Difficulties in the diagnosis and management of infant botulism.
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Australia↗
Biomedical subjects
M May
Publications and source records attributed to M May.
Sexual intercourse and risk of ischaemic stroke and coronary heart disease: the Caerphilly study.
OBJECTIVE: To examine the relation between frequency of sexual intercourse and risk of ischaemic stroke and coronary heart disease. DESIGN: Cohort study with 20 year follow up. SETTING: The town of Caerphilly, South Wales and five adjacent villages. SUBJECTS: 914 men aged 45-59 years at time of recruitment in 1979 to 1983. MAIN OUTCOME MEASURES: Ischaemic stroke and coronary heart disease, all first events and fatal events. RESULTS: Of the 914 men studied, 197 (21.5%) reported sexual intercourse less often than once a month, 231 (25.3%) reported sexual intercourse twice or more a week, and the remaining 486 (53.2%) men fell into the intermediate category. Frequency of sexual intercourse was not associated with all first ischaemic stroke events: age adjusted odds ratios (95% CI) for intermediate and low frequency of sexual intercourse of 0.61 (0.32 to 1.16) and 0.71 (0.34 to 1.49) respectively compared with the reference category of high frequency. A graded relation with fatal coronary heart disease events was observed in events recorded up to 10 years. The age adjusted relative risk (95% CI) of fatal coronary heart disease contrasting low frequency of sexual intercourse (that is, less than monthly) with the highest group (at least twice a week) was 2.80 (1.13 to 6.96, test for trend, p=0.04) which was not attenuated by adjustment for a wide range of potential confounders. Longer follow up to 20 years showed attenuation of this risk with odds of 1.69 (95% CI 0.90 to 3.20), contrasting low frequency of sexual intercourse with the highest group. CONCLUSIONS: The differential relation between frequency of sexual intercourse, stroke and coronary heart disease suggests that confounding is an unlikely explanation for the observed association with fatal coronary heart disease events. Middle aged men should be heartened to know that frequent sexual intercourse is not likely to result in a substantial increase in risk of strokes, and that some protection from fatal coronary events may be an added bonus.
Cerebrovascular Disorders↗
Outcomes at 1 year for the first 200 patients fitted with GyneFix at Margaret Pyke Centre.
The first 200 women to be fitted with GyneFix at the Margaret Pyke Centre, a National Health Service contraception clinic situated in central London, have been followed up at 1 year after insertion. Removals, expulsions and accidental pregnancies in that first year are recorded. Of the cohort, 80% had a known outcome at 12 months. There was one perforation with the inserter tube, leaving 199 women fitted with GyneFix who contributed 2033 woman-months of follow-up time. We recorded 22 early removals, of which 16 were for heavy or irregular bleeding and/or pain, three were because the women wished to conceive and three for other reasons. In addition there were 16 expulsions at intervals ranging from 1 day to 12 months after insertion. Four of the expulsions were unnoticed by the subjects (they were revealed by amenorrhea of pregnancy in two subjects and lost threads in the other two). There were no pregnancies with the GyneFix in situ. The expulsion rate of 8.4% (confidence interval (CI) 5.2-13.4%) and removal rate for bleeding and/or pain of 9.0% (CI 5.6-14.3%) at 12 months recorded in this cohort fall within acceptable ranges for framed intrauterine devices in a population with a large percentage of nulliparous women. However, they are perhaps not as good as had been anticipated for this revolutionary new intrauterine implant. Possible reasons for this are explored.
Adult↗
Production of (4)(double Lambda)H hypernuclei.
An experiment demonstrating the production of double-Lambda hypernuclei in (K(-),K(+)) reactions on (9)Be was carried out at the D6 line in the BNL alternating-gradient synchrotron. The technique was the observation of pions produced in sequential mesonic weak decay, each pion associated with one unit of strangeness change. The results indicate the production of a significant number of the double hypernucleus (4)(double Lambda)H and the twin hypernuclei (4)(Lambda)H and (3)(Lambda)H. The relevant decay chains are discussed and a simple model of the production mechanism is presented. An implication of this experiment is that the existence of an S = -2 dibaryon more than a few MeV below the double Lambda mass is unlikely.
Journal Article↗
Observation of spin-orbit splitting in lambda single-particle states.
The spin-orbit splitting of Lambda single-particle states in (13)(Lambda)C was measured. The 13C(K-,pi(-))(13)(Lambda)C reaction was used to excite both the 1/2(-) and 3/2(-) states simultaneously, which have predominantly 12C(0(+)) x p(Lambda) configuration. gamma rays from the states to the ground state were measured in coincidence with the pi(-)'s, by which ls splitting was found to be 152+/-54(stat)+/-36(syst) keV. The value is 20-30 times smaller than exhibited by the ls splitting in the nuclear shell model. This value gives us new insight into the YN interaction.
Journal Article↗
Non-Hodgkin's lymphoma after primary Hodgkin's disease in the German Hodgkin's Lymphoma Study Group: incidence, treatment, and prognosis.
PURPOSE: The cumulative incidence for non-Hodgkin lymphoma's (NHL) after primary Hodgkin's disease (HD) ranges between 1% and 6%. To investigate the course of disease for secondary NHL, we retrospectively analyzed patients treated within clinical trials of the German Hodgkin's Lymphoma Study Group (GHSG) since 1981. PATIENTS AND METHODS: From 1981 to 1998, the GHSG conducted three generations of clinical trials for the treatment of primary HD involving a total of 5,406 patients. Reference histology by an expert panel was obtained for 4,104 of the patients. Data on incidence, treatment, and outcome of secondary NHL were updated in March 1999. RESULTS: At first diagnosis of HD, the pathologists rejected 114 (2.1%) of 5,520 cases initially diagnosed as HD and rediagnosed them as primary NHL. Fifty-two (0.9%) of the remaining 5,406 patients developed a secondary NHL. One patient was excluded from further analyses because of insufficient documentation. Six patients had no further therapy because of patient refusal (n = 1) or rapidly progressive disease (n = 5). For the remaining 45 patients, overall response rate was 43% (36% complete response and 7% partial response). The actuarial 2-year freedom from treatment failure (FFTF) and overall survival (OS) for all patients was 24% and 30%, respectively, and for patients with diffuse large-cell lymphoma, it was 28% and 35%, respectively. Time of occurrence of secondary NHL after first diagnosis of HD and variables employed in the age-adjusted International Prognostic Factor Index (IPFI) significantly influenced treatment outcome. CONCLUSION: In the GHSG, the incidence of secondary NHL with 0.9% is relatively low compared with previously reported series. The prognosis of secondary NHL seems dismal and is significantly influenced by time of occurrence and the age-adjusted IPFI. In a subset of patients with secondary NHL, long-term disease-free survival could be achieved.
Actuarial Analysis↗
Environmental health training of promotoras in colonias along the Texas-Mexico border.
Poverty, overpopulation, and a lack of environmental controls have combined with cultural and linguistic division to produce a looming public health threat in unincorporated communities on the US-Mexico border. These rapidly multiplying colonias, from a Spanish term for neighborhoods, are settlements of varying size located along the border. Along the American side of the Texas-Mexico border alone, there are approximately 1800 colonias--the largest number of any border state--most of which lack basic water and sewer systems, paved roads, and safe and sanitary housing. Promotoras, from a Spanish term for lay community educators, are community leaders who live in the colonias and build important bridges between residents and the federal and state bureaucracies. These women have been trained to introduce their neighbors to state "systems" of government, education, and medical and social services that otherwise may lie out of reach. Promotoras are able to "translate" this training into culturally meaningful instruction that empowers community self-development. When neighbors teach neighbors, the message is received with greater trust and readiness to act.
Community Health Workers↗
Path integration while ignoring irrelevant movement.
Participants attempted to return to the origin of travel after following an outbound path by locomotion on foot (Experiments 1-3) or in a virtual visual environment (Experiment 4). Critical conditions interrupted the outbound path with verbal distraction or irrelevant, to-be-ignored movements. Irrelevant movement, real or virtual, had greater effects than verbal or cognitive distraction, indicating inability to ignore displacement during path integration. Effects of the irrelevant movement's direction (backward vs. rightward) and location (1st vs. 2nd leg of path) indicated that participants encoded a configural representation of the pathway and then cognitively compensated for the movement, producing errors directly related to the demands of compensation. An encoding-error model fit to the data indicated that backward movement produced downward rescaling, whereas movement that led to implied rotation (rightward on 2nd leg) produced distortions of shape and scale.
Adult↗
Two novel mutations confirm FGD1 is responsible for the Aarskog syndrome.
The Aarskog syndrome or facio-genital dysplasia (FGDY, MIM No. 305400) is an X-linked condition characterized by short stature, macrocephaly, facial, genital and skeletal anomalies. It is caused by mutation of the FGD1 gene mapped to the Xp11.21 region. To date, only one point mutation has been reported in an affected family, consisting of the insertion of an additional guanine residue at nucleotide 2122 of exon 7, which causes premature translational termination. We now report the finding of two novel FGD1 mutations, a missense mutation in a family of Italian origin and a deletion of 3 exons in a sporadic case from Germany. These mutations confirm the role of FGD1 as the gene responsible for the Aarskog syndrome.
Abnormalities, Multiple↗
Measurement of glutathione levels in intact roots of Arabidopsis.
Levels of glutathione were measured for different cell types in roots of intact Arabidopsis seedlings after labelling with monochlorobimane to give fluorescent glutathione S-bimane (GSB) and imaging using confocal laser scanning microscopy with excitation at 442 nm. Labelling increased to a plateau in most cell types after about 15-20 min and the GSB accumulated rapidly in the vacuole. Formation of GSB in the cytoplasm was not affected by treatment with sodium azide; however, vacuolar transport of GSB was substantially inhibited under these conditions. We infer that vacuolar sequestration was mediated by a tonoplast glutathione S-conjugate pump. Quantitative estimates of the cytoplasmic glutathione concentration involved correction for the loss in fluorescence signal with depth into the specimen using an empirically determined model derived in situ from a permeabilized root. Correction for the dilution experienced on transport into the vacuole also required an estimate of the amount of cytoplasm present in each cell type. This was achieved in two stages: first, the levels of protein were mapped after fixation, permeabilization and labelling with fluroescein isothiocyanate. Second, the corresponding cytoplasmic volume was determined as 40% for epidermal cells in the elongation zone by manual segmentation of the cytoplasm in serial optical sections. Values of relative cytoplasmic volume for other cells were extrapolated in proportion to their protein content. Using this approach, cytoplasmic glutathione concentrations were found to be 2-3 mM in most cell types. There was a marked difference between the central cells and the neighbouring, rapidly dividing initials, and between the columella cells and the outermost cells of the root cap. In the latter case, the difference was equalized in the presence of azide. This might indicate that additional cell-cell movement and preferential sequestration of GSB can occur during the detoxification process in an intact system.
Arabidopsis↗
History of facial nerve surgery.
The history of facial nerve surgery can be viewed as five overlapping periods, each characterized by a new understanding or approach to the management of facial nerve conditions. The first period, the period of discovery of the nerve of facial expression, began with Sir Charles Bell's description in 1829 of 3 cases of facial paralysis due to facial nerve trauma. The second period, from 1873 to 1960, was the era of facial nerve repair. Decompression of the facial nerve was the primary focus of facial nerve surgery in the third period, from 1908 to 1969. The fourth period, from 1970 to 2000, can be characterized as the "bottleneck" period in honor of the contributions to facial nerve surgery that resulted as Ugo Fisch and other surgeons sought ways to operate on this portion of the proximal nerve. In the current or fifth, period in the history of facial nerve surgery, we anticipate the advent of vaccines and antiviral medications to minimize the sequelae of Bell's palsy, further improvements in endoscopic equipment and techniques, and better surgical outcomes through the use of new technologies such as robotics.
Decompression, Surgical↗
Facial nerve repair: a retrospective review.
UNLABELLED: The purpose of this article is to review a large series of patients evaluated for disorders of the facial nerve in order to assess the indications for surgery, the timing of surgery, the techniques of nerve repair, and to better define those factors associated with a favorable outcome. STUDY DESIGN: A retrospective review of patients undergoing facial nerve repair from 1963-1997. METHODS: One hundred and three patients underwent surgical intervention designed to repair a disrupted facial nerve. All procedures were performed by one of the senior surgeons (M.M.) Seventy-two patients had a complete data set and at least one year of follow-up. RESULTS: Eighty percent of patients attained an outcome considered superb to fair. Twenty percent of patients had a poor outcome. There was a slight worsening of outcome with increased time to repair. Patients with a neoplastic etiology of nerve paralysis tended to have a worse outcome. CONCLUSIONS: Facial nerve grafting is most successful if intervention is undertaken at or near the time of initial injury. However, prolonged time (up to two years) to repair does not preclude the potential for some recovery. The limitations of the current systems for grading facial recovery after nerve repair are well known, and the adoption of a new grading scale for assessing recovery after reanimation procedure is recommended.
Adolescent↗
Breathtaking research.
Although the air we breathe is necessary for life, certain factors may make this same air detrimental to our health. For instance, a seemingly endless list of compounds can be toxic at certain concentrations, and inhaling such compounds may lead to damage in different parts of the body. To investigate the particular effects of inhaled toxicants, the NIEHS developed the Respiratory Toxicology Group. The group, which consists of toxicologist Dan Morgan, biologist Cassandra Shines, and engineer Michael Moorman, has been conducting experiments for about a decade at the NIEHS inhalation facility. Morgan says the group typically conducts studies of chemicals that have been nominated to the National Toxicology Program for investigation into their carcinogenic potential and other end points. "We provide research support and conduct special studies on these chemicals," he says. "We also do collaborative studies with other NIEHS investigators, other [federal] agencies such as the Environmental Protection Agency and the Department of Energy, universities, and industry."
Air Pollution↗
Disturbing behavior: neurotoxic effects in children.
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Child↗
Genome-wide analysis of oral cancer--early results from the Cancer Genome Anatomy Project.
The Cancer Genome Anatomy Project (CGAP) is a large cooperative effort sponsored by the US National Institutes of Health designed to find, catalog and annotate genes that are expressed during cancer development. In the past 2 years, the CGAP has sequenced over 700,000 clones from approximately 140 cDNA libraries, resulting in the identification of over 30,000 new human genes. As a first step in applying this project to oral cancer we entered four cell lines--two from oral cancer, one from primary oral keratinocytes, and one from oral keratinocytes which had been immortalized by human papillomavirus. Libraries of cDNA were made and sequenced and the data were deposited in GenBank. The expressed genes were then identified where possible. The cell lines, and the total number of expressed genes that were cloned from each were: HN3 (oral cancer), 263 genes; HN4 (oral cancer), 550 genes; HN5 (primary keratinocytes), 237 genes; HN6 (immortalized keratinocytes), 408 genes. The total number of different genes that were found was 1160. A total of 38 new genes, of unknown function, were discovered. The data presented here represent a beginning of the application of the CGAP technology to oral cancer. Even though the data are still quite incomplete, they already represent a large quantity of new information and clones of potential utility to the oral cancer community, and provide a glimpse of the data sets to be forthcoming from the Project. It must therefore be expected that there will soon be a large expansion in the volume of data regarding the genetics of oral cancer. Those who study this disease must be prepared to develop new methods of analysis and storage for handling the oncoming volumes of information.
Clone Cells↗
Live virus survives excimer laser ablation.
OBJECTIVES: To determine whether live virus can withstand excimer laser ablation and pose a possible health hazard to medical personnel. DESIGN: Experimental study. METHODS: Fibroblasts infected with oral polio vaccine virus were ablated with an excimer laser. The plume was collected using a smoke evacuator and bubbled through viral culture media. MAIN OUTCOME MEASURES: The inlet tube from the smoke evacuator was swabbed and cultured for virus. Liquid from the bubble trap was also cultured. RESULTS: Live virus was shown in the material trapped from the laser plume. CONCLUSIONS: Oral polio vaccine virus can survive excimer laser ablation. Whether other more clinically relevant viruses, such as human immunodeficiency virus, can withstand ablation and remain infectious remains to be determined.
Cells, Cultured↗
Innovations. DNA detectives.
To understand the many potential causes and resulting consequences of DNA damage, scientists first need methods to detect it. Canadian scientists X. Chris Le and Michael Weinfeld, with help from U.S. molecular biologist Steven Leadon, developed a selective, sensitive technique for measuring DNA damage. The scientists combined a thymine glycol antibody with thymine glycol to selectively tag a specific type of DNA damage. They then added a second antibody with fluorescing properties, and used laser-induced fluorescence to identify the damaged portion of the tagged DNA. The fluorescence can be quantified, with higher levels of fluorescence indicating higher DNA damage. The technique was shown to find 1 damaged base in 1 billion normal bases. This level of sensitivity could allow the measurement of DNA damage resulting from clinical levels of radiation, and may allow scientists to establish a day-to-day baseline for DNA damage. From this baseline, it would be possible to ascertain the levels of damage that a cell can tolerate, as well as how much damaged it is capable of repairing on a daily basis.
DNA↗
Nanotechnology: thinking small.
Nanotechnology--building devices on the atomic scale--may unleash some big scientific advances early in the new millennium. Last January in Arlington, Virginia, nearly 100 representatives from academia, industry, and government laid out the general goals for the next decade of nanotechnology research by U.S. government agencies. Some predict that the potentially rich opportunities in this field may trigger a nanotechnology initiative in the federal budget request for Fiscal Year 2001. In the meantime, Congress has asked the NIEHS to explore how nanotechnology might be used to address environmental heath problems.
Biotechnology↗