology GA 511UU UT WOS:000173284600015 PM 11786263 ER PT B AU Meyer, JS Chowdhury, MH Quach, M AF Meyer, JS Chowdhury, MH Quach, M BE Korczyn, AD TI Treatment of vascular dementia with daily 325 mg oral aspirin SO 2ND INTERNATIONAL CONGRESS ON VASCULAR DEMENTIA LA English DT Proceedings Paper CT 2nd International Congress on Vascular Dementia CY JAN 24-27, 2002 CL SALZBURG, AUSTRIA C1 Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Baylor Coll Med, Cerebrovasc Res Lab, Houston, TX USA. Vet Adm Hosp, Houston, TX USA. RP Meyer, JS (reprint author), Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. NR 3 TC 0 Z9 0 U1 1 U2 1 PU MEDIMOND S R L PI 40128 BOLOGNA PA VIA MASERATI 5, 40128 BOLOGNA, 00000, ITALY BN 88-323-1404-5 PY 2002 BP 215 EP 219 PG 5 WC Clinical Neurology; Radiology, Nuclear Medicine & Medical Imaging; Peripheral Vascular Disease SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging; Cardiovascular System & Cardiology GA BU06Q UT WOS:000174897200035 ER PT B AU Li, YS Meyer, JS Haque, A Chowdhury, MH Xu, G Quach, M AF Li, YS Meyer, JS Haque, A Chowdhury, MH Xu, G Quach, M BE Korczyn, AD TI Feasibility of vascular dementia treatment with cholinesterase inhibitors SO 2ND INTERNATIONAL CONGRESS ON VASCULAR DEMENTIA LA English DT Proceedings Paper CT 2nd International Congress on Vascular Dementia CY JAN 24-27, 2002 CL SALZBURG, AUSTRIA C1 Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Baylor Coll Med, Cerebrovasc Res Lab, Houston, TX USA. Vet Adm Hosp, Houston, TX USA. RP Li, YS (reprint author), Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND S R L PI 40128 BOLOGNA PA VIA MASERATI 5, 40128 BOLOGNA, 00000, ITALY BN 88-323-1404-5 PY 2002 BP 221 EP 225 PG 5 WC Clinical Neurology; Radiology, Nuclear Medicine & Medical Imaging; Peripheral Vascular Disease SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging; Cardiovascular System & Cardiology GA BU06Q UT WOS:000174897200036 ER PT J AU Haidet, P O'Malley, KJ Richards, B AF Haidet, P O'Malley, KJ Richards, B TI An initial experience with "team learning" in medical education SO ACADEMIC MEDICINE LA English DT Article AB Team learning is an approach to large-group teaching that combines the strengths of small-group interactive learning with teacher-driven content delivery. Team learning has been used successfully in professional disciplines other than medicine. The authors describe a field test of team learning in the setting of an internal medicine residency noontime lecture in the spring of 2000 at Baylor College of Medicine. They surveyed residents on their attitudes toward the usefulness of the lecture content before and after the session and surveyed them on their engagement in learning. Residents reported their engagement as high and demonstrated favorable changes in their attitudes about the Usefulness of the lecture content to their daily medical practice. The authors describe their adaptation of the team-learning approach and conclude that team learning may be a useful new pedagogic tool in medical education. C1 Houston VAMC, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Off Curriculum, Houston, TX 77030 USA. RP Haidet, P (reprint author), Houston VAMC, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. NR 9 TC 64 Z9 65 U1 2 U2 5 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JAN PY 2002 VL 77 IS 1 BP 40 EP 44 DI 10.1097/00001888-200201000-00009 PG 5 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 512AY UT WOS:000173300000009 PM 11788321 ER PT J AU Cradock, JA Young, AS Forquer, SL AF Cradock, JA Young, AS Forquer, SL TI Evaluating client and family preferences regarding outcomes in severe mental illness SO ADMINISTRATION AND POLICY IN MENTAL HEALTH LA English DT Article ID PERSPECTIVES; SCHIZOPHRENIA C1 W Los Angeles VA Healthcare Ctr, Dept Vet Affairs, VISN 22, Mental Illness Res Educ & Clin Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. Comprehens NeuroSci Inc, Educ Serv, Colorado Springs, CO USA. Colorado Hlth Networks, Colorado Springs, CO USA. RP Young, AS (reprint author), W Los Angeles VA Healthcare Ctr, Dept Vet Affairs, VISN 22, Mental Illness Res Educ & Clin Ctr, Bldg 210A,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Young, Alexander/A-1523-2009 OI Young, Alexander/0000-0002-9367-9213 FU NIMH NIH HHS [P50 MH-54623] NR 9 TC 4 Z9 4 U1 1 U2 1 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0894-587X J9 ADM POLICY MENT HLTH JI Adm. Policy. Ment. Health PD JAN PY 2002 VL 29 IS 3 BP 257 EP 261 DI 10.1023/A:1015195626742 PG 5 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 553QM UT WOS:000175687000006 PM 12033670 ER PT S AU Birbes, H El Bawab, S Obeid, LM Hannun, YA AF Birbes, H El Bawab, S Obeid, LM Hannun, YA BE Weber, G TI Mitochondria and ceramide: intertwined roles in regulation of apoptosis SO ADVANCES IN ENZYME REGULATION, VOL 42, PROCEEDINGS SE ADVANCES IN ENZYME REGULATION LA English DT Article; Proceedings Paper CT 42nd International Symposium on Regulation of Enzyme Acitvity and Synthesis in Normal and Neoplastic Tissues CY SEP 24-25, 2001 CL INDIANA UNIV SCH MED, INDIANAPOLIS, INDIANA SP Banyu Pharmaceut Co, Eli Lilly & Co, Elsevier Sci Ltd, Roche Diagnost Corp HO INDIANA UNIV SCH MED ID PROTEIN-KINASE-C; SPHINGOMYELIN-DERIVED LIPIDS; PROGRAMMED CELL-DEATH; AIRWAY SMOOTH-MUSCLE; CYTOCHROME-C; SPHINGOSINE 1-PHOSPHATE; MOLECULAR-CLONING; DNA-DAMAGE; SACCHAROMYCES-CEREVISIAE; ENDOPLASMIC-RETICULUM C1 Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson Vet Adm, Charleston, SC 29425 USA. RP Hannun, YA (reprint author), Med Univ S Carolina, Dept Biochem & Mol Biol, 171 Ashley Ave, Charleston, SC 29425 USA. OI obeid, lina/0000-0002-0734-0847 FU NIA NIH HHS [AG16583]; NIDDK NIH HHS [DK59340]; NIGMS NIH HHS [GM43825] NR 109 TC 106 Z9 109 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0065-2571 BN 0-080-44123-8 J9 ADV ENZYME REGUL PY 2002 VL 42 BP 113 EP 129 AR PII S0065-2571(01)00026-7 DI 10.1016/S0065-2571(01)00026-7 PG 17 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA BV57M UT WOS:000179396600008 PM 12123710 ER PT B AU Russell, DC Kosolcharoen, P AF Russell, DC Kosolcharoen, P BE Kimchi, A TI Assessment of cardiac resynchronization therapy by quantitative gated blood pool spect imaging SO ADVANCES IN HEART FAILURE LA English DT Proceedings Paper CT 8th World Congress on Heart Failure - Mechanisms and Management CY JUL 13-16, 2002 CL WASHINGTON, D.C. ID HEART-FAILURE AB Mechanical remodelling of the left ventricle has been demonstrated following cardiac, resynchronization therapy with biventricular pacing in patients with cardiomyopathy primarily by serial echocardiography. Quantitative gated blood pool SPECT imaging provides an alternate technique for accurate serial three-dimensional display of right and left ventricular morphology and wall motion and calculation of right and left ventricular volumes and ejection fractions. Three-dimensional cine loop and quantitative polar motion displays clearly show improved ventricular synchronicity after bi-ventricular pacing in a representative patient with, ischemic cardiomyopathy. Quantitative gated blood pool SPECT imaging provides an accurate non-invasive means of assessment of acute and long term effects of cardiac resynchronization therapy on right and left ventricular function without the window constraints of echocardiocardiography. C1 William S Middleton Mem Vet Adm Med Ctr, Pathol & Lab Med Serv, Madison, WI 53705 USA. RP Russell, DC (reprint author), William S Middleton Mem Vet Adm Med Ctr, Pathol & Lab Med Serv, Madison, WI 53705 USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND S R L PI 40128 BOLOGNA PA VIA MASERATI 5, 40128 BOLOGNA, 00000, ITALY BN 88-323-2713-9 PY 2002 BP 429 EP 433 PG 5 WC Cardiac & Cardiovascular Systems; Surgery; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Surgery GA BX05Y UT WOS:000184146900071 ER PT J AU Taylor, AN Tio, DL Heng, NS Yirmiya, R AF Taylor, AN Tio, DL Heng, NS Yirmiya, R TI Alcohol consumption attenuates febrile responses to lipopolysaccharide and interieukin-1 beta in male rats SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcohol consumption; lipopolysaccharide; interleukin-1 beta; fever; acute-phase response ID TUMOR-NECROSIS-FACTOR; SICKNESS BEHAVIOR; FEVER; INTERLEUKIN-1-BETA; BRAIN; IMMUNE; ETHANOL; CORTICOSTERONE; CONSEQUENCES; ACTIVATION AB Background: Chronic and acute alcohol use exert profound modulatory effects on the immune system which manifest as impaired host defense against infections. An important feature of this response is the interaction between the immune and the central nervous systems. This study investigated the effects of 14 days of alcohol exposure on cytokine-mediated neuroimmune interactions that affect the febrile component of the host-defense response. Methods: Adult male rats were fed a liquid diet containing ethanol (EtOH, 5% w/v) for 14 days. Pair-fed and normal chow- and water-fed rats served as controls. Continuous biotelemetric recordings of body temperature and locomotor activity commencing after 14 days of EtOH feeding were used to determine the effects of chronic EtOH on the circadian pattern of temperature and activity, on the febrile response to intraperitoneal (ip) administration of lipopolysaccharide (LPS) and interleukin (IL)-1beta, and on fever induced by IL-1beta administered intracerebroventricularly. We also examined the effects of EtOH consumption on LPS-induced hypothalamic production of the pyrogenic cytokines IL-1beta and tumor necrosis factor-alpha (TNFalpha) and on the blood levels of IL-1beta, TNFalpha, IL-6. adrenocorticotropin, and corticosterone at 2. 4, and 6 hr after ip LPS. Results: Fourteen days of EtOH consumption blunted the circadian increases in temperature and activity that normally occur in the dark phase of the light/dark cycle without affecting light-phase temperature or activity. EtOH consumption attenuated fever induced by LPS or IL-1beta administered ip during the light phase and significantly reduced hypothalamic production of IL-1beta. LPS-induced increases in hypothalamic TNFalpha and blood cytokines, adrenocorticotropin, and corticosterone were unaffected. Central administration of IL-1beta produced a normal febrile response in chronic-EtOH rats. Conclusions: The attenuated LPS- and IL-1beta-induced febrile responses in EtOH-consuming rats and he corresponding deficit in hypothalamic production of IL-1beta suggest that alcohol may impair IL-1beta-mediated neuroimmune communication. C1 Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare ctr, Los Angeles, CA USA. Hebrew Univ Jerusalem, Dept Psychol, IL-91905 Jerusalem, Israel. RP Taylor, AN (reprint author), Univ Calif Los Angeles, Sch Med, Dept Neurobiol, 10833 Le Conte Ave, Los Angeles, CA 90095 USA. RI Yirmiya, Raz/D-1090-2014 FU NIAAA NIH HHS [AA09850] NR 50 TC 15 Z9 15 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JAN PY 2002 VL 26 IS 1 BP 44 EP 52 PG 9 WC Substance Abuse SC Substance Abuse GA 513FZ UT WOS:000173368400006 PM 11821653 ER PT J AU Gariti, P Alterman, A Mulvaney, F Mechanic, K Dhopesh, V Yu, E Chychula, N Sacks, D AF Gariti, P Alterman, A Mulvaney, F Mechanic, K Dhopesh, V Yu, E Chychula, N Sacks, D TI Nicotine intervention during detoxification and treatment for other substance use. SO AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE LA English DT Article DE smoking cessation; substance abuse; inpatient detoxification ID DEPENDENCE AB This preliminary study evaluated the efficacy of a brief smoking cessation intervention (30 controls, 34 intervention groups) on a smoke-free inpatient unit for substance use detoxification. Controls received usual care, including the transdermal nicotine patch and referral to an outpatient smoking program. The intervention group additionally received a structured motivational enhancement program. Biochemically confirmed smoking cessation rate and abstinence/reduction of alcohol or other drug use were the main outcome measures taken 6 months after treatment initiation. The smoking cessation intervention did not result in greater participation in formal outpatient smoking cessation treatment and was not associated with either enhanced smoking cessation (6 vs. 0%) or greater smoking reduction at follow-up. Both groups significantly reduced the number of cigarettes smoked per day (cpd) from about 24 at baseline to 10 cpd. The groups did not differ on abstinence from nonnicotine addictive substances. Smoking cessation treatment in substance users undergoing detoxification resulted in little or no smoking cessation advantage. C1 Univ Penn, Treatment Res Ctr, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Gariti, P (reprint author), Univ Penn, Treatment Res Ctr, Sch Med, Dept Psychiat, 3900 Chestnut St, Philadelphia, PA 19104 USA. NR 8 TC 6 Z9 6 U1 0 U2 1 PU MARCEL DEKKER INC PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 USA SN 0095-2990 J9 AM J DRUG ALCOHOL AB JI Am. J. Drug Alcohol Abuse PY 2002 VL 28 IS 4 BP 673 EP 681 DI 10.1081/ADA-120015875 PG 9 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 623NX UT WOS:000179710700006 ER PT J AU Street, VA Goldy, JD Golden, AS Tempel, BL Bird, TD Chance, PF AF Street, VA Goldy, JD Golden, AS Tempel, BL Bird, TD Chance, PF TI Mapping of Charcot-Marie-Tooth disease type 1C to chromosome 16p identifies a novel locus for demyelinating neuropathies SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Article ID HEREDITARY MOTOR; GENE; DUPLICATION; MUTATIONS; PMP-22; PROTEIN-2; LINKAGE; FAMILY AB Charcot-Marie-Tooth (CMT) neuropathy represents a genetically heterogeneous group of diseases affecting the peripheral nervous system. We report genetic mapping of the disease to chromosome 16p13.1-p12.3, in two families with autosomal dominant CMT type 1C (CMT1C). Affected individuals in these families manifest characteristic CMT symptoms, including high-arched feet, distal muscle weakness and atrophy, depressed deep-tendon reflexes, sensory impairment, slow nerve conduction velocities, and nerve demyelination. A maximal combined LOD score of 14.25 was obtained with marker D16S500. The combined haplotype analysis in these two families localizes the CMT1C gene within a 9-cM interval flanked by markers D16S519 and D16S764. The disease-linked haplotypes in these two pedigrees are not conserved, suggesting that the gene mutation underlying the disease in each family arose independently. The epithelial membrane protein 2 gene (EMP2), which maps to chromosome 16p13.2, was evaluated as a candidate gene for CMT1C. C1 Univ Washington, Dept Pediat, Div Genet & Dev, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, VM Bloedel Hearing Res Ctr, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Undergrad Neurobiol Res Program, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Chance, PF (reprint author), Univ Washington, Dept Pediat, Div Genet & Dev, Box 356320, Seattle, WA 98195 USA. FU NIA NIH HHS [AG00057, T32 AG000057]; NICHD NIH HHS [HD02274, P30 HD002274]; NIDCD NIH HHS [R01 DC002739, DC02739]; NINDS NIH HHS [R01 NS038181, NS38181] NR 36 TC 22 Z9 28 U1 1 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD JAN PY 2002 VL 70 IS 1 BP 244 EP 250 DI 10.1086/337943 PG 7 WC Genetics & Heredity SC Genetics & Heredity GA 499LD UT WOS:000172571900022 PM 11713717 ER PT J AU Lindner, A Bankson, DD Stehman-Breen, C Mahuren, JD Coburn, SP AF Lindner, A Bankson, DD Stehman-Breen, C Mahuren, JD Coburn, SP TI Vitamin B-6 metabolism and homocysteine in end-stage renal disease and chronic renal insufficiency SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article; Proceedings Paper CT 32nd Annual Meeting of the American-Society-of-Nephrology CY NOV 01-08, 1999 CL MIAMI, FLORIDA SP Amer Soc Nephrol DE pyridoxic acid (PA); pyridoxin; homocysteine (tHcy); kidney; uremia ID PLASMA HOMOCYSTEINE; FOLIC-ACID; DIALYSIS PATIENTS; CARDIOVASCULAR-DISEASE; PYRIDOXAL 5'-PHOSPHATE; HEMODIALYSIS-PATIENTS; ALKALINE-PHOSPHATASE; RISK FACTOR; HYPERHOMOCYSTEINEMIA; FAILURE AB Homocysteine (tHcy) is a risk factor for atherosclerosis inpatients with end-stage renal disease and chronic renal insufficiency (CRI). Vitamin B-6 deficiency may result in high tHcy levels, especially after a methionine load (PML). Therefore, we evaluated vitamin B-6 metabolism and tHcy (fasting and PML) levels in patients with CRI and those on hemodialysis (HD) therapy before and during high-dose sequential vitamin B-6 and folic acid supplementation in mate patients (27 patients, HD, 17 patients, CRI) and 19 age-matched healthy controls. Vitamin B-6 doses were 100 mg/d in patients with CRI and 200 mg/d in HD patients, plus folic acid (5 mg/d), for more than 3 months in each period. We analyzed vitamin B-6 metabolites by high-performance liquid chromatography In plasma and red blood cells (RBCs) and fasting tHcy in all cases and PML in subgroups of 11 HD patients and 14 patients with CRI. We found vitamin 136 deficiency and high tHcy (fasting and PML) levels in all patients. Plasma and RBC levels of pyridoxal and pyridoxal phosphate were abnormally low, whereas levels of pyridoxic acid (PA), an end product of vitamin B-6 metabolism, were extremely high in both groups. Fasting and PML tHcy levels were partially resistant to vitamin B-6 supplements, with different response patterns In HD patients and those with CRI. Thus, the PML defect was more responsive to folic acid in HD patients, whereas vitamin B-6 partially reduced PML tHcy levels in patients with CRI. Resistance of tHcy to vitamin B6 treatment in patients with CRI and HD patients Is not caused by poor absorption or low tissue stores. Rather, nonvitamin factors or potentially toxic PA levels may be implicated in abnormal vitamin B-6 and/or tHcy metabolism during renal insufficiency. (C) 2002 by the National Kidney Foundation, Inc. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med Nephrol, Seattle, WA 98195 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Lab Med, Seattle, WA 98195 USA. Ft Wayne State Dev Ctr, Dept Biochem, Ft Wayne, IN USA. RP Lindner, A (reprint author), VA Puget Sound Hlth Care Syst, Renal Dialysis Unit, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [DK 35816] NR 40 TC 22 Z9 23 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JAN PY 2002 VL 39 IS 1 BP 134 EP 145 DI 10.1053/ajkd.2002.29904 PG 12 WC Urology & Nephrology SC Urology & Nephrology GA 509HU UT WOS:000173141700018 PM 11774112 ER PT J AU Million, M Maillot, C Saunders, P Rivier, J Vale, W Tache, Y AF Million, M Maillot, C Saunders, P Rivier, J Vale, W Tache, Y TI Human urocortin II, a new CRF-related peptide, displays selective CRF2-mediated action on gastric transit in rats SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE partial restraint; gastric emptying; distal colonic transit; CP-154,526; astressin(2)-B ID CORTICOTROPIN-RELEASING FACTOR; FACTOR RECEPTORS; BINDING-PROTEIN; NERVOUS-SYSTEM; GUINEA-PIG; ANTAGONIST; HORMONE; STRESS; ANTISAUVAGINE-30; RESPONSES AB Human urocortin (hUcn) II is a new member of the corticotropin-releasing factor (CRF) family that selectively binds to the CRF2 receptor. We investigated the CRF receptors involved in mediating the effects of hUcn II and human/rat CRF (h/rCRF) on gut transit. Gastric emptying, 4 h after a solid meal, and distal colonic transit (bead expulsion time) were monitored simultaneously in conscious rats. CRF antagonists were given subcutaneously 30 min before intravenous injection of peptides or partial restraint (for 90 min). hUcn II (3 or 10 mug/kg iv) inhibited gastric emptying (by 45% and 55%, respectively) and did not influence distal colonic transit. The CRF2 peptide antagonist astressin(2)-B blocked hUcn II action. h/rCRF, rat Ucn, and restraint delayed gastric emptying while accelerating distal colonic transit. The gastric response to intravenous h/rCRF and restraint was blocked by the CRF2 antagonist but not by the CRF1 antagonist CP-154,526, whereas the colonic response was blocked only by CP-154,526. None of the CRF antagonists influenced postprandial gut transit. These data show that intravenous h/rCRF and restraint stress-induced delayed gastric emptying involve CRF2 whereas stimulation of distal colonic transit involves CRF1. The distinct profile of hUcn II, only on gastric transit, is linked to its CRF2 selectivity. C1 Univ Calif Los Angeles, CURE, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Salk Inst Biol Studies, Clayton Fdn Labs Peptide Biol, San Diego, CA 92186 USA. RP Million, M (reprint author), Univ Calif Los Angeles, CURE, Dept Med, Div Digest Dis, Bldg 115,Rm 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-26741, DK-41301, DK-57238] NR 40 TC 56 Z9 57 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD JAN PY 2002 VL 282 IS 1 BP G34 EP G40 PG 7 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 505PN UT WOS:000172922700005 PM 11751155 ER PT B AU Mah, V Ball, SS AF Mah, V Ball, SS BE Kohane, IS TI Senex II: Ordering of molecular mechanisms in cancer SO AMIA 2002 SYMPOSIUM, PROCEEDINGS: BIOMEDICAL INFORMATICS: ONE DISCIPLINE LA English DT Proceedings Paper CT Annual Symposium of the American-Medical-Informatics-Association CY NOV 09, 2002 CL San Antonio, TX SP Amer Med Informat Assoc C1 Univ Calif Los Angeles, Multictr Program Geriatr & Gerontol, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Mah, V (reprint author), Univ Calif Los Angeles, Multictr Program Geriatr & Gerontol, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU HANLEY & BELFUS INC MED PUBLISHERS PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA BN 1-56053-600-4 PY 2002 BP 1095 EP 1095 PG 1 WC Computer Science, Information Systems; Medical Informatics SC Computer Science; Medical Informatics GA BY60A UT WOS:000189418100329 ER PT J AU Patten, LC Berger, DH Cleary, KR Curley, SA Hunt, KK Fagan, SP Lucci, A Feig, BW AF Patten, LC Berger, DH Cleary, KR Curley, SA Hunt, KK Fagan, SP Lucci, A Feig, BW TI A prospective evaluation of radiocolloid and immunohistochemical staining in colon cancer lymphatic mapping SO ANNALS OF SURGICAL ONCOLOGY LA English DT Meeting Abstract C1 Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD JAN PY 2002 VL 9 IS 1 SU S MA P107 BP S72 EP S72 PG 1 WC Oncology; Surgery SC Oncology; Surgery GA 516ZM UT WOS:000173586700202 ER PT J AU Mann, DL Deswal, A Bozkurt, B Torre-Amione, G AF Mann, DL Deswal, A Bozkurt, B Torre-Amione, G TI New therapeutics for chronic heart failure SO ANNUAL REVIEW OF MEDICINE LA English DT Review DE left ventricular remodeling; renin angiotensin system; cyokines; adrenergic nervous system ID PARTIAL LEFT VENTRICULECTOMY; DILATED CARDIOMYOPATHY; RANDOMIZED TRIAL; ANGIOTENSIN-II; ENDOTHELIN; SURVIVAL; DISEASE; INHIBITOR; MORTALITY; MORBIDITY AB Traditionally, clinicians have viewed heart failure either as a problem of excessive salt and water retention caused by abnormalities of renal blood flow, or as a hemodynamic problem associated with a reduced cardiac output and excessive peripheral vasoconstriction. Recently, clinicians have begun to adopt a neurohormonal model in which heart failure progresses because of the toxic effects of endogenous biological systems that become activated in heart failure. We review the rationale for existing heart failure therapies and discuss the reasoning behind the development of some emerging therapies. C1 Baylor Coll Med, Dept Med, Winters Ctr Heart Failure Res, Houston, TX 77030 USA. Houston Vet Adm Med Ctr, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. RP Mann, DL (reprint author), Baylor Coll Med, Dept Med, Winters Ctr Heart Failure Res, 6565 Fannin St, Houston, TX 77030 USA. OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [P50 HL-O6H, HL-42250-10/10, R01 HL58081-01, R01 HL61543-01] NR 38 TC 29 Z9 31 U1 0 U2 1 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0066-4219 J9 ANNU REV MED JI Annu. Rev. Med. PY 2002 VL 53 BP 59 EP 74 DI 10.1146/annurev.med.53.082901.104004 PG 16 WC Medicine, General & Internal SC General & Internal Medicine GA 531KL UT WOS:000174414500008 PM 11818463 ER PT J AU Derose, SF Schuster, MA Fielding, JE Asch, SM AF Derose, SF Schuster, MA Fielding, JE Asch, SM TI Public health quality measurement: Concepts and challenges SO ANNUAL REVIEW OF PUBLIC HEALTH LA English DT Review DE outcome and process assessment (health care); public health administration/indicator; quality/quality assurance; health care/public health practice ID COMMUNITY PREVENTIVE SERVICES; SO-STRANGE BEDFELLOWS; LOCAL HEALTH; ORGANIZATIONAL PRACTICES; CONSUMER REPORTS; MANAGED CARE; IMPROVEMENT; PERFORMANCE; DEPARTMENTS; DIFFERENCE AB Public health agencies increasingly are recognizing the need to formally and quantitatively assess and improve the quality of their programs, information, and policies. Measuring quality can help organizations monitor their progress toward public health goals and become more accountable to both the populations they serve and policy makers. Yet quality assessment is a complex task that involves precise determination and specification of useful measures. We discuss a well-established conceptual framework for organizing quality assessment in the context of planning and delivery of programs and services by local health departments, and consider the strengths and limitations of this approach for guiding quality improvement. We review several past and present quality measurement-related initiatives designed for public health department use, and discuss current and future challenges in this evolving area of public health practice. C1 So Calif Kaiser Permanente, Pasadena, CA 91101 USA. Univ Calif Los Angeles, Dept Pediat, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Hlth Serv, Los Angeles, CA 90095 USA. RAND Corp, Santa Monica, CA 90407 USA. Univ Calif Los Angeles, Dept Med, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. RP Derose, SF (reprint author), So Calif Kaiser Permanente, Pasadena, CA 91101 USA. FU ODCDC CDC HHS [U48/CCU915773] NR 87 TC 31 Z9 32 U1 2 U2 9 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0163-7525 J9 ANNU REV PUBL HEALTH JI Annu. Rev. Public Health PY 2002 VL 23 BP 1 EP 21 DI 10.1146/annurev.publhealth.23.092601.095644 PG 21 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 553QK UT WOS:000175686800002 PM 11910052 ER PT J AU Kuritzkes, DR Bassett, RL Young, RK Barrett, H Koel, JL Hazelwood, JD Johnson, VA AF Kuritzkes, DR Bassett, RL Young, RK Barrett, H Koel, JL Hazelwood, JD Johnson, VA CA ACTG 306 370 Protocol Teams TI Rate of emergence of thymidine analogue resistance mutations in HIV-1 reverse transcriptase selected by stavudine or zidovudine-based regimens in treatment-naive patients SO ANTIVIRAL THERAPY LA English DT Meeting Abstract C1 Harvard Univ, Brigham & Womens Hosp, Sch Med, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. Colorado Hlth Sci Ctr, Denver, CO USA. Birmingham VA Med Ctr, Birmingham, AL USA. Univ Alabama, Sch Med, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU INT MEDICAL PRESS LTD PI LONDON PA 2-4 IDOL LANE, LONDON EC3R 5DD, ENGLAND SN 1359-6535 J9 ANTIVIR THER JI Antivir. Ther. PY 2002 VL 7 SU 1 MA 36 BP S41 EP S41 PG 1 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA 583HM UT WOS:000177401300037 ER PT J AU Morton, SC Shekelle, PG Adams, JL Bennett, C Dobkin, BH Montgomerie, J Vickrey, BG AF Morton, SC Shekelle, PG Adams, JL Bennett, C Dobkin, BH Montgomerie, J Vickrey, BG TI Antimicrobial prophylaxis for urinary tract infection in persons with spinal cord dysfunction SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE bacteriuria; bladder, neurogenic; meta-analysis; myelopathy; rehabilitation; spinal cord injuries; urinary tract infections ID CATHETER-ASSOCIATED BACTERIURIA; INTERMITTENT CATHETERIZATION; TRIMETHOPRIM-SULFAMETHOXAZOLE; NEUROGENIC BLADDER; CONTROLLED TRIALS; CLINICAL-TRIALS; INJURY PATIENTS; DOUBLE-BLIND; CIPROFLOXACIN; EFFICACY AB Objective: To assess the benefits and harms Of antimicrobial prophylaxis to prevent urinary tract infections (UTIs) in persons with neurogenic bladders caused by spinal cord dysfunction. Data Sources: A broad search strategy with no language restriction was conducted of MEDLINE (1966-January 1998), EMBASE (1974-January 1998), and CINAHL (1982-July 1998) using the general search terms urinary tract, urinary tract infections, bacteriuria, paraplegia, quadriplegia, spinal cord injuries, multiple sclerosis, neurogenic bladder, and neuropathic bladder. Additional articles were identified by experts and by reviewing reference lists of articles obtained from searches. Study Selection: Criteria included human studies of adults and adolescents who had neurogenic bladder due to spinal cord dysfunction; the studies had to address antimicrobial prophylaxis of UTI and include bacteriuria or UTI as an outcome. We excluded any study that was clearly not a controlled trial or that only included children under the age of 13 years. Two reviewers independently abstracted data, and disagreements were resolved by consensus. Data Extraction: Two reviewers independently abstracted data, and disagreements were resolved by consensus. Studies were graded by 1 project investigator according to quality criteria developed by Jadad and Schulz. Data Synthesis: The sizes of the effect of antimicrobial prophylaxis on weekly infection rates from 15 trials that met the inclusion criteria were pooled by using a random effects model. Antimicrobial prophylaxis did not significantly decrease symptomatic infections. Prophylaxis was associated with a reduction in asymptomatic bacteriuria among acute patients (<90d after spinal cord injury; P <.05); 1 patient would require 3.7 weeks of treatment on average to prevent 1 symptomatic infection. For nonacute patients, the reduction approached statistical significance (P =.06) Prophylaxis resulted in an approximately twofold increase in antimicrobial-resistant bacteria. Conclusions: The regular use of antimicrobial prophylaxis for most patients who have neurogenic bladder caused by spinal cord dysfunction is not supported. A clinically important effect, however, has not been excluded. Future research should focus on randomized trials in those patients who have recurrent UTIs that limit their daily functioning and well-being. C1 So Calif Evidence Based Practice Ctr, Santa Monica, CA USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Urol, Los Angeles, CA 90024 USA. Univ So Calif, Rancho Los Amigos Med Ctr, Dept Med, Downey, CA 90242 USA. RP Morton, SC (reprint author), RAND Corp, POB 2138,1700 Main St, Santa Monica, CA 90407 USA. NR 48 TC 63 Z9 66 U1 1 U2 6 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD JAN PY 2002 VL 83 IS 1 BP 129 EP 138 DI 10.1053/apmr.2002.26605 PG 10 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 509JU UT WOS:000173145300020 PM 11782843 ER PT J AU Grover, FL Cleveland, JC Shroyer, LW AF Grover, FL Cleveland, JC Shroyer, LW TI Quality improvement in cardiac care SO ARCHIVES OF SURGERY LA English DT Article ID STS NATIONAL DATABASE; ARTERY BYPASS-SURGERY; NEW-YORK-STATE; OPERATIVE MORTALITY; ANGIOGRAPHIC PREDICTORS; RISK ASSESSMENT; GRAFT-SURGERY; CORONARY; SOCIETY; OUTCOMES AB Quality improvement in cardiac care has made considerable progress over the past 30 years. During that period, there has been the development of multi-institutional databases to monitor outcomes following cardiothoracic surgery. These databases initially began using only volume and unadjusted operative (30-day) mortality as outcome criteria. There has been a progressive increase in their sophistication, with the building of risk models based on preoperative variables, which accurately predict the risk of adverse outcomes. Other outcomes have been added including risk-adjusted mortality and morbidity; efficiency outcomes such as length of stay, quality of life, functional health status, neuropsychological outcomes; and long-term outcomes. C1 Univ Colorado, Hlth Sci Ctr, Div Cardiothorac Surg, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80202 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Grover, FL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Surg, Campus Box 305,4200 E 9th Ave,Room 5622, Denver, CO 80262 USA. RI Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 NR 28 TC 10 Z9 10 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD JAN PY 2002 VL 137 IS 1 BP 28 EP 36 DI 10.1001/archsurg.137.1.28 PG 9 WC Surgery SC Surgery GA 512BA UT WOS:000173300200004 PM 11772211 ER PT J AU He, CJ Charoenkul, V Kahn, T Langhoff, E Uribarri, J Sedlacek, M AF He, CJ Charoenkul, V Kahn, T Langhoff, E Uribarri, J Sedlacek, M TI Impact of the surgeon on the prevalence of arteriovenous fistulas SO ASAIO JOURNAL LA English DT Article ID VASCULAR ACCESS; HEMODIALYSIS AB Decreased use of native arteriovenous fistulas and an increased reliance on synthetic grafts as permanent dialysis access have accompanied the growth of the dialysis population in the United States, but not at our institution. Possible reasons for this difference were studied in a cross-sectional analysis in August of 2000. There were 51 chronic dialysis patients, all of whom had their access placed by the same surgeon; 75% of them were dialyzed through an arteriovenous fistula, which compares well with the 23% prevalence at the national level. Among our patients, 57% were diabetic, 98% had a history of hypertension, 35% had amputations or arterial bypass surgery, 37% had coronary artery disease, 12% had suffered a stroke, 35% were active smokers, and 22% had a history of intravenous drug use. The high prevalence of arteriovenous fistulas, despite so many comorbid conditions, suggests that the presence of a skilled and experienced surgeon may be more predictive of better dialysis access than other factors. C1 Bronx Vet Affairs Med Ctr, Div Nephrol, New York, NY USA. Bronx Vet Affairs Med Ctr, Dept Surg, New York, NY USA. Mt Sinai Sch Med, Div Nephrol, New York, NY USA. RP Sedlacek, M (reprint author), Mt Sinai Med Ctr, 1 Gustave L Levy Pl, New York, NY 10029 USA. NR 8 TC 6 Z9 6 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1058-2916 J9 ASAIO J JI Asaio J. PD JAN-FEB PY 2002 VL 48 IS 1 BP 39 EP 40 DI 10.1097/00002480-200201000-00009 PG 2 WC Engineering, Biomedical; Transplantation SC Engineering; Transplantation GA 510MH UT WOS:000173211500009 PM 11814096 ER PT J AU Fu, YC Luo, NL Lopes-Virella, MF AF Fu, YC Luo, NL Lopes-Virella, MF TI Upregulation of interleukin-8 expression by prostaglandin D2 metabolite 15-deoxy-delta12, 14 prostaglandin J2 (15d-PGJ2) in human THP-1 macrophages SO ATHEROSCLEROSIS LA English DT Article DE interleukin-8; 15-deoxy-delta12,14 prostaglandin J2; THP-1 macrophage; atherosclerosis ID SMOOTH-MUSCLE CELLS; NF-KAPPA-B; ACTIVATED RECEPTOR-GAMMA; LOW-DENSITY-LIPOPROTEIN; PPAR-GAMMA; 15-DEOXY-DELTA(12,14)-PROSTAGLANDIN J(2); SIGNALING PATHWAY; GENE-EXPRESSION; MESSENGER-RNA; OXIDIZED LDL AB Interleukin-8 (IL-8) is one of cytokines detected at sites of inflammation and in macrophage-foam cells of atherosclerotic lesions. The expression of IL-8 gene can be induced in cholesterol loaded THP-1 macrophages by oxidized low density lipoprotein. We report for the first time that the expression of human IL-8 gene in THP-1 macrophages is upregulated in a time- and concentration-dependent manner by prostaglandin D2 metabolite 15-deoxy-delta12, 14 prostaglandin J2 (15d-PGJ2), which is a natural ligand for activation of peroxisome proliferator-activated receptor-gamma transcription factor. Studies to identify the signal transduction pathways involved showed that IL-8 upregulation-mediated by 15d-PGJ2 was markedly inhibited when the THP-1 macrophages were incubated with a highly selective and cell-permeable inhibitor of the mitogen-activated protein kinase (MAPK) signaling pathway, 2'-amino-3'-methoxyflavone (PD98059). This inhibition was concentration-dependent., suggesting that 15d-PGJ2 regulates the expression of IL-8 gene in THP-1 macrophages through a MAPK signaling pathway. In contrast, THP-1 macrophages when treated with pyrrolidine dithiocarbamate, an anti-oxidant and the selective inhibitor for nuclear factor kappaB, showed an enhanced 15d-PGJ2-mediated upregulation of IL-8 gene expression. The data presented in this report may contribute to unravel some of the mechanisms behind the inflammatory component of atherosclerosis. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. C1 Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Strom Thurmond Biomed Ctr, Charleston, SC 29403 USA. Ralph H Johnson Vet Adm Med Ctr, Charleston, SC 29403 USA. RP Fu, YC (reprint author), Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Strom Thurmond Biomed Ctr, Room 520,114 Doughty St, Charleston, SC 29403 USA. NR 38 TC 38 Z9 38 U1 0 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0021-9150 J9 ATHEROSCLEROSIS JI Atherosclerosis PD JAN PY 2002 VL 160 IS 1 BP 11 EP 20 DI 10.1016/S0021-9150(01)00541-X PG 10 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 517AG UT WOS:000173588500002 PM 11755918 ER PT J AU Mukerjee, P Ostrow, JD Tiribelli, C AF Mukerjee, Pasupati Ostrow, J. Donald Tiribelli, Claudio TI Low solubility of unconjugated bilirubin in dimethylsulfoxide - water systems: implications for pK(a) determinations SO BMC BIOCHEMISTRY LA English DT Article AB Background: Aqueous pK(a) values of unconjugated bilirubin are important determinants of its solubility and transport. Published pK(a) data on an analog, mesobilirubin-XIII alpha, studied by C-13-NMR in buffered solutions containing 27 and 64 vol% ((CH3)-H-2)(2)SO because of low aqueous solubility of mesobilirubin, were extrapolated to obtain pK(a) values in water of 4.2 and 4.9. Previous chloroform-water partition data on bilirubin diacid led to higher estimates of its pK(a), 8.12 and 8.44, and its aqueous solubility. A thermodynamic analysis, using this solubility and a published solubility in DMSO, suggested that the systems used to measure C-13-NMR shifts were highly supersaturated. This expectation was assessed by measuring the residual concentrations of bilirubin in the supernatants of comparable DMSO-buffer systems, after mild centrifugation to remove microprecipitates. Results: Extensive sedimentation was observed from numerous systems, many of which appeared optically clear. The very low supernatant concentrations at the lowest pH values (4.1-5.9) were compatible with the above thermodynamic analysis. Extensive sedimentation and low supernatant concentrations occurred also at pH as high as 7.2. Conclusions: The present study strongly supports the validity of the aqueous solubility of bilirubin diacid derived from partition data, and, therefore, the corresponding high pK(a) values. Many of the mesobilirubin systems in the C-13-NMR studies were probably supersaturated, contained microsuspensions, and were not true solutions. This, and previously documented errors in pH determinations that caused serious errors in pK(a) values of the many soluble reference acids and mesobilirubin, raise doubts regarding the low pK(a) estimates for mesobilirubin from the C-13-NMR studies. C1 [Mukerjee, Pasupati] Univ Wisconsin, Sch Pharm, Madison, WI 53705 USA. [Ostrow, J. Donald] Acad Med Ctr, Gastroenterol Hepatol Dept, NL-1100 DE Amsterdam, Netherlands. [Ostrow, J. Donald] VA Puget Sound Healthcare Syst, Seattle Div, GI Hepatol Lab, Res Serv 151L, Seattle, WA 98108 USA. [Tiribelli, Claudio] Univ Trieste, Dept BBCM, Liver Study Ctr, I-34127 Trieste, Italy. RP Ostrow, JD (reprint author), Acad Med Ctr, Gastroenterol Hepatol Dept, NL-1100 DE Amsterdam, Netherlands. EM pmukerjee@aol.com; jdostrow@medicine.washington.edu; liver@fmc.units.it NR 31 TC 15 Z9 16 U1 0 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1471-2091 J9 BMC BIOCHEM JI BMC Boichem. PY 2002 VL 3 AR 17 DI 10.1186/1472-2091-3-17 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA V34NH UT WOS:000209092600017 PM 12079498 ER PT J AU Gruber, HE Yamaguchi, D Ingram, J Leslie, K Huang, WB Miller, TA Hanley, EN AF Gruber, HE Yamaguchi, D Ingram, J Leslie, K Huang, WB Miller, TA Hanley, EN TI Expression and localization of estrogen receptor-beta in annulus cells of the human intervertebral disc and the mitogenic effect of 17-beta-estradiol in vitro SO BMC MUSCULOSKELETAL DISORDERS LA English DT Article ID MOLECULAR MECHANISMS; STEROID-HORMONES; HUMAN BONE; IN-VITRO; ER-BETA; RAT; GROWTH; PROLIFERATION; CHONDROCYTES; SUPERFAMILY AB Background: Recent evidence suggests that estrogens exert effects in different tissues throughout the body, and that the estrogen receptor beta (ERbeta) may be important for the action of estrogen (17-beta-estradiol) on the skeleton. The cellular localization of ERbeta in the human intervertebral disc, however, has not yet been explored. Methods: Human disc tissue and cultured human disc cells were used for immunocytochemical localization of ERbeta. mRNA was isolated from cultured human disc cells, and RT-PCR amplification of ERbeta was employed to document molecular expression of this receptor. Cultured human disc cells were tested to determine if 17-beta-estradiol stimulated cell proliferation. Results: In this report data are presented which provide evidence for ERbeta gene expression in human intervertebral disc cells in vivo and in vitro. Culture of annulus cells in the presence of 10-7 M 17-beta-estradiol significantly increased cell proliferation. Conclusions: These data provide new insight into the biology of cells in the annulus of the intervertebral disc. C1 Carolinas Med Ctr, Charlotte, NC 28203 USA. Vet Adm Greater Los Angeles Healthcare Syst, Educ & Clin Ctr, Res Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Plast Surg Res Lab, Los Angeles, CA USA. RP Gruber, HE (reprint author), Carolinas Med Ctr, Charlotte, NC 28203 USA. NR 21 TC 18 Z9 19 U1 0 U2 0 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1471-2474 J9 BMC MUSCULOSKELET DI JI BMC Musculoskelet. Disord. PY 2002 VL 3 AR 4 DI 10.1186/1471-2474-3-4 PG 5 WC Orthopedics; Rheumatology SC Orthopedics; Rheumatology GA 654CQ UT WOS:000181476500004 PM 11846890 ER PT J AU Rich, MM McGarvey, ML Teener, JW Frame, LH AF Rich, MM McGarvey, ML Teener, JW Frame, LH TI ECG changes during septic shock SO CARDIOLOGY LA English DT Article DE cardiac excitability; sepsis; systemic inflammatory response syndrome; low QRS voltage ID ACUTE QUADRIPLEGIC MYOPATHY; ANIMAL-MODEL; DYSFUNCTION; SEPSIS; MUSCLE AB We have previously found that skeletal muscle becomes electrically inexcitable in septic patients. Work in an animal model suggests that a decrease in the available sodium current underlies the loss of electrical excitability. We examined ECGs from patients during periods of septic shock to determine whether there were any ECG abnormalities that might suggest a similar loss of excitability in cardiac tissue during sepsis. Fourteen out of 17 patients had low or significantly decreased QRS amplitudes during septic shock; 8 of 17 had long or increased QRS duration with or without bundle branch block. The mean decrease in QRS amplitude in septic patients was 41%, significantly higher than in controls where no consistent decrease in QRS amplitude was found (p < 0.01). In patients who recovered from septic shock, the QRS amplitude and the increased QRS duration both returned to normal. We conclude that there is a loss of QRS amplitude during septic shock that may be due to altered cardiac excitability. Copyright (C) 2002 S. Karger AG, Basel. C1 Emory Univ, Dept Neurol, Atlanta, GA 30322 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. St Marys Duluth Clin, Hlth Syst, Philadelphia, PA USA. Vet Affairs Med Ctr, Cardiol Sect, Philadelphia, PA USA. Univ Penn, Dept Med, Philadelphia, PA 19104 USA. RP Rich, MM (reprint author), Emory Univ, Dept Neurol, Suite 6000 WMB,1639 Pierce Dr, Atlanta, GA 30322 USA. NR 13 TC 21 Z9 21 U1 0 U2 2 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0008-6312 J9 CARDIOLOGY JI Cardiology PY 2002 VL 97 IS 4 BP 187 EP 196 DI 10.1159/000063120 PG 10 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 581EP UT WOS:000177278400004 PM 12145473 ER PT J AU Liu, XM Chapman, GB Wang, H Durante, W AF Liu, XM Chapman, GB Wang, H Durante, W TI Adenovirus-mediated heme oxygenase-1 gene expression stimulates apoptosis in vascular smooth muscle cells SO CIRCULATION LA English DT Article DE oxygenase; apoptosis; muscle; smooth; biliverdin; bilirubin ID CARBON-MONOXIDE; GUANYLATE-CYCLASE; METALLOPORPHYRINS; ANTIOXIDANT; INHIBITION; INDUCTION; ALPHA; DEATH; ROLES; RATS AB Background-Heme oxygenase-1 (HO-1) catalyzes the degradation of heme into biliverdin, iron, and carbon monoxide (CO). Although HO-1 is induced in vascular smooth muscle cells (SMCs), the biological role of HO-1 in these cells has not been completely characterized. Methods and Results-In the present study, we overexpressed HO-1 in rat aortic SMCs by generating a recombinant defective adenovirus containing the rat HO-1 1 gene (AdHO-1) and examined the effect on SMC proliferation. Infection of SMCs with AdHO-1 resulted in a dose-dependent increase in the expression of HO-1 mRNA, protein, and activity. Infection of SMCs with AdHO-1 inhibited serum-stimulated SMC proliferation in a dose-dependent manner. In contrast, the control adenovirus expressing, the green fluorescent protein failed to induce HO-1 expression and had minimal effects on SMC growth. Infection with AdHO-1 stimulated SMC apoptosis in a dose-dependent fashion, as demonstrated by DNA fragmentation, positive annexin V labeling, and caspase-3 activation. HO-1-mediated apoptosis was associated with a marked increase in the expression of the proapoptotic protein p53. Finally, the exogenous administration of biliverdin and bilirubin stimulated SMC apoptosis. In contrast, the administration of CO or iron failed to induce cell death. Conclusions-These results demonstrate that overexpression of HO-1 or the exogenous administration of biliverdin or bilirubin stimulates SMC apoptosis. Adenovirus-mediated transfer of the HO-1 gene may provide a novel therapeutic approach in treating occlusive vascular disease. C1 Houston VA Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX USA. Baylor Coll Med, Dept Pharmacol, Houston, TX USA. RP Durante, W (reprint author), Houston VA Med Ctr, Bldg 109,Rm 130,2002 Holcombe Blvd, Houston, TX 77030 USA. FU NHLBI NIH HHS [HL-59976] NR 33 TC 111 Z9 125 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JAN 1 PY 2002 VL 105 IS 1 BP 79 EP 84 DI 10.1161/hc0102.101369 PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 509GF UT WOS:000173137400016 PM 11772880 ER PT J AU Gerard, SK Cavalieri, RR AF Gerard, SK Cavalieri, RR TI I-123 diagnostic thyroid tumor whole-body scanning with imaging at 6, 24, and 48 hours SO CLINICAL NUCLEAR MEDICINE LA English DT Article DE diagnostic imaging; I-123; I-131; thyroid cancer ID CANCER PATIENTS; RADIOIODINE UPTAKE; I-131 THERAPY; DOSE I-131; CARCINOMA; ABLATION; REMNANTS AB Purpose: The use of I-123 in lieu of I-131 for diagnostic whole-body thyroid tumor scanning (DxRal) in patients with differentiated thyroid cancer obviates the risk for stunning and affords significantly improved image quality. Because of the shorter half-life (13 hours) of I-123, images have been acquired primarily 6 or 24 hours after injection, potentially decreasing the sensitivity for detecting weakly avid thyroid tumor or remnant. Materials and Methods: The authors evaluated the use of 111 1to 185 MBq (3 to 5 mCi) I-123 for DxRal under withdrawal conditions, imaging at 6, 24, and, in most cases, 48 hours. DxRal with I-123 was compared in 13 evaluations performed in 10 patients, with post-I-131 treatment scans acquired early (2 to 3 days) and late (7 to 10 days) in all cases but one. Results: Of 37 sites of tumor or remnant identified in post-treatment scans, 26 were found in the DxRal I-123 scan (sensitivity, 70%). Of the 11 sites missed by I-123, 7 were seen only in the late post-treatment scans. Therefore, the sensitivity of I-123 imaging compared with the early post-I-131 treatment scans was 26 of 30, or 86.7%. In 10 cases, 48-hour I-123 imaging was attempted, yielding images of acceptable quality in eight of them. Lesion identification was improved on the 48-hour images; in one case, this allowed the identification of a site of tumor recurrence that was confirmed positive on the I-131 post-treatment scan. Conclusions: I-123 doses of 111 to 185 MBq for DxRal provide acceptable levels of sensitivity overall and may permit 48-hour imaging for improved detection of weakly avid tumor or remnant without any risk for "stunning." C1 San Francisco VA Med Ctr, Nucl Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. RP Gerard, SK (reprint author), San Francisco VA Med Ctr, Nucl Med Sect, Nucl Med 115,4150 Clement St, San Francisco, CA 94121 USA. NR 29 TC 34 Z9 34 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0363-9762 J9 CLIN NUCL MED JI Clin. Nucl. Med. PD JAN PY 2002 VL 27 IS 1 BP 1 EP 8 DI 10.1097/00003072-200201000-00001 PG 8 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 519GN UT WOS:000173717400001 PM 11805475 ER PT J AU Dell'Italia, LJ Rocic, P Lucchesi, PA AF Dell'Italia, LJ Rocic, P Lucchesi, PA TI Use of angiotensin-converting enzyme inhibitors in patients with diabetes and coronary artery disease SO CURRENT PROBLEMS IN CARDIOLOGY LA English DT Review ID PLASMINOGEN-ACTIVATOR INHIBITOR; ISCHEMIC-HEART-DISEASE; SMOOTH-MUSCLE-CELLS; INSERTION-DELETION POLYMORPHISM; LEFT-VENTRICULAR DYSFUNCTION; CARDIOVASCULAR RISK-FACTORS; ACUTE MYOCARDIAL-INFARCTION; FATTY STREAK FORMATION; GROWTH-FACTOR-BETA; TISSUE ANGIOTENSIN C1 Univ Alabama, Birmingham Vet Affairs Med Ctr, Dept Med, Div Cardiovasc Dis, Birmingham, AL USA. Univ Alabama, Dept Physiol & Biophys, Birmingham, AL USA. RP Dell'Italia, LJ (reprint author), Univ Alabama, Birmingham Vet Affairs Med Ctr, Dept Med, Div Cardiovasc Dis, Birmingham, AL USA. RI Lucchesi, Pamela/E-3558-2011 NR 121 TC 7 Z9 8 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0146-2806 J9 CURR PROB CARDIOLOGY JI Curr. Probl. Cardiol. PD JAN PY 2002 VL 27 IS 1 BP 6 EP 36 DI 10.1067/med.2002.121580 PG 31 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 520PF UT WOS:000173789700002 PM 11815752 ER PT J AU Mendez, MF Ghajarania, M Perryman, KM AF Mendez, MF Ghajarania, M Perryman, KM TI Posterior cortical atrophy: Clinical characteristics and differences compared to Alzheimer's disease SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE posterior cortical atrophy; Alzheimer's disease; visual agnosia; Balint's syndrome; Gerstmann's syndrome ID PROGRESSIVE VISUAL AGNOSIA; BALINTS-SYNDROME; DEMENTIA; ALEXIA; DISCONNECTION; DISTURBANCES; ASSOCIATION; PATHWAYS; PATIENT; VARIANT AB Background. Predominant and progressive complex visual disorders are often due to posterior cortical atrophy (PCA), a rare early-onset dementing syndrome presenting with visual complaints. In clinicopathological studies, PCA is most commonly considered a form of Alzheimer's disease (AD); no prior study has evaluated clinical differences between PCA and AD. Methods: This study identified 15 patients who presented with progressive complex visual disorders and predominant occipitoparietal hypoperfusion on SPECT. These patients were retrospectively compared on clinical variables with 30 patients with clinically probable AD matched for gender, age and duration of illness. Results: The PCA patients presented with alexia, elements of Balint's syndrome, apperceptive visual agnosia, dressing apraxia and environmental disorientation along with elements of Gerstmann's syndrome. Compared to the AD patients, the 15 PCA patients (mean age of onset 58 years, range 51-64) had significantly better verbal fluency, less memory difficulty, more depression and greater insight into their illness but similar familial and apolipoprotein E risk factors. In the PCA patients, MRI often showed occipitoparietal atrophy without detectable mesiotemporal atrophy. Conclusions: PCA is a distinct clinical syndrome and not just AD with prominent visual deficits. Compared to AD controls, PCA patients have better language and memory but more insight and depression and more posterior atrophy on MRI. These results indicate clinical criteria for the diagnosis of PCA and recommend specific interventions such as visual aids and antidepressant medications. Similar risk factors and course suggest that PCA is most commonly an early-onset posteriorly shifted AD variant. Copyright (C) 2002 S. Karger AG, Basel. C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. VA Greater Los Angeles Hlthcare Syst, Neurobehav Unit 116AF, Los Angeles, CA 90073 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Hlthcare Syst, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 50 TC 155 Z9 164 U1 0 U2 17 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2002 VL 14 IS 1 BP 33 EP 40 DI 10.1159/000058331 PG 8 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 566CM UT WOS:000176409300006 PM 12053130 ER PT J AU Monnier, J Elhai, JD Frueh, BC Sauvageot, JA Magruder, KM AF Monnier, J Elhai, JD Frueh, BC Sauvageot, JA Magruder, KM TI Replication and expansion of findings related to racial differences in veterans with combat-related PTSD SO DEPRESSION AND ANXIETY LA English DT Article DE PTSD; anxiety disorders; psychotic disorders; trauma; combat ID POSTTRAUMATIC-STRESS-DISORDER; VIETNAM VETERANS; AFRICAN-AMERICAN; SYMPTOMS; RELIABILITY; VALIDITY; SCALE AB Racial differences in those seeking treatment at a Veterans Affairs Medical Center (VAMC) outpatient posttraumatic stress disorder (PTSD) treatment program were examined. One hundred eleven (71 Caucasian and 40 African American) veterans were compared on both self-report measures and interview measures of PTSD, depression, dissociation, and general psychopathology. Participants completed the following self-report measures: the Beck Depression Inventory, the Dissociative Experiences Scale, the Mississippi Combat PTSD Scale, and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Participants also completed the Clinician Administered PTSD Scale (CAPS-1), which is a structured interview for PTSD, and completed a non-structured clinical interview. The two groups did not differ on measured demographic variables, nor were there significant differences on self-report or interview measures of anxiety, depression, or PTSD symptomatology. Contrary to expectation, groups did not differ on se T-report measures of dissociation, paranoia, or schizophrenia. African Americans were significantly more likely to endorse items of bizarre mentation from the MMPI-2. These results suggest that African American and Caucasian veterans with combat-related PTSD do not differ with regard to manifestation or severity of psychopathology. (C) 2002 Wiley-Liss, Inc. C1 Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Monnier, J (reprint author), Med Univ S Carolina, Dept Psychiat & Behav Sci, POB 250681, Charleston, SC 29425 USA. FU NIMH NIH HHS [MH01660, MH61983] NR 30 TC 18 Z9 18 U1 1 U2 4 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 1091-4269 J9 DEPRESS ANXIETY JI Depress. Anxiety PY 2002 VL 16 IS 2 BP 64 EP 70 DI 10.1002/da.10060 PG 7 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 598DT UT WOS:000178260700003 PM 12219337 ER PT J AU Abeni, D Picardi, A Pasquini, P Melchi, CF Chren, MM AF Abeni, D Picardi, A Pasquini, P Melchi, CF Chren, MM TI Further evidence of the validity and reliability of the Skindex-29: An Italian study on 2,242 dermatological outpatients SO DERMATOLOGY LA English DT Article DE quality of life; outcome research; validity; reliability; factor analysis; Skindex-29 ID QUALITY-OF-LIFE; GENERAL HEALTH QUESTIONNAIRE; SKIN-DISEASE; VERSION; INSTRUMENT; COMMUNITY; SCIENCE; SAMPLE AB Background: Quality of life is increasingly recognized as an important measure in dermatology. The Skindex-29 is a self-administered questionnaire recently developed to measure comprehensively the complex effects of skin diseases on patients' quality of life. Objective: We aimed to provide further evidence of the reliability and validity of the Skindex-29 in a large sample of patients affected by a wide variety of skin diseases. Methods: An Italian version of the Skindex-29 was produced following accepted guidelines for the cross-cultural adaptation of questionnaires. All adult outpatients attending a dermatological hospital on predetermined days were given the Skindex-29 and the 12-item General Health Questionnaire (GHQ-12). Results: A total of 2,242 complete questionnaires were analyzed. The internal consistency and test-retest reliability of each scale were high. The factor structure of the Skindex-29 was strikingly similar to the one originally observed in American patients. The pattern of correlation with the GHQ-12 provided evidence of convergent validity of the Skindex-29. Conclusion: The instrument seems to measure three fundamental dimensions of skin health-related quality of life. Copyright (C) 2002 S. Karger AG, Basel. C1 IRCCS, IDI, Inst Dermatol, Clin Epidemiol Unit, I-00167 Rome, Italy. IRCCS, IDI, Inst Dermatol, Dermatol Clin 2, I-00167 Rome, Italy. Univ Calif San Francisco, Dept Dermatol, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, Serv Dermatol, San Francisco, CA USA. RP Abeni, D (reprint author), IRCCS, IDI, Inst Dermatol, Clin Epidemiol Unit, Via Monti Creta 104, I-00167 Rome, Italy. RI Picardi, Angelo/B-2181-2013 OI Picardi, Angelo/0000-0003-2392-3011; Abeni, Damiano/0000-0002-0167-7617 NR 27 TC 83 Z9 84 U1 0 U2 2 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1018-8665 J9 DERMATOLOGY JI Dermatology PY 2002 VL 204 IS 1 BP 43 EP 49 DI 10.1159/000051809 PG 7 WC Dermatology SC Dermatology GA 522AN UT WOS:000173873700010 PM 11834849 ER PT J AU Pape, TLB Kim, J Weiner, B AF Pape, TLB Kim, J Weiner, B TI The shaping of individual meanings assigned to assistive technology: a review of personal factors SO DISABILITY AND REHABILITATION LA English DT Review ID SPINAL-CORD INJURY; QUALITY-OF-LIFE; DEVICE USE; OLDER PERSONS; COPING STRATEGIES; DISABILITY; REHABILITATION; DISEASE; ADULTS; HOME AB Purpose: This review article examines the development of individualized meanings assigned to assistive technology and how these personal meanings influence the integration of assistive technology into daily activities. Methods: A review of the published literature regarding assistive technology use and abandonment was conducted by performing two independent searches using 26 search terms and three databases. Publications were reviewed for whether they addressed device use, device abandonment, coping, adjustment, adaptation, values, outcomes and/or cultural issues; 81 publications met these criteria. Results: The evidence suggests that psychosocial and cultural issues influence the shaping of individualized meanings assigned to assistive technology. Theoretical arguments suggest that the process of adapting to disability is another influential factor. Conclusions: The synthesis of evidence and theories suggests that successful integration of assistive technology into daily lives requires potential device users to explore: (1) the meanings they assign to devices; (2) their expectations of assistive technology; (3) the anticipated social costs; and (4) ways to understand that disability is one, but not the defining, feature of one's identity. C1 Rehabil Inst Chicago, Rehabil Serv Evaluat Unit, Chicago, IL 60611 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Midwest Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. Northwestern Univ, Sch Med, Dept Phys Med & Rehabil, Inst Hlth Serv Res & Policy Studies, Chicago, IL 60611 USA. Northwestern Univ, Sch Med, Dept Psychiat & Behav Sci, Div Psychol, Chicago, IL 60611 USA. Northwestern Univ, Sch Med, Dept Neuropsychol, Chicago, IL 60611 USA. Northwestern Univ, Sch Med, Dept Phys Med & Rehabil, Off Med Educ, Chicago, IL 60611 USA. RP Pape, TLB (reprint author), Rehabil Inst Chicago, Rehabil Serv Evaluat Unit, 345 E Super St,Suite 1374, Chicago, IL 60611 USA. OI Pape, Theresa/0000-0001-7738-5963 NR 72 TC 51 Z9 53 U1 1 U2 14 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK,, ABINGDON OX14 4RN, OXON, ENGLAND SN 0963-8288 J9 DISABIL REHABIL JI Disabil. Rehabil. PD JAN PY 2002 VL 24 IS 1-3 BP 5 EP 20 DI 10.1080/09638280110066235 PG 16 WC Rehabilitation SC Rehabilitation GA 511BV UT WOS:000173245200002 ER PT J AU Gariti, P Alterman, AI Ehrman, R Mulvaney, FD O'Brien, CP AF Gariti, P Alterman, AI Ehrman, R Mulvaney, FD O'Brien, CP TI Detecting smoking following smoking cessation treatment SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE urinalysis; cotinine; self-report; carbon monoxide; treatment research ID SELF-REPORTED SMOKING; CIGARETTE-SMOKING; COTININE; NICOTINE; VALIDITY; SMOKERS AB Our study compared the results of self-report (SR) plus breath carbon monoxide (CO) monitoring to SR plus urine cotinine (COT) analysis of recent tobacco use for a recently completed smoking cessation study that compared the efficacy of different intensities of psychosocial treatments coupled with 8 weeks of patch treatment. Treatment outcomes were assessed 9, 26, and 52 weeks from treatment initiation in 200+ patients using both measurement types. COT was able to detect self-reported smoking in over 97% of the cases at all time points, while CO detected self-reported smoking 62, 84, and 89% of the time for the three follow-up assessments. Under 2% of those reporting nonsmoking were found to be smoking via CO, whereas COT found smoking to have occurred for 23, 15, and 7% of the 'nonsmoking' SRs at the three time points. Abstinence rates using SR plus CO were 49, 29, and 26%, contrasted with abstinence rates of 38, 26, and 25%, for SR plus COT. These findings suggest, that use of urine analysis for COT may lead to more accurate but lowered measured abstinence rates. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Penn, Sch Med, Dept Psychiat, Treatment Res Ctr, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Gariti, P (reprint author), Univ Penn, Sch Med, Dept Psychiat, Treatment Res Ctr, 3900 Chestnut St, Philadelphia, PA 19104 USA. FU NIDA NIH HHS [DA10070, P60 DA 05186] NR 20 TC 36 Z9 36 U1 0 U2 2 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD JAN 1 PY 2002 VL 65 IS 2 BP 191 EP 196 DI 10.1016/S0376-8716(01)00162-4 PG 6 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 515UK UT WOS:000173514900009 PM 11772480 ER PT J AU Cholerton, B Gleason, CE Baker, LD Asthana, S AF Cholerton, B Gleason, CE Baker, LD Asthana, S TI Estrogen and Alzheimer's disease - The story so far SO DRUGS & AGING LA English DT Review ID AMYLOID PRECURSOR PROTEIN; HORMONE REPLACEMENT THERAPY; APOLIPOPROTEIN-E GENOTYPE; LONG-TERM POTENTIATION; CENTRAL-NERVOUS-SYSTEM; SPATIAL MEMORY TASK; CEREBRAL BLOOD-FLOW; DENDRITIC SPINE DENSITY; FEMALE RAT HIPPOCAMPUS; PITUITARY-ADRENAL AXIS AB The ovarian hormone estrogen has long been used to treat the physical symptoms of menopause and to aid in the prevention of osteoporosis in postmenopausal women. Cumulative evidence from basic science and clinical research suggests that estrogen also plays a significant neuromodulatory and neuroprotective role. The numerous estrogenic effects in the brain include the modulation of synaptogenesis, increased cerebral blood flow, mediation of important neurotransmitters and hormones, protection against apoptosis, anti-inflammatory actions, and antioxidant properties. These multiple actions in the central nervous system support estrogen as a potential treatment for the cognitive decline associated with Alzheimer's disease (AD), the most common form of dementia. Evidence from epidemiological studies supports enhanced cognitive function in women with AD taking estrogen replacement therapy (ERT) as well as a reduced risk for developing AD in healthy women receiving ERT. Additional clinical evidence suggests that estrogen may modulate specific cognitive functions such as working memory and verbal learning and memory. However, results from more recent controlled trials have not consistently shown a beneficial effect of estrogen on the cognitive function of women with AD. Future research should focus on examining the influence of multiple potential mediators of ERT including the route of estrogen administration, form of estrogen (conjugated estrogens vs estradiol), duration of treatment, opposed versus unopposed estrogen and the use of estrogen analogues. Further, sensitive neuropsychological measures may provide more detailed information concerning the specific effects of estrogen on cognitive function. These important issues must be addressed in order to establish the role of estrogen for the prevention and treatment of AD in women. C1 Univ Wisconsin, Sch Med, Sect Geriatr, Dept Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, GRECC, Seattle, WA USA. RP Asthana, S (reprint author), Univ Wisconsin, Sch Med, Sect Geriatr, Dept Med, 2870 Univ Ave,Ste 100, Madison, WI 53705 USA. FU NIA NIH HHS [AG17196, AG05136] NR 230 TC 52 Z9 54 U1 7 U2 12 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 1170-229X J9 DRUG AGING JI Drugs Aging PY 2002 VL 19 IS 6 BP 405 EP 427 DI 10.2165/00002512-200219060-00002 PG 23 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 587WL UT WOS:000177666800002 PM 12149049 ER PT J AU Lenze, EJ Mulsant, BH Shear, MK Houck, P Reynolds, CF AF Lenze, EJ Mulsant, BH Shear, MK Houck, P Reynolds, CF TI Anxiety symptoms in elderly patients with depression what is the best approach to treatment? SO DRUGS & AGING LA English DT Article ID PRIMARY-CARE PATIENTS; LATE-LIFE; ANXIOUS DEPRESSION; MAJOR DEPRESSION; DISORDERS; NORTRIPTYLINE; COMORBIDITY; PREDICTORS; RECOVERY; ECT AB Depressed elderly persons frequently have concurrent symptoms of anxiety or comorbid anxiety disorders. Such comorbidity is associated with a more severe presentation of depressive illness, including greater suicidality. Additionally, most antidepressant treatment studies in the elderly have found poorer treatment outcomes in those with comorbid anxiety (including delayed or diminished response and increased likelihood of dropout from treatment). While antidepressants such as selective serotonin reuptake inhibitors and tricyclic agents are efficacious for late-life depression, there is no evidence that either class is superior, in terms of efficacy or tolerability, in the treatment of anxious depression. Rather, the amount and quality of clinical management, and not the particular medication chosen, appears to influence the likelihood of re, mission or treatment withdrawal in anxious depressed elderly patients. Co-prescription of benzodiazepines, typically lorazepam, is also warranted in some cases for severe anxiety or insomnia, but carries the risk of cognitive or motor impairment. It is our experience that close clinical monitoring, together with maximisation of antidepressant treatment (by maximising dosage, augmenting or switching agents in cases of partial or no response, and/or adding psychotherapy) will almost always result in remission of depressive symptoms, together with improvement of anxiety, in these individuals. Therefore, optimism should be maintained when treating the depressed elderly individual, even when comorbid anxiety is present. The term 'anxious depression' refers to individuals in a major depressive episode who concurrently have significant anxiety symptoms. This presentation is common, because anxiety and depressive symptoms are overlapping and share risk factors.([1]) Symptoms of anxiety are seen in as many as 65% of older patients with depression.([2]) Anxious depression can also be used to describe individuals with depression who have a comorbid anxiety disorder. While in adults these comorbid anxiety disorders are common,([3]) similar studies of older adults have shown mixed results, with some studies finding low rates of comorbid anxiety disorders ([4,5]) and others showing higher rates. ([1,6]) The most common comorbid anxiety disorders in elderly patients with depression are phobias and generalised anxiety disorder (GAD). This review of the literature on anxious depression in the elderly will show that the disorder is associated with increased suicidality and treatment resistance compared with nonanxious depression (the combination of suicidality and treatment resistance is of obvious concern). Possible reasons for treatment resistance are discussed, as are clinical management strategies for improving treatment outcomes in anxious depression. C1 Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat,Sch Med, Intervent Res Ctr Late Life Mood Disorders, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlth Syst, GRECC, Pittsburgh, PA USA. RP Lenze, EJ (reprint author), Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat,Sch Med, Intervent Res Ctr Late Life Mood Disorders, 3811 Ohara St, Pittsburgh, PA 15213 USA. FU NIMH NIH HHS [K05 MH00295, K23 MH64196, P30 MH 52247, R01 MH37869, R37 MH43832, T32 MH19986] NR 37 TC 15 Z9 17 U1 2 U2 6 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 1170-229X J9 DRUG AGING JI Drugs Aging PY 2002 VL 19 IS 10 BP 753 EP 760 DI 10.2165/00002512-200219100-00004 PG 8 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 615ET UT WOS:000179233400004 PM 12390052 ER PT J AU Grill, HJ Schwartz, MW Kaplan, JM Foxhall, JS Breininger, J Baskin, DG AF Grill, HJ Schwartz, MW Kaplan, JM Foxhall, JS Breininger, J Baskin, DG TI Evidence that the caudal brainstem is a target for the inhibitory effect of leptin on food intake SO ENDOCRINOLOGY LA English DT Article ID RECEPTOR MESSENGER-RNA; GLUCAGON-LIKE PEPTIDE-1; BODY-WEIGHT; RAT HYPOTHALAMUS; LONG-FORM; IMMUNOHISTOCHEMICAL LOCALIZATION; ARCUATE NUCLEUS; SOLITARY TRACT; BINDING-SITES; BLOOD-GLUCOSE AB Three experiments were performed to investigate the hypothesis that leptin action within the caudal brain stem (CBS) contributes to its intake inhibitory effects. The first experiment evaluated the anatomical distribution of leptin receptor mRNA in rat CBS using a sensitive fluorescence in situ hybridization method with a riboprobe specific for the long form of the leptin receptor (Ob-Rb). An Ob-Rb mRNA hybridization signal was detected in neurons of several CBS nuclei involved in the control of food intake, including the dorsal vagal complex and parabrachial nucleus. A strong hybridization signal was also obtained from neuronal cell bodies of a number of other structures including the hypoglossal, trigeminal, lateral reticular, and cochlear nuclei; locus ceruleus; and inferior olive. The anatomical profile revealed by fluorescence in situ hybridization was in good agreement with immunocytochemical analysis with an antibody specific to Ob-Rb. In a second experiment, exploring the relevance of CBS Ob-Rb to feeding behavior, rats were given a fourth intracerebroventricular (i.c.v.) injection of leptin (0.1, 0.83, or 5.0 mug; n = 9-11/group) or vehicle 30 min before lights-out on three consecutive days The two higher doses reduced food intake significantly at 2,4, and 24 h after injection and caused significant reductions of body weight. The dose-response profiles for fourth i.c.v. administration were indistinguishable from those obtained from separate groups of rats that received leptin via a lateral i.c.v. cannula. In the last experiment, a ventricle-subthreshold dose of leptin (0.1 mug) microinjected unilaterally into the dorsal vagal complex suppressed food intake at 2,4, and 24 h. The results indicate that the CBS contains neurons that are potentially direct targets for the action of leptin in the control of energy homeostasis. C1 Univ Penn, Dept Psychol, Grad Grp Psychol, Philadelphia, PA 19104 USA. Univ Penn, Grad Grp Neurosci, Philadelphia, PA 19104 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Biol Struct, Seattle, WA 98195 USA. RP Grill, HJ (reprint author), Univ Penn, Dept Psychol, Grad Grp Psychol, 3815 Walnut St, Philadelphia, PA 19104 USA. FU NIDDK NIH HHS [DK-12829, DK-17047, DK-21397, DK-42284, DK-52989]; NINDS NIH HHS [NS-32272] NR 51 TC 251 Z9 256 U1 0 U2 8 PU ENDOCRINE SOC PI BETHESDA PA 4350 EAST WEST HIGHWAY SUITE 500, BETHESDA, MD 20814-4110 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD JAN PY 2002 VL 143 IS 1 BP 239 EP 246 DI 10.1210/en.143.1.239 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 508EH UT WOS:000173075400030 PM 11751615 ER PT J AU Wasterlain, CG Mazarati, AM Naylor, D Niquet, J Liu, HT Suchomelova, L Baldwin, R Katsumori, H Shirasaka, Y Shin, D Sankar, R AF Wasterlain, CG Mazarati, AM Naylor, D Niquet, J Liu, HT Suchomelova, L Baldwin, R Katsumori, H Shirasaka, Y Shin, D Sankar, R TI Short-term plasticity of hippocampal neuropeptides and neuronal circuitry in experimental status epilepticus SO EPILEPSIA LA English DT Article; Proceedings Paper CT 6th Workshop on the Neurology of Epilepsy (WONOEP VI) CY MAY 08-12, 2001 CL FOZ DO IGUACU, BRAZIL DE self-sustaining status epilepticus; galanin; dynorphin ID SUSTAINING STATUS EPILEPTICUS; BRIEF ELECTRICAL-STIMULATION; ACETYLCHOLINE-RELEASE; PERFORANT PATH; GRANULE CELLS; GALANIN; RAT; MODEL; MAINTENANCE; SEIZURES AB Purpose: We used a model of self-staining status epilepticus (SSSE), induced by brief intermittent stimulation of the perforant path in unanesthetized rats, to study the mechanism of initiation and of maintenance of SSSE and the role of neuropeptides in those processes. Methods: The perforant path was stimulated intermittently for 7 min (ineffective stimulation) or 30 min (generating SSSE). Peptides and their agonists and antagonists were delivered either intraperitoneally, or directly into the hippocampus through a implanted cannula. Behavior and electroencephalogram (EEG) were recorded through a videotape-telemetry system with automatic spike and seizures detection programs, which were supplemented by manual review of the records to confirm the diagnosis. Immunocytochemistry and enzyme-linked immunosorbent assay followed published methods. Results: Initiation of SSSE was blocked by many agonists of inhibitory neurotransmitters or neuromodulators, and by many antagonists of excitatory synapses, and was facilitated by agents with the opposite action, suggesting the activation of a complex circuit with multiple potential entry points. Once SSSE was established, however, only N-methyl-D-aspartate (NMDA)-receptor ligands and a few neuropeptides had major effects on its maintenance. Galanin and dynorphin had powerful anticonvulsant roles in the maintenance phase of SSSE, whereas somatostatin and neuropeptide Y suppressed seizures only transiently. SSSE seemed to induce maladaptive changes in neuropeptides: it depleted the hippocampus of the galanin- and dynorphin-immunoreactive (IR) fibers, which normally function as endogenous anticonvulsants; whereas it induced overexpression of the proconvulsant neuropeptides substance P and neurokinin B; however, late in the course of SSSE galanin-IR interneurons appeared in the dentate hilus. Conclusions: Initiation of SSSE seems to involve a circuit with many points of entry, and blockage of any point along this circuit inhibits the development of SSSE. Far fewer agents alter the maintenance phase of SSSE. Galanin, dynorphin, somatostatin, and neuropeptide Y have anticonvulsant roles, matching the previous described convulsant role of substance P and neurokinin B. Galanin and dynorphin seem to undergo maladaptive changes, which appear to play an important role of the maintenance phase of SSSE. Later, the de novo expression of inhibitory neuropeptides in novel cells in hippocampus coincides with the waning of seizures and may play a role in their termination. C1 VA Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Pediat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. RP Wasterlain, CG (reprint author), VA Greater Los Angeles Healthcare Syst, Serv Neurol, 127,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 49 TC 33 Z9 34 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2002 VL 43 SU 5 BP 20 EP 29 DI 10.1046/j.1528-1157.43.s.5.1.x PG 10 WC Clinical Neurology SC Neurosciences & Neurology GA 584AW UT WOS:000177445900006 PM 12121290 ER PT J AU Sankar, R Shin, D Liu, HT Wasterlain, TC Mazarati, T AF Sankar, R Shin, D Liu, HT Wasterlain, TC Mazarati, T TI Epileptogenesis during development: Injury, circuit recruitment, and plasticity SO EPILEPSIA LA English DT Article; Proceedings Paper CT 6th Workshop on the Neurology of Epilepsy (WONOEP VI) CY MAY 08-12, 2001 CL FOZ DO IGUACU, BRAZIL DE seizures; status epilepticus; epilepsy; development; neuronal injury; synaptic plasticity ID GRANULE CELL NEUROGENESIS; NEURON-SPECIFIC ENOLASE; INDUCED STATUS EPILEPTICUS; DEVELOPING BRAIN; RECURRENT SEIZURES; FEBRILE SEIZURES; SYNAPTIC REORGANIZATION; NEONATAL SEIZURES; LIMBIC EPILEPSY; IMMATURE BRAIN AB Purpose: To use animal models of variable seizure induction in rats at different developmental stages to determine contributing factors for spontaneous seizures resulting from status epilepticus (SE) early in life. Methods: Two models of SE with distinct modes of seizure induction, lithium-pilocarpine (LiPC) and perforant path stimulation (PPS), were used at different ages. Multiple methods of determining neurodegeneration during an acute period and plastic changes in those monitored during the chronic phase were used. Results: Different modes of seizure induction lead to varying types and extents of damage, dependent on the age of the animals at the time of insult. LiPC resulted in injury to animals as young as 2 weeks and became widespread in animals 3 weeks old, whereas widespread damage after PPS was not seen until P35. Rats at an age with widespread damage in response to seizures also showed extensive immediate-early gene activation and often developed spontaneous seizures and features of hippocampal plasticity seen in the epileptic brain. Conclusions: SE early in life results in multiple consequences to the developing brain. These changes, coexisting in the nonepileptic brain, can overlap in a maladaptive combination to result in the diseased state of epilepsy. The consequence of early seizures in immature animals is a function of both the developmental stage and the method of seizure induction. C1 Univ Calif Los Angeles, Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Serv Neurol, Los Angeles, CA USA. RP Sankar, R (reprint author), Univ Calif Los Angeles, Sch Med, Dept Pediat, 22-474 MDCC, Los Angeles, CA 90095 USA. NR 44 TC 15 Z9 16 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2002 VL 43 SU 5 BP 47 EP 53 DI 10.1046/j.1528-1157.43.s.5.11.x PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 584AW UT WOS:000177445900011 PM 12121295 ER PT J AU Mazarati, A Bragin, A Baldwin, R Shin, D Wilson, C Sankar, T Naylor, D Engel, J Wasterlain, CG AF Mazarati, A Bragin, A Baldwin, R Shin, D Wilson, C Sankar, T Naylor, D Engel, J Wasterlain, CG TI Epileptogenesis after self-sustaining status epilepticus SO EPILEPSIA LA English DT Article; Proceedings Paper CT 6th Workshop on the Neurology of Epilepsy (WONOEP VI) CY MAY 08-12, 2001 CL FOZ DO IGUACU, BRAZIL DE status epilepticus; epilepsy; epileptogenesis; hippocampus; antiepileptic drugs ID TEMPORAL-LOBE EPILEPSY; SPONTANEOUS RECURRENT SEIZURES; BRIEF ELECTRICAL-STIMULATION; RAT MODEL; PERFORANT PATH; CELL LOSS; PILOCARPINE; KAINATE; SPIKES AB Purpose: To describe the natural history of chronic epilepsy after experimental self-sustaining status epilepticus (SSSE) and to correlate patterns of SSSE with ictal, interictal, and plastic changes that characterize chronic epilepsy. Methods: SSSE was induced in adult Wistar rats by 30-min intermittent electrical stimulation of the perforant path. In some animals, SSSE was treated by short-term administration of antiepileptic drugs (AEDs). After SSSE, EEG and animal behavior were monitored for less than or equal to1 year. Some animals were killed to study mossy fiber sprouting in the dentate gyrus. Results: Despite the high reproducibility of the electro-graphic and behavioral manifestations of SSSE, patterns of chronic epilepsy varied considerably among animals in terms of seizure frequency, initial seizure pattern at the onset of chronic epilepsy, and frequency of interictal spikes. Statistically significant correlations were found between spike frequency during SSSE and interictal spike frequency, as well as between the frequency of spontaneous seizures and degree of mossy fiber sprouting. Early treatment of SSSE prevented the occurrence of spontaneous seizures and significantly decreased frequency of interictal spikes. Late treatment of SSSE did not prevent spontaneous seizures, but significantly decreased their frequency, and eventually may lead to remission of epilepsy. Conclusions: SSSE leads after a "silent" period to chronic epilepsy, which is maintained for 1 year in the rat. The silence is only behavioral, because EEG paroxysmal activity is seen in every animal. In this model of SSSE, the timing of treatment is a major determinant of outcome. Early treatment reduces the incidence of chronic epilepsy, whereas late treatment only reduces its severity. The possibility that this reduction of the severity of epilepsy may led to spontaneous remissions merits further study. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Pediat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. RP Mazarati, A (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NINDS NIH HHS [NS 02808, NS 11315, NS 33310] NR 21 TC 32 Z9 33 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2002 VL 43 SU 5 BP 74 EP 80 DI 10.1046/j.1528-1157.43.s.5.25.x PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 584AW UT WOS:000177445900015 PM 12121299 ER PT J AU Van Cott, AC AF Van Cott, AC TI Epilepsy and EEG in the elderly SO EPILEPSIA LA English DT Article DE epilepsy; elderly; seizures; EEG; CCTV-EEG ID SEIZURES; OLDER; AGE AB Seizures are now the third most frequently encountered neurologic problem in the elderly population. The incidence of recurrent unprovoked seizures peaks in older patients. Because of this a-e-related increase and the growing elderly population, evaluation and treatment of the elderly patient has received increasing attention. This article focuses on epilepsy, not acute seizures in the elderly. The causes and types of epilepsy older individuals experience are reviewed, along with the diagnostic role of EEG. Treatment options are briefly addressed. C1 Va Pittsburgh Hlth Care Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Pittsburgh, PA USA. RP Van Cott, AC (reprint author), Va Pittsburgh Hlth Care Syst, Neurol MDP 111 N U,Univ Dr C, Pittsburgh, PA 15240 USA. NR 42 TC 33 Z9 35 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2002 VL 43 SU 3 BP 94 EP 102 DI 10.1046/j.1528-1157.43.s.3.10.x PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 574KA UT WOS:000176887100012 PM 12060011 ER PT J AU Naylor, D AF Naylor, D TI Changes in Nonlinear signal processing in rat hippocampus associated with loss of paired-pulse inhibition or epileptogenesis SO EPILEPSIA LA English DT Article; Proceedings Paper CT 6th Workshop on the Neurology of Epilepsy (WONOEP VI) CY MAY 08-12, 2001 CL FOZ DO IGUACU, BRAZIL DE epilepsy; hippocampus; paired-pulse inhibition; Wiener analysis; nonlinear ID SEIZURES; MODEL; BRAIN; OSCILLATIONS; REDUCTION; EPILEPSY; DAMAGE AB Purpose: To study acute and chronic physiological effects of perforant path stimulation using paired-pulse and nonlinear signal analysis techniques (Wiener kernel analysis). Methods: Two to 3-month-old Wistar rats were implanted with stimulating electrodes in the perforant path and recording electrodes in the granule cell layer. Loss of paired-pulse inhibition was produced with 2 Hz continuous and 20 Hz (10 s/min) intermittent stimulation for periods of 1-15 min (0.1 ms, 20 v pulses). Some animals received 30-60 min of stimulation, a model for status epilepticus/epileptogenesis. Responses to paired-pulse or white noise inputs were recorded sequentially. Results: Loss of inhibition with brief 1-3 min of stimulation, measured by increase paired-pulse ratio (P2/P1 ISI 40 ms) from 0.25 (+/-0.27) pre- to 1.02 (+/-0.18) poststimulation (p < 0.001), lasted 43 ( 15) min. For 30-60 min of stimulation, the paired-pulse ratios were 0.088 (+/-0.11), 1.59 (+/-0.036), 0.06 (+/-0.11), 0.82 (+/-0.22) for pre-, immediate post-, 1 week post-, and 1 month poststimulation, respectively (p < 0.025). Compared to prestimulation values, Wiener kernel amplitudes for immediate, I week, and I month poststimulation were 24% (+/-13%), 72% (+/-17%). and 31% (+/-21%), respectively (p < 0.05). Wiener kernels 1 month poststimulation showed response prolongation with increased opportunity for excitatory interactions of inputs (particularly those separated by 4 ms). Conclusions: Brief perforant path stimulation causes sustained loss of inhibition in the dentate, possibly an early event in the transition to status epilepticus. Stimulation for 30-60 min causes chronic changes in paired-pulse and white noise (Wiener kernel) responses. Transient recovery occurs by I week, but later new features appear (including delayed/late inhibition and potential excitatory cross-talk) that might favor epileptic seizures. C1 Univ Calif Los Angeles, Med Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Med Ctr, Dept Neurol, Los Angeles, CA 90073 USA. RP Naylor, D (reprint author), Univ Calif Los Angeles, Med Ctr, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 500,Rm 3256, Los Angeles, CA 90073 USA. NR 16 TC 10 Z9 10 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2002 VL 43 SU 5 BP 188 EP 193 DI 10.1046/j.1528-1157.43.s.5.37.x PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 584AW UT WOS:000177445900035 PM 12121319 ER PT J AU Tache, Y Martinez, V Million, M Maillot, C AF Tache, Y Martinez, V Million, M Maillot, C TI Role of corticotropin releasing factor receptor subtype 1 in stress-related functional colonic alterations: Implications in irritable bowel syndrome SO EUROPEAN JOURNAL OF SURGERY LA English DT Article DE stress; CRF; CRF receptor; CRF antagonist; visceral pain; colonic motility; anxiety; IBS ID WATER-AVOIDANCE STRESS; CHRONIC HEPATITIS-C; FACTOR CRF; MOTOR FUNCTION; HIGH-AFFINITY; VISCERAL HYPERSENSITIVITY; PARAVENTRICULAR NUCLEUS; GASTROINTESTINAL-TRACT; CONSENSUS INTERFERON; MAJOR DEPRESSION AB The identification of the various elements of the Corticotropin Releasing Factor (CRF) system including the characterisation of four mammalian CRF-related peptides, the cloning of two CRF receptor subtypes 1 and 2 (CRF1; CRF2) and the development of selective CRF1 receptor antagonists has allowed investigators to establish an important role for the CRF signalling pathways in coordinating the physiological and behavioural components of the stress response. In particular, compelling preclinical evidence showed that both central and peripheral injection of CRF mimicked stress-induced stimulation of colonic motility, transit, defaecation, and occurrence of diarrhoea along with degranulation of mast cells, and increased secretion of prostaglandin E-2, Mucus, and ionic permeability. Central CRF also increased abdominal pain from colorectal distention in rats and peripheral CRF reduced pain threshold to colonic distention and increased colonic motility in humans. Non-selective CRF antagonists for receptors 1 and 2 and selective CRF1 antagonists inhibit exogenous (central or peripheral) CRF, and acute stress-induced stimulation of colonic motor and secretory function and visceral hyperalgesia. CRF1 receptors mediate stress-related anxiogenic and depression-like behaviours in rodents and CRF1 antagonist reduced depression in a phase II clinical trial. These findings lend support to the hypothesis that hyperactivation of CRF, receptors may contribute to the co-morbidity of anxiety and depression and irritable bowel syndrome. Targeting these pathways with selective CRF1 antagonists may be a novel therapeutic venue for diarrhoea-predominant IBS patients. C1 VA Greater Los Angeles Healthcare Syst, CURE, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Sch Med, Div Digest Dis, Los Angeles, CA USA. RP Tache, Y (reprint author), VA Greater Los Angeles Healthcare Syst, CURE, Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [R01 DK-33061] NR 70 TC 19 Z9 20 U1 1 U2 3 PU TAYLOR & FRANCIS AS PI OSLO PA CORT ADELERSGT 17, PO BOX 2562, SOLLI, 0202 OSLO, NORWAY SN 1102-4151 J9 EUR J SURG JI Eur. J. Surg. PY 2002 VL 168 SU 587 BP 16 EP 22 PG 7 WC Surgery SC Surgery GA 670DE UT WOS:000182391500004 PM 16144197 ER PT J AU Ogawa, M AF Ogawa, M TI Changing phenotypes of hematopoietic stem cells SO EXPERIMENTAL HEMATOLOGY LA English DT Article; Proceedings Paper CT 30th Annual Meeting of the International-Society-for-Experimental-Hematology CY AUG 25, 2001 CL TOKYO, JAPAN SP Int Soc Exptl Hematol ID COLONY-STIMULATING FACTOR; CD34(+) BLOOD-CELLS; PERIPHERAL-BLOOD; BONE-MARROW; IN-VIVO; EXPRESSION; TRANSPLANTATION; PROGENITOR C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29401 USA. RP Ogawa, M (reprint author), Med Univ S Carolina, Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. FU NCI NIH HHS [P01-CA78582]; NIDDK NIH HHS [R01-DK54197] NR 29 TC 56 Z9 58 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0301-472X J9 EXP HEMATOL JI Exp. Hematol. PD JAN PY 2002 VL 30 IS 1 BP 3 EP 6 DI 10.1016/S0301-472X(01)00770-6 PG 4 WC Hematology; Medicine, Research & Experimental SC Hematology; Research & Experimental Medicine GA 518XP UT WOS:000173693700002 PM 11823030 ER PT J AU Ayasolla, K Giri, S Khan, M Singh, A Singh, I AF Ayasolla, K Giri, S Khan, M Singh, A Singh, I TI Amyloid induced upregulation of inducible nitric oxide synthase by amyloid peptide in glial cells: Implications to Alzheimer's disease. SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Meeting Abstract C1 Med Univ S Carolina, Dept Pediat & Pathol & Lab Med, Charleston, SC 29425 USA. Ralph Johnson VA Med Ctr, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PY 2002 VL 33 SU 1 MA 489 BP S186 EP S187 PG 2 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 578AY UT WOS:000177096300488 ER PT J AU Richardson, A AF Richardson, A TI Utilization of transgenic mice to study the role of free radicals in aging SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Meeting Abstract CT 9th Annual Meeting of the Oxygen-Society CY NOV 20-24, 2002 CL SAN ANTONIO, TEXAS SP Oxygen Soc C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Adm Med Ctr, GRECC, San Antonio, TX 78284 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PY 2002 VL 33 SU 2 MA P5 BP S300 EP S300 PG 1 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 614PY UT WOS:000179199600006 ER PT J AU Van Remmen, H Hamilton, M Ikeno, Y Chang, J Shibatani, T Richardson, A AF Van Remmen, H Hamilton, M Ikeno, Y Chang, J Shibatani, T Richardson, A TI Using knockout and transgenic mouse models to study oxidative stress and mitochondria in aging. SO FREE RADICAL RESEARCH LA English DT Meeting Abstract CT Conference on European Research on Functional Effects of Dietary Antioxidants - Benefits and Risks CY SEP 25-28, 2002 CL CHURCHILL COLL, CAMBRIDGE, ENGLAND HO CHURCHILL COLL ID MICE C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1071-5762 J9 FREE RADICAL RES JI Free Radic. Res. PY 2002 VL 36 SU S BP 23 EP 24 PG 2 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 611VQ UT WOS:000179038800014 ER PT J AU Dulai, GS Guha, S Kahn, KL Gornbein, J Weinstein, WM AF Dulai, GS Guha, S Kahn, KL Gornbein, J Weinstein, WM TI Preoperative prevalence of Barrett's esophagus in esophageal adenocarcinoma: A systematic review SO GASTROENTEROLOGY LA English DT Article ID ESOPHAGOGASTRIC JUNCTION; SURGICAL-TREATMENT; GASTRIC CARDIA; CARCINOMA; CANCER; SURVEILLANCE; RISK; EPIDEMIOLOGY; METAPLASIA; DYSPLASIA AB Background & Aims: The public health impact of past screening and surveillance practices on the outcomes of Barrett's related cancers has not previously been quantified. Our purpose was to determine the prior prevalence of Barrett's esophagus in reported cases of incident adenocarcinoma undergoing resection, as an indirect measure of impact. Methods: We performed a systematic review of the literature from 1966 to 2000. Studies were included if they reported: (1) the number of consecutive adenocarcinomas resected, and (2) the number of those resected who had a previously known diagnosis of Barrett's. We generated summary estimates using a random effects model. Results: We identified and reviewed 752 studies. Twelve studies representing a total of :1503 unique cases of resected adenocarcinomas met inclusion criteria. Using a random effects model, the overall percentage of patients undergoing resection who had a prior diagnosis of Barrett's was 4.7% +/- 2.9%. Conclusions: The low prior prevalence (similar to5%) of Barrett's esophagus in this study population provides indirect evidence to suggest that recent efforts to identify patients with Barrett's-whether through endoscopic screening or evaluation of symptomatic patients-have had minimal public health impact on esophageal adenocarcinoma outcomes. The potential benefits of endoscopic surveillance seem to have been limited to only a fraction of those individuals at risk. These data thus provide a clear and compelling rationale for the development of effective screening strategies to identify patients with Barrett's esophagus. C1 Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Sch Med, Div Gastroenterol & Hepatol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Sch Med, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Sch Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Sch Med, Div Biomath,Dept Med, Los Angeles, CA 90073 USA. RP Dulai, GS (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Greater Los Angeles Vet Adm Healthcare Syst, Bldg 115,Room 318,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 53 TC 175 Z9 176 U1 0 U2 6 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JAN PY 2002 VL 122 IS 1 BP 26 EP 33 DI 10.1053/gast.2002.30297 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 508AQ UT WOS:000173065100007 PM 11781277 ER PT J AU Gukovskaya, AS Mouria, M Gukovsky, I Reyes, CN Kasho, VN Faller, LD Pandol, SJ AF Gukovskaya, AS Mouria, M Gukovsky, I Reyes, CN Kasho, VN Faller, LD Pandol, SJ TI Ethanol metabolism and transcription factor activation in pancreatic acinar cells in rats SO GASTROENTEROLOGY LA English DT Article ID KAPPA-B ACTIVATION; ACID ETHYL-ESTER; FATTY-ACID; GAS-CHROMATOGRAPHY; ALCOHOL; ACETALDEHYDE; LIVER; INJURY; BLOOD; INFLAMMATION AB Background & Aims: Ethanol metabolism by pancreatic acinar cells and the role of its metabolites in ethanol toxicity to the pancreas remain largely unknown. Here, we characterize ethanol metabolism in pancreatic acinar cells and determine the effects of ethanol metabolites on nuclear factor kappaB (NF-kappaB) and activator protein (AP)-1, transcription factors that are activated in pancreatitis and mediate expression of inflammatory molecules critical for this disease. Methods: We measured activities of fatty acid ethyl ester (FAEE) synthase and alcohol dehydrogenase (ADH), as well as accumulation of ethanol metabolites. We measured the effects of ethanol and its metabolites on NF-kappaB and AP-1 activation by using a gel shift assay, Results: Pancreas metabolizes ethanol via both oxidative and nonoxidative pathways. Acinar cells are the main source of ethanol metabolism in the pancreas. Compared with the liver, FAEE synthase activity in the pancreas Is greater, whereas that of ADH is much less. FAEEs activated NF-kappaB and AP-1, whereas acetaldehyde inhibited NF-kappaB activation. Ethanol decreased NF-kappaB binding activity in acinar cells, which was potentiated by cyanamide. Conclusion: Oxidative and nonoxidative ethanol metabolites regulate transcription factors differently in pancreatic acinar cells. Ethanol may regulate NF-kappaB and AP-1 positively or negatively, depending on which metabolic pathway's effect predominates. These regulatory mechanisms may play a role in ethanol toxicity to the pancreas. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. RP Gukovskaya, AS (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Bldg 258,Room 340,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU PHS HHS [P50-A11999] NR 55 TC 109 Z9 110 U1 0 U2 10 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JAN PY 2002 VL 122 IS 1 BP 106 EP 118 DI 10.1053/gast.2002.30302 PG 13 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 508AQ UT WOS:000173065100017 PM 11781286 ER PT J AU Katon, W Russo, J Frank, E Barrett, J Williams, JW Oxman, T Sullivan, M Cornell, J AF Katon, W Russo, J Frank, E Barrett, J Williams, JW Oxman, T Sullivan, M Cornell, J TI Predictors of nonresponse to treatment in primary care patients with dysthymia SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE dysthymia; depression; paroxetine ID PERSONALITY-DISORDERS; MEDICAL OUTCOMES; RISK-FACTORS; LIFE EVENTS; DEPRESSION; HEALTH; NEUROTICISM; COMORBIDITY; MODEL; TRIAL AB Dysthymia is one of the most prevalent problems in primary care, especially in the elderly. In this study, we evaluated the demographic and clinical predictors of nonresponse to treatment in primary care patients with dysthymia. The study sample consisted of 338 primary care patients meeting DSMIII-R criteria for dysthymia from 4 diverse geographic sites in a randomized controlled 11-week trial of paroxetine, problem-solving therapy or placebo. Patients who attended at least 4 treatment sessions were used in the analysis. A score of less than 7 on the Hamilton was defined as a positive response to treatment. By Week 11, 52.2% of patients had a positive response to treatment. Patients with lower levels of education (odds ratio 0.44, 95% CI 0.23, 0.86), higher scores on the personality dimension of neuroticism (odds ratio 0.58, 95% CI 0.36, 0.92) and those with more severe medical illness (odds ratio 0.97, 95% CI 0.95, 0.99) were less likely to recover with either active or placebo treatments. Elderly women (>60 years of age, odds ratio 0.19, 95% CI 0.05, 0.66) were also less likely to respond to all treatments; however, females had a significantly higher response to placebo treatment compared to males. The factors associated with lack of response to treatment included lower-levels of education. high neuroticism, more severe medical illness and being an older female. This analysis is based on patients agreeing to participate in a randomized controlled trial, limiting representativeness of the sample, however, the demographic and clinical characteristics are common in elderly depressed primary care patients, and may signal the need for increased mental health specialty consultation. (C) 2002 Elsevier Science Inc. All rights reserved. C1 Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. Dartmouth Coll Sch Med, Dept Community & Family Med, Hanover, NH USA. Univ Texas, Hlth Sci Ctr, Div Gen Internal Med, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX USA. Dartmouth Coll Sch Med, Dept Psychiat, Hanover, NH USA. Univ Texas, Hlth Sci Ctr, Div Geriatr, San Antonio, TX USA. RP Katon, W (reprint author), Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 NR 45 TC 31 Z9 33 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0163-8343 J9 GEN HOSP PSYCHIAT JI Gen. Hosp. Psych. PD JAN-FEB PY 2002 VL 24 IS 1 BP 20 EP 27 DI 10.1016/S0163-8343(01)00171-2 PG 8 WC Psychiatry SC Psychiatry GA 518YG UT WOS:000173695400004 PM 11814530 ER PT J AU Young, A Flower, L AF Young, A Flower, L TI Patients as partners, patients as problem-solvers SO HEALTH COMMUNICATION LA English DT Article ID BIOPSYCHOSOCIAL MODEL; PHYSICIAN; COMMUNICATION; DISCOURSE; OUTCOMES; CARE AB This article reports our ongoing work in developing a model of health care communication called collaborative interpretation, which we define as a rhetorical practice that generates building blocks for a more complete and coherent diagnostic story and for a collaborative treatment plan. It does this by situating patients as problem-solvers. Our study begins with an analysis of provider-patient interactions in a specific setting-the emergency department (ED) of an urban trauma-level hospital-where we observed patients and providers miscommunicating in at least 3 distinct areas: over the meaning of key terms, in the framing of the immediate problem, and over the perceived role of the ED in serving the individual and the community. From our observations, we argue that all of these miscommunications and missed opportunities are rooted in mismatched expectations on the part of both provider and patient and the lack of explicit comparison and negotiation of expectations-in other words, a failure to see the patient-provider interaction as a rhetorical, knowledge-building event. In the process of observing interactions, conversing with patients and providers, and working with a team of providers and patients, we have developed an operational model of communication that could narrow the gap between the lay public and the medical profession-a gap that is especially critical in intercultural settings like the one we have studied This model of collaborative interpretation (CI) provides strategies to help patients to represent their medical problems in the context of their life experiences and to share the logic behind their health care decisions. In addition, CI helps both patient and provider identify their goals and expectations in treatment, the obstacles that each party perceives, and the available options. It is adaptable to various settings, including short, structured conversations in the emergency room, extended dialogue between a health educator and a patient in a clinical setting, and group discussions in support groups, community groups, or health education classrooms. C1 VA Pittsburgh Healthcare Syst, OOGR U, GREEC, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Carnegie Mellon Univ, Ctr Univ Outres, Pittsburgh, PA 15213 USA. RP Young, A (reprint author), VA Pittsburgh Healthcare Syst, OOGR U, GREEC, Univ Dr C, Pittsburgh, PA 15240 USA. NR 81 TC 11 Z9 11 U1 0 U2 8 PU LAWRENCE ERLBAUM ASSOC INC PI MAHWAH PA 10 INDUSTRIAL AVE, MAHWAH, NJ 07430-2262 USA SN 1041-0236 J9 HEALTH COMMUN JI Health Commun. PY 2002 VL 14 IS 1 BP 69 EP 97 DI 10.1207/S15327027HC1401_4 PG 29 WC Communication; Health Policy & Services SC Communication; Health Care Sciences & Services GA 516UE UT WOS:000173574500004 PM 11853210 ER PT J AU Rosen, HR Miner, C Sasaki, AW Lewinsohn, DM Conrad, AJ Bakke, A Bouwer, HGA Hinrichs, DJ AF Rosen, HR Miner, C Sasaki, AW Lewinsohn, DM Conrad, AJ Bakke, A Bouwer, HGA Hinrichs, DJ TI Frequencies of HCV-specific effector CD4+T cells by flow cytometry: Correlation with clinical disease stages SO HEPATOLOGY LA English DT Article ID HEPATITIS-C VIRUS; CD4(+) T-CELLS; IMMUNE-RESPONSES; FOLLOW-UP; INFECTION; LIVER; LYMPHOCYTES; VIREMIA; MECHANISM; SUBTYPES AB Hepatitis C virus (HCV) is the leading cause of chronic hepatitis, affecting approximately 2% of the world's population. The immune mechanisms responsible for the highly variable natural history in a given individual are unknown. We used a multiparameter flow cytometric technique to functionally and phenotypically characterize HCV-specific effector T cells in the peripheral blood of 32 individuals with different stages of hepatitis C disease (resolved, mild chronic, advanced chronic) and normal controls. We found the highest frequencies of virus-specific effector cells with an activated memory phenotype (CD45RO+CD69+) in subjects who had resolved HCV infection, either spontaneously or with antiviral therapy. Effector cells from patients with resolved infection produced Th I type cytokines following stimulation with nonstructural antigens (NS3 and NS4), whereas effector cells from chronically infected patients produced Th1 type cytokines predominantly following stimulation with the HCV core antigen. Stimulation with superantigen staphylococcal enterotoxin (SEB) induced the same levels of cytokine production in the different patient groups. Among the HCV-seropositive patients, viral load inversely correlated with the Th1 effector cell response to NS3. Interleukin (IL)-4 was produced only in response to the control antigens, but not in response to the HCV recombinant proteins. Taken together, these findings suggest that a vigorous HCV-specific CD4+ Th1 response, particularly against the nonstructural proteins of the virus, may be associated with viral clearance and protection from disease progression. Prospective studies using this new flow cytometric assay will be required to determine whether antiviral therapy modifies the frequency, specificity, and function of these virus-specific effector cells. C1 Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Dept Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Dept Mol Microbiol & Immunol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Dept Gastroenterol Hepatol & Liver Transplantat, Portland, OR 97201 USA. Natl Inst Genet, Los Angeles, CA USA. Providence Med Ctr, Earle A Chiles Res Inst, Portland, OR USA. RP Rosen, HR (reprint author), Portland Vet Affairs Med Ctr, Div Gastroenterol Hepatol, 3710 SW US Vet Hosp Rd,P3-GI Portland, Portland, OR 97207 USA. RI Lewinsohn, David/I-4936-2013 OI Lewinsohn, David/0000-0001-9906-9494 NR 38 TC 139 Z9 148 U1 0 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD JAN PY 2002 VL 35 IS 1 BP 190 EP 198 DI 10.1053/jhep.2002.30293 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 506QM UT WOS:000172983300025 PM 11786976 ER PT J AU Andrulis, IL Anton-Culver, H Beck, J Bove, B Boyd, J Buys, S Godwin, AK Hopper, JL Li, F Neuhausen, SL Ozcelik, H Peel, D Santella, RM Southey, MC van Orsouw, NJ Venter, DJ Vijg, J Whittemore, AS AF Andrulis, IL Anton-Culver, H Beck, J Bove, B Boyd, J Buys, S Godwin, AK Hopper, JL Li, F Neuhausen, SL Ozcelik, H Peel, D Santella, RM Southey, MC van Orsouw, NJ Venter, DJ Vijg, J Whittemore, AS CA Cooperative Family Registry Breast TI Comparison of DNA- and RNA-based methods for detection of truncating BRCA1 mutations SO HUMAN MUTATION LA English DT Article DE BRCA1; molecular testing; two-dimensional gene scanning; TDGS; DHPLC; enzymatic mutation detection; EMD; single strand conformation polymorphism analysis; SSCP; protein truncation test; PTT ID T4 ENDONUCLEASE-VII; 2-DIMENSIONAL ELECTROPHORESIS; SIGNAL PEPTIDASE; OVARIAN-CANCER; SCANNING TESTS; CODING REGION; BREAST-CANCER; GENE; SEQUENCE; COST AB A number of methods are used for mutational analysis of BRCA1, a large multi-exon gene. A comparison was made of five methods to detect mutations generating premature stop codons that are predicted to result in synthesis of a truncated protein in BRCA1. These included four DNA-based methods: two-dimensional gene scanning (TDGS), denaturing high performance liquid chromatography (DHPLC), enzymatic mutation detection (EMD), and single strand conformation polymorphism analysis (SSCP) and an RNA/DNA-based protein truncation test (PTT) with and without complementary 5' sequencing. DNA and RNA samples isolated from 21 coded lymphoblastoid cell line samples were tested. These specimens had previously been analyzed by direct automated DNA sequencing, considered to be the optimum method for mutation detection. The set of 21 cell lines included 14 samples with 13 unique frameshift or nonsense mutations, three samples with two unique splice site mutations, and four samples without deleterious mutations. The present study focused on the detection of protein-truncating mutations, those that have been reported most often to be disease-causing alterations that segregate with cancer in families. PTT with complementary 5' sequencing correctly identified all 15 deleterious mutations. Not surprisingly, the DNA-based techniques did not detect a deletion of exon 22. EMD and DHPLC identified all of the mutations with the exception of the exon 22 deletion. Two mutations were initially missed by TDGS, but could be detected after slight changes in the test design, and five truncating mutations were missed by SSCP It will continue to be important to use complementary methods for mutational analysis. C1 Mt Sinai Hosp, Fred A Litwin Ctr Canc Genet, Samuel Lunenfeld Res Inst, Toronto, ON M5G 1X5, Canada. Univ Toronto, Dept Mol & Med Genet, Toronto, ON, Canada. Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada. Univ Calif Irvine, Div Epidemiol, Irvine, CA USA. Coriell Inst Med Res, Camden, NJ USA. Fox Chase Canc Ctr, New York, NY USA. Mem Sloan Kettering Canc Ctr, Dept Surg, New York, NY 10021 USA. Univ Utah, Huntsman Canc Inst, Salt Lake City, UT USA. Univ Melbourne, Ctr Genet Epidemiol, Parkville, Vic 3052, Australia. Harvard Univ, Ctr Canc, Boston, MA 02114 USA. Univ Utah, Dept Med Informat, Salt Lake City, UT 84112 USA. Columbia Univ, New York, NY 10032 USA. Univ Texas, Ctr Hlth Sci, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Melbourne, Dept Pathol, Parkville, Vic 3052, Australia. Stanford Univ, Sch Med, Dept Hlth Res & Policy, Stanford, CA 94305 USA. RP Andrulis, IL (reprint author), Mt Sinai Hosp, Fred A Litwin Ctr Canc Genet, Samuel Lunenfeld Res Inst, 600 Univ Ave, Toronto, ON M5G 1X5, Canada. RI Andrulis, Irene/E-7267-2013 FU NCI NIH HHS [U01 CA78296, CA74415, R01CA78564, R35 CA47448, U01 CA69398, U01 CA69417, U01 CA69446, U01 CA69467, U01 CA69631, U01 CA69638] NR 40 TC 63 Z9 63 U1 1 U2 3 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 1059-7794 J9 HUM MUTAT JI Hum. Mutat. PY 2002 VL 20 IS 1 BP 65 EP 73 DI 10.1002/humu.10097 PG 9 WC Genetics & Heredity SC Genetics & Heredity GA 571XM UT WOS:000176744500008 PM 12112659 ER PT J AU Cooper, RA Corfman, TA Fitzgerald, SG Boninger, ML Spaeth, DM Ammer, W Arva, J AF Cooper, RA Corfman, TA Fitzgerald, SG Boninger, ML Spaeth, DM Ammer, W Arva, J TI Performance assessment of a pushrim-activated power-assisted wheelchair control system SO IEEE TRANSACTIONS ON CONTROL SYSTEMS TECHNOLOGY LA English DT Article DE gain scheduling; human machine interface; power-assist; user interface; wheelchair ID BODY-WEIGHT; PROPULSION; BIOMECHANICS; RESPONSES; KINETICS; FORCES AB Wheelchairs are an important form of mobility ibr people with disabilities. For many years, there have only been three wheelchair varieties: electric powered wheelchairs, scooters, and manual wheelchairs. Recently there has been development of wheelchairs that use a combination of human power and electric power. The human power is delivered by the arms through the pushrims while the electric power is delivered by a battery through two electric motors. The shared control system for a pushrim-activated power-assisted wheelchair (PAPAW) must account for the human behavior and the interaction with the device. The PAPAW uses a form of gain scheduling based. upon events recorded from the pushrim torque. The control system significantly altered (p < 0.05) selected variables from pushrim torque curves for manual wheelchair propulsion and PAPAW operation as desired. The peak torque was reduced by over 50%, and the time on the rim was nearly doubled with the PAPAW. The PAPAW provided intuitive control and was capable of significantly reducing the strain on the upper extremities commonly associated with secondary disabling conditions among manual wheelchair users. C1 VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15261 USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs, Pittsburgh, PA 15206 USA. OI Boninger, Michael/0000-0001-6966-919X NR 23 TC 66 Z9 66 U1 2 U2 7 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI NEW YORK PA 345 E 47TH ST, NEW YORK, NY 10017-2394 USA SN 1063-6536 J9 IEEE T CONTR SYST T JI IEEE Trans. Control Syst. Technol. PD JAN PY 2002 VL 10 IS 1 BP 121 EP 126 DI 10.1109/87.974345 PG 6 WC Automation & Control Systems; Engineering, Electrical & Electronic SC Automation & Control Systems; Engineering GA 506WY UT WOS:000172995800014 ER PT J AU Reilly, CM Gilkeson, GS AF Reilly, CM Gilkeson, GS TI Use of genetic knockouts to modulate disease expression in a murine model of lupus, MRL/lpr mice SO IMMUNOLOGIC RESEARCH LA English DT Article DE lupus; mouse; knock out; autoimmune ID NITRIC-OXIDE SYNTHASE; TERMINAL DEOXYNUCLEOTIDYL TRANSFERASE; AUTOREACTIVE T-CELLS; MRL-LPR/LPR MICE; AUTOIMMUNE KIDNEY-DISEASE; B-CELLS; SYSTEMIC AUTOIMMUNITY; RHEUMATOID-ARTHRITIS; MRL-FAS(LPR) MICE; LPR MICE AB MRL-MPJ Fas(1pr) (MRL/1pr) mice are a prototypic murine model for lupus characterized by an accelerated autoimmune syndrome. Disease begins as early as 8-wk-of-age in these animals with polyclonal B cell activation and elevated levels of serum IgM. By 12 to 16-wk-of-age MRL/1pr mice begin to produce a variety of autoantibodies including anti-dsDNA and anti-ss-DNA antibodies. From 16 to 24 wk, MRL/1pr mice develop proliferative immune complex mediated glomerulonephritis, vasculitis, arthritis, and massive lymphadenopathy that results in renal failure and death in 50% of the mice by 24-wk-of-age. This review will discuss several different genetic knockout experimental approaches used to study disease expression in MRL/1pr mice including various approaches in our laboratory aimed at autoantibody (Ab) production and inflammatory mediators. C1 Med Univ S Carolina, Med Res Serv, Div Rheumatol & Immunol, Ralph H Johnson VAMC, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Reilly, CM (reprint author), Med Univ S Carolina, Med Res Serv, Div Rheumatol & Immunol, Ralph H Johnson VAMC, 96 Jonathon Lucas St,Suite 912,POB 25063, Charleston, SC 29425 USA. FU NIAMS NIH HHS [R01AR45499] NR 94 TC 25 Z9 25 U1 0 U2 2 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0257-277X J9 IMMUNOL RES JI Immunol. Res. PY 2002 VL 25 IS 2 BP 143 EP 153 DI 10.1385/IR:25:2:143 PG 11 WC Immunology SC Immunology GA 535CZ UT WOS:000174628800004 PM 11999168 ER PT S AU Palmer, JP AF Palmer, JP BE Sanjeevi, CB TI Beta cell rest and recovery - Does it bring patients with latent autoimmune diabetes in adults to euglycemia? SO IMMUNOLOGY OF DIABETES: AUTOIMMUNE MECHANISMS AND THE PREVENTION AND CURE OF TYPE 1 DIABETES SE Annals of the New York Academy of Sciences LA English DT Article; Proceedings Paper CT 5th Meeting of the Immunology-of-Diabetes-Society CY FEB 14-16, 2001 CL CHENNAI, INDIA SP Immunol Diabetes Soc DE LADA; type 1.5 diabetes; type 2 diabetes; beta cell rest ID GLUTAMIC-ACID DECARBOXYLASE; ENDOGENOUS INSULIN-SECRETION; RETROVIRAL ANTIGEN P73; FUNCTIONAL-STATE; HIGH-RISK; LYMPHOCYTIC THYROIDITIS; SUBCUTANEOUS INSULIN; ANTITHYROID DRUGS; ADOPTIVE TRANSFER; RANDOMIZED-TRIAL AB Diabetes mellitus in humans is a heterogeneous disorder classified clinically into two main types. The diagnosis of type 1 versus type 2 diabetes is made phenotypically using criteria such as age at onset, abruptness of hyperglycemic symptoms, presence of ketosis, degree of obesity and the perceived need for insulin replacement. The pathogeneses of type 1 and type 2 diabetes are believed to be different. Type I diabetes is an autoimmune disease mediated by cellular effector mechanisms; whereas classic type 2 diabetes is not autoimmune but results from insulin resistance and a nonautoimmune insulin secretory defect. Most type 1 diabetes patients are diagnosed in childhood or young adulthood before the age of 35 years. However, there is clearly a subgroup of patients clinically diagnosed with type 2 diabetes who are greater than 35 years of age and have evidence of autoimmunity. The disease of these autoantibody-positive type 2 diabetics is often termed latent autoimmune diabetes in adults (LADA), slowly progressive type I diabetes, latent type 1 diabetes, and type 1.5 diabetes. This group of patients comprises approximately 10-15% of Caucasian type 2 diabetes patients. Type 1.5 diabetes patients tend to present with islet cell autoantibodies, islet-reactive T cells, higher HbA(1c) levels, lower C peptide, and a propensity toward insulin dependency compared to autoantibody-negative classic type 2 diabetes subjects. C1 VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98198 USA. RP Palmer, JP (reprint author), VA Puget Sound Hlth Care Syst, Dept Med, 1660 S Columbian Way, Seattle, WA 98198 USA. EM jpp@u.washington.edu NR 79 TC 12 Z9 13 U1 0 U2 2 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-362-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2002 VL 958 BP 89 EP 98 PG 10 WC Endocrinology & Metabolism; Multidisciplinary Sciences SC Endocrinology & Metabolism; Science & Technology - Other Topics GA BU76Q UT WOS:000176952100011 PM 12021087 ER PT J AU Chang, MP Wang, Q Norman, DC AF Chang, MP Wang, Q Norman, DC TI Diminished proliferation of B blast cell in response to cytokines in ethanol-consuming mice SO IMMUNOPHARMACOLOGY AND IMMUNOTOXICOLOGY LA English DT Article ID RETROVIRUS INFECTION; MURINE AIDS; OLD MICE; T-CELLS; ALCOHOL; EXPRESSION; MECHANISM; IL-4; CONSUMPTION; IMMUNE AB We and others have demonstrated that ethanol suppresses the antibody response in humans and animals. The purpose of this study was to determine whether ethanol affects cytokine-induced proliferative responses of splenic B blast cells, and whether the decreased response was due to an imbalance of the cytokine activity. Thus, the ability of spleen cells from individual ethanol-diet-fed C57BL/6 mice to proliferate and produce cytokines was determined. The ability of anti-IgM monoclonal antibodies (mAb)-activated splenic B blast cells in response to mouse recombinant IL-2 (rIL-2) or rIL-4 was also assessed. A thymidine incorporation assay was used to determine cell proliferation, and the conventional bioassays for cytokine-dependent cell proliferation were used for determining the bioactivity of cytokines. Data were analyzed with general linear model procedure. Our results showed that ethanol weakened the proliferative response of B cells in response to mitogen as well as to mouse rIL-2 and rIL-4. The decreased B cell responses may result from an increase in the production of IL-4 by helper T cells. Finally, in the presence of excessive dose of rIL-4, the proliferative responses of B blast cells from all three groups of mice were diminished (p < 0.01). Thus, our data clearly indicated that the diminished B cell proliferation in ethanol-consuming mice was due in part to an excessive amount of IL-4 produced and an inability of the B cell to interact properly with IL-4 that was secreted by helper T cells. The results should extend our basic understanding of the mechanism by which chronic alcoholism impairs the interactions and interdependence of T- and B-cell immune functions. C1 W Los Angeles Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90025 USA. RP Chang, MP (reprint author), W Los Angeles Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 40 TC 5 Z9 6 U1 0 U2 0 PU MARCEL DEKKER INC PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 USA SN 0892-3973 J9 IMMUNOPHARM IMMUNOT JI Immunopharmacol. Immunotoxicol. PY 2002 VL 24 IS 1 BP 69 EP 82 DI 10.1081/IPH-120003404 PG 14 WC Immunology; Pharmacology & Pharmacy; Toxicology SC Immunology; Pharmacology & Pharmacy; Toxicology GA 553DJ UT WOS:000175660100006 PM 12022446 ER PT J AU Matsunaga, J Young, TA Barnett, JK Barnett, D Bolin, CA Haake, DA AF Matsunaga, J Young, TA Barnett, JK Barnett, D Bolin, CA Haake, DA TI Novel 45-kilodalton leptospiral protein that is processed to a 31-kilodalton growth-phase-regulated peripheral membrane protein SO INFECTION AND IMMUNITY LA English DT Article ID INTERROGANS SEROVAR HARDJO; OUTER-MEMBRANE; BORRELIA-BURGDORFERI; TREPONEMA-PALLIDUM; PATHOGENIC LEPTOSPIRA; MOLECULAR-CLONING; IMMUNOLOGICAL CHARACTERIZATION; MAMMALIAN INFECTION; SEQUENCE-ANALYSIS; IN-VIVO AB Leptospiral protein antigens are of interest as potential virulence factors and as candidate serodiagnostic and immunoprotective reagents. We identified leptospiral protein antigens by screening a genomic expression library with serum from a rabbit hyperimmunized with formal in-killed, virulent Leptospira kirschneri serovar grippotyphosa. Genes expressing known outer membrane lipoproteins LipL32 and LipL41, the heat shock protein GroEL, and the alpha, beta, and beta' subunits of RNA polymerase were isolated from the library. In addition, a new leptospiral gene that in Escherichia coli expressed a 45-kDa antigen with an amino-terminal signal peptide followed by the spirochetal lipobox Val(-4)-Phe(-3)-Asn(-2)-Ala(-1) down arrow Cys(+1) was isolated. We designated this putative lipoprotein LipL45. Immunoblot analysis of a panel of Leptospira strains probed with LipL45 antiserum demonstrated that many low-passage strains expressed LipL45. In contrast, LipL45 was not detected in high-passage, culture-attenuated strains, suggesting that LipL45 is a virulence-associated protein. In addition, all leptospiral strains tested, irrespective of culture passage, expressed a 31-kDa antigen that was recognized by LipL45 antiserum. Southern blot and peptide mapping studies indicated that this 31-kDa antigen was derived from the carboxy terminus of LipL45; therefore, it was designated P31(LipL35). Membrane fractionation studies demonstrated that P31(LipL45) is a peripheral membrane protein. Finally, we found that P31(LipL45) levels increased as Leptospira entered the stationary phase, indicating that P31(LipL45) levels were regulated. Hamsters infected with L. kirschneri formed an antibody response to LipL45, indicating that LipL45 was expressed during infection. Furthermore, the immunohistochemistry of kidneys from infected hamsters indicated that LipL45 was expressed by L. kirschneri that colonized the renal tubule. These observations suggest that expression of LipL45 responds to environmental cues, including those encountered during infection of a mammalian host. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ So Indiana, Dept Biol, Evansville, IN 47712 USA. Michigan State Univ, Coll Vet Med, E Lansing, MI 48824 USA. RP Matsunaga, J (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Bldg 113,Room 306, Los Angeles, CA 90073 USA. FU NIAID NIH HHS [R21 AI034431-06, AI-34431, R01 AI034431, R21 AI034431, R29 AI034431] NR 56 TC 41 Z9 42 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD JAN PY 2002 VL 70 IS 1 BP 323 EP 334 DI 10.1128/IAI.70.1.323-334.2002 PG 12 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 504FX UT WOS:000172847600043 PM 11748198 ER PT J AU Hoffman, TJ Gali, H Sieckman, GL Owen, NK Mazuru, DG Forte, LR Volkert, WA AF Hoffman, TJ Gali, H Sieckman, GL Owen, NK Mazuru, DG Forte, LR Volkert, WA TI Development of a new indium-111 labeled Escherichia coli st(h) analog for specific-targeting of human colorectal cancers SO INTERNATIONAL JOURNAL OF CANCER LA English DT Meeting Abstract C1 Univ Missouri, Columbia, MO USA. US Dept Vet Affairs, Columbia, MO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0020-7136 J9 INT J CANCER JI Int. J. Cancer PY 2002 SU 13 BP 225 EP 225 PG 1 WC Oncology SC Oncology GA 565PP UT WOS:000176378900717 ER PT J AU Hoffman, TJ Smith, CJ Gali, H Owen, NK Sieckman, GL Foster, BN Mazuru, DG Shelton, TD Volkert, WA AF Hoffman, TJ Smith, CJ Gali, H Owen, NK Sieckman, GL Foster, BN Mazuru, DG Shelton, TD Volkert, WA TI Preclinical evaluation of Y-90 and Lu-177 radiolabeled peptides for in vivo targeted radiotherapy of prostate cancer SO INTERNATIONAL JOURNAL OF CANCER LA English DT Meeting Abstract C1 US Dept Vet Affairs, Columbia, MO USA. Univ Missouri, Columbia, MO 65211 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0020-7136 J9 INT J CANCER JI Int. J. Cancer PY 2002 SU 13 BP 462 EP 463 PG 2 WC Oncology SC Oncology GA 565PP UT WOS:000176378901490 ER PT J AU Kampman, KM Pettinati, H Volpicelli, J Kaempf, G Turk, E Insua, A Lipkin, C Sparkman, T O'Brien, CP AF Kampman, KM Pettinati, H Volpicelli, J Kaempf, G Turk, E Insua, A Lipkin, C Sparkman, T O'Brien, CP TI Concurrent cocaine withdrawal alters alcohol withdrawal symptoms SO JOURNAL OF ADDICTIVE DISEASES LA English DT Article DE cocaine; alcohol; withdrawal; detoxification ID HUMANS; COCAETHYLENE; SEVERITY; DEPENDENCE; DISORDERS; ADDICTION; ABUSERS; MODEL AB This study compares alcohol withdrawal severity during outpatient detoxification in alcohol dependent subjects (ALC) and in subjects dependent on both alcohol and cocaine (ALC/COC). Subjects included 123 ALC and 66 ALC/COC subjects. Baseline demographic and drug use variables, alcohol withdrawal symptoms, and the total amount of oxazepam taken during alcohol detoxification were compared between the two groups. Compared to ALC subjects, ALC/COC subjects were younger, more likely to be African-American, and had less severe histories of alcohol dependence. However, alcohol withdrawal symptom severity did not differ significantly between the two groups. Nevertheless, controlling for differences in alcohol use history, ALC/COC subjects still received less oxazepam than did ALC subjects to treat alcohol withdrawal symptoms. Despite similar intensity of alcohol withdrawal symptoms, ALC/COC subjects received less oxazepam to treat alcohol withdrawal symptoms compared to ALC subjects. Both subject and clinician factors may explain the difference in oxazepam use. C1 Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Kampman, KM (reprint author), Univ Penn, Treatment Res Ctr, 3900 Chestnut St, Philadelphia, PA 19104 USA. FU NIDA NIH HHS [P60 DA051186] NR 25 TC 2 Z9 2 U1 3 U2 3 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 1055-0887 J9 J ADDICT DIS JI J. Addict. Dis. PY 2002 VL 21 IS 4 BP 13 EP 26 DI 10.1300/J069v21n04_02 PG 14 WC Substance Abuse SC Substance Abuse GA 606BC UT WOS:000178711900002 PM 12296498 ER PT J AU Nguyen, R Yu, FC Klaustermeyer, WB AF Nguyen, R Yu, FC Klaustermeyer, WB TI Response to cyclosporin in tacrolimus resistant patient with atopic dermatitis SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract C1 Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD JAN PY 2002 VL 109 IS 1 SU S MA 1089 BP S349 EP S349 DI 10.1016/S0091-6749(02)82223-0 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 519UX UT WOS:000173744801085 ER PT J AU Yu, FC Klaustermeyer, WB AF Yu, FC Klaustermeyer, WB TI Cholinergic urticaria associated with acquired hypohidrosis in an HIV-positive patient SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract C1 Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD JAN PY 2002 VL 109 IS 1 SU S MA 366 BP S127 EP S127 DI 10.1016/S0091-6749(02)81502-0 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 519UX UT WOS:000173744800365 ER PT J AU Amory, JK Anawalt, BD Blaskovich, PD Gilchriest, J Nuwayser, ES Matsumoto, AM AF Amory, JK Anawalt, BD Blaskovich, PD Gilchriest, J Nuwayser, ES Matsumoto, AM TI Testosterone release from a subcutaneous, biodegradable microcapsule formulation (Viatrel) in hypogonadal men SO JOURNAL OF ANDROLOGY LA English DT Article DE hypogonadism; poly-lactide-co-glycolide; pharmacokinetics; androgen; dihydrotestosterone; estradiol ID ANDROGEN REPLACEMENT; THERAPY; PHARMACOKINETICS; UNDECANOATE; DENSITY; MOOD AB Men with hypogonadism require testosterone replacement for optimal health. In the United States, testosterone is currently administered by daily transdermal patches, topical gels or intramuscular injections every 1-3 weeks. Biodegradable polylactide-co-glycolide microcapsules are currently used for long-term drug delivery in humans. Such microcapsules that contain testosterone could provide a better means of long-term testosterone therapy. We therefore studied the pharmacokinetics and pharmacodynamics of testosterone release from testosterone microcapsules in men with hypogonadism. Fourteen men who had been treated previously with testosterone were enrolled in an open-label, prospective study of testosterone microcapsule administration, Subjects were enrolled if 2 consecutive serum total testosterone levels were lower than 8.7 nmol/L after a 4-week washout from testosterone therapy. Subjects were injected with a single dose of either 267 mg (n = 7) or 534 mg (n = 7) of (Viatrel) testosterone microcapsule, and serum total testosterone, dihydrotestosterone, estradiol, sex-hormone binding globulin, luteinizing hormone, and follicle-stimulating hormone levels were determined at days -14, -7, and 0 before the injection; at days 1, 2, and 7 after the injection; and then weekly thereafter for 8-12 weeks. Mean serum total testosterone levels peaked immediately following injection on day 1 at 25.2 +/- 2.6 nmol/L in the 267 mg group and 34.7 +/- 2.4 nmol/L in the 534 mg group. Total serum testosterone levels declined gradually and fell below 8.7 nmol/L at 42 days after injection in the 267 mg group, and 70 days after injection in the 534 mg group. Estradiol and dihydrotestosterone levels followed a similar pattern. Mean serum free testosterone also peaked immediately following injection on day 1 at 0.51 +/- 0.05 nmol/L in the 267 mg group and 0.97 +/- 0.08 nmol/L in the 534 mg group. No significant adverse reactions were seen, although 2 subjects complained of transient tenderness and fullness at their injection sites. We conclude that a single injection of 534 mg of testosterone microcapsules to men with hypogonadism normalizes serum hormone levels for up to 10-11 weeks, albeit with a pronounced early peak and a relatively long period of low-normal serum total testosterone. Subcutaneously administered testosterone microcapsules may provide a safe and convenient method for the long-term treatment of male hypogonadism or testosterone replacement in male contraceptive regimens. C1 Univ Washington, Dept Med, Sch Med, Seattle, WA 98185 USA. Vet Affairs Puget Sound Hlth Care Syst, Populat Ctr Res Reprod, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. Biotek Inc, Woburn, MA USA. RP Amory, JK (reprint author), Univ Washington, Dept Med, Sch Med, 1959 NE Pacific St, Seattle, WA 98185 USA. FU NCRR NIH HHS [2RR4 HD20347-02A1] NR 18 TC 14 Z9 17 U1 1 U2 3 PU AMER SOC ANDROLOGY, INC PI LAWRENCE PA C/O ALLEN PRESS, INC PO BOX 368, LAWRENCE, KS 66044 USA SN 0196-3635 J9 J ANDROL JI J. Androl. PD JAN-FEB PY 2002 VL 23 IS 1 BP 84 EP 91 PG 8 WC Andrology SC Endocrinology & Metabolism GA 504EA UT WOS:000172843300015 PM 11780927 ER PT J AU Oh, Y Osato, MS Han, X Bennett, G Hong, WK AF Oh, Y Osato, MS Han, X Bennett, G Hong, WK TI Folk yoghurt kills Helicobacter pylori SO JOURNAL OF APPLIED MICROBIOLOGY LA English DT Article ID INFECTION; BACTERIOCINS; HUMANS AB Aims: To evaluate a traditional yoghurt used as folk medicine for its ability to kill Helicobacter pylori in vitro. Methods and Results: Micro-organisms from the yoghurt were identified and tested in different food substrates for their effects on H. pylori in a co-culture well system. Two yeasts and several strains of lactobacilli were isolated from the yoghurt, and both the yeast and the lactobacilli independently showed cidal activity against H. pylori. The microbes from the original yoghurt also retained their cidal effect when grown in corn meal and soy milk. Conclusions: The yeast and lactobacilli found in this yoghurt form a hardy symbiotic culture. The organisms secrete soluble factors capable of killing H. pylori, and these factors may include some organic by-products of fermentation. Significance and Impact of the Study: These yoghurt-derived food preparations could become simple and inexpensive therapies to suppress H. pylori infections in endemic countries. C1 Univ Texas, MD Anderson Canc Ctr, Dept Thorac Head & Neck Med Oncol, Houston, TX 77030 USA. Vet Adm Hosp, Dept Gastroenterol, Houston, TX USA. Univ Texas, MD Anderson Canc Ctr, Dept Microbiol Lab Med, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Div Canc Med, Houston, TX 77030 USA. Rice Univ, Dept Biochem, Houston, TX 77251 USA. RP Oh, Y (reprint author), Univ Texas, MD Anderson Canc Ctr, Dept Thorac Head & Neck Med Oncol, Box 432,1515 Holcombe Blvd, Houston, TX 77030 USA. FU NCI NIH HHS [CA16672] NR 14 TC 29 Z9 32 U1 0 U2 4 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 1364-5072 J9 J APPL MICROBIOL JI J. Appl. Microbiol. PY 2002 VL 93 IS 6 BP 1083 EP 1088 DI 10.1046/j.1365-2672.2002.01779.x PG 6 WC Biotechnology & Applied Microbiology; Microbiology SC Biotechnology & Applied Microbiology; Microbiology GA 618GN UT WOS:000179410500020 PM 12452966 ER PT J AU Friedrichs, WE Reddy, SV Bruder, JM Cundy, T Cornish, J Singer, FR Roodman, GD AF Friedrichs, WE Reddy, SV Bruder, JM Cundy, T Cornish, J Singer, FR Roodman, GD TI Sequence analysis of measles virus nucleocapsid transcripts in patients with Paget's disease SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article DE Paget's disease; measles virus nucleocapsid transcripts; osteoclasts; polymerase chain reaction ID CANINE-DISTEMPER VIRUS; POLYMERASE CHAIN-REACTION; BONE TISSUE; CELLS; OSTEOCLASTS; MUTATIONS; ANTIGENS; CULTURES; ABSENCE; RNA AB It has been debated for almost 30 years whether Paget's disease of bone results from paramyxoviral infection of osteoclasts (OCs). Paramyxoviral-like nuclear inclusions are found in OCs from patients with Paget's disease, and measles virus (MV) or canine distemper virus (CDV) messenger RNA (mRNA) transcripts have been detected by in situ hybridization in bone cells from pagetic lesions. Furthermore, immunocytochemical studies have shown the presence of several paramyxoviral species in OCs from patients with Paget's disease. However, others have been unable to detect paramyxoviral transcripts in bone samples from patients with Paget's disease or marrow cultures from involved sites of patients with Paget's disease. Furthermore, no one has been able to isolate an infectious virus from pagetic bone samples or marrow cells from patients with Paget's disease, and a full-length viral gene has not been sequenced from pagetic samples. In this study, we have obtained the full-length sequence for the MV nucleocapsid (MVNP) gene in bone marrow from an involved site from a patient with Paget's disease and more than 700 base pairs (bps) of MVNP sequence in 3 other patients with Paget's disease. These sequences were undetectable in four normal marrow samples studied simultaneously. The sequences from the patients contained multiple mutations that differed from the Edmonston strain MVNP gene. These findings are consistent with the presence of a chronic MV infection in affected sites from these patients with Paget's disease. C1 Univ Texas, Hlth Sci Ctr, Dept Med Hematol, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med Endocrinol, San Antonio, TX USA. Univ Auckland, Auckland 1, New Zealand. John Wayne Canc Inst, Santa Monica, CA USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX USA. RP Roodman, GD (reprint author), E1152 Biomed Sci Tower,200 Lothrup, Pittsburgh, PA 15261 USA. OI Cundy, Timothy/0000-0003-4890-9400 FU NIA NIH HHS [AG13625]; NIAMS NIH HHS [AR44603]; NIDCR NIH HHS [DE12603] NR 25 TC 58 Z9 63 U1 1 U2 1 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD JAN PY 2002 VL 17 IS 1 BP 145 EP 151 DI 10.1359/jbmr.2002.17.1.145 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 502EH UT WOS:000172730400017 PM 11771661 ER PT J AU Tang, SJ Nieto, JM Jensen, DM Ohning, GV Pisegna, JR AF Tang, SJ Nieto, JM Jensen, DM Ohning, GV Pisegna, JR TI The novel use of an intravenous proton pump inhibitor in a patient with short bowel syndrome SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Article DE intravenous proton pump inhibitor; pantoprazole; short bowel syndrome ID PANTOPRAZOLE AB Recent evidence suggests that parenteral proton pump inhibitors (PPIs) can effectively control gastric acid hypersecretion. Intravenous PPI (omeprazole) can substantially reduce the risk of recurrent bleeding in patients with peptic ulcer disease. We describe a patient with short bowel syndrome who had recurrent life-threatening upper gastrointestinal bleeding from severe gastric and esophageal ulcerations. The patient had failed long-terns maximal-dose intravenous ranitidine therapy but was successfully treated and maintained on long-term therapy with an intravenous PPI (pantoprazole). To our knowledge, this is the first case report in the literature describing the use of an intravenous PPI to treat upper gastrointestinal bleeding in a patient with complete intestinal resection. Intravenous PPIs should be considered as the first line of treatment of erosive esophagitis and peptic ulcer disease in patients with short bowel syndrome and in patients who are nil per os and who fail intravenous H-2-receptor antagonist treatment. Parenteral PPI may also be the drug of choice in intensive care patients who have erosive esophagitis. Furthermore, this is the first case report describing the novel use of intravenous pantoprazole to treat erosive esophagitis in a patient with short bowel syndrome, suggesting that intravenous PPI may also be useful for the treatment of ulcer prophylaxis in patients undergoing intestinal transplantation. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. RP Pisegna, JR (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, 111C,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 6 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD JAN PY 2002 VL 34 IS 1 BP 62 EP 63 DI 10.1097/00004836-200201000-00012 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 506UZ UT WOS:000172991300012 PM 11743248 ER PT J AU Caroff, SN Mann, SC Campbell, EC Sullivan, KA AF Caroff, SN Mann, SC Campbell, EC Sullivan, KA TI Movement disorders associated with atypical antipsychotic drugs SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Meeting on Safety Profiles of Mood Stabilizers Antipsychotics and Broad Spectrum Psychotropics CY AUG 29-30, 2001 CL AMELIA ISLAND, FLORIDA ID NEUROLEPTIC MALIGNANT SYNDROME; PLACEBO-CONTROLLED TRIAL; CHRONIC-SCHIZOPHRENIC PATIENTS; LEVODOPA-INDUCED DYSKINESIAS; TARDIVE-DYSKINESIA; DOUBLE-BLIND; PARKINSONS-DISEASE; SCHIZOAFFECTIVE DISORDER; PSYCHOTIC DISORDERS; ACUTE EXACERBATION AB Data from clinical trials reviewed in this article fulfill predictions based on preclinical findings that atypical antipsychotic drugs are associated with a reduced potential for inducing extrapyramidal symptoms (EPS) and other movement disorders. Atypical drugs have been shown to reduce all subtypes of acute EPS, the frequency of EPS-related patient dropouts, and the need for concomitant antiparkinsonian drug use. Clozapine remains superior to other atypicals in treating psychosis without worsening motor symptoms in patients with Parkinson's disease. Atypicals may be selectively advantageous in treating schizophrenic patients with a predisposition to catatonia. Although the risk of developing lethal neuroleptic malignant syndrome may be diminished with atypical drugs, clinicians must remain alert to the signs of this disorder. Atypicals have reduced liability for inducing tardive dyskinesia (TD) and show antidyskinetic properties in patients with preexisting TD. Passive resolution of TD may be facilitated in some patients by the use of these agents. Thus, the risk of movement disorders has become only one of several considerations in choosing among antipsychotic drugs. C1 Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Caroff, SN (reprint author), Dept Vet Affairs Med Ctr, Univ Ave,Ward 7 E-116A, Philadelphia, PA 19104 USA. NR 137 TC 81 Z9 85 U1 2 U2 4 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PY 2002 VL 63 SU 4 BP 12 EP 19 PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 534TR UT WOS:000174603300002 PM 11913670 ER PT J AU Rasgon, NL Altshuler, LL Fairbanks, LA Dunkin, JJ Davtyan, C Elman, S Rapkin, AJ AF Rasgon, NL Altshuler, LL Fairbanks, LA Dunkin, JJ Davtyan, C Elman, S Rapkin, AJ TI Estrogen replacement therapy in the treatment of major depressive disorder in perimenopausal women SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Closed Roundtable Symsosium on Womens Issues in Antidepressant Therapy CY JUN 12, 2000 CL LOS ANGELES, CALIFORNIA ID MENOPAUSAL WOMEN; BREAST-CANCER; SEROTONIN; MOOD; FLUOXETINE; STEROIDS; BRAIN; RAT AB Background: Increased vulnerability to mood disorders has been reported during perimenopause. Fluctuating estrogen levels accompany the perimenopausal transition, Thus. estrogen replacement therapy (ERT) has been proposed as a potentially effective treatment for mood disorders occurring during perimenopause. Method: We examined the efficacy of ERT in the treatment of depression in 16 perimenopausal women with DSM-IV-defined major depressive disorder who were participating in the Mood Disorders Research Program at the Department of Psychiatry of the University of California, Los Angeles. Ten antidepressant- and ERT-naive women received ERT alone. Six women who were nonresponders or partial responders to an antidepressant received ERT in addition to existing treatment with fluoxetine. The Hamilton Rating Scale for Depression (HAM-D) was administered to all patients at baseline and weekly thereafter during the 8-week open-protocol trial, Partial response was operationalized as a final HAM-D score less than or equal to 50% of the baseline score, Remission was defined as a Final HAM-D score less than or equal to 7. Results: All patients exhibited clinical improvement as measured by HAM-D scores after the first week of treatment. Of the 10 perimenopausal depressed women receiving ERT alone. 6 remitted, 3 partially responded to treatment, and I did not respond by the end of the trial. Of the 6 women receiving antidepressant treatment with ERT. I patient remitted and 5 had a partial response by the end of the trial. Conclusion: This small study suggests that for some antidepressant-naive perimenopausal women with clinical depression, ERT may have antidepressant efficacy. In depressed women who have minimal response to a selective serotonin reuptake inhibitor, ERT may augment response. Further controlled trials are needed. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Obstet & Gynecol, Los Angeles, CA 90024 USA. W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Dept Psychiat, Los Angeles, CA USA. RP Rasgon, NL (reprint author), 300 Med Plaza,Suite 1544,Box 957057, Los Angeles, CA 90095 USA. NR 27 TC 77 Z9 82 U1 2 U2 3 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PY 2002 VL 63 SU 7 BP 45 EP 48 PG 4 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 547GL UT WOS:000175324600006 PM 11995778 ER PT J AU Hussein, MR Wood, GS AF Hussein, MR Wood, GS TI Microsatellite instability in human melanocytic skin tumors: an incidental finding or a pathogenetic mechanism? SO JOURNAL OF CUTANEOUS PATHOLOGY LA English DT Editorial Material ID NONPOLYPOSIS COLON-CANCER; DNA MISMATCH REPAIR; COLORECTAL-CANCER; GASTRIC CARCINOMAS; MUTATOR PHENOTYPE; MUTATIONS; MELANOMA; HOMOLOG; REPEATS; GENES C1 Univ Wisconsin, Dept Med Dermatol, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Wood, GS (reprint author), Univ Wisconsin, Dept Med Dermatol, Madison, WI 53705 USA. FU NIAMS NIH HHS [AR01326] NR 45 TC 7 Z9 8 U1 0 U2 0 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 0303-6987 J9 J CUTAN PATHOL JI J. Cutan. Pathol. PD JAN PY 2002 VL 29 IS 1 BP 1 EP 4 DI 10.1034/j.1600-0560.2002.290101.x PG 4 WC Dermatology; Pathology SC Dermatology; Pathology GA 523TP UT WOS:000173971900001 PM 11841510 ER PT J AU Akiba, Y Nakamura, M Nagata, H Kaunitz, JD Ishii, H AF Akiba, Y Nakamura, M Nagata, H Kaunitz, JD Ishii, H TI Acid-sensing pathways in rat gastrointestinal mucosa SO JOURNAL OF GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT 43rd Annual Meeting of the Japanese-Society-of-Gastroenterology CY OCT 19-21, 2001 CL KYOTO INT CONVENT HALL, KYOTO, JAPAN SP Japanese Soc Gastroenterol HO KYOTO INT CONVENT HALL DE vanilloid receptor; capsaicin-sensitive afferent nerves; calcitonin gene-related peptide; nitric oxide; prostaglandin; indomethacin; Na+/H+ exchanger ID GENE-RELATED PEPTIDE; GUINEA-PIG ILEUM; MUCUS GEL THICKNESS; VANILLOID RECEPTOR-1; SENSORY NERVES; LOW PH; CAPSAICIN RECEPTOR; LUMINAL ACID; DUODENUM; RELEASE AB The gastrointestinal mucosa serves as the interface between the luminal contents, including nutrients and injurious substances, and submucosal structures. Secreted gastric acid is one of the principal injurious components of the luminal contents. To be protected against harm from this acid, the epithelium has an "early warning" system that can activate potent defense mechanisms. We studied the mechanisms that defend the epithelium against luminal acid-induced injury, including the regulation of epithelial intracellular pH (pH(i)), blood flow, and mucus gel secretion in the perfused rat duodenum, and the pathways involved in the activation and regulation of these mechanisms. Physiological concentrations of luminal acid acidified the epithelial cells and increased blood flow (hyperemic response) and mucus gel thickness. The hyperemic response to acid was abolished by inhibitors of the Na+/H+ exchange, vanilloid receptors (VR), calcitonin gene-related peptide (CGRP) receptors, and nitric oxide (NO) synthase, and also by sensory afferent denervation, but not by pretreatment with a nonselective cyclooxygenase (COX) inhibitor. Mucus secretion in response to luminal acid was delayed by an interruption to the capsaicin pathway, which includes VR, capsaicin-sensitive afferent nerves, CGRP, and NO, and was abolished by COX inhibition. These observations support the hypothesis that the capsaicin pathway is an acid-sensing pathway that promotes hyperemia and mucus secretion in response to luminal acid. The COX pathway is a secondary regulatory system for mucus secretion. A similar acid-sensing capsaicin pathway is also present in the colon, suggesting that the gastrointestinal mucosa "tastes" luminal acidity through epithelial-VR communication. C1 Keio Univ, Sch Med, Dept Internal Med, Shinjuku Ku, Tokyo 1608582, Japan. Kitasato Inst, Ctr Clin Pharmacol, Basic Res Ctr, Tokyo, Japan. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Digest Dis Res Ctr, Los Angeles, CA USA. CURE, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. RP Akiba, Y (reprint author), Keio Univ, Sch Med, Dept Internal Med, Shinjuku Ku, 35 Shinanomachi, Tokyo 1608582, Japan. FU NIDDK NIH HHS [R01 DK 54221] NR 35 TC 32 Z9 34 U1 0 U2 0 PU SPRINGER-VERLAG TOKYO PI TOKYO PA 3-3-13, HONGO, BUNKYO-KU, TOKYO, 113-0033, JAPAN SN 0944-1174 J9 J GASTROENTEROL JI J. Gastroenterol. PY 2002 VL 37 SU 14 BP 133 EP 138 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 617HX UT WOS:000179357200029 PM 12572881 ER PT J AU Miller, LG Liu, HH Hays, RD Golin, CE Beck, CK Asch, SM Ma, YY Kaplan, AH Wenger, NS AF Miller, LG Liu, HH Hays, RD Golin, CE Beck, CK Asch, SM Ma, YY Kaplan, AH Wenger, NS TI How well do clinicians estimate patients' adherence to combination antiretroviral therapy? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 6th Conference on Retroviruses and Opportunistic Infections CY JAN 31-FEB 04, 1999 CL CHICAGO, ILLINOIS DE adherence; compliance; HIV; clinician assessment; antiretroviral therapy ID HUMAN-IMMUNODEFICIENCY-VIRUS; LONGITUDINAL DATA; DRUG; ZIDOVUDINE; MEDICATION; NONCOMPLIANCE; SURVIVAL; REGIMEN; MODELS AB Objective: Adherence to combination antiretroviral therapy is critical for clinical and virologic success in HIV-infected patients. To combat poor adherence, clinicians must identify nonadherent patients so they can implement interventions. However, little is known about the accuracy of these assessments. We sought to describe the accuracy of clinicians' estimates of patients' adherence to combination antiretroviral therapy. Setting: Public HIV clinic. Design: Prospective cohort study. During visits, we asked clinicians (nurse practitioners, residents and fellows, and their supervising attending physicians) to estimate the percentage of antiretroviral medication taken by patients over the last 4 weeks and predicted adherence over the next 4 weeks. Adherence was measured using electronic monitoring devices, pill counts, and self-reports, which were combined into a composite adherence measure. Patients and participants: Clinicians estimated 464 episodes of adherence in 82 patients. Results: Among the 464 adherence estimates, 264 (57%) were made by principal care providers (31% by nurse practitioners, 15% by fellows, 6% by residents, and 5% by staff physicians) and 200 (43%) by supervising attending physicians. Clinicians' overestimated measured adherence by 8.9% on average (86.2% vs 77.3%). Greater clinician inaccuracy in adherence prediction was independently associated with higher CD4 count nadir (1.8% greater inaccuracy for every 100 CD4 cells, P=.005), younger patient age (3.7% greater inaccuracy for each decade of age, P=.02), and visit number (P=.02). Sensitivity of detecting nonadherent patients was poor (24% to 62%, depending on nonadherence cutoff). The positive predictive value of identifying a patient as nonadherent was 76% to 83%. Conclusions: Clinicians tend to overestimate medication adherence, Inadequately detect poor adherence, and may therefore miss important opportunities to Intervene to improve antiretroviral adherence. C1 Harbor UCLA Med Ctr, Div Infect Dis, Torrance, CA 90509 USA. Harbor UCLA Med Ctr, Div Allergy & Immunol, Torrance, CA 90509 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, AIDS Inst, Los Angeles, CA USA. Univ N Carolina, Dept Med, Chapel Hill, NC USA. Univ N Carolina, Div Infect Dis, Chapel Hill, NC USA. RP Miller, LG (reprint author), Harbor UCLA Med Ctr, Div Infect Dis, 1124 W Cardosn St,Box 466, Torrance, CA 90509 USA. RI Hays, Ronald/D-5629-2013 FU NIAID NIH HHS [AI28697, AI41413, P30 AI028697] NR 42 TC 108 Z9 110 U1 2 U2 3 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JAN PY 2002 VL 17 IS 1 BP 1 EP 11 DI 10.1046/j.1525-1497.2002.09004.x PG 11 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 542FM UT WOS:000175032900001 PM 11903770 ER PT J AU Oneta, CM Lieber, CS Li, JJ Ruttimann, S Schmid, B Lattmann, J Rosman, AS Seitz, HK AF Oneta, CM Lieber, CS Li, JJ Ruttimann, S Schmid, B Lattmann, J Rosman, AS Seitz, HK TI Dynamics of cytochrome P4502E1 activity in man: induction by ethanol and disappearance during withdrawal phase SO JOURNAL OF HEPATOLOGY LA English DT Article DE cytochrome P4502E1; induction; dynamics of ethanol metabolism; drugs; carcinogenesis; moderate alcohol consumption; ethanol withdrawal ID GLUTATHIONE-S-TRANSFERASE; UPPER AERODIGESTIVE TRACT; HEPATOCELLULAR-CARCINOMA; GENETIC POLYMORPHISMS; COLORECTAL-CANCER; LIVER-DISEASE; 2E1; SUSCEPTIBILITY; CHLORZOXAZONE; HYDROXYLATION AB Background/Aims: Chronic ethanol consumption results in the induction of hepatic cytochrome P4502E1 (CYP2E1) in man, which is believed to play an important role in the pathogenesis of alcoholic liver disease. However, the amount and duration of alcohol intake associated with CYP2E1 induction is not known but limited information is available on the disappearance of CYP2E1 following alcohol withdrawal. Methods: To study these questions, five healthy male volunteers received ethanol daily (40 g/day) over 4 weeks. CYP2E1 induction was monitored by using the chlorzoxazone test before and every week following the start of alcohol ingestion. In addition, CYP2E1 was also determined in five alcoholics 1, 3, 8 and 15 days following ethanol withdrawal and in five patients with non-alcoholic liver disease. Results: A significant CYP2E1 induction occurred 1 week following the ingestion of 40 g ethanol per day and increased further after 4 weeks. The disappearance of CYP2E1 was found to be significant 3 days following ethanol withdrawal and further decreased up to day 8. Thereafter, no significant change occurred and CYP2E1 activities were comparable with those in patients with non-alcoholic liver disease. Conclusions: These data show a significant and quick induction of CYP2E1 activity, already at moderate alcohol consumption, which may be of importance in the pathogenesis of alcoholic liver disease, of ethanol, drug and vitamin A interactions and in alcohol associated carcinogenesis. (C) 2002 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved. C1 Salem Med Ctr, Dept Internal Med, D-69121 Heidelberg, Germany. Salem Med Ctr, Lab Alcohol Res Liver Dis & Nutr, D-69121 Heidelberg, Germany. CHU Vaudois, Dept Internal Med, Div Gastroenterol, CH-1011 Lausanne, Switzerland. PMU, CH-1011 Lausanne, Switzerland. Bronx Vet Adm Med Ctr, Alcohol Res & Treatment Ctr, Liver Dis & Nutr Sect, New York, NY USA. Mt Sinai Sch Med, New York, NY USA. Kantonsspital, Dept Internal Med & Clin Pharmacol, Schaffhausen, Switzerland. Kantonsspital, Dept Internal Med, Winterthur, Switzerland. RP Seitz, HK (reprint author), Salem Med Ctr, Dept Internal Med, Zeppelinstr 11-33, D-69121 Heidelberg, Germany. FU NIAAA NIH HHS [AA-05934, AA-11115] NR 31 TC 93 Z9 98 U1 1 U2 5 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD JAN PY 2002 VL 36 IS 1 BP 47 EP 52 DI 10.1016/S0168-8278(01)00223-9 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 519MU UT WOS:000173730700008 PM 11804663 ER PT J AU Van Laer, A Dallalio, G McKenzie, SW Means, RT AF Van Laer, A Dallalio, G McKenzie, SW Means, RT TI Thioredoxin and protein nitrotyrosine in bone marrow supernatant from patients with human immunodeficiency virus infection SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Article DE HIV; thioredoxin; peroxynitrite; oxidative stress; anemia ID MANGANESE SUPEROXIDE-DISMUTASE; TUMOR-NECROSIS-FACTOR; OXIDATIVE STRESS; NITRIC-OXIDE; HIPPOCAMPAL-NEURONS; PROGENITOR CELLS; IRON-METABOLISM; T-CELL; CFU-E; ACTIVATION AB Background: Balance and imbalance between oxidant stress and antioxidants contributes to the manifestations of human immunodeficiency virus (HIV) infection. Previously, we demonstrated a characteristic cytokine pattern in marrow supernatant from HIV patients who underwent diagnostic examinations. Methods: In this report, we have determined the protein nitrotyrosine (pNT) concentration (an indicator of nitric oxide-superoxide interaction) as well as the concentration of the redox enzyme thioredoxin (Trx) in marrow supernatant from HIV patients, healthy controls, and other patients, and in serum from comparable subjects. Results: pNT concentrations were similar in serum and marrow supernatant and did not differ between subject subsets. Trx concentrations in both marrow supernatant and serum were higher for HIV patients than for other subjects; serum Trx concentrations were significantly higher than marrow Trx concentrations for the non-HIV patients and controls. The ratios of pNT/Trx concentrations in serum were similar in all subsets tested. In marrow aspirate, however, these ratios differed widely and significantly, with the highest values observed in non-HIV patients and the lowest in HIV patients. Only for HIV patients were serum and marrow supernatant pNT/Trx ratios similar. In HIV patients, marrow Trx concentrations correlated with CD4 count, CD4/CD8 ratio, and marrow colony-forming unit E (CFU-E) concentration; marrow pNT concentration correlated with the concentration of tumor necrosis factor in marrow supernatant, and with platelet count. No correlations were observed in other subject subsets. Conclusions: These findings suggest that there is a degree of local regulation of the redox state of the marrow micro-environment that varies with the patients' clinical statuses, and which is associated with effects on hematopoiesis. C1 Med Univ S Carolina, Div Hematol Oncol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Div Hematol Oncol, Charleston, SC USA. Ralph H Johnson VA Med Ctr, Div Infect Dis, Charleston, SC USA. RP Means, RT (reprint author), Med Univ S Carolina, Div Hematol Oncol, 903 CSB,96 Jonathan Lucas St, Charleston, SC 29425 USA. RI Means, Robert/A-4454-2008 FU NHLBI NIH HHS [HL-53703] NR 55 TC 2 Z9 2 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2002 VL 50 IS 1 BP 10 EP 18 PG 9 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 513LQ UT WOS:000173380400007 PM 11813824 ER PT J AU Natsume, A Mata, M Wolfe, D Oligino, T Goss, J Huang, SH Glorioso, J Fink, DJ AF Natsume, A Mata, M Wolfe, D Oligino, T Goss, J Huang, SH Glorioso, J Fink, DJ TI Bcl-2 and GDNF delivered by HSV-mediated gene transfer after spinal root avulsion provide a synergistic effect SO JOURNAL OF NEUROTRAUMA LA English DT Article DE apoptosis; Bcl-2; GDNF; gene therapy; herpes simplex; motor neuron; trauma ID MICE LACKING GDNF; NEUROTROPHIC FACTOR; MOTOR-NEURONS; CELL-DEATH; IN-VIVO; FACIAL MOTONEURONS; PERIPHERAL-NERVE; ADULT RATS; EXPRESSION; DEGENERATION AB Proximal spinal nerve injury results in the death of motor neurons in ventral horn. We have previously demonstrated this cell death can be prevented by HSV-mediated transfer of the gene coding for the antiapoptotic peptide Bcl-2 7 days prior to injury, but that expression of Bcl-2 does not preserve ChAT expression in the lesioned cells. In the current study, we examined two related issues: whether Bcl-2 delivered by HSV-mediated gene transfer 30 min after injury could similarly protect motor neurons from cell death, and whether the additional HSV-mediated expression of the glial cell derived neurotrophic factor (GDNF) could improve the result. At 30 min after avulsion of the L4, L5, and L6 spinal nerves, replication defective genomic HSV-based vectors coding for Bcl-2, GDNF, a reporter transgene (lacZ), or the Bcl-2 and GDNF vectors together were injected into spinal cord. Transduction of motor neurons with either the Bcl-2-expressing vector or the GDNF-expressing vector resulted in a substantial increase in the number of surviving motor neurons, and coinjection of the two vectors together resulted in cell survival that was similar to the result obtained with either vector alone. Neither the Bcl-2-expressing vector nor the GDNF-expressing vector delivered alone protected choline acetyltransferase (ChAT) expression in lesioned neurons. However, simultaneous injection of the Bcl-2- and the GDNF-expressing vectors together resulted in a substantial increase in the number of ChAT in cells in the lesioned ventral horn. Together, these findings suggest an approach to improving cell survival and regeneration following proximal root injury. C1 Univ Pittsburgh, Sch Med, Dept Mol Genet & Biochem, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA 15240 USA. RP Fink, DJ (reprint author), S-520 Biomed Sci Tower,200 Lothrop St, Pittsburgh, PA 15213 USA. RI Natsume, Atsushi/I-7364-2014 OI Natsume, Atsushi/0000-0002-9113-0470 NR 29 TC 37 Z9 43 U1 0 U2 1 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 0897-7151 J9 J NEUROTRAUM JI J. Neurotrauma PD JAN PY 2002 VL 19 IS 1 BP 61 EP 68 DI 10.1089/089771502753460240 PG 8 WC Critical Care Medicine; Clinical Neurology; Neurosciences SC General & Internal Medicine; Neurosciences & Neurology GA 517LD UT WOS:000173611300006 PM 11852979 ER PT J AU Perell, KL Gregor, S Kim, G Rushatakankovit, S Scremin, AME Levin, S Gregor, R AF Perell, KL Gregor, S Kim, G Rushatakankovit, S Scremin, AME Levin, S Gregor, R TI Comparison of cycling kinetics during recumbent bicycling in subjects with and without diabetes SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE bicycling; biomechanics; diabetes; peripheral neuropathy ID LOWER-EXTREMITY AMPUTATION; LIMITED JOINT MOBILITY; RISK-FACTORS; PLANTAR PRESSURES; MELLITUS; FOOT; GAIT; COMPLICATIONS; NEUROPATHY; ULCERATION AB We compared recumbent bicycle kinetics in diabetic peripheral neuropathy and nondiabetic men (nine per group). 3D kinematic and force pedal data in a linked-segment model were used. The generalized muscle moment (GMM) patterns were similar between the two groups except for (1) decreased maximum knee flexor moment, (2) increased minimum knee flexor GMM, and (3) maximum hip extensor GMM by the diabetic subjects. Similar to the walking support moment, a summation moment immutable pattern was observed, although the groups accomplished it differently. The diabetic group utilized the hip during the power phase and the knee during the recovery phase. The nondiabetic group utilized both joints together during both phases. Differences in ankle GMM were not observed, suggesting further research using the recumbent bicycle as an exercise modality for diabetic peripheral neuropathy patients to enhance ankle range of motion and strength, commonly observed walking deficits. C1 W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Indiana Univ, Sch Med, Indianapolis, IN USA. Mt St Marys Coll, Dept Phys Therapy, Los Angeles, CA USA. Georgia Inst Technol, Dept Hlth & Performance Sci, Atlanta, GA 30332 USA. RP Perell, KL (reprint author), W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 42 TC 9 Z9 9 U1 1 U2 5 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD JAN-FEB PY 2002 VL 39 IS 1 BP 13 EP 20 PG 8 WC Rehabilitation SC Rehabilitation GA 533GQ UT WOS:000174521500003 PM 11926324 ER PT J AU Liu, CD Tilch, L Kwan, D McFadden, DW AF Liu, CD Tilch, L Kwan, D McFadden, DW TI Vascular endothelial growth factor is increased in ascites from metastatic pancreatic cancer SO JOURNAL OF SURGICAL RESEARCH LA English DT Article DE ascites; pancreatic cancer; vascular endothelial growth factor; metastasis ID EXPRESSION; RECEPTORS; ANGIOGENESIS; KDR AB Introduction. Vascular endothelial growth factor (VEGF) is an angiogenic factor that increases vascular permeability. VEGF stimulates capillary formation and has mitogenic effects on vascular endothelial cells. The development of malignant ascites causes significant morbidity. We hypothesized that increased levels of VEGF play a role in the development of malignant ascites in patients with pancreatic cancer. Methods. Athymic mice underwent orthotopic implantation of human pancreatic ductal adenocarcinoma tumors (250,000 cells) into the body of the pancreas. Tumors were allowed to grow for 12 weeks, at which time ascites develops in 50% of mice. Paracentesis was performed on mice with noticeable ascites. Saline lavage was performed in mice with equivalent pancreatic tumor masses without ascites and served as control. Both ascites and tumor masses were harvested for VEGF protein quantitation by ELISA. Results. VEGF protein levels were elevated in malignant ascites by 15-fold compared to control mice with equivalent tumors (N = 6, P < 0.001, t test). VEGF levels were slightly higher in the primary tumor masses harvested from mice without ascites. Mice with ascites also had metastatic nodules throughout the abdominal cavity. Conclusions. We are reporting for the first time that VEGF levels are increased in the ascites of nude mice with orthotopically transplanted human pancreatic cancers. VEGF increases vascular permeability and allows for extrapancreatic seeding of tumors. Irrespective of primary tumor size, intraperitoneal VEGF levels are increased when ascites and extrapancreatic nodules are present, while a paradoxical decrease is observed in VEGF levels of primary tumors. (C) 2002 Elsevier Science. C1 W Los Angeles Vet Adm Med Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. Lewis A Johnson Vet Adm Med Ctr, Clarksburg, WV 26301 USA. RP Liu, CD (reprint author), W Los Angeles Vet Adm Med Ctr, Los Angeles, CA 90095 USA. NR 11 TC 19 Z9 21 U1 1 U2 1 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0022-4804 J9 J SURG RES JI J. Surg. Res. PD JAN PY 2002 VL 102 IS 1 BP 31 EP 34 DI 10.1006/jsre.2001.6307 PG 4 WC Surgery SC Surgery GA 517MU UT WOS:000173615000005 PM 11792148 ER PT J AU Friedlander, AH AF Friedlander, AH TI The physiology, medical management and oral implications of menopause SO JOURNAL OF THE AMERICAN DENTAL ASSOCIATION LA English DT Review ID ESTROGEN REPLACEMENT THERAPY; HYDROXYAPATITE-COATED IMPLANTS; CORONARY HEART-DISEASE; BURNING MOUTH SYNDROME; POSTMENOPAUSAL WOMEN; ALZHEIMERS-DISEASE; RISK-FACTORS; BONE-DENSITY; RECEPTOR MODULATORS; PERIODONTAL-DISEASE AB Background. Approximately 36 million women in the United States are in the postmenopausal phase of life. The vast majority of these women experienced spontaneous cessation of menses between the ages of 47 and 55 years when the production of estrogen decreased because of an inadequate number of functioning follicles within their ovaries. Fewer warren entered menopause after surgical removal of both ovaries. This procedure usually is performed prophylactically to prevent ovarian cancer in conjunction with a hysterectomy, which is required to treat abnormal bleeding, endometriosis or pelvic inflammatory disease. The physiological changes associated with spontaneous or surgical menopause cause some women to experience uncomfortable symptoms such as hot flashes, night sweats and vagina dryness. In addition, estrogen deprivation arising from menopause in association with age-related factors disproportionately increases the risk of developing cardiovascular lease (that is, myocardial infarct, stroke), osteoporosis, Alzheimer's disease and oral lease. Hormone replacement therapy, or HRT (estrogen or estrogen and progestin), often is prescribed on a short-term basis to alleviate the uncomfortable symptoms associated with estrogen deficiency and on a long-term basis to prevent some of the chronic illnesses common to postmenopausal women. Conclusions. Dentists who treat women entering menopause need to consider the Stressful phase of life their patients are experiencing. Clinical findings of postmenopausal problems on dental examination may include a paucity of saliva, increased dental caries, prevalent prevalent dysesthesia, taste alterations, atrophic gingivitis, penodontitis and osteoporotic jaws suitable for conventional prosthetic devices or dental implants. Panoramic dental radiographs may reveal calcified rid awry atheromas. Clinical Implications. Dentists have an opportunity to refer women who are not under the care of a gynecologist for an evaluation to determine the appropriateness of HRT for its systemic and oral health benefits. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Med Ctr, Hosp Dent Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. RP Friedlander, AH (reprint author), Vet Affairs Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 111 TC 53 Z9 56 U1 4 U2 6 PU AMER DENTAL ASSN PI CHICAGO PA 211 E CHICAGO AVE, CHICAGO, IL 60611 USA SN 0002-8177 J9 J AM DENT ASSOC JI J. Am. Dent. Assoc. PD JAN PY 2002 VL 133 IS 1 BP 73 EP 81 PG 9 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 513VZ UT WOS:000173402100022 PM 11811747 ER PT J AU Melhem, MF Craven, PA Liachenko, J DeRubertis, FR AF Melhem, MF Craven, PA Liachenko, J DeRubertis, FR TI alpha-lipoic acid attenuates hyperglycemia and prevents glomerular mesangial matrix expansion in diabetes SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID GROWTH-FACTOR-BETA; LIPID-PEROXIDATION; OXIDATIVE STRESS; SKELETAL-MUSCLE; VITAMIN-E; GLUCOSE-TRANSPORT; BLOOD-FLOW; ANTIOXIDANT; RATS; MELLITUS AB Previous studies demonstrated that 2 mo of dietary supple mentation with alpha -lipoic acid (LA) prevented early glomerular injury in non-insulin-treated streptozotocin diabetic rats (D). The present study examined the effects of chronic LA supplementation (30 mg/kg body wt per d) on nephropathy in D after 7 mo of diabetes. Compared with control rats. D developed increased urinary excretion of albumin and transforming growth factor beta. renal insufficiency, glomerular mesangial matrix expansion, and glomerulosclerosis in association with depletion of glutathione and accumulation of malondialdehyde in renal cortex. LA prevented or ameliorated all of these changes in D. Because chronic LA supplementation also attenuated hyperglycemia in D after 3 mo, its effects on renal injury were compared with treatment of rats with sufficient insulin to maintain a level of glycemic control for the entire 7-mo period (D-INS) equivalent to that observed with LA during, the final 4 mo. Despite superior longitudinal glycemic control in D-INS, urinary excretion of albumin and transforming growth factor beta, glomerular mesangial matrix expansion, the extent of glomerulosclerosis, and renal cortical malondialdehyde content were all significantly greater, whereas cortical glutathione content was lower than corresponding values in D given LA. Thus, the renoprotective effects of LA in D were not attributable to improved glycemic control alone but also likely reflected its antioxidant activity. The combined antioxidant and hypoglycemic actions of LA both may contribute to its utility in preventing renal injury and other complications of diabetes. C1 VA Pittsburgh Healthcare Syst, Dept Pathol, Pittsburgh, PA 15240 USA. VA Pittsburgh Healthcare Syst, Dept Med, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. RP DeRubertis, FR (reprint author), VA Pittsburgh Healthcare Syst, Dept Pathol, 111-U Univ Dr C, Pittsburgh, PA 15240 USA. NR 51 TC 76 Z9 80 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD JAN PY 2002 VL 13 IS 1 BP 108 EP 116 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 504ZZ UT WOS:000172887400016 PM 11752027 ER PT J AU Heffelfinger, AK Craft, S White, DA Shyken, J AF Heffelfinger, AK Craft, S White, DA Shyken, J TI Visual attention in preschool children prenatally exposed to cocaine: Implications for behavioral regulation SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article DE cocaine exposure; visual attention; children; neuropsychology ID IN-UTERO EXPOSURE; CEREBRAL-CORTEX; EARLY INFANCY; REACTION-TIME; HUMAN-BRAIN; DOPAMINE; RAT; CATECHOLAMINES; PERFORMANCE; COMPONENTS AB The presence of cocaine during the prenatal period disrupts the development of neural systems involved in mediating visual attention; therefore, it is possible that prenatal cocaine exposure results in impairments in visual attention in early childhood. In the current study we hypothesized that preschool children with prenatal cocaine exposure would exhibit difficulties in the disengagement operation of visual attention and in sustaining attention, particularly for targets presented in the right visual field. Fourteen cocaine-exposed children and 20 control children between 14 and 60 months of age were assessed on measures of visual attention, cognition, and behavior. Cocaine-exposed children had slower reaction times on disengagement trials in the second half of our attention task, supporting our hypotheses that impairments in disengagement and sustained attention are associated with prenatal cocaine exposure. There was a trend for slower reaction times to targets presented in the right visual field, but not to targets presented in the left visual field. Cocaine-exposed children also exhibited greater difficulties in behavioral regulation. Overall, our Findings suggest that children with prenatal cocaine exposure demonstrate specific impairments in visual attention and behavioral regulation. C1 Med Coll Wisconsin, Dept Neurol, Milwaukee, WI 53226 USA. Univ Washington, VA Puget SOund Hlth Care Syst, Seattle, WA 98195 USA. Washington Univ, Dept Psychol, St Louis, MO 63130 USA. St Louis Univ, Dept Obstet, St Louis, MO 63103 USA. RP Heffelfinger, AK (reprint author), MCW Clin Froedtert, Div Neuropsychol, 9200 W Wisconsin Ave, Milwaukee, WI 53226 USA. NR 64 TC 32 Z9 33 U1 2 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD JAN PY 2002 VL 8 IS 1 BP 12 EP 21 DI 10.1017/S1355617701020021 PG 10 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 535TT UT WOS:000174663000002 PM 11843069 ER PT J AU Matioc, AA Wells, JA AF Matioc, AA Wells, JA TI The LMA-unique in a prehospital trauma patient: Interaction with semirigid cervical collar: A case report SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE LA English DT Article ID LARYNGEAL MASK AIRWAY; LINE NECK STABILIZATION; ADULT PATIENTS; MANAGEMENT; TRANSPORT; PRESSURE C1 William S Middleton Mem Vet Adm Med Ctr, Anesthesiol Serv, Madison, WI 53705 USA. Univ Wisconsin, Dept Anesthesiol, Sch Med, Madison, WI USA. Univ Wisconsin, Sch Med, Dept Med, Sect Pulm Med, Madison, WI USA. Univ Wisconsin, Sch Med, Dept Med, Sect Crit Care Med, Madison, WI USA. Univ Wisconsin Hosp & Clin, Dept Med, Sect Emergency Med, Madison, WI 53792 USA. RP Matioc, AA (reprint author), William S Middleton Mem Vet Adm Med Ctr, Anesthesiol Serv, 2500 Overlook Terrace, Madison, WI 53705 USA. NR 18 TC 5 Z9 5 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5282 J9 J TRAUMA JI J. Trauma-Injury Infect. Crit. Care PD JAN PY 2002 VL 52 IS 1 BP 162 EP 164 DI 10.1097/00005373-200201000-00028 PG 3 WC Critical Care Medicine; Surgery SC General & Internal Medicine; Surgery GA 514PF UT WOS:000173449700030 PM 11791069 ER PT J AU Cook, JW Malinow, MR Moneta, GL Taylor, LM Orloff, SL AF Cook, JW Malinow, MR Moneta, GL Taylor, LM Orloff, SL TI Neointimal hyperplasia in balloon-injured rat carotid arteries: The influence of hyperhomocysteinemia SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID MUSCLE CELL-PROLIFERATION; INTIMAL HYPERPLASIA; VASCULAR-DISEASE; PLASMA HOMOCYSTEINE; RISK-FACTORS; FOLLOW-UP; HYPERHOMOCYST(E)INEMIA; FOLATE; ATHEROSCLEROSIS; ENDARTERECTOMY AB Purpose: Hyperhomocyst(e)inemia (hH[e]) is a risk factor for atherosclerosis. Neointimal hyperplasia (NH) after vessel injury can contribute to atherosclerosis. In this study, we investigated the effects of hH(e) on NH formation after arterial balloon injury in rats. Methods: Lewis rats that were given a hH(e)-inducing (high methionine, low folate) or normal diet for 150 days underwent common carotid artery (CCA) balloon injury. Two and 4 weeks after injury, CCAs were formalin perfusion-fixed, sectioned, and stained for elastin. Neointimal index (NI, percent lumen occlusion) and neointima (N) and media (M) area were measured by using computer-interfaced microscopy. Results: Plasma homocyst(e)ine (H[e]) levels were elevated in rats given the study diet compared with rats given the normal diet at days 40 and 90 (69 +/- 8 and 73 +/- 9 mumol/L vs 4 +/- 0.4 and 4 +/- 0.6 pmol/L, P < .001). After balloon injury, the CCA NI and N/M ratio, but not the M area, were increased by hH(e) compared with normal plasma H(e) (2 weeks [n = 6,7]: NI = 7.3 +/- 1.7 vs 2.9 +/- 0.7, P = .002, and N/M 0.31 +/- 0.08 vs 0.08 +/- 0.02, P < .001; 4 weeks [n = 4,71: NI = 13.1 +/- 2.2 vs 6.3 +/- 1.3, P = .002, and N/M = 0.36 +/- 0.08 vs 0.17 +/- 0.03, P < .001). Conclusion: hH(e) accelerates NTH in a rat CCA balloon-injury model. The effect of hH(e) on NH may contribute to increased atherosclerosis in humans with hH(e). C1 Oregon Hlth Sci Univ, Div Liver Pancreas Transplantat, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Vasc Surg, Dept Surg, Portland, OR 97201 USA. Oregon Reg Primate Res Ctr, Portland, OR USA. Portland Vet Affairs Med Ctr, Dept Surg, Portland, OR USA. RP Orloff, SL (reprint author), Oregon Hlth Sci Univ, Div Liver Pancreas Transplantat, Mail Code L-590,3181 SE Sam Jackson Pk Rd, Portland, OR 97201 USA. FU NCRR NIH HHS [RR 00163, RR 00334] NR 41 TC 13 Z9 15 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD JAN PY 2002 VL 35 IS 1 BP 158 EP 165 DI 10.1067/mva.2002.118819 PG 8 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 518VG UT WOS:000173688100031 PM 11802148 ER PT J AU Wild, CJ Greenlee, JJ Bolin, CA Barnett, JK Haake, DA Cheville, NE AF Wild, CJ Greenlee, JJ Bolin, CA Barnett, JK Haake, DA Cheville, NE TI An improved immunohistochemical diagnostic technique for canine leptospirosis using antileptospiral antibodies on renal tissue SO JOURNAL OF VETERINARY DIAGNOSTIC INVESTIGATION LA English DT Article ID OUTER-MEMBRANE PROTEIN; PATHOGENIC LEPTOSPIRA; MAMMALIAN INFECTION; MOLECULAR-CLONING; SEQUENCE-ANALYSIS; DOGS; LIPOPROTEIN; OMPL1; ANTIGENS; FEATURES AB The purpose of this study was to compare the immunoreactivity in canine renal tissues stained with antisera specific for 3 leptospiral antigens and those processed with traditional staining methods. In addition, immunoglobulin staining was done on tissues with immunoreactivity to leptospiral antigens. Formalin-fixed renal sections from 12 dogs with chronic interstitial nephritis suspected or proven to have leptospirosis (6 dogs with silver-stained leptospires and 6 dogs in which silver-stained leptospires were not detected) were used. Antibodies consisted of a monoclonal antibody to Leptospira kirschneri serovar grippotyphosa lipopolysaccharide (LPS) and 2 polyclonal antibodies to outer membrane proteins, including OmpL1, a leptospiral porin, and LipL41, an outer membrane lipoprotein. The murine monoclonal antisera against LPS (F71C2-1) had the most abundant and consistent immunoreactivity. Immunoreactive areas were present in 6 of 6 sections positive by silver staining and included extracellular granular debris in intertubular areas, debris in macrophages, organisms in tubular lumina, and cytoplasmic granules in tubular epithelia, Antisera with specificity for the outer membrane proteins OmpL1 and LipL41 detected only intact organisms in tubular lumina. Immunoreactivity to OmpL1 (polyclonal 338) occurred in 4 of 5 sections positive by silver staining, but immunoreactivity to LipL41 (polyclonal 813) occurred in only 1 of 6 silver-positive sections. Each of the kidney sections in which leptospiral antigens were detected by immunohistochemistry also was positive by silver staining. Sections negative by silver staining were also negative by immunostaining. Although immunohistochemistry did not enhance sensitivity, amplification of signal by secondary antibody and hematoxylin counterstaining improved the case of diagnosis and allowed better evaluation of tissue morphology than did silver staining methods. IgG was the most abundant immunoglobulin. IgG immunoreactivity occurred predominantly in plasma cells within interstitial infiltrates. Interstitial infiltrates contained abundant immunoreactivity to LPS, but immunoreactivity to OmpL1 and LipL41 was not noted. C1 Iowa State Univ, Coll Vet Med, Dept Vet Pathol, Ames, IA 50011 USA. ARS, Bacterial Dis Livestock Res Unit, Natl Anim Dis Ctr, USDA, Ames, IA 50010 USA. VA Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. RP Wild, CJ (reprint author), Iowa State Univ, Coll Vet Med, Dept Vet Pathol, Ames, IA 50011 USA. FU NIAID NIH HHS [R21 AI034431, R21 AI034431-06] NR 29 TC 20 Z9 21 U1 2 U2 3 PU AMER ASSOC VETERINARY LABORATORY DIAGNOSTICIANS INC PI TURLOCK PA PO BOX 1522, TURLOCK, CA 95381 USA SN 1040-6387 J9 J VET DIAGN INVEST JI J. Vet. Diagn. Invest. PD JAN PY 2002 VL 14 IS 1 BP 20 EP 24 PG 5 WC Veterinary Sciences SC Veterinary Sciences GA 513ZQ UT WOS:000173411600004 PM 12680639 ER PT J AU Seliger, SL Weiss, NS Gillen, DL Kestenbaum, B Ball, A Sherrard, DJ Stehman-Breen, CO AF Seliger, SL Weiss, NS Gillen, DL Kestenbaum, B Ball, A Sherrard, DJ Stehman-Breen, CO TI HMG-CoA reductase inhibitors are associated with reduced mortality in ESRD patients SO KIDNEY INTERNATIONAL LA English DT Article DE hypercholesterolemia; cardiovascular disease; end-stage renal disease; USRDS Wave 2; dialysis; blood pressure; lipoprotein ID INTERMEDIATE-DENSITY LIPOPROTEIN; AVERAGE CHOLESTEROL LEVELS; CORONARY-ARTERY DISEASE; HEMODIALYSIS-PATIENTS; MAINTENANCE HEMODIALYSIS; ESTER TRANSFER; SIMVASTATIN; PRAVASTATIN; DIALYSIS; EVENTS AB Background. Patients with end-stage renal disease (ESRD) suffer from markedly higher rates of cardiovascular disease than the general population. Although therapy with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors ("statins") has been demonstrated to reduce the mortality from cardiovascular disease in patients without ESRD, only 10% of patients on dialysis are treated with these medications by day 60 of ESRD. We determined whether the use of statins is associated with a reduction in cardiovascular-specific death and total mortality in ESRD patients. Methods. Data were analyzed from the U.S. Renal Data System Dialysis Morbidity and Mortality Wave-2 study, a cohort of randomly selected patients who were initiating dialysis in 1996. Information about the use of statins as well as other baseline characteristics was abstracted from the patients' dialysis records by dialysis personnel. Cox proportional hazards models were developed to determine the association between use of statins at baseline and subsequent risk of mortality, with adjustment for known mortality risk factors. Results. Follow-up data were available for 3716 patients through July 1998. At baseline, 362 (9.7%) of patients were using statins. These patients had a mortality rate of 143/1000 person-years, compared with a rate of 202/1000 person-years for patients not using statins. Statin use was independently associated with a reduced risk of total mortality [relative risk (RR) = 0.68, 95% confidence interval (CI) = 0.54, 0.87] as well as cardiovascular-specific mortality (RR = 0.64, 95% CI = 0.45, 0.91). In contrast, the use of fibrates was not associated with reduced mortality (RR = 1.29). Conclusions. Statin use was associated with a reduction in cardiovascular-specific death and total mortality in patients on dialysis. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Med Ctr, Div Nephrol, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Biostat, Seattle, WA 98195 USA. RP Stehman-Breen, CO (reprint author), VA Puget Sound Hlth Care Syst, Mailstop 111A,1650 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [DK07721-6] NR 31 TC 207 Z9 215 U1 0 U2 5 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD JAN PY 2002 VL 61 IS 1 BP 297 EP 304 DI 10.1046/j.1523-1755.2002.00109.x PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 505GK UT WOS:000172904900034 PM 11786112 ER PT J AU Krishnan, B Lechago, J Truong, L AF Krishnan, B Lechago, J Truong, L TI Intraoperative consultation (IOC) for renal lesions. Utilities and diagnostic pitfalls in 320 cases SO LABORATORY INVESTIGATION LA English DT Meeting Abstract C1 Baylor Coll Med, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. VA Med Ctr, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0023-6837 EI 1530-0307 J9 LAB INVEST JI Lab. Invest. PD JAN PY 2002 VL 82 IS 1 MA 698 BP 168A EP 168A PG 1 WC Medicine, Research & Experimental; Pathology SC Research & Experimental Medicine; Pathology GA 513LJ UT WOS:000173379700711 ER PT J AU Hsu, HC Mountz, JD Grizzle, WE AF Hsu, HC Mountz, JD Grizzle, WE TI Glomerulosclerosis in 22-month-old BXD recombinant inbred mouse strain 22 (BXD-22) related to T cell kidney infiltration and senescence of CD4 T cells SO LABORATORY INVESTIGATION LA English DT Meeting Abstract C1 Univ Alabama, Birmingham, AL USA. Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0023-6837 EI 1530-0307 J9 LAB INVEST JI Lab. Invest. PD JAN PY 2002 VL 82 IS 1 MA 1269 BP 305A EP 305A PG 1 WC Medicine, Research & Experimental; Pathology SC Research & Experimental Medicine; Pathology GA 513LJ UT WOS:000173379701282 ER PT J AU Rosen, HR Fontana, RJ Brown, RS Wiesner, RH Schiano, TD Bass, NM Bloomer, JR Kaplan, L AF Rosen, HR Fontana, RJ Brown, RS Wiesner, RH Schiano, TD Bass, NM Bloomer, JR Kaplan, L TI Curricular guidelines, for training in transplant hepatology SO LIVER TRANSPLANTATION LA English DT Article C1 Amer Soc Transplantat, Liver & Intraabdominal Subcomm, Moorestown, NJ 08057 USA. Amer Assoc Study Liver Dis, Training & Workforce Comm, Thorofare, NJ 08086 USA. RP Rosen, HR (reprint author), Oregon Hlth Sci Univ, Div Gastroenterol Hepatol, Portland VA Med Ctr, POB 1034,P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. NR 4 TC 10 Z9 10 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD JAN PY 2002 VL 8 IS 1 BP 85 EP 87 DI 10.1053/jlts.2002.29759 PG 3 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 512EE UT WOS:000173307500015 PM 11799493 ER PT J AU Cooper, GS Parks, CG Treadwell, EL St Clair, EW Gilkeson, GS Cohen, PL Roubey, RAS Dooley, MA AF Cooper, GS Parks, CG Treadwell, EL St Clair, EW Gilkeson, GS Cohen, PL Roubey, RAS Dooley, MA TI Differences by race, sex and age in the clinical and immunologic features of recently diagnosed systemic lupus erythematosus patients in the southeastern United States SO LUPUS LA English DT Article DE lupus; demographics; age; sex; race; autoantibodies ID GENDER DIFFERENCES; REVISED CRITERIA; MANIFESTATIONS; ONSET; CLASSIFICATION; EXPRESSION; PROGNOSIS; CHINESE; COHORT; MALES AB We examined the prevalence of clinical and immunologic features of systemic lupus erythematosus (SLE) by race, sex and age in a population-based study of 265 SLE patients. Patients fulfilled the American College of Rheumatology classification criteria. The median time between diagnosis and study enrollment was 13 months. The clinical and hematologic data were limited to occurrences up to 6 months after the diagnosis date, as documented in medical records. We used sera collected at study enrollment from 244 (92%) patients for serologic testing of autoantibodies. The associations between clinical and immunological features of SLE and age, sex and race were examined using logistic regression. The effect of each of these variables was examined adjusting for the other two demographic factors, Mean age at diagnosis was 6 years younger among African-Americans and other minorities compared with white patients (P < 0.01). Discoid lupus, proteinuria, anti-Sm and anti-RNP autoantibodies were more commonly seen in African-American patients, with odds ratios higher than 3.0. Photosensitivity and mucosal ulcers were noted less often in African-American patients. Proteinuria, leukopenia, lymphopenia and thrombocytopenia were approximately three times more common in men compared with women. The prevalence of oral or nasal ulcers and anti-DNA autoantibodies declined with age. The extent to which the differences we observed reflect genetic or environmental influences on the disease process should be investigated. C1 NIEHS, Epidemiol Branch, Durham, NC 27709 USA. E Carolina Univ, Sch Med, Div Rheumatol, Greenville, NC USA. Duke Univ, Med Ctr, Div Rheumatol Allergy & Clin Immunol, Durham, NC USA. Ralph H Johnson Vet Adm Med Ctr, Med Res Serv, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. Univ Penn, Dept Med, Div Rheumatol, Philadelphia, PA 19104 USA. Univ N Carolina, Div Rheumatol & Immunol, Thurston Arthritis Res Ctr, Chapel Hill, NC USA. RP Cooper, GS (reprint author), NIEHS, Epidemiol Branch, A3-05,POB 12233, Durham, NC 27709 USA. OI Parks, Christine/0000-0002-5734-3456 NR 25 TC 117 Z9 118 U1 0 U2 3 PU ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PY 2002 VL 11 IS 3 BP 161 EP 167 DI 10.1191/0961203302lu161oa PG 7 WC Rheumatology SC Rheumatology GA 541DW UT WOS:000174970800005 PM 11999880 ER PT J AU Johnson, ML Gordon, HS Petersen, NJ Wray, NP Shroyer, AL Grover, FL Geraci, JM AF Johnson, ML Gordon, HS Petersen, NJ Wray, NP Shroyer, AL Grover, FL Geraci, JM TI Effect of definition of mortality on hospital profiles SO MEDICAL CARE LA English DT Article DE coronary disease; mortality; outcome assessment; quality of care; surgery ID ADMINISTRATIVE DATA; VETERANS-AFFAIRS; CARDIAC-SURGERY; QUALITY; CARE; RATES; INDICATOR; AREA AB BACKGROUND: Hospitals are ranked based on risk-adjusted measures of postoperative mortality, but definitions differ about which deaths following surgery should be included. OBJECTIVE: To determine whether varying the case definition of deaths following surgery that are included in coronary artery bypass surgery quality assessment affects the identification of outlier hospitals. RESEARCH DESIGN: The study used a prospective cohort design. SUBJECTS: A total of 15,288 patients undergoing coronary artery bypass surgery without other cardiac procedures from October 1993 to March 1996 at all (N = 43) Veterans Affairs hospitals that conduct cardiac surgery. MEASURES: The first measure included any death occurring within 30 days after surgery, regardless of cause, in or out of the hospital (30-day mortality). The second measure included 30-day mortality plus any death occurring 30 days to 6 months after surgery that was judged to be a direct result of a perioperative complication of the surgery (all procedure-related mortality). RESULTS: Hospital performance as assessed by the two different definitions of death varied substantially. The rankings of hospitals differed for 86% (37/43) of hospitals. Twenty-one percent (9/43) changed their quartile of rank and five hospitals changed their outlier status. The correlation of observed-to-expected ratios was high (r = 0.96), but there was disagreement of outlier status (kappa = 0.71). CONCLUSIONS: judgments regarding the quality of a hospital's performance of coronary artery bypass surgery vary depending on the definition of postoperative mortality that is used. Further research is needed to assess what definition is most appropriate to identify quality of care problems. C1 Houston VAMC, Ctr Qual Care, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO USA. Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA. Univ Texas, Dept Gen Internal Med, Houston, TX 77030 USA. RP Johnson, ML (reprint author), Houston VAMC, Ctr Qual Care, 2002 Holcombe Blvd, Houston, TX 77030 USA. RI Gordon, Howard/E-4420-2010; Shroyer, Annie Laurie/B-8836-2016 OI Gordon, Howard/0000-0002-6712-5954; Shroyer, Annie Laurie/0000-0001-6461-0623 NR 29 TC 38 Z9 40 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2002 VL 40 IS 1 BP 7 EP 16 DI 10.1097/00005650-200201000-00003 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 507DD UT WOS:000173011000003 PM 11748422 ER PT J AU Dominitz, JA Maynard, C Billingsley, KG Boyko, EJ AF Dominitz, JA Maynard, C Billingsley, KG Boyko, EJ TI Race, treatment, and survival of veterans with cancer of the distal esophagus and gastric cardia SO MEDICAL CARE LA English DT Article DE esophageal neoplasms; epidemiology; racial stocks; blacks; surgery; survival; chemotherapy, adjuvant; radiation oncology; veterans ID COLORECTAL-CANCER; PROSTATE-CANCER; MEDICAL SYSTEM; COLON-CANCER; AFFAIRS; ACCESS; RATES; STATISTICS; CARCINOMA; PHYSICIAN AB CONTEXT. Prior studies have found racial differences in the use of invasive procedures and in cancer survival. OBJECTIVE. To assess the influence of race on the treatment and survival of patients with distal esophageal cancer. DESIGN. Retrospective cohort study. SETTING. All Veterans Affairs Medical Centers. PATIENTS. One thousand two hundred ninety white and 231 black male veterans with a new diagnosis of distal esophageal cancer during 1993 to 1997. MAIN OUTCOME MEASURES. Utilization of surgical resection, chemotherapy, radiation therapy, and survival. RESULTS. Black patients with esophageal adenocarcinoma were less likely to undergo surgery (OR, 0.54; 95% Cl, 0.30-0.96) but had similar odds of undergoing chemotherapy and radiation therapy. Black patients with squamous cell carcinoma (SCC) were less likely to undergo surgical resection (OR, 0.45; 95% Cl, 0.29-0.70), but were more likely to undergo radiation therapy (OR, 1.72; 95% CI, 1.21-2.47) and chemotherapy (OR, 1.74; 95% CL 1.19-2.54). Mortality was increased for black patients with SCC (adjusted risk ratio 1.33; 95% CI, 1.10-1.61) but not adenocarcinoma. Among those veterans who underwent surgical resection (n = 502), similar results were found. CONCLUSIONS. Black veterans with distal SCC are less likely than white veterans to undergo surgical resection, whereas the use of radiation therapy and chemotherapy, as well as mortality, is increased. Black patients with distal esophageal adenocarcinoma have lower odds of undergoing surgical resection but have similar utilization of radiation therapy and chemotherapy and similar survival. Despite the presence of an equal access medical system, treatment and outcomes differ for black and white veterans with distal esophageal cancer. C1 VA Puget Sound Hlth Care Syst, Seattle Div, Seattle Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dept Surg, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Surg, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Hlth Serv, Seattle, WA 98195 USA. RP Dominitz, JA (reprint author), VA Puget Sound Hlth Care Syst, Seattle Div, Seattle Epidemiol Res & Informat Ctr, 111-S Gastro,1660 S Columbian Way, Seattle, WA 98108 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 NR 35 TC 26 Z9 26 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2002 VL 40 IS 1 SU S BP 14 EP 26 PG 13 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 508DC UT WOS:000173072000003 ER PT J AU Collins, TC Clark, JA Petersen, LA Kressin, NR AF Collins, TC Clark, JA Petersen, LA Kressin, NR TI Racial differences in how patients perceive physician communication regarding cardiac testing SO MEDICAL CARE LA English DT Article DE communication; cardiac testing ID OF-VETERANS-AFFAIRS; CORONARY HEART-DISEASE; HEALTH-CARE SYSTEM; AFRICAN-AMERICANS; BLACK POPULATIONS; MEDICAL-RESEARCH; RACE; SATISFACTION; COMMUNITY; BEHAVIORS AB OBJECTIVES. Recent studies documenting racial variation in the use of cardiac procedures highlight the need to understand if there are racial differences in processes of communication and decision making. Investigations of patients' perceptions of their interaction with providers regarding cardiac testing were conducted. METHODS. Four focus groups were convened with 13 patients who had undergone cardiac stress testing with positive results, stratified by race (white vs. black). Verbatim transcripts of discussions of their interactions with providers relating to their cardiac problems were analyzed qualitatively by a team of behavioral scientists and general internists to identify significant dimensions of communication and patient-provider relationships. RESULTS. Four domains of communication were identified that appeared to bear on patients' comfort and preferences regarding cardiac procedures. First, the substance of the information that was provided by physicians and other providers was described as incomplete, vague, ambiguous, and unclear. Second, some recommendations either were inconsistent with expectations or awakened fears based on distressing previous experiences. Third, patients said they needed to be convinced of the need for additional, invasive tests and therapeutic procedures, and in some cases providers' arguments failed in this regard. Fourth, the patients highlighted the importance of trusting their provider. Although there were no apparent differences by race in patients' perception of the information they received, black patients consistently expressed a preference for building a relationship with physicians (trust) before agreeing to an invasive cardiac procedure, and just as consistently complained that trust was lacking. Conversely, white patients tended to emphasize that they were inadequately convinced of the need for recommended procedures. CONCLUSIONS. This study provided qualitative information regarding patients' perceptions of physician-patient communication and racial differences in such perceptions. For both black and white patients, we found problematic aspects of the patients' experiences regarding communication about cardiac testing. Our findings suggest that although patients desire clarity from physicians, they are often confused regarding the information received. Both a lack of substance and vagueness of the information received may be linked to feelings of mistrust toward physicians when considering further diagnostic testing. Mistrust may be a source of some of the documented racial variation in health care utilization. C1 Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. VAMC, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. Boston Univ, Sch Publ Hlth, Dept Hlth Serv, Boston, MA USA. RP Collins, TC (reprint author), Dept Vet Affairs, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 41 TC 40 Z9 40 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2002 VL 40 IS 1 SU S BP 27 EP 34 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 508DC UT WOS:000173072000004 ER PT J AU Ibrahim, SA Siminoff, LA Burant, CJ Kwoh, CK AF Ibrahim, SA Siminoff, LA Burant, CJ Kwoh, CK TI Understanding ethnic differences in the utilization of joint replacement for osteoarthritis - The role of patient-level factors SO MEDICAL CARE LA English DT Article DE health disparities; osteoarthritis; joint replacement therapy; patient factors ID TOTAL HIP-ARTHROPLASTY; RHEUMATOID-ARTHRITIS; RACIAL-DIFFERENCES; VALIDATION; DEPRESSION; PREFERENCES; POPULATION; SURGERY; HEALTH; BLACKS AB BACKGROUND. There is a marked difference between black patients and white patients in the utilization of joint replacement therapy. The reasons behind this disparity remain unknown. OBJECTIVES. To examine how black and white potential candidates for joint replacement compare with respect to their overall familiarity with joint replacement as an option, as well as their perceptions of the risks/benefits of this procedure. METHODS. Cross-sectional survey of 596 elderly patients with symptomatic osteoarthritis of the knee or hip or both attending primary care clinics at Cleveland VAMC. RESULTS. Black (44%) and white (56%) patients in this cohort were comparable with respect to age and clinical factors. However, black patients were less likely to be employed (8% vs. 15%, P = 0.017) or to be married (39% vs. 56%, P = 0.000), but more likely to report an annual household income of less than $10,000 (41% vs. 20%, P = 0.000) and less than high school education (43% vs. 29%, P = 0.001). Black patients were less likely than white patients to have had family or friends who had had joint replacement (OR, 0.39 [0.26-0.61]), or to report a good understanding of joint replacement as a form of treatment (OR, 0.62 [0.42-0.92]). They were more likely than white patients to expect longer hospital course (OR, 4.09 [2.57-6.54]), moderate to extreme pain (OR, 2.61 [1.74-3.89]), and moderate to extreme difficulty walking after replacement surgery (OR, 2.76 [1.83-4.16]). CONCLUSION. Black patients were less likely than white patients to be familiar with joint replacement surgery and more likely to express concerns about postsurgical pain and difficulty walking. C1 Case Western Reserve Univ, Sch Med, Cleveland, OH 44106 USA. Univ Hosp Cleveland, Div Gen Med, Dept Med, Louis Stokes Dept VAMC, Cleveland, OH 44106 USA. Univ Hosp Cleveland, Div Hlth Care Res, Dept Med, Louis Stokes Dept VAMC, Cleveland, OH 44106 USA. Univ Pittsburgh, Div Clin Immunol & Rheumatol, Pittsburgh, PA 15260 USA. RP Ibrahim, SA (reprint author), VA Pittsburgh Hlth Care Syst, Ctr Hlth Equity Res & Promot, Univ Dr C,11-E,130 A-U, Pittsburgh, PA 15264 USA. RI Siminoff, Laura /H-6277-2012 NR 32 TC 53 Z9 53 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2002 VL 40 IS 1 SU S BP 44 EP 51 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 508DC UT WOS:000173072000006 ER PT J AU Kressin, NR Clark, JA Whittle, J East, M Peterson, ED Chang, BH Rosen, AK Ren, XS Alley, LG Kroupa, L Collins, TC Petersen, LA AF Kressin, NR Clark, JA Whittle, J East, M Peterson, ED Chang, BH Rosen, AK Ren, XS Alley, LG Kroupa, L Collins, TC Petersen, LA TI Racial differences in health-related beliefs, attitudes, and experiences of VA cardiac patients - Scale development and application SO MEDICAL CARE LA English DT Article DE psychology; applied psychometrics; decision making; race relations ID CORONARY-ARTERY SURGERY; MYOCARDIAL-INFARCTION; CARE UTILIZATION; DECISION-MAKING; OLDER ADULTS; RELIABILITY; ASSOCIATION; SURVIVAL; AMERICAN; RACE AB OBJECTIVES. To determine whether there are racial differences in patients' health-related attitudes, beliefs, and experiences regarding invasive cardiac procedures, and to develop psychometrically and conceptually valid scales and single items to assess these dimensions. METHODS. A survey was designed and administered to 854 white and black patients with ischemic heart disease at five VA medical centers. Patients were queried about the domains proposed to be important to treatment decision making by the Health Decision Model: sociodemographic characteristics, social interactions, health care experiences, patient preferences for care, knowledge about diseases and potential treatments, and health beliefs. Using multitrait analysis, the psychometric properties of scales assessing these domains were examined. It was then assessed whether there were racial differences in scale or individual item scores using chi(2) and t test analyses. RESULTS. The analyses yielded eight psychometrically valid scales: disease severity, patient evaluation of physician's interpersonal style, patient evaluations of VA care, satisfaction with treatment decision making, perceived urgency of catheterization, vulnerability to catheterization, bodily impact of catheterization, and attitudes toward religion. There were only racial differences on mean scores for the latter scale. Individual item analyses indicated that black patients were less likely to have been encouraged by friends or family to have cardiac catheterization, and had less personal or familial experiences with this or other surgical procedures. In contrast to expectations, white patients were more likely to be skeptical of medical care. CONCLUSIONS. The multiple dimensions of white and black patients' health-related attitudes, beliefs, and experiences were examined, and few differences were found. These results suggest that racial differences in patients' attitudes, beliefs, and experiences are not a likely source of racial disparities in cardiac care. Future research will examine the association of beliefs, attitudes and experiences with actual use of invasive cardiac procedures. C1 Bedford VA Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, VA Hlth Serv Res & Dev, Natl Ctr Excellence, Bedford, MA 01730 USA. Boston Univ, Sch Publ Hlth, Dept Hlth Serv, Boston, MA USA. Pittsburgh VA Geriatr Res, Educ & Clin Ctr, Pittsburgh, PA USA. Pittsburgh VA Healthcare Syst, Gen Internal Med Sect, Pittsburgh, PA USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. VA Med Ctr, Ctr Hlth Serv Res & Dev, Durham, NC USA. Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA. Emory Univ, Rehabil R&D Ctr, Atlanta VA Med Ctr, Atlanta, GA 30322 USA. Emory Univ, Nell Hodgson Woodruff Sch Nursing, Atlanta, GA 30322 USA. St Louis Univ, Sch Med, St Louis VA Med Ctr, St Louis, MO USA. St Louis Univ, Sch Med, Dept Med, St Louis, MO 63104 USA. Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, VA Hlth Serv Res & Dev, Natl Ctr Excellence, Houston, TX USA. Baylor Coll Med, Dept Med, Div Hlth Serv Res, Houston, TX 77030 USA. RP Kressin, NR (reprint author), Bedford VA Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, VA Hlth Serv Res & Dev, Natl Ctr Excellence, 200 Springs Rd,Bldg 70,152, Bedford, MA 01730 USA. NR 29 TC 21 Z9 21 U1 14 U2 15 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2002 VL 40 IS 1 SU S BP 72 EP 85 PG 14 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 508DC UT WOS:000173072000009 ER PT J AU Conigliaro, J Whittle, J Good, CB Skanderson, M Kelley, M Goldberg, K AF Conigliaro, J Whittle, J Good, CB Skanderson, M Kelley, M Goldberg, K TI Delay in presentation for cardiac care by race, age, and site of care SO MEDICAL CARE LA English DT Article DE access; race; cardiac disease; bypass grafts; angioplasty ID CORONARY HEART-DISEASE; ACUTE MYOCARDIAL-INFARCTION; OF-VETERANS-AFFAIRS; BLACK-AND-WHITE; UNITED-STATES; REVASCULARIZATION PROCEDURES; RACIAL VARIATION; PREHOSPITAL DELAY; ARTERY DISEASE; MEDICAL-CARE AB BACKGROUND. Racial differences exist in the management of coronary artery disease. One hypothesis is that black patients delay seeking care and that this delay may influence the management of coronary artery disease. OBJECTIVES. To assess delay in seeking care for heart disease. RESEARCH DESIGN. Cross-sectional survey. SUBJECTS. One thousand six hundred and fifty-two patients awaiting coronary angiography at three VA and one non-VA Medical Center. MEASURES. Patients were asked to retrospectively report the time between symptom onset and presentation for medical care and what if any were the reasons for delay. RESULTS. One thousand five hundred eleven patients (12% VA & 43% non-VA) answered questions regarding delay in treatment. Overall, 73% reported delaying 1 month or more and 16% reported delaying more than 6 months. Black patients and white patients were equally likely to delay as were older persons (greater than or equal to65) compared with younger. Patients at the VA hospitals reported longer delays and patients with prior revascularization were less likely to report delays. We used ordinal logistic regression to predict delay using site type and prior revascularization as covariates. VA site of care independently predicted longer delays whereas prior revascularization predicted less delay. Among patients who reported at least a 1 month delay, patients at the non-VA hospital were more likely to cite ignoring symptoms as their reason for delay (72% vs. 61%; P = 0.03) as were those with at least a high school education 69% versus 50%; P = 0.003). Black patients reported that they ignored their symptom more often but this was marginally significant (77% vs. 63%; P = 0.053). CONCLUSIONS. Race was not associated with delay in seeking care among patients awaiting coronary angiography. Non-VA patients, and those with past revascularization, were less likely to delay. Ignoring symptoms was the most common reason for delays greater than 1 month. Further study of the sequence of patient and provider decisions that ultimately lead to revascularization is needed. C1 VA Pittsburgh Hlth Care Syst, Sect Gen Internal Med 11E120, Pittsburgh, PA 15240 USA. VA Pittsburgh Hlth Care Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. VA Pittsburgh Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA 15240 USA. VA Pittsburgh Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA. Duke Univ, Med Ctr, Durham Vet Affairs Med Ctr, Durham, NC USA. RP Conigliaro, J (reprint author), VA Pittsburgh Hlth Care Syst, Sect Gen Internal Med 11E120, Univ Dr C, Pittsburgh, PA 15240 USA. NR 29 TC 13 Z9 13 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2002 VL 40 IS 1 SU S BP 97 EP 105 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 508DC UT WOS:000173072000011 ER PT J AU Harada, ND Damron-Rodriguez, J Villa, VM Washington, DL Dhanani, S Shon, H Chattopadhyay, M Fishbein, H Lee, M Makinodan, T Andersen, R AF Harada, ND Damron-Rodriguez, J Villa, VM Washington, DL Dhanani, S Shon, H Chattopadhyay, M Fishbein, H Lee, M Makinodan, T Andersen, R TI Veteran identity and race/ethnicity - Influences on VA outpatient care utilization SO MEDICAL CARE LA English DT Article DE veteran; race; access ID MILITARY SERVICE AB BACKGROUND. "Veteran identity" is defined as veterans' self-concept that derives from his/her military experience within a sociohistorical context. Veteran identity may vary by race/ethnicity because the sociohistorical context of the military experience varies by race. OBJECTIVES. To explore veteran identity and how it varies by race/ethnicity, and to identify aspects of veteran identity that significantly influence preferences for, and use of, VA outpatient care. RESEARCH DESIGN. Focus groups were conducted at community sites to explore concepts related to veteran identity, race/ethnicity, military experience, and health services use. The focus groups informed the development of a telephone survey, which was administered to veterans of four racial/ethnic groups in Southern California and Southern Nevada. SUBJECTS. One hundred seventy-eight veterans participated in the focus groups, and 3,227 veterans completed the telephone survey. MEASURES. Dependent variables include: (1) preference for VA health services, (2) VA-only outpatient use, (3) Any VA outpatient use, and (4) number of outpatient visits within the previous 12 months. Independent variables include veteran identity, sociodemographic, and health-related characteristics. RESULTS. All veteran identity variables were significantly associated with race/ethnicity. Race/ethnicity, eg, being black or Hispanic, in addition to veteran identity factors, significantly influenced preferences for VA outpatient care. Veteran identity factors, however, had less influence on VA outpatient service utilization than socioeconomic factors. CONCLUSIONS. Minority veterans who highly identify with their veteran status may prefer the VA to other systems of care. Factors associated with veteran identity may be useful for incorporation into interventions to improve access to VA care. C1 VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Policy & Social Welfare, Los Angeles, CA USA. Gallup Org Inc, Princeton, NJ USA. VA Greater Los Angeles Healthcare, Ctr Study Healthcare Provider Behavior, Sepulveda Ambulatory Care Ctr, Los Angeles, CA USA. RP Harada, ND (reprint author), VA Greater Los Angeles Hlth Care Syst, Bldg 115,Rm 328,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM nharada@ucla.edu NR 30 TC 14 Z9 14 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2002 VL 40 IS 1 SU S BP 117 EP 128 PG 12 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 508DC UT WOS:000173072000013 ER PT J AU Armstrong, K Schwartz, JS Fitzgerald, G Putt, M Ubel, PA AF Armstrong, K Schwartz, JS Fitzgerald, G Putt, M Ubel, PA TI Effect of framing as gain versus loss on understanding and hypothetical treatment choices: Survival and mortality curves SO MEDICAL DECISION MAKING LA English DT Article DE decision making; framing effect; risk communication ID TREATMENT PREFERENCES; HEALTH-CARE; DECISIONS; EXPLANATIONS; PHYSICIANS AB Background. Presentation of information using survival or mortality(i.e., incidence) curves offers a potentially powerful method of communication because such curves provide information about risk over time in a relatively simple graphic format. However, the effect of framing as survival versus mortality, on understanding and treatment choice is not known. Methods. In this study, 451 individuals awaiting jury duty at the Philadelphia City Courthouse were randomized to receive 1 of 3 questionnaires: (1) survival curves, (2) mortality curves, or (3) both survival and mortality curves. Each questionnaire included a brief description of a hypothetical treatment decision, survival curve graphs and/or mortality curve graphs presenting the outcome of the treatment, and questions measuring understanding of the information contained in the graphs and preference for undergoing treatment. After completing a brief practice exercise, participants were asked to answer questions assessing their ability to interpret single points on a cure and the difference between curves, and then to decide whether they would choose to undergo preventive surgery for 3 different scenarios in which the benefit of surgery varied. Results. Participants who received only survival curves or who received both survival and mortality curves were significantly more accurate in answering questions about the information than participants who received only mortality, curves (P < 0.05). For 2 of the 3 treatment presentations, participants who received only mortality curves were significantly less likely to prefer preventive surgery than participants who received survival curves only or both survival and mortality curves (P < 0.05). The effect of framing on understanding was greatest among participants with less than a college education and among non-Caucasian participants. Conclusion. Framing graphic risk information as chance of death over time results in lower levels of understanding and less interest in preventive surgery than framing as chance of survival over time. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Ctr Canc, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Armstrong, K (reprint author), 1233 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. NR 17 TC 67 Z9 67 U1 0 U2 13 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0272-989X J9 MED DECIS MAKING JI Med. Decis. Mak. PD JAN-FEB PY 2002 VL 22 IS 1 BP 76 EP 83 DI 10.1177/02729890222062946 PG 8 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 513JW UT WOS:000173375600008 PM 11833668 ER PT J AU Achtmeyer, CE Payne, TH Anawalt, BD AF Achtmeyer, CE Payne, TH Anawalt, BD TI Computer order entry system decreased use of sliding scale insulin regimens SO METHODS OF INFORMATION IN MEDICINE LA English DT Article DE medical records systems; computerized; diabetes mellitus; physicians practice patterns; insulin ID DECISION-SUPPORT SYSTEMS; PRACTICE GUIDELINES; DIABETES-MELLITUS; MANAGEMENT; INTERVENTION; PERFORMANCE; OUTCOMES; ERRORS; TRIAL; PAPER AB Objectives: Despite evidence documenting their ineffectiveness, sliding scale insulin is a commonly used regimen for glucose management for hospitalized patients with diabetes, mellitus. At the Veterans Affairs Puget Sound Medical Center, where computer order entry has been mandated, we tested the hypothesis that an evidence-based minimal intervention order (supplemental insulin only when fasting serum glucoses exceeded 400 mg/dl) would decrease the use of sliding scale insulin orders. Methods. Using a computerized order entry system, providers were initially offered a traditional sliding scale order or their own ad hoc orders for glycemic control of inpatients. After 34 weeks providers were offered a third option; a "minimal intervention order" with supplemental insulin only for glucose >400 mg/dl. We extracted all regular insulin orders and performed a retrospective review of insulin sliding scale orders written between December 1, 1998 and November 16, 1999. We compared the frequency of traditional insulin sliding scale orders before and after the introduction of the minimal intervention order. Results. Nearly all orders in the first 34 weeks were traditional insulin sliding scales. We found a significant decrease in the number of traditional insulin sliding scale orders in the 16 weeks after the introduction of a computerized quick order for minimal intervention. from 978/1007 (97.1%) to 254/398 (63.8%) (P < 0.001). Conclusions. A simple evidenced based quick-order in a computer order entry system rapidly and significantly reduced use of sliding scale insulin regimens for glycemic control of inpatients. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA USA. RP Achtmeyer, CE (reprint author), Vet Affairs Puget Sound Hlth Care Syst, S-111,1660 S Columbian Way, Seattle, WA 98108 USA. NR 26 TC 11 Z9 11 U1 1 U2 1 PU SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN PI STUTTGART PA HOLDERLINSTRASSE 3, D-70174 STUTTGART, GERMANY SN 0026-1270 J9 METHOD INFORM MED JI Methods Inf. Med. PY 2002 VL 41 IS 4 BP 277 EP 281 PG 5 WC Computer Science, Information Systems; Health Care Sciences & Services; Medical Informatics SC Computer Science; Health Care Sciences & Services; Medical Informatics GA 607GL UT WOS:000178783700005 PM 12425238 ER PT S AU Moses, AV Jarvis, MA Raggo, C Bell, YC Ruhl, R Luukkonen, BGM Griffith, DJ Wait, CL Druker, BJ Heinrich, MC Nelson, JA Fruh, K AF Moses, AV Jarvis, MA Raggo, C Bell, YC Ruhl, R Luukkonen, BGM Griffith, DJ Wait, CL Druker, BJ Heinrich, MC Nelson, JA Fruh, K BE Aujame, L Burdin, N Dodet, B Vicari, M TI A functional genomics approach to Kaposi's sarcoma SO MICROARRAYS, IMMUNE RESPONSES AND VACCINES SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Microarrays, Immune Responses and Vaccines CY MAY 26-29, 2002 CL VEYRIER DU LAC, FRANCE SP Fdn Merieux DE Kaposi's sarcoma-associated herpesvirus; microarray; c-kit; antisense ID STEM-CELL FACTOR; C-KIT RECEPTOR; EPSTEIN-BARR-VIRUS; ENDOTHELIAL-CELLS; SPINDLE CELLS; DNA-SEQUENCES; SURFACE-ANTIGENS; GENE-EXPRESSION; HERPESVIRUS; COEXPRESSION AB Kaposi's sarcoma (KS) is the most frequent malignancy afflicting acquired immune-deficiency syndrome (AIDS) patients. Tumor lesions are characterized by spindle cells of vascular origin and vascularization. Kaposi's sarcoma-associated herpes virus (KSHV) is consistently found in all forms of KS. Infection of dermal microvascular endothelial cells (DMVEC) with KSHV recapitulates spindle cell formation in vitro. We studied this transformation process by DNA microarray analysis comparing the RNA expression profiles of KSHV-infected and mock-infected DMVEC. Genes involved in tumorigenesis, angiogenesis, host defense, cell growth and differentiation, transcription, and metabolism were observed to change significantly upon infection with KSHV. One of the most consistently KSHV-induced genes was the receptor tyrosine kinase and proto-oncogene c-Kit. Inhibition of c-Kit activity with the pharmacological inhibitor of c-Kit signaling ST1571 reversed the KSHV-induced morphological transformation of DMVEC. Moreover, overexpression studies showed that c-Kit was sufficient to induce spindle cell formation (Moses et al. J. Virol. 76(16): 8383-8399). These data demonstrate that microarrays are useful for the identification of pharmacological targets essential for KS tumorigenesis. C1 Oregon Hlth Sci Univ, Vaccine & Gene Therapy Inst, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97239 USA. RW Johnson Pharmaceut Res Inst, San Diego, CA 92121 USA. Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. RP Moses, AV (reprint author), 505 NW 185th Ave, Beaverton, OR 97006 USA. NR 45 TC 18 Z9 18 U1 0 U2 3 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-446-3 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2002 VL 975 BP 180 EP 191 PG 12 WC Immunology; Multidisciplinary Sciences SC Immunology; Science & Technology - Other Topics GA BW05G UT WOS:000180751500015 PM 12538164 ER PT J AU Gerard, HC Freise, J Wang, Z Roberts, G Rudy, D Krauss-Patz, B Kohler, L Zeidler, H Schumacher, HR Whittum-Hudson, JA Hudson, AP AF Gerard, HC Freise, J Wang, Z Roberts, G Rudy, D Krauss-Patz, B Kohler, L Zeidler, H Schumacher, HR Whittum-Hudson, JA Hudson, AP TI Chlamydia trachomatis genes whose products are related to energy metabolism are expressed differentially in active vs. persistent infection SO MICROBES AND INFECTION LA English DT Article DE Chlamydia trachomatis; ATP production; glycolysis; pentose phosphate pathway ID REACTIVE ARTHRITIS; REITERS-SYNDROME; HUMAN-MONOCYTES; PNEUMONIAE; VIABILITY; INVITRO; CULTURE AB The Chlamydia trachomatis genome encodes glycolysis and pentose phosphate pathway enzymes, two ATP/ADP exchange proteins, and other energy transduction-related components. We asked if and when chlamydial genes specifying products related to energy transduction are expressed during active vs. persistent infection in in vitro models and in synovia from Chlamydia-associated arthritis patients. Hep-2 cells infected with K serovar were harvested from 0-48 h post-infection (active infection). Human monocytes identically infected were harvested at 1, 2, 3, 5 days post-infection (persistent). RNA from each preparation and from synovial samples PCR-positive/-negative for Chlamydia DNA was subjected to RT-PCR targeting (a) chlamydial primary rRNA transcripts and adt1 mRNA, (b) chlamydial mRNA encoding enzymes of the glycolysis (pyk, gap, pgk) and pentose phosphate (gnd, tal) pathways, the TCA cycle (mdhC, fumC), electron transport system (cydA, cydB), and sigma factors (rpoD, rpsD, rpoN). Primary rRNA transcripts and adt1 mRNA were present in each infected preparation and patient sample; controls were negative for chlamydial RNA. In infected Hep-2 cells, all energy transduction-related genes were expressed by approximate to 11 h post-infection. In monocytes, pyk, gap, pgk, gnd, tal, cydA mRNA were present in 1-2-day-infected cells but absent at 3 days and after; cydB, mdhC, fumC were expressed through 5 days post-infection. RT-PCR targeting mRNA from sigma factor genes indicated that lack of these gene products cannot explain selective transcriptional down-regulation during persistence. Analyses of RNA from synovial tissues mirrored those from the monocyte system. These data suggest that in the first phase of active chlamydial infection, ADP/ATP exchange provides energy required for metabolism; in active growth, glycolysis supplements host ATP. In persistence host, rather than bacterially produced, ATP is the primary energy source. Metabolic rate in persistent C. trachomatis is lower than in actively growing cells, as judged from assays for relative chlamydial primary rRNA transcript levels in persistent vs. actively growing cells. (C) 2002 Editions scientifiques et medicales Elsevier SAS. All rights reserved. C1 Wayne State Univ, Sch Med, Dept Immunol & Microbiol, Detroit, MI 48201 USA. Med Hochschule Hannover, Abt Rheumatol, D-30625 Hannover, Germany. Wayne State Univ, Sch Med, Dept Internal Med, Div Rheumatol, Detroit, MI 48201 USA. Wayne State Univ, Sch Med, Dept Ophthalmol, Detroit, MI 48201 USA. Univ Penn, Sch Med, Dept Med, Div Rheumatol, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Detroit, MI 48201 USA. RP Hudson, AP (reprint author), Wayne State Univ, Sch Med, Dept Immunol & Microbiol, Gordon H Scott Hall,540 E Canfield Ave, Detroit, MI 48201 USA. FU NIAID NIH HHS [AI-44493]; NIAMS NIH HHS [AR-47186, AR-42541] NR 38 TC 56 Z9 57 U1 0 U2 7 PU EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER PI PARIS CEDEX 15 PA 23 RUE LINOIS, 75724 PARIS CEDEX 15, FRANCE SN 1286-4579 J9 MICROBES INFECT JI Microbes Infect. PD JAN PY 2002 VL 4 IS 1 BP 13 EP 22 AR PII S1286-4579(01)01504-0 DI 10.1016/S1286-4579(01)01504-0 PG 10 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 522UV UT WOS:000173916100002 PM 11825770 ER PT J AU Krishnan, B Lechago, J Truong, L AF Krishnan, B Lechago, J Truong, L TI Intraoperative consultation (IOC)for renal lesions. Utilities and diagnostic pitfalls in 320 cases SO MODERN PATHOLOGY LA English DT Meeting Abstract C1 Baylor Coll Med, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0893-3952 EI 1530-0285 J9 MODERN PATHOL JI Mod. Pathol. PD JAN PY 2002 VL 15 IS 1 MA 698 BP 168A EP 168A PG 1 WC Pathology SC Pathology GA 513QD UT WOS:000173388900715 ER PT J AU Hsu, HC Mountz, JD Grizzle, WE AF Hsu, HC Mountz, JD Grizzle, WE TI Glomerulosclerosis in 22-month-old BXD recombinant inbred mouse strain 22 (BXD-22) related to T cell kidney infiltration and senescence of CD4 T cells SO MODERN PATHOLOGY LA English DT Meeting Abstract C1 Univ Alabama, Birmingham, AL USA. Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0893-3952 EI 1530-0285 J9 MODERN PATHOL JI Mod. Pathol. PD JAN PY 2002 VL 15 IS 1 MA 1269 BP 305A EP 305A PG 1 WC Pathology SC Pathology GA 513QD UT WOS:000173388901292 ER PT J AU Frazer, A Benmansour, S AF Frazer, A Benmansour, S TI Delayed pharmacological effects of antidepressants SO MOLECULAR PSYCHIATRY LA English DT Article DE selective serotonin reuptake inhibitors; selective norepinephrine reuptake inhibitors; serotonin transporter; norepinephrine transporter ID NOREPINEPHRINE UPTAKE SITES; MAJOR DEPRESSIVE DISORDER; H-3 NISOXETINE; 5-HT UPTAKE; RAT; FLUOXETINE; BINDING; SEROTONIN; TRANSPORTER; BRAIN AB Although antidepressants may not be primary mood stabilizers, they are efficacious in the prophylaxis of recurrent depressive illnesses, as well as in the treatment of acute episodes. Pharmacological effects that may contribute to the prophylactic effects of these drugs are not understood. Studies have been carried out in which antidepressants have been given to laboratory animals, such as rats, for periods of up to 3-4 weeks. Data obtained in such studies are thought to be important for their beneficial effects in depressive episodes, but also may be relevant to their prophylactic effects. Results are presented showing that when selective inhibitors of serotonin or norepinephrine uptake are given for such time periods, they still produce selective effects on serotonergic or noradrenergic parameters. For example, long-term administration of selective norepinephrine reuptake inhibitors causes a down-regulation of beta(1) adrenoceptors. Selective serotonin reuptake inhibitors do not produce this effect. Longterm administration of selective serotonin reuptake inhibitors causes down-regulation of the serotonin transporter, but not the norepinephrine transporter. In contrast, selective norepinephrine reuptake inhibitors down-regulate the norepinephrine transporter but not the serotonin transporter. Substantial loss of serotonin transporter binding sites takes 15 days to occur and is accompanied by a marked reduction of serotonin transporter function in vivo. C1 Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78229 USA. Audie L Murphy Mem Hosp, S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Frazer, A (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pharmacol, 7703 Floyd Curl Dr,Mail Code 7764, San Antonio, TX 78229 USA. NR 38 TC 53 Z9 56 U1 0 U2 6 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1359-4184 J9 MOL PSYCHIATR JI Mol. Psychiatr. PY 2002 VL 7 SU 1 BP S23 EP S28 DI 10.1038/sj.mp.4001015 PG 6 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 539XT UT WOS:000174898700004 PM 11986992 ER PT J AU Proctor, ME Klein, BS Jones, JM Davis, JP AF Proctor, ME Klein, BS Jones, JM Davis, JP TI Cluster of pulmonary blastomycosis in a rural community: Evidence for multiple high-risk environmental foci following a sustained period of diminished precipitation SO MYCOPATHOLOGIA LA English DT Article DE Blastomyces dermatitidis; cluster investigation; fungal infection; pulmonary disease ID WISCONSIN; DERMATITIDIS; IMMUNITY; EPIDEMIC; OUTBREAK; SOIL AB Much of our understanding of the epidemiologic features of infection with Blastomyces dermatitidis has come from cluster and outbreak investigations which have established the association of human disease with recreational pursuits and the presence of infectious microfoci in areas of moist soil with high organic content. This report describes the clustering of eight cases of pulmonary blastomycosis without an apparent common source exposure which occurred during a 90 day period in a 96 square mile area (population 4,450) within Oconto County, Wisconsin. We conclude that multiple high-risk environmental foci may have existed following a sustained five-year period of diminished precipitation in the cluster area. A case-control study which included family and community controls concluded that multiple earth-disturbing activities engaged in by case-patients was statistically associated with illness. Lymphocyte-proliferation assays of whole blood samples detected previously unrecognized infection with B. dermatitidis among five of 32 family controls. C1 Wisconsin Dept Hlth & Family Serv, Div Publ Hlth, Bur Communicable Dis, Madison, WI 53701 USA. Univ Wisconsin, Sch Med, Dept Pediat, Madison, WI USA. Univ Wisconsin, Sch Med, Dept Med, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, Clin & Res Serv, Madison, WI 53705 USA. RP Proctor, ME (reprint author), Wisconsin Dept Hlth & Family Serv, Div Publ Hlth, Bur Communicable Dis, Madison, WI 53701 USA. NR 29 TC 18 Z9 18 U1 2 U2 3 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0301-486X J9 MYCOPATHOLOGIA JI Mycopathologia PY 2002 VL 153 IS 3 BP 113 EP 120 DI 10.1023/A:1014515230994 PG 8 WC Mycology SC Mycology GA 530KC UT WOS:000174356000001 PM 11998870 ER PT J AU McAllister, TW Arciniegas, D AF McAllister, TW Arciniegas, D TI Evaluation and treatment of postconcussive symptoms SO NEUROREHABILITATION LA English DT Review DE postconcussion syndrome; mild traumatic brain injury; postconcussive symptoms ID TRAUMATIC BRAIN INJURY; MINOR HEAD-INJURY; POSTTRAUMATIC-STRESS-DISORDER; MAGNETIC-RESONANCE SPECTROSCOPY; CORTICAL COGNITIVE FUNCTION; POST-CONCUSSION SYMPTOMS; POSITRON EMISSION TOMOGRAPHY; RANDOMIZED CONTROLLED TRIAL; WORKING-MEMORY PERFORMANCE; ROUTINE FOLLOW-UP AB Postconcussive symptoms such as headache, dizziness, irritability, and difficulties with memory and attention are reported frequently after traumatic brain injuries (TBI) of all severities. The etiology of these symptoms in individuals with mild TBI has been a subject of some controversy with theories ranging from neural damage to malingering. Furthermore, although the term postconcussive syndrome is commonly used clinically and in the scientific literature, it is not clear that postconcussive symptoms constitute a syndrome per se. Instead, it may be the case that the various symptoms that commonly co-occur after TBI are relatively independent consequences of a single neurological event. In other words, because the locations and severity of injury vary between individuals despite ostensibly similar injuries, it follows that there should be variations in symptom type and severity between individuals as well. This article reviews the sequelae and natural course of recovery from mild TBI, the evidence regarding both persistent postconcussive symptoms and the postconcussive syndrome, and outlines an approach to the assessment and treatment of individuals with these symptoms after TBI. C1 Dartmouth Hitchcock Med Ctr, Dartmouth Med Sch, Dept Psychiat, Lebanon, NH 03756 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. RP Dartmouth Hitchcock Med Ctr, Dartmouth Med Sch, Dept Psychiat, 1 Med Ctr Dr, Lebanon, NH 03756 USA. EM Thomas.W.McAllister@Dartmouth.edu RI Arciniegas, David/A-3792-2009 FU NINDS NIH HHS [R01 NS40472-01] NR 197 TC 67 Z9 68 U1 3 U2 13 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 EI 1878-6448 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2002 VL 17 IS 4 BP 265 EP 283 PG 19 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 636GA UT WOS:000180445200002 PM 12547976 ER PT J AU Hiott, DW Labbate, L AF Hiott, DW Labbate, L TI Anxiety disorders associated with traumatic brain injuries SO NEUROREHABILITATION LA English DT Article DE traumatic brain injury; obsessive compulsive disorder; posttraumatic stress disorder; panic disorder; generalized anxiety disorder ID OBSESSIVE-COMPULSIVE DISORDER; POSTTRAUMATIC-STRESS-DISORDER; HEAD-INJURY; PSYCHIATRIC-DISORDERS; PANIC DISORDER; CONSEQUENCES; INDIVIDUALS; DEPRESSION; TOMOGRAPHY; LESIONS AB Anxiety disorders are common in the general population and may be even more common in people with traumatic brain injuries. This article presents a review of the literature on anxiety disorders as a result of traumatic brain injury, specifically post-traumatic stress disorder, generalized anxiety disorder, obsessive compulsive disorder, and panic disorder. Our current understanding suggests that the increased frequency of anxiety disorders after TBI may reflect an overlap between brain regions vulnerable to traumatic brain injury, and the neural circuitry of these disorders. Issues regarding treatment are largely anecdotal, and much remains unsettled. More research is needed, both in terms of diagnosis and treatment. C1 Med Univ S Carolina, Dept Psychiat & Behav Sci, Ralph H Johnson VAMC, Charleston, SC 29425 USA. RP Hiott, DW (reprint author), Med Univ S Carolina, Dept Psychiat, 67 President St,5 South, Charleston, SC 29412 USA. NR 44 TC 43 Z9 45 U1 2 U2 5 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2002 VL 17 IS 4 BP 345 EP 355 PG 11 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 636GA UT WOS:000180445200008 PM 12547982 ER PT J AU Sattin, A Senanayake, SS Pekary, AE AF Sattin, A Senanayake, SS Pekary, AE TI Lithium modulates expression of TRH receptors and TRH-related peptides in rat brain SO NEUROSCIENCE LA English DT Article DE bipolar disorder; mood stabilizers; nucleus accumbens; amygdala thyrotropin releasing hormone (TRH) ID THYROTROPIN-RELEASING-HORMONE; CENTRAL-NERVOUS-SYSTEM; SEIZURES INCREASE LEVELS; PITUITARY RECEPTORS; INHIBITING FACTOR; BIPOLAR DISORDER; DEPRESSION; GLUTAMATE; RADIOIMMUNOASSAY; PATHOPHYSIOLOGY AB Lithium is an established mood stabilizer and neuroprotective agent frequently used in the treatment of bipolar disorder and as an adjuvant in drug-resistant unipolar depression. The mechanisms underlying both the therapeutic efficacy of lithium and the exacerbation of symptoms following rapid withdrawal are not understood. From previous studies showing antidepressant and neuroprotective activities of thyrotropin releasing hormone (TRH) and TRH-related neuropeptides we hypothesized that lithium may have substantial effects on the expression and secretion of these peptides and/or their receptors in various rat brain regions involved in the regulation of mood. Chronic lithium effect on TRH receptor binding studies: The effect of 1 and 2 weeks of dietary lithium on [H-3]3-Me-His-TRH binding to plasma membranes of nucleus accumbens, amygdala and pituitary of young adult male Wistar and the endogenously 'depressed' Wistar Kyoto (WKY) rats was measured by the method of Burt and Taylor [Burt, D.R., Taylor, R.L., Endocrinology 106 (1980) 1416-1423]. Acute, chronic and withdrawal effect of lithium on TRH and TRH-like peptide levels in young, adult male Sprague-Dawley rats: Rats were divided into four lithium treatment groups. Control animals received a standard laboratory rodent chow. The acute group received a single i.p. injection of 1.5 milli-equivalents of LiCl 2 h prior to killing. The chronic and withdrawal groups received standard rodent chow containing 1.7 g/kg LiCl for 2 weeks. Withdrawal rats were returned to standard chow 48 h prior to killing while the chronic animals continued on the LiCl diet. TRH, TRH-Gly (pGlu-His-Pro-Gly, a TRH precursor), EEP (pGlu-Glu-Pro-NH2, a TRH-like peptide with antidepressant activity) and Ps4 (a prepro-TRH-derived TRH-enhancing decapeptide) immunoreactivity (IR) were measured in 13 brain regions. The remaining samples were pooled and fractionated by high-pressure liquid chromatography followed by EEP radioimmunoassay. Chronic lithium treatment increased [H-3]3Me-TRH binding in the nucleus accumbens and amygdala about two-fold in both Wistar and WKY rats but no change was observed in pituitary binding. The most widespread changes in TRH and TRH-related peptide levels were observed in the withdrawal group compared to the controls. The direction of change for the total IR was consistent for all TRH-IR and TRH-related peptide-IR within a given tissue. For example, withdrawal increased all peptide levels in the pyriform cortex and striatum but decreased these levels in the anterior cingulate and lateral cerebellum. Both acute injection and chronic treatment with LiCl decreased TRH and TRH-related peptide levels in the entorhinal cortex. Acute injection and withdrawal both increased EEP-IR in striatum by more than two-fold. The acute effects are most likely due to changes in the release of these peptides since 2 h is not sufficient time for alterations in peptide biosynthesis. Chronic treatment increased levels of pGlu-Phe-Pro-NH2 levels in hippocampus, pGlu-Leu-Pro-NH2, and peak '2' in septum by more than four-fold. The present results are consistent with a component role for TRH and related peptides in the mood-altering effects of lithium administration and withdrawal frequently observed during treatment for depression and bipolar disorder. Published by Elsevier Science Ltd on behalf of IBRO. C1 VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Psychiat Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. RP Pekary, AE (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 114,Room 200,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 61 TC 10 Z9 11 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2002 VL 115 IS 1 BP 263 EP 273 AR PII S0306-4522(02)00373-1 DI 10.1016/S0306-4522(02)00373-1 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 615DX UT WOS:000179231500024 PM 12401339 ER PT J AU Epner, DE Morrow, S Wilcox, M Houghton, JL AF Epner, DE Morrow, S Wilcox, M Houghton, JL TI Nutrient intake and nutritional indexes in adults with metastatic cancer on a phase I clinical trial of dietary methionine restriction SO NUTRITION AND CANCER-AN INTERNATIONAL JOURNAL LA English DT Article ID BRAIN-TUMOR XENOGRAFTS; METABOLIC DEFECT; ATHYMIC MICE; CULTURE; CELLS; 5-FLUOROURACIL; DEPENDENCE; STARVATION; SURVIVAL; SYNERGY AB Animal studies have shown that dietary methionine restriction selectively inhibits growth of a variety of human tumor xenografts but has relatively few deleterious effects on normal tissues. The objectives of the present study were to determine whether enteral methionine restriction is safe and tolerable in adults with metastatic cancer and whether it reduces plasma methionine levels. Eight patients with a variety of metastatic solid tumors were enrolled in a phase I clinical trial. A commercially available methionine free medical food served as the primary dietary protein source for all patients. Patients were prescribed diets containing 0.6-0.8 g of protein, 25-35 kcal, and 2 mg of methionine per kilogram per day. Participants remained on the experimental diet for an average of 17.3 wk (range 8-39 wk). Plasma methionine levels fell from 21.6 +/- 7.3 to 9 +/- 4 muM within 2 wk, representing a 58% decline. Serum albumin and prealbumin levels remained stable or increased. Mean energy intake increased during participation compared with baseline, and protein intake was maintained at target levels. The only side effect was weight loss of similar to0.5% of body mass index (0.5 kg) per week. We conclude that enteral dietary methionine restriction is safe and tolerable in adults with metastatic solid tumors and results in significant reduction in plasma methionine levels. C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Texas Womans Univ, Dept Nutr & Food Sci, Houston, TX 77030 USA. RP Epner, DE (reprint author), Baylor Coll Med, Dept Med, Houston, TX 77030 USA. NR 25 TC 29 Z9 30 U1 1 U2 6 PU LAWRENCE ERLBAUM ASSOC INC PI MAHWAH PA 10 INDUSTRIAL AVE, MAHWAH, NJ 07430-2262 USA SN 0163-5581 J9 NUTR CANCER JI Nutr. Cancer PY 2002 VL 42 IS 2 BP 158 EP 166 DI 10.1207/S15327914NC422_2 PG 9 WC Oncology; Nutrition & Dietetics SC Oncology; Nutrition & Dietetics GA 606VT UT WOS:000178755800002 PM 12416254 ER PT J AU Leuchter, I Becker, M Mickel, R Dulguerov, P AF Leuchter, I Becker, M Mickel, R Dulguerov, P TI Horner's syndrome and thyroid neoplasms SO ORL-JOURNAL FOR OTO-RHINO-LARYNGOLOGY AND ITS RELATED SPECIALTIES LA English DT Article DE thyroid; cancer; tumor; Horner's syndrome; sympathetic nerve system; neck ID CARCINOMA; GOITER AB Although thyroid goiter is a common condition, it rarely results in Horner's syndrome. We report a case of a patient with an intrathoracic multinodular goiter complicated by Horner's syndrome. Benign thyroid disease was confirmed pathologically, and the patient's symptoms improved after surgery. In the literature, the major cause of Horner's syndrome is neoplasia, with malignant lesions being twice as frequent as benign tumors. An extensive review of the literature demonstrates a different repartition for thyroid neoplasia: including our case, 38 cases of Horner's syndrome secondary to a benign thyroid tumor are described, against only 8 cases caused by a thyroid carcinoma. We conclude that contrary to the commonly held opinion, Horner's syndrome is more often due to benign thyroid diseases than to thyroid malignancies. Copyright (C) 2002 S, Karger AG, Basel. C1 Univ Hosp Geneva, Dept Otolaryngol Head & Neck Surg, CH-1205 Geneva, Switzerland. Univ Hosp Geneva, Div Diagnost Radiol, CH-1205 Geneva, Switzerland. Univ Calif Los Angeles, Div Head & Neck Surg, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Dulguerov, P (reprint author), Univ Hosp Geneva, Dept Otolaryngol Head & Neck Surg, 24,Rue Micheli Crest, CH-1205 Geneva, Switzerland. RI Dulguerov, Pavel/I-7325-2015 OI Dulguerov, Pavel/0000-0001-5863-3933 NR 19 TC 16 Z9 17 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0301-1569 J9 ORL J OTO-RHINO-LARY JI ORL-J. Oto-Rhino-Laryngol. Relat. Spec. PD JAN-FEB PY 2002 VL 64 IS 1 BP 49 EP 52 DI 10.1159/000049270 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 527KD UT WOS:000174184500012 PM 11891400 ER PT J AU Jensen, MP Ehde, DM Hoffman, AJ Patterson, DR Czerniecki, JM Robinson, LR AF Jensen, MP Ehde, DM Hoffman, AJ Patterson, DR Czerniecki, JM Robinson, LR TI Cognitions, coping and social environment predict adjustment to phantom limb pain SO PAIN LA English DT Article DE beliefs; appraisals; coping; phantom limb pain ID SPOUSE BEHAVIORAL INTERACTIONS; STUMP PAIN; DEPRESSION; SUPPORT; STRATEGIES; AMPUTATION; INVENTORY; BELIEFS; ATTITUDES; AMPUTEES AB Biopsychosocial models of chronic pain hypothesize a role for psychological and environmental factors in adjustment to chronic pain. To test the utility of such models for understanding phantom limb pain, 61 persons with recent amputations were administered measures of average phantom limb pain intensity. pain interference, depression, pain coping use, pain cognitions and appraisals, and social environmental variables I month post-amputation. and the measures of pain intensity. pain interference, and depression again 5 months later. Multiple regression analyses showed that the psychosocial predictors made a statistically significant contribution to the concurrent prediction of average phantom limb pain, pain interference, and depression at the initial assessment. and a significant contribution to the prediction of subsequent change in pain interference and depression over the course of 5 months. The results support the utility of studying phantom limb pain from a biopsychosocial perspective, and identify specific biopsychosocial factors (e.g., catastrophizing cognitions, social support, solicitous responses from family members, and resting as a coping response) that may play an important role in adjustment to phantom limb pain. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved. C1 Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Med Ctr Roosevelt, Ctr Multidisciplinary Pain, Seattle, WA 98105 USA. VA Puget Hlth Care Syst, Seattle, WA 98108 USA. VA Ctr Amputat Prosthet & Limb Loss Prevent, Seattle, WA 98108 USA. RP Jensen, MP (reprint author), Univ Washington, Sch Med, Dept Rehabil Med, Box 356490, Seattle, WA 98195 USA. RI Robinson , Lawrence/D-8455-2013 FU NICHD NIH HHS [P01 HD/NS 33988] NR 52 TC 120 Z9 122 U1 4 U2 16 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0304-3959 J9 PAIN JI Pain PD JAN PY 2002 VL 95 IS 1-2 BP 133 EP 142 DI 10.1016/S0304-3959(01)00390-6 PG 10 WC Anesthesiology; Clinical Neurology; Neurosciences SC Anesthesiology; Neurosciences & Neurology GA 520GK UT WOS:000173772500016 PM 11790476 ER PT S AU Carabello, BA AF Carabello, BA BE Borer, JS Isom, OW TI Selection of patients with aortic stenosis for operation: The asymptomatic patient and the patient with poor LV function SO PATHOPHYSIOLOGY, EVALUATION AND MANAGEMENT OF VALVULAR HEART DISEASES SE ADVANCES IN CARDIOLOGY LA English DT Article; Proceedings Paper CT Conference on Valves in the Heart of the Big Apple - Evaluation and Management of Valvular Heart Diseases CY MAY 10-12, 2001 CL NEW YORK, NEW YORK SP Howard Gilman Inst Valvular Heat Dis, Cornell Univ, Weill Med Coll, New York Cardiol Soc Amer Coll Cardiol, New York State Chapter ID LEFT-VENTRICULAR DYSFUNCTION; VALVE-REPLACEMENT; DOBUTAMINE ECHOCARDIOGRAPHY; SYMPTOMATIC PATIENTS; STRATIFICATION; PROGNOSIS; GRADIENTS; SURVIVAL C1 Houston VA Med Ctr, Houston, TX USA. NR 17 TC 1 Z9 1 U1 0 U2 0 PU KARGER PI BASEL PA POSTFACH, CH-4009 BASEL, SWITZERLAND SN 0065-2326 BN 3-8055-7402-9 J9 ADV CARDIOL JI Adv.Cardiol. PY 2002 VL 39 BP 49 EP 60 PG 12 WC Cardiac & Cardiovascular Systems; Surgery; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Surgery GA BW56X UT WOS:000182432700006 PM 12060923 ER PT J AU Haidet, P Stone, DA Taylor, WC Makadon, HJ AF Haidet, P Stone, DA Taylor, WC Makadon, HJ TI When risk is low: primary care physicians' counseling about HIV prevention SO PATIENT EDUCATION AND COUNSELING LA English DT Article; Proceedings Paper CT 21st Annual Meeting of the Society-of-General-Internal-Medicine CY APR 23-25, 1998 CL CHICAGO, ILLINOIS SP Soc Gen Internal Med DE counseling; primary health care; primary prevention; HIV; physician-patient relations; persuasive communication ID HUMAN-IMMUNODEFICIENCY-VIRUS; SEXUALLY-TRANSMITTED DISEASES; PROMOTION PROGRAMS; ORAL INTERCOURSE; HOMOSEXUAL MEN; CONDOM USE; SEX; INFECTION; SEROCONVERSION; COMMUNICATION AB To explore the conceptualization of risk by primary care physicians about behaviors associated with a relatively low risk of HIV transmission, we performed open-ended telephone interviews with 59 primary care physicians throughout the United States. During the interviews, physicians were asked to respond to a series of clinical vignettes presenting situations where the risk of HIV transmission is relatively low or unknown. We performed a qualitative content analysis of physicians' responses to these clinical vignettes. We found that relatively few information-gathering statements were made in an effort to elicit the patient's perspective regarding risk, and that risk counseling by physicians often followed an 'all or nothing' heuristic that manifested itself as the advice to take maximum precautions under situations of any perceived risk, no matter how small. In addition, HIV testing was often incompletely explained. When combined with the all or nothing heuristic, this created advice that was potentially harmful by using testing as a means to achieve zero risk and forgo protective strategies in settings where patients may potentially be in the HIV negative 'window' phase of infection. Published by Elsevier Science Ireland Ltd. C1 Houston Vet Affairs Med Ctr, Gen Med Sect, Houston, TX 77030 USA. Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA. RP Haidet, P (reprint author), Houston Vet Affairs Med Ctr, Gen Med Sect, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. NR 46 TC 4 Z9 4 U1 3 U2 5 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0738-3991 J9 PATIENT EDUC COUNS JI Patient Educ. Couns. PD JAN PY 2002 VL 46 IS 1 BP 21 EP 29 DI 10.1016/S0738-3991(01)00154-9 PG 9 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA 520BG UT WOS:000173759600003 PM 11804766 ER PT J AU Sullivan, SD Lew, DP Devine, EB Hakim, Z Reiber, GE Veenstra, DL AF Sullivan, SD Lew, DP Devine, EB Hakim, Z Reiber, GE Veenstra, DL TI Health state preference assessment in diabetic peripheral neuropathy SO PHARMACOECONOMICS LA English DT Article ID QUALITY-OF-LIFE; POPULATION; OUTCOMES; MELLITUS; ULCERS AB Objective: To assess patient preferences for health states associated with diabetic peripheral neuropathy (DPN). Design and intervention: Seven health states describing varying stages of disease severity in DPN were developed: mild neuropathy, painful neuropathy, severe neuropathy, minor ulcer, severe ulcer, minor amputation and major amputation. Using a computer interview, both rating scale (RS) and standard gamble (SG) preference scores were elicited from 52 patients with diabetes mellitus. Setting: A US university medical centre and a Veterans Affairs clinic. Study participants: Adult patients with type 1 and type 2 diabetes mellitus between the ages of 18 and 80 years. Patients were excluded if they had been diagnosed with DPN. Results: Preference scores decreased in accordance with greater symptomatic and functional impairment. Median RS scores ranged from 0.89 to 0.23 for the seven health states. Median SG scores ranged from 0.96 to 0.65. Conclusions: Patient preferences for health states decrease as a function of increasing disease severity in DPN. The result is robust across the RS and SG methods of preference measurement. These results may be useful in informing policy analyses for resource allocation in patients with diabetes mellitus. C1 Univ Washington, Dept Pharm, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Kaiser Permanente, Drug Informat & Profess Serv, Oakland, CA USA. Roche Pharmaceut, Hlth Econ & Strateg Pricing, Nutley, NJ USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Sullivan, SD (reprint author), Univ Washington, Dept Pharm, Pharmaceut Outcomes Res & Policy Program, Box 357630, Seattle, WA 98195 USA. NR 25 TC 20 Z9 21 U1 1 U2 2 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 1170-7690 J9 PHARMACOECONOMICS JI Pharmacoeconomics PY 2002 VL 20 IS 15 BP 1079 EP 1089 DI 10.2165/00019053-200220150-00004 PG 11 WC Economics; Health Care Sciences & Services; Health Policy & Services; Pharmacology & Pharmacy SC Business & Economics; Health Care Sciences & Services; Pharmacology & Pharmacy GA 625MQ UT WOS:000179820600004 PM 12456202 ER PT J AU Reid, MS Ho, LB Hsu, K Fox, L Tolliver, BK Adams, JU Franco, A Berger, SP AF Reid, MS Ho, LB Hsu, K Fox, L Tolliver, BK Adams, JU Franco, A Berger, SP TI Evidence for the involvement of cyclooxygenase activity in the development of cocaine sensitization SO PHARMACOLOGY BIOCHEMISTRY AND BEHAVIOR LA English DT Article ID VENTRAL TEGMENTAL AREA; PLATELET-ACTIVATING-FACTOR; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; INDUCED BEHAVIORAL SENSITIZATION; LONG-TERM POTENTIATION; ARACHIDONIC-ACID; RAT-BRAIN; NUCLEUS-ACCUMBENS; NORDIHYDROGUAIARETIC ACID; PHOSPHOLIPASE-A2 ACTIVITY AB Phospholipase A2 (PLA(2)) activation generates the release of arachidonic acid (AA) and platelet-activating factor (PAF), two compounds which may be involved in neuroplasticity. In previous studies, we found that PLA(2) activation is involved in the development of stimulant sensitization. In the present study, we have examined the roles of AA and PAF in the development of stimulant sensitization using agonists and antagonists selective for PAF receptors or the induction of various AA cascade-mediated eicosanoids. Sprague-Dawley rats were treated for 5 days with cocaine (30 mg/kg) or D-amphetamine (1 mg/kg) preceded 15 min earlier by various antagonists, and then tested following a 10-day withdrawal period for cocaine (15 mg/kg) or D-amphetamine (0.5 mg/kg)-induced locomotion. Consistent with our earlier work, pretreatment with the PLA(2) inhibitor quinacrine (25 mg/kg) blocked the development of cocaine and amphetamine sensitization. The lipoxygenase (LOX) inhibitors nordihydroguaiaretic acid (NDGA) (5-10 mg/kg) and MK-886 (1 mg/kg) had no effect on cocaine sensitization. The PAF receptor antagonist WEB 2086 (5-10 mg/kg) reduced the development of cocaine sensitization. The cyclooxygenase (COX) inhibitors indomethacin (1-2 mg/kg), piroxicam (0.5-1 mg/kg), 6-methoxy-2-napthylacetic acid (6-MNA; 0.5-1 mg/kg), and NS-398 (0.5-1 mg/kg) blocked the development of cocaine sensitization. The COX inhibitors indomethacin (2 mg/kg) and 6-MNA (1 mg/kg) also reduced the development of amphetamine sensitization. Rats were administered bilateral intraventral tegmental area (VTA) injections of D-amphetamine (5 mug/side) or saline coadministered with indomethacin (0.5 mug/side) or vehicle three times over 5 days and were then tested after a 10-day withdrawal for D-amphetamine (0.5 mg/kg ip)-induced locomotion. Intra-VTA amphetamine induced a robust form of amphetamine sensitization, which was blocked by coadministration of indomethacin. Unilateral intra-VTA injections of PAF (1 [g) did not significantly alter cocaine (15 mg/kg ip)-induced locomotion when tested after a 3-day withdrawal. These findings suggest that COX, and possibly PAT, activity is involved in the development of stimulant sensitization. Neuroanatomical studies demonstrate that this may occur at the level of the VTA. (C) 2002 Elsevier Science Inc. All rights reserved. C1 NYU, Sch Med, Dept Psychiat, New York Vet Affairs Med Ctr, New York, NY 10010 USA. Univ Calif San Francisco, Dept Psychiat, Psychiat Serv 116W, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Cincinnati, Med Ctr, Dept Psychiat, Cincinnati, OH 45267 USA. RP Reid, MS (reprint author), NYU, Sch Med, Dept Psychiat, New York Vet Affairs Med Ctr, 423 E 23rd St, New York, NY 10010 USA. FU NIDA NIH HHS [YOIDA50038-01, R29 DA07376] NR 87 TC 18 Z9 20 U1 1 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0091-3057 J9 PHARMACOL BIOCHEM BE JI Pharmacol. Biochem. Behav. PD JAN-FEB PY 2002 VL 71 IS 1-2 BP 37 EP 54 DI 10.1016/S0091-3057(01)00614-1 PG 18 WC Behavioral Sciences; Neurosciences; Pharmacology & Pharmacy SC Behavioral Sciences; Neurosciences & Neurology; Pharmacology & Pharmacy GA 518UY UT WOS:000173687300005 PM 11812506 ER PT J AU Liberman, AM Best, SR Metzler, TJ Fagan, JA Weiss, DS Marmar, CR AF Liberman, AM Best, SR Metzler, TJ Fagan, JA Weiss, DS Marmar, CR TI Routine occupational stress and psychological distress in police SO POLICING-AN INTERNATIONAL JOURNAL OF POLICE STRATEGIES & MANAGEMENT LA English DT Article DE police; stress; USA; work study ID EMERGENCY SERVICES PERSONNEL; SOCIAL SUPPORT; OFFICERS; TRAUMA; DISORDER; IMPACT; WOMEN; DESIRABILITY; PREVALENCE; COMMUNITY AB The relationship between routine work stress and psychological distress was investigated among 733 police officers in three US cities, during 1998-1999. The Work Environment Inventory (WEI) was developed to assess exposure to routine work stressors, while excluding duty-related traumatic stressors (critical incidents). The WEI and its general properties are presented The relationship between routine work stress exposure and psychological distress is then explored. Exposure to routine work stressors predicted general psychological distress (r = 0.46), as well as post-traumatic stress symptoms following officers' most traumatic career incident (rs = 0.26 to 0.39). Multivariate analyses found that these effects were independent of and larger than, the effects of cumulative critical incident exposure. (Time since the most traumatic event, social support, and social desirability effects were also controlled statistically.) Routine occupational stress exposure appears to be a significant risk factor for psychological distress among police officers, and a surprisingly strong predictor of post-traumatic stress symptoms. C1 Natl Inst Justice, Washington, DC 20531 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Columbia Univ, New York, NY USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. RP Liberman, AM (reprint author), Natl Inst Justice, Washington, DC 20531 USA. NR 55 TC 65 Z9 67 U1 1 U2 13 PU EMERALD PI BRADFORD PA 60/62 TOLLER LANE, BRADFORD BD8 9BY, W YORKSHIRE, ENGLAND SN 1363-951X J9 POLICING JI Policing-An Int J Police Strategies & Manag. PY 2002 VL 25 IS 2 BP 421 EP 439 DI 10.1108/13639510210429446 PG 19 WC Criminology & Penology SC Criminology & Penology GA 574FY UT WOS:000176879100012 ER PT J AU Yehuda, R Halligan, SL Bierer, LM AF Yehuda, R Halligan, SL Bierer, LM TI Cortisol levels in adult offspring of Holocaust survivors: relation to PTSD symptom severity in the parent and child SO PSYCHONEUROENDOCRINOLOGY LA English DT Article DE PTSD; Holocaust; cortisol; depression ID POSTTRAUMATIC-STRESS-DISORDER; GLUCOCORTICOID RECEPTORS; MAJOR DEPRESSION; MATERNAL-CARE; COMORBIDITY; RESPONSES; RAT AB We have previously demonstrated lower mean 24-h urinary cortisol excretion in adult offspring of Holocaust survivors with parental posttraumatic stress disorder (and lifetime PTSD), compared to offspring without parental PTSD, and to demographically similar comparison subjects. In the current study, we re-analyze data from our previously published report, plus four new subjects, to further examine the relationship between cortisol and severity of PTSD symptoms in offspring and their parents. We also examine the contribution of current depressive disorder to cortisol levels. Two-way analysis of variance revealed lifetime PTSD to be associated with significantly lower cortisol levels, while depressive disorder was associated with higher cortisol levels. The presence of parental PTSD was associated with lower cortisol excretion in the offspring only if both parents were affected. There were significant negative correlations between severity of parental PTSD and offspring urinary cortisol excretion, and between severity of offspring PTSD symptoms and urinary cortisol levels. The findings amplify our earlier descriptions of children of Holocaust survivors with PTSD as a sample 'at risk' for PTSD by demonstrating relationships between lowered cortisol excretion in these offspring and their experience of their parents' PTSD symptoms. Published by Elsevier Science Ltd. C1 Bronx Vet Affairs Med Ctr, Psychiat OOMH, Bronx, NY 10468 USA. CUNY Mt Sinai Sch Med, Traumat Stress Studies Program, New York, NY 10029 USA. RP Yehuda, R (reprint author), Bronx Vet Affairs Med Ctr, Psychiat OOMH, 130 W Kingsbridge Rd,, Bronx, NY 10468 USA. OI Halligan, Sarah/0000-0002-3436-3358 FU NIMH NIH HHS [MH-49555] NR 20 TC 82 Z9 87 U1 2 U2 11 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4530 J9 PSYCHONEUROENDOCRINO JI Psychoneuroendocrinology PD JAN-FEB PY 2002 VL 27 IS 1-2 BP 171 EP 180 DI 10.1016/S0306-4530(01)00043-9 PG 10 WC Endocrinology & Metabolism; Neurosciences; Psychiatry SC Endocrinology & Metabolism; Neurosciences & Neurology; Psychiatry GA 518CQ UT WOS:000173649400012 PM 11750777 ER PT J AU Fung, MT Raine, A Lynam, DR Steinhauer, SR Loeber, R Stouthamer-Loeber, M AF Fung, MT Raine, A Lynam, DR Steinhauer, SR Loeber, R Stouthamer-Loeber, M TI Reduced anticipatory and reactive skin conductance: Evidence for an adolescent analog of psychopathy SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract C1 Univ So Calif, Los Angeles, CA 90089 USA. Univ Kentucky, Lexington, KY 40506 USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RI Lynam, Donald/J-5755-2014 OI Lynam, Donald/0000-0001-8306-498X NR 0 TC 1 Z9 1 U1 0 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0048-5772 EI 1469-8986 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PY 2002 VL 39 SU 1 BP S37 EP S37 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 592LT UT WOS:000177939700144 ER PT J AU Johnston-Brooks, CH Lewis, MA Garg, S AF Johnston-Brooks, CH Lewis, MA Garg, S TI Self-efficacy impacts self-care and HbA1c in young adults with Type I diabetes SO PSYCHOSOMATIC MEDICINE LA English DT Article DE diabetes; self-efficacy; self-esteem; HbA1c; self-care; mediation ID SHORT-TERM; COMPLICATIONS TRIAL; BEHAVIORS; MELLITUS; THERAPY; ESTEEM; ADOLESCENTS; MANAGEMENT; PREDICTORS; ADHERENCE AB Objective: The present study examined self-efficacy and self-esteem as basic aspects of the self that influence self-care and physiological outcomes among young adults with Type I diabetes. The two aims of this study were 1) to examine the cross-sectional and longitudinal role of the self-variables as they predict self-care and HbA1c and 2) to test whether self-care mediates the association between the self variables and HbA1c using cross-sectional and longitudinal data. Methods: One hundred ten participants were recruited from a regional diabetes outpatient clinic. Inclusion criteria were age (18-35 years) and duration of diabetes (>1 year before recruitment). Participants were 61% female and 88% white. In addition, the sample had an average annual income between $24,999 and $34,999, and 85% had completed some or all of college. The average duration of diabetes was 15 years. Results: Using multiple regression analyses we found that, compared with self-esteem, self-efficacy was a better predictor of all aspects of self-care and HbA1c in cross-sectional analyses, in addition to diet and exercise self-care, and a better predictor of HbA1c in longitudinal analyses. The data also supported the cross-sectional and longitudinal mediational model in which better self-care helped account for the association between greater self-efficacy and better HbA1c. Conclusions: Self-efficacy is an important factor for management of self-care practices and physiological outcomes among young adults with Type I diabetes, and self-care may be an important mechanism by which self-efficacy influences HbA1c levels. C1 Denver VAMC, Denver, CO 80220 USA. Univ N Carolina, Chapel Hill, NC USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. RP Johnston-Brooks, CH (reprint author), Denver VAMC, Routing 116 B,1055 Clermont St, Denver, CO 80220 USA. NR 59 TC 92 Z9 96 U1 3 U2 15 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0033-3174 J9 PSYCHOSOM MED JI Psychosom. Med. PD JAN-FEB PY 2002 VL 64 IS 1 BP 43 EP 51 PG 9 WC Psychiatry; Psychology; Psychology, Multidisciplinary SC Psychiatry; Psychology GA 520BM UT WOS:000173760200007 PM 11818585 ER PT J AU Oberley, TD AF Oberley, TD TI Ultrastructural localization and relative quantification of 4-hydroxynonenal-modified proteins in tissues and cell compartments SO REDOX CELL BIOLOGY AND GENETICS, PART A SE METHODS IN ENZYMOLOGY LA English DT Review ID OXIDATIVE DAMAGE; ADDUCTS; KIDNEY C1 Univ Wisconsin, Sch Med, Dept Pathol & Lab Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Oberley, TD (reprint author), Univ Wisconsin, Sch Med, Dept Pathol & Lab Med, Madison, WI 53705 USA. NR 13 TC 10 Z9 10 U1 0 U2 1 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA SN 0076-6879 J9 METHOD ENZYMOL JI Methods Enzymol. PY 2002 VL 352 BP 373 EP 377 PN A PG 5 WC Biochemical Research Methods; Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA BU93G UT WOS:000177426500032 PM 12125364 ER PT J AU Marder, SR Essock, SM Miller, AL Buchanan, RW Davis, JM Kane, JM Lieberman, J Schooler, NR AF Marder, SR Essock, SM Miller, AL Buchanan, RW Davis, JM Kane, JM Lieberman, J Schooler, NR TI The Mount Sinai conference on the pharmacotherapy of schizophrenia SO SCHIZOPHRENIA BULLETIN LA English DT Article DE schizophrenia; antipsychotics; tardive dyskinesia; evidence-based practice; clozapine ID REFRACTORY SCHIZOPHRENIA; TARDIVE-DYSKINESIA; RESISTANT SCHIZOPHRENIA; WEIGHT-GAIN; CLOZAPINE; HALOPERIDOL; RISPERIDONE; OLANZAPINE; BLIND; ANTIPSYCHOTICS AB This report summarizes the recommendations from a consensus meeting that focused on specific questions regarding the pharmacotherapy of schizophrenia. The issues were selected because there was evidence that experts had recently disagreed about the evidence supporting a particular practice or when there were substantial variations in a clinical practice indicating that there was disagreement among clinicians. The group of experts was able to reach a consensus regarding the evidence base pertaining to the following issues: First generation (FGAs) and second generation (SGAs) antipsychotics as first line agents; the duration of antipsychotic trials; the effectiveness of clozapine and other agents for treatment refractory schizophrenia; risk of tardive dyskinesia on FGAs and SGAs; differences among antipsychotics for different dimensions of psychopathology; and side effect monitoring for various antipsychotics. C1 VA Desert Pacific, MIRECC, Los Angeles, CA USA. VA Greater Los Angeles Hlth Care Syst, Dept Chair Psychiat, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. NYU, Dept Psychiat, Div Hlth Serv Res, Mt Sinai Sch Med, New York, NY 10016 USA. Vet Affairs New York Healthcare Syst, Mental Illness Res Educ & Clin Ctr, New York, NY USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Maryland Psychiat Res Ctr, Baltimore, MD 21228 USA. Univ Illinois, Chicago, IL USA. N Shore Long Isl Jewish Hlth Syst, Behav Hlth Serv, New York, NY USA. Albert Einstein Coll Med, New York, NY USA. Univ N Carolina, Dept Psychiat, Chapel Hill, NC USA. Hillside Hosp, Glen Oaks, NY 11004 USA. RP Marder, SR (reprint author), W Los Angeles VA Hlth Care Ctr, MIRECC 210A, 11301 Wiltshire Blvd, Los Angeles, CA 90073 USA. NR 46 TC 90 Z9 94 U1 1 U2 1 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPERINTENDENT DOCUMENTS,, WASHINGTON, DC 20402-9325 USA SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PY 2002 VL 28 IS 1 BP 5 EP 16 PG 12 WC Psychiatry SC Psychiatry GA 553CT UT WOS:000175658500002 PM 12047022 ER PT J AU Marder, SR AF Marder, SR TI Can clinical practice guide a research agenda? SO SCHIZOPHRENIA BULLETIN LA English DT Article DE schizophrenia; antipsychotic; clozapine; evidence-based practice; polypharmacy AB Articles from this issue of the Bulletin indicate that clinicians are frequently adopting clinical practices that have not been supported by an evidence base. Examples of these practices are prescribing more than one antipsychotic and reserving clozapine for patients who have had multiple antipsychotic trials. This commentary suggests that these practices can be used to define important research questions. C1 VA Greater Los Angeles Hlth Care Syst, Dept Chair Psychiat, VA Desert Pacific MIRECC, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA USA. RP Marder, SR (reprint author), W Los Angeles VA Hlth Care Ctr, MIRECC-210A,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 7 TC 6 Z9 6 U1 1 U2 1 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPERINTENDENT DOCUMENTS,, WASHINGTON, DC 20402-9325 USA SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PY 2002 VL 28 IS 1 BP 127 EP 129 PG 3 WC Psychiatry SC Psychiatry GA 553CT UT WOS:000175658500013 PM 12047012 ER PT J AU Marder, SR Aravagiri, M Wirshing, WC Wirshing, DA Lebell, M Mintz, J AF Marder, SR Aravagiri, M Wirshing, WC Wirshing, DA Lebell, M Mintz, J TI Fluphenazine plasma level monitoring for patients receiving fluphenazine decanoate SO SCHIZOPHRENIA RESEARCH LA English DT Article DE schizophrenia; antipsychotic; fluphenazine ID RELAPSE; SCHIZOPHRENIA; THERAPY AB Background: Finding a dose of an antipsychotic for maintenance therapy that is both safe and effective can be difficult because clinicians are unable to titrate dose against clinical response in patients who are already stable. Therapeutic monitoring of antipsychotic plasma levels has the potential for helping clinicians in dosage selection. With this in mind, we evaluated the usefulness of monitoring fluphenazine plasma levels for patients with schizophrenia who were receiving maintenance treatment with fluphenazine decanoate. Method: Thirty-one patients with schizophrenia were randomly assigned to low, medium, or high (0.1-0.3, 0.3-0.6, 0.6-1.0 ng/ml) plasma levels of fluphenazine. The dose of fluphenazine decanoate was adjusted in order to maintain patients in their assigned range. Side effects, psychopathology, and psychotic exacerbations were measured during the year following randomization. Results: All of the psychotic exacerbations occurred during the first eight weeks following randomization, before patients had adequate time to reach their plasma level assignments. We did not find a relationship between plasma levels of fluphenazine and clinical outcomes or side effects. Conclusion: Our results do not provide support for the usefulness of monitoring fluphenazine plasma levels for patients receiving fluphenazine decanoate. (C) 2002 Elsevier Science B.V. All rights reserved. C1 W Los Angeles Hlth Ctr, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Marder, SR (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd,MIRECC-210A, Los Angeles, CA 90073 USA. NR 16 TC 11 Z9 11 U1 2 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD JAN 1 PY 2002 VL 53 IS 1-2 BP 25 EP 30 DI 10.1016/S0920-9964(00)00184-5 PG 6 WC Psychiatry SC Psychiatry GA 507ZE UT WOS:000173060900004 PM 11728835 ER PT J AU Figlewicz, DP Van Dijk, G Wilkinson, CW Gronbeck, P Higgins, M Zavosh, A AF Figlewicz, D. P. Van Dijk, G. Wilkinson, C. W. Gronbeck, P. Higgins, M. Zavosh, A. TI Effects of Repetitive Hypoglycemia on Neuroendocrine Response and Brain Tyrosine Hydroxylase Activity in the Rat SO STRESS-THE INTERNATIONAL JOURNAL ON THE BIOLOGY OF STRESS LA English DT Article DE Catecholamines; Glucocorticoids; Neuroglucopenia; Stress ID DEPENDENT DIABETES-MELLITUS; INTENSIVE INSULIN THERAPY; VENTROMEDIAL HYPOTHALAMUS; PARAVENTRICULAR NUCLEUS; GENE-EXPRESSION; UNAWARENESS; RELEASE; COUNTERREGULATION; CORTICOSTERONE; STRESS AB Hypoglycemia-associated autonomic failure (HAAF) is a syndrome of acute adaptation to a metabolic stressor, in which neuroendocrine responses to repetitive hypoglycemic bouts are blunted. The CNS mechanisms that contribute to HAAF are unknown. In the present study, we modeled HAAF in the rat and measured the activity of tyrosine hydroxylase (TH) as an index of acute noradrenergic activation, to test the hypothesis that noradrenergic activation of the hypothalamus might be impaired. In association with a significant counter-regulatory response to a single bout of hypoglycemia (elevated corticosterone, catecholamines, and glucagon), TH activity was elevated overall in brainstem NE cell body areas and hypothalamus. With multiple hypoglycemic episodes in a 24 h period, the counter-regulatory response was blunted, and hypothalamic TH activity was comparable to that of saline-infused controls. In a similar paradigm, multiple bouts of CNS neuroglucopenia did not blunt the hyperglycemic or corticosterone responses, and were required for elevation of TH activity. This alternate response pattern suggests that insulin-induced hypoglycemia and cerebral neuroglucopenia represent somewhat different metabolic stressors at the CNS. C1 [Figlewicz, D. P.; Gronbeck, P.; Higgins, M.] VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. [Figlewicz, D. P.; Zavosh, A.] Univ Washington, Dept Psychol, Seattle, WA 98195 USA. [Van Dijk, G.] Univ Groningen, Dept Anim Physiol, NL-9750 AA Haren, Netherlands. [Wilkinson, C. W.] VA Puget Sound Hlth Care Syst, GRECC, Seattle, WA 98195 USA. [Wilkinson, C. W.] Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. RP Figlewicz, DP (reprint author), VA Puget Sound Hlth Care Syst, 1660 So Columbian Way, Seattle, WA 98108 USA. EM latte@u.washington.edu OI van Dijk, Gertjan/0000-0002-6565-4019 FU American Diabetes Association; Juvenile Diabetes Foundation; NIH [DK40963]; Department of Veterans Affairs; Dutch Diabetes Foundation FX The authors gratefully acknowledge the technical assistance of Libby Colasurdo, Carl Sikkema, Laura Beth Johnson, Anne Ferrel, and Rachael Bomar in these studies. Support for these studies was provided by the American Diabetes Association and the Juvenile Diabetes Foundation; and by NIH DK40963; the Department of Veterans Affairs; and the Dutch Diabetes Foundation. NR 34 TC 9 Z9 9 U1 1 U2 2 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 1025-3890 J9 STRESS JI Stress PY 2002 VL 5 IS 3 BP 217 EP 226 DI 10.1080/1025389021000010558 PG 10 WC Behavioral Sciences; Endocrinology & Metabolism; Neurosciences SC Behavioral Sciences; Endocrinology & Metabolism; Neurosciences & Neurology GA V19RV UT WOS:000208090400007 PM 12186684 ER PT J AU Keire, DA Anton, P Faull, KF Ruth, E Walsh, JH Chew, P Quisimoro, D Territo, M Reeve, JR AF Keire, DA Anton, P Faull, KF Ruth, E Walsh, JH Chew, P Quisimoro, D Territo, M Reeve, JR TI Diethyl phthalate, a chemotactic factor secreted by Helicobacter pylori SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID DI(2-ETHYLHEXYL) PHTHALATE; GASTRIC-CARCINOMA; PROTEIN-1 MCP-1; INFECTION; METABOLITES; CHEMOKINES; LEUKOCYTES; MUCOSA; IDENTIFICATION; HEMODIALYSIS AB The structure of a small-molecule, non-peptide chemotactic factor has been determined from activity purified to apparent homogeneity from Helicobacter pylori supernatants. H. pylori was grown in brucella broth media until one liter of solution had 0.9 absorbance units. The culture was centrifuged, and the bacteria re-suspended in physiological saline and incubated at 37 degreesC for 4 h. A monocyte migration bioassay revealed the presence of a single active chemotactic factor in the supernatant from this incubation. The chemotactic factor was concentrated by solid phase chromatography and purified by reverse phase high pressure liquid chromatography. The factor was shown to be indistinguishable from diethyl phthalate (DEP) on the basis of multiple criteria including nuclear magnetic resonance spectroscopy, electron impact mass spectroscopy, UV visible absorption spectrometry, GC and high pressure liquid chromatography retention times, and chemotactic activity toward monocytes. Control experiments with incubated culture media without detectable bacteria did not yield detectable DEP, suggesting it is bacterially derived. It is not known if the bacteria produce diethyl phthalate de novo or if it is a metabolic product of a precursor molecule present in culture media. DEP produced by H. pylori in addition to DEP present in man-made products may contribute to the high levels of DEP metabolites observed in human urine. DEP represents a new class of chemotactic factor. C1 Vet Affairs Greater Los Angeles Hlth Care Syst, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Civil & Environm Engn, Environm Engn Analyt Chem Lab, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Chem & Biochem, Pasarow Mass Spectrometry Lab, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Med, Div Hematol Oncol, Los Angeles, CA 90024 USA. City Hope Res Inst, Beckman Res Inst, Div Immunol, Duarte, CA 91010 USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA 90024 USA. RP Reeve, JR (reprint author), Vet Affairs Greater Los Angeles Hlth Care Syst, CURE Digest Dis Res Ctr, Bldg 115,Rm 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NCI NIH HHS [CA3572]; NIAID NIH HHS [K-24 AI 01610, AI 28697]; NIDDK NIH HHS [DK-41301] NR 52 TC 11 Z9 18 U1 0 U2 5 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD DEC 28 PY 2001 VL 276 IS 52 BP 48847 EP 48853 DI 10.1074/jbc.M109811200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 522XK UT WOS:000173922100031 PM 11677249 ER PT J AU Dolor, RJ Witsell, DL Hellkamp, AS Williams, JW Califf, RM Simel, DL AF Dolor, RJ Witsell, DL Hellkamp, AS Williams, JW Califf, RM Simel, DL CA CAFFS Investigators TI Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis - The CAFFS trial: A randomized controlled trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ACUTE MAXILLARY SINUSITIS; ORAL ANTIBIOTIC-THERAPY; CULTURES; SPRAY; IRRIGATION; CHILDREN; VALIDITY; ADJUNCT AB Context It is not known whether intranasal corticosteroids are beneficial to treat acute rhinosinusitis in patients with a history of chronic or recurrent sinus symptoms. Objective To assess whether the addition of an intranasal corticosteroid to antibiotic therapy affects the speed and rate of recovery of such patients with acute rhinosinusitis. Design, Setting, and Patients A double-blind, randomized, placebo-controlled multicenter trial of 95 patients (median age, 39 years) with a history of recurrent sinusitis or chronic rhinitis and evidence of acute infection by sinus radiograph or nasal endoscopy, which was conducted from October 1998 through April 2000 at 22 sites (12 primary care and 10 otolaryngology). Intervention Two puffs (total dose, 200 mug) of fluticasone propionate (n=47) or placebo nasal spray (n=48) in each nostril once daily for 21 days; all received 2 puffs of xylometazoline hydrochloride in each nostril twice daily for 3 days and 250 mg of cefuroxime axetil twice daily for 10 days. Main Outcome Measure Time to clinical success (patient reported cured or much improved) during telephone follow-up at 10, 21, and 56 days. Results A total of 88 patients (93%) completed follow-up. Patients recorded their symptoms, work assessment, and compliance during the 3-week treatment phase. Patients receiving fluticasone achieved a significantly higher rate of clinical success than patients receiving placebo (93.5% vs 73.9%; P=.009). Patients treated with fluticasone improved significantly more rapidly (median of 6.0 days to clinical success) vs patients in the placebo group (median of 9.5 days; P=.01). Conclusions The addition of fluticasone to xylometazoline and antimicrobial therapy with cefuroxime improves clinical success rates and accelerates recovery of patients with a history of chronic rhinitis or recurrent sinusitis who present for treatment of acute rhinosinusitis. C1 Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC 27705 USA. Durham Vet Affairs Med Ctr, Dept Med, Durham, NC USA. Durham Vet Affairs Med Ctr, Dept Surg, Div Internal Med, Durham, NC USA. Duke Univ, Med Ctr, Div Otolaryngol, Durham, NC USA. Univ Texas, Hlth Sci Ctr, Audie L Murphy Div, S Texas Vet Affairs Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Div Internal Med, San Antonio, TX USA. RP Dolor, RJ (reprint author), Duke Univ, Med Ctr, Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 NR 31 TC 96 Z9 101 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD DEC 26 PY 2001 VL 286 IS 24 BP 3097 EP 3105 DI 10.1001/jama.286.24.3097 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 505QM UT WOS:000172927100027 PM 11754675 ER PT J AU Shin, JM Goldshleger, R Munson, KB Sachs, G Karlish, SJD AF Shin, JM Goldshleger, R Munson, KB Sachs, G Karlish, SJD TI Selective Fe2+-catalyzed oxidative cleavage of gastric H+,K+-ATPase - Implications for the energy transduction mechanism of P-type cation pumps SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID TRANSPORT ADENOSINE-TRIPHOSPHATASE; SARCOPLASMIC-RETICULUM; ALPHA-SUBUNIT; CONFORMATIONAL TRANSITIONS; STRUCTURAL ASPECTS; CRYSTAL-STRUCTURE; + K+)-ATPASE; H,K ATPASE; H,K-ATPASE; NA,K-ATPASE AB In the presence of ascorbate/H2O2, Fe2+ ions or the ATP-Fe2+ complex catalyze selective cleavage of the alpha subunit of gastric H+, K+-ATPase. The electrophoretic mobilities of the fragments and dependence of the cleavage patterns on E-1 and E-2 conformational states are essentially identical to those described previously for renal Na+, K+-ATPase. The cleavage pattern of H+, K+-ATPase by Fe2+ ions is consistent with the existence of two Fe2+ sites: site I within highly conserved sequences in the P and A domains, and site 2 at the cytoplasmic entrance to trans-membrane segments M3 and MI. The change in the pattern of cleavage catalyzed by Fe2+ or the ATP-Fe2+ complex induced by different ligands provides evidence for large conformational movements of the N, P, and A cytoplasmic domains of the enzyme. The results are consistent with the Ca2+-ATPase crystal structure (Protein Data Bank identification code 1EUL; Toyoshima, C., Nakasako, M., Nomura, H., and Ogawa, H. (2000) Nature 405, 647-655), an E1Ca2+ conformation, and a theoretical model of Ca2+-ATPase in an E2 conformation (Protein Data Bank identification code 1FQU). Thus, it can be presumed that the movements of N, P, and A cytoplasmic domains, associated with the E-1 <----> E-2 transitions, are similar in all P-type ATPases. Fe-2-catalyzed cleavage patterns also reveal sequences involved in phosphate, Mg2+, and ATP binding, which have not yet been shown in crystal structures, as well as changes which occur in E-1 <----> E2 transitions, and subconformations induced by H+, K+-ATPase-specific ligands such as SCH28080. C1 Weizmann Inst Sci, Dept Biol Chem, IL-76100 Rehovot, Israel. Univ Calif Los Angeles, Dept Physiol, Membrane Biol Lab, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Karlish, SJD (reprint author), Weizmann Inst Sci, Dept Biol Chem, IL-76100 Rehovot, Israel. FU NIDDK NIH HHS [DK41301, DK53462, DK17294, DK46917] NR 54 TC 24 Z9 24 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD DEC 21 PY 2001 VL 276 IS 51 BP 48440 EP 48450 DI 10.1074/jbc.M106864200 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 505QL UT WOS:000172927000096 PM 11585827 ER PT J AU Usuka, J Grupe, A Germer, S Aud, D Belknap, JK Klein, RF Ahluwalia, MK Peltz, G AF Usuka, J Grupe, A Germer, S Aud, D Belknap, JK Klein, RF Ahluwalia, MK Peltz, G TI In silico mapping of mouse quantitative trait loci - Response SO SCIENCE LA English DT Editorial Material C1 Roche Biosci, Dept Genet & Genom, Palo Alto, CA 94303 USA. Roche Mol Syst, Alameda, CA 94501 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. RP Usuka, J (reprint author), Roche Biosci, Dept Genet & Genom, Palo Alto, CA 94303 USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC ADVANCEMENT SCIENCE PI WASHINGTON PA 1200 NEW YORK AVE, NW, WASHINGTON, DC 20005 USA SN 0036-8075 J9 SCIENCE JI Science PD DEC 21 PY 2001 VL 294 IS 5551 PG 2 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 505QU UT WOS:000172927700003 ER PT J AU Meier, DE Back, AL Morrison, RS AF Meier, DE Back, AL Morrison, RS TI The inner life of physicians and care of the seriously ill SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID DOCTOR-PATIENT COMMUNICATION; ASSISTED SUICIDE; MEDICAL-STUDENTS; PALLIATIVE CARE; PERSONAL GROWTH; NATIONAL SURVEY; SEXUAL CONTACT; STRESS; DEATH; COUNTERTRANSFERENCE AB Seriously ill persons are emotionally vulnerable during the typically protracted course of an illness. Physicians respond to such patients' needs and emotions with emotions of their own, which may reflect a need to rescue the patient, a sense of failure and frustration when the patient's illness progresses, feelings of powerlessness against illness and its associated losses, grief, fear of becoming ill oneself, or a desire to separate from and avoid patients to escape these feelings. These emotions can affect both the quality of medical care and the physician's own sense of well-being, since unexamined emotions may also lead to physician distress, disengagement, burnout, and poor judgment. In this article, which is intended for the practicing, nonpsychiatric clinician, we describe a model for increasing physician self-awareness, which includes identifying and working with emotions that may affect patient care. Our approach is based on the standard medical model of risk factors, signs and symptoms, differential diagnosis, and intervention. Although it is normal to have feelings arising from the care of patients, physicians should take an active role in identifying and controlling those emotions. C1 CUNY Mt Sinai Sch Med, Dept Geriatr & Adult Dev, Hertzberg Palliat Care Inst, New York, NY 10029 USA. Univ Washington, Sch Med, Dept Med Hist & Eth, Dept Med,VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Meier, DE (reprint author), CUNY Mt Sinai Sch Med, Dept Geriatr & Adult Dev, Hertzberg Palliat Care Inst, Box 1070, New York, NY 10029 USA. NR 95 TC 244 Z9 249 U1 4 U2 26 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD DEC 19 PY 2001 VL 286 IS 23 BP 3007 EP 3014 DI 10.1001/jama.286.23.3007 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 502VY UT WOS:000172764500036 PM 11743845 ER PT J AU Herbert, V AF Herbert, V TI Hereditary hemochromatosis SO ANNALS OF INTERNAL MEDICINE LA English DT Letter ID IRON C1 Mt Sinai New York Univ Hlth Syst, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. RP Herbert, V (reprint author), Mt Sinai New York Univ Hlth Syst, Bronx, NY 10468 USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD DEC 18 PY 2001 VL 135 IS 12 BP 1091 EP 1091 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 502TW UT WOS:000172759700015 PM 11747394 ER PT J AU Tsuang, DW Skol, AD Faraone, SV Bingham, S Young, KA Prabhudesai, S Haverstock, SL Mena, F Menon, AS Bisset, D Pepple, J Sauter, F Baldwin, C Weiss, D Collins, J Boehnke, M Schellenberg, GD Tsuang, MT AF Tsuang, DW Skol, AD Faraone, SV Bingham, S Young, KA Prabhudesai, S Haverstock, SL Mena, F Menon, AS Bisset, D Pepple, J Sauter, F Baldwin, C Weiss, D Collins, J Boehnke, M Schellenberg, GD Tsuang, MT TI Examination of genetic linkage of chromosome 15 to schizophrenia in a large veterans affairs cooperative study sample SO AMERICAN JOURNAL OF MEDICAL GENETICS LA English DT Article DE chromosome 15; schizophrenia; linkage; genetics; nicotinic cholinergic receptor ID GENOME SCAN; DIAGNOSTIC INTERVIEW; SUSCEPTIBILITY GENES; NO EVIDENCE; LOCUS; RELATIVES; FAMILIES; CHRNA7; CONSORTIUM; EXPRESSION AB Previous studies have reported genetic linkage evidence for a schizophrenia gene on chromosome 15q. Here, chromosome 15 was examined by genetic linkage analysis using 166 schizophrenia families, each with two or more affected subjects. The families, assembled from multiple centers by the Department of Veterans Affairs Cooperative Study Program, consisted of 392 sampled affected subjects and 216 affected sibling pairs. By DSM-III-R criteria, 360 subjects (91.8%) had a diagnosis of schizophrenia and 32 (8.2%) were classified as schizo-affective disorder, depressed. Participating families had diverse ethnic backgrounds. The largest single group were northern European American families (n = 62, 37%), but a substantial proportion was African American kindreds (n = 60, 36%). The chromosome 15 markers tested were spaced at intervals of approximately 10 cM over the entire chromosome and 2-5 cM for the region surrounding the alpha -7 nicotinic cholinergic receptor subunit gene (CHRNA7). These markers were genotyped and the data analyzed using semiparametric affecteds-only linkage analysis. In the European American families, there was a maximum Z-score of 1.65 between markers D15S165 and D15S1010. These markers are within 1 cM from CHRNA-7, the site previously implicated in schizophrenia. However, there was no evidence for linkage to this region in the African America kindreds. Published 2001 Wiley-Liss, Inc.(dagger). C1 Mental Illness Res Educ & Clin Ctr, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA. Univ Michigan, Ctr Stat Genet, Ann Arbor, MI 48109 USA. Brockton W Roxbury Vet Affairs Med Ctr, Brockton, MA USA. Harvard Univ, Sch Med, Massachusetts Mental Hlth Ctr, Dept Psychiat, Boston, MA 02115 USA. Harvard Univ, Inst Psychiat Epidemiol & Genet, Boston, MA 02115 USA. Vet Affairs Med Ctr, Cooperat Studies Program Coordinating Ctr, Perry Point, MD USA. Vet Affairs Med Ctr, Waco, TX USA. Vet Affairs Med Ctr, Danville, IL USA. Vet Affairs Med Ctr, Augusta, GA USA. Vet Affairs Med Ctr, Tuskegee, AL USA. Vet Affairs Med Ctr, Perry Point, MD USA. Ctr Geriatr Res Educ & Clin, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Gerontol, Seattle, WA 98195 USA. Univ Washington, Dept Geriatr Med, Seattle, WA 98195 USA. Vet Affairs Med Ctr, New Orleans, LA USA. Vet Affairs Med Ctr, Northport, NY USA. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. RP Schellenberg, GD (reprint author), Mental Illness Res Educ & Clin Ctr, Vet Affairs Puget Sound Hlth Care Syst, 182 GRECC,1660 S Columbian Way, Seattle, WA 98108 USA. RI Tsuang, Debby/L-7234-2016 OI Tsuang, Debby/0000-0002-4716-1894; Faraone, Stephen/0000-0002-9217-3982 NR 40 TC 54 Z9 55 U1 2 U2 5 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0148-7299 J9 AM J MED GENET JI Am. J. Med. Genet. PD DEC 8 PY 2001 VL 105 IS 8 BP 662 EP 668 DI 10.1002/ajmg.1550 PG 7 WC Genetics & Heredity SC Genetics & Heredity GA 497TE UT WOS:000172470900003 PM 11803512 ER PT J AU Freedman, R Leonard, S Olincy, A Kaufmann, CA Malaspina, D Cloninger, CR Svrakic, D Faraone, SV Tsuang, MT AF Freedman, R Leonard, S Olincy, A Kaufmann, CA Malaspina, D Cloninger, CR Svrakic, D Faraone, SV Tsuang, MT TI Evidence for the multigenic inheritance of schizophrenia SO AMERICAN JOURNAL OF MEDICAL GENETICS LA English DT Article DE schizophrenia; bipolar disorder; genetics; linkage analysis; chromosomes human pair 6, 10, and 15 ID GENETICALLY COMPLEX TRAITS; CHRNA7 GENE REGION; SUSCEPTIBILITY LOCUS; LINKAGE ANALYSIS; CHROMOSOME-15 LOCUS; VULNERABILITY LOCUS; SUGGESTIVE EVIDENCE; NO EVIDENCE; PEDIGREES; FAMILIES AB Schizophrenia is assumed to have complex inheritance because of its high prevalence and sporadic familial transmission. Findings of linkage on different chromosomes in various studies corroborate this assumption. It is not known whether these findings represent heterogeneous inheritance, in which various ethnic groups inherit illness through different major gene effects, or multigenic inheritance, in which affected individuals inherit several common genetic abnormalities. This study therefore examined inheritance of schizophrenia at different genetic loci in a nationally collected European American and African American sample. Seventy-seven families were previously genotyped at 458 markers for the NIMH Schizophrenia Genetics Initiative. Initial genetic analysis tested a dominant model, with schizophrenia and schizoaffective disorder, depressed type, as the affected phenotype. The families showed one genome-wide significant linkage (Z = 3.97) at chromosome 15q14, which maps within 1 cM of a previous linkage at the alpha7-nicotinic receptor gene. Chromosome 10p13 showed suggestive linkage (Z = 2.40). Six others (6q21, 9q32, 13q32, 15q24, 17p12, 20q13) were positive, with few differences between the two ethnic groups. The probability of each family transmitting schizophrenia through two genes is greater than expected from the combination of the independent segregation of each gene. Two trait-locus linkage analysis supports a model in which genetic alleles associated with schizophrenia are relatively common in the general population and affected individuals inherit risk for illness through at least two different loci. (C) 2001 Wiley-Liss, Inc. C1 Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Denver VA Med Ctr, Dept Psychiat, Denver, CO USA. Denver VA Med Ctr, Dept Pharmacol, Denver, CO USA. Columbia Univ, Dept Psychiat, New York, NY 10032 USA. Washington Univ, Dept Psychiat, St Louis, MO 63130 USA. Harvard Univ, Sch Med, Massachusetts Mental Hlth Ctr, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA. RP Freedman, R (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Psychiat, C268-71, Denver, CO 80262 USA. RI Cloninger, Claude/F-5357-2012 OI Cloninger, Claude/0000-0003-3096-4807; Faraone, Stephen/0000-0002-9217-3982 NR 50 TC 74 Z9 76 U1 0 U2 2 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0148-7299 J9 AM J MED GENET JI Am. J. Med. Genet. PD DEC 8 PY 2001 VL 105 IS 8 BP 794 EP 800 DI 10.1002/ajmg.10100 PG 7 WC Genetics & Heredity SC Genetics & Heredity GA 497TE UT WOS:000172470900024 PM 11803533 ER PT J AU Watson, PA Nesterova, A Burant, CF Klemm, DJ Reusch, JEB AF Watson, PA Nesterova, A Burant, CF Klemm, DJ Reusch, JEB TI Diabetes-related changes in cAMP response element-binding protein content enhance smooth muscle cell proliferation and migration SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID HIGH GLUCOSE; CARDIOVASCULAR-DISEASE; KINASE PATHWAY; CYCLIC-AMP; VITAMIN-E; TRANSCRIPTION; ACTIVATION; GROWTH; CREB; CBP AB We hypothesized that diabetes and glucose-induced reactive oxygen species lead to depletion of cAMP response element-binding protein (CREB) content in the vasculature. In primary cultures of smooth muscle cells (SMC) high medium glucose decreased CREB function but increased SMC chemokinesis and entry into the cell cycle. These effects were blocked by pretreatment with the antioxidants. High glucose increased intracellular reactive oxygen species detected by CM-H(2)DCFA. SMC exposed to oxidative stress (H2O2) demonstrated a 3.5-fold increase in chemokinesis (p < 0.05) and accelerated entry into cell cycle, accompanied by a significant decrease in CREB content. Chronic oxidative challenge similar to the microenvironment in diabetes (glucose oxidase treatment) decreases CREB content (40-50%). Adenoviral-mediated expression of constitutively active CREB abolished the increase in chemokinesis and cell cycle progression induced by either high glucose or oxidative stress. Analysis of vessels from insulin resistant or diabetic animals indicates that CREB content is decreased in the vascular stroma. Treatment of insulin-resistant animals with the insulin sensitizer rosiglitazone restores vessel wall CREB content toward that observed in normal animals. In summary, high glucose and oxidative stress decrease SMC CREB content increase chemokinesis and entry into the cell cycle, which is blocked by antioxidants or restoration of CREB content. Thus, decreased vascular CREB content could be one of the molecular mechanisms leading to increased atherosclerosis in diabetes. C1 Denver Vet Affairs Med Ctr, Denver Res Inst, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Div Endocrinol, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Cardiovasc Pulm Res Sect, Denver, CO 80220 USA. Pfizer Inc, Ann Arbor, MI 48105 USA. RP Reusch, JEB (reprint author), Denver Vet Affairs Med Ctr, Denver Res Inst, Rm 9C-120,1055 Clermont St, Denver, CO 80220 USA. OI Burant, Charles/0000-0001-9189-5003 FU NIDDK NIH HHS [K08 DK02351, R01 DK53969] NR 55 TC 54 Z9 55 U1 0 U2 2 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD DEC 7 PY 2001 VL 276 IS 49 BP 46142 EP 46150 DI 10.1074/jbc.M104770200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 499LR UT WOS:000172573100089 PM 11560925 ER PT J AU Rosenthal, MJ Hwang, IK Song, MK AF Rosenthal, MJ Hwang, IK Song, MK TI Effects of arachidonic acid and cyclo (his-pro) on zinc transport across small intestine and muscle tissues SO LIFE SCIENCES LA English DT Article DE zinc; arachidonic acid; cyclo (his-pro); rat; muscle tissue; small intestine ID THYROTROPIN-RELEASING-HORMONE; DEPENDENT DIABETES-MELLITUS; GLUCOSE-TOLERANCE; INSULIN; RAT; METABOLISM; COPPER; CYCLO(HIS-PRO); SUPPLEMENTS; CALCIUM AB Previously we have shown that arachidonic acid (AA) plus zinc or cyclo (his-pro) (CHP) plus zinc improve clinical signs of diabetes in streptozotocin-induced diabetic rats. Since streptozotocin destroys pancreatic P-cells, we hypothesize that the effect of either AA or CHP, plus zinc on glucose metabolism is via mobilization of intracellular zinc which in turn stimulates glucose uptake by peripheral tissues. We now report the relationship between zinc and AA and between zinc and CHP in controlling zinc influx and efflux across hindlimb muscle cells isolated from three-month old rats. Although CHP increased muscle zinc influx in a dose-dependent manner, AA was not effective. However, AA was more effective in stimulating zinc efflux than CHP. We have previously demonstrated that AA stimulates intestinal zinc uptake and absorption, and now present evidence that CHP also influences intestinal zinc transport. These results suggest that both AA and CHP affect glucose uptake in muscle cells via stimulating intestinal zinc absorption and muscle cell zinc flux. (C) 2001 Elsevier Science Inc. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda VA Med Ctr, Geriatr Res & Educ Ctr 11E, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Ctr Human Nutr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. RP Rosenthal, MJ (reprint author), VA Greater Los Angeles Healthcare Syst, Sepulveda VA Med Ctr, Geriatr Res & Educ Ctr 11E, Sepulveda, CA 91343 USA. FU NIDDK NIH HHS [1 R43 DK 56546-01] NR 45 TC 16 Z9 17 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0024-3205 J9 LIFE SCI JI Life Sci. PD DEC 7 PY 2001 VL 70 IS 3 BP 337 EP 348 DI 10.1016/S0024-3205(01)01395-9 PG 12 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 500PR UT WOS:000172636400009 PM 12005266 ER PT J AU Ozen, M Giri, D Ropiquet, F Mansukhani, A Ittmann, M AF Ozen, M Giri, D Ropiquet, F Mansukhani, A Ittmann, M TI Role of fibroblast growth factor receptor signaling in prostate cancer cell survival SO JOURNAL OF THE NATIONAL CANCER INSTITUTE LA English DT Article ID EPITHELIAL-CELLS; OVER-EXPRESSION; FGF RECEPTORS; IN-VITRO; APOPTOSIS; PROLIFERATION; TRANSDUCTION; SUPPRESSION; GENE AB Background: Expression of fibroblast growth factors (FGFs) is increased in a substantial fraction of human prostate cancers in vivo and in prostate cancer cell lines. Altered FGF signaling can potentially have a variety of effects, including stimulating cell proliferation and inhibiting cell death. To determine the biologic significance of altered FGF signaling in human prostate cancer, we disrupted signaling by expression of a dominant-negative (DN) FGF receptor in prostate cancer cell lines. Methods: PC-3, LNCaP, and DU145 prostate cancer cells were stably transfected with DN FGFR constructs, and LNCaP and DU145 cells were infected with a recombinant adenovirus expressing DN FGFR-1. The effect of DN FGFR-1 expression was assessed by colony-formation assays, cell proliferation assays, flow cytometry, and cytogenetic analysis. Key regulators involved in the G(2)-to-M cell cycle transition were assessed by western blotting to examine cyclin B1 expression and by in vitro kinase assay to assess cdc2 kinase activity. Results: Stable transfection of the DN FGFR-1 construct inhibited colony formation by more than 99% in all three cell lines. Infection of LNCaP and DU145 prostate cancer cells with adenovirus expressing DN FGFR-1 led to extensive cell death within 48 hours. Flow cytometry and cytogenetic analysis revealed that the DN FGFR-1 receptor led to arrest in the G(2) phase of the cell cycle before cell death. Cyclin B1 accumulated in DN FGFR-1-infected LNCaP cells, but cdc2 kinase activity was decreased. Conclusions: These findings reveal an unexpected dependence of prostate cancer cells on FGF receptor signal transduction to traverse the G(2)/M checkpoint. The mechanism for the G(2) arrest is not clear. Our results raise the possibility that FGF-signaling antagonists might enhance the cell death induced by other prostate cancer therapies. C1 Houston Dept Vet Affairs Med Ctr, Res Serv, Houston, TX 77030 USA. NYU, Sch Med, Dept Microbiol, New York, NY USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. RP Ittmann, M (reprint author), Houston Dept Vet Affairs Med Ctr, Res Serv, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 27 TC 60 Z9 64 U1 0 U2 2 PU NATL CANCER INSTITUTE PI BETHESDA PA 9030 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0027-8874 J9 J NATL CANCER I JI J. Natl. Cancer Inst. PD DEC 5 PY 2001 VL 93 IS 23 BP 1783 EP 1790 DI 10.1093/jnci/93.23.1783 PG 8 WC Oncology SC Oncology GA 498DN UT WOS:000172494700008 PM 11734594 ER PT J AU Udris, EM Au, DH McDonell, MB Chen, LW Martin, DC Tierney, WM Fihn, SD AF Udris, EM Au, DH McDonell, MB Chen, LW Martin, DC Tierney, WM Fihn, SD TI Comparing methods to identify general internal medicine clinic patients with chronic heart failure SO AMERICAN HEART JOURNAL LA English DT Article ID PRACTICE GUIDELINES; PHARMACY RECORDS; DECISION-SUPPORT; MANAGEMENT; OUTCOMES; MORTALITY; ENALAPRIL; DYSFUNCTION; CARVEDILOL; MORBIDITY AB Objectives Identification of patients with left ventricular systolic dysfunction is the first step in identifying which patients may benefit from clinical practice guidelines. The purpose of this study was to develop and validate a computerized tool using clinical information that is commonly available to identify patients with left ventricular systolic dysfunction (LVSD). Methods We performed a cross-sectional study of patients seen in a Department of Veterans Affairs General Internal Medicine Clinic who had echocardiography or radionuclide ventriculography performed as part of their clinical care. Results We identified 2246 subjects who had at least one cardiac imaging study. A total of 778 (34.6%) subjects met study criteria for LVSD. Subjects with LVSD were slightly older than subjects without LVSD (70 years vs 68 years, P = .00002) but were similar with regard to sex and race. Subjects with LVSD were more likely to have prescriptions for angiotensin-converting enzyme (ACE) inhibitors, carvedilol, digoxin, loop diuretics, hydralazine, nitrates, and angiotensin II receptor antagonists. Of the variables included in the final predictive model, ACE inhibitors, loop diuretics, and digoxin exerted the greatest predictive power. Discriminant analysis demonstrated that models containing pharmacy information were consistently more accurate (75% accurate [65% sensitivity, 81% specificity]) than those models that contained only International Classification of Diseases, 9th revision (ICD-9), codes, including ICD-9 codes for congestive heart failure (72% accurate [80% sensitivity, 68% specificity]). Conclusions We demonstrated that an automated, computer-driven algorithm identifying LVSD permits simple, rapid, and timely identification of patients with congestive heart failure by use of only routinely collected data. Future research is needed to develop accurate electronic identification of heart failure and other common chronic conditions. C1 Vet Affairs Puget Sound Hlth Care Syst, NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Rochester, Dept Med, Div Cardiol, Rochester, NY USA. Richard L Roudebush Vet Affairs Med Ctr, Hlth Serv Res & Dev Program, Indianapolis, IN USA. Indiana Univ, Sch Med, Dept Med, Div Gen Internal Med & Geriatr, Indianapolis, IN USA. RP Udris, EM (reprint author), Vet Affairs Puget Sound Hlth Care Syst, NW Hlth Serv Res & Dev Ctr Excellence, 1660 S Columbian Way, Seattle, WA 98108 USA. EM ed.udris@med.va.gov NR 31 TC 14 Z9 14 U1 0 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 EI 1097-5330 J9 AM HEART J JI Am. Heart J. PD DEC PY 2001 VL 142 IS 6 BP 1003 EP 1009 DI 10.1067/mhj.2001.119130 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 500JQ UT WOS:000172623900013 PM 11717604 ER PT J AU Metz, DC Forsmark, C Lew, EA Starr, JA Soffer, EF Bochenek, W Pisegna, JR AF Metz, DC Forsmark, C Lew, EA Starr, JA Soffer, EF Bochenek, W Pisegna, JR TI Replacement of oral proton pump inhibitors with intravenous pantoprazole to effectively control gastric acid hypersecretion in patients with Zollinger-Ellison syndrome SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID OMEPRAZOLE; MANAGEMENT; RESECTION; SECRETION AB OBJECTIVES: In patients with Zollinger-Ellison syndrome (ZES) or other conditions requiring oral doses of proton pump inhibitors, it frequently becomes necessary to use parenterally administered gastric acid inhibitors. However, i.v. histamine-2 receptor antagonists are not effective at usual doses and lose their effectiveness because of tachyphlaxis. With the approval in the United States of i.v. pantoprazole, a substituted benzimidazole available in i.v. formulation, it will become possible to acutely manage gastric acid secretion in the acute care setting of a hospital. This study was developed to monitor the safety and establish the efficacy of i.v. pantoprazole as an alternative to oral proton pump inhibitors for the control of gastric acid hypersecretion in patients with ZES. METHODS: The efficacy of replacing oral PPI therapy with i.v. pantoprazole was evaluated in 14 ZES patients. After study enrollment, patients taking their current doses of oral PPI (omeprazole or lansoprazole) were switched to pantoprazole i.v. for 6 days during an 8-day inpatient period in the clinical research center. Effective control was defined as an acid output (AO) of < 10 mEq/h (<5 mEq/h in patients with prior gastric acid-reducing surgery). RESULTS: The mean age of the 14 patients enrolled in the study was 52.4 yr (range = 38-67). Mean basal AO was 0.55 +/- 0.32 mEq/h and mean fasting gastrin was 1089 pg/ml (range = 36-3720). Four patients were also diagnosed with the multiple endocrine neoplasia type I syndrome, nine were male, and two had previously undergone acid-reducing surgery. Before study enrollment, gastric acid hypersecretion was controlled in nine of 14 patients with omeprazole (20-200 mg daily) and five of 14 with lansoprazole (30-210 mg daily). In the oral phase of the study all patients had adequate control of gastric acid secretion, with a mean AO of 0.55 0.32 mEq/h (mean SEM). Thereafter, 80 mg of i.v. pantoprazole was administered b.i.d. for 7 days by a brief (15 min) infusion and the dose was titrated upward to a predetermined maximum of 240 mg/24 h to control AO. A dose of 80 mg b.i.d. of i.v. pantoprazole controlled AO in 13 of 14 of the patients (93%) for the duration of the study (p > 0.05 compared to baseline values for all timepoints). One sporadic ZES patient (oral control value = 0.65 mEq/h on 100 mg of omeprazole b.i.d. p.o.) was not controlled with 80 mg of i.v. pantoprazole b.i.d. and dosage was titrated upward to 120 mg b.i.d. after day 2. CONCLUSIONS: There were no serious adverse events observed. Intravenous pantoprazole provides gastric acid secretory control that is equivalent to the acid suppression observed with oral proton pump inhibitors. Most ZES patients (93%) maintained effective control of AO previously established with oral PPIs when switched to 80 mg of i.v. pantoprazole b.i.d; however, for difficult-to-control patients, doses > 80 mg b.i.d. may be required. (C) 2001 by Am. Coll. of Gastroenterology. C1 Univ Penn, Med Ctr, Dept Med, Div Gastroenterol,GI Physiol Lab, Philadelphia, PA 19104 USA. Univ Calif Los Angeles, CURE, Digest Dis Res Ctr, Div Digest Dis,Dept Med,VA Greater Los Angeles He, Los Angeles, CA USA. Univ Florida, Div Gastroenterol, Gainesville, FL USA. Wyeth Ayerst Res, Clin Res & Dev, Radnor, PA USA. RP Pisegna, JR (reprint author), VA Greater Los Angeles Healthcare Syst 111C, Div Gastroenterol & Hepatol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NCRR NIH HHS [M01-RR00040, M01-RR00000] NR 20 TC 23 Z9 24 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD DEC PY 2001 VL 96 IS 12 BP 3274 EP 3280 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502WV UT WOS:000172766500009 PM 11774936 ER PT J AU Chang, L Lee, OY Naliboff, B Mayer, EA AF Chang, L Lee, OY Naliboff, B Mayer, EA TI Sensation of bloating and visible abdominal distension in patients with irritable bowel syndrome SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID INTESTINAL GAS; UNITED-STATES; DISORDERS; SYMPTOMS; IMPACT; PAIN; FERMENTATION; PREVALENCE; PERCEPTION AB OBJECTIVES: Abdominal bloating and distension are common symptoms of irritable bowel syndrome (IBS). The postulated pathophysiological mechanisms underlying these symptoms include increased production, retention, or perception of gas or luminal contents. The aims of this study were to prospectively compare the prevalence of, and clinical factors related to, bloating and distension in an IBS patient population. METHODS: A total of 714 consecutive patients who met Rome I criteria for IBS were prospectively surveyed, and were classified as having bloating alone (B) or bloating and distension (B-I-D) based on a comprehensive bowel symptom questionnaire. GI, extraintestinal, and psychological symptoms, as well as health-related quality of life measures were also assessed using validated survey instruments. RESULTS: A total of 542 IBS patients (76%) who reported abdominal bloating were studied. Of these, 132 patients fulfilled criteria for the B group, whereas 410 patients fulfilled criteria for the B+D group. There was a significantly different gender distribution in the B and B+D groups (female:male ratios, 1.4:1 and 2.8:1, respectively p < 0.02). There was also a significantly different bowel habit subgroup distribution, with a greater predominance of constipation in B+D group and of diarrhea in the B group (p < 0.03). Both groups were similar in other clinical parameters, including progressive worsening of symptoms during the day, and relief by passing stool or gas. Both bloating and distension worsened when other abdominal symptoms worsened. Abdominal distension was associated with greater symptom severity and less diurnal variation in symptoms, and was less often perceived as associated with food intake. CONCLUSIONS: Bloating and visible abdominal distension may arise from two distinct but interrelated physiological processes. Although the sensation of bloating may be related to enhanced sensitivity to visceral afferent stimulation, abdominal distension in more severely affected patients may be related to triggering of a visceromotor reflex affecting the tone of abdominal wall muscles. (C) 2001 by Am. Coll. of Gastroenterology. C1 Univ Calif Los Angeles, CURE, Digest Dis Res Ctr, Neuroenter Dis Program,Dept Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Hanyang Univ, Coll Med, Dept Med, Seoul 133791, South Korea. Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Gastroenterol, Mexico City, DF, Mexico. RP Chang, L (reprint author), Univ Calif Los Angeles, CURE Clin Res Ctr, 924 Westwood Blvd, Los Angeles, CA 90024 USA. NR 30 TC 90 Z9 94 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD DEC PY 2001 VL 96 IS 12 BP 3341 EP 3347 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502WV UT WOS:000172766500020 PM 11774947 ER PT J AU Wolfe, MM Welage, LS Sachs, G AF Wolfe, MM Welage, LS Sachs, G TI Proton pump inhibitors and gastric acid secretion SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Letter ID OMEPRAZOLE SUSPENSION; PANTOPRAZOLE; ULCERS C1 Boston Univ, Sch Med, Gastroenterol Sect, Boston, MA 02118 USA. Boston Med Ctr, Boston, MA 02118 USA. Univ Michigan, Coll Pharm, Ann Arbor, MI 48109 USA. Univ Calif Los Angeles, Sch Med, Div Gastroenterol, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Wolfe, MM (reprint author), Boston Med Ctr, Room 507,650 Albany St, Boston, MA 02118 USA. NR 8 TC 4 Z9 4 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD DEC PY 2001 VL 96 IS 12 BP 3467 EP 3468 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 502WV UT WOS:000172766500062 PM 11774990 ER PT J AU Giri, D Ozen, M Ittmann, M AF Giri, D Ozen, M Ittmann, M TI Interleukin-6 is an autocrine growth factor in human prostate cancer SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID CARCINOMA-CELLS; ANDROGEN RECEPTOR; MESSENGER-RNA; EXPRESSION; BENIGN; HYPERPLASIA; ACTIVATION; PARACRINE; PATHWAY; KINASE AB Prostate cancer is the most common cancer in American men and the second leading cause of cancer deaths in this group. We have found that interleukin (IL)-6 protein concentrations are increased similar to 18-fold in clinically localized prostate cancers when compared to normal prostate tissue. Normal and neoplastic prostatic epithelial cells in culture, with the exception of LNCaP cells, secrete IL-6. Addition of exogenous IL-6 to primary epithelial cells in culture or the LNCaP prostate cancer cell line leads to phosphorylation of Stat-3 and increases in net cell proliferation. The concentration of IL-6 receptor is increased eightfold in the prostate cancer tissues and is increased in the cancer cells by immunohistochemistry. The increased expression of IL-6 receptor is correlated with increased proliferation of prostate cancer cells in vivo as assessed by Ki67 immunohistochemistry. These findings strongly support the hypothesis that IL-6 acts as a significant autocrine growth factor in vivo for primary, androgen-dependent prostate cancers. C1 Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Houston, TX USA. RP Ittmann, M (reprint author), VAMC, Res Serv 151, 2002 Holcombe Blvd, Houston, TX 77030 USA. FU NIDDK NIH HHS [R01 DK54170, R01 DK054170] NR 24 TC 216 Z9 218 U1 0 U2 5 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 0002-9440 J9 AM J PATHOL JI Am. J. Pathol. PD DEC PY 2001 VL 159 IS 6 BP 2159 EP 2165 DI 10.1016/S0002-9440(10)63067-2 PG 7 WC Pathology SC Pathology GA 497LR UT WOS:000172457400021 PM 11733366 ER PT J AU Feig, BW Curley, S Lucci, A Hunt, KK Vauthey, JN Mansfield, PF Cleary, K Hamilton, S Ellis, V Brame, M Berger, DH AF Feig, BW Curley, S Lucci, A Hunt, KK Vauthey, JN Mansfield, PF Cleary, K Hamilton, S Ellis, V Brame, M Berger, DH TI A caution regarding lymphatic mapping in patients with colon cancer SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 53rd Annual Meeting of the Southwestern-Surgical-Congress CY APR 29-MAY 02, 2001 CL CANCUN, MEXICO SP SW Surg Congress DE colon cancer; lymphatic mapping; sentinel lymph node ID COLORECTAL-CANCER; NODE MICROMETASTASES; ADJUVANT THERAPY; CARCINOMA; FLUOROURACIL; IDENTIFICATION; LEVAMISOLE; RESECTION; MELANOMA; SURVIVAL AB Background: The value of lymphatic mapping and sentinel lymph node biopsy in the treatment of colon cancer is controversial. The purpose of this study was to determine the accuracy of lymphatic mapping in patients with colon cancer. Methods: Forty-eight patients with colon cancer underwent lymphatic mapping and sentinel lymph node biopsy using isosulfan blue dye followed by standard surgical resection. The sentinel lymph nodes underwent thin sectioning as will as immunohistochemical staining for cytokeratin, in addition to standard hematoxylin and eosin staining. Results: In 47 (98%) patients, a sentinel lymph node was identified. Sixteen patients had lymph nodes containing metastatic disease, and in 6 patients the sentinel lymph node was positive for disease. In no patient was the sentinel lymph node the only site of metastatic disease. In 10 patients the sentinel lymph node was negative for disease, whereas the nonsentinel lymph nodes contained metastatic disease (false negative rate = 38%) Conclusions: The role of lymphatic mapping and sentinel lymph node biopsy in colon cancer is not as clear as its role in other tumors. Further large prospective studies are needed to evaluate the accuracy and potential benefit of this procedure in patients with colon cancer. (C) 2002 Excerpta Medica, Inc. All rights reserved. C1 Univ Texas, MD Anderson Canc Ctr, Dept Surg Oncol, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Feig, BW (reprint author), Univ Texas, MD Anderson Canc Ctr, Dept Surg Oncol, Box 444,1515 Holcombe Blvd, Houston, TX 77030 USA. EM bwfeig@mdanderson.org NR 25 TC 54 Z9 58 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9610 EI 1879-1883 J9 AM J SURG JI Am. J. Surg. PD DEC PY 2001 VL 182 IS 6 BP 707 EP 712 DI 10.1016/S0002-9610(01)00803-0 PG 6 WC Surgery SC Surgery GA 522JZ UT WOS:000173894000031 PM 11839343 ER PT J AU McGregor, DK Khurana, KK Cao, C Tsao, CC Ayala, G Krishnan, B Ro, JY Lechago, J Truong, LD AF McGregor, DK Khurana, KK Cao, C Tsao, CC Ayala, G Krishnan, B Ro, JY Lechago, J Truong, LD TI Diagnosing primary and metastatic renal cell carcinoma - The use of the monoclonal antibody 'renal cell carcinoma marker' SO AMERICAN JOURNAL OF SURGICAL PATHOLOGY LA English DT Article DE primary renal cell carcinoma; metastatic renal cell carcinoma; immunostaining; monoclonal antibody; renal cell carcinoma marker ID IMMUNOHISTOCHEMICAL ANALYSIS; DIFFERENTIAL-DIAGNOSIS; EPITHELIAL NEOPLASMS; GRANULAR CYTOPLASM; INTERCALATED CELLS; SURFACE-ANTIGENS; TUMORS; ONCOCYTOMA; KIDNEY; CYTOKERATIN-7 AB The diagnosis of primary or metastatic renal cell carcinoma (RCC) can be difficult, especially in small biopsies, because of the wide variety of histologic appearances and clinical presentations that RCC can assume. An immunomarker specific for RCC is currently not available. We tested the relevant diagnostic use of the Renal Cell Carcinoma Marker (RCC Ma), a monoclonal antibody, against a normal human proximal tubular brush border antigen. immunostaining using RCC Ma and the avidin-biotin-peroxidase complex technique was performed on archival tissues from primary and metastatic tumors of renal or nonrenal origin. A total of 122 of 153 primary RCCs (79.7%) were positive (clear cell (84%), papillary (96%), chromophobe (45%), sarcomatoid (25%, and collecting duct (0%)], with greater than or equal to 10% of tumor cells stained in 93% of cases. None of the 64 primary renal tumors other than RCC, including 15 oncocytomas, was positive. Fifteen of 146 (10.2%) nonrenal primary tumors were positive (5 of 17 breast tumors, 8 of 8 parathyroid adenomas, and 2 of 7 embryonal carcinomas). Forty-two of 63 (67%) metastatic RCCs were positive with greater than or equal to 10% of cells being stained in 83% of them. Two of 108 (2%) metastases from tumors other than RCCs were positive, both of which were metastatic breast carcinomas; however, only 10% (2 of 19) of metastatic breast carcinomas were positive, RCC Ma is an excellent marker for primary RCC, which should facilitate its diagnosis in a small biopsy. Although RCC Ma remains highly specific (98%) for metastatic RCC, a negative result may not rule out metastatic RCC because of a rather low sensitivity and a focal staining pattern in some of the positive cases. RCC Ma may also facilitate the differential diagnosis between oncocytoma and other types of RCC when they are composed mostly of eosinophilic cells. C1 Methodist Hosp, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. VA Med Ctr, Dept Pathol, Houston, TX USA. MD Anderson Canc Ctr, Dept Pathol, Houston, TX USA. Upstate Med Univ, Syracuse, NY USA. RP Truong, LD (reprint author), Methodist Hosp, Dept Pathol, 6565 Fannin St,MS205, Houston, TX 77030 USA. NR 32 TC 120 Z9 123 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0147-5185 J9 AM J SURG PATHOL JI Am. J. Surg. Pathol. PD DEC PY 2001 VL 25 IS 12 BP 1485 EP 1492 DI 10.1097/00000478-200112000-00003 PG 8 WC Pathology; Surgery SC Pathology; Surgery GA 496ZU UT WOS:000172428900003 PM 11717537 ER PT J AU Huerta, S Heber, D Sawicki, MP Liu, CD Arthur, D Alexander, P Yip, I Li, ZP Livingston, EH AF Huerta, S Heber, D Sawicki, MP Liu, CD Arthur, D Alexander, P Yip, I Li, ZP Livingston, EH TI Reduced length of stay by implementation of a clinical pathway for bariatric surgery in an academic health care center SO AMERICAN SURGEON LA English DT Article; Proceedings Paper CT Annual Meeting of the Southern-California-Chapter-of-the-American-College-of-Surgeons CY JAN 19-21, 2001 CL SANTA BARBARA, CALIFORNIA SP American Coll Surgeons, S California Chapter ID VERTICAL BANDED GASTROPLASTY; MORBID-OBESITY; PRACTICE GUIDELINES; GASTRIC BYPASS; MANAGED CARE; MEDICINE; REALITY AB Bariatric surgery is being performed in increasing numbers in an era when reimbursements are being reduced. Academic health centers bear the responsibility for training surgeons to perform these operations yet must keep costs to a minimum and retain high quality. The UCLA Bariatric Surgery Program developed a clinical pathway for the pre- and postoperative management for gastric bypass patients to achieve these goals. Medical records for 182 consecutive gastric bypass patients were retrospectively reviewed before implementation of the pathway (Group I) during the fiscal year of 1998/1999. Data on average length of stay, average intensive care unit length of stay, average standard variable cost, percentage readmission rate, and percentage return to the operating room were collected. This information was compared with the data collected prospectively from 182 patients after implementation of the pathway in July of 1999 (Group II) during the fiscal year of 1999/2000. Hospital cost per admission was reduced by 40 per cent in Group II compared with Group I (P < 0.02). The average length of stay was reduced from 4.05 days in Group I to 3.17 days in Group II (P < 0.033). Overall readmission rate was decreased from 4.2 per cent in Group I to 3.2 per cent in Group II (P < 0.05). There were no differences in morbidities between both groups. The pathway reduced costs by reducing the hospital length of stay, intensive care unit utilization, and readmission rates. Quality was maintained as evidenced by a similar pattern of postoperative morbidities yet readmission rates were reduced. Our results indicate that implementation of a clinical pathway for bariatric surgery reduces cost and improves quality of care in an academic institution. C1 VA Greater Los Angeles Hlth Care Syst, Dept Surg 10H2, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Ctr Human Nutr, Los Angeles, CA USA. RP Livingston, EH (reprint author), VA Greater Los Angeles Hlth Care Syst, Dept Surg 10H2, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 23 TC 27 Z9 27 U1 0 U2 0 PU SOUTHEASTERN SURGICAL CONGRESS PI ATLANTA PA 141 WEST WIEUCA RD, STE B100, ATLANTA, GA 30342 USA SN 0003-1348 J9 AM SURGEON JI Am. Surg. PD DEC PY 2001 VL 67 IS 12 BP 1128 EP 1135 PG 8 WC Surgery SC Surgery GA 501HA UT WOS:000172678200003 PM 11768815 ER PT J AU Wexler, HM Molitoris, D Finegold, SM AF Wexler, HM Molitoris, D Finegold, SM TI In vitro activity of gatifloxacin against 238 strains of anaerobic bacteria SO ANAEROBE LA English DT Article DE anaerobic bacteria; quinolone; gatifloxacin; susceptibility; resistance ID UNITED-STATES; QUINOLONES AB The activity of gatifloxacin, a new 8-methoxy-fluoroquinolone, was tested against 208 pulmonary pathogens and against an additional 30 isolates of the Bacteroides fragilis group. Pulmonary isolates were from patients with documented anaerobic pleuropulmonary infections and were obtained by appropriate sampling methods. MICs were determined using the NCCLS-approved Wadsworth brucella laked blood agar method and compared to those of clindamycin, imipenem, metronidazole and trovafloxacin. Breakpoints used to define susceptible and [resistant] categories were (in mug/ml): Clindamycin-2, imipenem-4, metronidazole 8 and trovafloxacin. No breakpoint has been defined for gatifloxacin. Gatifloxacin inhibited 99% of all anaerobes tested at 4 mug/ml and 97% of all strains at 2 mug/ml. One strain of B. fragilis was resistant to gatifloxacin at 4 mug/ml; all strains of other B. fragilis group species were susceptible. One strain of Peptostreptococclis sp. was resistant to both gatifloxacin and trovafloxacin (MIC > 4 pg/ml). All other strains were susceptible to all agents at less than or equal to2 mug/ml. All of the non-sporeforming Gram-positive rods were susceptible to gatifloxacin at less than or equal to4 mug/ml (three strains had an MIC of 4 mug/ml). Trovafloxacin had MICs of 4 mug/ml for two strains, and an MIC of 8 pg/ml for one strain. Five percent of B. fragilis, 21% of other B. fragilis group species and 20% of Clostridium species (other than C. difficile, C. perfringens or C. ramosum) were resistant to clindamycin. No imipenem resistant isolates were found in this study Gatifloxacin appears to have excellent hi vitro activity against pulmonary isolates of anaerobes and very good activity against strains of the B. fragilis group. (C) 2001 Academic Press. C1 VA Greater Los Angeles Healthcare Syst, Med Serv, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Microbiol & Immunol, Los Angeles, CA 90024 USA. RP Wexler, HM (reprint author), Microbial Dis Res Lab, Bldg 304,Room E3-224,VAGLAHS 691-151J, Los Angeles, CA 90073 USA. NR 11 TC 9 Z9 9 U1 0 U2 0 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1075-9964 J9 ANAEROBE JI Anaerobe PD DEC PY 2001 VL 7 IS 6 BP 285 EP 289 DI 10.1006/anae.2001.0395 PG 5 WC Microbiology SC Microbiology GA 523XX UT WOS:000173983800001 ER PT J AU Paiste, J Bjerke, RJ Williams, JP Zenati, MA Nagy, GE AF Paiste, J Bjerke, RJ Williams, JP Zenati, MA Nagy, GE TI Minimally invasive direct coronary artery bypass surgery under high thoracic epidural SO ANESTHESIA AND ANALGESIA LA English DT Article ID ANESTHESIA; ANALGESIA; PATIENT; DISEASE C1 Univ Pittsburgh, Sch Med, Dept Anesthesiol & Crit Care Med, Pittsburgh, PA 15260 USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. RP Paiste, J (reprint author), Univ Pittsburgh, VA Med Ctr, Univ Dr C, Pittsburgh, PA 15240 USA. NR 12 TC 12 Z9 13 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-2999 J9 ANESTH ANALG JI Anesth. Analg. PD DEC PY 2001 VL 93 IS 6 BP 1486 EP 1488 DI 10.1097/00000539-200112000-00028 PG 3 WC Anesthesiology SC Anesthesiology GA 495WU UT WOS:000172364000022 PM 11726428 ER PT J AU Anawalt, BD Amory, JK AF Anawalt, BD Amory, JK TI Advances in male hormonal contraception SO ANNALS OF MEDICINE LA English DT Article DE androgen; gonadotropins; gonadotropin-releasing hormone antagonists; male contraception; progestin; spermatogenesis; testosterone ID EFFECTIVELY SUPPRESSES SPERMATOGENESIS; INJECTABLE TESTOSTERONE UNDECANOATE; HEALTHY-MEN; ORAL LEVONORGESTREL; CYPROTERONE-ACETATE; HYPOGONADAL MEN; CLINICAL-TRIAL; ENANTHATE; GONADOTROPIN; ANDROGEN AB New male contraceptive options are urgently needed. Safe, effective and fully reversible methods of male contraception would be useful for monogamous couples who are trying to regulate their family size. In addition, an effective male hormonal contraceptive that could be implanted or injected as a long-acting formulation every 3-6 months would be useful in countries where limiting population growth has become a public policy imperative. Male hormonal contraception is based on the same principles as traditional oestrogen-progestin female oral contraceptives. Both spermatogenesis and ovulation are dependent upon normal secretion of the pituitary gonadotropins, follicle stimulating hormone (FSH) and luteinizing hormone (LH). Exogenous gonadotropin-releasing hormone (GnRH) analogues and sex steroid hormones such as testosterone (T) and progestins suppress gonadotropins and spermatogenesis. Two large multicentre trials demonstrated that weekly administration of high-dosage T was very effective in suppressing gonadotropins and spermatogenesis and conferred an overall contraceptive efficacy comparable to female oral contraceptives. Studies of combination regimens of lower-dosage T plus a progestin or a GnRH analogue have demonstrated greater suppression of spermatogenesis than the World Health Organization trials of high-dosage T. Most of these male hormonal contraceptives have been associated with modest weight gain and suppression of serum high-density cholesterol (HDL) levels. In this article, we review the new developments in male hormonal contraception. C1 Univ Washington, Dept Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Anawalt, BD (reprint author), Univ Washington, Dept Med, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 57 TC 15 Z9 15 U1 1 U2 2 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1M 8AE, ENGLAND SN 0785-3890 J9 ANN MED JI Ann. Med. PD DEC PY 2001 VL 33 IS 9 BP 587 EP 595 DI 10.3109/07853890109002104 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 512DB UT WOS:000173304900004 PM 11817653 ER PT J AU Vander Zanden, JA Valuck, RJ Bunch, CL Perlman, JI Anderson, C Wortman, GI AF Vander Zanden, JA Valuck, RJ Bunch, CL Perlman, JI Anderson, C Wortman, GI TI Systemic adverse effects of ophthalmic beta-blockers SO ANNALS OF PHARMACOTHERAPY LA English DT Article DE beta-adrenergic antagonists; adverse effects; ophthalmic solutions ID OPEN-ANGLE GLAUCOMA; MEDICAL LITERATURE; EYE DROPS; OCULAR HYPERTENSION; RESPIRATORY ARREST; ASTHMATIC SUBJECTS; TOPICAL TIMOLOL; BETAXOLOL; DRUG; CARTEOLOL AB OBJECTIVE: To review published clinical information on the systemic adverse effects of ophthalmic beta -blockers for the purpose of developing a pilot contraindication/warning system for active prescriptions in the Veterans Affairs dispensing database. DATA SOURCES: Articles were identified by searching MEDLINE (1966-October 2000) and International Pharmaceutical Abstracts (1970-October 2000). STUDY SELECTION AND DATA EXTRACTION: Article relevance was determined by review of titles, abstracts, and key words. DATA SYNTHESIS: The preponderance of the evidence suggests that ophthalmic beta -blockers may be associated with bronchospasm and adverse cardiovascular effects including bradycardia. Depression and other central nervous system effects are reported less commonly. Data are inadequate to suggest that ophthalmic beta -blocker use is routinely associated with adverse metabolic effects. CONCLUSIONS: The strongest level of evidence (grade A1) supports a contraindication for use of ophthalmic beta -blockers for respiratory disease, with a moderate level of evidence (grade B1) for cardiovascular disease. Data are insufficient to support or refute contraindications for other disease states. The search technique and classification scheme described in this article provide a methodology for evaluating, grading, and applying evidence on potential adverse effects of drug therapy. C1 Univ Colorado, Hlth Sci Ctr, Sch Pharm, Dept Pharm Practice, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Sch Pharm, Dept Pharm Practice, Greenwood Village, CO USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Ophthalmol Sect, Hines, IL 60141 USA. Pharmacia Corp, Global Hlth Outcomes Unit, Evergreen, CO USA. RP Valuck, RJ (reprint author), Univ Colorado, Hlth Sci Ctr, Sch Pharm, Dept Pharm Practice, 4200 E 9th Ave,Box C-238, Denver, CO 80262 USA. NR 43 TC 20 Z9 21 U1 1 U2 4 PU HARVEY WHITNEY BOOKS CO PI CINCINNATI PA PO BOX 42696, CINCINNATI, OH 45242 USA SN 1060-0280 J9 ANN PHARMACOTHER JI Ann. Pharmacother. PD DEC PY 2001 VL 35 IS 12 BP 1633 EP 1637 PG 5 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 505VP UT WOS:000172936500023 PM 11793633 ER PT J AU Hind, JA Nicosia, MA Roecker, EB Carnes, ML Robbins, J AF Hind, JA Nicosia, MA Roecker, EB Carnes, ML Robbins, J TI Comparison of effortful and noneffortful swallows in healthy middle-aged and older adults SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE deglutition disorders; geriatrics; rehabilitation; therapeutics ID CLEARANCE; PRESSURE; VOLUME AB Objective: To assess the effects of effortful swallowing, a common compensatory strategy for dysphagia, on the bolus and swallowing mechanism of middle-aged and older men and women. Design: Case-controlled design in which subjects completed both the intervention technique and the control behavior. Setting: A university hospital. Participants: Sixty-four healthy men and women between 45 and 93 years of age from the community. Interventions: Participants swallowed 3-mL thin liquid boluses both normally and using the effortful swallow strategy. Main Outcomes Measures: The biomechanics and bolus flow patterns of swallows were analyzed from videofluoroscopic and simultaneous oral pressure data. Results: Subjects at all ages generated significantly increased oral pressures at each sensor location using the effortful swallow (p = .0001), with the pressure increase greater for the middle-aged subjects compared with older subjects. Several durational measures were significantly longer with the effortful swallow including: hyoid maximum anterior excursion (p < .04), laryngeal vestibule closure (p < .0001), and duration of the upper esophageal sphincter opening (p =.0001). The hyoid bone moved further in the superior direction with the effortful swallow (p = .002). There was a trend of decreased oral residue with the effortful swallow (p = .06). Conclusion: Biomechanical and bolus flow aspects of swallowing changed when healthy individuals performed effortful swallows with 3-mL boluses. C1 William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI USA. Univ Wisconsin, Inst Aging, Madison, WI USA. Univ Wisconsin, Dept Biostat, Madison, WI USA. RP Robbins, J (reprint author), William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, 2500 Overlook Ter GRECC 11G, Madison, WI 53705 USA. FU NINDS NIH HHS [R01 NS24427] NR 20 TC 109 Z9 112 U1 0 U2 10 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD DEC PY 2001 VL 82 IS 12 BP 1661 EP 1665 DI 10.1053/apmr.2001.28006 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 499DR UT WOS:000172556200005 PM 11733879 ER PT J AU Coghlan, ME Sommadossi, JP Jhala, NC Many, WJ Saag, MS Johnson, VA AF Coghlan, ME Sommadossi, JP Jhala, NC Many, WJ Saag, MS Johnson, VA TI Symptomatic lactic acidosis in hospitalized antiretroviral-treated patients with human immunodeficiency virus infection: A report of 12 cases SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 38th Annual Meeting of the Infectious-Diseases-Society-of-America CY SEP 07-10, 2000 CL NEW ORLEANS, LOUISIANA SP Infect Dis Soc Amer ID REVERSE-TRANSCRIPTASE INHIBITORS; MITOCHONDRIAL-DNA; NUCLEOSIDE ANALOG; HEPATIC STEATOSIS; TOXICITY; ZIDOVUDINE; CELLS; DEPLETION; STAVUDINE; FAILURE AB We retrospectively investigated the clinical and histopathologic features of hospitalized patients infected with human immunodeficiency virus who had symptomatic lactic acidosis syndrome at a university teaching hospital during 1995-2000. Twelve patients were identified, 11 during 1998-2000; of these, 5 died with rapid progression to otherwise unexplained multiple-organ failure. All had extensive prior exposure to nucleoside analog reverse-transcriptase inhibitors (NRTIs). At presentation, the most commonly identified NRTI component of antiretroviral regimens was stavudine plus didanosine. Eleven patients presented with abdominal pain, nausea, and/or emesis. Eight patients had prior acute weight loss (mean [+/- SD],12 +/- 5.3 kg). Median venous plasma lactate levels were greater than or equal to2-fold greater than the upper limit of normal (2.1 mmol/L). Serum transaminase levels were near normal limits at presentation. Histopathologic studies confirmed hepatic macrovesicular and microvesicular steatosis in 6 patients. Concurrent chemical pancreatitis was identified in 6 patients. The increasing number of cases identified during the study period suggests that physicians better recognize symptomatic lactic acidosis and/or that cumulative NRTI exposure may increase the risk for this syndrome. C1 Univ Alabama, Sch Med, Div Infect Dis, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Sch Med, Dept Pharmacol & Toxicol, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Anat Pathol, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Johnson, VA (reprint author), Univ Alabama, Sch Med, Div Infect Dis, Dept Med, THT 229,1530 3rd Ave S, Birmingham, AL 35294 USA. FU NHLBI NIH HHS [SK30 HL04146-03]; NIAID NIH HHS [1-RO1-AI40876, 1-RO1-AI33239, 5P30 AI27767-14] NR 26 TC 72 Z9 74 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD DEC 1 PY 2001 VL 33 IS 11 BP 1914 EP 1921 DI 10.1086/323783 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 489NX UT WOS:000171998800018 PM 11692304 ER PT J AU Raisch, DW Troutman, WG Sather, MR Fudala, PJ AF Raisch, DW Troutman, WG Sather, MR Fudala, PJ TI Variability in the assessment of adverse events in a multicenter clinical trial SO CLINICAL THERAPEUTICS LA English DT Article DE adverse events; clinical investigations; research ID DRUG-REACTIONS; JUDGMENTS AB Background: Consistent documentation, characterization, and evaluation of adverse events (AEs) are needed during multicenter clinical trials to ensure accuracy of data reported to the US Food and Drug Administration and in the medical literature. Objective: The purpose of this study was to identify and characterize variations in the assessment of AEs by clinical trial personnel. Methods: During the annual meeting of personnel from a multicenter, controlled clinical trial of an investigational new drug treatment for opioid dependence, an oral presentation of procedures for AE data collection was given to 25 principal investigators and ancillary study personnel who assessed AEs for the study. A post-test using 3 hypothetical AE cases in which AEs were categorized by type of reaction, relatedness to study drug, severity, action taken, and outcome was completed by study participants. Cases and expected responses were reviewed for content and validity by clinical research pharmacists who were not involved with the study. The level of agreement with expected responses was assessed using McNemar symmetry chi-square tests. Results: Assessments of type of AE, relatedness to study drug, and severity were less frequently aligned with expected responses than were action taken and outcome (P < 0.013). Less consistency with expected responses was found in 1 case than in the other 2, suggesting that certain types of AEs may be more difficult to assess. Conclusions: There was considerable variability in categorization of AEs in an exercise following training for AE data collection. Type of report, relatedness, and severity were found to have more variability in reporting than did action taken or outcome. The results suggest that unless data are gathered to verify reliability of reporting, subcategorization of AE data should be undertaken cautiously. Further research is needed regarding methods for improving consistency in reporting of AEs. C1 Dept Vet Affairs, Cooperat Studies Program, Clin Res Pharm Coordinating Ctr, Albuquerque, NM 87106 USA. Univ New Mexico, Coll Pharm, Albuquerque, NM 87131 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Raisch, DW (reprint author), Dept Vet Affairs, Cooperat Studies Program, Clin Res Pharm Coordinating Ctr, 2401 Ctr SE, Albuquerque, NM 87106 USA. NR 19 TC 18 Z9 18 U1 2 U2 3 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0149-2918 J9 CLIN THER JI Clin. Ther. PD DEC PY 2001 VL 23 IS 12 BP 2011 EP 2020 DI 10.1016/S0149-2918(01)80153-3 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 509KA UT WOS:000173145900008 PM 11813935 ER PT J AU Robertson, CL Bell, MJ Kochanek, PM Adelson, PD Ruppel, RA Carcillo, JA Wisniewski, SR Mi, ZC Janesko, KL Clark, RSB Marion, DW Graham, SH Jackson, EK AF Robertson, CL Bell, MJ Kochanek, PM Adelson, PD Ruppel, RA Carcillo, JA Wisniewski, SR Mi, ZC Janesko, KL Clark, RSB Marion, DW Graham, SH Jackson, EK TI Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children: Association with severity of injury and excitotoxicity SO CRITICAL CARE MEDICINE LA English DT Article DE head injury; purine; pediatrics; Glasgow Coma Scale; glutamate; shaken baby syndrome; child abuse ID CEREBRAL-BLOOD-FLOW; SEVERE HEAD-INJURY; AMINO-ACID RELEASE; GLUTAMATE-EVOKED RELEASE; ENDOGENOUS ADENOSINE; INTERSTITIAL ADENOSINE; RECEPTOR STIMULATION; NMDA RECEPTORS; FOCAL ISCHEMIA; RAT STRIATUM AB Objectives. To measure adenosine concentration in the cerebrospinal fluid of infants and children after severe traumatic brain injury and to evaluate the contribution of patient age, Glasgow Coma Scale score, mechanism of injury, Glasgow Outcome Score, and time after injury to cerebrospinal fluid adenosine concentrations. To evaluate the relationship between cerebrospinal fluid adenosine and glutamate concentrations in this population. Design. Prospective survey. Setting. Pediatric intensive care unit in a university-based children's hospital. Patients: Twenty-seven critically ill infants and children who had severe traumatic brain injury (Glasgow Coma Scale <8), who required placement of an intraventricular catheter and drainage of cerebrospinal fluid as part of their neurointensive care. Interventions. None. Measurements and Main Results: Patients ranged in age from 2 months to 14 yrs. Cerebrospinal fluid samples (n = 304) were collected from 27 patients during the first 7 days after traumatic brain injury. Control cerebrospinal fluid samples were obtained from lumbar puncture on 21 infants and children without traumatic brain injury or meningitis. Adenosine concentration was measured by using high-pressure liquid chromatography. Adenosine concentration was increased markedly in cerebrospinal fluid of children after traumatic brain injury vs. controls (p < .001). The increase in cerebrospinal fluid adenosine was independently associated with Glasgow Coma Scale less than or equal to4 vs. >4 and time after injury (both p < .005). Cerebrospinal fluid adenosine concentration was not independently associated with either age (less than or equal to4 vs. >4 yrs), mechanism of injury (abuse vs. other), or Glasgow Outcome Score (good/moderately disabled vs. severely disabled, vegetative, or dead). Of the 27 patients studied, 18 had cerebrospinal fluid glutamate concentration previously quantified by high-pressure liquid chromatography. There was a strong association between increases in cerebrospinal fluid adenosine and glutamate concentrations (p < .005) after injury. Conclusions: Cerebrospinal fluid adenosine concentration is increased in a time- and severity-dependent manner in infants and children after severe head injury. The association between cerebrospinal fluid adenosine and glutamate concentrations may reflect an endogenous attempt at neuroprotection against excitotoxicity after severe traumatic brain injury. C1 Univ Pittsburgh, Safar Ctr Resuscitat Res, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Anesthesiol & Crit Care Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Pediat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Neurol Surg, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Publ Hlth, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Ctr Clin Pharmacol, Pittsburgh, PA 15260 USA. Univ Maryland, Dept Pediat, Baltimore, MD 21201 USA. Childrens Natl Med Ctr, Dept Crit Care Med, Washington, DC 20010 USA. Va Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. Childrens Hosp Pittsburgh, Gen Clin Res Ctr, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Ctr Injury Control & Res, Pittsburgh, PA USA. RP Kochanek, PM (reprint author), Univ Pittsburgh, Safar Ctr Resuscitat Res, 3434 5th Ave, Pittsburgh, PA 15260 USA. EM kochanekpm@anes.upmc.edu RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X; Wisniewski, Stephen/0000-0002-3877-9860 FU NINDS NIH HHS [NS38087] NR 67 TC 32 Z9 34 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD DEC PY 2001 VL 29 IS 12 BP 2287 EP 2293 DI 10.1097/00003246-200112000-00009 PG 7 WC Critical Care Medicine SC General & Internal Medicine GA 505HN UT WOS:000172907500009 PM 11801827 ER PT J AU Redding, SW AF Redding, SW TI The role of yeasts other than Candida albicans in oropharyngeal candidiasis SO CURRENT OPINION IN INFECTIOUS DISEASES LA English DT Review ID HIV-INFECTED INDIVIDUALS; ORAL CANDIDOSIS; ANTIFUNGAL AGENTS; IN-VITRO; DUBLINIENSIS; FLUCONAZOLE; GLABRATA; PATIENT; SUSCEPTIBILITIES; COLONIZATION AB Candida albicans has been recognized as the predominant infecting organism in oropharyngeal candidiasis. Yeasts other than C. albicans are commonly recognized as colonizing the oral cavity but have not been thought to be a significant cause of disease. This review will describe the emergence of yeasts other than C. albicans as causative pathogens in oropharyngeal candidiasis both as co-infecting organisms with C. albicans and as sole pathogens themselves. Diagnosis and treatment of these emerging infections will also be discussed. Curr Opin Infect Dis 14:673-677, (C) 2001 Lippincott Williams & Wilkins. C1 Univ Texas, Hlth Sci Ctr, S Texas Vet Healthcare Syst, Dept Gen Dent, San Antonio, TX 78229 USA. RP Redding, SW (reprint author), Univ Texas, Hlth Sci Ctr, S Texas Vet Healthcare Syst, Dept Gen Dent, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 31 TC 28 Z9 30 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0951-7375 J9 CURR OPIN INFECT DIS JI Curr. Opin. Infect. Dis. PD DEC PY 2001 VL 14 IS 6 BP 673 EP 677 PG 5 WC Infectious Diseases SC Infectious Diseases GA 501BM UT WOS:000172663200002 PM 11964883 ER PT J AU Fan, HX Schichman, SA Swinnen, LJ Nicholls, JM Eagan, PA Luther, M Gulley, ML AF Fan, HX Schichman, SA Swinnen, LJ Nicholls, JM Eagan, PA Luther, M Gulley, ML TI Analytic validation of a competitive polymerase chain reaction assay for measuring Epstein-Barr viral load SO DIAGNOSTIC MOLECULAR PATHOLOGY LA English DT Article DE Epstein-Barr virus; viral load; competitive polymerase chain reaction; analytic test validation ID POSTTRANSPLANT LYMPHOPROLIFERATIVE DISEASE; PEDIATRIC TRANSPLANT PATIENTS; URACIL-DNA GLYCOSYLASE; CYTOTOXIC T-CELLS; NASOPHARYNGEAL CARCINOMA; VIRUS DNA; QUANTITATIVE-ANALYSIS; HODGKINS-DISEASE; PERIPHERAL-BLOOD; PLASMA AB Epstein-Barr virus (EBV) is associated with several benign and malignant diseases, and blood tests for EBV viral load show promise as markers of disease burden in affected patients. A commercial quantitative PCR method (BioSource International) was recently introduced to facilitate measuring viral load. It relies on coamplification of EBV DNA and a spiked competitor in plasma or serum, followed by semiautomated product detection on enzyme-linked immunosorbent assay (ELISA) plates. In the current study, analytic performance characteristics were assessed, and the authors describe several methodologic improvements to facilitate laboratory implementation. Rapid DNA extraction was accomplished using commercial silica spin columns, heat-labile uracil-N-glycosylase was used to inhibit amplicon contamination, and inexpensive agarose gels were used to screen for polymerase chain reaction products requiring ELISA plate quantitation. Accuracy and precision were verified using EBV DNA standards derived from two cell lines and plasmid containing viral sequences. The assay was sensitive to as few as five template copies per polymerase chain reaction and was linear across four orders of magnitude (correlation coefficient 0.995). When applied to matched plasma and serum samples from 15 patients with nasopharyngeal carcinoma, both sample types yielded similar viral load results. This commercial EBV viral load assay provides sensitive and quantitative detection of EBV DNA using equipment already available in many molecular diagnostic laboratories. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Univ Arkansas Med Sci, Little Rock, AR 72205 USA. JL McClellan Vet Affairs Med Ctr, Little Rock, AR USA. Loyola Univ, Cardinal Bernardin Canc Ctr, Maywood, IL 60153 USA. Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. SW Oncol Grp, San Antonio, TX USA. RP Gulley, ML (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. FU NCI NIH HHS [U10 CA32102] NR 25 TC 8 Z9 8 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1052-9551 J9 DIAGN MOL PATHOL JI Diagn. Mol. Pathol. PD DEC PY 2001 VL 10 IS 4 BP 255 EP 264 DI 10.1097/00019606-200112000-00008 PG 10 WC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Pathology SC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Pathology GA 496GY UT WOS:000172388900008 PM 11763317 ER PT J AU Fagerlie, S Lensch, MW Pang, QS Bagby, GC AF Fagerlie, S Lensch, MW Pang, QS Bagby, GC TI The Fanconi anemia group C gene product: Signaling functions in hematopoietic cells SO EXPERIMENTAL HEMATOLOGY LA English DT Review ID DEPENDENT PROTEIN-KINASE; COMPLEMENTATION GROUP-C; NECROSIS-FACTOR-ALPHA; EUKARYOTIC TRANSLATION INITIATION-FACTOR-2; INDUCED APOPTOTIC RESPONSES; MITOMYCIN-C; APLASTIC-ANEMIA; NUCLEAR-COMPLEX; CYTOPLASMIC LOCALIZATION; TARGETED DISRUPTION C1 Oregon Hlth Sci Univ, Inst Canc, Dept Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Inst Canc, Dept Med & Mol Genet, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. RP Bagby, GC (reprint author), Oregon Hlth Sci Univ, Inst Canc, Dept Med, 3181 SW Sam Jackson Pk Rd,Mail Code CR145, Portland, OR 97201 USA. FU NHLBI NIH HHS [HL48546] NR 99 TC 27 Z9 27 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0301-472X J9 EXP HEMATOL JI Exp. Hematol. PD DEC PY 2001 VL 29 IS 12 BP 1371 EP 1381 DI 10.1016/S0301-472X(01)00755-X PG 11 WC Hematology; Medicine, Research & Experimental SC Hematology; Research & Experimental Medicine GA 506BB UT WOS:000172949100003 PM 11750095 ER PT J AU Birbes, H El Bawab, S Hannun, YA Obeid, LM AF Birbes, H El Bawab, S Hannun, YA Obeid, LM TI Selective hydrolysis of a mitochondrial pool of sphingomyelin induces apoptosis SO FASEB JOURNAL LA English DT Article DE targeting; ceramide; mitochondria; apoptosis; Bcl-2; cytochrome c ID PERMEABILITY TRANSITION PORE; CERAMIDE-INDUCED APOPTOSIS; TUMOR-NECROSIS-FACTOR; CYTOCHROME-C RELEASE; DISTINCT POOL; CELL-SURFACE; BCL-2; ACTIVATION; MEMBRANES; DEATH AB Our previous results have indicated that the major cellular pool of sphingomyelin present on the outer leaflet of the plasma membrane is not involved in the ceramide pathway of apoptosis. Thus, in this study we aimed at defining which intracellular pools of sphingomyelin and ceramide are involved in cell death. The bacterial sphingomyelinase (SMase) gene fused with green fluorescent protein was subcloned into mammalian vectors containing sequences that target the fusion proteins to cytoplasm, plasma membrane, mitochondria, Golgi apparatus, endoplasmic reticulum, or nucleus. Transfection of MCF7 breast cancer cells showed for all constructs an increase in SMase activity ranging from 2- to 60-fold, concomitant with an increase in total cellular ceramide levels (10-100%) as compared with vector-transfected cells. Next, the effect of overexpression of the SMase on cell death was examined. Results demonstrate that only when bacterial SMase was targeted to mitochondria did cells undergo apoptosis; its targeting to the other intracellular compartments was ineffective. Further, the results show that apoptosis induced by mitochondrial targeting of bacterial SMase requires SMase catalytic activity, is prevented by the overexpression of Bcl-2, and is mediated by inducing cytochrome c release. These results demonstrate that ceramide induces cell death specifically when generated in mitochondria. The results highlight the significance of compartment-specific lipid-mediated cell regulation, and they offer a novel general approach for these studies. C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm, Charleston, SC 29425 USA. RP Obeid, LM (reprint author), Med Univ S Carolina, Dept Med, 114 Doughty St,Strom Thurmond Bldg,Room 605, Charleston, SC 29425 USA. EM obeidl@musc.edu OI obeid, lina/0000-0002-0734-0847 FU NIA NIH HHS [AG16583]; NIGMS NIH HHS [GM43825] NR 60 TC 166 Z9 170 U1 0 U2 3 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD DEC PY 2001 VL 15 IS 14 BP 2669 EP 2679 DI 10.1096/fj.01-0539com PG 11 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 506HT UT WOS:000172964800037 PM 11726543 ER PT J AU Faigel, DO Gopal, D Weeks, DA Corless, C AF Faigel, DO Gopal, D Weeks, DA Corless, C TI Cap-assisted endoscopic submucosal resection of a pancreatic rest SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID ECTOPIC PANCREAS; ADENOMYOMA; STOMACH C1 Oregon Hlth Sci Univ, Portland VA Med Ctr, Dept Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland VA Med Ctr, Dept Pathol, Portland, OR 97201 USA. RP Faigel, DO (reprint author), Oregon Hlth Sci Univ, Portland VA Med Ctr, Dept Med, P3GI,3710 US Vet Hosp Rd, Portland, OR 97201 USA. NR 12 TC 12 Z9 12 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD DEC PY 2001 VL 54 IS 6 BP 782 EP 784 DI 10.1067/mge.2001.116620 PG 3 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 499HJ UT WOS:000172565500024 PM 11726863 ER PT J AU Mitchell, GF Tardif, JC Arnold, JMO Marchiori, G O'Brien, TX Dunlap, ME Pfeffer, MA AF Mitchell, GF Tardif, JC Arnold, JMO Marchiori, G O'Brien, TX Dunlap, ME Pfeffer, MA TI Pulsatile Hemodynamics in congestive heart failure SO HYPERTENSION LA English DT Article; Proceedings Paper CT 4th International Workshop on Structure and Function on Large Arteries CY APR 27-28, 2001 CL PARIS, FRANCE DE heart failure; hemodynamics; aorta; pulse pressure; vascular stiffness ID AORTIC INPUT IMPEDANCE; LEFT-VENTRICULAR DYSFUNCTION; PULSE PRESSURE; MYOCARDIAL-INFARCTION; ARTERIAL COMPLIANCE; HYDRAULIC LOAD; EXPRESSION; SUPEROXIDE; ACTIVATION; SYNTHASE AB Pulse pressure, an indirect measure of vascular stiffness and pulsatile load, predicts clinical events in congestive heart failure (CHF), suggesting that abnormal pulsatile load may contribute to CHF. This study was designed to assess more direct measures of central pulsatile load in CHF. Noninvasive hemodynamic evaluations were performed in 28 subjects with CHF and 40 controls using calibrated tonometry of the brachial, radial, femoral, and carotid arteries along with echocardiographic assessment of left ventricular outflow tract (LVOT) diameter and Doppler flow. Characteristic impedance (Z(c)) was calculated as the ratio of DeltaP (carotid) and DeltaQ (LVOT flow) in early systole. Carotid-radial (CR-PWV) and carotid-femoral (CF-PWV) pulse wave velocities were calculated from tonometry. Augmentation index was assessed from the carotid waveform. Total arterial compliance (TAC) was calculated using the area method. Brachial pulse pressure was elevated (62 16 versus 53+/-15 mm Hg, P=0.015) in CHF because of lower diastolic pressure (66 10 versus 73 9 mm Hg, P=0.003). CHF had higher Zc (225+/-76 versus 184+/-66 dyne . sec . cm(-5), P=0.020). CF-PWV did not differ (9.7+/-2.7 versus 9.2+/-2.0, P=0.337), whereas CR-PWV was lower in CHF (8.6+/-1.4 versus 9.4+/-1.5, P=0.038). There was no difference in TAC (1.4+/-0.5 versus 1.4+/-0.6 mL/mmHg, P=0.685), and augmentation index was lower in CHF (8 17 versus 21+/-13%, P=0.001). CHF subjects have elevated central pulsatile load (Z(c)), which is not apparent in global measures such as augmentation index or TAC, possibly because of contrasting changes in central and peripheral conduit vessels. This increased pulsatile load represents an important therapeutic target in CHF. C1 Cardiovasc Engn Inc, Holliston, MA 01746 USA. Montreal Heart Inst, Montreal, PQ, Canada. London Sci Ctr, London, ON, Canada. Ralph H Johnson VA Med Ctr, Charleston, SC USA. Louis Stokes VA Med Ctr, Cleveland, OH USA. Brigham & Womens Hosp, Boston, MA USA. RP Mitchell, GF (reprint author), Cardiovasc Engn Inc, 327 Fiske St, Holliston, MA 01746 USA. NR 29 TC 123 Z9 126 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD DEC PY 2001 VL 38 IS 6 BP 1433 EP 1439 DI 10.1161/hy1201.098298 PG 7 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 509HT UT WOS:000173141500038 PM 11751731 ER PT J AU Lenze, EJ Miller, MD Dew, MA Martire, LM Mulsant, BH Begley, AE Schulz, R Frank, E Reynolds, CF AF Lenze, EJ Miller, MD Dew, MA Martire, LM Mulsant, BH Begley, AE Schulz, R Frank, E Reynolds, CF TI Subjective health measures and acute treatment outcomes in geriatric depression SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE self-rated health; geriatric depression; antidepressants; interpersonal psychotherapy ID SELF-RATED HEALTH; QUALITY-OF-LIFE; PERCEIVED HEALTH; ELDERLY PATIENTS; MORTALITY; COMMUNITY; RECURRENT; DISEASE; OLDER; NORTRIPTYLINE AB Background Prior research suggests that elderly patients are less likely to respond to antidepressant treatment if they have low self-rated health. However, successful treatment for depression ha's been associated with improvement in self-rated health and other health measures. Objectives To examine measures of self-rated health, physical disability, and social function as predictors of treatment response in late-life depression, and to assess these same health measures as treatment outcomes. We hypothesized that greater impairment in these measures would predict poorer treatment response, and that these measures would show significant improvements with recovery from depression. Method Subjects were enrolled in a depression intervention study for people aged 60 and older with recurrent unipolar major depression; they were assessed with measures of self-rated health, physical disability, and social functioning at baseline and at the end of treatment. Baseline measures were compared between the 88 remitters. I I non-remitters, and seven dropouts. Additionally, changes in the measures were examined in subjects who recovered from the index depressive episode. Results Subjects with poorer self-rated health at baseline were more likely both to drop out of treatment and to not respond to adequate treatment. This relationship was independent of demographic measures, severity of depression, physical and social functioning, medical illness, personality, hopelessness, overall medication use, and side effects or non-compliance with treatment. Conclusion Although this finding is preliminary because of the small number of dropouts and non-remitters, it suggests that lower self-rated health may independently predict premature discontinuation of treatment for depression. Additionally, subjects who recovered from depression showed significant improvements in self-rated health, physical disability, and social functioning. Copyright (C) 2001 John Wiley Sons, Ltd. C1 Univ Pittsburgh, Sch Med, Dept Psychiat, Intervent Res Ctr Late Life Mood Disorders, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlth Care Syst, GRECC, Pittsburgh, PA USA. RP Lenze, EJ (reprint author), Western Psychiat Inst & Clin, 3811 OHara St,Room E1124, Pittsburgh, PA 15213 USA. FU NIMH NIH HHS [K01 MH01683, K05 MH00295, P30 MH52247, R01 MH37869, T32 MH19986] NR 36 TC 23 Z9 23 U1 1 U2 5 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD DEC PY 2001 VL 16 IS 12 BP 1149 EP 1155 DI 10.1002/gps.503 PG 7 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 508BU UT WOS:000173068000005 PM 11748774 ER PT J AU Mintzer, J Faison, W Street, JS Sutton, VK Breier, A AF Mintzer, J Faison, W Street, JS Sutton, VK Breier, A TI Olanzapine in the treatment of anxiety symptoms due to Alzheimer's disease: a post hoc analysis SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article; Proceedings Paper CT Symposium on Management of Psychoses in Older People CY NOV, 2000 CL BARCELONA, SPAIN SP Eli Lilly DE Behavoral and Psychological Symptoms of Dementia (BPSD); Alzheimer's disease; anxiety; pharmacological treatment; atypical antipsycholics ID BEHAVIORAL SYMPTOMS; NEUROPSYCHIATRIC INVENTORY; ELDERLY PATIENTS; DOUBLE-BLIND; DEMENTIA; DISORDERS; PLACEBO; TRIAL; HALOPERIDOL; PSYCHOSIS AB Background Alzheimer's disease (AD) is associated with both cognitive and behavioral symptoms. Agitation, hallucinations, delusions, aggression, irritability, and anxiety are observed in up to 90% of patients with dementia. Although new information has emerged in recent years on the treatment of psychosis and agitation in dementia, very little information is available about the treatment of anxiety symptoms in this population. Objectives To assess the efficacy and tolerability of olanzapine in the treatment of significant anxiety symptoms in patients with AD. Methods A post hoc analysis of a previously published study was performed. Those post hoc analysis evaluated the response to treatment with olanzapine of a subgroup of AD patients presenting with significant symptoms of anxiety. Patients were considered to have significant symptoms or anxiety if their baseline in the Nursing home version of the Neuropsychiatric Instrument NPI/NH anxiety scores were greater than or equal to 2. The analysis included 120 patients. Results Patients receiving olanzapine 5 mg/d were statistically significantly improved on the NPI/NH Anxiety item compared to those receiving placebo (olanzapine, 5 mg/d: -3.72; placebo: -1.67; p = 0.034). In the group of patients with clinically significant anxiety, somnolence was the only treatment-emergent event that was statistically different in any olanzapine treatment group compared with placebo (olanzapine 5 mg/d: 9 patients [25%], p = 0.034 10 mg/d: 7 [23%], p = 0.054; 15 mg/d: 7 [26%], p = 0.050; placebo: 1 [3.7%]). When controlling for treatment-emergent somnolence, the improvement in anxiety in the olanzapine 5 mg/d group remained Statistically significant (p = 0.049). Conclusions These findings suggest that olanzapine could be a safe and effective treatment for anxiety in Alzheimer's disease. Copyright (C), 2001 John Wiley Sons, Ltd. C1 Med Univ S Carolina, Alzheimers Res & Clin Programs, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Mental Hlth Serv, Charleston, SC USA. Ralph H Johnson VA Med Ctr, Div Publ Psychiat, Charleston, SC USA. Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA. RP Mintzer, J (reprint author), Med Univ S Carolina, Alzheimers Res & Clin Programs, 5900 Core Rd,Suite 203, N Charleston, SC 29406 USA. NR 33 TC 19 Z9 20 U1 0 U2 3 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD DEC PY 2001 VL 16 SU 1 BP S71 EP S77 DI 10.1002/1099-1166(200112)16:1+<::AID-GPS568>3.0.CO;2-M PG 7 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 509EC UT WOS:000173132000009 PM 11748790 ER PT J AU De Andrade, E Otomo-Corgel, J Pucher, J Ranganath, KA St George, N AF De Andrade, E Otomo-Corgel, J Pucher, J Ranganath, KA St George, N TI The intraosseous course of the mandibular incisive nerve in the mandibular symphysis SO INTERNATIONAL JOURNAL OF PERIODONTICS & RESTORATIVE DENTISTRY LA English DT Article ID INFERIOR ALVEOLAR NERVE; BONE-GRAFTS; OSSEOINTEGRATED IMPLANTS; CHIN; JAW AB The use of the mandibular symphysis as a source of autogenous bone grafting material has been well documented. Currently, no references in the literature describe the intraosseous distribution of the neurovascular complex anterior to the mental nerve with respect to its position buccolingually and apicocoronally. The objective of this study was to evaluate the distribution of the incisive nerve and measure its location buccolingually and apicocoronally in the anterior mandible and determine its possible significance to clinical practice. According to macroscopic dissection, the mandibular incisive nerve is a normal structure that typically extends closer to the midline than previously reported. To reduce postoperative neurovascular morbidity, this should be considered when using the mandibular symphysis as a source of autogenous bone or during placement of implants in the anterior mandible. C1 VA Greater Los Angeles Hlth Care Syst, Dept Periodontol, Sch Dent, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Periodontol, Sch Dent, Los Angeles, CA 90024 USA. Private Practice Ltd Periodont, Los Angeles, CA USA. VA Greater Los Angeles Hlth Care Syst, Postdoctoral Periodont Residency Program, Los Angeles, CA USA. VA Greater Los Angeles Hlth Care Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. RP De Andrade, E (reprint author), 529 Artola St, Las Vegas, NV 89144 USA. NR 22 TC 27 Z9 27 U1 0 U2 0 PU QUINTESSENCE PUBL CO INC PI CAROL STREAM PA 551 NORTH KIMBERLY DR, CAROL STREAM, IL 60188-1881 USA SN 0198-7569 J9 INT J PERIODONT REST JI Int. J. Periodontics Restor. Dent. PD DEC PY 2001 VL 21 IS 6 BP 591 EP 597 PG 7 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 508UK UT WOS:000173107900007 PM 11794570 ER PT J AU Sweet, RA Pollock, BG Sukonick, DL Mulsant, BH Rosen, J Klunk, WE Kastango, KB DeKosky, ST Ferrell, RE AF Sweet, RA Pollock, BG Sukonick, DL Mulsant, BH Rosen, J Klunk, WE Kastango, KB DeKosky, ST Ferrell, RE TI The 5-HTTPR polymorphism confers liability to a combined phenotype of psychotic and aggressive behavior in Alzheimer disease SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Article DE serotonin transporter; Alzheimer disease; genetic; polymorphism; psychosis ID SEROTONIN TRANSPORTER GENE; COGNITIVE DECLINE; SYMPTOMS; DEMENTIA; PREDICTORS; DELUSIONS; PROGRESSION; DEPRESSION; AGITATION; PROMOTER AB Background: Psychotic symptoms in subjects with Alzheimer disease (AD+psychosis, AD+P) are a marker for a distinct phenotype characterized by more rapid cognitive and functional decline and a liability to aggressive behaviors. We recently found that AD subjects homozygous for long alleles (1) of an insertion/deletion polymorphism in the promoter region of the serotonin transporter (5-HTTPR) had elevated rates of aggressive behavior. Objective: To examine whether the 5-HTTPR ll genotype confers an increased risk of AD+P, and of the combined AD+P/aggressive phenotype. Methods: The 5-HTTPR genotype was determined in 332 subjects diagnosed with possible or probable AD. All subjects received structured psychiatric assessments and were categorized with regard to their history of aggressive behaviors and psychotic symptoms. Results: Consistent with other reports, AD+P was associated with a significant increased risk for aggressive behavior. AD+P and aggression were both significantly associated with 5-HTTPR ll genotype and with an increased I allele frequency. Subjects with the combined behavioral phenotype (AD+P and aggressive behavior) had the highest rate of ll genotype and highest l allele frequency. Conclusion: The 5-HTTPR I allele appears to confer risk for the combined AD+P/aggressive phenotype. Confirmation of this association in a similar behaviorally well-characterized independent sample is needed. C1 Univ Pittsburgh, Grad Sch Publ Hlth, Dept Psychiat, Div Geriatr & Neuropsychiat, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Neurol, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Sch Med, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Human Genet, Pittsburgh, PA 15261 USA. VA Pittsburgh Hlth Care Syst, GRECC, Pittsburgh, PA USA. RP Sweet, RA (reprint author), Western Psychiat Inst & Clin, 3811 OHara St, Pittsburgh, PA 15213 USA. OI Klunk, William/0000-0001-5512-0251 FU NIA NIH HHS [AG05133]; NIMH NIH HHS [MH01509, MH01613, MH52247, MH59666] NR 34 TC 72 Z9 73 U1 4 U2 9 PU SPRINGER PUBLISHING CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10012 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PD DEC PY 2001 VL 13 IS 4 BP 401 EP 409 DI 10.1017/S1041610201007827 PG 9 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 541QP UT WOS:000174995500002 PM 12003247 ER PT J AU Asch, SM Gifford, AL Bozzette, SA Turner, B Mathews, WC Kuromiya, K Cunningham, W Andersen, R Shapiro, M Rastegar, A McCutchan, JA AF Asch, SM Gifford, AL Bozzette, SA Turner, B Mathews, WC Kuromiya, K Cunningham, W Andersen, R Shapiro, M Rastegar, A McCutchan, JA TI Underuse of primary Mycobacterium avium complex and Pneumocystis carinii prophylaxis in the United States SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article; Proceedings Paper CT 12th World AIDS Conference CY JUN 28-JUL 03, 1998 CL GENEVA, SWITZERLAND DE MAC prophylaxis; PCP prophylaxis; HIV guidelines; HIV-positive; HIV prevention ID HIV-INFECTED ADULTS; ANTIRETROVIRAL THERAPY; GUIDELINES; ADHERENCE; PREVENTION; DISEASE AB Background: Little is known about the rates of Mycobacterium avium complex (MAC) and Pneumocystis carinii (PCP) prophylaxis adherence to guidelines and how they have changed after introduction of effective antiretroviral therapy. Objective: To determine rates of primary prophylaxis for MAC and PCP and to evaluate the influence of sociodemographic characteristics. region, and provider experience. Design: National probability sample cohort of HIV patients in care. Setting: One hundred sixty HIV health care providers. Patients: A total of 2864 patients interviewed in 1996 to 1997 (68% response) and 2267 follow-up interviews, representing 65% of surviving sampled patients (median follow-up, 15.1 months). Measurements: Use of prophylactic drugs, most recent CD4 count, sociodemographics, and regional and total HIV patients/providers. Results: Of patients eligible for primary MAC prophylaxis (most recent CD4 count < 50/mm(3)), 41% at baseline and 40% at follow-up patients were treated. Of patients eligible for primary PCP prophylaxis (i.e., those with CD4 counts < 200/mm(3);). 64% and 72% were treated, respectively. MAC prophylaxis at baseline was less likely in African American (adjusted odds ratio [OR], 35; 95% confidence interval [CI], 0.20-0.59), Hispanic (OR, 27; 95% CI, 0.08-0.94) and less-educated (OR, 0.61; 95% Cl, 0.36-1.0) patients and more likely in U. S. geographic regions in the Pacific West (OR, 4.9; 95% Cl, 1.0-23) and Midwest (OR, 6.4; 95% Cl, 1.2-33) and in practices with more HIV patients. Conclusions: Most eligible patients did not receive MAC prophylaxis; PCP prophylaxis rates were better but still suboptimal. Our results support outreach efforts to African Americans, Hispanics, the less educated, and those in the northeastern United States and in practices with fewer HIV patients. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. San Diego Hlth Syst, San Diego, CA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Univ Calif San Diego, San Diego, CA 92103 USA. RAND Hlth, Santa Monica, CA USA. Thomas Jefferson Univ, Jefferson Med Coll, Philadelphia, PA 19107 USA. RP Asch, SM (reprint author), VA Greater Los Angeles Healthcare Syst, 111G,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Mathews, William/E-4451-2010 OI Mathews, William/0000-0002-2352-0725 FU AHRQ HHS [U-01HS08578] NR 11 TC 24 Z9 24 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD DEC 1 PY 2001 VL 28 IS 4 BP 340 EP 344 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 494YH UT WOS:000172313100006 PM 11707670 ER PT J AU Bauer, MS Williford, WO Dawson, EE Akiskal, HS Altshuler, L Fye, C Gelenberg, A Glick, H Kinosian, B Sajatovic, M AF Bauer, MS Williford, WO Dawson, EE Akiskal, HS Altshuler, L Fye, C Gelenberg, A Glick, H Kinosian, B Sajatovic, M TI Principles of effectiveness trials and their implementation in VA cooperative study #430: 'Reducing the efficacy-effectiveness gap in bipolar disorder' SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE bipolar disorder; clinical trial; outcome assessment (health care); costs and cost analysis (cost-benefit analysis); United States Department of Veterans Affairs; National Institute of Mental Health ID MENTAL-HOSPITAL TREATMENT; LITHIUM CARBONATE PROPHYLAXIS; ASSERTIVE COMMUNITY TREATMENT; FOLLOW-UP; NATIONAL-INSTITUTE; CLINICAL-PRACTICE; MANIA; ILLNESS; READMISSIONS; CARE AB Despite the availability of efficacious treatments for bipolar disorder, their effectiveness in general clinical practice is greatly attenuated, resulting in what has been called an 'efficacy-effectiveness gap'. In designing VA Cooperative Studies Program (CSP) Study #430 to address this gap, nine principles for conducting an effectiveness (in contrast to an efficacy) study were identified. These principles are presented and discussed, with specific aspects of CSP #430 serving as illustrations of how they can be implemented in an actual study. CSP #430 hypothesizes that an integrated, clinic-based treatment delivery system that emphasizes ( I) algorithm-driven somatotherapy, (2) standardized patient education. and (3) easy access to a single primary mental health care provider to maximize continuity-of-care, will address the efficacy-effectiveness gap and improve disease. functional, and economic outcome. It is an 11-site, randomized controlled clinical trial of this multi-modal, clinic-based intervention versus usual VA care running from 1997 to 2003. The trial has enrolled 191 subjects in each arm. using minimal exclusion criteria to maximize the external validity of the study. Subjects are followed for 3 years. The intervention is highly specified in a series of operations manuals for each of the three components. Several continuous quality improvement (CQI) interventions, process measures, and statistical techniques deal with drift of care in both the intervention and usual care arms to ensure the internal validity of the study. CSP #430 is designed to have impact well beyond the VA, since it evaluates a basic health care operational principle: that augmenting ambulatory access for major mental illness will improve outcome and reduce overall treatment costs. If results are positive, this study will provide a reason to reconsider the prevailing trend toward limitation of ambulatory services that is characteristic of many managed care systems today. Published by Elsevier Science B.V. C1 Providence VA Med Ctr, Providence, RI USA. Brown Univ, Dept Psychiat & Human Behav, Providence, RI 02912 USA. VA Cooperat Studies Coordinating Ctr, Perry Point, MD USA. Univ Calif Los Angeles, San Diego, CA USA. W Los Angeles VA Med Ctr, Los Angeles, CA USA. VA Cooperat Studies Program Clin Res Pharm Coordi, Albuquerque, NM USA. Univ Arizona, Dept Psychiat, Tucson, AZ USA. Univ Penn, Sect Gen Med, Philadelphia, PA 19104 USA. Case Western Reserve Univ, Dept Psychiat, Cleveland, OH 44106 USA. VA Med Ctr, Cleveland, OH USA. RP Bauer, MS (reprint author), Brown Univ, VAMC, 116R, Providence, RI 02908 USA. RI Sajatovic, Martha/I-8001-2014 NR 90 TC 60 Z9 60 U1 5 U2 10 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD DEC PY 2001 VL 67 IS 1-3 BP 61 EP 78 AR PII S0165-0327(01)00440-2 DI 10.1016/S0165-0327(01)00440-2 PG 18 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 535FD UT WOS:000174633800006 PM 11869753 ER PT J AU Yerevanian, BI Koek, RJ Ramdev, S AF Yerevanian, BI Koek, RJ Ramdev, S TI Anxiety disorders comorbidity in mood disorder subgroups: data from a mood disorders clinic SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE bipolar disorder; mood disorders; epidemiology; comorbidity ID OBSESSIVE-COMPULSIVE DISORDER; PANIC DISORDER; BIPOLAR DISORDER; UNIPOLAR DEPRESSION; MAJOR DEPRESSION; FAMILY HISTORY; MANIA; CONNECTION; HYPOMANIA; PHOBIA AB Background: Previous research has identified a high rate of anxiety disorders comorbidity in patients with a primary mood disorder diagnosis. Discrepancies between studies in the comorbidity prevalence of specific anxiety disorders in mood disorders, and of anxiety disorders comorbidity between unipolar depression and bipolar mood disorder are in part due to differences in sampling and diagnostic assessment methodology. Method: The authors reviewed the charts of 138 patients who received the SCID-P for DSM-III on enrollment in a Mood Disorders Clinic during the period 1982 through 1988. The comorbidity of specific DSM-III Anxiety Disorders with specific mood disorders was determined and comparatively examined using non-parametric statistics. Results: There was high overall comorbidity of anxiety disorders that did not differ between bipolar and unipolar subjects. There were no differences in the comorbidity of individual anxiety disorder diagnoses in the unipolar vs. bipolar groups. However, in unipolar patients with, compared to those without an additional diagnosis of dysthymia, there was greater overall anxiety disorders comorbidity, with a particularly high prevalence of generalized anxiety disorder. Limitations: The subgroup of patients with bipolar I disorder was relatively small (N = 8). Conclusion: Mood and anxiety disorders comorbidity is complex and presents a continuing challenge for both clinicians and researchers. (C) 2001 Elsevier Science B.V. All rights reserved. C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst, Sepulveda Mood Disorders Clin, Sepulveda, CA USA. RP Yerevanian, BI (reprint author), 16111 Plummer St,116A-11, Sepulveda, CA 91343 USA. NR 36 TC 21 Z9 22 U1 1 U2 6 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD DEC PY 2001 VL 67 IS 1-3 BP 167 EP 173 AR PII S0165-0327(01)00448-7 DI 10.1016/S0165-0327(01)00448-7 PG 7 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 535FD UT WOS:000174633800017 PM 11869764 ER PT J AU Merriam, GR Barsness, S Buchner, D Kletke, M Larsen, LH Moe, KE Schwartz, RS Vitiello, MV AF Merriam, GR Barsness, S Buchner, D Kletke, M Larsen, LH Moe, KE Schwartz, RS Vitiello, MV TI Growth hormone releasing hormone treatment in normal aging SO JOURNAL OF ANTI-AGING MEDICINE LA English DT Article ID HEALTHY OLDER MEN; FACTOR-I; BODY-COMPOSITION; ELDERLY SUBJECTS; GH; AGE; ADULTS; SECRETION; PEPTIDE; SECRETAGOGUE AB Because the aging pituitary remains responsive to stimulation by growth hormone (GH) secret-agogues-GHRH, ghrelin, and their mimetics-these compounds could potentially be used instead of GH itself to increase GH secretion in aging. The factors contributing to the age-related decline in GH secretion are largely extrapituitary, and with repeated or continuous administration GHS's can significantly increase GH secretion and elevate levels of insulin-like growth factor-I (IGF-I) to the young adult normal range. Treatment with GHS's has both theoretical and practical potential advantages over GH-preserving feedback regulation by IGF-I to buffer against overtreatment, and yielding a more physiologic pulsatile pattern of GH secretion. Non-peptide GHS's can also be administered orally. This review focuses primarily on results using GHRH; studies with ghrelin agonists are reviewed in detail in other articles from this symposium. We and others have shown that GHRH stimulates the brisk release of GH in healthy seniors, and that repeated administration of GHRH elevates IGF-I in a dose-dependent manner. In two 6-month treatment studies in healthy older women and men, subcutaneous injections of GHRH(1-29)NH2, self-administered once nightly, chronically increased nighttime GH secretion and produced sustained elevations of IGF-I levels. IGF-I increases were greatest in men, averaging 30%. Women not taking estrogen showed somewhat lesser increases (23%), and women taking oral estrogen replacement had no significant increase despite the greatest increments in GH secretion. Lean body mass increased; body fat was reduced by an average of 5-8%, with greatest effect on abdominal visceral fat; and again this effect was blunted in estrogenized women. Effects on physical function varied by group. In nonestrogenized women, physical function deteriorated in those receiving placebo; some measures were stabilized in women receiving GHRH. These changes were not significant in estrogenized subjects. GHRH appeared to improve cognitive function, especially in domains sensitive to changes in processing speed. The formulation of GHRH used in these studies is short-acting, with effects ending within a few hours. Perhaps for this reason, late-night GH secretion decreased after the initial GHRH-stimulated surge, and sleep quality was not improved. Side effects were those of fluid retention and were generally mild. The duration of these studies do not allow inferences to be drawn on prevention of the onset of clinical features of frailty. Thus, 6-month treatment with once-daily GHRH can elevate GH secretion and IGF-I, and improve body composition in a manner similar to the effects of GH. Effects on physical function are equivocal. Effects on cognition are encouraging but preliminary. The current GHRH formulation is too short-acting to provide optimal effects. C1 Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Merriam, GR (reprint author), Univ Washington, VA Puget Sound HCS, 9600 Vet Dr SW,Res A-151,Bldg 18S,Room 5, Lakewood, WA 98493 USA. OI Vitiello, Michael/0000-0002-9776-0473 NR 52 TC 2 Z9 2 U1 0 U2 2 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1094-5458 J9 J ANTI-AGING MED JI J. Anti-Aging Med. PD WIN PY 2001 VL 4 IS 4 BP 331 EP 343 DI 10.1089/10945450152850650 PG 13 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 535DR UT WOS:000174630400005 ER PT J AU Kahn, SE Montgomery, B Howell, W Ligueros-Saylan, M Hsu, CH Devineni, D McLeod, JF Horowitz, A Foley, JE AF Kahn, SE Montgomery, B Howell, W Ligueros-Saylan, M Hsu, CH Devineni, D McLeod, JF Horowitz, A Foley, JE TI Importance of early phase insulin secretion to intravenous glucose tolerance in subjects with type 2 diabetes mellitus SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID BETA-CELL FUNCTION; RESISTANCE; HYPERGLYCEMIA; SENSITIVITY; CONTRIBUTE; CAPACITY AB Insulin secretion is impaired in type 2 diabetes with the early response being essentially absent. The loss of this early insulin secretion is hypothesized to be important in the deterioration of glucose tolerance. To determine whether enhancement of the early-phase insulin response can enhance, glucose tolerance, we administered 1) 120 mg nateglinide, an insulinotropic agent that enhances early insulin secretion; 2) 10 mg glyburide, which enhances the later. phases of insulin secretion; or 3) placebo in random order to 21 subjects with type 2 diabetes (14 males and 7 females; aged 59.2 +/- 2.1 yr, x +/- SEM; body mass index 29.7 +/- 1.0 kg/m(2); fasting plasma glucose 8.1 +/- 0.1 mM). beta -Cell function was quantified as the incremental area under the curve for different time periods for the 5 h following iv glucose administration and glucose tolerance as the glucose disappearance constant (Kg) from 10 to 60 min. Insulin release commenced immediately after nateglinide administration, even before glucose injection, but this was not observed with glyburide. Both nateglinide and glyburide enhanced glucose-induced insulin release, compared with placebo (area under the curve -15-300 min: nateglinide 23,595 +/- 11,212 pM/min, glyburide 54,556 +/- 15,253 pM/min, placebo 10,242 +/- 2,414 pM/min). The profiles of insulin release demonstrated significant enhancement of release between -15 and 30 min for nateglinide, compared with glyburide and between 60 and 300 min for glyburide over nateglinide. Kg increased by 15% with nateglinide (0.87 +/- 0.04/min), but it did not increase significantly with glyburide (0.79 +/- 0.04%/min), compared with placebo (0.76 +/- 0.04%/min). The enhancement of insulin release by glyburide resulted in a lower minimal glucose concentration with glyburide (3.8 +/- 0.2 mM), compared with nateglinide (5.0 +/- 0.2 mM) and placebo (5.9 +/- 0.2 mM). Thus, enhancement of the early phase of insulin secretion improves iv glucose tolerance, whereas delaying it by 30 min results in a slower rate of glucose disappearance for the first 2 h after iv glucose administration. Further, the differences in the kinetics of nateglinide and glyburide. action results in continued insulin release with glyburide despite the fact that glucose levels have returned to basal, thus resulting-iu a further reduction in glucose levels and a lower nadir. C1 VA Puget Sound Health Care Syst, Dept Med, Seattle, WA 98108 USA. VA Puget Sound Health Care Syst, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. Novartis Pharmaceut Corp, E Hanover, NJ 07936 USA. RP Kahn, SE (reprint author), VA Puget Sound Health Care Syst, Dept Med, 151,1660 S Columbian Way, Seattle, WA 98108 USA. EM skahn@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002 FU NIDDK NIH HHS [DK-17047, DK-02654] NR 28 TC 58 Z9 68 U1 0 U2 0 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD DEC PY 2001 VL 86 IS 12 BP 5824 EP 5829 DI 10.1210/jc.86.12.5824 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 502DJ UT WOS:000172728200028 PM 11739446 ER PT J AU Rabeneck, L Menke, T Simberkoff, MS Hartigan, PM Dickinson, GM Jensen, PC George, WL Goetz, MB Wray, NP AF Rabeneck, L Menke, T Simberkoff, MS Hartigan, PM Dickinson, GM Jensen, PC George, WL Goetz, MB Wray, NP TI Using the national registry of HIV-infected veterans in research: Lessons for the development of disease registries SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE HIV infection; disease registry; health outcomes ID POPULATION; AIDS; CARE AB Disease-specific registries have many important applications in epidemiologic, clinical and health services research. Since 1989 the Department of Veterans Affairs has maintained a national HIV registry. VA's HIV registry is national in scope. it contains longitudinal data and detailed resource utilization and clinical information. To describe the structure, function, and limitations of VA's national HIV registry, and to test its accuracy and completeness. The VA's national HIV registry contains data that are electronically extracted from VA's computerized comprehensive clinical and administrative databases, called Veterans Integrated Health Systems Technology and Architecture (VISTA). We examined the number of AIDS patients and the number of new patients identified to the registry, by year, through December 1996. We verified data elements against information obtained from the medical records at five VA sites. By December 1996, 40.000 HIV-infected patients had been identified to the registry. We encountered missing data and problems with data classification. Missing data occurred for some elements related to the computer programming that creates the registry (e.g., pharmacy files), and for other elements because manual entry is required (e.g., ethnicity). Lack of a standardized data classification system was a problem. especially for the pharmacy and laboratory files. In using VA's national HIV registry we have learned important lessons, which, if taken into account in the future, could lead to the creation of model disease-specific registries. (C) 2001 Elsevier Science Inc. All rights reserved. C1 Dept Vet Affairs VA Hlth Serv Res & Dev HSR&D, Ctr Excellence, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Manhattan VA Med Ctr, New York, NY USA. NYU, New York, NY USA. VA Cooperat Studies Program Coordinating Ctr, West Haven, CT USA. VAMC, Miami, FL USA. Univ Miami, Miami, FL 33152 USA. VAMC, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. W Los Angeles VAMC, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Rabeneck, L (reprint author), VA Med Ctr 111D, 2002 Holcombe Blvd, Houston, TX 77030 USA. OI Goetz, Matthew/0000-0003-4542-992X NR 15 TC 19 Z9 20 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2001 VL 54 IS 12 BP 1195 EP 1203 DI 10.1016/S0895-4356(01)00397-3 PG 9 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 501WF UT WOS:000172708500004 PM 11750188 ER PT J AU Danielson, ME Justice, AC AF Danielson, ME Justice, AC CA VACS Project Team TI Veterans aging cohort study (VACS) meeting summary SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE veterans; aging; cohort study AB The Veterans Aging Cohort Study (VACS) planning meeting vas the first of a series of organizational meetings and VA-sponsored conference calls designed to build the scientific foundation and methodological infrastructure for a multisite, longitudinal study of HI-V and chronic disease outcomes among aging veterans. More specifically, it served as a consensus conference to determine scientific priorities, develop hypotheses, and to assemble working groups and committees to outline the specific methodological approaches needed. Scientists, physicians from 20 VA clinical facilities in the United States, community members, and experts in the fields of immunology, cancer, sociology, aging, cognition, psychiatry and mental health, epidemiology, large database analysis, and health services research gathered for an intense, 2-day meeting held in Pittsburgh, PA, November 8-9, 2000. (C) 2001 Elsevier Science Inc. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Re & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, VACS Ctr, Pittsburgh, PA USA. RP Justice, AC (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Re & Promot, Univ Dr C 111E0U,130-U, Pittsburgh, PA 15240 USA. FU NIA NIH HHS [K23 AG 00826-03] NR 12 TC 1 Z9 2 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2001 VL 54 SU 1 BP S9 EP S11 DI 10.1016/S0895-4356(01)00441-3 PG 3 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 503QK UT WOS:000172811300003 PM 11750203 ER PT J AU Justice, AC Holmes, W Gifford, AL Rabeneck, L Zackin, R Sinclair, G Weissman, S Neidig, J Marcus, C Chesney, M Cohn, SE Wu, AW AF Justice, AC Holmes, W Gifford, AL Rabeneck, L Zackin, R Sinclair, G Weissman, S Neidig, J Marcus, C Chesney, M Cohn, SE Wu, AW CA Adult AIDS Clinical Trials Unit Ou TI Development and validation of a self-completed HIV symptom index SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE self-completed HIV symptom index; clinical management; adverse drug-event reporting ID QUALITY-OF-LIFE; HUMAN-IMMUNODEFICIENCY-VIRUS; ANTIRETROVIRAL THERAPY; CLINICAL PREDICTORS; MEDICAL OUTCOMES; RELIABILITY; INFECTION; VALIDITY; DISEASE; AIDS AB Traditional, open-ended provider questions regarding patient symptoms are insensitive. Better methods are needed to measure symptoms for clinical management, patient-oriented research, and adverse drug-event reporting. Our objective was to develop and initially validate a brief, self-reported HIV symptom index tailored to patients exposed to multidrug antiretroviral therapies and protease inhibitors, and to compare the new index to existing symptom measures. The research design was a multistage design including quantitative review of existing literature, qualitative and quantitative analyses of pilot data, and quantitative analyses of a prospective sample, Statistical analyses include frequencies, chi-square tests for significance, linear and logistic regression. The subjects were from a multisite convenience sample (n = 73) within the AIDS Clinical Trials Group and a prospective sample from the Cleveland Veterans Affairs Medical Center (n = 115). Measures were patient-reported symptoms and health-related quality of life, physician-assessed disease severity, CD4 cell count, and HIV-1 RNA viral quantification. A 20-item, self-completed HIV symptom index was developed based upon prior reports of symptom frequency and bother and expert opinion. When compared with prior measures the index included more frequent and bothersome symptoms, yet was easier to use (self-report rather than provider interview). The index required less than 5 minutes to complete, achieved excellent completion rates, and was thought comprehensive and comprehensible in a convenience sample. It was further tested in a prospective sample of patients and demonstrated strong associations with physical and mental health summary scores and with disease severity. These associations were independent of CD4 cell count and HIV-1 RNA viral quantification. This 20-item HIV symptom index has demonstrated construct validity, and offers a simple and rational approach to measuring HIV symptoms for clinical management, patient-oriented research, and adverse drug reporting. (C) 2001 Elsevier Science Inc. All rights reserved. C1 VA Piitsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, VACS Ctr, Div Gen Med, Pittsburgh, PA USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Calif San Diego, San Diego, CA 92103 USA. VA San Diego Healthcare Syst, San Diego, CA USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Vet Affairs Hlth Serv Res & Dev Ctr Excellen, Houston, TX 77030 USA. Harvard Univ, Stat & Data Anal Ctr, Boston, MA 02115 USA. Parkland Hosp, Dallas, TX USA. Yale Univ, Sch Med, St Raphaels Hosp, New Haven, CT USA. Ohio State Univ, Columbus, OH 43210 USA. Univ N Carolina, Chapel Hill, NC USA. Univ Calif San Francisco, Ctr AIDS Prevent Studies, San Francisco, CA 94143 USA. Univ Rochester, Med Ctr, Infect Dis Unit, Rochester, NY 14642 USA. Johns Hopkins Univ, Dept Hlth Policy & Management, Baltimore, MD 21218 USA. Johns Hopkins Univ, Dept Med, Baltimore, MD 21218 USA. RP Justice, AC (reprint author), VA Piitsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C 11E-124 130-U, Pittsburgh, PA 15240 USA. FU NIA NIH HHS [K23 AG 00826-03]; NIAID NIH HHS [U01 AI38855, U01 AI38858] NR 33 TC 193 Z9 194 U1 3 U2 8 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2001 VL 54 SU 1 BP S77 EP S90 DI 10.1016/S0895-4356(01)00449-8 PG 14 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 503QK UT WOS:000172811300013 PM 11750213 ER PT J AU Justice, AC Landefeld, CS Asch, SM Gifford, AL Whalen, CC Covinsky, KE AF Justice, AC Landefeld, CS Asch, SM Gifford, AL Whalen, CC Covinsky, KE TI Justification for a new cohort study of people aging with and without HIV infection SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE cohort study; people aging; HIV-positive; HIV-negative ID HUMAN-IMMUNODEFICIENCY-VIRUS; RANDOMIZED CLINICAL-TRIALS; QUALITY-OF-LIFE; PRIMARY-CARE; HEPATITIS-C; HOSPITALIZED-PATIENTS; DIABETES-MELLITUS; ADVERSE EVENTS; AIDS; SURVIVAL AB This supplement contains a series of papers supporting the justification, design, and implementation of a longitudinal cohort study of an aging HIV-positive and HIV-negative veteran population called the Veterans Aging Cohort Study (VACS). Although the papers cover a wide range of topics and several papers address methodologic issues not unique to a study of aging-veterans, all are motivated by a unifying set of assumptions. Specifically: (a) HIV/AIDS is a chronic disease in an aging population; (b) conditions among HIV-positive and -negative patients in care have overlapping etiologies; (c) individuals with pre-existing organ injury are at increased risk for iatrogenic injury; (d) cohort studies are uniquely suited to the study of chronic disease complicated by aging, comorbid conditions, drug toxicities, and substance use/abuse; (e) VACS is well positioned to study HIN as a chronic disease in an aging population. (C) 2001 Elsevier-Science, Inc. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, VACS Ctr, Div Gen Internal Med, Pittsburgh, PA USA. VA San Francisco Healthcare Syst, San Francisco, CA USA. Univ Calif San Francisco, Sch Med, Dept Geriatr, San Francisco, CA USA. VA Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Div Gen Internal Med, Los Angeles, CA USA. VA San Diego Healthcare Syst, San Diego, CA USA. Univ Calif San Diego, Sch Med, Div Gen Internal Med, San Diego, CA 92103 USA. Case Western Reserve Univ, Sch Med, Div Infect Dis, Cleveland, OH USA. Case Western Reserve Univ, Sch Med, Dept Epidemiol, Cleveland, OH USA. RP Justice, AC (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C 11E-124 130-U, Pittsburgh, PA 15240 USA. FU FIC NIH HHS [D43 TW000011]; NIA NIH HHS [K23 AG 00826-03] NR 72 TC 26 Z9 26 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2001 VL 54 SU 1 BP S3 EP S8 DI 10.1016/S0895-4356(01)00440-1 PG 6 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 503QK UT WOS:000172811300002 PM 11750202 ER PT J AU Kilbourne, AM Justice, AC Rabeneck, L Rodriguez-Barradas, M Weissman, S AF Kilbourne, AM Justice, AC Rabeneck, L Rodriguez-Barradas, M Weissman, S CA VACS 3 Project Team TI General medical and psychiatric comorbidity among HIV-infected veterans in the post-HAART era SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE psychiatric comorbidity; HIV-infected veterans; post-HAART era ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; IDENTIFICATION TEST AUDIT; ANTIRETROVIRAL THERAPY; VIRUS-INFECTION; PRIMARY-CARE; HEPATITIS-C; DISORDERS; DISEASE; AIDS; DEPRESSION AB We examined the prevalence of HIV, general medical, and psychiatric comorbidities by age based on a recent multisite cohort of HIV infected veterans receiving care: the Veterans with HIV/AlDS 3 Site Study (VACS 3). VACS 3 includes 881 adult patients with HIV infection enrolled between June 1999 and July 2000. Providers reported their patients' CDC-defined HIV comorbidities, general medical comorbidities (based on Duke and Charlson comorbidity scales), and psychiatric comorbidity. Mean age of participants was 49 years and 54% were African-American. The most common HIV comorbidities were oral candidiasis (21%), peripheral neuropathy (16%), and herpes zoster (16%). The most common general medical comorbidities included chemical hepatitis (53%), hypertension (24%), and hyperlipidemia (17%). The mean number of HIV and general medical-comorbidities experienced by patients were respectively 1.1 and 1.4 (P < .001). Older (greater than or equal to 50 years) HIV-infected patients experienced a greater number of general medical comorbidities than those < 50 years (respectively 1.7 versus 1.2, P < .001). There was no significant difference in mean HIV comorbidity number by age. Based on patient report, 46% had significant depressive symptoms (greater than or equal to 10 on 10-item CES-D) and 21% reported at-risk drinking (greater than or equal to8 on AUDIT). Providers reported 32% of patients had anxiety, 4% mania, 4% schizophrenia, and 11% cognitive impairment/dementia. General medical and psychiatric comorbidities constituted a higher disease burden for HIV-Infected veterans than HIV comorbidities. Whether these comorbidities are due to antiretroviral drug toxicity or are age or lifestyle-associated conditions, the substantial prevalence of these "non-HIV" comorbidities suggest an important role for general medical and psychiatric management of HIV-infected patients. (C) 2001 Elsevier Science Inc. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, VACS Ctr, Div Gen Internal Med, Pittsburgh, PA USA. VA Hlth Serv Res & Dev Ctr Excellence, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Yale Univ, Sch Med, Dept Internal Med, Infect Dis Sect, New Haven, CT 06510 USA. Hosp St Raphael, New Haven, CT USA. RP Justice, AC (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C 11E-124 130-U, Pittsburgh, PA 15240 USA. FU NIA NIH HHS [K23 AG 00826-03] NR 33 TC 75 Z9 76 U1 1 U2 6 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2001 VL 54 SU 1 BP S22 EP S28 DI 10.1016/S0895-4356(01)00443-7 PG 7 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 503QK UT WOS:000172811300006 PM 11750206 ER PT J AU Landefeld, CS Justice, AC Covinsky, KE Gifford, AL Whalen, CC Asch, SM AF Landefeld, CS Justice, AC Covinsky, KE Gifford, AL Whalen, CC Asch, SM TI Introduction to the supplement SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Editorial Material C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Calif San Francisco, Sch Med, Div Geriatr, San Francisco, CA USA. VA San Francisco Healthcare Syst, San Francisco, CA USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, VACS Ctr, Pittsburgh, PA USA. VA San Diego Healthcare Syst, San Diego, CA USA. Univ Calif San Diego, Sch Med, Div Gen Internal Med, San Diego, CA 92103 USA. Case Western Reserve Univ, Sch Med, Div Infect Dis, Cleveland, OH 44106 USA. Case Western Reserve Univ, Sch Med, Dept Epidemiol, Cleveland, OH 44106 USA. Univ Calif Los Angeles, Sch Med, Div Gen Internal Med, Los Angeles, CA USA. VA Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Justice, AC (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C 11E-124 130-U, Pittsburgh, PA 15240 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2001 VL 54 SU 1 BP S1 EP S2 DI 10.1016/S0895-4356(01)00439-5 PG 2 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 503QK UT WOS:000172811300001 ER PT J AU Smola, S Justice, AC Wagner, J Rabeneck, L Weissman, S Rodriguez-Barradas, M AF Smola, S Justice, AC Wagner, J Rabeneck, L Weissman, S Rodriguez-Barradas, M CA VACS 3 Project Team TI Veterans aging cohort three-site study (VACS 3): overview and description SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE Veterans Aging Cohort Three-Site Study; middle-aged individuals; HIV infection; age-related differences ID DEPRESSION SCALE; NEGATIVE AFFECT; OLDER ADULTS; PRIMARY-CARE; SHORT-FORM; CES-D; VALIDITY; RELIABILITY; VALIDATION; ATTRIBUTES AB Outcomes for middle-aged and older individuals with HIN infection are poor, and are likely to be mediated by age-related differences in risks and resources (access to care, relationship with the provider, comorbid conditions, health habits, and changes brought about by aging). The goal of the Veterans Aging Cohort Three-Site Study (VACS 3) is to study the influence of age and mediating factors on outcomes with HIV in order to identify mutable mediators of poorer outcomes. VACS 3 is an observational, longitudinal study. Data sources include patient and provider surveys and electronic medical data collected at baseline and 12-month follow-up from the Infections Disease Clinics at three Veterans Affairs Medical Centers (Cleveland, OH, Houston, TX, and Manhattan, NY). Trained Survey Coordinators at each site determined which patients are HIV infected, obtained consent, and asked the patient to complete a questionnaire. The primary provider also completed a questionnaire. Twelve-month follow-up will be completed July 2001. Of all veterans with HIV seen in these clinics 85% (881) have consented and enrolled. Of the 881 corresponding provider surveys, 92% were completed. Mean age is 49; 55% are African-American; 38% of the sample were men who have sex with men; and less than 2% are women. Almost a third (32%) have been without a permanent address. Complimentary or alternative therapies are common as are the use of cigarettes, alcohol, and illicit drugs. The majority (87%) of the patients are taking multiple antiretroviral medications. The median CD4 count is 331 mm(3), and the median viral load was 714 copies/ml. There is substantial variation by site. Veterans with HIV infection have characteristics that will likely become more prevalent among HIN-infected persons in the United States: they are older, commonly suffer comorbid disease, and are members of minority populations. VACS 3 may help inform the design of future clinical interventions to improve outcomes for people aging with HIV. (C) 2001 Elsevier Science Inc. All rights reserved. C1 Univ Pittsburgh, Sch Med, VACS Ctr, Div Gen Internal Med, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. RP Justice, AC (reprint author), Univ Pittsburgh, Sch Med, VACS Ctr, Div Gen Internal Med, Pittsburgh, PA 15260 USA. FU NIA NIH HHS [K23 AG 00826-03] NR 27 TC 24 Z9 26 U1 1 U2 6 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2001 VL 54 SU 1 BP S61 EP S76 DI 10.1016/S0895-4356(01)00448-6 PG 16 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 503QK UT WOS:000172811300012 PM 11750212 ER PT J AU Wagner, JH Justice, AC Chesney, M Sinclair, G Weissman, S Rodriguez-Barradas, M AF Wagner, JH Justice, AC Chesney, M Sinclair, G Weissman, S Rodriguez-Barradas, M CA VACS 3 Project Team TI Patient- and provider-reported adherence: toward a clinically useful approach to measuring antiretroviral adherence SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE HIV; adherence; drug use; alcohol use; depressive symptoms; homelessness; HIV-1 viral load; AUDIT; CESD-10 ID HUMAN-IMMUNODEFICIENCY-VIRUS; IDENTIFICATION TEST AUDIT; PROTEASE INHIBITORS; DRUG-RESISTANCE; NATURAL-HISTORY; HIV-INFECTION; THERAPY; MEDICATION; TRIALS; DETERMINANTS AB We seek to develop a clinically useful measure of antiretroviral medication adherence. Because there is no gold standard for adherence, we will assess the clinical validity of patient- and provider-reported adherence by the strength of their expected associations with current viral load, depressive symptoms, alcohol and illicit drug use, and homelessness. The Veterans Aging Cohort 3 Site Study (VACS 3) is a multisite study of 881 patients at Cleveland, Houston, and Manhattan Veterans Affairs health care systems. Data was collected on adherence using patient report and provider assessment; depressive symptoms using the Center for Epidemiological Studies Depression (CESD) and provider assessment; alcohol use using the Alcohol Use Disorders Identification Test (AUDIT) and provider assessment; and homelessness using patient report only. Viral load was collected from electronic laboratory data. Although agreement between providers and patients about the patient's adherence was not better than chance (61%; weighted kappa = .07), both patient and provider-reported adherence were related to viral load (P < .001), current alcohol use (P < .01), current drug use (P < .01), and depressive symptoms (P < .001). Patient-reported adherence was also associated with homelessness (P < .05). In multivariate regression models, provider assessment of adherence demonstrated independent associations with viral load (P < .001), current alcohol use (P < .001), current drug use (P < .001), and depressive symptoms (P < .001) after adjustment for the patient's report of adherence (also significantly associated). The consistent and largely independent association between patient and provider reported adherence and a range of variables previously shown to be associated with adherence suggests that patient- and provider-reported adherence independently measure actual adherence. Future work will explore how patient- and provider-reported adherence might best be combined, and whether the measure may be further enhanced with pharmacy refill data. (C) 2001 Elsevier Science Inc. All rights reserved. C1 Univ Pittsburgh, Sch Med, Div Gen Internal Med, VACS Ctr, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Calif San Francisco, Sch Med, AIDS Res Inst, San Francisco, CA USA. Univ Texas, SW Med Ctr, Dept Internal Med, Div Infect Dis, Dallas, TX USA. Yale Univ, Sch Med, St Raphael Hosp, New Haven, CT USA. VA Med Ctr, AIDS Unit, Houston, TX USA. RP Justice, AC (reprint author), Univ Pittsburgh, Sch Med, Div Gen Internal Med, VACS Ctr, Pittsburgh, PA 15260 USA. FU NIA NIH HHS [K23 AG 00826-03] NR 44 TC 76 Z9 77 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD DEC PY 2001 VL 54 SU 1 BP S91 EP S98 DI 10.1016/S0895-4356(01)00450-4 PG 8 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 503QK UT WOS:000172811300014 PM 11750214 ER PT J AU McCullough, LB Molinari, V Workman, RH AF McCullough, LB Molinari, V Workman, RH TI Implications of impaired executive control functions for patient autonomy and surrogate decision making SO JOURNAL OF CLINICAL ETHICS LA English DT Article ID CONSENT C1 Baylor Coll Med, Ctr Med Eth & Hlth Policy, Houston, TX USA. Baylor Coll Med, Huffington Ctr Aging, Houston, TX USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX USA. Houston Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. RP McCullough, LB (reprint author), Baylor Coll Med, Ctr Med Eth & Hlth Policy, Houston, TX USA. NR 29 TC 5 Z9 5 U1 2 U2 2 PU UNIV PUBLISHING GROUP PI HAGERSTOWN PA 17100 COLE RD #312, HAGERSTOWN, MD 21740-6901 USA SN 1046-7890 J9 J CLIN ETHIC JI J. Clin. Ethics PD WIN PY 2001 VL 12 IS 4 BP 397 EP 405 PG 9 WC Ethics; Social Sciences, Biomedical SC Social Sciences - Other Topics; Biomedical Social Sciences GA 551DB UT WOS:000175543300008 PM 12026746 ER PT J AU Akiba, Y Furukawa, O Guth, PH Engel, E Nastaskin, I Sassani, P Dukkipatis, R Pushkin, A Kurtz, I Kaunitz, JD AF Akiba, Y Furukawa, O Guth, PH Engel, E Nastaskin, I Sassani, P Dukkipatis, R Pushkin, A Kurtz, I Kaunitz, JD TI Cellular bicarbonate protects rat duodenal mucosa from acid-induced injury SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID CYSTIC-FIBROSIS; ALKALINE SECRETION; HCO3 SECRETION; INTRACELLULAR PH; GASTROESOPHAGEAL REFLUX; NA+HCO3 COTRANSPORTER; HELICOBACTER-PYLORI; CL-/HCO3 EXCHANGE; EPITHELIAL-CELLS; NA+/H+ EXCHANGER AB Secretion of bicarbonate from epithelial cells is considered to be the primary mechanism by which the duodenal mucosa is protected from acid-related injury. Against this view is the Finding that patients with cystic fibrosis, who have impaired duodenal bicarbonate secretion, are paradoxically protected from developing duodenal ulcers. Therefore, we hypothesized that epithelial cell intracellular pH regulation, rather than secreted extracellular bicarbonate, was the principal means by which duodenal epithelial cells are protected from acidification and injury. Using a novel in vivo microscopic method, we have measured bicarbonate secretion and epithelial cell intracellular pH (pH(i)), and we have followed cell injury in the presence of the anion transport inhibitor DIDS and the Cl-channel inhibitor, 5-nitro-2-(3-phenylpropylamino) benzoic acid (NPPB). DIDS and NPPB abolished the increase of duodenal bicarbonate secretion following luminal acid perfusion. DIDS decreased basal pHi, whereas NPPB increased pHi; DIDS further decreased pHi during acid challenge and abolished the pHi overshoot over baseline observed after acid challenge, whereas NPPB attenuated the fall of pHi and exaggerated the overshoot. Finally, acid-induced epithelial injury was enhanced by DIDS and decreased by NPPB. The results support the role of intracellular bicarbonate in the protection of duodenal epithelial cells from luminal gastric acid. C1 Univ Calif Los Angeles, CURE, Digest Dis Res Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Div Nephrol, Los Angeles, CA USA. Univ Calif Los Angeles, Coll Letters & Sci, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Biomath, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA USA. Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd,Bldg 114,Room 217, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK85863, R01-DK54221, R01 DK054221, DK07789, T32 DK007789] NR 62 TC 44 Z9 46 U1 0 U2 1 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD DEC PY 2001 VL 108 IS 12 BP 1807 EP 1816 DI 10.1172/JCI12218 PG 10 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 503WC UT WOS:000172823700012 PM 11748264 ER PT J AU Choi, SJ Oba, Y Gazitt, Y Alsina, M Cruz, J Anderson, J Roodman, GD AF Choi, SJ Oba, Y Gazitt, Y Alsina, M Cruz, J Anderson, J Roodman, GD TI Antisense inhibition of macrophage inflammatory protein 1-alpha blocks bone destruction in a model of myeloma bone disease SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID RESISTANCE CAM-DR; MULTIPLE-MYELOMA; CELL-LINES; ADHESION; MARROW; EXPRESSION; PROTEIN-1-ALPHA; IDENTIFICATION; RESORPTION; CHEMOKINES AB We recently identified macrophage inflammatory protein 1-alpha (MIP-1 alpha) as a factor produced by multiple myeloma (MM) cells that maybe responsible for the bone destruction in MM (1). To investigate the role of MIP-1 alpha in MM bone disease in vivo, the human MM-derived cell line ARH was stably transfected with an antisense construct to MIP-1 alpha (AS-ARH) and tested for its capacity to induce MM bone disease in SCID mice. Human MIP-1 alpha levels in marrow plasma from AS-ARH mice were markedly decreased compared with controls treated with ARH cells transfected with empty vector (EV-ARH). Mice treated with AS-ARH cells lived longer than controls and, unlike the controls, they showed no radiologically identifiable lytic lesions. Histomorphometric analysis demonstrated that osteoclasts (OCLs) per square millimeter of bone and OCLs per millimeter of bone surface of AS-ARH mice were significantly less than in EV-ARH mice, and the percentage of tumors per total bone area was also significantly decreased. AS-ARH cells demonstrated decreased adherence to marrow stromal cells, due to reduced expression of the alpha (5)beta (1) integrin and diminished homing capacity and survival. These data support an important role for MIP-1 alpha in cell homing, survival, and bone destruction in MM. C1 Univ Texas, Hlth Sci Ctr, Dept Med Hematol, San Antonio, TX USA. Univ S Florida, H Lee Moffitt Canc Ctr, Tampa, FL 33682 USA. Texas Tech Univ, Hlth Sci Ctr, Lubbock, TX 79430 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP Roodman, GD (reprint author), Res 151, E-1152 BST,200 Lothrop St, Pittsburgh, PA 15213 USA. FU NCI NIH HHS [P01 CA040035, CA40035]; NIA NIH HHS [AG-13625, R01 AG013625]; NIAMS NIH HHS [AR-41336, AR-44603, R01 AR041336, R01 AR044603] NR 22 TC 153 Z9 155 U1 1 U2 1 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD DEC PY 2001 VL 108 IS 12 BP 1833 EP 1841 DI 10.1172/JCI13116 PG 9 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 503WC UT WOS:000172823700015 PM 11748267 ER PT J AU Steinman, MA Sands, LP Covinsky, KE AF Steinman, MA Sands, LP Covinsky, KE TI Self-restriction of medications due to cost in seniors without prescription coverage - A national survey SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 24th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 04, 2001 CL SAN DIEGO, CALIFORNIA SP Soc Gen Internal Med DE insurance, pharmaceutical services; health services accessibility; prescriptions, drug; fees, pharmaceutical; aged ID MEDICARE BENEFICIARIES; DRUG COVERAGE; CARDIOVASCULAR DRUGS; HEALTH; RECALL; CARE; VALIDITY; AGREEMENT; ADMISSION; BENEFITS AB OBJECTIVE: Little is known about patients who skip doses or otherwise avoid using their medications because of cost. We sought to identify which elderly patients are at highest risk of restricting their medications because of cost, and how prescription coverage modifies this risk. DESIGN AND PARTICIPANTS: Cross-sectional study from the 1995-1996 wave of the Survey of Asset and Health Dynamics Among the Oldest Old, a population-based survey of Americans age 70 years and older. MEASUREMENTS: Subjects were asked the extent of their prescription coverage, and whether they had taken less medicine than prescribed for them because of cost over the prior 2 years. We used bivariate and multivariate analyses to identify risk factors for medication restriction in subjects who lacked prescription coverage. Among these high-risk groups, we then examined the effect of prescription coverage on rates of medication restriction. MAIN RESULTS: Of 4,896 seniors who regularly used prescription medications, medication restriction because of cost was reported by 8% of subjects with no prescription coverage, 3% with partial coverage, and 2% with full coverage (P < .01 for trend). Among subjects with no prescription coverage, the strongest independent predictors of medication restriction were minority ethnicity (odds ratio [OR], 2.9 compared with white ethnicity; 95% confidence interval [95% CI], 2.0 to 4.2), annual income <$10,000 (OR, 3.8 compared with income greater than or equal to $20,000; 95% CI, 2.4 to 6.1), and out-of-pocket prescription drug costs >$100 per month (OR, 3.3 compared to costs less than or equal to $20; 95% CI, 1.5 to 7.2). The prevalence of medication restriction in members of these 3 risk groups was 21%, 16%, and 13%, respectively. Almost half (43%) of subjects with all 3 risk factors and no prescription coverage reported restricting their use of medications. After multivariable adjustment, highrisk subjects with no coverage had 3 to 15 times higher odds of medication restriction than subjects with partial or full coverage (P < .01). CONCLUSIONS: Medication restriction is common in seniors who lack prescription coverage, particularly among certain vulnerable groups. Seniors in these high-risk groups who have prescription coverage are much less likely to restrict their use of medications. C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, VA Natl Qual Scholars Program, San Francisco, CA 94121 USA. RP Steinman, MA (reprint author), San Francisco VA Med Ctr, Div Geriatr, VA Box 181-G,4150 Clement St, San Francisco, CA 94121 USA. RI Sands, Laura/E-8919-2015 OI Sands, Laura/0000-0003-2446-4486 FU AHRQ HHS [K02 HS000006, K02HS00006-01] NR 42 TC 144 Z9 151 U1 1 U2 3 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD DEC PY 2001 VL 16 IS 12 BP 793 EP 799 DI 10.1046/j.1525-1497.2001.10412.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 504AY UT WOS:000172835700001 PM 11903757 ER PT J AU Fremont, AM Cleary, PD Hargraves, JL Rowe, RM Jacobson, NB Ayanian, JZ AF Fremont, AM Cleary, PD Hargraves, JL Rowe, RM Jacobson, NB Ayanian, JZ TI Patient-centered processes of care and long-term outcomes of myocardial infarction SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 23rd Annual Meeting of the Society-for-General-Internal Medicine CY MAY 02-06, 2000 CL BOSTON, MASSACHUSETTS SP Soc Gen Internal Med DE myocardial infarction; quality of care; patient-centered care; patient satisfaction; outcomes; health status; longitudinal study ID CORONARY-ARTERY DISEASE; COOPERATIVE CARDIOVASCULAR PROJECT; QUALITY-OF-LIFE; HEART-DISEASE; MEDICAL-CARE; PSYCHOSOCIAL FACTORS; SOCIOECONOMIC-STATUS; HEALTH; DEPRESSION; SATISFACTION AB OBJECTIVE: To examine whether patients' experiences with nontechnical aspects of care such as patient education and discharge planning are associated with long-term outcomes. DESIGN: Observational cohort study. SETTING: Twenty-three New Hampshire hospitals during 1996 and 1997. PARTICIPANTS: Acute myocardial infarction (AMI) patients (N = 2,272) enrolled prior to discharge. MEASUREMENTS: Surveys asking about problems with care and health were mailed to patients 1, 3, and 12 months after discharge. Patients were stratified into "worse" or "better" care groups on the basis of their hospital care problem score. Outcomes included self-reported overall health, physical health, mental health, chest pain, and shortness of breath. Other clinical measures were obtained from hospital discharge abstracts. MAIN RESULTS: The 1-, 3-, and 12-month surveys were returned by 1,346 (59.2%), 1,046 (46%), and 964 (42.4%) enrolled patients, respectively. The primary analytic cohort consisted of the 762 patients who completed both the 1- and 12-month surveys. After adjustment for postdischarge health status and other clinical factors, patients experiencing worse hospital care had lower ratings of overall health (48.4 vs 52.5 on 100-point scale; P = .02) and physical health (59.7 vs 68.4; P < .001), and were more likely to have chest pain (odds ratio [OR], 1.6; confidence interval [CI], 1.0 to 2.4; P = .04) 12 months after their AMI than other patients. However, differences in reports of chest pain were reduced if patients reporting worse hospital care had better experiences with subsequent ambulatory care. CONCLUSIONS: Patients' experiences with nontechnical processes of AMI hospital care are associated with long-term outcomes; however the association between a negative hospital experience and subsequent chest pain may be offset by more positive outpatient experiences. C1 RAND Corp, Hlth, Santa Monica, CA 90407 USA. W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90073 USA. Brigham & Womens Hosp, Dept Med, Div Gen Med, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA USA. Ctr Studying Hlth Syst Change, Washington, DC USA. Fdn Healthy Communities, Concord, NH USA. HBS Int, Burlington, MA USA. RP Fremont, AM (reprint author), RAND Corp, Hlth, 1700 Main St,POB 2138, Santa Monica, CA 90407 USA. NR 56 TC 59 Z9 59 U1 3 U2 5 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD DEC PY 2001 VL 16 IS 12 BP 800 EP 808 DI 10.1046/j.1525-1497.2001.10102.x PG 9 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 504AY UT WOS:000172835700002 PM 11903758 ER PT J AU Kiefe, CI AF Kiefe, CI TI Processes and outcomes in acute myocardial infarction - How technical should we get? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material ID QUALITY; CARE C1 Univ Alabama, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Kiefe, CI (reprint author), Univ Alabama, Birmingham, AL 35294 USA. NR 7 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD DEC PY 2001 VL 16 IS 12 BP 868 EP 869 DI 10.1046/j.1525-1497.2001.11016.x PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 504AY UT WOS:000172835700013 PM 11903769 ER PT J AU Karlawish, JHT Casarett, D AF Karlawish, JHT Casarett, D TI Addressing the ethical challenges of clinical trials that involve patients with dementia SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article ID ALZHEIMERS-DISEASE; DEPRESSED-PATIENTS; INFORMED CONSENT; ELDERLY PATIENTS; DRUGS; PREFERENCES; COMPETENCE; EQUIPOISE; OUTCOMES; PROXY AB Research subjects face uncertainties, risks, burdens, and indignities, and research protocol requirements inhibit the physician's ability to make individualized treatment decisions. To address these problems, investigators and Institutional Review Boards (IRBs) should justify research risks using informed consent and the judgment that the risks of research are reasonable with respect to the potential benefits, if any, to subjects and to the expectation that the research will produce important knowledge. But clinical research in Alzheimer's disease (AD) presents investigators and IRBs with significant challenges to achieve these two requirements. Broadly, these challenges are the result of the impact of patients' cognitive impairment and the caregiving experience on decision making and the indeterminacy of defining clinically meaningful treatment benefits. In this article, we review the data that begin to answer whether and how patients' cognitive impairments and the caregiving experience impact on their decision making and what kinds of research results justify research risks. We will use these data to suggest changes to the design and conduct of clinical research in AD that can meet the challenge of justifying research risks. C1 Ctr Bioeth, Philadelphia, PA USA. Rush Alzheimers Dis Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia Vet Affairs Med Ctr, Dept Med, Div Geriatr, Philadelphia, PA 19104 USA. RP Karlawish, JHT (reprint author), 3815 Chestnut St,Room 215, Philadelphia, PA 19104 USA. FU NIA NIH HHS [K01-AG00931, P30-AG01024] NR 40 TC 10 Z9 10 U1 2 U2 3 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD WIN PY 2001 VL 14 IS 4 BP 222 EP 228 DI 10.1177/089198870101400407 PG 7 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 498QE UT WOS:000172521500007 PM 11794450 ER PT J AU Li, W Nadelman, C Henry, G Fan, JH Muellenhoff, M Medina, E Gratch, NS Chen, M Han, JH Woodley, D AF Li, W Nadelman, C Henry, G Fan, JH Muellenhoff, M Medina, E Gratch, NS Chen, M Han, JH Woodley, D TI The p38-MAPK/SAPK pathway is required for human keratinocyte migration on dermal collagen SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Article DE extracellular matrix; keratinocytes; p38-MAPK; motility; signal transduction ID ACTIVATED PROTEIN-KINASE; SIGNAL-TRANSDUCTION PATHWAY; GROWTH-FACTOR EGF; P38 MAP KINASE; SELECTIVE ACTIVATION; CELL-MIGRATION; EXPRESSION; MOTILITY; HYPOXIA; PHOSPHORYLATION AB Human keratinocyte motility plays an important role in the re-epithelialization of human skin wounds. The wound bed over which human keratinocytes migrate is rich in extracellular matrices, such as fibrin, fibronectin, and collagen, and serum factors, such as platelet-derived growth factor and transforming growth factor beta1. Extracellular matrices and the serum factors bind to cell surface receptors and initiate a cascade of intracellular signaling events that regulate cell migration. In this study, we identified an intracellular signaling pathway that mediates collagen-driven motility of human keratinocytes. Pharmacologic inhibition of the activation of p38-alpha and p38-beta mitogen-activated protein kinase activation potently blocked collagen-driven human keratinocyte migration. Transfection of the same keratinocytes with the kinase-negative mutants of p38-alpha or p38-beta mitogen-activated protein kinase markedly inhibited keratinocyte migration on collagen. Attachment of keratinocytes to collagen activated p38 mitogen-activated protein kinase, as well as p44/p42 ERKs. Interestingly, activation of the p38 mitogen-activated protein kinase cascade by overexpressing the constitutively active MKK3 and MKK6, MKK3b(E) and MKK6b(E), could neither initiate migration in the absence of collagen nor enhance collagen-driven migration. This study provides evidence that the p38-MAPK/SAPK pathway is necessary, but insufficient, for mediating human keratinocyte migration on collagen. C1 Univ So Calif, Keck Sch Med, Dept Med, Div Dermatol, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Norris Canc Ctr, Los Angeles, CA 90033 USA. Scripps Res Inst, Dept Immunol, La Jolla, CA 92037 USA. Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA USA. RP Woodley, D (reprint author), Univ So Calif, Keck Sch Med, Dept Med, Div Dermatol, 1303 N Mission Rd, Los Angeles, CA 90033 USA. RI Han, J/G-4671-2010 FU NIAMS NIH HHS [R01 AR46538-01] NR 56 TC 35 Z9 35 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD DEC PY 2001 VL 117 IS 6 BP 1601 EP 1611 DI 10.1046/j.0022-202x.2001.01608.x PG 11 WC Dermatology SC Dermatology GA 505FR UT WOS:000172903200038 PM 11886529 ER PT J AU Bourdette, DN McCauley, LA Barkhuizen, A Johnston, W Wynn, M Joos, SK Storzbach, D Shuell, T Sticker, D AF Bourdette, DN McCauley, LA Barkhuizen, A Johnston, W Wynn, M Joos, SK Storzbach, D Shuell, T Sticker, D TI Symptom factor analysis, clinical findings, and functional status in a population-based case control study of Gulf War unexplained illness SO JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; CHRONIC FATIGUE SYNDROME; FIBROMYALGIA SYNDROME; GENERAL-POPULATION; COMMON SYMPTOMS; LYME-DISEASE; CIVIL-WAR; PREVALENCE; VETERANS; INFECTION AB Few epidemiological studies have been conducted that haze incorporated clinical evaluations of Gulf War veterans with unexplained health symptoms and healthy controls. We conducted a mail survey of 2022 Gulf War veterans residing in the northwest United States and clinical examinations on a subset of 443 responders who seemed to have unexplained health symptoms or were healthy. Few clinical differences were found between cases and controls. The most frequent unexplained symptoms were cognitive/psychological, but significant overlap existed with musculoskeletal and fatigue symptoms. Over half of, for the veterans with unexplained musculoskeletal pain met the criteria fibromyalgia, and a significant portion of the veterans with unexplained fatigue met the criteria. for chronic fatigue syndrome. Similarities were found in the clinical interpretation of unexplained illness in this population and statistical factor analysis performed by this study group and others. C1 Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Div Med Informat & Outcome Res, Portland, OR USA. RP Bourdette, DN (reprint author), Portland Vet Affairs Med Ctr, Serv Neurol, Mailcode P-3-NEURO,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. NR 62 TC 40 Z9 40 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-2752 J9 J OCCUP ENVIRON MED JI J. Occup. Environ. Med. PD DEC PY 2001 VL 43 IS 12 BP 1026 EP 1040 PG 15 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 501TK UT WOS:000172702000005 PM 11765674 ER PT J AU Spencer, PS McCauley, LA Lapidus, JA Lasarev, M Joos, SK Storzbach, D AF Spencer, PS McCauley, LA Lapidus, JA Lasarev, M Joos, SK Storzbach, D TI Self-reported exposures and their association with unexplained illness in a population-based case-control study of Gulf War veterans SO JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE LA English DT Article ID PYRIDOSTIGMINE BROMIDE; HEALTH SYMPTOMS; STRESS; PENETRATION; SERVICE; SYSTEM; STATES; BRAIN; DEET AB Many factors haze been considered as possible causes of the unexplained illness reported by veterans of the Gulf War (GW). In this study, we report an analysis of risk factors and unexplained illness in a population-based sample of GW veterans who underwent clinical evaluation. Multiple risk factors were compared in 241 veterans who met criteria for unexplained illness and 113 healthy controls. Results suggest that GW unexplained illness is most highly associated with combat conditions, heat stress, and hazing sought medical attention during the GW. When controlling for multiple simultaneous exposures during the GW, interactions around pyridostigmine bromide, insecticides and repellents, and stress were not significant. These results indicate that most unexplained illness in GW veterans cannot be explained by neurotoxic effects of exposures to chemicals that inhibit cholinesterase activity: C1 Oregon Hlth & Sci Univ, Ctr Res Occupat & Environm Toxicol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Spencer, PS (reprint author), Oregon Hlth & Sci Univ, Ctr Res Occupat & Environm Toxicol, 3181 SW Sam Jackson Pk Rd,CROET Mailcode L606, Portland, OR 97201 USA. OI Lasarev, Michael R/0000-0002-1896-2705 NR 46 TC 26 Z9 26 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-2752 J9 J OCCUP ENVIRON MED JI J. Occup. Environ. Med. PD DEC PY 2001 VL 43 IS 12 BP 1041 EP 1056 PG 16 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 501TK UT WOS:000172702000006 PM 11765675 ER PT J AU Starkebaum, G AF Starkebaum, G TI Rheumatoid arthritis, methotrexate, and lymphoma: Risk substitution, or cat and mouse with Epstein-Barr virus? SO JOURNAL OF RHEUMATOLOGY LA English DT Editorial Material ID POSTTRANSPLANTATION LYMPHOPROLIFERATIVE DISORDERS; CANCER; INFECTION; NEOPLASMS; HODGKINS; THERAPY C1 Univ Washington, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Starkebaum, G (reprint author), Univ Washington, S-01 CMO,1660 S Columbian Way, Seattle, WA 98108 USA. NR 28 TC 22 Z9 22 U1 0 U2 1 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD DEC PY 2001 VL 28 IS 12 BP 2573 EP 2575 PG 3 WC Rheumatology SC Rheumatology GA 498NP UT WOS:000172517800002 PM 11764198 ER PT J AU Cooper, GS Dooley, MA Treadwell, EL St Clair, EW Gilkeson, GS AF Cooper, GS Dooley, MA Treadwell, EL St Clair, EW Gilkeson, GS TI Smoking and use of hair treatments in relation to risk of developing systemic lupus erythematosus SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE systemic lupus erythematosus; autoimmune disease; tobacco; aromatic amines ID REVISED CRITERIA; DISEASE; CLASSIFICATION AB Objective. To examine the association between smoking and hair treatments (dyes, permanents) and risk of developing systemic lupus erythematosus (SLE). Methods. Patients (n = 265) diagnosed between January 1, 1995, and July 31, 1999, were recruited through 4 university based and 30 community based rheumatology practices in eastern North Carolina and South Carolina. Controls (n = 355) were identified through driver's license records and were frequency matched to patients by age, sex, and state. Data collection included a 60 min in-person interview. Analyses were limited to experiences that occurred before age at diagnosis (patients) or reference age (controls). Because the prevalence of use of hair treatments among men was very low, the analyses of those exposures were limited to women. Results. There was no association with smoking history and risk of developing SLE when analyzed as status (current, former, or never-smoker) or measures of dose (duration or pack-years). Use of permanent hair dyes in women was associated with a small increased risk of developing SLE (OR 1.5, 95% CI 1.0, 2.2). This association increased with longer duration of use (compared with nonusers, OR 1.7, 95% CI 1.0, 2.7 for 6 or more years). There was little evidence of an association between SLE and use of temporary dyes or of permanents and straighteners. Conclusion. These results suggest at most a weak association between SLE risk and permanent hair dyes or smoking. Genetic variability in the metabolism of these products may be important to assess in future studies. C1 NIEHS, Epidemiol Branch, Res Triangle Pk, NC 27709 USA. Univ N Carolina, Div Rheumatol, Chapel Hill, NC USA. E Carolina Univ, Sch Med, Div Rheumatol, Greenville, NC USA. Duke Univ, Med Ctr, Div Rheumatol Allergy & Clin Immunol, Durham, NC USA. Ralph H Johnson Vet Adm Med Ctr, Med Res Serv, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Cooper, GS (reprint author), NIEHS, Epidemiol Branch, A3-05,POB 12233, Res Triangle Pk, NC 27709 USA. NR 15 TC 25 Z9 27 U1 0 U2 2 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD DEC PY 2001 VL 28 IS 12 BP 2653 EP 2656 PG 4 WC Rheumatology SC Rheumatology GA 498NP UT WOS:000172517800016 PM 11764212 ER PT J AU Livingston, EH Sebastian, JL Huerta, S Yip, I Heber, D AF Livingston, EH Sebastian, JL Huerta, S Yip, I Heber, D TI Biexponential model for predicting weight loss after gastric surgery for obesity SO JOURNAL OF SURGICAL RESEARCH LA English DT Article DE compartment modeling; biexponential models; obesity surgery; gastric bypass; weight loss; mathematical models; bioimpedance analysis ID BODY-MASS INDEX; BIOELECTRICAL-IMPEDANCE ANALYSIS; MORBID-OBESITY; REDUCTION; MORTALITY; SLEEP; TERM; ASSOCIATION; VALIDATION; BYPASS AB Background. Following gastric restrictive surgery, morbidly obese patients rarely achieve their ideal body weight defined by Metropolitan Life tables. The final body weight will depend on the initial body composition because there will be greater weight loss from fat than lean body mass. The purpose of this study was to develop a mathematical model that accurately estimates the rate and extent of weight loss following gastric bypass surgery. Methods. Patients underwent gastric bypass followed by intensive medical therapy and serial bioelectrical impedance analysis (BIA) body composition measurements. Differential equations were derived to model weight loss. Results. Weight loss in the fat and lean body compartments followed monoexponential decay kinetics with differing rate constants. Total body weight loss (W-T) at time t was W-T = k(f)/(k(f) - k(l)) (W(fo)e(-kft) + Wl(o)e(-klt)), where W-fo and W-lo are the initial fat and lean body masses determined by BIA and k(f) and k(l) are the rate constants for the fat and lean compartments, respectively. Following surgically induced weight loss, kf = 7.61 +/- 1.27 x 10(-2), and k(l) = -0.93 +/- 0.13 x 10(-2), with the ratio of residual sum of the squares to the total sum of the squares of 98.8%. Conclusion. Accurate prediction of weight loss depends on the initial fat and lean compartment mass since each of these loses weight at a different rate and to a different extent. When these effects are accounted for, the total body weight loss can be accurately predicted for any given time following surgery. (C) 2001 Elsevier Science. C1 VA Greater Los Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Ctr Human Nutr, Los Angeles, CA 90095 USA. RP Livingston, EH (reprint author), Univ Calif Los Angeles, Sch Med, Bariatr Surg Program, Box 95-6904, Los Angeles, CA 90095 USA. NR 35 TC 9 Z9 9 U1 0 U2 1 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0022-4804 J9 J SURG RES JI J. Surg. Res. PD DEC PY 2001 VL 101 IS 2 BP 216 EP 224 DI 10.1006/jsre.2001.6286 PG 9 WC Surgery SC Surgery GA 510QN UT WOS:000173218900016 PM 11735279 ER PT J AU Saliba, D Elliott, M Rubenstein, LZ Solomon, DH Young, RT Kamberg, CJ Roth, C MacLean, CH Shekelle, PG Sloss, EM Wenger, NS AF Saliba, D Elliott, M Rubenstein, LZ Solomon, DH Young, RT Kamberg, CJ Roth, C MacLean, CH Shekelle, PG Sloss, EM Wenger, NS TI The vulnerable elders survey: A tool for identifying vulnerable older people in the community SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY, 2000 CL NASHVILLE, TENNESSEE SP Amer Geriatr Soc DE function; mortality; frail; risk; survey ID HEALTH-STATUS; FUNCTIONAL STATUS; PREDICTING MORTALITY; PHYSICAL-DISABILITY; SELF-REPORT; FOLLOW-UP; CARE; ADULTS; RISK; HOSPITALIZATION AB OBJECTIVES: To develop a simple method for identifying community-dwelling vulnerable older people, defined as persons age 65 and older at increased risk of death or functional decline. To assess whether self-reported diagnoses and conditions add predictive ability to a function-based survey. DESIGN: Analysis of longitudinal survey data. SETTING: A nationally representative community-based survey. PARTICIPANTS: Six thousand two hundred five Medicare beneficiaries age 65 and older. MEASUREMENTS: Bivariate and multivariate analyses of the Medicare Current Beneficiary Survey; development and comparison of scoring systems that use age, function, and self-reported diagnoses to predict future death and functional decline. RESULTS: A multivariate model using function, self-rated health, and age to predict death or functional decline was only slightly improved when self-reported diagnoses and conditions were included as predictors and was significantly better than a model using age plus self-reported diagnoses alone. These analyses provide the basis for a 13-item function-based scoring system that considers age, self-rated health, limitation in physical function, and functional disabilities. A score of greater than or equal to3 targeted 32% of this nationally representative sample as vulnerable. This targeted group had 4.2 times the risk of death or functional decline over a 2-year period compared with those with scores <3. The receiver operating characteristics curve had an area of .78. An alternative scoring system that included self-reported diagnoses did not substantially improve predictive ability when compared with a function-based scoring system. CONCLUSIONS: A function-based targeting system effectively and efficiently identifies older people at risk of functional decline and death. Self-reported diagnoses and conditions, when added to the system, do not enhance predictive ability. The function-based targeting system relies on self-report and is easily transported across care settings. C1 RAND Corp, Santa Monica, CA USA. Greater Los Angeles Syst Vet Adm Med Ctr, Sepulveda Geriatr Res Educ & Clin Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA USA. RP Saliba, D (reprint author), RAND Corp, 1700 Main St, Santa Monica, CA USA. FU NIA NIH HHS [AG10415] NR 57 TC 359 Z9 365 U1 3 U2 14 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD DEC PY 2001 VL 49 IS 12 BP 1691 EP 1699 DI 10.1046/j.1532-5415.2001.49281.x PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 505JH UT WOS:000172909300016 PM 11844005 ER PT J AU Hazzard, WR AF Hazzard, WR TI An open letter to every medical student who aspires to become a leader in academic geriatric medicine SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Editorial Material C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Hazzard, WR (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 1 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD DEC PY 2001 VL 49 IS 12 BP 1733 EP 1734 DI 10.1046/j.1532-5415.2001.49288.x PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 505JH UT WOS:000172909300022 PM 11844011 ER PT J AU Wu, JH Billings, BJ Balkovetz, DF AF Wu, JH Billings, BJ Balkovetz, DF TI Hepatocyte growth factor alters renal epithelial cell susceptibility to uropathogenic Escherichia coli SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID E-CADHERIN; POLARITY; KIDNEY; MONOLAYERS; IDENTIFICATION; CYTOTOXICITY; GRANULOCYTES; REGENERATION; OBSTRUCTION; POLYPEPTIDE AB The urinary tract is frequently the source of Escherichia coli bacteremia. Bacteria from the urinary tract must cross an epithelial layer to enter the bloodstream. Hepatocyte growth factor (HGF) alters the polarity of Madin-Darby canine kidney (MDCK) epithelial cells. The role of cell polarity in determining renal epithelial resistance to Escherichia coli invasion is not well known. A model of polarized and HGF-treated MDCK epithelial cells grown on filters was used to study the role of epithelial cell polarity during the interaction of nonvirulent (XL1-Blue) and uropathogenic (J96) strains of Escherichia coli with renal epithelium. Basolateral. exposure of MDCK cells to J96, but not XL1-Blue, resulted in loss of transepithelial resistance (TER), which was due to epithelial cytotoxicity and not degradation of epithelial junctional proteins by bacterial proteases. Apical exposure to both J96 and XL1-Blue did not alter TER. Pretreatment of polarized MDCK cell monolayers with HGF renders the cells sensitive to loss of TER and cytotoxicity by apical exposure to J96. Analysis by confocal microscopy demonstrated that HGF treatment of MDCK cell monolayers also greatly enhances adherence of J96 to the apical surface of the cell monolayer. These data demonstrate that the basolateral surface of polarized epithelia is more susceptible to J96 cytotoxicity. The data also support the hypothesis that processes that alter epithelial cell polarity increase sensitivity of epithelia to bacterial injury and adherence from the apical compartment. C1 Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Cell Biol, Birmingham, AL 35294 USA. Univ Alabama, Dept Surg, Birmingham, AL 35294 USA. RP Balkovetz, DF (reprint author), 668 LHRB,1530 3rd Ave S, Birmingham, AL 35294 USA. FU NIAID NIH HHS [T32 AI 07041] NR 45 TC 13 Z9 13 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD DEC PY 2001 VL 12 IS 12 BP 2543 EP 2553 PG 11 WC Urology & Nephrology SC Urology & Nephrology GA 496TM UT WOS:000172412900001 PM 11729222 ER PT J AU Clarke, P Meintzer, SM Widmann, C Johnson, GL Tyler, KL AF Clarke, P Meintzer, SM Widmann, C Johnson, GL Tyler, KL TI Reovirus infection activates JNK and the JNK-dependent transcription factor c-Jun SO JOURNAL OF VIROLOGY LA English DT Article ID NF-KAPPA-B; PROTEIN-KINASE PATHWAYS; INDUCED APOPTOSIS; TERMINAL KINASE; SIGNAL-TRANSDUCTION; MEDIATED APOPTOSIS; CHROMIUM RELEASE; M2 GENE; T-CELLS; DEATH AB Viral infection often perturbs host cell signaling pathways including those involving mitogen-activated protein kinases (MAPKs). We now show that reovirus infection results in the selective activation of c-Jun N-terminal kinase (JNK). Reovirus-induced JNK activation is associated with an increase in the phosphorylation of the JNK-dependent transcription factor c-Jun. Reovirus serotype 3 prototype strains Abney (T3A) and Dearing (T3D) induce significantly more JNK activation and c-Jun phosphorylation than does the serotype 1 prototypic strain Lang (TIL). T3D and T3A also induce more apoptosis in infected cells than TIL, and there was a significant correlation between the ability of these viruses to phosphorylate c-Jun and induce apoptosis. However, reovirus-induced apoptosis, but not reovirus-induced c-Jun phosphorylation, is inhibited by blocking TRAIL/receptor binding, suggesting that apoptosis and c-Jun phosphorylation involve parallel rather than identical pathways. Strain-specific differences in JNK activation are determined by the reovirus S1 and M2 gene segments, which encode viral outer capsid proteins (sigma1 and mu 1c) involved in receptor binding and host cell membrane penetration. These same gene segments also determine differences in the capacity of reovirus strains to induce apoptosis, and again a significant correlation between the capacity of T1L X T3D reassortant reoviruses to both activate JNK and phosphorylate c-Jun and to induce apoptosis was shown. The extracellular signal-related kinase (ERK) is also activated in a strain-specific manner following reovirus infection. Unlike JNK activation, ERK activation could not be mapped to specific reovirus gene segments, suggesting that ERK activation and JNK activation are triggered by different events during virus-host cell interaction. C1 Denver VA Med Ctr, Dept Neurol 127, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Microbiol & Immunol, Denver, CO 80262 USA. RP Tyler, KL (reprint author), Denver VA Med Ctr, Dept Neurol 127, 1055 Clermont St, Denver, CO 80220 USA. RI Widmann, Christian/N-9851-2013 OI Widmann, Christian/0000-0002-6881-0363; Tyler, Kenneth/0000-0003-3294-5888 FU NIA NIH HHS [1RO1AG14071]; NIGMS NIH HHS [GM30324, R01 GM030324, R37 GM030324] NR 63 TC 52 Z9 55 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD DEC PY 2001 VL 75 IS 23 BP 11275 EP 11283 DI 10.1128/JVI.75.23.11275-11283.2001 PG 9 WC Virology SC Virology GA 490CP UT WOS:000172033100002 PM 11689607 ER PT J AU Lai, LL Liu, HM Wu, XY Kappes, JC AF Lai, LL Liu, HM Wu, XY Kappes, JC TI Moloney murine leukemia virus integrase protein augments viral DNA synthesis in infected cells SO JOURNAL OF VIROLOGY LA English DT Article ID TYPE-1 INTEGRASE; NUCLEOCAPSID PROTEIN; CARBOXYL-TERMINUS; GENETIC-ANALYSIS; IN-VITRO; MUTATIONS; MUTANTS; POL; REPLICATION; EXPRESSION AB Mutations in the IN domain of retroviral DNA may affect multiple steps of the virus life cycle, suggesting that the IN protein may have other functions in addition to its integration function. We previously reported that the human immunodeficiency virus type 1 IN protein is required for efficient viral DNA synthesis and that this function requires specific interaction with other viral components but not enzyme (integration) activity. In this report, we characterized the structure and function of the Moloney murine leukemia virus (MLV) IN protein in viral DNA synthesis. Using an MLV vector containing green fluorescent protein as a sensitive reporter for virus infection, we found that mutations in either the catalytic triad (D184A) or the HHCC motif (H61A) reduced infectivity by approximately 1,000-fold. Mutations that deleted the entire IN (Delta IN) or 34 C-terminal amino acid residues (Delta 34) were more severely defective, with infectivity levels consistently reduced by 10,000-fold. Immunoblot analysis indicated that these mutants were similar to wild-type MLV with respect to virion production and proteolytic processing of the Gag and Pol precursor proteins. Using semiquantitative PCR to analyze viral cDNA synthesis in infected cells, we found the Delta 34 and Delta IN mutants to be markedly impaired while the D184A and H61A mutants synthesized cDNA at levels similar to the wild type. The DNA synthesis defect was rescued by complementing the Delta 34 and Delta IN mutants in trans with either wild-type IN or the D184A mutant IN, provided as a Gag-IN fusion protein. However, the DNA synthesis defect of Delta IN mutant virions could not be complemented with the Delta 34 IN mutant. Taken together, these analyses strongly suggested that the MLV IN protein itself is required for efficient viral DNA synthesis and that this function may be conserved among other retroviruses. C1 Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Res Serv, Birmingham, AL 35233 USA. RP Kappes, JC (reprint author), Univ Alabama, Dept Med, THT 513H,1530 3rd Ave, Birmingham, AL 35294 USA. FU NCI NIH HHS [CA73470]; NIAID NIH HHS [P30 AI027767, R01 AI047714, AI47714, P30-AI-27767] NR 34 TC 24 Z9 24 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD DEC PY 2001 VL 75 IS 23 BP 11365 EP 11372 DI 10.1128/JVI.75.23.11365-11372.2001 PG 8 WC Virology SC Virology GA 490CP UT WOS:000172033100012 PM 11689617 ER PT J AU Perell, KL Nelson, A Goldman, RL Luther, SL Prieto-Lewis, N Rubenstein, LZ AF Perell, KL Nelson, A Goldman, RL Luther, SL Prieto-Lewis, N Rubenstein, LZ TI Fall risk assessment measures: An analytic review SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID ELDERLY PATIENTS; FUNCTIONAL ASSESSMENT; ASSESSMENT-TOOL; OLDER ADULTS; NURSING-HOME; PRIMARY-CARE; WILL FALL; PREVENTION; COMMUNITY; INDEX AB Background. Clinicians are often unaware of the many existing scales for identifying fall risk and are uncertain about how to select an appropriate one. Our purpose was to summarize existing fall risk assessment scales to enable more informed choices regarding their use. Methods. After a systematic literature search, 21 articles published from 1984 through 2000 describing 20 fall risk assessments were reviewed independently for content and validation by a panel of five reviewers using a standardized review form. Fourteen were institution-focused nursing assessment scales, and six were functional assessment scales. Results. The majority of the scales were developed for elderly populations. mainly in hospital or nursing home settings. The patient characteristics assessed were quite similar across the nursing assessment forms. The time to complete the form varied from less than I minute to 80 minutes. For those scales with reported diagnostic accuracy, sensitivity varied from 43% to 100% (median = 80%), and specificity varied from 38% to 96% (median = 75%). Several scales with superior diagnostic characteristics were identified. Conclusions. A substantial number of fall risk assessment tools are readily available and assess similar patient characteristics. Although their diagnostic accuracy and overall usefulness showed wide variability, there are several scales that can be used with confidence as part of an effective falls prevention program. Consequently, there should be little need for facilities to develop their own scales. To continue to develop fall risk assessments unique to individual facilities may be counterproductive because scores will not be comparable across facilities. C1 VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, Phys Med & Rehabil Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Mt St Marys Coll, Dept Phys Therapy, Los Angeles, CA USA. James A Haley Vet Adm Med Ctr, Vet Integrated Serv Network 8, Patient Safety Ctr Inquiry, Tampa, FL 33612 USA. Off Qual & Performance, VA Headquarters, Washington, DC USA. Gait & Balance Clin N Florida, S Georgia Vet Hlth Syst, Phys Med & Rehabil Serv, Gainesville, FL USA. VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda Ambulatory Care Ctr, Sepulveda, CA USA. RP Perell, KL (reprint author), VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, Phys Med & Rehabil Serv, 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 44 TC 182 Z9 184 U1 13 U2 34 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD DEC PY 2001 VL 56 IS 12 BP M761 EP M766 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 498DT UT WOS:000172495100010 PM 11723150 ER PT J AU Simmons, SF Osterweil, D Schnelle, JF AF Simmons, SF Osterweil, D Schnelle, JF TI Improving food intake in nursing home residents with feeding assistance: A staffing analysis SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID PROTEIN-CALORIE UNDERNUTRITION; WEIGHT-LOSS; CARE; MEALTIME; PREDICTORS; MORTALITY; INDEX; RISK AB Background. Recommendations have been made to increase the number of nursing home (NH) staff available to provide feeding assistance during mealtime. There are. however, no specific data related to two critical variables necessary to estimate mealtime staffing needs: (1) How many residents are responsive to feeding assistance? (2) How much staff time is required to provide feeding assistance to these residents? The purpose of this study was to collect preliminary data relevant to these two issues. Methods. Seventy-four residents in three NHs received a 2-day. or six-meal. trial of one-on-one feeding assistance. Total percentage (0% to 100%) of food and fluid consumed during mealtime was estimated across 3 days during usual NH care and 2 days during the intervention. The amount of time that staff spent providing assistance and type of assistance (i.e,, frequency of verbal and physical prompts) was measured under each condition. Results. One half (50%) of the participants significantly increased their oral food and fluid intake during mealtime. The intervention required significantly more staff time to implement (average of 38 minutes per resident/meal vs 9 minutes rendered by NH staff). Conclusions. The time required to implement the feeding assistance intervention greatly exceeded the time the nursing staff spent assisting residents in usual mealtime care conditions. These data suggest that it will almost certainly be necessary to both increase staffing levels and to organize staff better to produce higher quality feeding assistance during mealtimes. C1 Univ Calif Los Angeles, Jewish Home Aging, Borun Ctr Gerontol Res, Reseda, CA 91335 USA. Univ Calif Los Angeles, Sch Med, Dept Geriatr, Borun Ctr Gerontol Res, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syt, Sepulveda Geriat Res Educ & Clin Ctr, Sepulveda, CA USA. RP Simmons, SF (reprint author), Univ Calif Los Angeles, Jewish Home Aging, Borun Ctr Gerontol Res, 7150 Tampa Ave, Reseda, CA 91335 USA. NR 32 TC 76 Z9 81 U1 1 U2 4 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD DEC PY 2001 VL 56 IS 12 BP M790 EP M794 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 498DT UT WOS:000172495100016 PM 11723156 ER PT J AU Arva, J Fitzgerald, SG Cooper, RA Boninger, ML AF Arva, J Fitzgerald, SG Cooper, RA Boninger, ML TI Mechanical efficiency and user power requirement with a pushrim activated power assisted wheelchair SO MEDICAL ENGINEERING & PHYSICS LA English DT Article DE wheelchairs; human-machine power; metabolic energy; mechanical power ID FORCE APPLICATION; PROPULSION; PAIN AB The objective of this study was to quantify the difference in mechanical efficiency and user power generation between traditional manual wheelchairs and a pushrim activated power assisted wheelchair (PAPAW). Ten manual wheelchair users were evaluated in a repeated measures design trial with and without the PAPAW for propulsion efficiency. Subjects propelled a Quickie GP equipped with the PAPAW and their own chair on a computer controlled wheelchair dynamometer at five different resistance levels. Power output, user power with the PAPAW hubs, subjects' oxygen consumption per minute and mechanical efficiency were analyzed. Metabolic energy and user power were significantly lower (p<0.05), and mechanical efficiency significantly higher with the PAPAW than with subjects' own chairs. Subjects needed to generate on average 3.65 times more power when propelling their own wheelchairs as compared to PAPAW. Mean mechanical efficiency over all trials was 80.33% higher with the power assisted hubs. PAPAW provides on average 73% of the total power when subjects propel with power assistance. Significantly increased efficiency and reduced requirement of user power is achieved using the PAPAW. With use, the PAPAW may contribute to delaying secondary injuries of manual wheelchair users. In addition, it may be suitable for people who have (or at risk for) upper extremity joint degeneration, reduced exercise capacity, low strength or endurance who currently use electric powered wheelchairs. Published by Elsevier Science Ltd on behalf of IPEM. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Ctr, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15261 USA. RP Fitzgerald, SG (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R1, 7180 Highland Dr, Pittsburgh, PA 15206 USA. OI Boninger, Michael/0000-0001-6966-919X NR 21 TC 28 Z9 29 U1 1 U2 5 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1350-4533 J9 MED ENG PHYS JI Med. Eng. Phys. PD DEC PY 2001 VL 23 IS 10 BP 699 EP 705 DI 10.1016/S1350-4533(01)00054-6 PG 7 WC Engineering, Biomedical SC Engineering GA 516AN UT WOS:000173529300005 PM 11801411 ER PT J AU Dowd, B Feldman, R Maciejewski, M Pauly, MV AF Dowd, B Feldman, R Maciejewski, M Pauly, MV TI The effect of tax-exempt out-of-pocket premiums on health plan choice SO NATIONAL TAX JOURNAL LA English DT Article; Proceedings Paper CT International Tax Policy Forum Conference CY APR 30, 2001 CL BROOKINGS INST, WASHINGTON, D.C. HO BROOKINGS INST ID ADVERSE SELECTION; INSURANCE; DEMAND; BENEFITS; REFORM; MARKET AB Market-based health care reform proposals typically rely on 1) consumer choice among competing health plans, 2) premiums paid out-of-pocket for higher priced plans, and 3) a significant out-of-pocket premium-p rice elasticity of health plan choice, Section 125 of the Internal Revenue Code exempts employee out-of-pocket premiums from personal income taxes and FICA taxes. The predicted effect is attenuation of the out-of-pocket premium-price elasticity of health plan choice. Using 1994 data from a national sample of large public employers, we find that employees are sensitive to out-of-pocket premiums, but tax-exempt out-of-pocket premiums reduce substantially the price elasticity of health plan choice. C1 Univ Minnesota, Sch Publ Hlth, Div Hlth Serv Res & Policy, Minneapolis, MN 55455 USA. VA Puget Sound Hlth Care Syst, HSR&D 152, Seattle, WA 98108 USA. Univ Penn, Wharton Sch, Hlth Care Syst Dept, Philadelphia, PA 19104 USA. RP Dowd, B (reprint author), Univ Minnesota, Sch Publ Hlth, Div Hlth Serv Res & Policy, Minneapolis, MN 55455 USA. NR 32 TC 6 Z9 8 U1 1 U2 3 PU NATL TAX ASSOC PI WASHINGTON PA 725 15TH ST, N W #600, WASHINGTON, DC 20005-2109 USA SN 0028-0283 J9 NATL TAX J JI Natl. Tax J. PD DEC PY 2001 VL 54 IS 4 BP 741 EP 756 PG 16 WC Business, Finance; Economics SC Business & Economics GA 506BQ UT WOS:000172950400004 ER PT J AU de Silva, AM Walder, KR Boyko, EJ Whitecross, KF Nicholson, G Kotowicz, M Pasco, J Collier, GR AF de Silva, AM Walder, KR Boyko, EJ Whitecross, KF Nicholson, G Kotowicz, M Pasco, J Collier, GR TI Genetic variation and obesity in Australian women: A prospective study SO OBESITY RESEARCH LA English DT Article DE polymorphisms; longitudinal; white; body composition ID LEPTIN RECEPTOR GENE; BODY-MASS INDEX; INSULIN-RESISTANCE; BETA(3)-ADRENERGIC RECEPTOR; MORBID-OBESITY; ADRENERGIC-RECEPTOR; TRP64ARG MUTATION; DIABETES-MELLITUS; WEIGHT-GAIN; POLYMORPHISM AB Objective: A number of candidate genes have been implicated in the pathogenesis of obesity in humans. This study examines associations between longitudinal changes in body mass and composition and the presence of polymorphisms in the beta -3 adrenergic receptor, tumor necrosis factor-alpha, leptin, and leptin receptor (Lepr) in a cohort of Australian women. Research Methods and Procedures: Healthy white Australian women (n = 335) were randomly selected from the Barwon region of Victoria and underwent baseline anthropometry and double-energy X-ray absorptiometry for assessment of body mass and adiposity. These measurements were repeated again at 2-year follow-up. Genomic DNA was extracted and used for polymerase chain reaction-based genotyping of all polymorphisms. Results: The Pro1019Pro Lepr polymorphism was associated with longitudinal increases in body weight (p = 0.02), fat mass (p = 0.05), and body mass index (p = 0.01) in this study, and individuals homozygous for the A allele at this locus had a greater propensity to gain body fat over time. The largest effects on body composition seemed to be in individuals already obese at baseline. Changes in body weight, fat mass., percent body fat, and body mass index over a 2-year period were not associated with genetic variation in the beta -3 adrenergic receptor (Trp64Arg), tumor necrosis factor-alpha promoter, or leptin genes in non-obese or obese women. Discussion: These results suggest that a Lepr polymorphism is involved in the regulation of body mass and adiposity in obese Australian white women, which may have implications for the treatment of obesity in this population. C1 Deakin Univ, Sch Hlth Sci, Metab Res Unit, Geelong, Vic 3217, Australia. Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Melbourne, Dept Clin & Biomed Sci, Geelong, Vic, Australia. RP de Silva, AM (reprint author), Deakin Univ, Sch Hlth Sci, Metab Res Unit, Geelong, Vic 3217, Australia. RI Nicholson, Geoffrey/F-1901-2010 OI Nicholson, Geoffrey/0000-0002-0152-1153; Kotowicz, Mark/0000-0002-8094-1411; Boyko, Edward/0000-0002-3695-192X NR 33 TC 21 Z9 21 U1 0 U2 0 PU NORTH AMER ASSOC STUDY OBESITY PI SILVER SPRING PA 8630 FENTON ST, SUITE 918, SILVER SPRING, MD 20910 USA SN 1071-7323 J9 OBES RES JI Obes. Res. PD DEC PY 2001 VL 9 IS 12 BP 733 EP 740 DI 10.1038/oby.2001.101 PG 8 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 505BU UT WOS:000172892000001 PM 11743056 ER PT J AU Garrick, T Morrow, N Shalev, AY Eth, S AF Garrick, T Morrow, N Shalev, AY Eth, S TI Stress-induced enhancement of auditory startle: An animal model of posttraumatic stress disorder SO PSYCHIATRY-INTERPERSONAL AND BIOLOGICAL PROCESSES LA English DT Article ID VIETNAM VETERANS; PHYSIOLOGICAL-RESPONSES; AMYGDALOID NUCLEUS; CONDITIONED FEAR; LOUD TONES; COMMUNITY; RELEVANCE; PTSD; RATS AB AN innovative animal model of, posttraumatic stress disorder (PTSD) is proposed in which nonhabituation of the acoustic startle response is developed in rats subsequent to tailshock exposure. Subjects (n = 3 1) received 3 0 minutes of intermittent tail shock on 2 days followed by exposure to the tailshock apparatus on the third day. Compared to baseline startle reactions, 9 of 31 tailshock-exposed rats developed nonhabituation of startle response reactions during the subsequent 3 weeks of testing. No control rats developed nonhabituation of startle reactions over a similar time period. These data suggest that this system models useful aspects of clinical PTSD emphasizing nonhabituation of startle reactions as a dependent variable. The method consistently identifies a subgroup of rats that develop persistent nonhabituation of startle in response to a tailshock-stress paradigm. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Hadassah Univ Hosp, IL-91120 Jerusalem, Israel. St Vincents Catholic Med Ctr New York, New York, NY USA. RP Garrick, T (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 37 TC 40 Z9 44 U1 2 U2 5 PU GUILFORD PUBLICATIONS INC PI NEW YORK PA 72 SPRING STREET, NEW YORK, NY 10012 USA SN 0033-2747 J9 PSYCHIATRY JI Psychiatry-Interpers. Biol. Process. PD WIN PY 2001 VL 64 IS 4 BP 346 EP 354 DI 10.1521/psyc.64.4.346.18600 PG 9 WC Psychiatry SC Psychiatry GA 513EZ UT WOS:000173366100006 PM 11822211 ER PT J AU Bradley, KA Bush, KR Davis, TM Dobie, DJ Burman, ML Rutter, CM Kivlahan, DR AF Bradley, KA Bush, KR Davis, TM Dobie, DJ Burman, ML Rutter, CM Kivlahan, DR TI Binge drinking among female veterans affairs patients: Prevalence and associated risks SO PSYCHOLOGY OF ADDICTIVE BEHAVIORS LA English DT Article ID ALCOHOL-CONSUMPTION QUESTIONS; PRIMARY-CARE PATIENTS; NATIONAL SURVEY; SCREENING INSTRUMENTS; COLLEGE-STUDENTS; EMERGENCY ROOM; AUDIT; WOMEN; HEALTH; SEX AB This study evaluated the prevalence and associated risks of binge drinking, defined as having greater than or equal to4 drinks on an occasion in the past year, in a female patient population. Of 1,259 female Veterans Affairs patients surveyed, 780 reported drinking alcohol in the past year, and 305 (24% of respondents, 39% of drinkers) reported binge drinking in the past year; 84 (11% of drinkers) had done so monthly or more often. Age-adjusted logistic regression analyses indicated that women who reported past-year binge drinking monthly or more often reported significantly increased odds of morning drinking (odds ratio [OR] = 40.3), others worrying about their drinking (OR = 38.6), arguments after drinking (OR = 13.5), hepatitis or cirrhosis (OR = 3.1), frequent injuries (OR = 2.6), smoking (OR = 3.7), drug use (OR = 22.2), and multiple sexual partners (OR = 4.6). C1 Vet Affairs Puget Sound Hlth Care Syst, HSR&D 152, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98195 USA. RP Bradley, KA (reprint author), Vet Affairs Puget Sound Hlth Care Syst, HSR&D 152, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIAAA NIH HHS [AA00313] NR 42 TC 27 Z9 27 U1 3 U2 4 PU EDUCATIONAL PUBLISHING FOUNDATION PI WASHINGTON PA 750 FIRST ST, NE, WASHINGTON, DC 20002-4242 USA SN 0893-164X J9 PSYCHOL ADDICT BEHAV JI Psychol. Addict. Behav. PD DEC PY 2001 VL 15 IS 4 BP 297 EP 305 DI 10.1037//0893-164X.15.4.297 PG 9 WC Substance Abuse; Psychology, Multidisciplinary SC Substance Abuse; Psychology GA 500BP UT WOS:000172606300004 PM 11767260 ER PT J AU Chung, MH Pisegna, J Spirt, M Giuliano, AE Ye, W Ramming, KP Bilchik, AJ AF Chung, MH Pisegna, J Spirt, M Giuliano, AE Ye, W Ramming, KP Bilchik, AJ TI Hepatic cytoreduction followed by a novel long-acting somatostatin analog: A paradigm for intractable neuroendocrine tumors metastatic to the liver SO SURGERY LA English DT Article; Proceedings Paper CT 22nd Annual Meeting of the American-Association-of-Endocrine-Surgeons CY APR 28-MAY 01, 2001 CL ATLANTA, GEORGIA SP Amer Assoc Endocrine Surg ID MALIGNANT CARCINOID-SYNDROME; RADIOFREQUENCY ABLATION; ENDOCRINE TUMORS; RESECTION; MANAGEMENT; INTERFERON AB Background. Optimal management of symptomatic neuroendocrine tumors that metastasize to the liver is controversial. We investigated aggressive hepatic cytoreduction and postoperative administration of octreotide long acting release (LAR), a long-acting somatostatin analog. Methods. Between December 1992 and August 2000, 31 patients underwent hepatic surgical cytoreduction (20 carcinoid, 10 islet cell, and 1 medullary). All patients had progressive symptoms refractory to conventional therapy. Results. Hepatic cytoreduction (resection, cryosurgery, and/or radiofrequency ablation) eliminated symptoms in 27 patients (87%) and decreased secretion of hormones by an overall mean of 59%. When minor symptoms returned and/or hormonal levels increased during follow-up, adjuvant therapy was started. Ten patients received adjuvant octreotide LAR once a month, and 21 received other adjuvants. At a median postoperative follow-up of 26 months, 16 patients had progressive/recurrent disease. 13 had died of their disease, and 2 remained free of disease. Median symptom-free interval was 60 months (95% confidence interval, 48-72) with octreotide LAR and 16 months (95% confidence interval, 10-29) with other adjuvants (P =.0007). Two-year symptom-free survival rate was 100% with octreotide LAR and 33% with other adjuvants. Conclusions. Hepatic surgical cytoreduction can palliate progressive symptoms associated with liver metastases from intractable neuroendocrine tumors. Postoperative adjuvant therapy with octreotide LAR can prolong symptom-free survival. C1 St Johns Hlth Ctr, John Wayne Canc Inst, Santa Monica, CA 90404 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Century City Hosp, Century City Canc Ctr, Century City, CA USA. RP Bilchik, AJ (reprint author), St Johns Hlth Ctr, John Wayne Canc Inst, 2200 Santa Monica Blvd, Santa Monica, CA 90404 USA. NR 25 TC 45 Z9 45 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0039-6060 J9 SURGERY JI Surgery PD DEC PY 2001 VL 130 IS 6 BP 954 EP 962 DI 10.1067/msy.2001.118388 PG 9 WC Surgery SC Surgery GA 507FA UT WOS:000173015300016 PM 11742323 ER PT J AU Pinsky, LE Burke, W Bird, TD AF Pinsky, LE Burke, W Bird, TD TI Why should primary care physicians know about the genetics of dementia? SO WESTERN JOURNAL OF MEDICINE LA English DT Article ID APOLIPOPROTEIN-E GENOTYPE; PLACEBO-CONTROLLED TRIAL; E EPSILON-4 ALLELE; ALZHEIMERS-DISEASE; FAMILIAL AGGREGATION; TACRINE THERAPY; AD; POPULATION; DIAGNOSIS; RISK C1 Univ Washington, Sch Med, Dept Med, Div Gen Internal Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med Hist & Eth, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Pinsky, LE (reprint author), Univ Washington, Sch Med, Dept Med, Div Gen Internal Med, Box 354760,1959 NE Pacific, Seattle, WA 98195 USA. NR 35 TC 0 Z9 0 U1 0 U2 0 PU B M J PUBLISHING INC PI SAN FRANCISCO PA 221 MAIN ST, PO BOX 7690, SAN FRANCISCO, CA 94120-7690 USA SN 0093-0415 J9 WESTERN J MED JI West. J. Med. PD DEC PY 2001 VL 175 IS 6 BP 412 EP 416 DI 10.1136/ewjm.175.6.412 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 497PB UT WOS:000172463700021 PM 11733436 ER PT J AU Sudhakar, S Li, Y Katz, MS Elango, N AF Sudhakar, S Li, Y Katz, MS Elango, N TI Translational regulation is a control point in RUNX2/Cbfa1 gene expression SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE osteoblast differentiation; RUNX2 transcription factor; isoforms; type-specific antibodies; translational regulation ID TRANSCRIPTION FACTOR; OSTEOBLAST DIFFERENTIATION; CLEIDOCRANIAL DYSPLASIA; BONE-FORMATION; CELL-LINES; CBFA1; AML1; OSF2/CBFA1; PHENOTYPE; ISOFORMS AB Runt-related transcription factor-2 (RUNX2)/core binding factor al (Cbfa1) is implicated in the regulation of osteoblast differentiation and osteoblast-specific gene expression. Mutations in RUNX2 cause the bone disease cleidocranial dysplasia, which is characterized by multiple skeletal defects. RUNX2 is expressed as two isoforms (type-I and type-II) encoded by two different mRNAs. We report here the detection of both mRNAs in osteoblastic cells and osteoblast precursors as well as nonosteoblastic cells. Surprisingly, however, osteoblast precursors and nonosteoblastic cells express no RUNX2 protein; mature osteoblasts express both isoforms, while less mature osteoblastic cells express only type-I protein. Northern blot analysis of RNA isolated from polysomes and ribonucleoprotein particles demonstrated that RUNX2 mRNA is polysome-associated in osteoblastic cells but polysome-free in osteoblast precursors. These results suggest that (a) RUNX2 mRNAs are expressed but dormant in osteoblast precursors and nonosteoblastic cells, (b) RUNX2 gene expression is controlled at the translational level, and (c) the expression of individual protein isoforms of RUNX2 is differentiation stage specific. Thus, differentiation of cells along the osteoblast lineage appears to be regulated at the level of RUNX2 mRNA translation. (C) 2001 Elsevier Science. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Div Geriatr & Gerontol, San Antonio, TX 78229 USA. RP Elango, N (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, GRECC 182, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. NR 38 TC 42 Z9 43 U1 0 U2 0 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD NOV 30 PY 2001 VL 289 IS 2 BP 616 EP 622 DI 10.1006/bbrc.2001.6033 PG 7 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 500CG UT WOS:000172607900048 PM 11716520 ER PT J AU Cornelussen, RNM van Nieuwenhoven, FA Snoeckx, LHEH Knowlton, AA AF Cornelussen, RNM van Nieuwenhoven, FA Snoeckx, LHEH Knowlton, AA TI Presence of heat shock protein 72 in cardiomyocytes after heat stress SO CIRCULATION LA English DT Letter ID RAT-HEART; LOCALIZATION C1 Maastricht Univ, Cardiovasc Res Inst Maastricht, Maastricht, Netherlands. Houston VA Med Ctr, Baylor Coll Med, Houston, TX USA. RP Cornelussen, RNM (reprint author), Maastricht Univ, Cardiovasc Res Inst Maastricht, Maastricht, Netherlands. NR 5 TC 4 Z9 4 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD NOV 27 PY 2001 VL 104 IS 22 BP E123 EP E123 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 497BH UT WOS:000172432500006 PM 11723036 ER PT J AU Lawrence, VA AF Lawrence, VA TI Predicting postoperative pulmonary complications: The sleeping giant stirs SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material ID NONCARDIAC SURGERY; RISK; INDEX; MEN C1 Univ Texas, Hlth Sci Ctr, Audie Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Lawrence, VA (reprint author), Univ Texas, Dept Med, Div Gen Med, Hlth Sci Ctr, 7703 Floyd Curl Dr,Mail Code 7879, San Antonio, TX 78229 USA. NR 11 TC 7 Z9 7 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD NOV 20 PY 2001 VL 135 IS 10 BP 919 EP 921 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 494DY UT WOS:000172267500008 PM 11712882 ER PT J AU Kanai, AJ Pearce, LL Clemens, PR Birder, LA VanBibber, MM Choi, SY de Groat, WC Peterson, J AF Kanai, AJ Pearce, LL Clemens, PR Birder, LA VanBibber, MM Choi, SY de Groat, WC Peterson, J TI Identification of a neuronal nitric oxide synthase in isolated cardiac mitochondria using electrochemical detection SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article DE cardiomyocytes; cytochrome oxidase; oxidative phosphorylation; respiration; chronoamperometry ID CYTOCHROME-C-OXIDASE; DUCHENNE MUSCULAR-DYSTROPHY; MUSCLE FIBERS; RAT-LIVER; RESPIRATION; PEROXYNITRITE; MODULATION; SKELETAL; RELEASE; PURIFICATION AB Mitochondrial nitric oxide synthase (mtNOS), its cellular NOS isoform, and the effects of mitochondrially produced NO on bioenergetics have been controversial since mtNOS was first proposed in 1995. Here we functionally demonstrate the presence of a NOS in cardiac mitochondria. This was accomplished by direct porphyrinic microsensor measurement of Ca2+-dependent NO production in individual mitochondria isolated from wild-type mouse hearts. This NO production could be inhibited by NOS antagonists or protonophore collapse of the mitochondrial membrane potential. The similarity of mtNOS to the neuronal isoform was deduced by the absence of NO production in the mitochondria of knockout mice for the neuronal, but not the endothelial or inducible, isoforms. The effects of mitochondrially produced NO on bioenergetics were studied in intact cardiomyocytes isolated from dystrophin-deficient (mdx) mice. mdx cardiomyocytes are also deficient in cellular endothelial NOS, but overexpress mtNOS, which allowed us to study the mitochondrial enzyme in intact cells free of its cytosolic counterpart. In these cardiomyocytes, which produce NO beat-to-beat, inhibition of mtNOS increased myocyte shortening by approximately one-fourth. Beat-to-beat NO production and altered shortening by NOS inhibition were not observed in wildtype cells. A plausible mechanism for the reversible NO inhibition of contractility in these cells involves the reaction of NO with cytochrome c oxidase. This suggests a modulatory role for NO in oxidative phosphorylation and, in turn, myocardial contractility. C1 Univ Pittsburgh, Dept Med, Lab Epithelial Cell Biol, Renal Electrolyte Div, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Med, Dept Pharmacol, Pittsburgh, PA 15261 USA. Vet Affairs Pittsburgh Healthcare Syst, Serv Neurol, Pittsburgh, PA 15240 USA. Carnegie Mellon Univ, Dept Chem, Pittsburgh, PA 15213 USA. RP Kanai, AJ (reprint author), Univ Pittsburgh, Dept Med, Lab Epithelial Cell Biol, Renal Electrolyte Div, Pittsburgh, PA 15261 USA. OI Pearce, Linda/0000-0002-0940-965X; Peterson, James/0000-0002-7300-5887 FU NHLBI NIH HHS [HL 61411, R01 HL061411]; NIDDK NIH HHS [R01 DK054824, DK 54824, R37 DK054824] NR 51 TC 267 Z9 274 U1 1 U2 13 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD NOV 20 PY 2001 VL 98 IS 24 BP 14126 EP 14131 DI 10.1073/pnas.241380298 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 495EW UT WOS:000172328100117 PM 11717466 ER PT J AU Haile, D Liu, XB Ghio, A Quinones, M Yang, FM AF Haile, D Liu, XB Ghio, A Quinones, M Yang, FM TI Regulation of reticuloendothelial cell iron transporter, SLC11A3, by inflammation. SO BLOOD LA English DT Meeting Abstract C1 Audie L Murphy Vet Admin Hosp, S Texas Vet Hlth Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. US EPA, Natl Hlth & Environm Effects Res Lab, Chapel Hill, NC USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 1 BP 4A EP 4A PN 1 PG 1 WC Hematology SC Hematology GA 491WY UT WOS:000172134100002 ER PT J AU Feng, SJ Resendiz, JC Lu, X Ji, GL Kroll, MH AF Feng, SJ Resendiz, JC Lu, X Ji, GL Kroll, MH TI Pathological shear stress stimulates alpha IIb beta 3-dependent signaling. SO BLOOD LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Rice Univ, Houston, TX 77251 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 99 BP 26A EP 26A PN 1 PG 1 WC Hematology SC Hematology GA 491WY UT WOS:000172134100100 ER PT J AU Resendiz, JC Feng, SJ Ji, GL Lu, X Kroll, MH AF Resendiz, JC Feng, SJ Ji, GL Lu, X Kroll, MH TI Activation of SLP-76 by shear-induced von Willebrand factor binding to platelet alpha IIb beta 3. SO BLOOD LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Rice Univ, Houston, TX 77251 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 102 BP 27A EP 27A PN 1 PG 1 WC Hematology SC Hematology GA 491WY UT WOS:000172134100103 ER PT J AU Massarweh, S Varadhachary, G Ho, VT Bharwani, L AF Massarweh, S Varadhachary, G Ho, VT Bharwani, L TI Natural killer acute lymphoblastic leukemia; Case description and potential role for maintenance chemotherapy. SO BLOOD LA English DT Meeting Abstract C1 Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. RI Massarweh, Suleiman/O-1332-2013 NR 0 TC 0 Z9 1 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 4516 BP 203B EP 203B PN 2 PG 1 WC Hematology SC Hematology GA 491WZ UT WOS:000172134200927 ER PT J AU Feng, SJ Resendiz, JC Lu, X Ji, GL Berndt, MC Kroll, MH AF Feng, SJ Resendiz, JC Lu, X Ji, GL Berndt, MC Kroll, MH TI Cytoplasmic domains of platelet glycoprotein Ib alpha regulate filamin 1a binding. SO BLOOD LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Rice Univ, Houston, TX 77251 USA. Baker Med Res Inst, Prahran, Vic 3181, Australia. RI Berndt, Michael/D-5580-2012 NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 1007 BP 240A EP 240A PN 1 PG 1 WC Hematology SC Hematology GA 491WY UT WOS:000172134101011 ER PT J AU Ruffner, KL Radich, JP Bryant, E Maziarz, RT Rosamilia, M Druker, BJ Chauncey, TR AF Ruffner, KL Radich, JP Bryant, E Maziarz, RT Rosamilia, M Druker, BJ Chauncey, TR TI Serial cytogenetic and quantitative molecular monitoring of disease burden in a patient on imatinib (STI-571) for CML-AP undergoing G-CSF mobilization of peripheral blood stem cells (PBSC). SO BLOOD LA English DT Meeting Abstract C1 Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA. Univ Washington, Med Ctr, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Novartis Pharmaceut, E Hanover, NJ USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 1356 BP 321A EP 321A PN 1 PG 1 WC Hematology SC Hematology GA 491WY UT WOS:000172134101360 ER PT J AU Restrepo, A Restrepo, ML Devore, PE Callander, NS Schneider, DL Litofsky, ID Walsh, T Gokmen, E Ochoa, L Ehsan, A Patterson, JE Freytes, CO AF Restrepo, A Restrepo, ML Devore, PE Callander, NS Schneider, DL Litofsky, ID Walsh, T Gokmen, E Ochoa, L Ehsan, A Patterson, JE Freytes, CO TI Infectious during the early post-transplant period in patients undergoing autologous peripheral blood stem cell transplantation (APBSCT) for multiple myeloma (MM). SO BLOOD LA English DT Meeting Abstract C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 5219 BP 361B EP 362B PN 2 PG 2 WC Hematology SC Hematology GA 491WZ UT WOS:000172134201630 ER PT J AU McCoy, AMG Smith, EP Atkinson, ME Baranski, B Kahl, BS Juckett, MB Mitchell, TL Gangnon, R Longo, WL AF McCoy, AMG Smith, EP Atkinson, ME Baranski, B Kahl, BS Juckett, MB Mitchell, TL Gangnon, R Longo, WL TI High dose thiotepa and etoposide: Long term experience with a novel conditioning regimen for autologous BM/PBPC transplant in 65 NHL patients. SO BLOOD LA English DT Meeting Abstract C1 Univ Wisconsin, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 5350 BP 392B EP 392B PN 2 PG 1 WC Hematology SC Hematology GA 491WZ UT WOS:000172134201761 ER PT J AU Maziarz, RT Chauncey, TR Capdeville, R Druker, BJ Seelig, F AF Maziarz, RT Chauncey, TR Capdeville, R Druker, BJ Seelig, F TI Growth factor mobilization of CD34(+) PBSC in CML patients treated with imatinib (STI571). SO BLOOD LA English DT Meeting Abstract C1 Oregon Hlth Sci Univ, Bone Marrow Transplant Program, Portland, OR 97201 USA. VA Puget Sound Hlth Care Syst, Bone Marrow Transplant Program, Seattle, WA USA. Novartis Pharmaceut, E Hanover, NJ USA. Oregon Hlth Sci Univ, Leukemia Program, Portland, OR 97201 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2001 VL 98 IS 11 MA 3078 BP 738A EP 738A PN 1 PG 1 WC Hematology SC Hematology GA 491WY UT WOS:000172134103091 ER PT J AU Sloan, KL Sales, AE Willems, JP Every, NR Martin, GV Sun, HL Pineros, S Sharp, N AF Sloan, KL Sales, AE Willems, JP Every, NR Martin, GV Sun, HL Pineros, S Sharp, N TI Frequency of serum low-density lipoprotein cholesterol measurement and frequency of results <= 100 mg/dl among patients who had coronary events (Northwest VA Network study) SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID LIPID-LOWERING THERAPY; ARTERY DISEASE; HEART-DISEASE; UNITED-STATES; ADHERENCE; GOALS AB This population-based, cross-sectional analysis targeted all veterans with coronary heart disease (CHD) who were active patients in primary care or cardiology clinics in the Veterans Health Administration Northwest Network from July 1998 to June 1999. We report guideline compliance rates, including whether low-density lipoprotein (LDL) was measured, and if measured, whether the LDL was less than or equal to 100 mg/dl. In addition, we utilized multivariate logistic regression to determine patient characteristics associated with LDL measurements and levels. Of 13,891 active patients with CHD, 5,552 (40.0%) did not have a current LDL measurement. Of those with LDL measurements, 39.1% were at the LDL goal of less than or equal to 100 mg/dl, whereas 26.5% had LDL greater than or equal to 130 mg/dl. Male gender, younger age, history of angioplasty or coronary artery bypass grafting, current hypertension, diabetes mellitus, and angina pectoris were associated with increased likelihood of LDL measurement. Older age and current diabetes and angina were associated with increased likelihood of LDL being less than or equal to 100 mg/dl, if measured. Although these rates of guideline adherence in the CHD population compare well to previously published results, they continue to be unacceptably low for optimal clinical outcomes. Attention to both LDL measurement and treatment (if elevated) is warranted. (C) 2001 by Excerpta Medica, Inc. C1 VA Puget Sound Hlth Care Syst, Mental Hlth Serv, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Div Cardiol, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA 98108 USA. Psychiat & Behav Sci Serv, Seattle, WA USA. Psychiat & Behav Hlth Serv, Seattle, WA USA. Robert Wood Johnson Clin Scholars Program, Seattle, WA USA. RP Sloan, KL (reprint author), VA Puget Sound Hlth Care Syst, Mental Hlth Serv, 116-DDTP, Seattle, WA 98108 USA. OI Sales, Anne/0000-0001-9360-3334 NR 10 TC 19 Z9 19 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD NOV 15 PY 2001 VL 88 IS 10 BP 1143 EP 1146 DI 10.1016/S0002-9149(01)02050-1 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 496TH UT WOS:000172412300012 PM 11703960 ER PT J AU Park, WY Goodman, RB Steinberg, KP Ruzinski, JT Radella, F Park, DR Pugin, J Skerrett, SJ Hudson, LD Martin, TR AF Park, WY Goodman, RB Steinberg, KP Ruzinski, JT Radella, F Park, DR Pugin, J Skerrett, SJ Hudson, LD Martin, TR TI Cytokine balance in the lungs of patients with acute respiratory distress syndrome SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE acute respiratory distress syndrome; cytokine receptors; cytokines; IL-1; TNF ID TUMOR-NECROSIS-FACTOR; INTERLEUKIN-1 RECEPTOR ANTAGONIST; SOLUBLE IL-6 RECEPTOR; INFLAMMATORY CYTOKINES; HUMAN-MONOCYTES; FACTOR-ALPHA; BRONCHOALVEOLAR; FLUID; ARDS; AUTOANTIBODIES AB Acute respiratory distress syndrome (ARDS) involves an Intense Inflammatory response in the lungs, with accumulation of both pro- and antiinflammatory cytokines in bronchoalveolar lavage fluid (BALF). Our goal was to determine how the balance between pro- and antiinflammatory mediators in the lungs changes before and after the onset of ARDS. We identified 23 patients at risk for ARDS and 46 with established ARDS and performed serial bronchoalveolar lavage (BAL). We used immunoassays to measure tumor necrosis factor alpha (TNF-alpha) and soluble TNF-alpha receptors I and II; interleukin 1 beta (IL-1 beta), IL-1 beta receptor antagonist, and soluble IL-1 receptor II; IL-6 and soluble IL-6 receptor; and IL-10. We used sensitive bioassays to measure net TNF-alpha, IL-1 beta and IL-6 activity. Although individual cytokines increased before and after onset of ARDS, greater increases occurred in cognate receptors and/or antagonists, so that molar ratios of agonists/antagonists declined dramatically at the onset of ARDS. The molar ratios remained low for 7 d or longer, limiting the activity of soluble IL-1 beta and TNF-alpha in the lungs at the onset of ARDS. This significant antiinflammatory response early in ARDS may provide a key mechanism for limiting the net inflammatory response in the lungs. C1 VA Puget Sound Hlth Care Syst, Harborview Med Ctr, Sect Pulm Crit Care Med, Med Res Serv, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Div Pulm & Crit Care Med, Seattle, WA 98195 USA. Univ Geneva, Med Ctr, Dept Med Intens Care, CH-1211 Geneva, Switzerland. RP Martin, TR (reprint author), Seattle VA Med Ctr, Pulm Res Labs, 151L,1660 S Columbian Way, Seattle, WA 98108 USA. FU NHLBI NIH HHS [HL30542]; NIAID NIH HHS [AI29103] NR 47 TC 268 Z9 311 U1 0 U2 5 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD NOV 15 PY 2001 VL 164 IS 10 BP 1896 EP 1903 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 502TK UT WOS:000172758700029 PM 11734443 ER PT J AU Gurubhagavatula, I Maislin, G Pack, AI AF Gurubhagavatula, I Maislin, G Pack, AI TI An algorithm to stratify sleep apnea risk in a sleep disorders clinic population SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE obstructive sleep apnea; risk stratification; polysomnography; nocturnal pulse oximetry; questionnaire ID 2-STAGE SCREENING-PROCEDURE; HYPOPNEA SYNDROME; HEALTH; DIAGNOSIS; POLYSOMNOGRAPHY; COMMUNITY; VALIDITY; OXIMETRY; QUESTIONNAIRE; HYPERTENSION AB Obstructive sleep apnea may lead to complications if not identified and treated. Polysomnography is the diagnostic standard, but is often inaccessible due to bed shortages. A system that facilitates prioritization of patients requiring sleep studies would thus be useful. We retrospectively compared the accuracy of a two-stage risk-stratification algorithm for sleep apnea using questionnaire plus nocturnal pulse oximetry against using polysomnography to identify patients without apnea (Objective 1) and those with severe apnea (Objective 2). Patients were those referred to a university-based sleep disorders clinic due to suspicion of sleep apnea. Subjects completed a sleep apnea symptom questionnaire, and underwent oximetry and two-night polysomnography. We used bootstrap methodology to maximize sensitivity of our model for Objective I and specificity for Objective 2. We calculated sensitivity, specificity, positive and negative predictive values, and rate of misclassification error of the two-stage risk-stratification algorithm for each of our two objectives. The model identified cases of sleep apnea with 95% sensitivity and severe apnea with 97% specificity. It excluded only 8% of patients from sleep studies, but prioritized up to 23% of subjects to receive in-laboratory studies. Among sleep disorders clinic referrals, a two-stage risk-stratification algorithm using questionnaire and nocturnal pulse oximetry excluded few patients from sleep studies, but identified a larger proportion of patients who should receive early testing because of their likelihood of having severe disease. C1 Univ Penn, Ctr Sleep & Resp Neurobiol, Div Pulm & Crit Care, Dept Med,Med Ctr, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Pulm & Crit Care Sect, Philadelphia, PA USA. RP Gurubhagavatula, I (reprint author), Hosp Univ Penn, Ctr Sleep & Resp Neurobiol, 9th Floor,Maloney Bldg,3600 Spruce St, Philadelphia, PA 19104 USA. FU CCR NIH HHS [CRC-RR-00040]; NHLBI NIH HHS [T32 HL007713, HL-07713, HL-42236] NR 41 TC 52 Z9 52 U1 0 U2 0 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD NOV 15 PY 2001 VL 164 IS 10 BP 1904 EP 1909 PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 502TK UT WOS:000172758700030 PM 11734444 ER PT J AU Fabian, TJ Dew, MA Pollock, BG Reynolds, CF Mulsant, BH Butters, MA Zmuda, MD Linares, AM Trottini, M Kroboth, PD AF Fabian, TJ Dew, MA Pollock, BG Reynolds, CF Mulsant, BH Butters, MA Zmuda, MD Linares, AM Trottini, M Kroboth, PD TI Endogenous concentrations of DHEA and DHEA-S decrease with remission of depression in older adults SO BIOLOGICAL PSYCHIATRY LA English DT Article DE DHEA; DHEA-S; depression; neurosteroids; remission; elderly ID PLASMA DEHYDROEPIANDROSTERONE-SULFATE; MAJOR DEPRESSION; PREGNENOLONE-SULFATE; SALIVARY CORTISOL; ANTAGONIST; RECEPTOR; SECRETION; RESPONSES; GABA; AGE AB Background: Clinical studies of endogenous concentrations of dehydroepiandrosterone (DHEA) and its sulfated conjugate DHEA-S in depression are limited. This study was designed to evaluate the influence of successful pharmacological treatment of late-life depression on concentrations of DHEA, DHEA-S and cortisol. Methods: We determined endogenous concentrations of DHEA, DHEA-S and cortisol in elderly control subjects (n = 16) and in elderly depressed patients who remitted (n = 44) or failed to remit (n = 16) with pharmacological treatment. Depressed patients were treated for 12 weeks with either nortriptyline or paroxetine. Results: In remitters, DHEA and DHEA-S concentrations were lower at week 12 than at week 0 (p = .002 and p = .0001, respectively). In the nonremitters and control subjects, neither DHEA nor DHEA-S concentrations changed. Decreases in hormone concentrations were associated with improvement in mood and functioning in depressed patients. Although cortisol concentrations decreased in remitters and nonremitters, the change was not significant. Conclusions: Our delta suggest that the decrease in DHEA and DHEA-S in remitters is related to remission of depression rather than to a direct drug effect on steroids, as nonremitters had no change in hormone concentrations. Biol Psychiatry (C) 2001 Society of Biological. C1 Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15261 USA. VA Pittsburgh Hlth Syst, GRECC, Pittsburgh, PA USA. Carnegie Mellon Univ, Dept Stat, Pittsburgh, PA 15213 USA. RP Kroboth, PD (reprint author), Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, 903 Salk Hall,3501 Terrace St, Pittsburgh, PA 15261 USA. RI Trottini, Mario/I-3832-2015 FU NIA NIH HHS [AG05133]; NIMH NIH HHS [MH01509, MH37869, MH00295, MH55756, MH19986, MH52247, MH01613] NR 49 TC 54 Z9 55 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD NOV 15 PY 2001 VL 50 IS 10 BP 767 EP 774 DI 10.1016/S0006-3223(01)01198-2 PG 8 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 495RJ UT WOS:000172353900005 PM 11720695 ER PT J AU Holschneider, DP Chen, K Seif, I Shih, JC AF Holschneider, DP Chen, K Seif, I Shih, JC TI Biochemical, behavioral, physiologic, and neurodevelopmental changes in mice deficient in monoamine oxidase A or B SO BRAIN RESEARCH BULLETIN LA English DT Article DE monoamine oxidase; serotonin; norepinephrine; phenylethylamine; dopamine ID ALZHEIMER-TYPE DEMENTIA; FORCED SWIMMING TEST; AGGRESSIVE-BEHAVIOR; D-FENFLURAMINE; RAT-BRAIN; SOMATOSENSORY CORTEX; SEROTONERGIC SYSTEM; TRANSGENIC MICE; NORRIE DISEASE; MEMORY STORAGE AB The availability of mutant mice that lack either MAO A or MAO B has created unique profiles in the central and peripheral availability of serotonin, norepinephrine, dopamine, and phenylethylamine. This paper summarizes some of the current known phenotypic findings in MAO A knock-out mice and contrast these with those of MAO B knock-out mice. Differences are discussed in relation to the biochemical, behavioral, and physiologic changes investigated to date, as well as the role played by redundancy mechanisms, adaptational responses, and alterations in neurodevelopment. (C) 2001 Elsevier Science Inc. C1 Univ So Calif, Sch Pharm, Dept Mol Pharmacol & Toxicol, Los Angeles, CA 90089 USA. Univ So Calif, Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA 90033 USA. Univ So Calif, Sch Med, Dept Neurol, Los Angeles, CA 90033 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. Inst Curie, CNRS, Unite Mixte Rech 146, F-91405 Orsay, France. Univ So Calif, Sch Med, Dept Cell & Neurobiol, Los Angeles, CA USA. RP Shih, JC (reprint author), Univ So Calif, Sch Pharm, Dept Mol Pharmacol & Toxicol, 1985 Zonal Ave,Rm 528, Los Angeles, CA 90089 USA. FU NIMH NIH HHS [R37 MH39085, R01 MH NS62148, KO5 MH 00796, R37 MH039085, R01 MH 37020]; NINDS NIH HHS [K23 NS062148] NR 89 TC 44 Z9 44 U1 2 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0361-9230 J9 BRAIN RES BULL JI Brain Res. Bull. PD NOV 15 PY 2001 VL 56 IS 5 BP 453 EP 462 DI 10.1016/S0361-9230(01)00613-X PG 10 WC Neurosciences SC Neurosciences & Neurology GA 505TE UT WOS:000172931000005 PM 11750790 ER PT J AU Feikin, DR Elie, CM Goetz, MB Lennox, JL Carlone, GM Romero-Steiner, S Holder, PF O'Brien, WA Whitney, CG Butler, JC Breiman, RF AF Feikin, DR Elie, CM Goetz, MB Lennox, JL Carlone, GM Romero-Steiner, S Holder, PF O'Brien, WA Whitney, CG Butler, JC Breiman, RF TI Randomized trial of the quantitative and functional antibody responses to a 7-valent pneumococcal conjugate vaccine and/or 23-valent polysaccharide vaccine among HIV-infected adults SO VACCINE LA English DT Article DE pneumococcal disease; conjugate vaccines; HIV ID HUMAN-IMMUNODEFICIENCY-VIRUS; STREPTOCOCCUS-PNEUMONIAE; GLYCOPROTEIN CONJUGATE; DISEASE; CHILDREN; ASSAY AB In a double-blinded, randomized trial, human immunodeficiency virus (HIV)-infected adults with greater than or equal to 200 CD4 cells/mul received placebo (PL), 7-valent conjugate. or 23-valent pneumococcal polysaccharide (PS) vaccine in one of the following two-dose combinations given 8 weeks apart: conjugate-conjugate, conjugate-polysaccharide. placebo-polysaccharide, placebo-placebo. A total of 67 persons completed the study. Neither significant increases in HIV viral load nor severe adverse reactions occurred in any group. After controlling for confounders. when compared with persons receiving placebo-polysaccharide, persons receiving conjugate-conjugate and conjugate-polysaccharide had higher antibody concentrations (serotypes 4. 6B, 9V and serotype 23F respectively) and opsonophagocytic titers (functional antibody assay, serotypes 9V, 23F and serotypes 4, 6B, 9V. respectively) after the second dose (P < 0.05). The second dose with either conjugate or polysaccharide following the first conjugate dose, however, produced no further increase in immune responses. Published by Elsevier Science Ltd. C1 CDCP, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Resp Dis Branch, Atlanta, GA 30332 USA. Univ Calif Los Angeles, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Emory Univ, Atlanta, GA 30322 USA. Grady Infect Dis Program, Atlanta, GA USA. Univ Texas, Med Branch, Galveston, TX 77550 USA. RP Feikin, DR (reprint author), CDCP, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Resp Dis Branch, 1600 Clifton Rd,MS-C23, Atlanta, GA 30332 USA. RI Lennox, Jeffrey/D-1654-2014 OI Lennox, Jeffrey/0000-0002-2064-5565; Romero-Steiner, Sandra/0000-0003-4128-7768; Goetz, Matthew/0000-0003-4542-992X NR 32 TC 96 Z9 101 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD NOV 12 PY 2001 VL 20 IS 3-4 BP 545 EP 553 DI 10.1016/S0264-410X(01)00347-4 PG 9 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 492DP UT WOS:000172153400034 PM 11672921 ER PT J AU Ishikawa, T Yang, H Tache, Y AF Ishikawa, T Yang, H Tache, Y TI Microinjection of bombesin into the ventrolateral reticular formation inhibits peripherally stimulated gastric acid secretion through spinal pathways in rats SO BRAIN RESEARCH LA English DT Article DE bombesin; CRF; gastric secretions; spinal cord; brainstem; sympathetic ID DORSAL MOTOR NUCLEUS; SYMPATHETIC PREGANGLIONIC NEURONS; CORTICOTROPIN-RELEASING FACTOR; CENTRAL-NERVOUS-SYSTEM; VAGAL EFFERENT DISCHARGE; MUCOSAL BLOOD-FLOW; IMMUNOREACTIVE NEURONS; RECEPTOR SUBTYPES; BRAIN; MEDULLA AB Bombesin injected into the cisterna magna potently inhibits gastric acid secretion stimulated by intravenous infusion of pentagastrin. Sites in the medulla oblongata where bombesin acts to suppress gastric acid secretion were investigated in urethane-anesthetized rats with gastric cannula. Bombesin or vehicle was injected into the medullary parenchyma or intracisternally (i.c.) 60 min after the start of an intravenous pentagastrin infusion; gastric acid secretion was monitored every 10 min for 20 min before and 150 min after the start of pentagastrin. Bombesin (0.2, 0.6 or 6.2 pmol) microinjected into the ventrolateral reticular formation (VLRF) inhibited dose-dependently the net acid response to pentagastrin by 40.8 +/- 11.1. 75.4 +/- 12.8 and 96.7 +/- 19.4%, respectively, at the 40-50 min period after microinjection compared with the vehicle group. Bombesin action in the VLRF was long lasting (96% inhibition still observed at 90 min after 6.2 pmol), and completely abolished by cervical spinal cord transection at the C6 level. By contrast, bombesin injected i.c. at 0.2 or 0.6 pmol had no effect while at 6.2 pmol, there was a 79.0 +/- 3.9% peak inhibition of pentagastrin-stimulated acid secretion. Bombesin (6.2 pmol) injected into the dorsal motor nucleus reduced the acid response to pentagastrin by 29%. The parvicellular and gigantocellular reticular nuclei were not responsive to bombesin. These results indicate that bombesin acts in the VLRF to inhibit pentagastrin-stimulated gastric acid secretion through spinal pathways, suggesting a potential role of medullary VLRF area in the sympathetic control of gastric acid secretion. (C) 2001 Elsevier Science B.V. All rights reserved. C1 Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Dept Med,Div Digest Dis, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. RP Tache, Y (reprint author), Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Dept Med,Div Digest Dis, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-41301, DK-30110, DK 33061] NR 50 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD NOV 9 PY 2001 VL 918 IS 1-2 BP 1 EP 9 DI 10.1016/S0006-8993(01)02833-5 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 494TN UT WOS:000172302100001 PM 11684036 ER PT J AU Gooch, JL Tang, YP Ricono, JM Abboud, HE AF Gooch, JL Tang, YP Ricono, JM Abboud, HE TI Insulin-like growth factor-I induces renal cell hypertrophy via a calcineurin-dependent mechanism SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID URINARY ALBUMIN EXCRETION; MESANGIAL CELLS; CARDIAC-HYPERTROPHY; TRANSGENIC MICE; HORMONE; RECEPTOR; EXPRESSION; SYSTEM; NFAT AB Insulin-like growth factor-I (IGF-I) may play an important role in the development of renal hypertrophy. In this study we determined the effect of IGF-I on cultured mesangial cells (MCs) and examined activation of key signaling pathways. IGF-I induced hypertrophy as determined by an increase in cell size and an increase in protein to DNA ratio and increased accumulation of extracellular matrix (ECM) proteins. IGF-I also activated both Erk1/Erk2 MAPK and phosphatidylinositol 3-kinase (PI3K) in MCs. Inhibition of either MAPK or PI3K, however, had no effect on IGF-I-induced hypertrophy or ECM production. Next, we examined the effect of IGF-I on activation of the calcium-dependent phosphatase calcineurin. IGF-I treatment stimulated calcineurin activity and increased the protein levels of calcineurin and the calcineurin binding protein, calmodulin. Cyclosporin A, an inhibitor of calcineurin, blocked both IGF-I-mediated hypertrophy and up-regulation of ECM. In addition, calcineurin resulted in sustained Akt activation, indicating possible cross-talk with other signaling pathways. Finally, IGF-I treatment resulted in the calcineurindependent nuclear localization of NFATc1. Therefore, IGF-I induces hypertrophy and increases ECM accumulation in MCs. IGF-I-mediated hypertrophy is associated with activation of Erk1/Erk2 MAPK and PI3K but does not require either of these pathways. Instead, IGF-I mediates hypertrophy via a calcineurin-dependent pathway. C1 Univ Texas, Hlth Sci Ctr, Dept Med Nephrol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX 78229 USA. RP Gooch, JL (reprint author), Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 36 TC 56 Z9 61 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD NOV 9 PY 2001 VL 276 IS 45 BP 42492 EP 42500 DI 10.1074/jbc.M102994200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 497HY UT WOS:000172450400122 PM 11509557 ER PT J AU Song, CS Echchgadda, I Baek, BS Ahn, SC Oh, T Roy, AK Chatterjee, B AF Song, CS Echchgadda, I Baek, BS Ahn, SC Oh, T Roy, AK Chatterjee, B TI Dehydroepiandrosterone sulfotransferase gene induction by bile acid activated farnesoid X receptor SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID RAT-LIVER; MOLECULAR-CLONING; STRUCTURAL CHARACTERIZATION; NUCLEAR RECEPTORS; ANDROGEN; PROTEIN; BINDING; IDENTIFICATION; EXPRESSION; PROMOTER AB Dehydroepiandrosterone sulfotransferase (STD) is a hydroxysteroid sulfo-conjugating enzyme with preferential substrate specificity for C-19 androgenic steroids and C-24 bile acids. STD is primarily expressed in the liver, intestine and adrenal cortex. Earlier studies have shown that androgens inhibit the rat Std promoter function through a negative androgen response region located between -235 and -310 base pair positions (Song, C. S., Jung, M. H., Kim, S. C., Hassan, T., Roy, A. K., and Chatterjee, B. (1998) J. Biol Chem. 273, 21856-21866). Here we report that the primary bile acid chenodeoxycholic acid (CDCA) also acts as an important regulator of the Std gene promoter. CDCA is a potent inducer of the Std gene, and its inducing effect is mediated through the bile acid-activated farnesoid X receptor (FXR), a recently characterized member of the nuclear receptor superfamily. The ligand-activated FXR acts as a heterodimer with the 9-cis-retinoic acid receptor (RXR) and regulates the Std gene by binding to an upstream region at base pair positions -169 to -193. This specific binding region was initially identified by bile acid responsiveness of the progressively deleted forms of the Std promoter in transfected HepG2 hepatoma and enterocyte-like Caco-2 cells. Subsequently, the precise RXR/FXR binding position was established by protein-DNA interaction using in vitro footprinting and electrophoretic mobility shift analyses. Unlike all other previously characterized FXR target genes, which contain an inverted repeat (IR) of the consensus hexanucleotide half-site (A/G)G(G/T)TCA with a single nucleotide spacer (IR-1), the bile acid response element of the Std promoter does not contain any spacer between the two hexanucleotide repeats (IR-0). A promoter-reporter construct carrying three tandem copies of the IR-0 containing -169/-193 element, linked to a minimal thymidine kinase promoter, can be stimulated more than 70-fold in transfected Caco-2 cells upon CDCA treatment. Autoregulation of the STD gene by its bile acid substrate may provide an important contributing role in the enterohepatic bile acid metabolism and cholesterol homeostasis. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Chatterjee, B (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIA NIH HHS [AG-10486] NR 44 TC 144 Z9 144 U1 0 U2 4 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD NOV 9 PY 2001 VL 276 IS 45 BP 42549 EP 42556 DI 10.1074/jbc.M107557200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 497HY UT WOS:000172450400130 PM 11533040 ER PT J AU Kaunitz, JD Akiba, Y AF Kaunitz, JD Akiba, Y TI Integrated duodenal protective response to acid SO LIFE SCIENCES LA English DT Article; Proceedings Paper CT 3rd International Symposium on Cell/Tissue Injury and Cytoprotection/Organoprotection CY FEB 24-27, 2000 CL LONG BEACH, CALIFORNIA DE bicarbonate secretion; mucosal defense; hydrochloric acid; blood flow; mucus secretion; mucus gel thickness ID GENE-RELATED PEPTIDE; GASTRIC HYPEREMIC RESPONSE; CYSTIC-FIBROSIS; BICARBONATE SECRETION; HELICOBACTER-PYLORI; MUCOSAL PROTECTION; ANION-EXCHANGER; HCO3 SECRETION; RAT DUODENUM; PH GRADIENTS AB The proximal duodenum is unique in that it is the only leaky epithelium regularly exposed to concentrated gastric acid. To prevent injury from occurring, numerous duodenal defense mechanisms have evolved. The most studied is bicarbonate secretion, which is presumed to neutralize luminal acid. Less well studied in their protective roles are the mucus gel layer and blood flow. Measuring duodenal epithelial intracellular pH [pH(i)], blood flow and mucus gel thickness (MGT), we studied duodenal defense mechanisms in vivo so as to more fully understand the mucosal response to luminal acid. Exposure of the mucosa to physiologic acid solutions promptly lowered pH(i), followed by recovery after acid was removed, indicating that acid at physiologic concentrations readily diffuses into, but does not damage duodenal epithelial cells. Cellular acid then exits the cell via an amiloride-inhibitable process, presumably sodium-proton exchange (NHE). MGT and blood flow increase promptly during acid perfusion; both decrease after acid challenge and are inhibited by vanilloid receptor antagonists or by sensory afferent denervation. Bicarbonate secretion is not affected by acid superfusion but increases after challenge. Inhibition of cellular base loading lowers pH(i), whereas inhibition of apical base extrusion alkalinizes pH(i). These observations support the following hypothesis: luminal acid diffuses into the epithelial cells, lowering pH(i). Acidic pH(i) increases the activity of a basolateral NHE, acidifying the submucosal space and increasing cellular base loading. The acidic submucosal space activates capsaicin receptors on afferent nerves, increasing MGT and blood flow. With concontinued acid exposure, a new steady state with thickened mucus gel, increased blood flow, and a higher cellular buffering power protects against acid injury. After acid challenge, mucus secretion decreases, blood flow slows, and pH(i) returns to normal, the latter occurring via apical bicarbonate extrusion, increasing bicarbonate secretion. Through these integrated mechanisms, the epithelial cells are protected from damage due to repeated pulses of concentrated gastric acid. Published by Elsevier Science Inc. All rights reserved. C1 W Los Angeles Vet Affairs Med Ctr, Greater Los Angeles Vet Affairs Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Keio Univ, Sch Med, Dept Internal Med, Div Gastroenterol & Hepatol,Shinjuku Ku, Tokyo 1608582, Japan. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, Greater Los Angeles Vet Affairs Hlth Care Syst, 11301 Wilshire Blvd,Bldg 114,Suite 217, Los Angeles, CA 90073 USA. NR 41 TC 12 Z9 17 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0024-3205 J9 LIFE SCI JI Life Sci. PD NOV 9 PY 2001 VL 69 IS 25-26 BP 3073 EP 3081 DI 10.1016/S0024-3205(01)01413-8 PG 9 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 493YR UT WOS:000172251500012 PM 11758832 ER PT J AU Suzuki, T Ganesh, S Agarwala, KL Morita, R Sugimoto, Y Inazawa, J Delgado-Escueta, AV Yamakawa, K AF Suzuki, T Ganesh, S Agarwala, KL Morita, R Sugimoto, Y Inazawa, J Delgado-Escueta, AV Yamakawa, K TI A novel gene in the chromosomal region for juvenile myoclonic epilepsy on 6p12 encodes a brain-specific lysosomal membrane protein SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE lysosomal membrane protein; brain; epilepsy; JME ID IDIOPATHIC GENERALIZED EPILEPSY; LOCUS; STORAGE; LINKAGE; HETEROGENEITY; ASSOCIATION; CHANNELS; MOUSE AB Juvenile myoclonic epilepsy (JME) is the most frequent and, hence, most important form of hereditary grand mal epilepsy. Genetic linkage, haplotype, and recombination analyses have indicated that 6p11-12 (EJM1) is one of the candidate regions harboring a gene responsible for JME. In efforts to identify a gene responsible for JME, we identified several expressed sequences in the EJM1 critical region. Here we report the identification and characterization of a gene, named C6orf33, in the EJM1 region. Northern blot analysis showed that C6orf33 is predominantly expressed in brain but in mice, testis shows additional transcripts. C6orf33 is predicted to encode a novel similar to 40-kDa membrane protein, LMPB1, that defines a novel protein family by having highly conserved orthologs in eukaryotes and three putative paralogs in human. Biochemical and immunocytochemical studies revealed that LMPB1 is indeed an integral membrane protein that targets to lysosomal structures. LAY-PBI may be involved in specialized lysosomal functions that are unique to brain and testis, and the C6orf33 gene is of interest as a candidate for EJM1. (C) 2001 Academic Press. C1 RIKEN, Brain Sci Inst, Neurogenet Lab, Wako, Saitama 3510198, Japan. Tokyo Med & Dent Univ, Inst Med Res, Div Genet, Dept Mol Cytodenet, Tokyo, Japan. Univ Calif Los Angeles, Sch Med, Comprehens Epilepsy Program, Epilepsy Genet Genom Labs, Los Angeles, CA 90024 USA. VA GLAHS W Los Angeles, Los Angeles, CA USA. RP Yamakawa, K (reprint author), RIKEN, Brain Sci Inst, Neurogenet Lab, 2-1 Hirosawa, Wako, Saitama 3510198, Japan. RI Ganesh, Subramniam/B-4131-2009; Yamakawa, Kazuhiro/N-5050-2015 OI Delgado-Escueta, Antonio V./0000-0002-1581-6999 NR 29 TC 11 Z9 14 U1 0 U2 0 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD NOV 2 PY 2001 VL 288 IS 3 BP 626 EP 636 DI 10.1006/bbrc.2001.5825 PG 11 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 490WW UT WOS:000172077500021 PM 11676489 ER PT J AU Ballou, LM Tian, PY Lin, HY Jiang, YP Lin, RZ AF Ballou, LM Tian, PY Lin, HY Jiang, YP Lin, RZ TI Dual regulation of glycogen synthase kinase-3 beta by the alpha(1A)-adrenergic receptor SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID PROTEIN-KINASE-C; CELL-FATE SPECIFICATION; P70 S6 KINASE; DIFFERENTIAL REGULATION; GLUCOSE-TRANSPORT; PHOSPHATIDYLINOSITOL 3-KINASE/AKT; ALPHA-1-ADRENERGIC RECEPTORS; SIGNALING PATHWAY; COUPLED RECEPTORS; POTENTIAL ROLE AB Catecholamines, acting through adrenergic receptors, play an important role in modulating the effects of insulin on glucose metabolism. Insulin activation of glycogen synthesis is mediated in part by the inhibitory phosphorylation of glycogen synthase kinase-3 (GSK-3). In this study, catecholamine regulation of GSK-3 beta was investigated in Rat-1 fibroblasts stably expressing the alpha (1A)-adrenergic receptor. Treatment of these cells with either insulin or phenylephrine (PE), an al-adrenergic receptor agonist, induced Ser-9 phosphorylation of GSK-3 beta and inhibited GSK-3 beta activity. Insulin-induced GSK-3 beta phosphorylation is mediated by the phosphatidylinositol 3-kinase/Akt signaling pathway. PE treatment does not activate phosphatidylinositol 3-kinase or Akt (Ballou, L. M., Cross, M. E., Huang, S., McReynolds, E. M., Zhang, B. X., and Lin, R. Z. (2000) J. Biol. Chem. 275, 4803-4809), but instead inhibits insulin-induced Akt activation and GSK-3 beta phosphorylation. Experiments using protein kinase C (PKC) inhibitors suggest that phorbol ester-sensitive novel PKC and Go 6983-sensitive atypical PKC isoforms are involved in the PE-induced phosphorylation of GSK-3 beta. Indeed, PE treatment of Rat-1 cells increased the activity of atypical PKC zeta, and expression of PKC zeta in COS-7 cells stimulated GSK-3 beta Ser-9 phosphorylation. In addition, PE-induced GSK-3 beta phosphorylation was reduced in Rat-1 cells treated with a cell-permeable PKC zeta pseudosubstrate peptide inhibitor. These results suggest that the alpha (1A)-adrenergic receptor regulates GSK-3 beta through two signaling pathways. One pathway inhibits insulin-induced GSK-3 beta phosphorylation by blocking insulin activation of Akt. The second pathway stimulates Ser-9 phosphorylation of GSK3 beta, probably via PKC. C1 Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Audie L Murphy Vet Affairs Med Ctr, Res Serv, San Antonio, TX 78284 USA. RP Lin, RZ (reprint author), SUNY Stony Brook, Dept Med, Div Hematol, Stony Brook, NY 11794 USA. RI Lin, Richard/J-1754-2014 OI Lin, Richard/0000-0002-3473-7276 NR 50 TC 49 Z9 50 U1 1 U2 2 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD NOV 2 PY 2001 VL 276 IS 44 BP 40910 EP 40916 DI 10.1074/jbc.M103480200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 488FM UT WOS:000171925600072 PM 11533051 ER PT J AU Harper, RJ Brady, WJ Perron, AD Mangrum, M AF Harper, RJ Brady, WJ Perron, AD Mangrum, M TI The paced electrocardiogram: Issues for the emergency physician SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Review DE ECG; pacemaker; electrocardiogram ID ACUTE MYOCARDIAL-INFARCTION; DIAGNOSIS; PACEMAKER; RHYTHMS AB Since the first introduction of implantable pacemaker approximately 50 years ago, these devices have become increasingly more common and more complex. It is estimated that there are approximately 1 million patients with implanted pacemakers in the United States and I with an aging population, the number of pacemakers is certain to increase. This review focuses on basics of pacemaker function as well as the common rhythm disturbance issues and other clinical syndromes that the emergency physician is likely to encounter. Copyright (C) 2001 by W.B. Saunders Company. C1 Univ Virginia, Hlth Sci Ctr, Dept Emergency Med, Charlottesville, VA 22908 USA. Oregon Hlth Sci Univ, Dept Emergency Med, Portland VA Med Ctr, Portland, OR 97201 USA. Univ Virginia, Hlth Sci Ctr, Dept Internal Med, Div Cardiol Electrophysiol, Charlottesville, VA 22908 USA. RP Brady, WJ (reprint author), Univ Virginia, Hlth Sci Ctr, Dept Emergency Med, Box 523-21, Charlottesville, VA 22908 USA. NR 13 TC 3 Z9 3 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0735-6757 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD NOV PY 2001 VL 19 IS 7 BP 551 EP 560 DI 10.1053/ajem.2001.24486 PG 10 WC Emergency Medicine SC Emergency Medicine GA 491LC UT WOS:000172109000005 PM 11699000 ER PT J AU Andress, DL AF Andress, DL TI Intravenous versus oral vitamin D therapy in dialysis patients: What is the question? SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE vitamin D therapy; intravenous (IV); oral; hypercalcemia; hyperphosphatemia ID CHRONIC-HEMODIALYSIS PATIENTS; CHRONIC-RENAL-FAILURE; SECONDARY HYPERPARATHYROIDISM; PARATHYROID-HORMONE; CALCITRIOL THERAPY; SERUM PHOSPHORUS; 1,25-DIHYDROXYCHOLECALCIFEROL; SUPPRESSION; DISEASE AB The debate regarding the administration of vitamin D (parenteral versus pulse oral) in dialysis patients has centered on the efficacy of parathyroid hormone (PTH) suppression while ignoring other questions related to complications and compliance. Past studies looking at efficacy showed no differences during short-term treatment, although the small number of patients studied reduces the significance of these findings. Long-term studies with larger populations have shown that parenteral calcitriol is more effective than pulse oral calcitriol in suppressing PTH. When considering the questions of complications and compliance the current literature demonstrates that parenteral vitamin D therapy is associated with fewer episodes of hypercalcemia and hyperphosphatemia and that patients receiving pulse oral calcitriol require more phosphate binders. Because of the documented high noncompliance rate with oral medications in the dialysis population, parenterally administered vitamin D is expected to more completely suppress PTH long term and result in fewer parathyroidectomies. Based on these considerations it is suggested that parenteral vitamin D analogs are superior to pulse oral calcitriol for the long-term control of hyperparathyroidism in dialysis patients. (C) 2001 by the National Kidney Foundation, Inc. C1 VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. RP Andress, DL (reprint author), VA Puget Sound Hlth Care Syst, Dept Med, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 24 TC 12 Z9 12 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD NOV PY 2001 VL 38 IS 5 SU 5 BP S41 EP S44 DI 10.1053/ajkd.2001.28108 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 489BW UT WOS:000171973000005 PM 11689386 ER PT J AU Kresse, AE Million, M Saperas, E Tache, Y AF Kresse, AE Million, M Saperas, E Tache, Y TI Colitis induces CRF expression in hypothalamic magnocellular neurons and blunts CRF gene response to stress in rats SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE 2,4,6-trinitrobenzenesulfonic acid; arginine vasopressin gene expression; supraoptic nucleus; osmolarity; heteronuclear corticotropin-releasing factor gene expression; defecation; food intake ID CORTICOTROPIN-RELEASING HORMONE; PARVOCELLULAR NEUROSECRETORY NEURONS; ADJUVANT-INDUCED ARTHRITIS; WATER-AVOIDANCE STRESS; PARAVENTRICULAR NUCLEUS; DIFFERENTIAL REGULATION; ARGININE-VASOPRESSIN; NEUROPEPTIDE GENES; FOS EXPRESSION; LEWIS RATS AB We investigated hypothalamic neuronal corticotropin-releasing factor (CRF) gene expression changes in response to visceral inflammation induced by 2,4,6-trinitrobenzenesulfonic acid (TNB) and acute stress. Seven days after TNB, rats were subjected to water-avoidance stress (WAS) or restraint for 30 min and euthanized. Hypothalamic CRF primary transcripts (heteronuclear RNA, hnRNA) and CRF and arginine vasopressin (AVP) mRNAs were assessed by in situ hybridization. Antisense S-35-labeled cRNA probes against CRF mRNA intronic and exonic sequences and an oligonucleotide probe against the AVP mRNA were used. TNB induced macroscopic lesions and a fivefold elevation in myeloperoxidase activity in the colon. Colitis increased CRF hnRNA and mRNA signals in the magnocellular part of the paraventricular nucleus of the hypothalamus (PVN) and supraoptic neurons, whereas AVP mRNA was not altered. Colitis did not modify CRF hnRNA signal in the parvocellular part of the PVN (pPVN), plasma corticosterone, and serum osmolarity levels. However, CRF hnRNA expression in the pPVN and the rise in corticosterone and defecation induced by WAS or restraint were blunted in colitic rats. These data show that colitis upregulates CRF gene synthesis in magnocellular hypothalamic neurons but dampens CRF gene transcription in the pPVN and plasma corticosterone responses to environmental acute stressors. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, CURE, Dept Med,Digest Dis Div, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90073 USA. Autonomous Univ Barcelona, Hosp Gen Valle Hebron, Digest Syst Res Unit, E-08035 Barcelona, Spain. RP Million, M (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, CURE, Dept Med,Digest Dis Div, Bldg 115,Rm 203,11302 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-33061, DK-41301] NR 58 TC 40 Z9 40 U1 1 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD NOV PY 2001 VL 281 IS 5 BP G1203 EP G1213 PG 11 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 483RB UT WOS:000171648700012 PM 11668029 ER PT J AU Zhang, XQ Song, JL Rothblum, LI Lun, MY Wang, XJ Ding, F Dunn, J Lytton, J McDermott, PJ Cheung, JY AF Zhang, XQ Song, JL Rothblum, LI Lun, MY Wang, XJ Ding, F Dunn, J Lytton, J McDermott, PJ Cheung, JY TI Overexpression of Na+/Ca2+ exchanger alters contractility and SR Ca2+ content in adult rat myocytes SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE excitation-contraction coupling; fura 2; cardiac myocyte culture; video imaging ID VENTRICULAR MYOCYTES; CARDIAC MYOCYTES; POSTINFARCTION MYOCYTES; NA+-CA2+ EXCHANGER; PRIMARY CULTURE; CALCIUM; RABBIT; CELLS; HOMEOSTASIS; RELAXATION AB The functional consequences of overexpression of rat heart Na+/Ca2+ exchanger (NCX1) were investigated in adult rat myocytes in primary culture. When maintained under continued electrical field stimulation conditions, cultured adult rat myocytes retained normal contractile function compared with freshly isolated myocytes for at least 48 h. Infection of myocytes by adenovirus expressing green fluorescent protein (GFP) resulted in 95% infection as ascertained by GFP fluorescence, but contraction amplitude at 6-, 24-, and 48- h postinfection was not affected. When they were examined 48 h after infection, myocytes infected by adenovirus expressing both GFP and NCX1 had similar cell sizes but exhibited significantly altered contraction amplitudes and intracellular Ca2+ concentration ([Ca2+](i)) transients, and lower resting and diastolic [Ca2+](i) when compared with myocytes infected by the adenovirus expressing GFP alone. The effects of NCX1 overexpression on sarcoplasmic reticulum (SR) Ca2+ content depended on extracellular Ca2+ concentration ([ Ca2+](o)), with a decrease at low [Ca2+](o) and an increase at high [Ca2+](o). The half-times for [Ca2+](i) transient decline were similar, suggesting little to no changes in SR Ca2+-ATPase activity. Western blots demonstrated a significant (P less than or equal to0.02) threefold increase in NCX1 but no changes in SR Ca2+-ATPase and calsequestrin abundance in myocytes 48 h after infection by adenovirus expressing both GFP and NCX1 compared with those infected by adenovirus expressing GFP alone. We conclude that overexpression of NCX1 in adult rat myocytes incubated at high [Ca2+](o) resulted in enhanced Ca2+ influx via reverse NCX1 function, as evidenced by greater SR Ca2+ content, larger twitch, and [Ca2+](i) transient amplitudes. Forward NCX1 function was also increased, as indicated by lower resting and diastolic [Ca2+](i). C1 Geisinger Med Ctr, Weis Ctr Res, Danville, PA 17822 USA. Univ Calgary, Hlth Sci Ctr, Dept Biochem & Mol Biol, Calgary, AB T2N 4N1, Canada. Med Univ S Carolina, Dept Med, Charleston, SC 29403 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29403 USA. RP Cheung, JY (reprint author), Geisinger Med Ctr, Weis Ctr Res, Danville, PA 17822 USA. FU NHLBI NIH HHS [HL-58672]; NIDDK NIH HHS [DK-46678]; NIGMS NIH HHS [GM-46991] NR 33 TC 48 Z9 48 U1 0 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD NOV PY 2001 VL 281 IS 5 BP H2079 EP H2088 PG 10 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 483TW UT WOS:000171652800027 PM 11668069 ER PT J AU Evans, SB Wilkinson, CW Bentson, K Gronbeck, P Zavosh, A Figlewicz, DP AF Evans, SB Wilkinson, CW Bentson, K Gronbeck, P Zavosh, A Figlewicz, DP TI PVN activation is suppressed by repeated hypoglycemia but not antecedent corticosterone in the rat SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE paraventricular nucleus; stress; c-Fos; hypoglycemia-associated autonomic failure ID HYPOTHALAMIC PARAVENTRICULAR NUCLEUS; NEONATAL MONOSODIUM GLUTAMATE; STRESS-INDUCED EXPRESSION; SYMPATHETIC PREGANGLIONIC NEURONS; PITUITARY-ADRENOCORTICAL AXIS; CENTRAL-NERVOUS-SYSTEM; EARLY GENE-EXPRESSION; IMMEDIATE-EARLY GENES; FOS MESSENGER-RNA; VENTROMEDIAL HYPOTHALAMUS AB The mechanism(s) underlying hypoglycemia-associated autonomic failure (HAAF) are unknown. To test the hypothesis that the activation of brain regions involved in the counterregulatory response to hypoglycemia is blunted with HAAF, rats were studied in a 2-day protocol. Neuroendocrine responses and brain activation (c-Fos immunoreactivity) were measured during day 2 insulin-induced hypoglycemia (0.5 U insulin . 100 g body wt(-1) . h(-1) iv for 2 h) after day 1 hypoglycemia (Hypo-Hypo) or vehicle. Hypo-Hypo animals demonstrated HAAF with blunted epinephrine, glucagon, and corticosterone (Cort) responses and decreased activation of the medial hypothalamus [the paraventricular (PVN), dorsomedial (DMH), and arcuate (Arc) nuclei]. To evaluate whether increases in day 1 Cort were responsible for the decreased hypothalamic activation, Cort was infused intracerebroventricularly (72 mug) on day 1 and the response to day 2 hypoglycemia was measured. Intracerebroventricular Cort infusion failed to alter the neuroendocrine response to day 2 hypoglycemia, despite elevating both central nervous system and peripheral Cort levels. However, day 1 Cort blunted responses in two of the same hypothalamic regions as Hypo-Hypo (the DMH and Arc) but not in the PVN. These results suggest that decreased activation of the PVN may be important in the development of HAAF and that antecedent exposure to elevated levels of Cort is not always sufficient to produce HAAF. C1 Dept Vet Affairs, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Evans, SB (reprint author), Dept Vet Affairs, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 63 TC 51 Z9 51 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD NOV PY 2001 VL 281 IS 5 BP R1426 EP R1436 PG 11 WC Physiology SC Physiology GA 483HW UT WOS:000171630200013 PM 11641112 ER PT J AU Wang, LX Martinez, V Rivier, JE Tache, Y AF Wang, LX Martinez, V Rivier, JE Tache, Y TI Peripheral urocortin inhibits gastric emptying and food intake in mice: differential role of CRF receptor 2 SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE antisauvagine-30; astressin B; capsaicin; cholecystokinin; CP-154,526; DMP904; corticotropin-releasing factor ID CORTICOTROPIN-RELEASING FACTOR; FACTOR ANTAGONISTS; ASTRESSIN ANALOGS; NERVOUS-SYSTEM; LEAN MICE; RAT-BRAIN; CHOLECYSTOKININ; EXPRESSION; MODULATION; SAUVAGINE AB Intraperitoneal urocortin inhibits gastric emptying and food intake in mice. We investigated corticotropin-releasing factor receptor (CRF-R) subtypes involved in intraperitoneal urocortin actions using selective CRF-R antagonists. Gastric emptying was measured 2 h after a chow meal, and food intake was measured hourly after an 18-h fast in mice. Urocortin (3 mug/kg ip) inhibited gastric emptying by 88%. The CRF-R1/CRF-R2 antagonist astressin B (30 mug/kg ip) and the selective CRF-R2 antagonist antisauvagine-30 (100 mug/kg ip) completely antagonized urocortin action, whereas the selective CRF-R1 antagonist CP-154,526 (10 mg/kg ip) had no effect. Urocortin (1-10 mug/kg ip) dose dependently decreased the 2-h cumulative food intake by 30-62%. Urocortin (3 mug/kg)-induced hypophagia was completely antagonized by astressin B (30 mug/kg ip) and partially (35 and 31%) by antisauvagine-30 (100 or 200 mug/kg ip). The CRF-R1 antagonists CP-154,526 or DMP904 (10 mg/kg ip) had no effect. Capsaicin did not alter urocortin-inhibitory actions while blocking the satiety effect of intraperitoneal CCK. These data indicate that intraperitoneal urocortin-induced decrease in feeding is only partly mediated by CRF-R2, whereas urocortin action to delay gastric emptying of a meal involves primarily CRF-R2. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Div Digest Dis,Digest Dis Res Ctr, Ctr Ulcer Res & Educ, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. Salk Inst Biol Studies, Clayton Fdn Labs Peptide Biol, La Jolla, CA 92037 USA. Cardenal Herrera Univ, Dept Basic Biomed Sci, Valencia 46113, Spain. RP Wang, LX (reprint author), CURE VA, Bldg 115,Rm 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [DK-41301, DK-26741] NR 57 TC 71 Z9 73 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD NOV PY 2001 VL 281 IS 5 BP R1401 EP R1410 PG 10 WC Physiology SC Physiology GA 483HW UT WOS:000171630200010 PM 11641109 ER PT J AU Tian, W Bonkovsky, HL Shibahara, S Cohen, DM AF Tian, W Bonkovsky, HL Shibahara, S Cohen, DM TI Urea and hypertonicity increase expression of heme oxygenase-1 in murine renal medullary cells SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE sodium chloride; osmotic; oxidative stress; transcription ID EMBRYO LIVER-CELLS; DUCT MIMCD3 CELLS; NITRIC-OXIDE; TRANSCRIPTIONAL CONTROL; MEDIATED INDUCTION; EPITHELIAL-CELLS; OXIDATIVE STRESS; PRIMARY CULTURES; GENE-EXPRESSION; PROTEIN-KINASE AB Epithelial cells derived from the mammalian kidney medulla are responsive to urea at the levels of signal transduction and gene regulation. Hybridization of RNA harvested from control- and urea-treated murine inner medullary collecting duct (mIMCD3) cells with a cDNA expression array encoding stress-responsive genes suggested that heme oxygenase (HO)-1 mRNA was upregulated by urea. RNase protection assay confirmed this upregulation; hypertonicity also increased HO-1 mRNA expression but neither hypertonic NaCl nor urea were effective in the nonrenal 3T3 cell line. The effect on HO-1 expression appeared to be transcriptionally mediated on the basis of mRNA half-life studies and reporter gene analyses using the promoters of both human and chicken HO-1. Although urea signaling resembles that of heavy metal signaling in other contexts, the effect of urea on HO-1 transcription was independent of the cadmium response element in this promoter. Urea-inducible HO-1 expression was sensitive to antioxidants but not to scavengers of nitric oxide. Urea also upregulated HO-1 protein expression and pharmacological inhibition of HO-1 action with zinc protoporphyrin-sensitized mIMCD3 cells to the adverse effects of hypertonicity but not to urea. Coupled with the prior observation of others that HO-1 expression increases along the renal corticomedullary gradient, these data suggest that HO-1 expression may comprise an element of the adaptive response to hypertonicity and/or urea in renal epithelial cells. C1 Oregon Hlth Sci Univ, Div Nephrol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Mol Med, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Univ Massachusetts, Sch Med, Dept Med, Worcester, MA 01655 USA. Tohoku Univ, Sch Med, Dept Mol Biol & Appl Physiol, Sendai, Miyagi 980, Japan. RP Cohen, DM (reprint author), Oregon Hlth Sci Univ, Div Nephrol, Mailcode PP262,3314 SW US Vet Hosp Rd, Portland, OR 97201 USA. EM cohend@ohsu.edu RI Shibahara, Shigeki/M-3644-2014 FU NIDDK NIH HHS [DK-52494] NR 49 TC 19 Z9 19 U1 0 U2 5 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD NOV PY 2001 VL 281 IS 5 BP F983 EP F991 PG 9 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 480QJ UT WOS:000171473200023 PM 11592956 ER PT J AU Tobin, MJ AF Tobin, MJ TI Asthma, airway biology, and allergic rhinitis in AJRCCM 2000 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review ID EXHALED NITRIC-OXIDE; IMMUNODEFICIENCY-VIRUS TYPE-1; OBSTRUCTIVE PULMONARY-DISEASE; PLATELET-ACTIVATING-FACTOR; COLONY-STIMULATING FACTOR; ANTIGEN-PRESENTING CELLS; SMOOTH-MUSCLE CELLS; MUCOSAL BLOOD-FLOW; GUINEA-PIG AIRWAYS; QUALITY-OF-LIFE C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Div Pulm & Crit Care Med, Chicago, IL 60611 USA. RP Tobin, MJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Route 111N, Hines, IL 60141 USA. NR 234 TC 8 Z9 9 U1 0 U2 1 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD NOV 1 PY 2001 VL 164 IS 9 BP 1559 EP 1580 PG 22 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 499RR UT WOS:000172584600005 PM 11719293 ER PT J AU Tobin, MJ AF Tobin, MJ TI Pediatrics, surfactant, and cystic fibrosis in AJRCCM 2000 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review ID SYNCYTIAL VIRUS BRONCHIOLITIS; ENVIRONMENTAL TOBACCO-SMOKE; FUNCTION REFERENCE VALUES; HYALINE-MEMBRANE DISEASE; EXHALED NITRIC-OXIDE; LUNG-FUNCTION GROWTH; INNER-CITY CHILDREN; YOUNG-CHILDREN; ASTHMATIC-CHILDREN; AIRWAY INFLAMMATION C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Div Pulm & Crit Care Med, Chicago, IL 60611 USA. RP Tobin, MJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Route 111N, Hines, IL 60141 USA. NR 116 TC 0 Z9 0 U1 0 U2 0 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD NOV 1 PY 2001 VL 164 IS 9 BP 1581 EP 1594 PG 14 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 499RR UT WOS:000172584600006 PM 11719294 ER PT J AU Steinbart, EJ Smith, CO Poorkaj, P Bird, TD AF Steinbart, EJ Smith, CO Poorkaj, P Bird, TD TI Impact of DNA testing for early-onset familial Alzheimer disease and frontotemporal dementia SO ARCHIVES OF NEUROLOGY LA English DT Article ID HUNTINGTONS-DISEASE; CANDIDATE GENE; EXPERIENCE; MUTATIONS; DISORDERS; DISTRESS; SUICIDE; SCALE; TAU AB Background: DNA testing of persons at risk for hereditary, degenerative neurologic diseases is relatively new. Only anecdotal reports of such testing in familial Alzheimer disease (FAD) exist, and little is know about the personal and social impact of such testing. Methods: in a descriptive, observational study, individuals at 50% risk for autosomal dominant, early-onset FAD or frontotemporal dementia with parkinsonism linked to chromosome 17 underwent DNA testing for the genetic mutations previously identified in affected family members. Individuals were followed up for (1)/(2) to 3 years and were interviewed regarding attitudes toward the testing process and the impact of the results. Results: Twenty-one (8.4%) of 251 persons at risk for FAD or frontotemporal dementia requested genetic testing. The most common reasons for requesting testing were concern about early symptoms of dementia, financial or family planning, and relief from anxiety. Twelve individuals had positive DNA test results, and 6 of these had early symptoms of demential 8 had negative results; and I has not vet received results. Of 14 asymptomatic individuals completing testing, 13 believed the testing was beneficial. Two persons reported moderate anxiety and 1 reported moderate depression. As expected, persons with negative test results had happier experiences overall, but even they had to deal with ongoing anxiety and depression. Thus far, there have been no psychiatric hospitalizations, suicide attempts, or denials of insurance. Conclusions: Genetic testing in early-onset FAD and frontotemporal dementia can be completed successfully. Most individuals demonstrate effective coping skills and find the testing to be beneficial, but long-term effects remain unknown. C1 Univ Washington, Sch Med, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. RP Bird, TD (reprint author), VA Med Ctr, Geriatr Res 182,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIA NIH HHS [AG05136]; PHS HHS [H133B980008] NR 27 TC 57 Z9 57 U1 0 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD NOV PY 2001 VL 58 IS 11 BP 1828 EP 1831 DI 10.1001/archneur.58.11.1828 PG 4 WC Clinical Neurology SC Neurosciences & Neurology GA 490MH UT WOS:000172055300016 PM 11708991 ER PT J AU Poorkaj, P Tsuang, D Wijsman, E Steinbart, E Garruto, RM Craig, UK Chapman, NH Anderson, L Bird, TD Plato, CC Perl, DP Weiderholt, W Galasko, D Schellenberg, GD AF Poorkaj, P Tsuang, D Wijsman, E Steinbart, E Garruto, RM Craig, UK Chapman, NH Anderson, L Bird, TD Plato, CC Perl, DP Weiderholt, W Galasko, D Schellenberg, GD TI TAU as a susceptibility gene for amyotropic lateral sclerosis-parkinsonism dementia complex of Guam SO ARCHIVES OF NEUROLOGY LA English DT Article ID PROGRESSIVE SUPRANUCLEAR PALSY; FRONTOTEMPORAL DEMENTIA; LINKAGE DISEQUILIBRIUM; NEURODEGENERATIVE DISORDERS; FTDP-17 MUTATIONS; CHROMOSOME-17; CALCIUM; POLYMORPHISM; METABOLISM; FAMILIES AB Background: A Guam variant of amyotrophic lateral sclerosis (ALS-G) and parkinsonism. dementia complex (PDC-G) are found in the Chamorro people of Guam. Both disorders have overlapping neuropathologic findings, with neurofibrillary tangles in spinal cord and brain. The cause of ALS-G-PDC-G is unknown, although inheritance and environment appear important. Because neurofibrillary tangles containing tau protein are present in ALS-G-PDC-G, and because mutations in the tau gene (TAU) cause autosomal dominant frontotemporal dementia, TAU was examined as a candidate gene for ALS-G-PDC-G. Methods: TAU was evaluated by DNA sequence analysis in subjects with ALS-G-PDC-G, by linkage analysis of TAU polymorphisms in an extended pedigree from the village of Umatac, and by evaluation of linkage disequilibrium with polymorphic markers flanking and within TAU. Results: Linkage disequilibrium between ALS-G-PDC-G and the TAU polymorphism CA3662 was observed. For this 2-allele system, PDC and ALS cases were significantly less likely than Guamanian controls to have the 1 allele (4.9% and 2% vs 11.5%, respectively; Fisher exact P=.007). DNA sequence analysis of TAU coding regions did not demonstrate a mutation responsible for ALS-C-PDC-G. Analysis of TAU genotypes in an extended pedigree of subjects from Umatac showed obligate recombinants between TAU and ALS-G-PDC-G. Linkage analysis of the Umatac pedigree indicates that TAU is not the major gene for ALS-G-PDC-G. Conclusions: The genetic association between ALS-GPDC-G implicates TAU in the genetic susceptibility to ALS-G-PDC-G. TAU may be a modifying gene increasing risk for ALS-G-PDC-G in the presence of another, as yet, unidentified gene. C1 Vet Affairs Puget Sound Hlth Care Syst, GRECC 182B, Seattle Div, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Mental Illness Res Educ Clin Ctr, Seattle Div, Seattle, WA USA. Univ Washington, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Med Genet, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Pharmacol, Seattle, WA 98195 USA. SUNY Binghamton, Dept Anthropol, Binghamton, NY USA. SUNY Binghamton, Dept Biol Sci, Binghamton, NY USA. NINCDS, NIH, Bethesda, MD 20892 USA. Univ Guam, Dept Publ Hlth, Mangilao, GU USA. Univ San Diego, Dept Neurosci, San Diego, CA 92110 USA. Mt Sinai Sch Med, Dept Pathol, New York, NY USA. Mt Sinai Sch Med, Dept Psychol, New York, NY USA. RP Schellenberg, GD (reprint author), Vet Affairs Puget Sound Hlth Care Syst, GRECC 182B, Seattle Div, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Tsuang, Debby/L-7234-2016 OI Tsuang, Debby/0000-0002-4716-1894 FU PHS HHS [P010135316] NR 57 TC 48 Z9 49 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD NOV PY 2001 VL 58 IS 11 BP 1871 EP 1878 DI 10.1001/archneur.58.11.1871 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 490MH UT WOS:000172055300022 PM 11708997 ER PT J AU Lin, AL Johnson, DA Wu, Y Wong, G Ebersole, JL Yeh, CK AF Lin, AL Johnson, DA Wu, Y Wong, G Ebersole, JL Yeh, CK TI Measuring short-term gamma-irradiation effects on mouse salivary gland function using a new saliva collection device SO ARCHIVES OF ORAL BIOLOGY LA English DT Article DE whole saliva collection; mice; radiation; longitudinal approach; flow rates; salivary composition ID PAROTID-GLAND; X-IRRADIATION; ACINAR-CELLS; RAT SALIVA; PROTEIN; PEROXIDASE; SECRETION AB A restraining device was designed specifically for the collection of whole saliva from mice without using anesthesia. As the procedure does not involve surgical cannulation of the salivary glands, saliva can be collected from the same mouse at different times. The time between the injection of a secretory stimulant (pilocarpine) and the appearance of saliva in the mouth (lag time) was 100.5 +/- 8.5 s (mean +/- S.E.M., n = 10) for control mice. The volume of saliva collected in the first 5 min was three times greater than that collected between 15 and 20 min. The average flow rate for a collection period of 15 min was 16.7 +/- 1.8 ulmin (n = 10). The flow rate was decreased 50%. (P < 0.005) whereas the lag time was increased more than 300% (P < 0.05) at 24 h after irradiation. The concentrations of a 23.5-kDa protein and a mucin were decreased after irradiation whereas there was no significant effect on the concentration of amylase or peroxidase. (C) 2001 Elsevier Science Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Sch Dent, Dept Dent Diagnost Sci 7919, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Sch Dent, Dept Community Dent 7917, San Antonio, TX 78229 USA. Univ Kentucky, Coll Dent, Ctr Oral Hlth Res, Lexington, KY 40536 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Ctr Geriatr Res Educ & Clin 182, San Antonio, TX 78229 USA. RP Yeh, CK (reprint author), Univ Texas, Hlth Sci Ctr, Sch Dent, Dept Dent Diagnost Sci 7919, 4450 Med Dr, San Antonio, TX 78229 USA. NR 24 TC 27 Z9 27 U1 1 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0003-9969 J9 ARCH ORAL BIOL JI Arch. Oral Biol. PD NOV PY 2001 VL 46 IS 11 BP 1085 EP 1089 DI 10.1016/S0003-9969(01)00063-2 PG 5 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 483MU UT WOS:000171639500012 PM 11543716 ER PT J AU Creasey, GH Grill, JH Korsten, M Sang, H Betz, R Anderson, R Walter, J AF Creasey, GH Grill, JH Korsten, M Sang, H Betz, R Anderson, R Walter, J CA Implanted Neuroprosthesis Res Grp TI An implantable neuroprosthesis for restoring bladder and bowel control to patients with spinal cord injuries: A multicenter trial SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE bladder, neurogenic; electric stimulation; rehabilitation; rhizotomy; spinal cord injuries; urinary incontinence ID ANTERIOR ROOT STIMULATORS; ELECTRICAL-STIMULATION; NERVE ROOTS; RHIZOTOMY; PARAPLEGIA AB Objective: To evaluate the safety and efficacy of an implanted neuroprosthesis for management of the neurogenic bladder and bowel in individuals with spinal cord injury (SCI). Design: Prospective Study comparing bladder and bowel control before and at 3. 6. and 12 months after implantation of the neuroprosthesis. Setting: Six US hospitals specializing in treatment of SCI. Patients: Twenty-three neurologically stable patients with complete suprasacral SCIs. Intervention: Implantation of an externally controlled neuroprosthesis for stimulating the sacral nerves and posterior sacral rhizotomy. Main Outcome Measures: Ability to urinate more than 200mL on demand and a resulting postvoid residual volume of less than 50mL. Results: At 1-year follow-up, 18 of 21 patients could urinate more than 200mL with the neuroprosthesis. and 15 of 21 had postvoid volumes less than 50mL (median, 15mL). Urinary tract infection. catheter use. reflex incontinence, anticholinergic drug use, and autonomic dysreflexia were substantially reduced. At 1-year follow-up, 15 of 17 patients reduced the time spent with bowel management. Conclusions: Neural stimulation and posterior rhizotomy is a safe and effective method of bladder and bowel management after suprasacral SCI. (C) 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Stanford Univ, Med Ctr, Stanford, CA 94305 USA. Shriners Hosp Children, Philadelphia Unit, Philadelphia, PA USA. Univ Calif San Diego, Med Ctr, San Diego, CA 92103 USA. VA San Diego Hlth Care Syst, San Diego, CA USA. Vet Affairs Med Ctr, Bronx, NY USA. NeuroControl Corp, Cleveland, OH USA. Case Western Reserve Univ, Cleveland, OH 44106 USA. Metrohlth Med Ctr, Louis Stokes Dept Vet Affairs Med Ctr, Cleveland, OH 44109 USA. RP Creasey, GH (reprint author), Metrohlth Med Ctr, Louis Stokes Dept Vet Affairs Med Ctr, 2500 Metrohlth Dr, Cleveland, OH 44109 USA. NR 24 TC 62 Z9 72 U1 0 U2 4 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD NOV PY 2001 VL 82 IS 11 BP 1512 EP 1519 DI 10.1053/apmr.2001.25911 PG 8 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 488WK UT WOS:000171959600002 PM 11689969 ER PT J AU Masel, BE Scheibel, RS Kimbark, T Kuna, ST AF Masel, BE Scheibel, RS Kimbark, T Kuna, ST TI Excessive daytime sleepiness in adults with brain injuries SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT 50th Annual Meeting of the American-Academy-of-Neurology CY APR 25-MAY 02, 1998 CL MINNEAPOLIS, MINNESOTA SP Amer Acad Neurol DE Xbrain injuries; disorders of excessive somnolence; rehabilitation; sleep apnea syndromes; sleep disorders ID CLOSED-HEAD-INJURY; LATENCY TEST; SCALE; POPULATION; PREVALENCE AB Objectives: To determine the prevalence, demographics, and causes of excessive daytime sleepiness in adults with brain injuries after the acute phase of their injury and to investigate the relations between self-report and objective measures of hypersomnolence. Design: A case series of patients enrolled consecutively into a residential rehabilitation program. Setting: University sleep laboratory, live-in rehabilitation center. Patients: Adults with brain injuries (n = 71); mean time +/- standard deviation from injury to study, 38 +/- 60 months. Interventions: A polysomnogram and Multiple Sleep Latency Test (MSLT) were performed in each subject. Each subject also completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Main Outcome Measures: Sleep patterns, by polysomnogram. Daytime hypersomnolence, diagnosed by mean sleep latency on the MSLT less than or equal to 10 minutes. Sleep apnea-hypopnea syndrome, diagnosed by Apnea-Hypopnea Index greater than 10 events/hr. Periodic limb movement disorder, diagnosed by a Periodic Leg Movement Index greater than 10 events/hr. Results: Mean sleep latency was : 10 minutes in 47% of the cohort and less than or equal to 5 minutes in 18.3%. Subjects were classified into 3 groups: nonhypersomnolent (n = 38, 53%), hypersomnolent with abnormal indices (n = 12, 17%), or hypersomnolent with normal indices (n = 21, 30%). Among the 3 groups, no significant differences were present in Glasgow Coma Scale score, length of coma, or time since brain injury. No differences across groups were found in nature of the injury, gender, or medications. No significant correlation existed between the ESS or PSQI results and mean sleep latency on the MSLT. Conclusions: Hypersomnia is common in adults with brain injuries, with a relatively high prevalence of sleep apnea-hypopnea syndrome, periodic limb movement disorder, and posttraurnatic hypersomnia. Subjects with objectively measured sleepiness were not identified on self-reporting questionnaires, suggesting their inability to perceive their hypersomnolence. (C) 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. C1 Transit Learning Ctr Galveston, Galveston, TX 77550 USA. Univ Texas, Med Branch, Galveston, TX 77550 USA. Univ Penn, Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Masel, BE (reprint author), Transit Learning Ctr Galveston, 1528 PO, Galveston, TX 77550 USA. FU NCRR NIH HHS [RR-73] NR 31 TC 71 Z9 72 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD NOV PY 2001 VL 82 IS 11 BP 1526 EP 1532 DI 10.1053/apmr.2001.26093 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 488WK UT WOS:000171959600004 PM 11689971 ER PT J AU Peters, JH Carsons, S Kalunian, K McDougall, S Yoshida, M Ko, F van der Vliet-Hristova, M Hahn, TJ AF Peters, JH Carsons, S Kalunian, K McDougall, S Yoshida, M Ko, F van der Vliet-Hristova, M Hahn, TJ TI Preferential recognition of a fragment species of osteoarthritic synovial fluid fibronectin by antibodies to the alternatively spliced EIIIA segment SO ARTHRITIS AND RHEUMATISM LA English DT Article ID ARTICULAR-CARTILAGE; MESSENGER-RNA; MONOCLONAL-ANTIBODIES; ISOFORM DISTRIBUTION; SIGNAL-TRANSDUCTION; OSTEO-ARTHRITIS; EDA SEGMENT; V-SEGMENT; EXPRESSION; PROTEIN AB Objective. To characterize the species of synovial fluid (SF) fibronectin (FN) bearing the alternatively spliced EIIIA segment. Methods. SF from patients with osteoarthritis (OA) and rheumatoid arthritis (RA), as well as corresponding affinity isolation products, were subjected to I-dimensional and 2-dimensional electrophoresis followed by Western blot analysis. Results. Regardless of the clinical type of arthritis, a polyclonal antibody that recognizes antigenic determinants throughout the FN molecule produced staining of predominantly similar to 200+ and similar to 170-kd species in reduced 1-dimensional electrophoresis. Despite the overall prevalence of the larger species, 4 monoclonal antibodies (mAb) reactive with sequences lying near the center of the EIIIA segment exhibited a relative failure to recognize the larger of these 2 species in OA, but not RA, SF. The absence of recognition of EIIIA sequences within the similar to 200+ kd forms of OA SF FN was unrelated to their derivation from dimers, since anti-EIIIA, mAb recognized the smaller fragment species in preference to both monomeric and dimeric forms. The similar to 170-kd EIIIA+ fragments were observed to have minimal gelatin-binding capacity and appeared on 2-dimensional electrophoresis to extend from the N-terminus of FN through at least the center of the EIIIA segment. Similar results were obtained for samples obtained by needle aspiration or arthroscopic lavage, suggesting a widespread applicability of these findings. Conclusion. The similar to 170-kd EIIIA+ species of FN could potentially constitute a soluble "vehicle" by which chondrocyte-regulating EIIIA sequences, liberated from inhibitory flanking C-terminal sequences, could reach cells in the arthritic joint. Additionally, "FN species-specific" recognition of this segment within OA SF could constitute a marker by which to gauge the activity of the OA disease process. C1 Sacramento VA Med Ctr, Mather, CA 95655 USA. Univ Calif Los Angeles, Sch Med, W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. Univ Calif Davis, Davis, CA 95616 USA. Winthrop Univ Hosp, Mineola, NY 11501 USA. SUNY Stony Brook, Stony Brook, NY 11794 USA. RP Peters, JH (reprint author), Sacramento VA Med Ctr, 151-SMC,10535 Hosp Way, Mather, CA 95655 USA. FU NIA NIH HHS [P60-AG-10415]; NIAMS NIH HHS [AR-42469] NR 38 TC 10 Z9 10 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0004-3591 J9 ARTHRITIS RHEUM JI Arthritis Rheum. PD NOV PY 2001 VL 44 IS 11 BP 2572 EP 2585 DI 10.1002/1529-0131(200111)44:11<2572::AID-ART438>3.0.CO;2-Y PG 14 WC Rheumatology SC Rheumatology GA 498CC UT WOS:000172491400015 PM 11710714 ER PT J AU Silverman, SL Minshall, ME Shen, W Harper, KD Xie, S AF Silverman, SL Minshall, ME Shen, W Harper, KD Xie, S CA Hlth-Related Quality Life Subgroup TI The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis - Results from the multiple outcomes of raloxifene evaluation study SO ARTHRITIS AND RHEUMATISM LA English DT Article ID OF-LIFE; BACK PAIN; QUESTIONNAIRE; DEFORMITIES; ASSOCIATION; IMPAIRMENT; DENSITY; TRIAL AB Objective. To examine the effect of both Prevalent and incident vertebral fractures on health-related quality of life (HRQOL) in postmenopausal women with osteoporosis and to characterize the effect of prevalent vertebral fractures on HRQOL with respect to number, location, severity, and adjacency. Methods. Participants were a subset of women (n = 1,395, mean age 68.5 years) from the Multiple Outcomes of Raloxifene Evaluation trial who had low bone mineral density and/or prevalent vertebral fractures. Vertebral fractures were measured by radiography at baseline, 2 years, and 3 years. HRQOL was assessed using the Osteoporosis Assessment Questionnaire (OPAQ), a validated disease-targeted instrument, at baseline and annually for 3 years. Results. Both prevalent and incident radiographic vertebral fractures were associated with decreased HRQOL. At baseline, women with a prevalent vertebral fracture had significantly lower OPAQ scores on physical function, emotional status, clinical symptoms, and overall HRQOL compared with women without a prevalent fracture (all P < 0.01). HRQOL scores were lower with each subsequent fracture. The effect of prevalent vertebral fracture was dependent on the location within the spine and was strongest in the lumbar region (L1-L4). Incident vertebral fractures significantly decreased OPAQ scores on physical function, emotional status, clinical symptoms, and overall HRQOL (all P < 0.001). Conclusion. Our findings demonstrate the importance of treating postmenopausal women who have prevalent vertebral fractures to prevent further decreases in HRQOL associated with subsequent incident vertebral fracture. C1 OMC Clin Res Ctr, Beverly Hills, CA 90211 USA. Univ Calif Los Angeles, Cedars Sinai Med Ctr, Greater Los Angeles VA Hlth Syst, Los Angeles, CA 90048 USA. Eli Lilly & Co, Lilly Corp Ctr, Indianapolis, IN 46285 USA. RP Silverman, SL (reprint author), OMC Clin Res Ctr, 8641 Wilshire Blvd,Suite 310, Beverly Hills, CA 90211 USA. NR 26 TC 196 Z9 199 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0004-3591 J9 ARTHRITIS RHEUM JI Arthritis Rheum. PD NOV PY 2001 VL 44 IS 11 BP 2611 EP 2619 DI 10.1002/1529-0131(200111)44:11<2611::AID-ART441>3.0.CO;2-N PG 9 WC Rheumatology SC Rheumatology GA 498CC UT WOS:000172491400018 PM 11710717 ER PT J AU Goldstein, AS Amory, JK Martin, SM Vernon, C Matsumoto, A Yager, P AF Goldstein, AS Amory, JK Martin, SM Vernon, C Matsumoto, A Yager, P TI Testosterone delivery using glutamide-based complex high axial ratio nficrostructures SO BIOORGANIC & MEDICINAL CHEMISTRY LA English DT Article ID IN-VITRO; MICROSTRUCTURES; MICROSPHERES; DEGRADATION; UNDECANOATE AB Complex high axial ratio microstructures (CHARMs) were evaluated for delivery of testosterone in vivo. Methods to incorporate testosterone included noncovalent mixing and covalent attachment of testosterone to the lipid to form a prodrug monomer. When prepared by covalent attachment, testosterone-loaded CHARMs were resistant to in vitro spontaneous hydrolysis; when injected into rats, testosterone was released with biphasic kinetics consisting of a burst followed by a much slower phase. Some CHARM material associated with testosterone persisted at the site of injection for at least 9 days. (C) 2001 Elsevier Science Ltd. All rights reserved. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Gen Internal Med Sect, Seattle, WA 98108 USA. Univ Washington, Dept Chem, Seattle, WA 98195 USA. Univ Washington, Dept Biochem, Seattle, WA 98195 USA. Univ Washington, Dept Bioengn, Mol Bioengn Program, Seattle, WA 98195 USA. RP Yager, P (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, S-182-GRECC,1660 S Columbian Way, Seattle, WA 98108 USA. NR 32 TC 20 Z9 22 U1 1 U2 4 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0968-0896 J9 BIOORGAN MED CHEM JI Bioorg. Med. Chem. PD NOV PY 2001 VL 9 IS 11 BP 2819 EP 2825 DI 10.1016/S0968-0896(01)00149-3 PG 7 WC Biochemistry & Molecular Biology; Chemistry, Medicinal; Chemistry, Organic SC Biochemistry & Molecular Biology; Pharmacology & Pharmacy; Chemistry GA 485KF UT WOS:000171753000008 PM 11597462 ER PT J AU Hsu, JH Shi, YJ Krajewski, S Renner, S Fisher, M Reed, JC Franke, TF Lichtenstein, A AF Hsu, JH Shi, YJ Krajewski, S Renner, S Fisher, M Reed, JC Franke, TF Lichtenstein, A TI The AKT kinase is activated in multiple myeloma tumor cells SO BLOOD LA English DT Article ID INDUCED APOPTOSIS; GROWTH-FACTORS; PLASMA-CELLS AB Immunohistochemistry (IHC) was performed on archived bone marrow (BM) with a phosphospecific anti-AKT antibody. IHC on 26 BM biopsies from patients with multiple myeloma (MM) demonstrated phospho-AKT staining of malignant plasma cells in a cell membrane-specific pattern, whereas nonmalignant hematopoietic cells did not stain. Preabsorption of the antibody with phosphorylated AKT peptide, but not nonphosphorylated peptide, abrogated staining. Frequency of plasma cell staining in BMs of patients with stage I or smoldering MM was significantly less than that of stage III MM marrows. Plasma cells in 10 patients with monoclonal gammopathy of undetermined significance were not stained by the antibody. To investigate the significance of AKT activation, 2 cell lines initiated from cultures of primary MM cells were also studied. Both demonstrated constitutive AKT activation. Interruption of AKT activation and activity, achieved by either exposure to wortmannin or by ectopic expression of a dominant negative AKT mutant, resulted in inhibition of MM cell growth in vitro. These results indicate that activation of the AKT kinase is a characteristic of MM cells and suggest that AKT activity is important for MM cell expansion. (C) 2001 by The American Society of Hematology. C1 W Los Angeles Vet Adm Med Ctr, Dept Pathol & Med, Los Angeles, CA USA. Jonsson Comprehens Canc Ctr, Los Angeles, CA 90034 USA. Burnham Inst, La Jolla, CA 92037 USA. Columbia Univ, Dept Pharmacol, New York, NY USA. RP Lichtenstein, A (reprint author), VA W LA Hosp, W111H,11301 Wiltshire Blvd, Los Angeles, CA 90073 USA. FU NCI NIH HHS [CA69381]; NINDS NIH HHS [NS3621] NR 14 TC 136 Z9 138 U1 0 U2 6 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 1 PY 2001 VL 98 IS 9 BP 2853 EP 2855 DI 10.1182/blood.V98.9.2853 PG 3 WC Hematology SC Hematology GA 487CK UT WOS:000171855900036 PM 11675360 ER PT J AU Bliziotes, MM Eshleman, AJ Zhang, XW Wiren, KM AF Bliziotes, MM Eshleman, AJ Zhang, XW Wiren, KM TI Neurotransmitter action in osteoblasts: Expression of a functional system for serotonin receptor activation and reuptake SO BONE LA English DT Article DE bone; osteoblast; neurotransmitter; serotonin; receptor; transporter ID VASOACTIVE INTESTINAL POLYPEPTIDE; PROTEIN-KINASE-C; IMMUNOREACTIVE NERVES; RAT OSTEOBLASTS; ANTIPEPTIDE ANTIBODIES; GLUTAMATE RECEPTORS; 5-HT1A RECEPTOR; BINDING PROTEIN; BONE-RESORPTION; EMBRYONIC MOUSE AB Neurotransmitter regulation of bone metabolism has been the subject of increasing interest and investigation. Because serotonin (5-HT) plays a role as a regulator of craniofacial morphogenesis, we investigated the expression and function of 5-HT receptors and the 5-HT transporter (5-HTT) in bone. Primary cultures of rat osteoblasts (rOB) and a variety of clonal osteoblastic cell lines, including ROS 17/2.8, UMR 106-H5, and Pyla, showed mRNA expression for 5-HTT as well as the 5-HT1A, 5-HT1D, 5-HT2A, and 5-HT2B, receptors by reverse transcription-polymerase chain reaction (RT-PCR) analysis. Protein expression of the 5-HT1A, 5-HT2A, and 5-HT2B receptors was confirmed by immunoblot. 5-HTT binding sites were assessed in ROS 17/2.8 and UMR 106-H5 cells by binding of the stable cocaine analog [I-125]RTI-55, which showed a relatively high density of nanomolar affinity binding sites. Imipramine and fluoxetine, antagonists with specificity for 5-HTT, showed the highest potency to antagonize [I-125]RTI-55 binding in ROS and UMR cells. GBR-12935, a relatively selective dopamine transporter antagonist, had a much lower potency, as did desipramine, a selective norepinephrine transporter antagonist. The maximal [H-3]5-HT uptake rate in ROS cells was 110 pmol/10 min per well, with a K-m value of 1.13 mu mol/L. Imipramine and fluoxetine inhibited specific [H-3]5-HT uptake with IC50 values in the nanomolar range. In normal differentiating rOB cultures, 5-HTT functional activity was observed initially at day 25, and activity increased almost eightfold by day 31. In mature rOB cultures, the estimated density of [I-125]RTI-55 binding sites was 600 fmol/mg protein. Functional downregulation of transporter activity was assessed after PMA treatment, which caused a significant 40% reduction in the maximal uptake rate of [H-3]5-HT, an effect that was prevented by pretreatment with staurosporine. The affinity of 5-HT for the transporter was significantly increased following PMA treatment. We assessed the functional significance of expression of the 5-HT receptors by investigating the interaction between 5-HT and parathyroid hormone (PTH) signaling. 5-HT potentiates the PTH-induced increase in AP-1 activity in UMR cells. These results demonstrate that osteoblastic cells express a functional serotonin system, with mechanisms for responding to and regulating uptake of 5-HT. (C) 2001 by Elsevier Science Inc. All rights reserved. C1 Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR USA. RP Bliziotes, MM (reprint author), Dept Vet Affairs Med Ctr, P3-3710 SW Vet Hosp Rd, Portland, OR 97201 USA. OI Wiren, Kristine/0000-0002-6159-4450 FU NIDDK NIH HHS [DK54415] NR 58 TC 120 Z9 129 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 8756-3282 J9 BONE JI Bone PD NOV PY 2001 VL 29 IS 5 BP 477 EP 486 DI 10.1016/S8756-3282(01)00593-2 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 492ET UT WOS:000172156000013 PM 11704501 ER PT J AU Bernard, GR Ely, EW Wright, TJ Fraiz, J Stasek, JE Russell, JA Mayers, I Rosenfeld, BA Morris, PE Yan, SB Helterbrand, JD AF Bernard, GR Ely, EW Wright, TJ Fraiz, J Stasek, JE Russell, JA Mayers, I Rosenfeld, BA Morris, PE Yan, SB Helterbrand, JD CA rhAPC Sepsis Study Grp TI Safety and dose relationship of recombinant human activated protein C for coagulopathy in severe sepsis SO CRITICAL CARE MEDICINE LA English DT Article DE recombinant proteins; activated protein C; sepsis; septic shock; severe sepsis; D-dimer; phase II clinical trial; randomized controlled trial; disseminated intravascular coagulopathy; critical care; inflammation ID DISSEMINATED INTRAVASCULAR COAGULATION; CRITICALLY ILL PATIENTS; NECROSIS-FACTOR-ALPHA; PURPURA FULMINANS; SEPTIC SHOCK; MENINGOCOCCAL DISEASE; ANTITHROMBIN-III; PROGNOSTIC VALUE; ORGAN FAILURE; FACTOR-V AB Objectives: To assess the safety and effect on coagulopathy of a range of doses of recombinant human activated protein C (rhAPC). To determine an effective dose and duration of rhAPC for use in future clinical trials. Design: Double-blind, randomized, placebo-controlled, multicenter, dose-ranging (sequential), phase II clinical trial. Setting., Forty community or academic medical institutions in United States and Canada. Patients. One hundred thirty-one adult patients with severe sepsis. Interventions. Intravenous infusion of rhAPC (12, 18, 24, or 30 mug/kg/hr) or placebo for 48 or 96 hrs. Measurements and Main Results. No significant differences in incidence of serious bleeding events (4% rhAPC, 5% placebo, p > .999) or incidence of serious adverse events (39% rhAPC, 46% placebo, p = 0.422) between rhAPC- and placebo-treated patients were observed. One of 53 rhAPC-treated patients with suitable immunogenicity samples had a low level, transient, non-neutralizing anti-APC antibody response not associated with any clinical adverse event. Significant dose-dependent decreases in both D-dimer (p < 0.001) and end of infusion interleukin 6 levels (p = .021) were demonstrated. No statistically significant effects on fibrinogen or platelet counts were observed. A nonstatistically significant 15% relative risk reduction in 28-day all-cause mortality was observed between rhAPC- and placebo-treated patients. Conclusions. rhAPC was safe and well-tolerated and demonstrated a dose-dependent reduction in D-dimer and interleukin 6 levels relative to placebo. The dose of 24 mug/kg/hr for 96 hrs was selected for use in future clinical studies. C1 Vanderbilt Univ, Sch Med, Med Ctr,Dept Med, Med Ctr N,Div Allergy Pulm & Crit Care Med, Nashville, TN 37232 USA. Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA. St Vincent Hosp, Res Dept, Indianapolis, IN USA. Baylor Coll Med, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX USA. St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada. Univ Alberta, Dept Med, Edmonton, AB, Canada. Johns Hopkins Univ, Sch Med, Dept Anesthesiol & Crit Care Med & Surg, Baltimore, MD USA. Wake Forest Univ, Sch Med, Winston Salem, NC 27109 USA. RP Bernard, GR (reprint author), Vanderbilt Univ, Sch Med, Med Ctr,Dept Med, Med Ctr N,Div Allergy Pulm & Crit Care Med, T-1208, Nashville, TN 37232 USA. RI Stasek, Jerome/E-4138-2011 NR 59 TC 188 Z9 203 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD NOV PY 2001 VL 29 IS 11 BP 2051 EP 2059 DI 10.1097/00003246-200111000-00003 PG 9 WC Critical Care Medicine SC General & Internal Medicine GA 490WL UT WOS:000172076700003 PM 11700394 ER PT J AU Wang, F Hull, RL Vidal, J Cnop, M Kahn, SE AF Wang, F Hull, RL Vidal, J Cnop, M Kahn, SE TI Islet amyloid develops diffusely throughout the pancreas before becoming severe and replacing endocrine cells SO DIABETES LA English DT Article ID DIABETES-MELLITUS; BETA-CELL; TRANSGENIC MICE; MOUSE MODEL; MACACA-NIGRA; POLYPEPTIDE; INSULIN; LANGERHANS; SECRETION; HYPERGLYCEMIA AB Islet amyloid occurs in > 90% of type 2 diabetic patients and may play a role in the pathogenesis of this disease. To determine whether islet amyloid occurs diffusely throughout the pancreas, whether it affects islets equally, and whether it decreases islet endocrine cells, we characterized islet amyloidosis by computerized fluorescence microscopy in transgenic mice that develop typical islet amyloid. These mice produce the unique amyloidogenic component of human islet amyloid, human islet amyloid polypeptide (hIAPP). The prevalence of amyloid (number of islets containing amyloid/total number of islets x 100) and the severity of amyloid (Sigma amyloid area/Sigma islet area x 100) were found to be uniform throughout the pancreas. Furthermore, a high prevalence of amyloid was observed in islets when the severity of amyloid was only 1.5% of the islet area, suggesting a diffuse distribution of amyloid from the very early stages of islet amyloidosis. In 12 hIAPP transgenic mice with an amyloid severity of 9.6 +/- 3.4%, the proportion of islets composed of beta- and delta -cells was reduced in the transgenic mice compared with 6 nontransgenic mice that do not develop amyloid (beta -cells: 62.9 +/- 3.1% vs. 75.5 +/- 0.9%, P = 0.02; delta -cells: 2.8 +/- 0.5% vs. 4.4 +/- 0.4%, P = 0.05), whereas the proportion of islets composed of alpha -cells did not significantly differ between the two groups of mice. In the individual islets in these transgenic mice, amyloid severity was inversely correlated with P-cell, (r = -0.59, P < 0.0001), alpha -cell (r = -0.32, P < 0.0001), and delta -cell (r = -0.25, P < 0.0001) areas. In conclusion, islet amyloidosis occurs uniformly throughout the pancreas, affecting all islets before becoming severe. A reduction in islet endocrine mass starts at this early stage of islet amyloid development and progresses as amyloid mass increases. C1 Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98195 USA. RP Kahn, SE (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, 151,1660 S Columbian Way, Seattle, WA 98108 USA. OI Kahn, Steven/0000-0001-7307-9002; Hull, Rebecca/0000-0001-9690-4087 FU NIDDK NIH HHS [DK-50703, DK-17047] NR 27 TC 45 Z9 46 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0012-1797 J9 DIABETES JI Diabetes PD NOV PY 2001 VL 50 IS 11 BP 2514 EP 2520 DI 10.2337/diabetes.50.11.2514 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 488CJ UT WOS:000171917200014 PM 11679429 ER PT J AU Hassani, S Braunstein, GD Seibel, MJ Brickman, AS Geola, F Pekary, AE Hershman, JM AF Hassani, S Braunstein, GD Seibel, MJ Brickman, AS Geola, F Pekary, AE Hershman, JM TI Alendronate therapy of primary hyperparathyroidism SO ENDOCRINOLOGIST LA English DT Article ID BONE-MINERAL DENSITY; POSTMENOPAUSAL WOMEN; PARATHYROID SURGERY; CALCIUM; DIPHOSPHONATE; OSTEOPOROSIS; REPLACEMENT AB There is a growing interest in preventing bone loss through medical treatment of patients with primary hyperparathyroidism who have mild asymptomatic disease or who are not candidates for surgical parathyroidectomy. Bisphosphonates are inhibitors of bone resorption and could be useful to improve the bone resorption of hyperparathyroidism. There fore, we conducted a controlled trial of alendronate therapy in patients with primary hyperparathyroidism. Participants were 45 asymptomatic patients with primary hyperparathyroidism who either had mild disease or a coexistent disease making surgical therapy hazardous or who refused parathyroidectomy. Their femoral bone mineral density (BMD) was in the osteoporotic or osteopenic range. Eight assigned to alendronate therapy had complete biochemical studies performed prospectively before therapy, then after 1 month, and every 2 months for 1 year. Another 37 patients were assigned as: 11 to the alendronate group and 26 to the nonalendronate or control group; all of them had regular follow-up with their endocrinologists. All the patients administered the alendronate therapy were administered 10 mg/d of alendronate for 1 year. Bone mineral density was measured by dual-energy x-ray absorptiometry at the lumbar spine and proximal femur initially and at 12 months in all patients. Eight patients had measurement of BMD of the radius and a complete biochemical profile. By 12 months, patients using alendronate had a significant increase in BMD at the lumbar spine by 3.38% and at the femoral neck by 3.05%. In contrast, the control group had losses of 1.41% at the lumbar spine and 0.80% at the femoral neck. The markers of bone turnover (urine pyridinoline and deoxypyridinoline) decreased in the eight patients using alendronate at 1 to 4 months. The serum total alkaline phosphatase level decreased significantly at 6 months and remained decreased at 12 months. Serum calcium, phosphorus, intact parathyroid hormone, 1,25-dihydroxyvitamin D-3. and 25-hydroxyvitamin D levels did not change significantly, but there was a small increase in ionized calcium at 6 months. We conclude that in patients with hyperparathyroidism, alendronate prevents bone loss and significantly improves BMD at the lumbar spine and femoral neck. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Kaiser Permanente Med Ctr, Woodland Hills, CA USA. Univ Calif Los Angeles, Cedars Sinai Med Ctr, Dept Med, Los Angeles, CA 90048 USA. Concord Hosp, Dept Endocrinol & Metab, Sydney, NSW, Australia. W Los Angeles VA Med Ctr, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Hershman, JM (reprint author), VA Greater Los Angeles Healthcare Syst, Endocrinol-111D,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 28 TC 16 Z9 17 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1051-2144 J9 ENDOCRINOLOGIST JI Endocrinologist PD NOV-DEC PY 2001 VL 11 IS 6 BP 459 EP 464 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 501EC UT WOS:000172669000005 ER PT J AU Hazzard, WR AF Hazzard, WR TI Clinical investigation: But why? SO EXPERIMENTAL BIOLOGY AND MEDICINE LA English DT Editorial Material C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Hazzard, WR (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,S-GEC-182, Seattle, WA 98108 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SOC EXPERIMENTAL BIOLOGY MEDICINE PI MAYWOOD PA 195 WEST SPRING VALLEY AVE, MAYWOOD, NJ 07607-1727 USA SN 0037-9727 J9 EXP BIOL MED JI Exp. Biol. Med. PD NOV PY 2001 VL 226 IS 10 BP 871 EP 872 PG 2 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 487RU UT WOS:000171889700001 PM 11682692 ER PT J AU Meyer, JH Lembo, A Elashoff, JD Fass, R Mayer, EA AF Meyer, JH Lembo, A Elashoff, JD Fass, R Mayer, EA TI Duodenal fat intensifies the perception of heartburn SO GUT LA English DT Article DE gastro-oesophageal reflux disease; heartburn; perception; fat ID LOWER ESOPHAGEAL SPHINCTER; NUTRIENT-DRIVEN SATIETY; GASTROESOPHAGEAL-REFLUX; ACID EXPOSURE; SMALL-INTESTINE; MEALS; MECHANOSENSITIVITY; MODULATION; HUMANS AB Background-Patients with gastrooesophageal reflux disease (GORD) frequently report that meals high in fat worsen heartburn. Nevertheless, studies to determine whether high fat meals promote gastro-oesophageal reflux have produced conflicting and equivocal conclusions. Patients and methods-To determine, alternatively, whether fat in the small intestinal lumen intensifies the perception of heartburn, we studied 11 patients with typical heartburn from GORD. After being placed on omeprazole to suppress endogenous acid, these fasting subjects underwent oesophageal perfusions with graded doses of HCl at pH values of 1.0, 1.5, 2.0, and 2.5. Oesophageal perfusions were conducted while the duodenum was perfused with saline (control) and again with fat at 8 g/h. Results-Time to onset, intensity, and severity of heartburn varied with dose of oesophageal acid (p < 0.01). Time to onset was significantly (p < 0.01) shorter, and intensity and severity of heartburn significantly (p < 0.05) greater, during duodenal perfusion with fat. Conclusion-We conclude that duodenal fat intensifies the perception of heartburn. C1 Univ Calif Los Angeles, Sch Med,Dept Med,Div Gastroenterol, W Los Angeles Healthcare Syst, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, CURE, Neuroenter Dis Program, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Cedars Sinai Med Ctr, Biostat Core Res Inst, Los Angeles, CA USA. RP Mayer, EA (reprint author), W Los Angeles Vet Affairs Med Ctr, Rm 223,Bldg 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM emayer@ucla.edu NR 27 TC 30 Z9 34 U1 0 U2 4 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD NOV PY 2001 VL 49 IS 5 BP 624 EP 628 DI 10.1136/gut.49.5.624 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 483PX UT WOS:000171645500009 PM 11600463 ER PT J AU Vernig, PG Schumacher, TA AF Vernig, PG Schumacher, TA TI Nuclear medicine survey recommendations for a changing regulatory environment SO HEALTH PHYSICS LA English DT Article DE operational topic; radiopharmaceuticals; surveys; regulations AB The revision of 10 CFR 35 approved on 23 September 2000 and due for implementation in 2001, reduces the number of required radiation and contamination surveys to one ambient radiation survey each day when art administration requiring a written directive is used. This paper compares the current requirements in 10 CFR 35; the single, remaining, specific requirement in the revised part 35; the Nuclear Regulatory Commission's guidance in the proposed NUREG SR1556 and the general requirement for surveys to demonstrate compliance with 10 CFR 20. We also make recommendations on what periodic surveys are prudent. C1 Denver VA Med Ctr, Denver, CO USA. RP Vernig, PG (reprint author), 1055 Clermont St, Denver, CO 80220 USA. EM peter.vernig@med.va.gov NR 7 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0017-9078 EI 1538-5159 J9 HEALTH PHYS JI Health Phys. PD NOV PY 2001 VL 81 IS 5 SU S BP S70 EP S74 DI 10.1097/00004032-200111001-00012 PG 5 WC Environmental Sciences; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging GA 485PD UT WOS:000171762000013 PM 11669196 ER PT J AU Small, GW Chen, ST Komo, S Ercoli, L Miller, K Siddarth, P Kaplan, A Dorsey, D Lavretsky, H Saxena, S Bookheimer, SY AF Small, GW Chen, ST Komo, S Ercoli, L Miller, K Siddarth, P Kaplan, A Dorsey, D Lavretsky, H Saxena, S Bookheimer, SY TI Memory self-appraisal and depressive symptoms in people at genetic risk for Alzheimer's disease SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE subjective memory; apolipoprotein E-4; depressive symptoms; memory self-appraisal; age-related cognitive decline; memory complaint ID LATE-ONSET DEPRESSION; LATE-LIFE DEPRESSION; E ALLELE EPSILON-4; APOLIPOPROTEIN-E; OLDER ADULTS; FUNCTIONING QUESTIONNAIRE; COGNITIVE CHANGE; ASSOCIATION; COMMUNITY; PERFORMANCE AB Objective A previous study found that subjective memory loss in middle-aged and older persons is associated with the major genetic risk for Alzheimer's disease, the apolipoprotein E-4 (APOE-4) allele. No previous study has focused on subjective memory complaints and depressive symptoms in the same subject population at genetic risk for Alzheimer's disease. Method Sixty-six persons (mean age = 64 years, range = 43 to 82 years) without major depression or dementia but with mild age-related memory complaints were rated for severity of depressive symptoms, using the Hamilton Depression Rating Scale, and assessed for the presence of the APOE-4 allele. Severity of subjective memory loss was assessed using the Memory Functioning Questionnaire, which measures four memory domains: frequency of forgetting, seriousness of forgetting, retrospective functioning, and mnemonics usage. Results Depressive symptoms were significantly associated with subjective memory loss in subjects without the APOE-4 allele, for retrospective functioning (perceived change in memory) and mnemonics usage, but not in APOE-4 carriers. The same significant associations were found when the analysis was limited to the 44 subjects in the mid-age range (55-74 years), wherein APOE-4 confers its greatest effects on risk for Alzheimer's disease. Conclusions These results confirm that mild depressive symptoms are related to subjective memory loss, but for some forms of memory complaint, the relationship holds true only for people without the major known genetic risk for Alzheimer's disease. Copyright (C) 2001 John Wiley & Sons, Ltd. C1 Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Alzheimers Dis Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Ctr Aging, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Small, GW (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, 760 Westwood Plaza,Room 88-201, Los Angeles, CA 90024 USA. RI Lavretsky, Helen/M-5711-2015 OI Lavretsky, Helen/0000-0001-9990-5085 FU CSR NIH HHS [RG2-96-051]; NCRR NIH HHS [M01 RR00856-21]; NIA NIH HHS [AG13308, AG10123, AG05128, AG11268]; NIMH NIH HHS [MH52453]; NINDS NIH HHS [NS26630, NS31153] NR 31 TC 21 Z9 21 U1 1 U2 2 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD NOV PY 2001 VL 16 IS 11 BP 1071 EP 1077 DI 10.1002/gps.481 PG 7 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 494RW UT WOS:000172300500009 PM 11746653 ER PT J AU Robinson-Whelen, S Tada, Y MacCallum, RC McGuire, L Kiecolt-Glaser, JK AF Robinson-Whelen, S Tada, Y MacCallum, RC McGuire, L Kiecolt-Glaser, JK TI Long-term caregiving: What happens when it ends? SO JOURNAL OF ABNORMAL PSYCHOLOGY LA English DT Article ID BECK DEPRESSION INVENTORY; OLDER-ADULTS; CHRONIC STRESS; BEREAVEMENT SUPPORT; ALZHEIMERS-DISEASE; SOCIAL SUPPORT; FAMILY; SYMPTOMS; DEMENTIA; DEATH AB Data from a longitudinal study were used to examine what happens to caregivers in the years after their cognitively impaired spouse dies. Comparisons of 42 current caregivers, 49 former caregivers, and 52 noncaregivers over a 4-year period showed that former caregivers did not improve on several measures of psychological well-being. Although former caregivers experienced decreases in stress and negative affect, their scores on depression, loneliness, and positive affect did not rebound to levels comparable to noncaregivers and, in fact, remained similar to those of current caregivers up to 3 years after caregiving had ceased. The most consistent predictors of postcaregiving outcomes were social support and intrusive-avoidant thinking about caregiving. The data suggest that some consequences of long-term caregiving may be long-term as well. The needs of former spousal caregivers warrant greater attention both in research and in practice. C1 Houston VAMC, Ctr Excellence Healthy Aging Disabil, Houston, TX 77030 USA. Ohio State Univ, Dept Psychol, Columbus, OH 43210 USA. Ohio State Univ, Dept Psychiat, Columbus, OH 43210 USA. RP Robinson-Whelen, S (reprint author), Houston VAMC, Ctr Excellence Healthy Aging Disabil, 153, Houston, TX 77030 USA. EM susanrw@bcm.tmc.edu RI Kiecolt-Glaser, Janice/A-3236-2009 OI Kiecolt-Glaser, Janice/0000-0003-4900-9578 FU NIA NIH HHS [P01 AG11585]; NIMH NIH HHS [R01 MH50538, K02 MH01467, R37 MH42096] NR 58 TC 58 Z9 62 U1 3 U2 14 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0021-843X J9 J ABNORM PSYCHOL JI J. Abnorm. Psychol. PD NOV PY 2001 VL 110 IS 4 BP 573 EP 584 DI 10.1037//0021-843X.110.4.573 PG 12 WC Psychology, Clinical; Psychology, Multidisciplinary SC Psychology GA 491KK UT WOS:000172107400008 PM 11727947 ER PT J AU Amory, JK Anawalt, BD Bremner, WJ Matsumoto, AM AF Amory, JK Anawalt, BD Bremner, WJ Matsumoto, AM TI Daily testosterone and gonadotropin levels are similar in azoospermic and nonazoospermic normal men administered weekly testosterone: Implications for male contraceptive development SO JOURNAL OF ANDROLOGY LA English DT Article DE contraception; gonadotropins; azoospermia ID FOLLICLE-STIMULATING-HORMONE; LUTEINIZING-HORMONE; SPERM PRODUCTION; SPERMATOGENESIS; ENANTHATE; COMBINATION; SUPPRESSION; EFFICACY AB Weekly intramuscular administration of testosterone esters such as testosterone enanthate (TE) suppresses gonadotropins and spermatogenesis and has been studied as a male contraceptive. For unknown reasons, however, some men fail to achieve azoospermia with such regimens. We hypothesized that either 1) daily circulating serum fluoroimmunoreactive gonadotropins were higher or testosterone levels were lower during the weekly injection interval, or 2) monthly circulating bioactive gonadotropin levels were higher in nonazoospermic men. We therefore analyzed daily testosterone and fluoroimmunoreactive gonadotropin levels as well as pooled monthly bioactive and fluoroimmunoreactive gonadotropin levels in normal men receiving chronic TE injections and correlated these levels with sperm production. After a 3-month control period, 51 normal men were randomly assigned to receive intramuscular TE at 25 mg (n = 10), 50 mg (n = 9), 100 mg (n = 10), 300 mg (n = 10), or placebo (n = 12) weekly for 6 months. After 5 months of testosterone administration, morning testosterone and fluoroimmunoreactive follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured daily for a 1-week period between TE injections. In addition, fluoroimmunoreactive and bioactive FSH and LH levels were measured in pooled monthly blood samples drawn just before the next TE injection. In the 100-mg and 300-mg TE groups, mean monthly fluoroimmunoreactive FSH and LH levels were suppressed by 86%-97%, bioactive FSH and LH levels by 62%-80%, and roughly half the subjects became azoospermic. In the 1-week period of month 6, daily testosterone levels between TE injections were within the normal range in men receiving placebo, or 25 or 50 mg of weekly TE, but were significantly elevated in men receiving 100 or 300 mg of weekly TE. At no point during treatment, however, were there significant differences in daily testosterone or fluoroimmunoreactive gonadotropin levels, or monthly bioactive gonadotropin levels between men achieving azoospermia and those with persistent spermatogenesis. This study, therefore, demonstrates that neither monthly nor daily differences in serum testosterone, or fluoroimmunoreactive or bioactive gonadotropins explain why some men fail to completely suppress their sperm counts to zero with weekly TE administration. Innate differences in the testicle's ability to maintain spermatogenesis in a low-gonadotropin environment may explain persistent spermatogenesis in some men treated with androgen-based contraceptive regimens. C1 Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Populat Ctr Res Reprod, Seattle, WA USA. Univ Washington, Clin Res Ctr, Seattle, WA 98195 USA. RP Univ Washington, Sch Med, Dept Med, Box 356429,1959 NE Pacific St, Seattle, WA 98195 USA. EM jamory@u.washington.edu FU NCRR NIH HHS [RR-37]; NICHD NIH HHS [P-50-HD-12629] NR 18 TC 27 Z9 27 U1 0 U2 0 PU AMER SOC ANDROLOGY, INC PI LAWRENCE PA C/O ALLEN PRESS, INC PO BOX 368, LAWRENCE, KS 66044 USA SN 0196-3635 EI 1939-4640 J9 J ANDROL JI J. Androl. PD NOV-DEC PY 2001 VL 22 IS 6 BP 1053 EP 1060 PG 8 WC Andrology SC Endocrinology & Metabolism GA 487FU UT WOS:000171863600016 PM 11700852 ER PT J AU Cradock, J Young, AS Sullivan, G AF Cradock, J Young, AS Sullivan, G TI The accuracy of medical record documentation in schizophrenia SO JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH LA English DT Article ID MENTAL-HEALTH; RATING-SCALE; QUALITY; CARE; DEPRESSION; AGREEMENT; SERVICES AB Medical records are commonly used to measure quality of care. However, little is known about how accurately they reflect patients' clinical condition. Even less is understood about what influences the accuracy of provider's documentation and whether patient characteristics impact documentation habits. Discrepancies between symptoms and side effects evaluated by direct assessment and medical records were examined for 224 patients with schizophrenia at two public mental health clinics. Multivariate regression was used to study the relationship between patient, provider; and treatment characteristics and documentation accuracy. Overall, documentation of symptoms and side effects was frequently absent. Documentation varied substantially between clinics, and it was generally less likely for patients who were severely ill, black, or perceived as noncompliant. The accuracy and consistency of medical record documentation should be demonstrated before using it to evaluate care at public mental health clinics. C1 W Lost Angeles Vet Healthcare Ctr, VISN MIRECC 22, Los Angeles, CA 90073 USA. Dept Vet Affairs, VISN MIRECC 22, Hlth Serv Unit, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. Univ Arkansas Med Sci, Little Rock, AR 72205 USA. Dept Vet Affairs, VISN MIRECC 16, Little Rock, AR USA. RP Cradock, J (reprint author), W Lost Angeles Vet Healthcare Ctr, VISN MIRECC 22, 11301 Wilshire Blvd,Bldg 210A, Los Angeles, CA 90073 USA. RI Young, Alexander/A-1523-2009 OI Young, Alexander/0000-0002-9367-9213 FU NIMH NIH HHS [P50 MH-54623] NR 28 TC 34 Z9 34 U1 0 U2 0 PU ASPEN PUBL INC PI GAITHERSBURG PA 200 ORCHARD RIDGE DR, STE 200, GAITHERSBURG, MD 20878 USA SN 1094-3412 J9 J BEHAV HEALTH SER R JI J. Behav. Health Serv. Res. PD NOV PY 2001 VL 28 IS 4 BP 456 EP 465 DI 10.1007/BF02287775 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 492NX UT WOS:000172175400006 PM 11732247 ER PT J AU Klein, RF Carlos, AS Vartanian, KA Chambers, VK Turner, RJ Phillips, TJ Belknap, JK Orwoll, ES AF Klein, RF Carlos, AS Vartanian, KA Chambers, VK Turner, RJ Phillips, TJ Belknap, JK Orwoll, ES TI Confirmation and fine mapping of chromosomal regions influencing peak bone mass in mice SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article DE bone mineral density; osteoporosis; heredity; quantitative trait; quantitative trait locus analysis ID QUANTITATIVE TRAIT LOCI; RECOMBINANT INBRED STRAINS; GENETIC DISSECTION; COMPLEX TRAITS; MINERAL DENSITY; MOUSE STRAINS; LINKAGE; QTL; OSTEOPENIA; FRACTURE AB Bone mineral density (BMD) is determined by both environmental influences and polygenic inheritance. The extreme difficulty of dissecting out environmental factors from genetic ones in humans has motivated the investigation of animal models. Previously, we used quantitative trait locus (QTL) analysis to examine peak BMD in 24 recombinant inbred (RI) mouse strains, derived from a cross between C57BL/6 (B6) and DBA/2 (D2) progenitors (RI-BXD). The distribution of BMD values among these strains indicated strong genetic influences and a number of chromosomal sites linked to BMD were identified provisionally. Using three additional independent mapping populations derived from the same progenitors, we have confirmed loci on chromosomes 1, 2, and 4, and 11 that contain genes that influence peak BMD. Using a novel fine-mapping approach (RI segregation testing [RIST]), we have substantially narrowed two of the BMD-related chromosomal regions and in the process eliminated a number of candidate genes. The homologous regions in the human genome for each of these murine QTLs have been identified in recent human genetic studies. In light of this, we believe that findings in mice should aid in the identification of specific candidate genes for study in humans. C1 Oregon Hlth Sci Univ, Dept Med, Bone & Mineral Res Unit, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Dept Med, Bone & Mineral Res Unit, Portland, OR USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Dept Behav Neurosci, Portland, OR USA. RP Klein, RF (reprint author), Oregon Hlth Sci Univ, Dept Med, Bone & Mineral Res Unit, Portland, OR 97201 USA. OI Orwoll, Eric/0000-0002-8520-7355 NR 35 TC 43 Z9 44 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD NOV PY 2001 VL 16 IS 11 BP 1953 EP 1961 DI 10.1359/jbmr.2001.16.11.1953 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 484NE UT WOS:000171695800003 ER PT J AU Orwoll, ES Belknap, JK Klein, RF AF Orwoll, ES Belknap, JK Klein, RF TI Gender specificity in the genetic determinants of peak bone mass SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article DE quantitative trait; gender; osteoporosis; bone mineral density; mouse ID QUANTITATIVE TRAIT LOCI; RECOMBINANT INBRED STRAINS; MINERAL DENSITY; OLDER WOMEN; MICE; SEX; RATS; IDENTIFICATION; LINKAGE; OSTEOPOROSIS AB Peak bone mass is a major determinant of osteoporotic fracture risk. Gender differences in peak bone mass acquisition are well recognized in humans and may account for a substantial share of the increased prevalence of fragility fractures in women compared with men. Skeletal development is regulated by both heritable and environmental factors. Experimental animal models provide a means to circumvent complicating environmental factors. In this study we examined the heritability of peak bone mineral density (BMD) in genetically distinct laboratory mouse strains raised under strict environmental control and sought to identify genetic loci that may contribute to gender differences in this skeletal phenotype. Peak whole body BMD of male and female mice from a panel of 18 recombinant inbred (RI) strains derived from a cross between C57BL/6 and DBA/2 progenitors (BXD) was measured by dual-energy X-ray absorptiometry (DXA). A, highly significant relationship existed between body weight and BMD in the BXD RI mice (r(2) = 0.25; p = 1 x 10(-43)). To allow for comparison between male and female RI strains, whole body BMD values were corrected for the influence of body weight. The distribution of weight-corrected BMD (WC-BMD) values among the strains indicated the presence of strong genetic influences in both genders, with an estimated narrow sense heritability of 45% and 22% in male and female mice, respectively. Comparison of RI strain results by two-way analysis of variance (ANOVA) revealed a significant strain-by-gender interaction (F-1,F-17,F-479 = 6.13; p < 0.0001). Quantitative trait locus (QTL) analysis of the BXD RI strain series provisionally identified nine chromosomal sites linked to peak bone mass development in males and seven regions in females. In two cases, the provisional chromosomal loci were shared between genders, but in most cases they were distinct (five female-specific QTLs and six male-specific QTLs). QTL analysis of a genetically heterogeneous F-2 population derived from the B6 and D2 progenitor strains provided additional support for the gender specificity of two loci. A significant phenotype-genotype correlation was only observed in male F-2 mice at microsatellite marker D7Mit114 on chromosome 7, and a correlation at D2Mit94 on chromosome 2 was only observed in female F-2 mice. The present data highlight the important role of gender in the genetic basis of peak bone mass in laboratory mice. Because the male phenotype is associated with considerable fracture risk reduction, an elucidation of the nature of that effect could provide the basis for novel diagnostic, preventative, or therapeutic approaches. C1 Oregon Hlth Sci Univ, Dept Med, Bone & Mineral Res Unit, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Bone & Mineral Res Unit, Dept Med, Portland, OR USA. Portland Vet Affairs Med Ctr, Dept Behav Neurosci, Portland, OR USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. RP Orwoll, ES (reprint author), Oregon Hlth Sci Univ, Dept Med, Bone & Mineral Res Unit, Portland, OR 97201 USA. OI Orwoll, Eric/0000-0002-8520-7355 FU NIAAA NIH HHS [AA 10760]; NIAMS NIH HHS [AR 44659, R01 AR044659, R01 AR044659-08] NR 48 TC 144 Z9 146 U1 0 U2 5 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD NOV PY 2001 VL 16 IS 11 BP 1962 EP 1971 DI 10.1359/jbmr.2001.16.11.1962 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 484NE UT WOS:000171695800004 PM 11697792 ER PT J AU Minshew, NJ Goldstein, G AF Minshew, NJ Goldstein, G TI The pattern of intact and impaired memory functions in autism SO JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES LA English DT Article DE Autistic Disorder; memory; learning; abstract reasoning; concept formation; information processing ID DIAGNOSTIC INTERVIEW; INFANTILE-AUTISM; CHILDREN; INDIVIDUALS; DISORDER AB A battery of tests of auditory and visual memory was used to investigate memory function in 52 high-functioning adolescents and young adults with autism and 40 group-matched normal controls. It was hypothesized that memory dysfunction is present in autism but is not modality specific and is produced by poor utilization of organizing strategies. It was therefore hypothesized that memory impairment in autism would become more prominent as task complexity was increased. The participants with autism performed as well as controls on short-term memory and paired-associate learning tasks, but performed significantly less well than controls on a list learning task. They also performed significantly more poorly on immediate and delayed recall of a story and of a complex geometric figure. On a maze learning task, their performance became progressively worse relative to controls as the complexity of the maze increased. On a series of span tasks, they did not differ from controls on letter span, but did significantly worse on word span and sentences of increasing complexity. These findings indicate a lack of modality specificity and a failure to initiate organizing strategies as evidenced by inefficiency in new learning, poor utilization of contextual cues in story and complex pattern recall, and greater impairment with increasing complexity of the material. C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Minshew, NJ (reprint author), Western Psychiat Inst & Clin, Dept Psychiat, 3811 OHara St,Suite 430,Bellefield Towers Bldg, Pittsburgh, PA 15213 USA. FU NICHD NIH HHS [HD35469]; NINDS NIH HHS [NS33355] NR 36 TC 110 Z9 110 U1 0 U2 11 PU BLACKWELL PUBL LTD PI OXFORD PA 108 COWLEY RD, OXFORD OX4 1JF, OXON, ENGLAND SN 0021-9630 J9 J CHILD PSYCHOL PSYC JI J. Child Psychol. Psychiatry Allied Discip. PD NOV PY 2001 VL 42 IS 8 BP 1095 EP 1101 DI 10.1111/1469-7610.00808 PG 7 WC Psychology, Developmental; Psychiatry; Psychology SC Psychology; Psychiatry GA 515FM UT WOS:000173484800013 PM 11806691 ER PT J AU Phillips, SA Rotman-Pikielny, P Lazar, J Ando, S Hauser, P Skarulis, MC Brucker-Davis, F Yen, PM AF Phillips, SA Rotman-Pikielny, P Lazar, J Ando, S Hauser, P Skarulis, MC Brucker-Davis, F Yen, PM TI Extreme thyroid hormone resistance in a patient with a novel truncated TR mutant SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID RECEPTOR-BETA GENE; GENERALIZED RESISTANCE; TRANSCRIPTIONAL REGULATION; BINDING DOMAIN; LIGAND-BINDING; MUTATION; FAMILIES; MICE; EXPRESSION; PHENOTYPE AB Resistance to thyroid hormone (RTH) is a syndrome in which patients have elevated thyroid hormone (TH) levels and decreased sensitivity to its action. We describe a child with extreme RTH and a severe phenotype. A 22-month-old female presented to the NIH with goiter, growth retardation, short stature, and deafness. Additionally, the patient had hypotonia, mental retardation, visual impairment, and a history of seizures. Brain magnetic resonance imaging showed evidence of demyelination and bilateral ventricular enlargement. The patient had markedly elevated free T(3) and free T(4) levels of more than 2000 pg/dl (normal, 230-420 pg/dl) and more than 64 pmol/liter (normal, 10.3-20.6 pmol/liter), respectively, and TSH of 6.88 mU/liter (normal, 0.6-6.3 mU/liter). These are the highest TH levels reported for a heterozygous RTH patient. A T(3) stimulation test confirmed the diagnosis of RTH in the pituitary and peripheral tissues. Molecular analyses of the patient's genomic DNA by PCR identified a single base deletion in exon 10 of her TR beta gene that resulted in a frameshift and early stop codon. This, in turn, encoded a truncated receptor that lacked the last 20 amino acids. Cotransfection studies showed that the mutant TR was transcriptionally inactive even in the presence of 10(-6) M T(3) and had strong dominant negative activity over the wild-type receptor. It is likely that the severely defective TR beta mutant contributed to the extreme RTH phenotype and resistance in our patient. C1 NIDDKD, Clin Endocrinol Branch, Mol Regulat & Neuroendocrinol Sect, NIH, Bethesda, MD 20892 USA. Univ Maryland, Sch Med, Baltimore, MD 21201 USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Univ Nice, Ctr Hosp, Dept Med, Nice, France. RP Yen, PM (reprint author), NIDDKD, Clin Endocrinol Branch, Mol Regulat & Neuroendocrinol Sect, NIH, Bldg 10,Room 8D12, Bethesda, MD 20892 USA. EM pauly@intra.niddk.nih.gov NR 34 TC 15 Z9 17 U1 0 U2 2 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD NOV PY 2001 VL 86 IS 11 BP 5142 EP 5147 DI 10.1210/jc.86.11.5142 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 491YK UT WOS:000172137600008 PM 11701667 ER PT J AU Maianu, L Keller, SR Garvey, WT AF Maianu, L Keller, SR Garvey, WT TI Adipocytes exhibit abnormal subcellular distribution and translocation of vesicles containing glucose transporter 4 and insulin-regulated aminopeptidase in type 2 diabetes mellitus: Implications regarding defects in vesicle trafficking SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID GLUT4 GLUCOSE TRANSPORTERS; SKELETAL-MUSCLE; 3T3-L1 ADIPOCYTES; MEMBRANE AMINOPEPTIDASE; PRETRANSLATIONAL SUPPRESSION; PLASMA-MEMBRANE; ADIPOSE-CELLS; RESISTANCE; PROTEIN; OBESITY AB Insulin resistance in type 2 diabetes is due to impaired stimulation of the glucose transport system in muscle and fat. Different defects are operative in these two target tissues because glucose transporter 4 (GLUT 4) expression is normal in muscle but markedly reduced in fat. In muscle, GLUT 4 is redistributed to a dense membrane compartment, and insulin-mediated translocation to plasma membrane (PM) is impaired. Whether similar trafficking defects are operative in human fat is unknown. Therefore, we studied subcellular localization of GLUT4 and insulin-regulated aminopeptidase (IRAP; also referred to as vp165 or gp160), which is a constituent of GLUT4 vesicles and also translocates to PM in response to insulin. Subcutaneous fat was obtained from eight normoglycemic control subjects (body mass index, 29 +/- 2 kg/m(2)) and eight type 2 diabetic patients (body mass index, 30 +/- 1 kg/m(2); fasting glucose, 14 +/- 1 mm). In adipocytes isolated from diabetics, the basal 3-O-methylglucose transport rate was decreased by 50% compared with controls (7.1 +/- 2.9 vs. 14.1 +/- 3.7 mmol/mm(2) surface area/min), and there was no increase in response to maximal insulin (7.9 +/- 2.7 vs. 44.5 +/- 9.2 in controls). In membrane subfractions from controls, insulin led to a marked increase of IRAP in the PM from 0.103 +/- 0.04 to 1.00 +/- 0.33 relative units/mg protein, concomitant with an 18% decrease in low-density microsomes and no change in high-density microsomes (HDM). In type 2 diabetes, IRAP overall expression in adipocytes was similar to that in controls; however, two abnormalities were observed. First, in basal cells, IRAP was redistributed away from low-density microsomes, and more IRAP was recovered in HDM (1.2-fold) and PM (4.4-fold) from diabetics compared with controls. Second, IRAP recruitment to PM by maximal insulin was markedly impaired. GLUT4 was depleted in all membrane subfractions (43-67%) in diabetes, and there was no increase in PM GLUT4 in response to insulin. Type 2 diabetes did not affect the fractionation of marker enzymes. We conclude that in human adipocytes: 1) IRAP is expressed and translocates to PM in response to insulin; 2) GLUT4 depletion involves all membrane subfractions in type 2 diabetes, although cellular levels of IRAP are normal; and 3) in type 2 diabetes, IRAP accumulates in membrane vesicles cofractionating with HDM and PM under basal conditions, and insulin-mediated recruitment to PM is impaired. Therefore, in type 2 diabetes, adipocytes express defects in trafficking of GLUT4/IRAP-containing vesicles similar to those causing insulin resistance in skeletal muscle. C1 Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. Univ Virginia, Sch Med, Dept Med, Charlottesville, VA 22908 USA. RP Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Dept Med, CSB323,96 Jonathan Lucas St, Charleston, SC 29425 USA. EM garveywt@musc.edu FU NCRR NIH HHS [M01-RR-1070]; NIDDK NIH HHS [DK-25336, DK-38764] NR 43 TC 54 Z9 59 U1 0 U2 2 PU ENDOCRINE SOC PI WASHINGTON PA 2055 L ST NW, SUITE 600, WASHINGTON, DC 20036 USA SN 0021-972X EI 1945-7197 J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD NOV PY 2001 VL 86 IS 11 BP 5450 EP 5456 DI 10.1210/jc.86.11.5450 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 491YK UT WOS:000172137600056 PM 11701721 ER PT J AU Meisler, A AF Meisler, A TI E1A is an oncogene and may immortalize normal cells, especially in combination with other oncoproteins SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Letter C1 Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Meisler, A (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD NOV 1 PY 2001 VL 19 IS 21 BP 4183 EP 4183 PG 1 WC Oncology SC Oncology GA 487WB UT WOS:000171901100017 PM 11689591 ER PT J AU Bayon, JE Pascolo, L Gonzalo-Orden, JM Altonaga, JR Gonzalez-Gallego, J Webster, C Haigh, WG Stelzner, M Pekow, C Tiribelli, C Ostrow, JD AF Bayon, JE Pascolo, L Gonzalo-Orden, JM Altonaga, JR Gonzalez-Gallego, J Webster, C Haigh, WG Stelzner, M Pekow, C Tiribelli, C Ostrow, JD TI Pitfalls in preparation of H-3-unconjugated bilirubin by biosynthetic labeling from precursor H-3-5-aminolevulinic acid in the dog SO JOURNAL OF LABORATORY AND CLINICAL MEDICINE LA English DT Article ID 5-AMINOLEVULINIC ACID; AMINOLEVULINIC-ACID; AQUEOUS-SOLUTION; UNCONJUGATED BILIRUBIN; NATIVE BILE; RAT; ANESTHESIA; MODEL; ISOFLURANE; METABOLISM AB We report problems encountered during preparation of tritium-labeled unconjugated bilirubin (H-3-UCB) from precursor H-3-5-aminolevulinic acid (H-3-ALA) in 2 dogs with external biliary drainage installed into the animals under general anesthesia. Under prolonged sedation, 12.9 or 14.0 mCi of H-3-ALA was administered intravenously in two divided doses, and bile was collected for 9 hours. In one animal, taurocholate (TC) infusion was needed to maintain bile flow. H-3-UCB was isolated from the bile and recrystallized with the improved method of Webster et al (Webster CC, Tiribelii! C, Ostrow JD. J Lab Clin Med 2001; 137:370-3). Based on radioactivity and pigment content, hourly bile collections were pooled to optimize specific activities. Surprisingly, in the first dog, only 2.9% of injected radioactivity was recovered in bile and only 14.1% in urine, and the specific activities of the crystalline H-3-UCB from the two pools were only 39.5 and 30.0 x 10(3) dpm/mug. High-performance liquid chromatography analysis revealed that only 4% of ALA degraded during 5 minutes in injection solution at pH 6.8. The low incorporation of H-3-ALA and low specific activity of H-3-UCB was apparently caused mainly by prior degradation and exchange of labile tritium of the H-3-ALA and probably by enhanced endogenous ALA synthesis caused by the anesthetic/sedative agents. Revised procedures in the second dog improved the incorporation of H-3-ALA to 11.9% excreted in bile and the specific activity of the crystalline H-3-UCB to 122.0 and 50.8 x 10(3) dpm/mug, while urinary excretion of tritium increased to 28.5%. These experiences emphasize possible pitfalls in preparing H-3-UCB by biosynthetic labeling from H-3-ALA administered to dogs. C1 Univ Leon, Dept Physiol, E-24071 Leon, Spain. Univ Leon, Dept Anim Pathol, E-24071 Leon, Spain. Univ Trieste, Dept Biochem Biophys & Chem Macromol, Trieste, Italy. Dept Vet Affairs Lakeside Med Ctr, Res Serv, Chicago, IL USA. Northwestern Univ, Div Gastroenterol Hepatol, Chicago, IL 60611 USA. Vet Affairs Puget Sound Hlth Care Syst, Res Serv, Gastroenterol Hepatol Lab, Seattle, WA USA. Univ Washington, Sch Med, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Surg Serv, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Vet Med Unit, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Comparat Med, Seattle, WA USA. Univ Amsterdam, Acad Med Ctr, Dept Gastroenterol Hepatol, NL-1105 AZ Amsterdam, Netherlands. RP Gonzalez-Gallego, J (reprint author), Univ Leon, Dept Physiol, E-24071 Leon, Spain. RI Gonzalez-Gallego, Javier/D-8219-2012 OI Gonzalez-Gallego, Javier/0000-0002-4386-9342 NR 36 TC 11 Z9 11 U1 1 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0022-2143 J9 J LAB CLIN MED JI J. Lab. Clin. Med. PD NOV PY 2001 VL 138 IS 5 BP 313 EP 321 DI 10.1067/mlc.2001.118746 PG 9 WC Medical Laboratory Technology; Medicine, General & Internal; Medicine, Research & Experimental SC Medical Laboratory Technology; General & Internal Medicine; Research & Experimental Medicine GA 494KE UT WOS:000172280700003 PM 11709655 ER PT J AU Boedeker, JC Doolittle, MH White, AL AF Boedeker, JC Doolittle, MH White, AL TI Differential effect of combined lipase deficiency (cld/cld) on human hepatic lipase and lipoprotein lipase secretion SO JOURNAL OF LIPID RESEARCH LA English DT Article DE calnexin; castanospermine; endoplasmic reticulum; fetal hepatocytes; glucosidase enzymes ID ENDOPLASMIC-RETICULUM; BROWN ADIPOCYTES; MOUSE; MICE; EXPRESSION; METABOLISM; CALNEXIN; PLASMA; GENE; CLD AB Combined lipase deficiency (cld) is a recessively inherited disorder in mice associated with a deficiency of LPL and hepatic lipase (HL) activity. LPL is synthesized in cld tissues but is retained in the endoplasmic reticulum (ER), whereas mouse HL (mHL) is secreted but inactive. In this study we investigated the effect of cld on the secretion of human HL (hHL) protein mass and activity. Differentiated liver cell lines were derived from cld mice and their normal heterozygous (het) littermates by transformation of hepatocytes with SV40 large T antigen. After transient transfection with lipase expression constructs, secretion of hLPL activity from cld cells was only 12% of that from het cells. In contrast, the rate of secretion of hHL activity and protein mass per unit of expressed hHL mRNA was identical for the two cell lines. An intermediate effect was observed for mHL, with a 46% reduction in secretion of activity from cld cells. The ER glucosidase inhibitor, castanospermine, decreased secretion of both hLPL and hHL from het cells by similar to 70%, but by only similar to 45% from cld cells. This is consistent with data suggesting that cld may result from a reduced concentration of the ER chaperone calnexin. In conclusion, our results demonstrate a differential effect of cld on hLPL, mHL, and hHL secretion, suggesting differential requirements for activation and exit of the enzymes from the ER. C1 Univ Texas, SW Med Ctr, Dept Internal Med, Dallas, TX 75390 USA. Univ Texas, SW Med Ctr, Ctr Human Nutr, Dallas, TX 75390 USA. W Los Angeles Vet Affairs Med Ctr, Lipid Res Lab, Los Angeles, CA 90073 USA. RP White, AL (reprint author), Univ Texas, SW Med Ctr, Dept Internal Med, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. NR 28 TC 10 Z9 11 U1 0 U2 0 PU LIPID RESEARCH INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0022-2275 J9 J LIPID RES JI J. Lipid Res. PD NOV PY 2001 VL 42 IS 11 BP 1858 EP 1864 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 498NQ UT WOS:000172517900015 PM 11714855 ER PT J AU Lim, GP Chu, T Yang, FS Beech, W Frautschy, SA Cole, GM AF Lim, GP Chu, T Yang, FS Beech, W Frautschy, SA Cole, GM TI The curry spice curcumin reduces oxidative damage and amyloid pathology in an Alzheimer transgenic mouse SO JOURNAL OF NEUROSCIENCE LA English DT Article DE Alzheimer's disease; inflammation; oxidative damage; anti-oxidant; microglia; plaque; interleukin-1 beta; Tg2576; APPswedish ID APOLIPOPROTEIN-E; LIPID-PEROXIDATION; IN-VIVO; PRECURSOR PROTEIN; BETA-PROTEIN; ALPHA-TOCOPHEROL; FIBRIL FORMATION; OXYGEN RADICALS; FATTY-ACIDS; DISEASE AB Inflammation in Alzheimer's disease (AD) patients is characterized by increased cytokines and activated microglia. Epidemiological studies suggest reduced AD risk associates with long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Whereas chronic ibuprofen suppressed inflammation and plaque-related pathology in an Alzheimer transgenic APPSw mouse model (Tg2576), excessive use of NSAIDs targeting cyclooxygenase I can cause gastrointestinal, liver, and renal toxicity. One alternative NSAID is curcumin, derived from the curry spice turmeric. Curcumin has an extensive history as a food additive and herbal medicine in India and is also a potent polyphenolic antioxidant. To evaluate whether it could affect Alzheimer-like pathology in the APPSw mice, we tested a low (160 ppm) and a high dose of dietary curcumin (5000 ppm) on inflammation, oxidative damage, and plaque pathology. Low and high doses of curcumin significantly lowered oxidized proteins and interleukin-1 beta, a proinflammatory cytokine elevated in the brains of these mice. With low-dose but not high-dose curcumin treatment, the astrocytic marker GFAP was reduced, and insoluble beta -amyloid (A beta), soluble A beta, and plaque burden were significantly decreased by 43-50%. However, levels of amyloid precursor (APP) in the membrane fraction were not reduced. Microgliosis was also suppressed in neuronal layers but not adjacent to plaques. In view of its efficacy and apparent low toxicity, this Indian spice component shows promise for the prevention of Alzheimer's disease. C1 Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Ctr Geriatr Res Educ & Clin, Dept Med,San Fernando Valley Program, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. RP Cole, GM (reprint author), Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Ctr Geriatr Res Educ & Clin, Dept Med,San Fernando Valley Program, GRECC11E,16111 Plummer St, Sepulveda, CA 91343 USA. FU NIA NIH HHS [AG13471, R01 AG013741, U01 AG028583] NR 73 TC 822 Z9 867 U1 15 U2 133 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD NOV 1 PY 2001 VL 21 IS 21 BP 8370 EP 8377 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 482ZL UT WOS:000171608600016 PM 11606625 ER PT J AU Fiedler, J Simon, FR Iwahashi, M Murphy, RC AF Fiedler, J Simon, FR Iwahashi, M Murphy, RC TI Effect of peroxisome proliferator-activated receptor a activation on leukotriene B-4 metabolism in isolated rat hepatocytes SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID OMEGA-OXIDATION; PPAR-ALPHA; ADULT-RAT; IDENTIFICATION; INFLAMMATION; EXPRESSION; ETHANOL; 5-LIPOXYGENASE; DEGRADATION; CHEMOTAXIS AB Leukotriene B-4 (LTB4) is a potent mediator of inflammation that recruits granulocytes to the site of injury during the inflammatory response. The biological activity of LTB4 is terminated by its metabolism into inactive metabolites. Recent studies have suggested that LTB4 may have additional activity as an endogenous ligand for the transcription factor peroxisome proliferator-activated receptor alpha (PPAR alpha). Based on the data presented, a model was proposed in which LTB4 acts in a negative feedback manner by inducing the transcription of genes involved its own metabolism. In the present study the effect of PPAR alpha activation on LTB4 metabolism was directly investigated. Primary cultures of rat hepatocytes were treated with LTB4 or the PPAR alpha agonist WY-14,643, and LTB4 metabolism was assessed by measuring levels of LTB4 and the formation of LTB4 metabolites. In addition, the effect of PPARa activation on levels of acyl-CoA oxidase mRNA and expression of CYP4F proteins, which are specific omega -hydroxylases for LTB4, was determined. Treatment of hepatocytes with WY-14,643, but not LTB4, was found to increase acyl-CoA oxidase mRNA and enhance expression of rat hepatic CYP4F proteins and CYP4A1. Neither WY-14,643 nor LTB4 caused an increase of the basal levels of LTB4 metabolism, and no novel metabolites were observed. These results do not support the hypothesis that a pathway of negative feedback regulation of LTB4 metabolism involving PPAR alpha exists in hepatocytes, because activation of PPAR alpha by LTB4 or other PPAR alpha agonists did not correlate with an increase in LTB4 metabolism. C1 Natl Jewish Med & Res Ctr, Div Cell Biol, Denver, CO 80206 USA. Univ Colorado, Hlth Sci Ctr, Div Gastroenterol, Denver, CO USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Murphy, RC (reprint author), Natl Jewish Med & Res Ctr, Div Cell Biol, 1400 Jackson St, Denver, CO 80206 USA. FU NHLBI NIH HHS [HL25785]; NIDDK NIH HHS [DK15851] NR 34 TC 16 Z9 16 U1 0 U2 0 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0022-3565 J9 J PHARMACOL EXP THER JI J. Pharmacol. Exp. Ther. PD NOV PY 2001 VL 299 IS 2 BP 691 EP 697 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 485PU UT WOS:000171764100035 PM 11602682 ER PT J AU Henry, C Mitropoulou, V New, AS Koenigsberg, HW Silverman, J Siever, LJ AF Henry, C Mitropoulou, V New, AS Koenigsberg, HW Silverman, J Siever, LJ TI Affective instability and impulsivity in borderline personality and bipolar II disorders: similarities and differences SO JOURNAL OF PSYCHIATRIC RESEARCH LA English DT Article DE borderline personality disorder; bipolar disorder; affective instability; affective intensity; aggression; impulsiveness ID DSM-III; DEPRESSION; INTERVIEW; RELIABILITY; COMORBIDITY; INTENSITY; BEHAVIOR; VALIDITY; TRAITS AB Objectives: many studies have reported a high degree of comorbidity between mood disorders, among which are bipolar disorders, and borderline personality disorder and some studies have suggested that these disorders are co-transmitted in families. However. few studies have compared personality traits between these disorders to determine whether there is a dimensional overlap between the two diagnoses. The aim of this study was to compare impulsivity, affective lability and intensity in patients with borderline personality and bipolar II disorder and in subjects with neither of these diagnoses. :Methods: patients with borderline personality but without bipolar disorder (n=29), patients with bipolar II disorder without borderline personality but with other personality disorders (n= 14), patients with both borderline personality and bipolar II disorder (n= 12), and patients with neither borderline personality nor bipolar disorder but other personality disorders (OPD: n=93) were assessed using the Affective Lability Scale (ALS), the Affect Intensity Measure (AIM), the Buss-Durkee Hostility Inventory (BDHI) and the Barratt Impulsiveness Scale (BIS-7B). Results: borderline personality patients had significantly higher ALS total scores (P <0.05) and bipolar II patients tended to have higher ALS scores than patients with OPD (P <0.06). On one of the ALS subscales, the borderline patients displayed significant higher affective lability between euthymia and anger (P <0.002), whereas patients with bipolar II disorder displayed affective lability between euthymia and depression (P <0.04), or elation (P <0.01) or between depression and elation (P < 0.01). A significant interaction between borderline personality and bipolar II disorder was observed for lability between anxiety and depression (P <0.01) with the ALS. High scores for impulsiveness (BISTOT, P <0.001) and hostility (BDHL P <0.05) were obtained for borderline personality patients only and no significant interactions between diagnoses were observed. Only borderline personality patients tended to have higher affective intensity (AIM, P <0.07). Conclusions: borderline personality disorder and bipolar II disorder appear to involve affective lability, which may account for the efficacy of mood stabilizers treatments in both disorders. However, our results suggest that borderline personality disorder cannot be viewed as an attenuated group of affective disorders. (C) 2001 Elsevier Science Ltd. All rights reserved. C1 Ctr Hosp Charles Perrens, Serv Univ Psychiat, F-33076 Bordeaux, France. Bronx Vet Adm Med Ctr, Bronx, NY 10468 USA. INSERM, U394, F-33077 Bordeaux, France. RP Siever, LJ (reprint author), Bronx Vet Adm Med Ctr, 116A,130 W Kingsbridge Rd, Bronx, NY 10468 USA. FU NCRR NIH HHS [5 M01 RR00071]; NIMH NIH HHS [R01-MH-41131] NR 39 TC 214 Z9 220 U1 0 U2 27 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3956 J9 J PSYCHIAT RES JI J. Psychiatr. Res. PD NOV-DEC PY 2001 VL 35 IS 6 BP 307 EP 312 DI 10.1016/S0022-3956(01)00038-3 PG 6 WC Psychiatry SC Psychiatry GA 502EU UT WOS:000172731400001 PM 11684137 ER PT J AU Bradley, KA Maynard, C Kivlahan, DR McDonell, MB Fihn, SD AF Bradley, KA Maynard, C Kivlahan, DR McDonell, MB Fihn, SD CA Ambulatory Care Quality Improvemen TI The relationship between alcohol screening questionnaires and mortality among male veteran outpatients SO JOURNAL OF STUDIES ON ALCOHOL LA English DT Article ID IDENTIFICATION TEST AUDIT; PRIMARY-CARE PATIENTS; ALL-CAUSE MORTALITY; USE DISORDERS; CONSUMPTION QUESTIONS; PROBLEM DRINKING; ADULTS; CAGE; POPULATION; WOMEN AB Objective: This study evaluated whether responses to alcohol screening questionnaires predicted mortality in a Department of Veterans Affairs (VA) primary care population. Method: This study involved 5,703 male outpatients (mean age = 64) who were enrolled in General Internal Medicine clinics at three Veterans Affairs (VA) medical centers and returned mailed questionnaires in 1993-94. The two questionnaires included the CAGE and Alcohol Use Disorders Identification Test (AUDIT) alcohol screening tests. Mortality was ascertained using the VA Beneficiary Identification and Record Locator System. Five-year crude and adjusted mortality rates were calculated for patients who screened positive and patients who screened negative on each alcohol screening test. Results: The risk of mortality was increased among drinkers who scored greater than or equal to8 on the full AUDIT (hazard ratio: 1.47; 95% confidence interval [Cl]: 1.08-2.00) or the three AUDIT consumption questions (1.59; 1.11-2.27), after adjusting for age, smoking, sociodemographic characteristics and chronic illnesses. The risk of mortality was also increased among drinkers who reported drinking greater than or equal to3 drinks daily (1.69; 1.28-2.22) or prior alcohol treatment (1.66; 1.27-2.17), in "fully adjusted" models. A positive CAGE score ( greater than or equal to2) was associated with significantly increased risk of mortality among drinkers in a model adjusted only for age and smoking (1.27; 1.02-1.58). Among nondrinkers, neither a positive CAGE score ( greater than or equal to2) nor report of prior alcohol treatment was associated with increased risk of mortality. Conclusions: VA outpatients who reported drinking during the previous year and who had a positive result on an alcohol screening test experienced higher mortality over the subsequent 5 years than did patients who screened negative. C1 VA Puget Sound Hlth Care Syst, NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98108 USA. RP Bradley, KA (reprint author), VA Puget Sound Hlth Care Syst, NW Hlth Serv Res & Dev Ctr Excellence, Mail Stop 152,1660 S Columbian Way, Seattle, WA 98108 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 FU NIAAA NIH HHS [K23 AA00313] NR 25 TC 29 Z9 29 U1 1 U2 1 PU ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV PI PISCATAWAY PA C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA SN 0096-882X J9 J STUD ALCOHOL JI J. Stud. Alcohol PD NOV PY 2001 VL 62 IS 6 BP 826 EP 833 PG 8 WC Substance Abuse; Psychology SC Substance Abuse; Psychology GA 517JU UT WOS:000173608000016 PM 11838920 ER PT J AU Watts, D Damasco-Ty, E Ryan, F Goodman, B AF Watts, D Damasco-Ty, E Ryan, F Goodman, B TI Geriatricians Health Survey 2000 SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE geriatrician; vitamin supplements; behavior ID CARDIOVASCULAR-DISEASE; MULTIVITAMIN USE; UNITED-STATES; OLDER ADULTS; PHYSICIANS; STROKE; WOMEN; RISK; SUPPLEMENTATION; ANTIOXIDANTS AB OBJECTIVES: To characterize geriatricians' preventive health behaviors including vitamin/supplement use, exercise, smoking, alcohol use, and weight control. DESIGN: Mailed questionnaire. SETTING: United States. PARTICIPANTS: Two thousand six hundred eleven U.S. physicians certified as having added qualifications in geriatric medicine and who were members in the American Geriatrics Society; 1,524 returned completed questionnaires (58%). MEASUREMENTS: Rates of supplement use and recommendations, preventive health visits, advance directive completion, exercise, religious service attendance, smoking, alcohol use, and amount of adult weight gain. RESULTS: Most responding geriatricians took at least one vitamin supplement: 50% vitamin E, 50% a multivitamin (MVI), and 31% vitamin C. Calcium ingestion was common among women. Other supplement use was uncommon: ginkgo compounds were consumed by 47 (3%), and 77 (5%) took a variety of other nonvitamin supplements. Over 90% recommended vitamins, especially multivitamins and vitamin E, at least sometimes. Recommendations for ginkgo (38%) and St. John's wort (33%) were also common. Almost half of respondents had completed a formal advance directive. Exercise was practiced at least weekly by 88%. Cigarette smoking was rare (1%), but at least occasional alcohol use was common (85%). Most of respondents were men (74%), and 35% had completed fellowship training. CONCLUSION: Vitamin/supplement use was common among responding geriatricians but not universal. Respondents often recommended MVI, vitamin E, and vitamin C, but were less likely to consume or recommend other supplements. The most common preventive health behavior among our respondents was exercise. C1 Univ Wisconsin, Sch Med, Dept Med, Sect Geriatr & Gerontol, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Watts, D (reprint author), Univ Wisconsin, Sch Med, Dept Med, Sect Geriatr & Gerontol, 2870 Univ Ave,Suite 100, Madison, WI 53705 USA. NR 26 TC 2 Z9 2 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD NOV PY 2001 VL 49 IS 11 BP 1535 EP 1538 DI 10.1046/j.1532-5415.2001.4911250.x PG 4 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 490MF UT WOS:000172055100019 PM 11890595 ER PT J AU Hazzard, WR AF Hazzard, WR TI What heterogeneity among centenarians can teach us about genetics, aging, and longevity SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Editorial Material ID APOLIPOPROTEIN-E; E PHENOTYPES; DYSBETALIPOPROTEINEMIA; POLYMORPHISM; DISEASE C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Hazzard, WR (reprint author), VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 12 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD NOV PY 2001 VL 49 IS 11 BP 1568 EP 1569 DI 10.1046/j.1532-5415.2001.4911256.x PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 490MF UT WOS:000172055100026 PM 11890602 ER PT J AU Binder, LM Storzbach, D Campbell, KA Rohlman, DS Anger, WK AF Binder, LM Storzbach, D Campbell, KA Rohlman, DS Anger, WK CA Portland Env Hazards Res Center TI Neurobehavioral deficits associated with chronic fatigue syndrome in veterans with Gulf War unexplained illnesses SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article DE chronic fatigue syndrome; cognitive function; Gulf War unexplained illnesses ID SYMPTOMS; PERFORMANCE; COMPUTER AB Gulf War unexplained illnesses (GWUI) are a heterogeneous collection of symptoms of unknown origin known to be more common among veterans of the Gulf War than among nonveterans. In the present study we focused on one of these unexplained il I nesses, We tested the hypothesis that in a sample of Persian Gulf War veterans chronic fatigue syndrome (CFS) was associated with cognitive deficits on computerized cognitive testing after controlling for the effects of premorbid cognitive differences. We obtained Armed Forces Qualification Test (AFQT) data acquired around the date of induction into the military on 94 veterans of the Gulf War, 32 with CFS and 62 healthy controls. Controls performed better than participants diagnosed with CFS on the AFQT. Cognitive deficits were associated with CFS on 3 of 8 variables after the effect of premorbid AFQT scores was removed with ANCOVA. C1 Oregon Hlth Sci Univ, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Binder, LM (reprint author), 4900 SW Griffith Dr,Suite 244, Beaverton, OR 97005 USA. NR 20 TC 16 Z9 16 U1 3 U2 6 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD NOV PY 2001 VL 7 IS 7 BP 835 EP 839 PG 5 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 496YV UT WOS:000172426700006 PM 11771626 ER PT J AU Paige, NM Hays, RD Litwin, MS Rajfer, J Shapiro, MF AF Paige, NM Hays, RD Litwin, MS Rajfer, J Shapiro, MF TI Improvement in emotional well-being and relationships of users of sildenafil SO JOURNAL OF UROLOGY LA English DT Article DE impotence; quality of life; questionnaires ID QUALITY-OF-LIFE; ERECTILE DYSFUNCTION; INDEX; MEN AB Purpose: We estimated the association of sildenafil use with erectile function, relationship with sexual partner, functional status and emotional well-being in men with erectile dysfunction. Materials and Methods: Letters were mailed to eligible patients at a university hospital urology and internal medicine clinic, and university affiliated community primary care clinics by the primary care provider or urologist inviting them to participate in the study. Of the eligible sample 124 men (53%) completed and returned a survey, including 85 who reported current sildenafil use. Change scores in these patients were calculated using the International Index of Erectile Function, marital interaction scale from the Cancer Rehabilitation Evaluation System Short Form, 5-item emotional well-being scale of the RAND 36-Item Health Survey and 12-Item Short Form Health Survey. Results: Sildenafil users reported an 88% increase in erectile function scores, 60% increase in overall sexual satisfaction and 36% increase in intercourse satisfaction related to the use of sildenafil (p <0.001). Of the respondents 38% indicated that using sildenafil had definitely improved quality of life. Likewise 29% of respondents indicated that using sildenafil had definitely improved the relationship with their partner. With sildenafil there was a statistically significant improvement in the scores of erectile and sexual function (p <0.001), sexual partner relationship (p = 0.007) and emotional well-being (p <0.001). In a multivariate model improved erectile function and sexual partner relationship were each significantly associated with improved emotional well-being (R-2 = 0.20, p <0.001). Conclusions: Sildenafil users reported significant improvements in erectile and sexual function that were associated with positive changes in emotional well-being and the sexual partner relationships with their sexual partner. C1 Univ Calif Los Angeles, Sch Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Div Urol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Los Angeles, CA USA. RP Paige, NM (reprint author), Univ Calif Los Angeles, Sch Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90024 USA. RI Hays, Ronald/D-5629-2013 NR 22 TC 52 Z9 52 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD NOV PY 2001 VL 166 IS 5 BP 1774 EP 1778 DI 10.1016/S0022-5347(05)65673-X PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 481YC UT WOS:000171547200041 PM 11586222 ER PT J AU Covinsky, KE Eng, C Lui, LY Sands, LP Sehgal, AR Walter, LC Wieland, D Eleazer, GP Yaffe, K AF Covinsky, KE Eng, C Lui, LY Sands, LP Sehgal, AR Walter, LC Wieland, D Eleazer, GP Yaffe, K TI Reduced employment in caregivers of frail elders: Impact of ethnicity, patient clinical characteristics, and caregiver characteristics SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID LONG-TERM-CARE; OLDER ADULTS; HEALTH; MODEL; PREFERENCES; DISABILITY; PREVALENCE; FAMILIES; DEMENTIA; COSTS AB Background. Without family caregivers, many frail elders who live at home would require nursing home care. However, providing care to frail elders requires a large time commitment that may interfere with the caregiver's ability to work. Our goal was to determine the patient and caregiver characteristics associated with the reduction of employment hours in caregivers of frail elders. Methods. This was a cross-sectional study of 2806 patients (mean age 78, 73% women, 29% African American, 12% Hispanic, 54% with dementia) with at least one potentially working caregiver (defined as one who is either currently employed or who would have been employed if they had not been providing care) and their 4592 potentially working caregivers. Patients were enrollees at I I sites of the Program of All-Inclusive Care for the Elderly (PACE). Social workers interviewed patients and caregivers at the time of PACE enrollment. Caregivers were asked if they had reduced the hours they worked or had stopped working to care for the patient. Nurses interviewed patients and caregivers to assess independence in activities of daily living (ADLs) and the presence of behavioral disturbances. Comorbid conditions were assessed by physicians during enrollment examinations. Results. A total of 604 (22%) of the 2806 patients had at least one caregiver who either reduced the number of hours they worked or quit working to care for the patient. Patient characteristics independently associated with a caregiver reducing hours or quitting work were ethnicity (odds ratio [OR] = 1.42, 95% confidence interval [CI] 1.14-1.78 for African American; OR = 1.90, 95% CI 1.43-2.52 for Hispanic), ADL function below the median (OR = 1.76,95% CI 1.44-2.15), a diagnosis of dementia (OR = 1.68, 95% CI = 1.31-2.17 if associated with a behavioral disturbance; OR = 1.31, 95% CI 1.06-1.63 if not associated with a behavioral disturbance), or a history of stroke (OR = 1.42, 95% CI 1.16-1.73). After controlling for these patient characteristics, caregiver characteristics associated with reducing work hours included being the daughter or daughter-in-law of the patient (OR = 1.69, 95% CI 1.37-2.08) and living with the patient (OR = 4.66, 95% CI 3.65-5.95 if no other caregiver lived at home, OR = 2.53, 95% CI 2.03-3.14 if another caregiver lived at home). Conclusions. Many caregivers reduce the number of hours they work to care for frail elderly relatives. The burden of reduced employment is more likely to be incurred by the families of ethnic minorities and of patients with specific clinical characteristics. Daughters and caregivers who Eve with the patient are more likely to reduce work hours than other caregivers. Future research should examine the impact of lost caregiver employment on patients' families and the ways in which the societal responsibility of caring for frail elders can be equitably shared. C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, Dept Psychiat, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, Dept Neurol, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. On Lok Senior Hlth Serv, San Francisco, CA USA. Case Western Reserve Univ, Metrohlth Med Ctr, Div Nephrol, Cleveland, OH 44106 USA. Univ S Carolina, Sch Med, Div Geriatr, Columbia, SC 29208 USA. Palmetto Hlth Alliance, Columbia, SC USA. RP Covinsky, KE (reprint author), San Francisco VA Med Ctr, Div Geriatr, 111G,4150 Clement St,Bldg 1, San Francisco, CA 94121 USA. RI Sands, Laura/E-8919-2015 OI Sands, Laura/0000-0003-2446-4486 FU PHS HHS [K02H500006-01] NR 31 TC 52 Z9 54 U1 6 U2 16 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD NOV PY 2001 VL 56 IS 11 BP M707 EP M713 PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 489LG UT WOS:000171992400014 PM 11682579 ER PT J AU Rosen, HR AF Rosen, HR TI Hepatitis B and C in the liver transplant recipient: Current understanding and treatment SO LIVER TRANSPLANTATION LA English DT Article; Proceedings Paper CT Meeting of the American-Association-for-the-Study-of-Liver-Diseases/International-Liver -Transplantation-Society CY NOV 09, 2001 CL DALLAS, TEXAS SP Amer Assoc Stud Liver Dis, Internat Liver Transplant Soc ID IMMUNE GLOBULIN; LAMIVUDINE THERAPY; GRAFT REINFECTION; INFECTED PATIENTS; INTERFERON-ALPHA; VIRUS RECURRENCE; SURFACE-ANTIGEN; UNITED-STATES; FOLLOW-UP; PROPHYLAXIS AB 1. Liver disease related to chronic viral hepatitis is the leading indication for orthotopic liver transplantation (OLT) worldwide. 2. The natural history of hepatitis B virus infection has been dramatically modified, and outcome has improved substantially in the last decade with the use of hepatitis B immunoglobulin and lamivudine. 3. Hepatitis C virus (HCV) recurrence, defined by histological injury, is almost universal, and a subset of patients (20% to 30%) develops allograft cirrhosis by the fifth year post-OLT. 4. Unfortunately, antiviral therapy for hepatitis C post-OLT, even when initiated preemptively before the development of histological recurrence in the first few weeks post-OLT, has failed to alter the natural history of HCV disease recurrence. 5. HCV-related allograft cirrhosis is associated with a high rate of decompensation and mortality. C1 Oregon Hlth Sci Univ, Portland VA Med Ctr, Div Gastroenterol Hepatol, Portland, OR 97207 USA. Portland Vet Adm, Liver Transplantat Program, Portland, OR USA. RP Rosen, HR (reprint author), Oregon Hlth Sci Univ, Portland VA Med Ctr, Div Gastroenterol Hepatol, POB 1034,P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. NR 75 TC 16 Z9 16 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD NOV PY 2001 VL 7 IS 11 SU 1 BP S87 EP S98 DI 10.1053/jlts.2001.28519 PG 12 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 492JU UT WOS:000172165300012 PM 11689781 ER PT J AU Clark, JI Kancharla, K Qamar, R Fisher, S Hantel, A Panganiban, J Millbrandt, L Albain, KS AF Clark, JI Kancharla, K Qamar, R Fisher, S Hantel, A Panganiban, J Millbrandt, L Albain, KS TI Pilot study of sequential vinorelbine and cisplatin followed by docetaxel for selected IIIB and stage IV non-small cell lung cancer SO LUNG CANCER LA English DT Article DE sequential therapy; pilot study; non-small cell lung cancer ID SOUTHWEST-ONCOLOGY-GROUP; RANDOMIZED TRIAL; CHEMOTHERAPY; IFOSFAMIDE; SURVIVAL; P53 AB Vinorelbine, cisplatin and docetaxel are known to be efficacious in non-small cell lung cancer (NSCLC). This limited institution pilot study evaluated the novel strategy of sequencing active first line agents prior to progression. The primary objective of this study was to assess the toxicity profile in anticipation of a larger cooperative group standard phase If study. Patients with selected stage IIIB and IV NSCLC, Southwest Oncology Group (SWOG) performance status (PS) of I or less and measurable or evaluable disease were eligible. Treatment was cisplatin 100 mg/ml(2) day I and 29, vinorelbine 25 mg/m(2) weekly for 8 weeks, followed by docetaxel 100 mg/m(2) every 21 days for four cycles if no progression. If grade IV neutropenia developed, G-CSF 5 mcg/kg/day was used in subsequent cycles. Of IS eligible patients, 17 patients had stage IV disease with a median age of 66 years (range 48-80). Eight patients had a SWOG PS of 1, 10 had a PS of zero. Six of eighteen patients received all 8 weeks of vinorelbine/cisplatin and six of eight patients who went on to receive docetaxel received all four planned cycles; only two patients overall received all planned therapy. One grade III/IV event each of cardiotoxicity myocardial infarction), renal toxicity (acute renal failure), anemia and thrombocytopenia occurred with vinorelbine and cisplatin, and 2 Grade IV hypersensitivity reactions, manifested by severe back pain with docetaxel occurred. Three deaths occurred during the study, all during treatment with vinorelbine and cisplatin: one due to neutropenic sepsis, one from a pulmonary embolism; and one secondary to severe hypoglycemia in a diabetic patient. Of the 16 patients evaluable for response after vinorelbine/cisplatin, there were two complete responses (12.5%) and three partial responses (19%) for an overall response rate of 31% (95% CI 8 - 58). One additional patient who received docetaxel experienced a partial response. Two patients remain alive (21 + and 18 + months, respectively). The 1-year survival was 44%. Conclusion: This sequence, as defined, was tolerated marginally well in patients with advanced NSCLC. Granulocytopenia was the major toxicity requiring dose adjustments throughout the sequence. Based on response rates and tolerability that were somewhat comparable to other regimens in this disease setting, a modified version of this program, adjusted to decrease the incidence of grade III and IV toxicity, was selected as one arm of a recent randomized phase II trial in the Southwest Oncology Group (SWOG), S9806, evaluating sequential therapy in advanced NSCLC. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Loyola Univ, Med Ctr, Cardinal Bernardin Canc Ctr, Maywood, IL 60153 USA. Edward Hosp, Naperville, IL USA. RP Clark, JI (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. RI qamar, raheel/D-4543-2012 NR 23 TC 16 Z9 16 U1 0 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0169-5002 J9 LUNG CANCER-J IASLC JI Lung Cancer PD NOV PY 2001 VL 34 IS 2 BP 271 EP 277 DI 10.1016/S0169-5002(01)00251-3 PG 7 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 498KP UT WOS:000172509000013 PM 11679186 ER PT J AU Karakousis, PC Page, KR Varello, MA Howlett, PJ Stieritz, DD AF Karakousis, PC Page, KR Varello, MA Howlett, PJ Stieritz, DD TI Waterhouse-Friderichsen syndrome after infection with group A streptococcus SO MAYO CLINIC PROCEEDINGS LA English DT Article ID SPLENECTOMY; BACTEREMIA; PATIENT; DISEASE AB We report a case of Waterhouse-Friderichsen syndrome associated with group A streptococcus (GAS) toxic shock syndrome in a previously healthy man. The patient presented with neck pain and fevers of 2 days' duration. Computed tomography of the neck revealed a mass in the retropharyngeal space, suggesting an abscess. Despite prompt treatment with appropriate antibiotics, the patient experienced a fulminant course and died within 8 hours of presentation. Antemortem blood cultures grew GAS positive for exotoxins A, B, and C. Postmortem examination revealed bilateral adrenal hemorrhage, consistent with Waterhouse-Friderichsen syndrome. Immunohistochemical analysis of the adrenal glands revealed the presence of GAS antigens. However, no disseminated intravascular coagulation was evident. This case demonstrates that adrenal hemorrhage can occur without associated coagulopathy and may result directly from the action of bacterial toxins. C1 Hosp Univ Penn, Dept Internal Med, Philadelphia, PA 19104 USA. Philadephia Vet Affairs Med Ctr, Dept Pathol, Philadelphia, PA USA. RP Karakousis, PC (reprint author), 1823 Pine St 2, Philadelphia, PA 19103 USA. NR 18 TC 15 Z9 16 U1 0 U2 0 PU MAYO CLINIC PROCEEDINGS PI ROCHESTER PA 660 SIEBENS BLDG MAYO CLINIC, ROCHESTER, MN 55905 USA SN 0025-6196 J9 MAYO CLIN PROC JI Mayo Clin. Proc. PD NOV PY 2001 VL 76 IS 11 BP 1167 EP 1170 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 488WN UT WOS:000171960000014 PM 11702906 ER PT J AU Rhew, DC Weingarten, SR AF Rhew, DC Weingarten, SR TI Achieving a safe and early discharge for patients with community-acquired pneumonia SO MEDICAL CLINICS OF NORTH AMERICA LA English DT Article ID RESPIRATORY-TRACT INFECTIONS; SEQUENTIAL ANTIMICROBIAL THERAPY; IN-HOSPITAL OBSERVATION; LOW-RISK PATIENTS; EARLY SWITCH; INTRAVENOUS ANTIBIOTICS; CEFUROXIME AXETIL; ORAL ANTIBIOTICS; ECONOMIC-IMPACT; INTERVENTIONAL TRIAL AB Methods to achieve a safe and early discharge for patients with community-acquired pneumonia may include. early switch from parenteral to oral antibiotics and early discharge once a patient achieves clinical stability (e.g., systolic blood pressure 90 mm Hg or more, heart rate 100 beats per minute or less, respiratory rate 24 breaths per minute or fewer, temperature 38.3 degreesC [101 degreesF] or lower, oxygen saturation 90% or more, able to eat, and stable mental status) or fulfills appropriate criteria. For many patients, this may occur on day three of hospitalization. Elimination of in-hospital observation for patients who do not have an obvious reason for continued hospitalization is another method. Improved efficiency of care by implementing critical pathways, identifying and correcting causes of medically unnecessary hospital days, initiating early discharge planning, enlisting the services of a discharge coordinator, and organizing outpatient parenteral antibiotic treatment programs are also methods that can be used. These strategies are effective in many but not in all patients, and their application should be tempered with careful clinical judgment. C1 Zynx Hlth Inc, Beverly Hills, CA 90212 USA. Univ Calif Los Angeles, Sch Med, Greater Los Angeles Vet Affairs Healthcare Syst, Div Infect Dis,Dept Med, Los Angeles, CA 90024 USA. RP Rhew, DC (reprint author), Zynx Hlth Inc, 9100 Wilshire Blvd,Suite 655,East Tower, Beverly Hills, CA 90212 USA. NR 76 TC 9 Z9 9 U1 2 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0025-7125 J9 MED CLIN N AM JI Med. Clin. N. Am. PD NOV PY 2001 VL 85 IS 6 BP 1427 EP + DI 10.1016/S0025-7125(05)70389-8 PG 16 WC Medicine, General & Internal SC General & Internal Medicine GA 483DA UT WOS:000171617400008 PM 11686189 ER PT J AU Bertrand, E Brouillet, E Caille, I Bouillot, C Cole, GM Prochiantz, A Allinquant, B AF Bertrand, E Brouillet, E Caille, I Bouillot, C Cole, GM Prochiantz, A Allinquant, B TI A short cytoplasmic domain of the amyloid precursor protein induces apoptosis in vitro and in vivo SO MOLECULAR AND CELLULAR NEUROSCIENCE LA English DT Article ID ALZHEIMERS-DISEASE; WILD-TYPE; DNA FRAGMENTATION; TRANSGENIC MICE; BETA-PEPTIDE; CELLS; BRAIN; DEGENERATION; NEURONS; SIGNAL AB The amyloid precursor protein presents several cleavage sites leading to the release of its entire C-terminal domain into the cytoplasm. During apoptosis, this C-terminal domain can be cleaved at amino acid 664 by caspases 3, 6, and 8 and can thus generate two peptides N- and C-terminal to amino acid 664 (C31). Recently, it was shown that the C31 induces apoptosis after transfection into N2A and 293 T cell lines. We have analyzed here, by internalization into neurons, the physiological consequences of the entire C-terminal domain (APP-Cter) and of its membrane proximal sequence corresponding to the N-terminal peptide unmasked after caspase cleavage. We find that whereas micromolar concentrations of APP-Cter are harmless, the peptide extending from the membrane (amino acid 649) to the caspase cleavage site (amino acid 664) in the same range of concentrations induces DNA fragmentation, cleavage of actin at a caspase-sensitive site, and activates caspase 3. A mutated version of this sequence (tyrosine 653 replaced by an aspartate) abolishes the effect in vitro and in vivo. Taken together, this report suggests the existence of a new mechanism contributing to Alzheimer's Disease-associated cell death. C1 Ecole Normale Super, CNRS, UMR 8542, F-75230 Paris 05, France. VA Greater LA, GRECC 11E, Sepulveda, CA 91343 USA. RP Bertrand, E (reprint author), Ecole Normale Super, CNRS, UMR 8542, 46 Rue Ulm, F-75230 Paris 05, France. RI Brouillet, Emmanuel/B-4784-2014 OI Brouillet, Emmanuel/0000-0001-6322-7403 FU NIA NIH HHS [AG13471] NR 37 TC 55 Z9 58 U1 1 U2 3 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1044-7431 J9 MOL CELL NEUROSCI JI Mol. Cell. Neurosci. PD NOV PY 2001 VL 18 IS 5 BP 503 EP 511 DI 10.1006/mcne.2001.1030 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 498QN UT WOS:000172522100005 PM 11922141 ER PT J AU Ku, NO Darling, J Wright, TL Krams, S Omary, MB AF Ku, NO Darling, J Wright, TL Krams, S Omary, MB TI Keratin 8 and 18 mutations associate with a broad range of human liver diseases SO MOLECULAR BIOLOGY OF THE CELL LA English DT Meeting Abstract C1 Palo Alto VA Med Ctr, Dept Med, Palo Alto, CA 94304 USA. Stanford Univ, Palo Alto, CA 94304 USA. San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. Stanford Univ, Med Ctr, Dept Surg, Stanford, CA 94305 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC CELL BIOLOGY PI BETHESDA PA 8120 WOODMONT AVE, STE 750, BETHESDA, MD 20814-2755 USA SN 1059-1524 J9 MOL BIOL CELL JI Mol. Biol. Cell PD NOV PY 2001 VL 12 SU S MA 303 BP 56A EP 56A PG 1 WC Cell Biology SC Cell Biology GA 496AL UT WOS:000172372500304 ER PT J AU Toivola, DM Ku, NO Nelson, DR Wright, TL Omary, MB AF Toivola, DM Ku, NO Nelson, DR Wright, TL Omary, MB TI Keratin hyperphosphorylation as a marker of human liver disease SO MOLECULAR BIOLOGY OF THE CELL LA English DT Meeting Abstract C1 Palo Alto VA Med Ctr, Dept Med, Palo Alto, CA 94304 USA. Stanford Univ, Palo Alto, CA 94304 USA. Univ Florida, Coll Med, Gainesville, FL USA. San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC CELL BIOLOGY PI BETHESDA PA 8120 WOODMONT AVE, STE 750, BETHESDA, MD 20814-2755 USA SN 1059-1524 J9 MOL BIOL CELL JI Mol. Biol. Cell PD NOV PY 2001 VL 12 SU S MA 304 BP 56A EP 56A PG 1 WC Cell Biology SC Cell Biology GA 496AL UT WOS:000172372500305 ER PT J AU Peskind, ER Griffin, WST Akama, KT Raskind, MA Van Eldik, LJ AF Peskind, ER Griffin, WST Akama, KT Raskind, MA Van Eldik, LJ TI Cerebrospinal fluid S100B is elevated in the earlier stages of Alzheimer's disease SO NEUROCHEMISTRY INTERNATIONAL LA English DT Article DE cerebrospinal fluid S100B; elevated; earlier stages; Alzheimer's disease ID AMYLOID PRECURSOR PROTEIN; FIBRILLARY ACIDIC PROTEIN; NEURON-SPECIFIC ENOLASE; S-100 PROTEIN; TRANSGENIC MICE; DOWNS-SYNDROME; COGNITIVE STATE; S100-BETA; OVEREXPRESSION; ASTROCYTES AB Postmortem demonstration of increased expression of biologically active S100B in Alzheimer's disease (AD) and its relation to progression of neuropathological changes across the cortical regions suggests involvement of this astrocytic cytokine in the pathophysiology of AD. The hypothesis that the overexpression of S100B in Alzheimer brain is related to the progression of clinical symptoms was addressed in living persons by measuring S100B concentrations in cerebrospinal fluid (CSF) from AD patients with a broad range of clinical dementia severity and from healthy older persons. The effect of normal aging on CSF S100B concentrations also was estimated. CSF S100B did not differ between all 68 AD subjects (0.98 +/- 0.09 ng/ml (mean +/- S.E.M.)) and 25 healthy older subjects (0.81 +/- 0.13 ng/ml). When AD subjects were divided into mild/moderate stage and advanced stage clinical dementia severity by the established Clinical Dementia Rating Scale (CDR) criteria, S100B was significantly higher in the 46 mild/moderate stage AD subjects (1.17 +/-0.11 ng/ml) than in either the 22 advanced stage AD subjects (0.60 +/- 0.12 ng/ml) or the healthy older subjects. Consistent with higher CSF S100B in mild to moderate AD, there was a significant correlation among all AD subjects between CSF S100B and cognitive status as measured by the Mini Mental State Exam (MMSE) score. CSF S100B did not differ between healthy older subjects and healthy young subjects. These results suggest increased CNS expression of S100B in the earlier stages of AD, and are consistent with a role for S100B in the initiation and/or facilitation of neuritic plaque formation in AD brain. (C) 2001 Published by Elsevier Science Ltd. C1 Vet Affairs Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98108 USA. VA Med Ctr, Ctr Geriatr Res Educ & Clin, Little Rock, AR 72205 USA. Northwestern Univ, Sch Med, Inst Neurosci, Dept Mol & Cell Biol, Chicago, IL 60611 USA. NW Drug Doscovery Program, Chicago, IL 60611 USA. RP Peskind, ER (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, 116MIRECC,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIA NIH HHS [AG05136, AG08419, AG12411, AG13939, AG15501]; NIGMS NIH HHS [GM08061] NR 40 TC 99 Z9 101 U1 1 U2 9 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0197-0186 J9 NEUROCHEM INT JI Neurochem. Int. PD NOV-DEC PY 2001 VL 39 IS 5-6 BP 409 EP 413 DI 10.1016/S0197-0186(01)00048-1 PG 5 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 490LE UT WOS:000172052700010 PM 11578776 ER PT J AU Sackeim, HA Rush, AJ George, MS Marangell, LB Husain, MM Nahas, Z Johnson, CR Seidman, S Giller, C Haines, S Simpson, RK Goodman, RR AF Sackeim, HA Rush, AJ George, MS Marangell, LB Husain, MM Nahas, Z Johnson, CR Seidman, S Giller, C Haines, S Simpson, RK Goodman, RR TI Vagus nerve stimulation (VNS (TM)) for treatment-resistant depression: Efficacy, side effects, and predictors of outcome SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE vagus nerve stimulation; major depressive disorder; bipolar disorder; treatment-resistant depression; clinical trial; efficacy; side effects ID ELECTROCONVULSIVE-THERAPY; ATYPICAL DEPRESSION; LONG-TERM; PARTIAL SEIZURES; MEDICATION RESISTANCE; REFRACTORY EPILEPSY; CLINICAL-RESPONSE; MAJOR DEPRESSION; IMIPRAMINE; PHENELZINE AB This open pilot study of vagus nerve stimulation (VNS (TM)) in 60 patients with treatment-resistant major depressive episodes (MDEs) aimed to: 1) define the response rate; 2) determine the profile of side effects; and, most importantly; 3) establish predictors of clinical outcome. Participants were outpatients with nonatypical, nonpsychotic, major depressive or bipolar disorder who had not responded to at least two medication trials from different antidepressant classes in the current MDE. While on stable medication regimens, the patients completed a baseline period followed by device implantation. A 2-week, single blind, recovery period (no stimulation) was followed by 10 weeks of VNS. Of 59 completers (one patient improved during the recovery period), the response rate was 30.5% for the primary HRSD28 measure, 34.0% for the Montgomery-Asberg Depression Rating Scale (MADRAS), and 37.3% for the Clinical Global Impression-Improvement Score (CGI-1 of 1 or 2). The most common side effect was voice alteration or hoarseness, 55.0% (33/60), which was generally mild and related to output current intensity. History of treatment resistance was predictive of VNS outcome. Patients who had never received ECT (lifetime) were 3.9 times more likely to respond. Of the 13 patients who had not responded to more than seven adequate antidepressant trials in the current MDE, none responded, compared to 39.1% of the remaining 46 patients (p = .0057), Thus, VNS appears to be most effective in patients with low to moderate, but not extreme, antidepressant resistance. Evidence concerning VNS' long-term therapeutic bene fits and tolerability will be critical in determining its role in treatment-resistant depression. (C) 2001 American College of Neuropsychopharmacology. Published by Elsevier Science Inc. C1 New York State Psychiat Inst & Hosp, Dept Biol Psychiat, Unit 126, New York, NY 10032 USA. Columbia Univ, Coll Phys & Surg, Dept Psychiat, New York, NY USA. Columbia Univ, Coll Phys & Surg, Dept Radiol, New York, NY USA. Columbia Univ, Coll Phys & Surg, Dept Neurosurg, New York, NY USA. Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX USA. Univ Texas, SW Med Ctr, Dept Neurosurg, Dallas, TX USA. Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurosurg, Charleston, SC 29425 USA. Ralph H Johnson Vet Hosp, Charleston, SC USA. Baylor Coll Med, Dept Psychiat, Houston, TX USA. Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA. RP Sackeim, HA (reprint author), New York State Psychiat Inst & Hosp, Dept Biol Psychiat, Unit 126, 1051 Riverside Dr, New York, NY 10032 USA. RI Haines, Stephen/L-3209-2013 OI Haines, Stephen/0000-0002-4263-0268; Rush, Augustus/0000-0003-2004-2382 NR 42 TC 263 Z9 266 U1 4 U2 21 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD NOV PY 2001 VL 25 IS 5 BP 713 EP 728 DI 10.1016/S0893-133X(01)00271-8 PG 16 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 488TR UT WOS:000171952200012 PM 11682255 ER PT J AU Siegel, JM Moore, R Thannickal, T Nienhuis, R AF Siegel, JM Moore, R Thannickal, T Nienhuis, R TI A brief history of hypocretin/orexin and narcolepsy SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE hypocretin; orexin; narcolepsy; sleep ID LOCUS-COERULEUS NEURONS; REM-SLEEP INDUCTION; EYE-MOVEMENT SLEEP; CANINE NARCOLEPSY; OREXIN-A; IMMUNOREACTIVE NEURONS; AFFECTIVE-ILLNESS; RATS; PROJECT; BRAIN AB The hypothalmic peptides named the orexins, or hypocretins, were discovered in 1998. In 1999 it was established that genetic narcolepsy could be caused by mutations in the genes synthesizing these peptides or their receptors. In September of 2000 it was found that most human narcolepsy is caused by loss of hypocretin cells, most likely as a result of a degenerative process. This paper reviews these events and their implications for our understanding of brain arousal and motor control systems. (C) 2001 American College of Neuropsychopharmacology. Published by Elsevier Science Inc. C1 Univ Calif Los Angeles, Dept Psychiat, North Hills, CA 91343 USA. Univ Calif Los Angeles, Brain Res Inst, North Hills, CA 91343 USA. VA GLAHCS, North Hills, CA 91343 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Dept Psychiat, North Hills, CA 91343 USA. FU NHLBI NIH HHS [HL60296]; NIMH NIH HHS [MH64109]; NINDS NIH HHS [NS14610] NR 54 TC 15 Z9 15 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD NOV PY 2001 VL 25 SU 5 BP S14 EP S20 DI 10.1016/S0893-133X(01)00317-7 PG 7 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 490RZ UT WOS:000172066000004 PM 11682268 ER PT J AU Lieber, CS AF Lieber, CS TI Alcoholic liver injury: pathogenesis and therapy in 2001 SO PATHOLOGIE BIOLOGIE LA English DT Article DE alcoholic liver disease; CYP2E1; diagnosis; dilinoleoylphosphatidylcholine (DLPC) polyenylphosphatidylcholine (PPC); S-adenosylmethionine (SAMe); therapy ID CHRONIC ETHANOL-CONSUMPTION; ADENOSYL-L-METHIONINE; HEPATIC VITAMIN-A; FAT-STORING CELLS; BETA-CAROTENE; RETINOIC ACID; RAT-LIVER; CYTOCHROME P-4502E1; OXIDIZING SYSTEM; DOUBLE-BLIND AB Much progress has been made in the understanding of the pathogenesis of alcoholic liver disease, resulting in improvement of prevention and promising prospects for even more effective treatments, It continues to be important to replenish nutritional deficiencies when present but it is crucial to recognize that, because of the alcohol-induced disease process, some of the nutritional requirements change. For instance, methionine, one of the essential amino acids for humans, must be activated to SAMe but, in severe liver disease, the activity of the corresponding enzyme is depressed. Therefore, the resulting deficiencies and associated pathology can be attenuated by the administration of SAMe, but not by methionine. Similarly, phosphatidylethanolamine methyltransferase (PEMT) activity, which is important for hepatic phosphatidylcholine (PC) synthesis, is also depressed in alcoholic liver disease, therefore calling for administration of the products of the reaction. It might also be beneficial to add other compounds to such therapeutic regiment. Since free radical generation by the ethanol-induced CYP2E1 plays a key role in the oxidative stress, inhibitors of this enzyme have great promise. Several have been investigated experimentally and PPC is particularly interesting because of its innocuity. In view of the striking negative interaction between alcoholic liver injury and hepatitis C, an antiviral agent is eagerly awaited that, unlike Interferon, is not contraindicated in the alcoholic. Anti-inflamatory agents are also required. In addition to down-regulators of cytokines and end toxic are being considered. Finally, since excess drinking is the crux of the issue, anticraving agents should be incorporated in any contemplated therapeutic cocktail, in view of the recent promising results obtained with some of these agents such as naltrexone and acamprosate. (C) 2001 Editions scientifiques et medicales Elsevier SAS. C1 Mt Sinai Sch Med, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Ctr Alcohol Res & Treatment, Sect Liver Dis & Nutr, Bronx, NY 10468 USA. RP Lieber, CS (reprint author), Mt Sinai Sch Med, Bronx, NY 10468 USA. FU NIAAA NIH HHS [AA05934, AA07275, AA11115, AA11160] NR 97 TC 33 Z9 35 U1 1 U2 2 PU EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER PI PARIS CEDEX 15 PA 23 RUE LINOIS, 75724 PARIS CEDEX 15, FRANCE SN 0369-8114 J9 PATHOL BIOL JI Pathol. Biol. PD NOV PY 2001 VL 49 IS 9 BP 738 EP 752 DI 10.1016/S0369-8114(01)00239-5 PG 15 WC Pathology SC Pathology GA 495VK UT WOS:000172360900011 PM 11762137 ER PT J AU Raymond, JR Mukhin, YV Gelasco, A Turner, J Collinsworth, G Gettys, TW Grewal, JS Garnovskaya, MN AF Raymond, JR Mukhin, YV Gelasco, A Turner, J Collinsworth, G Gettys, TW Grewal, JS Garnovskaya, MN TI Multiplicity of mechanisms of serotonin receptor signal transduction SO PHARMACOLOGY & THERAPEUTICS LA English DT Review DE signal transduction; adenylyl cyclase; phospholipase; kinase; channel ID ACTIVATED PROTEIN-KINASE; NITRIC-OXIDE SYNTHASE; CENTRAL-NERVOUS-SYSTEM; C6 GLIOMA-CELLS; ADENYLYL-CYCLASE ACTIVITY; CYCLIC-AMP ACCUMULATION; HUMAN 5-HT1A RECEPTOR; DORSAL RAPHE NEURONS; RAT SEXUAL-BEHAVIOR; HUMAN 5-HYDROXYTRYPTAMINE(1A) RECEPTOR AB The serotonin (5-hydroxytryptamine, 5-HT) receptors have been divided into 7 subfamilies by convention, 6 of which include 13 different genes for G-protein-coupled receptors. Those subfamilies have been characterized by overlapping pharmacological properties, amino acid sequences, gene organization, and second messenger coupling pathways. Post-genomic modifications, such as alternative mRNA splicing or mRNA editing, creates at least 20 more G-protein-coupled 5-HT receptors, such that there are at least 30 distinct 5-HT receptors that signal through G-proteins, This review will focus on what is known about the signaling linkages of the G-protein-linked 5-HT receptors, and will highlight some fascinating new insights into 5-HT receptor signaling. (C) 2001 Elsevier Science Inc. All rights reserved. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Med, Div Gastroenterol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biol Mol, Charleston, SC 29425 USA. RP Raymond, JR (reprint author), Med Univ S Carolina, Dept Med, Div Nephrol, Room 829 CSB,171 Ashley Ave, Charleston, SC 29425 USA. OI Gettys, Thomas/0000-0001-7125-7995 FU NIDDK NIH HHS [DK02694, DK053981, DK52448, DK54720] NR 419 TC 273 Z9 281 U1 2 U2 30 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0163-7258 J9 PHARMACOL THERAPEUT JI Pharmacol. Ther. PD NOV-DEC PY 2001 VL 92 IS 2-3 BP 179 EP 212 AR PII S0163-7258(01)00169-3 DI 10.1016/S0163-7258(01)00169-3 PG 34 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 558PY UT WOS:000175976800008 PM 11916537 ER PT J AU El-Saden, SM Grant, EG Hathout, GM Zimmerman, PT Cohen, SN Baker, JD AF El-Saden, SM Grant, EG Hathout, GM Zimmerman, PT Cohen, SN Baker, JD TI Imaging of the internal carotid artery: The dilemma of total versus near total occlusion SO RADIOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting and Scientific-Assembly of the Radiological-Society-of-North-America (RSNA) CY NOV 28-DEC 03, 1999 CL CHICAGO, ILLINOIS SP Radiol Soc N Amer DE angiography, comparative studies; carotid arteries, angiography; carotid arteries, stenosis or obstruction ID PSEUDO-OCCLUSION; MR-ANGIOGRAPHY; COLOR-FLOW; CEREBROVASCULAR-DISEASE; STRING SIGN; STENOSIS; DUPLEX; ENDARTERECTOMY; DOPPLER; ULTRASONOGRAPHY AB PURPOSE: To evaluate ultrasonography (US) and magnetic resonance (MR) angiography in the differentiation between occlusion and near occlusion of internal carotid artery (ICA). MATERIALS AND METHODS: Consecutive patients with occlusion or near occlusion of ICA at catheter angiography and who underwent MR angiography and US were included. MR angiography and US were compared with catheter angiography, the standard, for the ability to help distinguish occlusion from near occlusion. Noninvasive examinations were evaluated for the ability to classify near occlusions as having severe focal stenosis with distal luminal collapse versus diffuse nonfocal disease. The 95% Cls were calculated. RESULTS: In 55 of 274 patients with 548 ICAs, catheter angiography depicted 37 total occlusions and 21 near occlusions. US depicted all total occlusions; MR angiography depicted 34 (92%) (95% CI: 0.78, 0.98). US depicted 18 (86%) of 21 (95% CI: 0.64, 0.97) near occlusions; MR angiography depicted all (100%). Of 18 vessels that were determined to be patent at US, 17 (94%) (95% CI: 0.73, 0.99) were classified as having focal stenosis or diffuse disease. Because flow gaps were identified in vessels with focal and diffuse disease, MR angiography was not effective in helping to differentiate these lesions. CONCLUSION: Assuming US is the initial imaging examination, when occlusion is diagnosed, MR angiography can depict it. If occlusion is confirmed, no further imaging is necessary. US performed well in helping to differentiate vessels with focal severe stenosis from those with diffuse disease. MR angiography added little in this group. Catheter angiography remains beneficial for vessels with diffuse nonfocal narrowing. C1 W Los Angeles Vet Adm Med Ctr, Dept Radiol, Los Angeles, CA 90073 USA. W Los Angeles Vet Adm Med Ctr, Dept Neurol, Los Angeles, CA 90073 USA. W Los Angeles Vet Adm Med Ctr, Dept Surg, Los Angeles, CA 90073 USA. RP El-Saden, SM (reprint author), W Los Angeles Vet Adm Med Ctr, Dept Radiol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 25 TC 32 Z9 34 U1 0 U2 0 PU RADIOLOGICAL SOC NORTH AMERICA PI OAK BROOK PA 820 JORIE BLVD, OAK BROOK, IL 60523 USA SN 0033-8419 J9 RADIOLOGY JI Radiology PD NOV PY 2001 VL 221 IS 2 BP 301 EP 308 DI 10.1148/radiol.2212001606 PG 8 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 489ZU UT WOS:000172023800005 PM 11687668 ER PT J AU Cook, KF Ashton, CM Byrne, MM Brody, B Geraci, J Giesler, RB Hanita, M Souchek, J Wray, NP AF Cook, KF Ashton, CM Byrne, MM Brody, B Geraci, J Giesler, RB Hanita, M Souchek, J Wray, NP TI A psychometric analysis of the measurement level of the rating scale, time trade-off, and standard gamble SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE utility measurement; health-state preferences; cost utility analysis; cost-effectiveness; quality-adjusted life; preference weights; psychometrics ID HEALTH; UTILITIES; PREFERENCES; INTERVAL; QUALITY AB A fundamental assumption of utility-based analyses is that patient utilities for health states can be measured on an equal-interval scale. This assumption, however, has not been widely examined. The objective of this study was to assess whether the rating scale (RS), standard gamble (SG), and time trade-off (TTO) utility elicitation methods function as equal-interval level scales. We wrote descriptions of eight prostate-cancer-related health states. In interviews with patients who had newly diagnosed, advanced prostate cancer, utilities for the health states were elicited using the RS, SG, and TTO methods. At the time of the study, 77 initial and 73 follow-up interviews had been conducted with a consecutive sample of 77 participants. Using a Rasch model, the boundaries (Thurstone Thresholds) between four equal score sub-ranges of the raw utilities were mapped onto an equal-interval logit scale. The distance between adjacent thresholds in logit units was calculated to determine whether the raw utilities were equal-interval. None of the utility scales functioned as interval-level scales in our sample. Therefore, since interval-level estimates are assumed in utility-based analyses, doubt is raised regarding the validity of findings from previous analyses based on these scales. Our findings need to be replicated in other contexts, and the practical impact of non-interval measurement on utility-based analyses should be explored. If cost-effectiveness analyses are not found to be robust to violations of the assumption that utilities are interval, serious doubt will be cast upon findings from utility-based analyses and upon the wisdom of expending millions in research dollars on utility-based studies. Published by Elsevier Science Ltd. C1 Vet Affairs Med Ctr, Ctr Study Healthy Aging Disabil, A VA R&D Program, Houston, TX 77030 USA. Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, A VA Hlth Serv, R&D Ctr Excellence, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Ctr Eth Med & Publ Issues, Houston, TX 77030 USA. Indiana Univ, Sch Med, Indianapolis, IN USA. Indiana Univ, Sch Nursing, Indianapolis, IN USA. RP Cook, KF (reprint author), VA Med Ctr, Ctr Healthy Aging Disabil, 153,2002 Holcombe Blvd,Bldg 110T Res, Houston, TX 77030 USA. NR 28 TC 19 Z9 20 U1 2 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD NOV PY 2001 VL 53 IS 10 BP 1275 EP 1285 DI 10.1016/S0277-9536(00)00409-3 PG 11 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 479QN UT WOS:000171415200002 PM 11676400 ER PT J AU Basile, JN AF Basile, JN TI Hypertension 2001: Pearls for the clinician SO SOUTHERN MEDICAL JOURNAL LA English DT Article ID RANDOMIZED TRIAL; CARDIOVASCULAR MORBIDITY; SYSTOLIC HYPERTENSION; MORTALITY; PRESSURE C1 Ralph H Johnson VA Med Ctr, Dept Primary Care, Charleston, SC 29401 USA. Med Univ S Carolina, Div Gen Internal Med Geriatr, Charleston, SC 29425 USA. RP Basile, JN (reprint author), Ralph H Johnson VA Med Ctr, Dept Primary Care, 109 Bee St, Charleston, SC 29401 USA. NR 21 TC 1 Z9 1 U1 0 U2 0 PU SOUTHERN MEDICAL ASSN PI BIRMINGHAM PA 35 LAKESHORE DR PO BOX 190088, BIRMINGHAM, AL 35219 USA SN 0038-4348 J9 SOUTHERN MED J JI South.Med.J. PD NOV PY 2001 VL 94 IS 11 BP 1054 EP 1057 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 505NL UT WOS:000172918800004 PM 11780673 ER PT J AU Collard, CL AF Collard, CL TI Thiazide diuretics SO SOUTHERN MEDICAL JOURNAL LA English DT Article C1 Ralph H Johnson VA Med Ctr, Dept Primary Care, Charleston, SC USA. RP Collard, CL (reprint author), Ralph H Johnson VA Med Ctr, Dept Primary Care, Charleston, SC USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU SOUTHERN MEDICAL ASSN PI BIRMINGHAM PA 35 LAKESHORE DR PO BOX 190088, BIRMINGHAM, AL 35219 USA SN 0038-4348 J9 SOUTHERN MED J JI South.Med.J. PD NOV PY 2001 VL 94 IS 11 BP 1065 EP 1065 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 505NL UT WOS:000172918800006 PM 11780675 ER PT J AU Huerta, S Srivatsan, ES Venkatesan, N Peters, J Moatamed, F Renner, S Livingston, EH AF Huerta, S Srivatsan, ES Venkatesan, N Peters, J Moatamed, F Renner, S Livingston, EH TI Alternative mRNA splicing in colon cancer causes loss of expression of neural cell adhesion molecule SO SURGERY LA English DT Article ID FIBRONECTIN-TYPE-III; N-CAM; TUMOR-METASTASIS; DOMAIN; MUSCLE; LINES; NCAM; IDENTIFICATION; PROTEIN; TISSUES AB Background. The neural cell adhesion molecule (NCAM) has numerous isoforms resulting from alternative splicing of mRNA. The 3 major isoforms found in adult tissue are (1) a 120-kDa protein that is linked to the plasma membrane by glycosylphosphatidylinositol; (2) a 140-kDa form that has a transmembrane component and a cytoplasmic tail with unknown function; and (3) a 180-kDa isoform that has an intracellular protein that binds the cytoskeleton. NCAM is capable of homotypic binding and therefore plays a role in cell-cell adhesion for cells expressing the 180-kDa isoform by anchoring groups of cells into epithelial sheets. NCAM-180 is the isoform found in colonocytes, and loss of expression is associated with clinically aggressive colon cancers. Methods. Western blotting and reverse transcriptase-polymerase chain reaction were used to screen commercially, available cell lines for NCAM-180 expression. For cell-line pairs with differential. NCAM-180 expression, exon analysis was performed with reverse transcriptase-polymerase chain reaction to determine where the molecule was spliced, culminating in failed expression. These results were confirmed with exon analysis in colon cancers harvested at the time of laparotomy. Results. Analysis of a SW480 cell line (derived from a patient's primary colon cancer lesion) revealed, NCAM-180 expression, whereas no expression was found in the SW620 cell line (derived from a metastatic lesion from the same patient). Exon analysis of NCAM mRNA transcripts from SW620 revealed that the transcripts were truncated after exon 12. This region correlates to an area between 2 fibronectin-III domains on the NCAM protein. Conclusions. The most common site for NCAM alternative splicing is between the 2 fibronectin-III domains corresponding to the border between exons 12 and 13 of the NCAM gene. Loss of NCAM-180 expression in aggressive colon carcinoma results from a splice defect in the same area, which may result in defective intracellular adhesion between colonocytes. C1 Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Hlth Care Syst, Dept Surg 10112, Los Angeles, CA 90073 USA. USC, Sch Med, Childrens Hosp, Dept Pediat, Los Angeles, CA USA. RP Livingston, EH (reprint author), Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Hlth Care Syst, Dept Surg 10112, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 38 TC 43 Z9 46 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0039-6060 J9 SURGERY JI Surgery PD NOV PY 2001 VL 130 IS 5 BP 834 EP 843 DI 10.1067/msy.2001.116415 PG 10 WC Surgery SC Surgery GA 490AL UT WOS:000172026000010 PM 11685193 ER PT J AU Weisler, S Basina, M Hershman, JM AF Weisler, S Basina, M Hershman, JM TI Utilization of thyrogen SO THYROID LA English DT Letter C1 Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Weisler, S (reprint author), Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1050-7256 J9 THYROID JI Thyroid PD NOV PY 2001 VL 11 IS 11 BP 1083 EP 1083 DI 10.1089/105072501753271815 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 497QU UT WOS:000172467600015 PM 11762721 ER PT J AU Hayter, HL Pettus, BJ Ito, F Obeid, LM Hannun, YA AF Hayter, HL Pettus, BJ Ito, F Obeid, LM Hannun, YA TI TNF alpha-induced glutathione depletion lies downstream of cPLA(2) in L929 cells SO FEBS LETTERS LA English DT Article DE arachidonic acid; apoptosis; ceramide; glutathione; sphingomyelin ID TUMOR-NECROSIS-FACTOR; MITOCHONDRIAL RESPIRATORY-CHAIN; CYTOSOLIC PHOSPHOLIPASE A(2); CERAMIDE-INDUCED APOPTOSIS; ARACHIDONIC-ACID; NEUTRAL SPHINGOMYELINASE; MEDIATED APOPTOSIS; CYTOTOXIC ACTION; INVOLVEMENT; DEATH AB Both glutathione (GSH) depletion and arachidonic acid (AA) generation have been shown to regulate sphingomyelin (SM) hydrolysis and are known components in tumor necrosis factor alpha (TNF alpha)-induced cell death. In addition, both have hypothesized direct roles in activation of N-sphingomyelinase (SMase); however, it is not known whether these are independent pathways of N-SMase regulation or linked components of a single ordered pathway. This study was aimed at differentiating these possibilities using L929 cells. Depletion of GSH with L-buthionin-(S,R)-sulfoximine (BSO) induced 50% hydrolysis of SM at 12 h. In addition, TNF induced a depletion of GSH, and exogenous addition of GSH blocked TNF-induced SM hydrolysis as well as TNF-induced cell death. Together, these results establish GSH upstream of SM hydrolysis and ceramide generation in L929 cells. We next analyzed the L929 variant, C12, which lacks both cytosolic phospholipase A(2) (cPLA(2)) mRNA and protein, in order to determine the relationship of cPLA(2) and GSH. TNF did not induce a significant drop in GSH levels in the C12 line. On the other hand, AA alone was capable of inducing a 60% depletion of GSH in C12 cells, suggesting that these cells remain responsive to AA distal to the site of cPLA(2). Furthermore, depleting GSH with BSO failed to effect AA release, but caused a drop in SM levels, showing that the defect in these cells was upstream of the GSH drop and SMase activation. When cPLA(2) was restored to the C12 line by expression of the cDNA, the resulting CPL4 cells regained sensitivity to TNF. Treatment of the CPL4 cells with TNF resulted in GSH levels dropping to levels near those of the wildtype L929 cells. These results demonstrate that GSH depletion following TNF treatment in L929 cells is dependent on intact cPLA(2) activity, and suggest a pathway in which activation of cPLA(2) is required for the oxidation and reduction of GSH levels followed by activation of SMases. (C) 2000 Published by Elsevier Science B.V. on behalf of the Federation of European Biochemical Societies. C1 Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Duke Univ, Med Ctr, Dept Cell Biol, Durham, NC 27710 USA. Setsunan Univ, Dept Biochem, Hirakata, Osaka 57301, Japan. Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. RP Hannun, YA (reprint author), Med Univ S Carolina, Dept Biochem & Mol Biol, 173 Ashley Ave,POB 250780, Charleston, SC 29425 USA. FU NIA NIH HHS [AG 16583]; NIGMS NIH HHS [GM 43825] NR 39 TC 20 Z9 20 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0014-5793 J9 FEBS LETT JI FEBS Lett. PD OCT 26 PY 2001 VL 507 IS 2 BP 151 EP 156 DI 10.1016/S0014-5793(01)02967-2 PG 6 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 488HY UT WOS:000171922900007 PM 11684089 ER PT J AU Thompson, KW Wasterlain, CG AF Thompson, KW Wasterlain, CG TI Urethane anesthesia produces selective damage in the piriform cortex of the developing brain SO DEVELOPMENTAL BRAIN RESEARCH LA English DT Article DE development; piriform; anesthetics; toxicity; urethane ID LONG-TERM POTENTIATION; APOPTOTIC NEURODEGENERATION; RETROSPLENIAL CORTEX; IMMATURE BRAIN; NMDA; RAT; MK-801; STIMULATION; RELEVANCE; BLOCKADE AB The potential induction of neuronal death by neuroactive drugs at specific stages of embryonic or postnatal development is a serious concern in treating brain disease. Recent evidence indicates that NMDA antagonists, GABA agonists, ethanol and some anesthetics can all produce massive neuronal cell loss at critical times during development. We show here that the anesthetic urethane, once used clinically, produces a selective lesion of the piriform cortex, a region not previously implicated in such toxicity, in the developing brain. Young rats were injected with urethane at 1, 2, 3, and 4 weeks of age and brain damage was measured 1-4 days later. We found that urethane produces a large lesion in subfields of the piriform cortex and that the damage is most severe in 2 week-old animals. These data, together with other recent reports, show that there are multiple neuronal death-inducing pathways in the developing nervous system. It will be important to determine if anesthesties used in pregnant women and young children may have similar effects. (C) 2001 Elsevier Science B.V. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. RP Thompson, KW (reprint author), VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, Bldg 114,Rm 137,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 19 TC 9 Z9 9 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-3806 J9 DEV BRAIN RES JI Dev. Brain Res. PD OCT 24 PY 2001 VL 130 IS 2 BP 167 EP 171 DI 10.1016/S0165-3806(01)00228-0 PG 5 WC Developmental Biology; Neurosciences SC Developmental Biology; Neurosciences & Neurology GA 499LV UT WOS:000172573400002 ER PT J AU Thompson, DC McPhillips, H Davis, RL Lieu, TL Homer, CJ Helfand, M AF Thompson, DC McPhillips, H Davis, RL Lieu, TL Homer, CJ Helfand, M TI Universal newborn hearing screening - Summary of evidence SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Review ID DEMONSTRATION PROJECT; EARLY IDENTIFICATION; OTOACOUSTIC EMISSION; OUTCOME MEASURES; OTITIS-MEDIA; CHILDREN; IMPAIRMENT; INTERVENTION; INFANTS; AGE AB Context Each year, approximately 5000 infants are born in the United States with moderate-to-profound, bilateral permanent hearing loss (PHL). Universal newborn hearing screening (UNHS) has been proposed as a means to speed diagnosis and treatment and thereby improve language outcomes in these children. Objectives To identify strengths, weaknesses, and gaps in the evidence supporting UNHS and to compare the additional benefits and harms of UNHS with those of selective screening of high-risk newborns. Data Sources We searched the MEDLINE, CINAHL, and PsychINFO databases for relevant articles published from 1994 to August 2001, using terms for hearing disorders, infants or newborns, screening, and relevant treatments. We contacted experts and reviewed reference lists to identify additional articles, including those published before 1994. Study Selection We included controlled and observational studies of (1) the accuracy, yield, and harms of screening using otoacoustic emissions (OAEs), auditory brainstem response (ABR), or both in the general newborn population and (2) the effects of screening or early identification and treatment on language outcomes. Of an original 340 articles identified, 19 articles, including 1 controlled trial, met these inclusion criteria. Data Extraction Data on population, test performance, outcomes, and methodological quality were extracted by 2 authors (D.C.T., H.M.) using prespecified criteria developed by the US Preventive Services Task Force. We queried authors when information needed to assess study quality was missing. Data Synthesis Good-quality studies show that from 2041 to 2794 low-risk and 86 to 208 high-risk newborns were screened to find 1 case of moderate-to-profound PHL. The best estimate of positive predictive value was 6.7%. Six percent to 15% of infants who are missed by the screening tests are subsequently diagnosed with bilateral PHL. In a trial of UNHS vs clinical screening at age 8 months, UN HS increased the proportion of infants with moderate-to-severe hearing loss diagnosed by age 10 months (57% vs 14%) but did not reduce the rate of diagnosis after age 18 months. No good-quality controlled study has compared UNHS with selective screening of high-risk new. borns. In fair- to poor-quality cohort studies, intervention before age 6 months was associated with improved language and communication skills by ages 2 to 5 years. These studies had unclear criteria for selecting subjects, and none compared an inception cohort of low-risk newborns identified by screening with those identified in usual care, making it impossible to exclude selection bias as an explanation for the results. In a mathematical model based on the literature review, we estimated that extending screening to low-risk infants would detect 1 additional case before age 10 months for every 1441 low-risk infants screened, and result in treatment before 10 months of 1 additional case for every 2401 low-risk infants screened. With UNHS, 254 newborns would be referred for audiological evaluation because of false-positive second-stage screening test results vs 48 for selective screening. Conclusions Modern screening tests for hearing Impairment can improve identification of newborns with PHL, but the efficacy of UNHS to improve long-term language outcomes remains uncertain. C1 Univ Washington, Harborview Med Ctr, Harborview Injury Prevent & Res Ctr, Seattle, WA 98104 USA. Harvard Pilgrim Hlth Care, Seattle, WA USA. Natl Initiat Childrens Healthcare Qual, Boston, MA USA. Oregon Hlth Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. RP Thompson, DC (reprint author), Univ Washington, Harborview Med Ctr, Harborview Injury Prevent & Res Ctr, 325 9th Ave,Box 359960, Seattle, WA 98104 USA. FU PHS HHS [290-97-0018] NR 76 TC 164 Z9 176 U1 0 U2 21 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 24 PY 2001 VL 286 IS 16 BP 2000 EP 2010 DI 10.1001/jama.286.16.2000 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 485JD UT WOS:000171750500024 PM 11667937 ER PT J AU Tal, DM Capasso, JM Munson, K Karlish, SJD AF Tal, DM Capasso, JM Munson, K Karlish, SJD TI Proximity of transmembrane segments M3 and M1 of the alpha subunit of Na+,K+-ATPase revealed by specific oxidative cleavage mediated by a complex of Cu2+ ions and 4,7-diphenyl-1,10-phenanthroline SO BIOCHEMISTRY LA English DT Article ID P-TYPE ATPASES; PROTEOLYZED NA,K-ATPASE; CATALYZED CLEAVAGE; NA+/K+-ATPASE; BETA-SUBUNIT; NA/K-ATPASE; CROSS-LINKS; TRANSPORT; PUMP; ORGANIZATION AB This paper describes a novel approach to specific oxidative cleavage of Na+, K+-ATPase, mediated by Cu2+ ions and a hydrophobic phenanthroline, 4,7-diphenyl-1,10-phenanthroline (DPP), in the presence of ascorbate and H2O2. The cleavage produces two major fragments of the a subunit, with apparent molecular masses of 96.5 and 76 kDa, and N-termini near the cytoplasmic entrance of transmembrane segments M1 and M3, respectively, The kinetics indicate that both cleavages are mediated by a single Cu2+-DPP complex. We infer that M3 and MI are in proximity near the cytoplasmic surface. The yields of 96.5 and 76 kDa fragments are not significantly affected by ligands that stabilize different E1 and E2 conformations. In E-2(K) and E2P conformations, a minor 5.5 kDa fragment with its N-terminus in M10 is also observed. The 96.5 and 76 kDa fragments are indistinguishable from two fragments near M3 and M I produced by Fe2+-catalyzed cleavage described previously [Goldshleger, R., and Karlish, S. J. D. (1999) J. Biol. Chem. 274, 16213-16221], whereas other Fe2+-catalyzed cleavage fragments in the cytoplasmic P and A domains are not observed with the Cu2+-DPP complex. These findings provide experimental support for the concept of two separate Fe2+ sites. A homology model, with Na+, K+-ATPase residues within transmembrane segments and connecting loops substituted into the crystal structure of Ca2+-ATPase, shows the proximity between the sequences HFIH in M3 and EVWK in M1, near the cytoplasmic surface. Thus, the model strongly supports the conclusions based on cleavages mediated by the Cu2+-DPP complex (or Fe2+ at site 2). As a corollary, the cleavages provide evidence for similar packing of M1 and M3 of Na+, K+-ATPase and Ca2+-ATPase. C1 Weizmann Inst Sci, Dept Biol Chem, IL-76100 Rehovot, Israel. Univ Colorado, Hlth Sci Ctr, Denver, CO 80262 USA. W Los Angeles Vet Affairs Med Ctr, Marine Biol Lab, Los Angeles, CA 90073 USA. RP Karlish, SJD (reprint author), Weizmann Inst Sci, Dept Biol Chem, IL-76100 Rehovot, Israel. NR 31 TC 9 Z9 9 U1 0 U2 1 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0006-2960 J9 BIOCHEMISTRY-US JI Biochemistry PD OCT 23 PY 2001 VL 40 IS 42 BP 12505 EP 12514 DI 10.1021/bi011167n PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 486CP UT WOS:000171801100006 PM 11601974 ER PT J AU Rath, MR Stallone, J Lin, M Knuefermann, P Knowlton, AA AF Rath, MR Stallone, J Lin, M Knuefermann, P Knowlton, AA TI Gender differences in the expression of heat shock proteins: The effect of estrogen SO CIRCULATION LA English DT Meeting Abstract C1 Baylor Coll Med, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. Texas A&M Univ, College Stn, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 546 BP 113 EP 113 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895000543 ER PT J AU Schwartz, GG Xu, Y Lu, L Young, L Schwartz, GG AF Schwartz, GG Xu, Y Lu, L Young, L Schwartz, GG TI The PPAR-gamma activator, troglitazone, increases content of glucose transport proteins in hearts of non-diabetic pigs SO CIRCULATION LA English DT Meeting Abstract C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Yale Univ, New Haven, CT 06520 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 577 BP 120 EP 120 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895000574 ER PT J AU Nemoto, S Diwan, A De Freitas, G Tanaka, R Sugawara, M Carabello, BA Mann, DL AF Nemoto, S Diwan, A De Freitas, G Tanaka, R Sugawara, M Carabello, BA Mann, DL TI Post-translational processing of tumor necrosis factor determines whether transgenic mice develop systolic or diastolic dysfunction SO CIRCULATION LA English DT Meeting Abstract C1 Houston VAMC, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Winters Ctr Heart Failure Res, Houston, TX USA. Nihon Kohden Corp, Tokyo, Japan. Tokyo Womens Med Univ, Tokyo, Japan. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 610 BP 127 EP 127 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895000606 ER PT J AU Glatter, KA Dorostkar, PC Yang, YF Lee, RJ Van Hare, GF Keung, E Modin, G Scheinman, MM AF Glatter, KA Dorostkar, PC Yang, YF Lee, RJ Van Hare, GF Keung, E Modin, G Scheinman, MM TI Electrophysiologic effects of ibutilide in patients with accessory pathways. SO CIRCULATION LA English DT Meeting Abstract C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 1588 BP 331 EP 331 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895001576 ER PT J AU Butler, J Abraham, WT Forman, DE Gottlieb, SS Loh, E Massie, BM O'Connor, CM Rich, MW Stevenson, LW Wang, YF Young, JB Krumholz, HM AF Butler, J Abraham, WT Forman, DE Gottlieb, SS Loh, E Massie, BM O'Connor, CM Rich, MW Stevenson, LW Wang, YF Young, JB Krumholz, HM TI Relationship between heart failure treatment and development of worsening renal function among hospitalized patients SO CIRCULATION LA English DT Meeting Abstract C1 Vanderbilt Univ, Ctr Med, Nashville, TN 37232 USA. Univ Kentucky, Lexington, KY USA. Boston Med Ctr, Boston, MA USA. Univ Maryland, Baltimore, MD 21201 USA. Univ Penn, Philadelphia, PA 19104 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Duke Univ, Durham, NC USA. Barnes Jewish Hosp, St Louis, MO 63110 USA. Brigham & Womens Hosp, Boston, MA 02115 USA. Yale Univ, New Haven, CT USA. Cleveland Clin Fdn, Cleveland, OH 44195 USA. Yale Univ, Sch Med, New Haven, CT USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 2486 BP 526 EP 526 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895002467 ER PT J AU Peterson, ED Coombs, LP Ferguson, TBB Shroyer, L Delong, ER Edwards, FH AF Peterson, ED Coombs, LP Ferguson, TBB Shroyer, L Delong, ER Edwards, FH TI Patient factors that influence early discharge or prolonged length of stay after bypass surgery SO CIRCULATION LA English DT Meeting Abstract C1 Duke Clin Res Inst, Durham, NC USA. Louisiana State Univ, Hlth Sci Ctr, Marrero, LA USA. Denver VA Med Ctr, Denver, CO USA. Univ Florida, Jacksonville, FL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 2821 BP 596 EP 596 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895002799 ER PT J AU Rumsfeld, JS Magid, DJ Plomondon, ME Spertus, JA O'Brien, MM Every, NR Sales, AE AF Rumsfeld, JS Magid, DJ Plomondon, ME Spertus, JA O'Brien, MM Every, NR Sales, AE TI Depression is associated with anginal frequency, anginal stability, physical limitation, and quality of life following acute coronary syndromes SO CIRCULATION LA English DT Meeting Abstract C1 Denver VA Med Ctr, Denver, CO USA. Colorado Permanente Med Grp, Denver, CO USA. St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 3069 BP 649 EP 649 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895003045 ER PT J AU Gottlieb, SS Abraham, WT Butler, J Forman, D Krumholz, HM Loh, E Massie, B Rich, M Stevenson, LW Young, JB AF Gottlieb, SS Abraham, WT Butler, J Forman, D Krumholz, HM Loh, E Massie, B Rich, M Stevenson, LW Young, JB TI The impact of different definitions of worsening renal function in CHF SO CIRCULATION LA English DT Meeting Abstract C1 Univ Maryland, Baltimore, MD 21201 USA. Univ Kentucky, Lexington, KY 40506 USA. Vanderbilt Univ, Med Ctr, Nashville, TN USA. Boston Univ, Boston, MA 02215 USA. Yale Univ, Sch Med, New Haven, CT USA. Univ Penn, Philadelphia, PA 19104 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Washington Univ, St Louis, MO 63130 USA. Brigham & Womens Hosp, Boston, MA 02115 USA. Cleveland Clin Fdn, Cleveland, OH 44195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 3251 BP 688 EP 689 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895003224 ER PT J AU Mangat, I Yang, YF Tschopp, D Cheng, J Keung, E Scheinman, MM AF Mangat, I Yang, YF Tschopp, D Cheng, J Keung, E Scheinman, MM TI Atrial flutter ablation: Optimizing the detection of bidirectional block across the flutter isthmus SO CIRCULATION LA English DT Meeting Abstract C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. Thorac & CV Inst, E Lansing, MI USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 3376 BP 715 EP 716 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895003348 ER PT J AU Deswal, A Petersen, NJ Ashton, CM Ku-Goto, M Wray, NP AF Deswal, A Petersen, NJ Ashton, CM Ku-Goto, M Wray, NP TI Differences in outcomes in African Americans and white veterans with heart failure SO CIRCULATION LA English DT Meeting Abstract C1 Baylor Coll Med, Houston, TX USA. VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 SU S MA 3883 BP 830 EP 830 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 487UW UT WOS:000171895003853 ER PT J AU Yuan, C Mitsumori, LM Ferguson, MS Polissar, NL Echelard, D Ortiz, G Small, R Davies, JW Kerwin, WS Hatsukami, TS AF Yuan, C Mitsumori, LM Ferguson, MS Polissar, NL Echelard, D Ortiz, G Small, R Davies, JW Kerwin, WS Hatsukami, TS TI In vivo accuracy of multispectral magnetic resonance imaging for identifying lipid-rich necrotic cores and intraplaque hemorrhage in advanced human carotid plaques SO CIRCULATION LA English DT Article DE magnetic resonance imaging; lipids; atherosclerosis; carotid arteries ID ATHEROSCLEROTIC PLAQUE; IN-VIVO; RUPTURE; LESIONS; CLASSIFICATION; DISRUPTION; STENOSIS AB Background-High-resolution MRI has been shown to be capable of identifying plaque constituents, such as the necrotic core and intraplaque hemorrhage, in human carotid atherosclerosis. The purpose of this study was to evaluate differential contrast-weighted images, specifically a multispectral MR technique, to improve the accuracy of identifying the lipid-rich necrotic core and acute intraplaque hemorrhage in vivo. Methods and Results-Eighteen patients scheduled for carotid endarterectomy underwent a preoperative carotid MRI examination in a 1.5-T GE Signa scanner using a protocol that generated 4 contrast weightings (T1, T2, proton density, and 3D time of flight). MR images of the vessel wall were examined for the presence of a lipid-rich necrotic core and/or intraplaque hemorrhage. Ninety cross sections were compared with matched histological sections of the excised specimen in a double-blinded fashion. Overall accuracy (95% CI) of multispectral MRI was 87% (80% to 94%), sensitivity was 85% (78% to 92%), and specificity was 92% (86% to 98%). There was good agreement between MRI and histological findings, with a value of kappa =0.69 (0.53 to 0.85). Conclusions-Multispectral MRI can identify the lipid-rich necrotic core in human carotid atherosclerosis in vivo with high sensitivity and specificity. This MRI technique provides a noninvasive tool to study the pathogenesis and natural history of carotid atherosclerosis. Furthermore, it will permit a direct assessment of the effect of pharmacological therapy, such as aggressive lipid lowering, on plaque lipid composition. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. Univ Washington, Dept Surg, Seattle, WA 98195 USA. Marina Merguson Inc, Seattle, WA USA. Mt Whisper Light Stat Consulting, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Yuan, C (reprint author), Univ Washington, Dept Radiol, Box 357115,1959 NE Pacific Ave, Seattle, WA 98195 USA. FU NHLBI NIH HHS [HL-56874, R01-HL-60213, R01-HL-61851] NR 31 TC 445 Z9 479 U1 4 U2 12 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2001 VL 104 IS 17 BP 2051 EP 2056 DI 10.1161/hc4201.097839 PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 486QQ UT WOS:000171828800014 PM 11673345 ER PT J AU Zhou, ZQ Manguino, D Kewitt, K Intano, GW McMahan, CA Herbert, DC Hanes, M Reddick, R Ikeno, Y Walter, CA AF Zhou, ZQ Manguino, D Kewitt, K Intano, GW McMahan, CA Herbert, DC Hanes, M Reddick, R Ikeno, Y Walter, CA TI Spontaneous hepatocellular carcinoma is reduced in transgenic mice overexpressing human O-6-methylguanine-DNA methyltransferase SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID O(6)-METHYLGUANINE DNA METHYLTRANSFERASE; MISMATCH REPAIR DEFICIENCY; O6-METHYLGUANINE-DNA METHYLTRANSFERASE; GENETIC SUSCEPTIBILITY; MUTATOR PHENOTYPE; ESCHERICHIA-COLI; EXPRESSION; CELLS; HEPATOCARCINOGENESIS; MUTATIONS AB O-6-methylguanine (O(6)mG) is a potent mutagenic and procarcinogenic DNA lesion. Organisms have evolved with a DNA repair mechanism that largely ameliorates the deleterious effects of O(6)mG through a direct reversal mechanism by a protein termed O-6-methylguanine-DNA methyltransferase (MGMT). However, the contribution of O(6)mG to carcinogenesis, in the absence of known exposure to agents that produce it, has not been defined. Nontransgenic C3HeB male mice have a high frequency of spontaneous liver tumors. Transgenic CeHeB/FeJ mice expressing human MGMT (hMGMT) were generated that had elevated hepatic MGMT activity. The spontaneous development of hepatocellular carcinoma was significantly reduced in those mice expressing hMGMT compared with nontransgenic C3HeB/FeJ male mice. No differences were detected in spontaneous mutant frequencies in lacl transgenes in mice carrying hMGMT compared with that without hMGMT but the proportion of GC to AT transition mutations was lower in the transgenic mice carrying hMGMT as well as lacl. Tumors that arose in C3HeB/FeJ transgenic mice were largely deficient in hMGMT protein as determined by immunohistochemistry with a monoclonal antibody directed against hMGMT. Together these data indicate that spontaneous O(6)mG lesions induced hepatocellular carcinogenesis in C3HeB/FeJ male mice. These transgenic mice represent a rare example of reduced spontaneous carcinogenesis. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Lab Anim Resources, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. RP Walter, CA (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIEHS NIH HHS [ES05798] NR 61 TC 37 Z9 42 U1 0 U2 1 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD OCT 23 PY 2001 VL 98 IS 22 BP 12566 EP 12571 DI 10.1073/pnas.221232998 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 486EU UT WOS:000171806100051 PM 11606727 ER PT J AU Cole, SW Naliboff, BD Kemeny, ME Griswold, MP Fahey, JL Zack, JA AF Cole, SW Naliboff, BD Kemeny, ME Griswold, MP Fahey, JL Zack, JA TI Impaired response to HAART in HIV-infected individuals with high autonomic nervous system activity SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID PROTEIN-KINASE-A; ANTIRETROVIRAL THERAPY; VIRUS-REPLICATION; IMMUNE-SYSTEM; TNF-ALPHA; CAMP; EXPRESSION; RESERVOIR; PATHWAYS; LINEAGE AB Neurotransmitters can accelerate HIV-1 replication in vitro, leading us to examine whether differences in autonomic nervous system (ANS) activity might promote residual HIV-1 replication in patients treated with highly active antiretroviral therapy. Patients who showed constitutively high levels of ANS activity before highly active antiretroviral therapy experienced poorer suppression of plasma viral load and poorer CD4(+) T cell recovery over 3-11 months of therapy. ANS activity was not related to demographic or behavioral characteristics that might influence pathogenesis. However, the ANS neurotransmitter norepinephrine enhanced replication of both CCR5- and CXCR4-tropic strains of HIV-1 in vitro via chemokine receptor up-regulation and enhanced viral gene expression, suggesting that neural activity may directly promote residual viral replication. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Microbiol Mol Genet & Immunol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, AIDS Inst, Los Angeles, CA 90095 USA. Vet Adm Greater Los Angeles Area Healthcare Syst, Los Angeles, CA 90073 USA. Consolidated Lab Serv, Van Nuys, CA 91406 USA. RP Cole, SW (reprint author), Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. FU NIAID NIH HHS [AI 33259, AI 36554, AI 49135, R01 AI036554] NR 29 TC 85 Z9 86 U1 1 U2 2 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD OCT 23 PY 2001 VL 98 IS 22 BP 12695 EP 12700 DI 10.1073/pnas.221134198 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 486EU UT WOS:000171806100073 PM 11675501 ER PT J AU Vergis, EN Brennen, C Wagener, M Muder, RR AF Vergis, EN Brennen, C Wagener, M Muder, RR TI Pneumonia in long-term care - A prospective case-control study of risk factors and impact on survival SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID NURSING-HOME RESIDENTS; NOSOCOMIAL INFECTIONS; ACQUIRED PNEUMONIA; SURVEILLANCE; FACILITIES; MORTALITY; HOSPITALIZATION; VALIDATION; PREVALENCE; MANAGEMENT AB Background: Pneumonia is a major cause of morbidity and mortality in long-term care facilities. Prior studies of pneumonia have failed to identify risk factors potentially amenable to intervention. Our objectives were to (1) identify modifiable risk factors for the occurrence of pneumonia and (2) determine the long-term impact of pneumonia on survival. Methods: We performed a case-control study among residents of a Veterans Affairs long-term care facility. Case patients included all patients developing pneumonia from 2 days to 1 year after admission. Control subjects were matched for admission date, level of nursing care, and dependence in activities of daily living. Patients were followed up for 2 years or until death or discharge from the facility. Results: We identified 104 case-control pairs. Risk factors significantly associated with pneumonia included witnessed aspiration (odds ratio, 13.9; 95% confidence interval, 1.7-111.0; P=.01), sedative medication (odds ratio, 2.6; 95% confidence interval, 1.2-5.4; P=.01), and comorbidity score (odds ratio, 1.2; 95% confidence interval, 1.0-1.4;P=.05). Mortality due to pneumonia was 23% at 14 days. Patients with pneumonia had a significantly higher mortality than did controls at 1 year (75% vs 40%; P < .001); survival curves converged at 2 years. In a Cox proportional hazards regression model, an episode of pneumonia was independently associated with mortality during follow-up (odds ratio, 2.6; 95% confidence interval, 1.7-3,9; P < .001). Conclusions: Among long-term care patients closely matched for age, level of dependency, and duration of institutionalization, an episode of pneumonia is associated with significant excess mortality that persists for up to 2 years, Two identified risk factors, large-volume aspiration and receipt of sedating medication, are potentially amenable to intervention. C1 VA Pittsburgh Healthcare Syst, Div Infect Dis, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Med Ctr, Div Infect Dis, Dept Med, Pittsburgh, PA USA. RP Muder, RR (reprint author), VA Pittsburgh Healthcare Syst, Div Infect Dis, Univ Dr C, Pittsburgh, PA 15240 USA. NR 31 TC 74 Z9 78 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD OCT 22 PY 2001 VL 161 IS 19 BP 2378 EP 2381 DI 10.1001/archinte.161.19.2378 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 483RL UT WOS:000171649600013 PM 11606155 ER PT J AU Gama, L Wilt, SG Breitwieser, GE AF Gama, L Wilt, SG Breitwieser, GE TI Heterodimerization of calcium sensing receptors with metabotropic glutamate receptors in neurons SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID HUMAN CA2+ RECEPTOR; EXTRACELLULAR CA2+-SENSING RECEPTOR; CELL-SURFACE EXPRESSION; N-LINKED GLYCOSYLATION; OUTWARD K+ CHANNEL; SYNAPTIC CLEFT; MESSENGER-RNA; DIFFERENTIAL EXPRESSION; HETEROMERIC COMPLEXES; MUSCARINIC RECEPTORS AB Calcium sensing (CaR) and Group I metabotropic glutamate receptors exhibit overlapping expression patterns in brain, and share common signal transduction pathways. To determine whether CaR and Group I metabotropic glutamate receptors (mGluRs) (mGluR1 alpha and mGluR5) can form heterodimers, we immunoprecipitated CaR from bovine brain and observed co-precipitation of mGluR1a. CaR and mGluR1 alpha co-localize in hippocampal and cerebellar neurons, but are expressed separately in other brain regions. In vitro transfection studies in HEK-293 cells established the specificity and disulfide-linked nature of the CaR:mGluR1 alpha (CaR: mGluR5) interactions. CaR:mGluR1 alpha (CaR:mGluR5) heterodimers exhibit altered trafficking via Homer 1c when compared with CaR:CaR homodimers. CaR becomes sensitive to glutamate-mediated internalization when present in CaR:mGluR1 alpha heterodimers. These results demonstrate cross-family covalent heterodimerization of CaR with Group I mGluRs, and increase the potential role(s) for CaR in modulating neuronal function. C1 Johns Hopkins Univ, Sch Med, Dept Physiol, Baltimore, MD 21205 USA. Bronx Vet Affairs Med Ctr, Res Serv, Bronx, NY 10468 USA. RP Breitwieser, GE (reprint author), Syracuse Univ, Dept Biol, 122 Lyman Hall,108 Coll Pl, Syracuse, NY 13244 USA. OI Gama, Lucio/0000-0001-9511-012X FU NIGMS NIH HHS [GM58578] NR 69 TC 95 Z9 96 U1 0 U2 2 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD OCT 19 PY 2001 VL 276 IS 42 BP 39053 EP 39059 DI 10.1074/jbc.M105662200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 484CT UT WOS:000171673200095 PM 11489900 ER PT J AU Linseman, DA Laessig, T Meintzer, MK McClure, M Barth, H Aktories, K Heidenreich, KA AF Linseman, DA Laessig, T Meintzer, MK McClure, M Barth, H Aktories, K Heidenreich, KA TI An essential role for Rac/Cdc42 GTPases in cerebellar granule neuron survival SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID GLYCOGEN-SYNTHASE KINASE-3-BETA; GTP-BINDING PROTEINS; RHO-FAMILY GTPASES; N-TERMINAL KINASE; DIFFICILE TOXIN-B; C-JUN; CLOSTRIDIUM-DIFFICILE; GROWTH-FACTOR; SYMPATHETIC NEURONS; INDUCED APOPTOSIS AB Rho family GTPases are critical molecular switches that regulate the actin cytoskeleton and cell function. In the current study, we investigated the involvement of Rho GTPases in regulating neuronal survival using primary cerebellar granule neurons. Clostridium difficile toxin B, a specific inhibitor of Rho, Rac, and Cdc42, induced apoptosis of granule neurons characterized by c-Jun phosphorylation, caspase-3 activation, and nuclear condensation. Serum and depolarization-dependent survival signals could not compensate for the loss of GTPase function. Unlike trophic factor withdrawal, toxin B did not affect the antiapoptotic kinase Akt or its target glycogen synthase kinase-3 beta. The proapoptotic effects of toxin B were mimicked by Clostridium sordellii lethal toxin, a selective inhibitor of Rac/Cdc42. Although Rac/Cdc42 GTPase inhibition led to F-actin disruption, direct cytoskeletal disassembly with Clostridium botulinum C2 toxin was insufficient to induce c-Jun phosphorylation or apoptosis. Granule neurons expressed high basal JNK and low p38 mitogen-activated protein kinase activities that were unaffected by toxin B. However, pyridyl imidazole inhibitors of JNK/p38 attenuated c-Jun phosphorylation. Moreover, both pyridyl imidazoles and adenoviral dominant-negative c-Jun attenuated apoptosis, suggesting that JNK/c-Jun signaling was required for cell death. The results indicate that Rac/Cdc42 GTPases, in addition to trophic factors, are critical for survival of cerebellar granule neurons. C1 Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80220 USA. Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. Univ Freiburg, Inst Pharmakol & Toxikol, D-79104 Freiburg, Germany. RP Linseman, DA (reprint author), Denver VAMC 111H, 1055 Clermont St, Denver, CO 80220 USA. RI Barth, Holger/E-7920-2013 NR 57 TC 59 Z9 60 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD OCT 19 PY 2001 VL 276 IS 42 BP 39123 EP 39131 DI 10.1074/jbc.M103959200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 484CT UT WOS:000171673200104 PM 11509562 ER PT J AU Li, SL Valente, AJ Wang, L Gamez, MJ Clark, RA AF Li, SL Valente, AJ Wang, L Gamez, MJ Clark, RA TI Transcriptional regulation of the p67(phox) gene - Role of AP-1 in concert with myeloid-specific transcription factors SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID CHRONIC GRANULOMATOUS-DISEASE; CCAAT DISPLACEMENT PROTEIN; SEQUENCE-BINDING PROTEIN; NADPH OXIDASE; RESPIRATORY BURST; GP91(PHOX) EXPRESSION; PROMOTER ACTIVITY; RETINOIC ACID; DNA-BINDING; HL-60 CELLS AB We have investigated the myeloid-specific transcriptional regulation of p67(phox), an essential component of phagocyte respiratory burst NADPH oxidase. Analysis was carried out on the p67(phox), 5'-flanking region from -3669 to -4 (relative to ATG), including the first exon and intron and part of the second exon. The construct extending from -985 to -4 produced the highest luciferase activity in myeloid HL-60 cells but was not active in HeLa or Jurkat cells, indicating myeloid-specific expression. Four active elements were identified: Sp1/Sp3 at -694, PU.1 at -289, AP-1 at -210, and PU.1/HAF1 at -182, the latter three being in the first intron. These cis elements bound their cognate transacting factors both in vitro and in vivo. Mutation of the Sp1, PU.1, or PU.1/ HAFT site each decreased promoter activity by 35-50%. Mutations in all three sites reduced promoter activity by 90%. However, mutation of the AP-1 site alone nearly abolished promoter activity. The AP-1 site bound Jun and Fos proteins from HL-60 cell nuclear extract. Coexpression with Jun B in AP-1-deficient cells increased promoter activity by 3-fold. These data show that full p67(phox) promoter activity requires cooperation between myeloid-specific and nonmyeloid transcription factors, with AP-1 being the most critical for function. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. RP Clark, RA (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIA NIH HHS [R01 AG019519]; NIAID NIH HHS [R01 AI020866, AI20866, R37 AI020866] NR 42 TC 22 Z9 22 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD OCT 19 PY 2001 VL 276 IS 42 BP 39368 EP 39378 DI 10.1074/jbc.M106111200 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 484CT UT WOS:000171673200136 PM 11483614 ER PT J AU Clarke, P Meintzer, SM Spalding, AC Johnson, GL Tyler, KL AF Clarke, P Meintzer, SM Spalding, AC Johnson, GL Tyler, KL TI Caspase 8-dependent sensitization of cancer cells to TRAIL-induced apoptosis following reovirus-infection SO ONCOGENE LA English DT Article DE apoptosis; TRAIL; reovirus; caspase 8; chemotherapy ID INFLUENZA-VIRUS INFECTION; NECROSIS-FACTOR-ALPHA; TUMORICIDAL ACTIVITY; SIGNALING PATHWAY; DEATH RECEPTORS; MOLECULAR-BASIS; LIGAND; EXPRESSION; ACTIVATION; MODULATION AB TRAIL (TNF-related apoptosis-inducing ligand) induces apoptosis in susceptible cells by binding to death receptors 4 (DR4) and 5 (DR5). TRAIL preferentially induces apoptosis in transformed cells and the identification of mechanisms by which TRAIL-induced apoptosis can be enhanced may lead to novel cancer chemotherapeutic strategies. Here we show that reovirus infection induces apoptosis in cancer cell lines derived from human breast, lung and cervical cancers. Reovirus-induced apoptosis is mediated by TRAIL and is associated with the release of TRAIL from infected cells. Reovirus infection synergistically and specifically sensitizes cancer cell lines to killing by exogenous TRAIL. This sensitization both enhances the susceptibility of previously resistant cell lines to TRAIL-induced apoptosis and reduces the amount of TRAIL needed to kill already sensitive lines. Sensitization is not associated with a detectable change in the expression of TRAIL. receptors in reovirus-infected cells. Sensitization is associated with an increase in the activity of the death receptor-associated initiator caspase. caspase 8, and is inhibited by the peptide IETD-fmk, suggesting that reovirus sensitizes cancer cells to TRAIL-induced apoptosis in a caspase 8-dependent manner. Reovirus-induced sensitization of cells to TRAIL is also associated with increased cleavage of PARP, a substrate of the effector caspases 3 and 7. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med Microbiol & Immunol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol B 182, 4200 E 9th Ave, Denver, CO 80262 USA. OI Tyler, Kenneth/0000-0003-3294-5888 FU NIA NIH HHS [1RO1AG14071]; NIGMS NIH HHS [GM30324] NR 43 TC 41 Z9 44 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI BASINGSTOKE PA HOUNDMILLS, BASINGSTOKE RG21 6XS, HAMPSHIRE, ENGLAND SN 0950-9232 J9 ONCOGENE JI Oncogene PD OCT 18 PY 2001 VL 20 IS 47 BP 6910 EP 6919 DI 10.1038/sj.onc.1204842 PG 10 WC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity GA 483NK UT WOS:000171641000012 PM 11687970 ER PT J AU Holmes, WC Conare, KR AF Holmes, WC Conare, KR TI Twenty years into the HIV epidemic, do we CARE enough to manage it well? SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material C1 Univ Penn, Sch Med, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. ActionAIDS Inc, Philadelphia, PA 19107 USA. RP Holmes, WC (reprint author), 733 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD OCT 16 PY 2001 VL 135 IS 8 BP 610 EP 612 PN 1 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 481VY UT WOS:000171542200007 PM 11601933 ER PT J AU Shekelle, PG MacLean, CH Morton, SC Wenger, NS AF Shekelle, PG MacLean, CH Morton, SC Wenger, NS TI Assessing Care of Vulnerable Elders: Methods for developing quality indicators SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID VALIDITY; CRITERIA; UNDERUSE; TRIALS C1 RAND Corp, Santa Monica, CA 90407 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Rand Stat Grp, San Francisco, CA USA. RAND Hlth, Santa Monica, CA USA. RAND Stat Grp, Santa Monica, CA USA. RP Shekelle, PG (reprint author), RAND Corp, 1700 Main St,Box 2138, Santa Monica, CA 90407 USA. NR 21 TC 128 Z9 131 U1 0 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD OCT 16 PY 2001 VL 135 IS 8 BP 647 EP 652 PN 2 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 481WA UT WOS:000171542400003 PM 11601947 ER PT J AU Wenger, NS Rosenfeld, K AF Wenger, NS Rosenfeld, K TI Quality indicators for end-of-life care in vulnerable elders SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID CRITICALLY ILL PATIENTS; NURSING-HOME RESIDENTS; ADVANCE DIRECTIVES; SUSTAINING TREATMENT; RESUSCITATION PREFERENCES; CLINICAL MANAGEMENT; DYING PATIENTS; PHYSICIANS; DECISIONS; DEATH C1 Univ Calif Los Angeles, Dept Med, Div Gen Internal Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Health Care Syst, Los Angeles, CA USA. RP Wenger, NS (reprint author), Univ Calif Los Angeles, Dept Med, Div Gen Internal Med, 911 Broxton Plaza, Los Angeles, CA 90095 USA. NR 64 TC 46 Z9 46 U1 7 U2 9 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD OCT 16 PY 2001 VL 135 IS 8 BP 677 EP 685 PN 2 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 481WA UT WOS:000171542400006 PM 11601950 ER PT J AU Chodosh, J Ferrell, BA Shekelle, PG Wenger, NS AF Chodosh, J Ferrell, BA Shekelle, PG Wenger, NS TI Quality indicators for pain management in vulnerable elders SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID CHRONIC MUSCULOSKELETAL PAIN; PLACEBO-CONTROLLED TRIAL; GENERAL-POPULATION; NUTRITION EXAMINATION; DEPRESSIVE SYMPTOMS; DIABETIC NEUROPATHY; RANDOMIZED TRIAL; NATIONAL-HEALTH; PEPTIC-ULCER; DRUG-USE C1 Univ Calif Los Angeles, Div Geriatr, Dept Med, Los Angeles, CA 90095 USA. RAND Corp, Hlth, Santa Monica, CA 90406 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Chodosh, J (reprint author), Univ Calif Los Angeles, Div Geriatr, Dept Med, Los Angeles, CA 90095 USA. NR 38 TC 24 Z9 24 U1 0 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD OCT 16 PY 2001 VL 135 IS 8 BP 731 EP 735 PN 2 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 481WA UT WOS:000171542400012 PM 11601956 ER PT J AU Rhew, DC AF Rhew, DC TI Quality indicators for the management of pneumonia in vulnerable elders SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID COMMUNITY-ACQUIRED PNEUMONIA; PNEUMOCOCCAL POLYSACCHARIDE VACCINE; PROSPECTIVE PAYMENT SYSTEM; INFLUENZA VACCINATION; HOSPITALIZED-PATIENTS; PRACTICE GUIDELINE; EARLY SWITCH; LOW-RISK; IMMUNIZATION; EFFICACY C1 Zynx Hlth Inc, Beverly Hills, CA 90212 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Rhew, DC (reprint author), Zynx Hlth Inc, 9100 Wilshire Blvd,Suite 655 E Tower, Beverly Hills, CA 90212 USA. NR 53 TC 16 Z9 18 U1 0 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD OCT 16 PY 2001 VL 135 IS 8 BP 736 EP 743 PN 2 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 481WA UT WOS:000171542400013 PM 11601957 ER PT J AU Schnelle, JF Smith, RL AF Schnelle, JF Smith, RL TI Quality indicators for the management of urinary incontinence in vulnerable community-dwelling elders SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID INTRINSIC SPHINCTERIC DEFICIENCY; GENUINE STRESS-INCONTINENCE; RANDOMIZED CONTROLLED TRIAL; MUSCLE EXERCISE TREATMENT; DETRUSOR INSTABILITY; OLDER WOMEN; OXYBUTYNIN CHLORIDE; SURGICAL-TREATMENT; FOLLOW-UP; FEMALE C1 Anna & Harry Borun Ctr Gerontol Res, Reseda, CA 91335 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Los Angeles Jewish Home Aging, Los Angeles, CA USA. Ctr Geriatr Res Educ & Clin, Sepulveda, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. RP Schnelle, JF (reprint author), Anna & Harry Borun Ctr Gerontol Res, 7150 Tampa Ave, Reseda, CA 91335 USA. NR 61 TC 23 Z9 23 U1 1 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD OCT 16 PY 2001 VL 135 IS 8 BP 752 EP 758 PN 2 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 481WA UT WOS:000171542400015 PM 11601959 ER PT J AU Glatter, KA Dorostkar, PC Yang, YF Lee, RJ Van Hare, GF Keung, E Modin, G Scheinman, MM AF Glatter, KA Dorostkar, PC Yang, YF Lee, RJ Van Hare, GF Keung, E Modin, G Scheinman, MM TI Electrophysiological effects of ibutilide in patients with accessory pathways SO CIRCULATION LA English DT Article; Proceedings Paper CT 20th Scientific Session of the North-American-Society-of-Pacing-and-Electrophysiology CY MAY 12-14, 1999 CL TORONTO, CANADA SP N Amer Soc Pacing & Electrophysiol DE Wolff-Parkinson-White syndrome; fibrillation; antiarrhythmia agents ID PARKINSON-WHITE-SYNDROME; ATRIAL-FIBRILLATION; INTRAVENOUS IBUTILIDE; EFFICACY; FLUTTER; TERMINATION; CONVERSION; SAFETY AB Background-Atrial fibrillation (AF) may cause life-threatening ventricular arrhythmias in patients with Wolff-Parkinson-White syndrome. We prospectively evaluated the effects of ibutilide on the conduction system in patients with accessory pathways (AP). Methods and Results-In part I, we gave ibutilide to 22 patients (18 men, 31 +/-3 years of age) who had AF during electrophysiology study, including 6 pediatric patients less than or equal to 18 years of age. Ibutilide terminated AF in 21 of 22 patients (95%) during or 8 +/-5 minutes after infusion and prolonged the shortest preexcited R-R interval during AF. Successful ablation was performed in all patients. In part II, ibutilide was given to 18 patients ( 14 men, 28 +/- 21 years) to assess its effects on the AP and conduction system. Ibutilide prolonged the antegrade atrioventricular node effective refractory period (ERP) (from 252 +/- 60 to 303 +/- 70 ms; P <0.02). Ibutilide caused transient loss of the delta wave in 1 patient and abolished inducible tachycardia in 2 patients, although retrograde mapping still allowed for successful AP ablation. The antegrade AP ERP prolonged from 275 +/- 40 to 320 +/- 60 ms (P <0.01), as did the antegrade AP block cycle length; the retrograde AP ERP and block cycle length similarly prolonged with ibutilide. The relative and effective refractory period of the His-Purkinje system increased in 61% of patients after ibutilide. There were no adverse side effects. Conclusions-We report the use of ibutilide in terminating AP-mediated AF, including the first report in the pediatric population. Ibutilide prolonged refractoriness of the atrioventricular node, His-Purkinje system, and AP. C1 Univ Calif San Francisco, Inst Cardiovasc Res, San Francisco, CA 94143 USA. Univ Calif San Francisco, Sect Adult & Pediat Cardiac Electrophysiol, San Francisco, CA 94143 USA. San Francisco Vet Adm Med Ctr, San Francisco, CA USA. RP Scheinman, MM (reprint author), Univ Calif San Francisco, Inst Cardiovasc Res, 500 Parnassus Ave,MU E 4S Box 1354, San Francisco, CA 94143 USA. NR 19 TC 31 Z9 32 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2001 VL 104 IS 16 BP 1933 EP 1939 DI 10.1161/hc4101.097538 PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 486QP UT WOS:000171828700014 PM 11602497 ER PT J AU Musher, DM Mediwala, R Phan, HM CHen, G Baughn, RE AF Musher, DM Mediwala, R Phan, HM CHen, G Baughn, RE TI Diagnosis of pneumococcal pneumonia - Reply SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID CIRCULATING IMMUNE-COMPLEXES; EXPERIMENTAL SYPHILIS; ANTIBODIES; VACCINE; TRIAL C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Sect Infect Dis 111G, Houston, TX 77030 USA. RP Musher, DM (reprint author), Baylor Coll Med, Houston Vet Affairs Med Ctr, Sect Infect Dis 111G, Bldg 100,Rm 4B370,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 8 TC 1 Z9 1 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD OCT 15 PY 2001 VL 33 IS 8 BP 1440 EP 1441 DI 10.1086/323482 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 476NZ UT WOS:000171235600032 ER PT J AU Stanislaus, R Singh, AK Singh, I AF Stanislaus, R Singh, AK Singh, I TI Lovastatin treatment decreases mononuclear cell infiltration into the CNS of Lewis rats with experimental allergic encephalomyelitis SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE EAE; macrophages; Lovastatin; cytokines; CNS; statins ID NITRIC-OXIDE SYNTHASE; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; MULTIPLE-SCLEROSIS; ASTROCYTES; MICROGLIA; AMINOGUANIDINE; PEROXYNITRITE; DEMYELINATION; LYMPHOCYTES; MACROPHAGES AB Mononuclear cell infiltration into the CNS and induction of inflammatory cytokines and NOS in diseases like multiple sclerosis (MS) and experimental allergic encephalomyelitis (EAE) have been implicated in subsequent disease pathogenesis and progression. We report that Lovastatin treatment blocks the clinical disease and induction of inflammatory cytokines; and NOS in spinal cords of MBP induced EAE rats. A significant number of the infiltrating cells in CNS were ED1+ cells of monocyte/macrophage lineage. To understand the mechanism of efficacy of Lovastatin against EAE, we examined the effect of Lovastatin on the transmigration of mononuclear cells into EAE spinal cord. The data presented here documents that Lovastatin treatment attenuates the transmigration of mononuclear cells possibly by down regulating the expression of LFA-1, a ligand for ICAM, in endothelial-leukocyte interaction. These results indicate that Lovastatin treatment prevents infiltration by mononuclear cells into the CNS of rats induced for EAE, thereby lessening the histological changes and clinical signs and thus ameliorating the disease. These observations indicate that Lovastatin treatment may be of therapeutic value against inflammatory disease process associated with infiltration of activated mononuclear cells into the tissue. (C) 2001 Wiley-Liss, Inc. C1 Med Univ S Carolina, Dept Pediat & Pathol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Dept Pathol & Lab Med, Charleston, SC USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, 171 Ashley Ave, Charleston, SC 29425 USA. FU NINDS NIH HHS [NS-22576, NS-37766, NS-34741, NS-40810] NR 35 TC 103 Z9 107 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD OCT 15 PY 2001 VL 66 IS 2 BP 155 EP 162 DI 10.1002/jnr.1207 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 477RL UT WOS:000171298000002 PM 11592110 ER PT J AU Walter, LC Covinsky, KE AF Walter, LC Covinsky, KE TI Use of prognostic indexes for determining malpractice liability - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Geriatr, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94143 USA. RP Walter, LC (reprint author), Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Geriatr, San Francisco, CA 94143 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 10 PY 2001 VL 286 IS 14 BP 1712 EP 1712 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 480NC UT WOS:000171466800018 ER PT J AU Reue, K Glueck, SB AF Reue, K Glueck, SB TI Accumulating evidence for differences during preadipocyte development - Focus on "Differential gene expression in white and brown preadipocytes" SO PHYSIOLOGICAL GENOMICS LA English DT Editorial Material C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Reue, K (reprint author), Univ Calif Los Angeles, Dept Med, 11301 Wilshire Blvd,Bldg 113,Rm 312, Los Angeles, CA 90073 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1094-8341 J9 PHYSIOL GENOMICS JI Physiol. Genomics PD OCT 10 PY 2001 VL 7 IS 1 BP 1 EP 2 PG 2 WC Cell Biology; Genetics & Heredity; Physiology SC Cell Biology; Genetics & Heredity; Physiology GA 481BV UT WOS:000171500000001 PM 11595786 ER PT J AU Vergis, EN Hayden, MK Chow, JW Snydman, DR Zervos, MJ Linden, PK Wagener, MM Schmitt, B Muder, RR AF Vergis, EN Hayden, MK Chow, JW Snydman, DR Zervos, MJ Linden, PK Wagener, MM Schmitt, B Muder, RR TI Determinants of vancomycin resistance and mortality rates in enterococcal bacteremia - A prospective multicenter study SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID BLOOD-STREAM INFECTIONS; FAECIUM BACTEREMIA; RISK-FACTORS; CLINICAL-FEATURES; GENTAMICIN-RESISTANT; SURGICAL PATIENTS; FAECALIS; LEVEL; ENDOCARDITIS; GENE AB Background: Enterococcus species are major nosocomial pathogens and are exhibiting vancomycin resistance with increasing frequency. Previous studies have not resolved whether vancomycin resistance Is an independent risk factor for death in patients with invasive disease due to Enterococcus species or whether antibiotic therapy alters the outcome of enterococcal bacteremia. Objective: To determine whether vancomycin resistance is an independent predictor of death in patients with enterococcal bacteremia and whether appropriate antimicrobial therapy influences outcome. Design: Prospective observational study. Setting: Four academic medical centers and a community hospital. Patients: All patients with enterococcal bacteremia. Measurements: Demographic characteristics; underlying disease; Acute Physiology and Chronic Health Evaluation (APACHE) II scores; antibiotic therapy, immunosuppression, and procedures before onset; and antibiotic therapy during the ensuing 6 weeks. The major end point was 14-day survival. Results: Of 398 episodes, 60% were caused by E. faecalis and 37% were caused by E. faecium. Thirty-seven percent of isolates exhibited resistance or Intermediate susceptibility to vancomycin. Twenty-two percent of E. faecium isolates showed reduced susceptibility to quinupristin-dalfopristin. Previous vancomycin use (odds ratio [OR], 5.82 [95% Cl, 3.20 to 10.58]; P < 0.001), previous corticosteroid use (OR, 2.43 [Cl, 1.22 to 4.86]; P = 0.01), and total APACHE II score (OR, 1.06 per unit change [Cl, 1.02 to 1.10 per unit change]; P = 0.003) were associated with vancomycin-resistant enterococcal bacteremia. The mortality rate was 19% at 14 days. Hematologic malignancy (OR, 3.83 [Cl, 1.56 to 9.39]; P = 0.003), vancomycin resistance (OR, 2.10 [Cl, 1.14 to 3.88]; P = 0.02), and APACHE II score (OR, 1.10 per unit change [Cl, 1.05 to 1.14 per unit change]; P < 0.001) were associated with 14-day mortality. Among patients with monomicrobial enterococcal bacteremia, receipt of effective antimicrobial therapy within 48 hours independently predicted survival (OR for death, 0.21 [Cl, 0.06 to 0.80]; P = 0.02). Conclusions: vancomycin resistance is an independent predictor of death from enterococcal bacteremia. Early, effective antimicrobial therapy is associated with a significant improvement in survival. C1 Univ Pittsburgh, Med Ctr, Vet Affairs Med Ctr, Pittsburgh, PA USA. Rush Presbyterian St Lukes Med Ctr, Rush Med Coll, Chicago, IL 60612 USA. Wayne State Univ, Sch Med, Detroit, MI USA. John D Dingell Vet Affairs Med Ctr, Detroit, MI USA. William Beaumont Hosp, Royal Oak, MI 48072 USA. Tufts Univ, Sch Med, Boston, MA 02111 USA. Tufts Univ New England Med Ctr, Boston, MA 02111 USA. RP Muder, RR (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Infect Dis Sect, Univ Dr C, Pittsburgh, PA 15240 USA. RI Snydman, David/O-3889-2014 OI Snydman, David/0000-0003-0119-3978 NR 48 TC 193 Z9 200 U1 0 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD OCT 2 PY 2001 VL 135 IS 7 BP 484 EP 492 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 477EF UT WOS:000171269600002 PM 11578151 ER PT J AU Williams, SV Fihn, SD Gibbons, RJ AF Williams, SV Fihn, SD Gibbons, RJ TI Guidelines for the management of patients with chronic stable angina: Diagnosis and risk stratification SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID CORONARY-ARTERY-DISEASE; EMISSION COMPUTED-TOMOGRAPHY; AMERICAN-HEART-ASSOCIATION; MEDICALLY TREATED PATIENTS; BUNDLE-BRANCH BLOCK; INCREMENTAL PROGNOSTIC VALUE; LEFT-VENTRICULAR FUNCTION; DOBUTAMINE STRESS ECHOCARDIOGRAPHY; ACUTE MYOCARDIAL-INFARCTION; HIGH-DOSE DIPYRIDAMOLE AB Patients with suspected chronic stable angina can be evaluated in three stages. In stage one, the clinician uses information from the history, physical examination, laboratory tests for diabetes and hyperlipidemia, and resting electrocardiography to estimate the patient's probability of coronary artery disease (CAD). In stage two, additional testing for patients with a low probability of CAD focuses on diagnosing noncoronary causes of chest pain. Patients with a high probability of CAD have stress tests to assess their risk from CAD, and patients with an intermediate probability of CAD have stress tests to estimate the probability of CAD and assess their risk from CAD. Most patients with new-onset angina can start stress testing with exercise electrocardiography. The initial stress test should be a stress imaging procedure for patients with rest ST-segment depression greater than 1 mm, complete left bundle-branch block, ventricular paced rhythm, preexcitation syndrome, or previous revascularization with percutaneous coronary angioplasty or coronary artery bypass grafting. Patients who cannot exercise can have an imaging procedure with stress induced by pharmacologic agents. In stage three, patients with a predicted average annual cardiac mortality rate between 1% and 3% should have a stress Imaging study or coronary angiography with left ventriculography. Those with a known left ventricular dysfunction should have cardiac catheterization. Patients with CAD who have an estimated annual mortality rate greater than 3% should have cardiac catheterization to determine whether their anatomy is suitable for revascularization. Patients with an estimated annual mortality rate less than 1% can begin to receive medical therapy. C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Penn, Philadelphia, PA 19104 USA. Univ Washington, Seattle, WA 98195 USA. Mayo Med Ctr, Rochester, MN USA. RP Williams, SV (reprint author), 1220 Blockley Hall,423 Guadrian Dr, Philadelphia, PA 19104 USA. NR 159 TC 32 Z9 35 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD OCT 2 PY 2001 VL 135 IS 7 BP 530 EP 547 PG 18 WC Medicine, General & Internal SC General & Internal Medicine GA 477EF UT WOS:000171269600009 PM 11578158 ER PT J AU Haidet, P Dains, JE Paterniti, DA Chang, T Tseng, E Rogers, JC AF Haidet, P Dains, JE Paterniti, DA Chang, T Tseng, E Rogers, JC TI Medical students' attitudes toward patient-centered care and standardized patients' perceptions of humanism: A link between attitudes and outcomes SO ACADEMIC MEDICINE LA English DT Article; Proceedings Paper CT 40th Annual Conference of the Research in Medical Education CY NOV 04-07, 2001 CL WASHINGTON, D.C. ID PHYSICIAN C1 Baylor Coll Med, Houston VAMC, Houston, TX 77030 USA. RP Haidet, P (reprint author), Baylor Coll Med, Houston VAMC, 2002 Holcombe Blvd 152A, Houston, TX 77030 USA. NR 14 TC 23 Z9 24 U1 1 U2 5 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD OCT PY 2001 VL 76 IS 10 SU S BP S42 EP S44 DI 10.1097/00001888-200110001-00015 PG 3 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 482TX UT WOS:000171592300015 PM 11597869 ER PT J AU Liu, QN Reddy, S Sayre, JW Pop, V Graves, MC Fiala, M AF Liu, QN Reddy, S Sayre, JW Pop, V Graves, MC Fiala, M TI Essential role of HIV type 1-infected and cyclooxygenase 2-activated macrophages and T cells in HIV type 1 myocarditis SO AIDS RESEARCH AND HUMAN RETROVIRUSES LA English DT Article ID NITRIC-OXIDE SYNTHASE; HUMAN-IMMUNODEFICIENCY-VIRUS; EXPERIMENTAL AUTOIMMUNE MYOCARDITIS; POLYMERASE-CHAIN-REACTION; PROSTAGLANDIN SYNTHASE-2; ADHESION MOLECULES; MESSENGER-RNA; INFECTION; HEART; CARDIOMYOPATHY AB HIV-1 cardiomyopathy has become a major cause of death in AIDS patients, but its pathogenesis is unclear. We used an antigen retrieval technique and immunostaining to investigate the hearts of 15 AIDS patients, of whom 3 had dilated cardiomyopathy. Immunocytochemistry shows infiltration of the left ventricular myocardium with mononuclear cells, ranging from minimal to diagnostic of myocarditis. The infiltrates include macrophages and CD3(+) and CD8(+) T cells. The tight junction protein ZO-1 is disrupted at the site of monocyte-macrophage vascular penetration and the coronary vessels show fibrinogen leakage in the hearts of AIDS patients, but not in the normal heart. A subset of infiltrating macrophages is doubly positive for cyclooxygenase 2 (COX-2) and inducible nitric oxide synthase. HIV-1 peptides gp120 and Nef are expressed in macrophages and T cells, but not in cardiomyocytes. COX-2 is expressed by both gp120-positive and gp120-negative macrophages. The hearts of AIDS patients separate into those showing minimal infiltrates with low COX-2 expression and those with dense infiltrates and high COX-2; all failing hearts are in the latter group. These data suggest that COX-2- activated and HIV-1-infected monocyte-macrophages and T cells play a crucial role in the progression of HIV-1 myocarditis to HIV-1 cardiomyopathy. C1 Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Mol & Med Pharmacol, Los Angeles, CA 90095 USA. RP Fiala, M (reprint author), Univ Calif Los Angeles, RNRC, Rm 2150,710 Westwood Plaza, Los Angeles, CA 90095 USA. FU NHLBI NIH HHS [HL63065, HL63639]; NIDA NIH HHS [DA10442] NR 49 TC 21 Z9 21 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 0889-2229 J9 AIDS RES HUM RETROV JI Aids Res. Hum. Retrovir. PD OCT PY 2001 VL 17 IS 15 BP 1423 EP 1433 DI 10.1089/088922201753197097 PG 11 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 487CX UT WOS:000171857000007 PM 11679155 ER PT J AU Bradley, KA Kivlahan, DR Bush, KR McDonell, MB Fihn, SD AF Bradley, KA Kivlahan, DR Bush, KR McDonell, MB Fihn, SD CA Ambulatory Care Quality Improveme TI Variations on the CAGE alcohol screening questionnaire: Strengths and limitations in VA general medical patients SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcohol screening ID PRIMARY-CARE; PROBLEM DRINKING; USE DISORDERS; CONSUMPTION QUESTIONS; BRIEF INTERVENTIONS; PROBLEM DRINKERS; BINGE-DRINKING; AUDIT; BIAS; FREQUENCY AB Background: Several variations on the CAGE alcohol screening questionnaire have been recommended. This report evaluates modifications and additions to the CAGE. Methods: Alcohol screening questionnaires were evaluated in male VA general medicine patients (n=227; mean age, 65.8). Mailed questionnaires included two scoring options for the CAGE (standard and last-year time frames), questions about quantity and frequency of drinking, two questions about episodic heavy drinking, and the question "Have you ever had a drinking problem?" Main analyses compared alcohol screening questions, at various cut-points, to a gold standard of hazardous drinking during the past year (greater than or equal to 14 drinks/week or greater than or equal to5 drinks on an occasion) and/or DSM-III-R alcohol abuse or dependence, based on standardized interviews. Results: The CAGE questionnaire with a past-year time frame was much less sensitive (0.57 vs. 0.77) but more specific (0.82 vs. 0.59) than the standard CAGE for detecting hazardous drinking during the past year and/or DSM-III-R alcohol abuse or dependence. An eight-item questionnaire that included the standard CAGE was most sensitive (0.92) but had low specificity (0.50). A single question about the frequency of drinking greater than or equal to6 drinks on an occasion, included in the eight-item questionnaire, was both relatively sensitive (0.77), and specific (0.83). Conclusion: The CAGE questionnaire with a past-year time frame was an insensitive alcohol-screening test. An eight-item augmented version of the standard CAGE was the most sensitive. A question about the frequency of drinking greater than or equal to6 drinks on an occasion performed better than the standard CAGE, which made it the optimal brief screening test for at-risk drinking. C1 VA Puget Sound Hlth Care Syst, HSR&D 152, NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA 98108 USA. RP Bradley, KA (reprint author), VA Puget Sound Hlth Care Syst, HSR&D 152, NW Hlth Serv Res & Dev Ctr Excellence, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIAAA NIH HHS [K23AA00313] NR 40 TC 43 Z9 45 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD OCT PY 2001 VL 25 IS 10 BP 1472 EP 1478 DI 10.1111/j.1530-0277.2001.tb02149.x PG 7 WC Substance Abuse SC Substance Abuse GA 483YJ UT WOS:000171663200010 PM 11696667 ER PT J AU Rumsfeld, JS Magid, DJ Plomondon, ME O'Brien, MM Spertus, JA Every, NR Sales, AE AF Rumsfeld, JS Magid, DJ Plomondon, ME O'Brien, MM Spertus, JA Every, NR Sales, AE TI Predictors of quality of life following acute coronary syndromes SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; OF-LIFE; ARTERY DISEASE; DEPRESSION; BIAS; ANXIETY; ANGINA; TRIAL AB We determined the predictors of physical and mental health status 7 months after admission for an acute coronary syndrome in a cohort of 1,660 Veterans Administration patients. Noncardiac variables were stronger predictors of quality of life than cardiac variables, depression was associated with worse physical and mental health status, and revascularization was associated with better physical and mental health status. C1 Denver VA Med Ctr, Cardiol Sect, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. Colorado Permanente Med Grp, Clin Res Unit, Denver, CO USA. Univ Missouri, Div Cardiol, Kansas City, MO 64110 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Rumsfeld, JS (reprint author), Denver VA Med Ctr, Cardiol Sect, 1055 Clermont St, Denver, CO 80220 USA. OI Sales, Anne/0000-0001-9360-3334 NR 20 TC 33 Z9 33 U1 0 U2 1 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 1 PY 2001 VL 88 IS 7 BP 781 EP + DI 10.1016/S0002-9149(01)01852-5 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 478XR UT WOS:000171374300014 PM 11589849 ER PT J AU Bruner, GR Scofield, RH Kelly, JA Kilpatrick, J Klein, DK Nath, SK Lam, T Reid, JS James, JA Harley, JB AF Bruner, GR Scofield, RH Kelly, JA Kilpatrick, J Klein, DK Nath, SK Lam, T Reid, JS James, JA Harley, JB TI Linkages associated with thrombocytopenia in pedigrees multiplex for lupus are potentially related to lupus morbidity and mortality. SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Meeting Abstract C1 Oklahoma Med Res Fdn, Arthritis & Immunol Program, Oklahoma City, OK 73104 USA. Univ Oklahoma, Hlth Sci Ctr, Dept Med, Oklahoma City, OK USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD OCT PY 2001 VL 69 IS 4 SU 1 MA 117 BP 199 EP 199 PG 1 WC Genetics & Heredity SC Genetics & Heredity GA 483RD UT WOS:000171648900118 ER PT J AU Jaju, M Sepulveda, AR Graham, DY Peterson, LE AF Jaju, M Sepulveda, AR Graham, DY Peterson, LE TI Database to study genetic susceptibility to Gastric Cancer. SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Meeting Abstract C1 Baylor Coll Med, Dept Med, Chron Dis Prevent & Control Res Ctr, Houston, TX 77030 USA. Univ Pittsburgh, Med Ctr, Dept Pathol, Pittsburgh, PA USA. VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD OCT PY 2001 VL 69 IS 4 SU 1 MA 412 BP 254 EP 254 PG 1 WC Genetics & Heredity SC Genetics & Heredity GA 483RD UT WOS:000171648900412 ER PT J AU Kelly, J Kilpatrick, J Nath, SK Namjou-Khales, B Bruner, GR Scofield, RH Harley, JB AF Kelly, J Kilpatrick, J Nath, SK Namjou-Khales, B Bruner, GR Scofield, RH Harley, JB TI Pedigree selection may increase genetic homogeneity in complex phenotypes: an example from lupus with hemolytic anemia. SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Meeting Abstract C1 Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. Univ Oklahoma, Oklahoma City, OK USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD OCT PY 2001 VL 69 IS 4 SU 1 MA 1915 BP 509 EP 509 PG 1 WC Genetics & Heredity SC Genetics & Heredity GA 483RD UT WOS:000171648901915 ER PT J AU Edberg, JC Langefeld, CD Moser, KL Kelly, J Kaufman, JM Rich, SS Harley, JB Kimberly, RP AF Edberg, JC Langefeld, CD Moser, KL Kelly, J Kaufman, JM Rich, SS Harley, JB Kimberly, RP CA SCOR Genet SLE TI Linkage and association of a functional single nucleotide polymorphism (SNP) in the Fc gamma RIIIA gene with SLE. SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Meeting Abstract C1 Univ Alabama, Birmingham, AL USA. Wake Forest Univ, Winston Salem, NC 27109 USA. Univ Minnesota, Minneapolis, MN USA. Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA. US Dept Vet Affairs, Oklahoma City, OK USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD OCT PY 2001 VL 69 IS 4 SU 1 MA 1979 BP 519 EP 519 PG 1 WC Genetics & Heredity SC Genetics & Heredity GA 483RD UT WOS:000171648901977 ER PT J AU Lopes, HF Stojiljkovic, MP Zhang, D Goodfriend, TL Egan, BM AF Lopes, HF Stojiljkovic, MP Zhang, D Goodfriend, TL Egan, BM TI The pressor response to acute hyperlipidemia is enhanced in lean normotensive offspring of hypertensive parents SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Article DE family history of hypertension; blood pressure; nonesterified fatty acids ID FREE FATTY-ACIDS; BAROREFLEX SENSITIVITY; ARTERIAL COMPLIANCE; HDL CHOLESTEROL; FAMILY HISTORY; BLOOD-PRESSURE; CHILDREN; PLASMA; PREDISPOSITION; VASODILATION AB Family history is an important predictor of the cardiovascular risk factor cluster associated with insulin resistance. The dyslipidemia associated with insulin resistance may contribute to elevated blood pressure (BP). This study was undertaken to further explore the link between family history, dyslipidemia, and BP regulation. Twenty-three lean normal volunteers with a negative family history (FH -, n = 11) or positive family history (FH +, n = 12) of hypertension were evaluated under baseline conditions and during a 4-h infusion of intralipid and heparin (acute hyperlipidemia). Fasting blood was drawn for lipids including nonesterified fatty acids (NEFA). After 2 and 4 h of intralipid and heparin, blood was drawn for NEFA. The BP was measured at baseline and every 30 min after starting the intralipid and heparin infusion. Baseline triglycerides and very low density lipoprotein cholesterol concentrations were higher in FH+ than FH- subjects (P < .05). However, NEFA increased similarly in both groups during the infusion of intralipid and heparin. The BP and heart rate increased with acute hyperlipidemia in all subjects combined (P < .05). Despite the similar increase of NEFA, mean BP, pulse pressure, and pressure-rate product increased significantly in FH+ subjects but not in FH- volunteers with acute hyperlipidemia. Although systolic BP increased in both groups, the increase was greater in FH+ than in FH- volunteers during acute hyperlipidemia (14 +/- 2 v 10 +/- 2 mm Hg, P < .05). These results suggest that higher plasma lipids combined with a greater pressor response to hyperlipidemia may contribute to the development of high BP in subjects with a family history of hypertension. Am J Hypertens 2001;14:1032-1037 (C) 2001 American Journal of Hypertension, Ltd. C1 Med Univ S Carolina, Dept Pharmacol, Div Clin Pharmacol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Clin Pharmacol, Charleston, SC 29425 USA. USP, HCFMC, Inst Heart, Unidade Hipertensao, BR-09500900 Sao Paulo, Brazil. Mil Med Acad, Dept Pharmacol & Toxicol, YU-11002 Belgrade, FR, Yugoslavia. Univ Wisconsin, William S Middleton Mem Vet Hosp, Dept Med, Madison, WI USA. Univ Wisconsin, William S Middleton Mem Vet Hosp, Dept Pharmacol, Madison, WI USA. RP Egan, BM (reprint author), Med Univ S Carolina, Dept Pharmacol, Div Clin Pharmacol, 96 Jonathan Lucas St,CSB 826H, Charleston, SC 29425 USA. FU NCRR NIH HHS [RR-01070]; NHLBI NIH HHS [R01 HL58794, K24 HL04920, P01 HL55782] NR 32 TC 10 Z9 10 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD OCT PY 2001 VL 14 IS 10 BP 1032 EP 1037 DI 10.1016/S0895-7061(01)02166-5 PG 6 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 485BV UT WOS:000171734400009 PM 11710782 ER PT J AU Kraut, JA Kurtz, I AF Kraut, JA Kurtz, I TI Use of base in the treatment of severe acidemic states SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Review DE bicarbonate; metabolic acidosis; tris-hydroxymethyl aminomethane (THAM); Carbicarb ID SEVERE DIABETIC-KETOACIDOSIS; HYPOXIC LACTIC-ACIDOSIS; LEFT-VENTRICULAR CONTRACTILITY; SODIUM-BICARBONATE; METABOLIC-ACIDOSIS; INTRACELLULAR PH; CARDIAC-ARREST; RAT-HEART; CARDIOPULMONARY-RESUSCITATION; MYOCARDIAL-CONTRACTILITY AB Severe acidemia (blood pH < 7.1 to 7.2) suppresses myocardial contractility, predisposes to cardiac arrhythmias, causes venoconstriction, and can decrease total peripheral vascular resistance and blood pressure, reduce hepatic blood flow, and impair oxygen delivery. These alterations in organ function can contribute to increased morbidity and mortality. Although it seemed logical to administer sodium bicarbonate to attenuate acidemia and therefore lessen the impact on cardiac function, the routine use of bicarbonate in the treatment of the most common causes of severe acidemia, diabetic ketoacidosis, lactic acidosis, and cardiac arrest, has been an issue of great controversy. Studies of animals and patients with these disorders have reported conflicting data on the benefits of bicarbonate, showing both beneficial and detrimental effects. Alternative alkalinizing agents, tris-hydroxymethyl aminomethane and Carbicarb, have shown some promise in studies of animals and humans, and reevaluation of these buffers in the treatment of severe acidemic states seems warranted. The potential value of base therapy in the treatment of severe acidemia remains an important Issue, and further studies are required to determine which patients should be administered base therapy and what base should be used. (C) 2001 by the National Kidney Foundation, Inc. C1 VA Greater Los Angeles Hlth Care Syst, Nephrol Sect 691 1111, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Div Nephrol, Ctr Hlth Sci, Los Angeles, CA 90024 USA. RP Kraut, JA (reprint author), VA Greater Los Angeles Hlth Care Syst, Nephrol Sect 691 1111, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK54221, DK58563] NR 135 TC 43 Z9 47 U1 1 U2 9 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD OCT PY 2001 VL 38 IS 4 BP 703 EP 727 DI 10.1053/ajkd.2001.27688 PG 25 WC Urology & Nephrology SC Urology & Nephrology GA 476KQ UT WOS:000171226600001 PM 11576874 ER PT J AU Mei, Q Mundinger, TO Kung, D Baskin, DG Taborsky, GJ AF Mei, Q Mundinger, TO Kung, D Baskin, DG Taborsky, GJ TI Fos expression in rat celiac ganglion: an index of the activation of postganglionic sympathetic nerves SO AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM LA English DT Article DE hypoglycemia; nicotine; nerve stimulation; deoxyglucose; insulin ID SUPERIOR CERVICAL-GANGLION; FUNCTIONAL VAGAL INPUT; NERVOUS-SYSTEM; STIMULATION; DOG; NOREPINEPHRINE; GLUCAGON; LIVER; NEURONS; IMMUNOREACTIVITY AB To develop an index of the activation of abdominal sympathetic nerves, we used Fos immunostaining of the celiac ganglion (CG) taken from rats receiving nicotine, preganglionic nerve stimulation, or glucopenic agents. Subcutaneous nicotine injection moderately increased Fos expression in the principal ganglionic cells of the CG (17 +/- 4 Fos+ per mm(2), similar to 12% of all principal CG cells), whereas subcutaneous saline had no effect (0 +/- 0 Fos+ per mm(2); n = 7; P < 0.01). Greater Fos expression was obtained by applying nicotine topically to the CG (71 8 Fos+ per mm(2); 52% of all principal CG cells, n = 5; P < 0.01 vs. topical saline, n = 4) and by preganglionic nerve stimulation (126 9 Fos+ per mm(2); 94% of all principal CG cells, n = 11; P < 0.01 vs. nerve isolation, n = 7). Moderate Fos expression was also observed in the CG after intraperitoneal 2-deoxy-D-glucose (2DG) injection (21 2 Fos+ per mm(2); 16%,of all principal CG cells, n = 5; P < 0.01 vs. saline ip) or insulin injection (16 Fos+ per mm(2); similar to 12% of all principal CG cells, n = 6; P < 0.01 vs. saline ip). Furthermore, Fos expression induced by 2DG was dose and time dependent. These data demonstrate significant Fos expression in the CG in response to chemical, electrical, and reflexive stimulation. Thus Fos expression in the CG may be a useful index to describe various levels of activation of its postganglionic sympathetic neurons. C1 Vet Affairs Puget Sound Hlth Care Syst, Div Endocrinol & Metab 151, Dept Med, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98159 USA. RP Mei, Q (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Div Endocrinol & Metab 151, Dept Med, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [DK-12047, DK-50154, DK-12829] NR 43 TC 6 Z9 6 U1 1 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1849 J9 AM J PHYSIOL-ENDOC M JI Am. J. Physiol.-Endocrinol. Metab. PD OCT PY 2001 VL 281 IS 4 BP E655 EP E664 PG 10 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 482NY UT WOS:000171583200002 PM 11551840 ER PT J AU Lloyd, KCK Wang, JF Solomon, TE AF Lloyd, KCK Wang, JF Solomon, TE TI Acid inhibition by intestinal nutrients mediated by CCK-A receptors but not plasma CCK SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE gastric acid secretion; enterogastrone; intestinal phase; cholecystokinin; peptone meal ID STIMULATED GASTRIC-ACID; FOS PROTEIN EXPRESSION; FAT-INDUCED INHIBITION; SOLITARY TRACT; PEPTIDE-YY; BRAIN-STEM; OLEIC-ACID; AWAKE RATS; CHOLECYSTOKININ; SECRETION AB We examined the role of CCK-A receptors in acid inhibition by intestinal nutrients. Gastric acid and plasma CCK and gastrin levels were measured in rats with gastric and duodenal fistulas during intragastric 8% peptone and duodenal perfusion with saline, complete liquid diet (CLD; 20% carbohydrate, 6% fat, and 5% protein), and the individual components of CLD. Acid output was significantly inhibited (50-60%) by CLD, lipid, and dextrose. Plasma CCK was significantly increased by CLD (from 2.6 +/-0.3 to 4.8 +/-0.5 pM) and lipid (4.6 +/-0.5 pM). CCK levels 50-fold higher (218 +/- 33 pM) were required to achieve similar acid inhibition by exogenous CCK-8 (10 nmol.kg(-1).h(-1) iv). Intestinal soybean trypsin inhibitor elevated CCK (10.9 +/-2.5 pM) without inhibiting acid secretion. The CCK-A antagonist MK-329 (1 mg/kg iv) reversed acid inhibition caused by CLD, lipid, and dextrose. Peptone-stimulated gastrin (21.7 +/-1.9 pM) was significantly inhibited by CLD (14.5 +/-3.6 pM), lipid (12.3 +/-2.2 pM), and dextrose (11.9 +/-1.5 pM). Lipid and carbohydrate inhibit acid secretion by activating CCK-A receptors but not by altering plasma CCK concentrations. C1 Univ Calif Davis, Ctr Comparat Med, Sch Vet Med, Dept Anat Physiol & Cell Biol, Davis, CA 95616 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, CURE, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA 90024 USA. RP Lloyd, KCK (reprint author), Univ Calif Davis, Ctr Comparat Med, Sch Vet Med, Dept Anat Physiol & Cell Biol, 1 Shields Ave, Davis, CA 95616 USA. FU NIDDK NIH HHS [DK-45752, DK-41301] NR 34 TC 4 Z9 5 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD OCT PY 2001 VL 281 IS 4 BP G924 EP G930 PG 7 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 483RA UT WOS:000171648600008 PM 11557512 ER PT J AU Kraut, JA Helander, KG Helander, HF Iroezi, ND Marcus, EA Sachs, G AF Kraut, JA Helander, KG Helander, HF Iroezi, ND Marcus, EA Sachs, G TI Detection and localization of H+-K+-ATPase isoforms in human kidney SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE renal hydrogen-potassium-adenosinetriphosphatase; hydrogen; potassium; immunohistochemistry ID MEDULLARY COLLECTING DUCT; H,K-ATPASE ALPHA-SUBUNIT; GASTRIC H,K-ATPASE; DISTAL COLON; H+,K+-ATPASE; IMMUNOREACTIVITY; EXPRESSION; TRANSPORT; SECRETION; ACIDOSIS AB An H+-K+-ATPase contributes to hydrogen secretion and potassium reabsorption by the rat and rabbit collecting ducts. Transport of these ions appears to be accomplished by one or both of two isoforms of the H+-K+-ATPase, HK alpha (1) and HK alpha (2), because both isoforms are found in the collecting ducts and transport of hydrogen and potassium is attenuated by exposure to inhibitors of these transport proteins. To evaluate whether an H+-K+-ATPase is present in the human kidney, immunohistochemical studies were performed using normal human renal tissue probed with antibodies directed against epitopes of three of the known isoforms of the H+-K+-ATPase, HK alpha (1), HK alpha (2), and HK alpha (4), and the V-type H+-ATPase. Cortical and medullary tissue probed with antibodies against HK alpha (1) showed cytoplasmic staining of intercalated cells that was less intense than that observed in the parietal cells of normal rat stomach stained with the same antibody. Also, weak immunoreactivity was detected in principal cells of the human collecting ducts. Cortical and medullary tissue probed with antibodies directed against HK alpha (4) revealed weak, diffuse staining of intercalated cells of the collecting ducts and occasional light staining of principal cells. Cortical and medullary tissue probed with antibodies directed against the H+-ATPase revealed staining of intercalated cells of the collecting ducts and some cells of the proximal convoluted tubules. By contrast, no discernible staining was noted with the use of the antibody against HK alpha (2), These data indicate that HK alpha (1). and HK alpha (4) are present in the collecting ducts of the human kidney. In this location, these isoforms might contribute to hydrogen and potassium transport by the kidney. C1 VA Greater Los Angeles Hlth Care Syst, Div Nephrol 691 111L, Los Angeles, CA 90073 USA. VA Greater Los Angeles Hlth Care Syst, Res Serv, Membrane Biol Lab, Los Angeles, CA 90073 USA. VA Greater Los Angeles Hlth Care Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90073 USA. AstraZeneca, Molndal, Sweden. Univ Gothenburg, Dept Biomed Lab Sci, Gothenburg, Sweden. RP Kraut, JA (reprint author), VA Greater Los Angeles Hlth Care Syst, Div Nephrol 691 111L, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jkraut@ucla.edu NR 33 TC 23 Z9 25 U1 0 U2 6 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD OCT PY 2001 VL 281 IS 4 BP F763 EP F768 PG 6 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 477LL UT WOS:000171285000019 PM 11553523 ER PT J AU Netscher, DT Eladoumikdachi, F Schneider, A AF Netscher, DT Eladoumikdachi, F Schneider, A TI A case study of a patient with closed avulsion rupture of a single slip of the flexor digitorum superficialis tendon SO ANNALS OF PLASTIC SURGERY LA English DT Article AB A case of a closed rupture of a single slip of flexor digitorum superficialis to the little finger is described. Closed rupture injuries of the flexor digitorum profundus tendon are quite common, but closed injuries to the superficialis tendon have been rarely reported, A single slip avulsion rupture of this tendon would seem to be very uncommon. The clinical presentation is reviewed. C1 Baylor Coll Med, Div Plast Surg, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Houston, TX USA. RP Netscher, DT (reprint author), 6560 Fannin,Suite 800, Houston, TX 77030 USA. NR 17 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0148-7043 J9 ANN PLAS SURG JI Ann. Plast. Surg. PD OCT PY 2001 VL 47 IS 4 BP 431 EP 434 DI 10.1097/00000637-200110000-00012 PG 4 WC Surgery SC Surgery GA 479MD UT WOS:000171407400012 PM 11601580 ER PT J AU Perea, S Lopez-Ribot, JL Kirkpatrick, WR McAtee, RK Santillan, RA Martinez, M Calabrese, D Sanglard, D Patterson, TF AF Perea, S Lopez-Ribot, JL Kirkpatrick, WR McAtee, RK Santillan, RA Martinez, M Calabrese, D Sanglard, D Patterson, TF TI Prevalence of molecular mechanisms of resistance to azole antifungal agents in Candida albicans strains displaying high-level fluconazole resistance isolated from human immunodeficiency virus-infected patients SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID AMINO-ACID SUBSTITUTION; LANOSTEROL 14-ALPHA-DEMETHYLASE; OROPHARYNGEAL CANDIDIASIS; REDUCED AFFINITY; DRUG-RESISTANCE; MULTIPLE RESISTANCE; CHROMOGENIC AGAR; IN-VITRO; CONTRIBUTE; MUTATION AB Molecular mechanisms of azole resistance in Candida albicans, including alterations in the target enzyme and increased efflux of drug, have been described, but the epidemiology of the resistance mechanisms has not been established. We have investigated the molecular mechanisms of resistance to azoles in C albicans strains displaying high-level fluconazole resistance (MICs, greater than or equal to 64 mug/ml) isolated from human immunodeficiency virus (HM-infected patients with oropharyngeal candidiasis. The levels of expression of genes encoding lanosterol 14 alpha -demethylase (ERG11) and efflux transporters (MDR) and CDR) implicated in azole resistance were monitored in matched sets of susceptible and resistant isolates. In addition, ERG11 genes were amplified by PCR, and their nucleotide sequences were determined in order to detect point mutations with a possible effect in the affinity for azoles. The analysis confirmed the multifactorial nature of azole resistance and the prevalence of these mechanisms of resistance in C. albicans clinical isolates exhibiting frank fluconazole resistance, with a predominance of overexpression of genes encoding efflux pumps, detected in 85% of all resistant isolates, being found. Alterations in the target enzyme, including functional amino acid substitutions and overexpression of the gene that encodes the enzyme, were detected in 65 and 35% of the isolates, respectively. Overall, multiple mechanisms of resistance were combined in 75% of the isolates displaying high-level fluconazole resistance. These results may help in the development of new strategies to overcome the problem of resistance as well as new treatments for this condition. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis,S Texas Ctr Biol Med, San Antonio, TX 78245 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. CHU Vaudois, CH-1011 Lausanne, Switzerland. RP Lopez-Ribot, JL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis,S Texas Ctr Biol Med, Texas Res Pk,15355 Lambda Dr, San Antonio, TX 78245 USA. RI Lopez-Ribot, Jose/D-2048-2010 OI Sanglard, Dominique/0000-0002-5244-4178 FU NCRR NIH HHS [M01 RR001346]; NIAID NIH HHS [1 R29 AI 42401]; NIDCR NIH HHS [3 R01 DE11381-04A2S2, 5 R01 DE 11381, R01 DE011381] NR 42 TC 261 Z9 289 U1 1 U2 17 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD OCT PY 2001 VL 45 IS 10 BP 2676 EP 2684 DI 10.1128/AAC.45.10.2676-2684.2001 PG 9 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 475GQ UT WOS:000171154500002 PM 11557454 ER PT J AU Wambaugh, JL Linebaugh, CW Doyle, PJ Martinez, AL AF Wambaugh, JL Linebaugh, CW Doyle, PJ Martinez, AL TI Effects of two cueing treatments on lexical retrieval in aphasic speakers with different levels of deficit SO APHASIOLOGY LA English DT Article; Proceedings Paper CT 30th Annual Clinical Aphasiology Conference CY MAY, 2000 CL WAIKOLON, HAWAII ID NAMING DISORDERS; THERAPY; PRINCIPLES; ACCESS AB The effects of two cueing treatments for lexical retrieval were examined with three aphasic speakers who demonstrated different levels of lexical processing impairment (i.e., predominately semantic, predominately phonologic, and mixed semantic-phonologic). Each speaker received both treatments, with treatments being applied sequentially to different word lists in a multiple baseline design. Both treatments consisted of a prestimulation phase followed by the application of a response-contingent cueing hierarchy. One treatment employed semantic-level cueing, whereas the other treatment utilised phonologic-level cueing. All participants evidenced a positive response to both of the treatments and one participant (predominately phonologic-level deficit) showed a superior response to lexical-semantic treatment. C1 Univ Utah, Salt Lake City, UT 84112 USA. VA Salt Lake City Healthcare Syst, Salt Lake City, UT USA. George Washington Univ, Washington, DC USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. GRECC, Pittsburgh, PA USA. RP Wambaugh, JL (reprint author), Univ Utah, 1201 Behav Sci Bldg,390 S 1530 E, Salt Lake City, UT 84112 USA. NR 28 TC 49 Z9 49 U1 4 U2 7 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD OCT-NOV PY 2001 VL 15 IS 10-11 BP 933 EP 950 PG 18 WC Clinical Neurology SC Neurosciences & Neurology GA 483EW UT WOS:000171621600006 ER EF