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Cytogenetic monitoring of pesticide sprayers.

The induction of chromosome aberrations, micronuclei, and sister-chromatid exchanges (SCEs) was examined in cultured lymphocytes of 27 vineyard growers exposed to pesticides. Cytogenetic examinations were performed during the prespraying period, a month after spraying, and at the end of the spraying season. For comparison purposes, the same cytogenetic monitoring program was applied to two control groups. The first consisted of 15 individuals from a nearby town, and the second consisted of 20 volunteers living 200 km from the vine-growing area (reference control group). A positive, though low statistically significant (P < 0.017) difference in the yield of unstable chromosomal aberrations in exposed sprayers was observed compared with both control groups during the prespraying period. The mean group value of micronuclei in exposed workers averaged 5.41 per 1000 binucleated cells, with individual means ranging from 0 to 15. In both control groups, the yield of micronuclei averaged 5.09 per 1000 binucleated cells, with individual means ranging from 1 to 10. No statistically significant (P < 0.5) differences in yield of micronuclei were found in exposed subjects compared with both control groups. Significant individual variation (F = 14.09, P < 0.000) in SCE frequency was observed in exposed subjects, as well as in both control groups (F = 14.09, P < 0.000). A month after spraying, the average incidence of unstable aberrations in pesticide sprayers was 0.22%, and the yield of micronuclei averaged 17.78 per 1000 binucleated cells, with individual means ranging from 7 to 28. The incidence of micronuclei a month after spraying in exposed subjects was elevated (statistically significant at P < 0.01) in comparison with the prespraying period, while the difference in the yield of chromosomal aberrations in exposed subjects was insignificant (P < 0.5). At the end of the spraying season, the average incidence of unstable aberrations in exposed subjects was 0.79%, and the yield of micronuclei averaged 39.92 micronuclei per 1000 binucleated cells, with individual means ranging from 21 to 62. The appearance of more than one micronucleus per binucleated cell was related to the results on chromosome aberrations. The frequencies of chromosomal aberrations and micronuclei were significantly higher (P < 0.001, P < 0.000) in the exposed group than in their matched control groups. The yield of micronuclei in pesticide sprayers at the end of the season was higher than expected with respect to chromosomal aberration frequency, which provides some evidence that some of the micronuclei are induced by the spindle-inhibiting effects of pesticides. A statistically significant (P < 0.003) difference in micronuclei in the first control group was observed compared with the reference control group at the end of the spraying season. With respect to the incidence of micronuclei in the control group in the vine-growing area, a poor but positive correlation (r = 0.074, P < 0.104) with duration of the spraying season was found, which is probably due to airborne pesticides in the vine-growing area. SCE frequencies of the workers' lymphocytes were not significantly changed due to the exposure. The yield of aberrations as well as that of micronuclei in exposed subjects correlated positively (r = 16, P = 0.016) with duration of exposure.

Adult↗

Interpretation of static time-of-flight secondary ion mass spectra of adsorbed protein films by multivariate pattern recognition.

Multivariate analysis has become increasingly common in the analysis of multidimensional spectral data. We previously showed that the multivariate analysis technique principal component analysis (PCA) is an excellent method for interpreting the static time-of-flight secondary ion mass spectrometry (TOF-SIMS) spectra of adsorbed protein films. PCA is an unsupervised pattern recognition technique that loses resolution between spectra of different proteins as more proteins are added to the data set due to large within-group variation. The supervised pattern recognition techniques discriminant principal component analysis (DPCA) and linear discriminant analysis (LDA), which aim to control within-group variation while maximizing between-group separation to enhance discrimination between groups, were compared with PCA using data sets of TOF-SIMS spectra of proteins adsorbed onto mica and PTFE substrates. DPCA and LDA quantitatively improved discrimination between groups and provided different information about the data than PCA. LDA was able to classify unknown samples with a misclassification rate lower than PCA or DPCA. Both unsupervised and supervised pattern recognition techniques are useful for the interpretation and classification of static TOF-SIMS spectra of adsorbed protein films.

Adsorption↗

Experimental evaluation of gastric banding for treatment of morbid obesity in pigs.

The effectiveness and complications of gastric banding were evaluated in 15 miniature pigs. A Gore-tex or Dacron graft was employed to encircle the stomach. The animals were divided into five groups, three pigs in each group. Group 1 had a 13 mm pouch stoma with a Gore-tex band, Group 2 had a 16 mm pouch stoma with a Gore-tex band, Group 3 had a 13 mm pouch stoma with a Dacron band, Group 4 had a 16 mm pouch stoma with a Dacron band, and Group 5 had a sham operation. The weight variation in the control group was significantly higher than that in the other groups at the ninth postoperative week (p less than 0.05). There was no significant difference among Groups 1, 2, 3, and 4. The gastric band had migrated distally in seven pigs. It was located in the body of the stomach in four animals and in the pylorus in three. These three pigs died from stenosis of the pylorus. The band had eroded and penetrated all stomach layers in three other animals. There was no difference in the incidence of postoperative complications between the Gore-tex and Dacron band groups. The use of this simple operation in the treatment of the morbidly obese patient should be applied with caution.

Animals↗

Effects of slow release bezafibrate on the lipid pattern and on blood glucose of type 2 diabetic patients with hyperlipidaemia.

Ninety-eight type 2 diabetic patients with hyperlipidaemia in stable metabolic control with diet alone (41) or diet plus hypoglycaemic agents (57) were divided into two groups: group 1 was put on treatment with slow release bezafibrate 400 mg a day, while group 2 was considered as control. In group 1, after 1 month of bezafibrate, serum triglycerides fell by 47% and cholesterol by 13%. HDL cholesterol showed a non-significant trend toward an increase. Fasting blood glucose significantly decreased by 6%, fructosamine and glycated haemoglobin by 5%. During OGTT, the area under the curve of both serum C-peptide and blood glucose showed a trend toward a decrease after bezafibrate. However, the difference did not reach statistical significance. Thirty-six patients continued the treatment with the drug for 4 months and 23 for 8 months, without further changes of the lipid pattern and glycaemic control. In the control group no significant variation of the lipid levels occurred and diabetic control slightly worsened during the study. Bezafibrate has been proved to be effective in the treatment of hyperlipidaemia in type 2 diabetic patients. The drug seems moreover to improve glycaemic control. The mechanism by which bezafibrate produces this latter effect remains to be elucidated, though an increase of peripheral insulin sensitivity might be suggested.

Aged↗

Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases.

Retrospective analysis of the spino-pelvic alignment in a population of 85 patients with a lumbar degenerative disease. Several previous publications reported the analysis of spino-pelvic alignment in the normal and low back pain population. Data suggested that patients with lumbar diseases have variations of sagittal alignment such as less distal lordosis, more proximal lumbar lordosis and a more vertical sacrum. Nevertheless most of these variations have been reported without reference to the pelvis shape which is well-known to strongly influence spino-pelvic alignment. The objective of this study was to analyse spino-pelvic parameters, including pelvis shape, in a population of 85 patients with a lumbar degenerative disease and compare these patients with a control group of normal volunteers. We analysed three different lumbar degenerative diseases: disc herniation (DH), n = 25; degenerative disc disease (DDD), n = 32; degenerative spondylolisthesis (DSPL), n = 28. Spino-pelvic alignment was analysed pre-operatively on full spine radiographs. Spino-pelvic parameters were measured as following: pelvic incidence, sacral slope, pelvic tilt, lumbar lordosis, thoracic kyphosis, spino-sacral angle and positioning of C7 plumb line. For each group of patients the sagittal profile was compared with a control population of 154 asymptomatic adults that was the subject of a previous study. In order to understand variations of spino-pelvic parameters in the patients' population a stratification (matching) according to the pelvic incidence was done between the control group and each group of patients. Concerning first the pelvis shape, patients with DH and those with DDD demonstrated to have a mean pelvic incidence equal to 49.8 degrees and 51.6 degrees, respectively, versus 52 degrees for the control group (no significant difference). Only young patients, less than 45 years old, with a disc disease (DH or DDD) demonstrated to have a pelvic incidence significantly lower (48.3 degrees) than the control group, P < 0.05. On the contrary, in the DSPL group the pelvic incidence was significantly greater (60 degrees) than the control group (52 degrees), P < 0.0005. Secondly the three groups of patients were characterized by significant variations in spino-pelvic alignment: anterior translation of the C7 plumb line (P < 0.005 for DH, P < 0.05 for DDD and P < 0.05 for DSPL); loss of lumbar lordosis after matching according to pelvic incidence (P < 0.0005 for DH, DDD and DSPL); decrease of sacral slope after matching according to pelvic incidence (P = 0.001 for DH, P < 0.0005 for DDD and P < 0.0005 for DSPL). Measurement of the pelvic incidence and matching according to this parameter between each group of patients and the control group permitted to understand variations of spino-pelvic parameters in a population of patients.

Adult↗

Cytosol and nuclear estrogen and progestin receptors and 17 beta-hydroxysteroid dehydrogenase activity in normal and carcinomatous endometrium.

Endometrial estrogen and progestin receptors were quantitatively measured in the cytosol (ERc, PRc) and nuclear (ERn, PRn) fractions, the activity of 17 beta-hydroxysteroid dehydrogenase measured in 13 normal women in the late proliferative phase of the cycle (control group), in 33 patients with adenocarcinoma, and in 6 patients with other malignancies of the endometrium. The parameters measured had relatively small variations in the control group, whereas the opposite was true for the malignant endometrium. ERc and PRc were present in significantly higher concentrations in normal endometrial tissue (167 and 1697 fmol/mg cytosol protein, respectively) than in malignant endometrial tissue (45 and 116 fmol/mg cytosol protein, respectively), and the ratios of ERc/ERn and PRc/PRn were higher (P much less than .001 in both cases) in the normal group. The activities of 17 beta-hydroxysteroid dehydrogenase were identical in normal and adenocarcinoma tissue and correlated with PRc in carcinomatous endometrium. The present results support previous findings that the great majority of endometrial adenocarcinoma specimens have significant concentrations of ERc and PRc and that these concentrations are lower than in normal endometrium. In addition, they demonstrate that nuclear location of the female sex steroid receptors is favored in the malignant tissue. Despite these differences, the 17 beta-hydroxysteroid dehydrogenase activities were identical in proliferative endometrium and in endometrial adenocarcinoma.

17-Hydroxysteroid Dehydrogenases↗

Effect of long-term treatment with raloxifene on mammary density in postmenopausal women.

OBJECTIVE: To evaluate in a group of postmenopausal women the effects of long-term raloxifene treatment on breast density using a digitized analysis of mammograms and on insulinlike growth factor-1 (IGF-1), insulinlike growth factor binding protein-3 (IGFBP-3), and sex hormone-binding globulin (SHBG) plasma levels. DESIGN: Seventy healthy postmenopausal women with normal body weight were enrolled in this study and were divided into two groups based on their bone status, evaluated by dual-energy x-ray at the lumbar spine (L2-4). Fifty women (chronological age 52.4 +/- 4.1 y, menopausal age 42.1 +/- 3.9 y), in whom the L2-4 T score was less than -2.5 SD, were treated with raloxifene HCl 60 mg/day orally for 2 years. The other 20 women (chronological age 53.6 +/- 3.5 y, age at menopause 43.1 +/- 3.6 y), in whom the L2-4 T score ranged between -1 and -2.5 SD, were enrolled as controls. All 70 women received calcium (1 g/d orally) and cholecalciferol (880 UI/d orally) supplementation. Moreover, all women followed a normocaloric and personalized diet. All women had mammography at baseline and after 2 years of therapy. The mammographic images on traditional support (radiography) were acquired by using a film scanner and were then elaborated by means of ad hoc software. Moreover, assessments of IGF-1, IGFBP-3, and SHBG plasma levels were obtained at baseline and after 24 months. RESULTS: After 24 months of therapy, there was a significant variation in the raloxifene-treated group with respect to baseline in the distribution of gray classes of radiographic images. In particular, an attenuation of graphic trace with a reduction of the areas with the lowest and most elevated gray classes was observed. In the control group, no significant variations of graphic traces were observed. Moreover, raloxifene treatment significantly reduced IGF-1 and increased IGFBP-3 and SHBG plasma levels at 24 months. During follow-up, IGF-1, IGFPB-3, and SHBG levels did not change significantly in the control group. CONCLUSIONS: Long-term treatment with raloxifene in a population of postmenopausal women is able to reduce breast density. Such an effect could perhaps explain the reduction in the incidence of mammary carcinoma observed in the Multiple Outcomes of Raloxifene Evaluation study probably due to the direct antiestrogenic activity of raloxifene on mammalian tissue and/or its indirect activity increasing SHBG levels or modifying the IGF-1/IGFBP-3 ratio.

Absorptiometry, Photon↗

A diurnal variation in testicular hormone production is maintained following gonadotrophin suppression in normal men.

OBJECTIVE: A diurnal variation in serum testosterone in adult men is well recognized, but whether this occurs during exogenous testosterone administration and the degree to which it is endogenous to the testis is unclear. DESIGN: A clinical research centre investigation of testicular function in normal men. PATIENTS: Twenty normal men were recruited, 10 of whom were investigated during administration of testosterone with etonogestrel to suppress gonadotrophin secretion. MEASUREMENTS: Hourly blood samples were taken over 24 h for measurement of testosterone, inhibin B, LH, FSH and cortisol. Urinary excretion of testosterone and the testicular steroid epitestosterone was also measured. RESULTS: In the controls, a diurnal variation in serum testosterone and LH but not FSH was detected. The treated group had similar testosterone concentrations but showed no diurnal variation. Periodicity was also detected in inhibin B concentrations in 5 of the controls and in 9 of the treated group, who also showed synchrony not seen in the controls. Both groups showed diurnal variation in cortisol. Urinary testosterone excretion did not show a diurnal variation in either group, but this was apparent for epitestosterone with a morning peak in both groups despite the markedly lower excretion in the treated men. CONCLUSIONS: The diurnal variation of testosterone in normal men is due to a change in secretion rather than in clearance and is largely LH driven. An endogenous rhythm in both testicular steroidogenesis (epitestosterone) and Sertoli cell function (inhibin B) is also present.

Adult↗

Preliminary trial: motility comparisons of a unique freezing technology (UFT) to liquid nitrogen mist methodology for cryopreservation of porcine spermatozoa.

The motility outcomes of boar semen frozen with newly developed freezing techniques using a new unique freezing technology (UFT) compared with traditional liquid nitrogen methodology were investigated with the intent of improving current fertility outcomes using semen. The UFT is an electronically controlled cooling chamber that houses an organic fluid bath that can be maintained at temperatures below 0 degrees C without solidifying to freeze samples. Four ejaculates from four different boars were collected for this trial. Samples were handled consistently during the pre- and post-freeze processing. From each ejaculate, samples were separated into eight cryopreservation treatment groups, six UFT variations and two control liquid nitrogen groups, immediately before freezing, in replicates of two. After the initial cryopreservation was complete, all samples were stored in liquid nitrogen for at least 48 h. Post-thaw motilities and original motility return percentages were assessed on a random, individual-sample basis. After the initial evaluations, samples from two boars were recollected and frozen using the UFT for breeding purposes. Four sows were bred with the UFT frozen semen to confirm fertility capability. When assessing the individual UFT techniques, all of six UFT techniques had improved post-thaw motilities. However, treatments F (micro = 29%, return micro = 37%) and J (micro = 27%, return micro = 34%) showed the highest statistical improvement for post-thaw (p < 0.05) and original motility percent returns (p < 0.05) when compared with either the control cryo-tube (micro = 15%, return micro = 19%) or straw groups (micro = 12%, return micro = 16%). The UFT semen had a 50% conception rate, with an average of seven piglets from the sows that farrowed. Our preliminary data suggest a higher motility return with a slower pre-freeze phase below the freezing point before the acceleration to liquid nitrogen temperatures. The preliminary data suggest that the UFT could be utilized as a potential cryopreservation option for boar semen.

Animals↗

Do health plans influence quality of care?

OBJECTIVE: To investigate the relative impact of physician groups and health plans on quality of care measures. DESIGN: Secondary data analysis of receipt of preventive care services included in the Health Plan Employer Data and Information Set (HEDIS) among 10 758 patients representing 21 health maintenance organizations and 22 large provider groups in the San Francisco and Los Angeles, California, areas in 1997. Each patient was eligible for (at least) one of six HEDIS-measured services. Data identify whether or not the service was provided, the patient's health plan, and the provider group responsible for the care. We used logistic regression to examine variations across plans in HEDIS rates, and whether variations persist after controls for provider groups are included. SETTING: Patients from 21 health maintenance organizations serving San Francisco and Los Angeles, California, in 1997. MAIN OUTCOME MEASURES: Breast cancer screening, childhood immunizations, cervical cancer screening, diabetic retinal exam, prenatal care in the first trimester, and check-ups after delivery among patients for whom these services are appropriate. RESULTS: There are statistically significant differences across health plans in utilization rates for the six services examined. These differences are not substantially affected when we control for the provider group that cared for the patient. That is, controlling for provider group does not explain variations across plans, consistent with the view that health plans have an impact on HEDIS quality measures independent of the providers that they contract with. CONCLUSIONS: There are activities that plans can undertake which influence their HEDIS scores. On the face of it, these results suggest that plans can independently improve quality, in contrast to hypotheses that plans would be "too far" from patients to have an influence. Continued attention to collecting plan-level data is warranted. Further work should address other possible sources of variations in HEDIS scores, such as variability in the quality of plan administrative databases.

California↗

Reproducibility of electrophysiological parameters of sinus node following autonomic blockade.

We investigated the reproducibility of sinus node cycle length (SCL), corrected sinus node recovery time (CSRT) and sino-atrial conduction time (SACT) during the control state and following autonomic blockade in 25 patients (mean age: 56.9 +/- 13.8 years). Autonomic blockade was induced by i.v. administration of propranolol (0.2 mg/kg) and atropine (0.04 mg/kg). The electrophysiological study was repeated after 24 hr and the results were compared. The patients were divided into two groups: Group 1 (15) with normal and Group 2 (10) with abnormal intrinsic sinus node function. Following autonomic blockade in Group 1 the daily variations in SCL, CSRT and SACT were very slight whereas in Group 2 there was far greater variability in these parameters. However, in the latter group there were no patients who changed their status from prolonged to normal intrinsic CSRT on the second study, whereas SACT changed its status in 2 patients. In Group 1 the daily variations in sinus node parameters were much slighter following autonomic blockade than during the control state. In Group 2 the variations were very similar during control and following autonomic blockade. These data suggest that: (1) following autonomic blockade the reproducibility of sinus node parameters is very good in Group 1, whereas in Group 2 several patients show marked daily variations in sinus node parameters; (2) following autonomic blockade the sinus node electrophysiological parameters are meaningful in diagnosing an involvement of intrinsic sinus node function; and (3) in patients with abnormal sinus node parameters during control state, but with normal intrinsic sinus node function, the daily variations are mainly due to change in autonomic tone, whereas when the intrinsic sinus node function is abnormal, the day to day variations during control state appear due predominantly to intrinsic sinus node abnormalities.

Adolescent↗

Left ventricular regional myocyte contractility in normal and heart failure states.

Fundamental determinants of left ventricular (LV) pump performance are preload, afterload and myocyte contractility. Regional variability in LV end systolic wall stress, an important index of LV afterload, has been well defined in both control and congestive heart failure (CHF) states. The goal of this study was to examine end systolic wall stress and myocyte contractile function in three circumferential regions of the LV in both control and CHF states. Accordingly, LV end systolic wall stress and myocyte velocity of shortening were measured from the basal, mid and apical regions in control pigs (n=5) and following the induction of pacing-induced CHF (3 weeks, 240 beats/min, n=5). LV mid wall, circumferential, end systolic wall stress decreased from base to apex in both control (35+/-7 v 16+/-4 g/cm2, P<0.05) and CHF (155+/-23 v 92+/-24 g/cm2, P<0.05) states. In the CHF group, LV end systolic wall stress was elevated by 300% compared to control values in all regions. LV myocyte velocity of shortening was equivalent in the basal and mid regions of control myocytes (52+/-2 v 57+/-2 m/s), and was higher in the apical region (63+/-3 microm/s, P<0.05). In the CHF group, LV myocyte velocity of shortening was reduced by 45% compared to controls with no regional variation. beta-adrenergic stimulation increased myocyte velocity in both the control and CHF groups, however, regional variation was observed only in the CHF group. These unique results demonstrated that minimal regional variations in myocyte contractile function exist in both control and congestive heart failure states, and does not necessarily parallel patterns of regional LV end systolic wall stress.

Animals↗

Regional lung hematocrit variation and assessment of acute lung injury.

Estimating blood content in the lung remains a key step in calculating lung water volume and microvascular permeability. We studied the effect of regional lung hematocrit (Hct) variation on assessment of acute lung injury. Escherichia coli endotoxin was administered in guinea pigs intravenously. Lung injury was evaluated by measuring the wet-to-dry weight ratio (W/D) and transvascular 125I-labeled albumin leakage for 3 h [tissue-to-plasma 125I-albumin ratio (T/P)] in five tissue samples from each animal. Residual blood content was corrected using either 51Cr-red blood cells as a blood cell marker, 99mTc-albumin as a plasma marker, or both, injected 10 min before the guinea pigs were killed. Lung Hct, estimated from the marker counts of lung and peripheral blood samples, was lower than peripheral blood Hct; intraindividual variation, represented by the standard deviation in each subject, was 0.024 +/- 0.015 for the control group (coefficient of variation 8.0 +/- 5.1%) and 0.026 +/- 0.013 for the endotoxin group (coefficient of variation 8.5 +/- 4.1%). Uncorrected W/D for residual blood content was greater than the corrected W/D. 99mTc-albumin correction gave values closer to the W/D corrected by both markers. T/P corrected by 99mTc-albumin showed smaller data variations than the values obtained with 51Cr-red blood cell correction, which was affected by variations in lung Hct. We recommend using a plasma marker to correct for blood content in assessing acute lung injury by W/D and T/P.

Animals↗

Outcome of pregnancies in patients with anti-SSA/Ro antibodies: a study of 165 pregnancies, with special focus on electrocardiographic variations in the children and comparison with a control group.

OBJECTIVE: Aside from congenital heart block (CHB), sinus bradycardia and prolongation of the corrected QT (QTc) interval have been reported in infants born to mothers with anti-SSA antibodies. To assess the pathologic nature of these manifestations, this study focused on electrocardiographic (EKG) variations in these children, comparing them with findings in a control group. METHODS: We studied 165 consecutive pregnancies in 106 anti-SSA-positive women with connective tissue diseases (CTDs). EKGs obtained on 58 children of this group were compared with those obtained on 85 infants born to mothers with CTD who were negative for both anti-SSA and anti-SSB. RESULTS: No statistically significant difference was seen between the 2 study groups with regard to gestational age, prematurity, birth weight, age of the children at the time of EKG, age of the mothers, or treatments received by the mothers during their pregnancies. Seven of 137 children developed cutaneous neonatal lupus syndrome; 1 child developed CHB (CHB risk of 1 in 99 [1%] if only the first prospectively observed pregnancy in women without a history of CHB is included in the analysis). For EKGs recorded during the first 2 months of life, the mean +/- SD PR interval was 96 +/- 16 msec in the anti-SSA-positive group and 96 +/- 13 msec in the anti-SSA-negative group (P = 0.84), with mean QTc values of 397 +/- 27 and 395 +/- 25 msec (P = 0.57) and mean heart rates of 141 +/- 23 and 137 +/- 21 beats per minute (P = 0.20), respectively. No difference in the PR interval, QTc interval, or heart rate was observed for EKGs obtained between 2 and 4 months of life. When EKGs obtained at 0-2 months were compared with those obtained at 2-4 months, a physiologic prolongation of the QTc interval was observed in both study groups. No sudden infant death or symptomatic arrhythmia occurred during the first year of life. CONCLUSION: The EKG findings in children of anti-SSA-positive and anti-SSA-negative mothers were not significantly different. Our results suggest that the prolongation of the QTc interval and sinus bradycardia that have recently been reported in children of mothers with anti-SSA antibodies occur independently of the anti-SSA antibodies. The pathologic nature of these EKG variations was not confirmed by our controlled study.

Adult↗

Percutaneous transluminal angioplasty for shepherd's crook right coronary artery stenosis.

Angiograms from 1,043 consecutive patients undergoing right coronary artery angioplasty were reviewed to determine the incidence of "shepherd's crook" origin of the right coronary artery. Primary results, complications, and technical difficulties were compared with a control group. Fifty-one patients (4.9%) were found to have this anatomic variation. Compared with a control group, the primary success rate was lower (86% vs. 98%) and the incidence of procedural difficulties was higher (33% vs. 13%). Technical problems led to the use of more guiding catheters and more guidewires per patient than in the control group. Thus, coronary angioplasty of shepherd's crook right coronary artery imposes technical problems and is associated with less than an optimal primary success rate.

Angiography↗

Eales' disease: accumulation of reactive oxygen intermediates and lipid peroxides and decrease of antioxidants causing inflammation, neovascularization and retinal damage.

PURPOSE: To measure the blood levels of oxygen and lipid-free radicals as lipid peroxidation products and of vitamins E, C and A, in order to explain intraocular inflammation, retinal neovascularization and detachment in Eales' disease. METHODS: Levels of the lipid peroxidation products produced by oxygen and lipid free radicals (estimated as thiobarbituric acid reactive substances-TBARS), vitamin E with ferric chloride, vitamin C with 2,6-dichlorophenol-indophenol and vitamin A with antimony trichloride were all evaluated in three groups of subjects between 20 and 40 years of age. Twenty three were patients with Eales' disease in the active perivasculitis stage (Group I), 19 were patients with Eales' disease in the healed-perivasculitis stage (Group II), and 46 were healthy volunteers (Group III), used as normal controls. Patients in each group were subdivided into two age groups, 20-30 and 31-40 years, each group containing both sexes. RESULTS: The results showed a 4.6- and 5.6-fold increase in the levels of TBARS in erythrocytes of patients with Eales' disease in the active perivasculitis stage (Group I) and a 2-fold increase in patients with Eales' disease in the healed perivasculitis stage (Group II), when compared to levels in the controls (Group III). On the other hand, there was a decrease of 75 and 76.2% in the levels of vitamin E in serum, 34 and 40.9% of vitamin C in plasma and 72.8 and 67% of vitamin A in serum in patients with Eales' disease in the active perivasculitis stage (Group I), as compared to the controls (Group III). Also decreases of 56 and 43.5% of vitamin E in serum, 26.8 and 12.5% of vitamin C in plasma and 50.5 and 49.4% of vitamin A in serum were found in patients with Eales' disease in the healed perivasculitis stage (Group II) as compared to the healthy controls (Group III). The two values of variations between the patients and the normal control group given above for TBARS, vitamins E,C and A are for the two age groups, 20-30 and 31-40 respectively. The differences were statistically significant (P < 0.01 to 0.001). CONCLUSIONS: Lowered levels of antioxidant vitamins E and C and consequent accumulation of oxygen and lipid free radicals, or vice versa, could explain the inflammation, neovascularization and retinal pathology in patients with Eales' disease. Also, vitamin A deficiency could aggravate retinal illness.

Adult↗

Cardiac cycle-dependent variation of integrated backscatter is not distorted by abnormal myocardial wall motion in human subjects with paradoxical septal motion.

To define the dependence of cardiac cycle-dependent variation of integrated backscatter on regional myocardial wall motion, 8 children mean age 10.6 +/- 1.3 y with congenital cardiac lesions associated with paradoxical septal motion were studied (study group). Six healthy children mean age 9.0 +/- 0.3 y with no history of cardiac disease served as controls (control group). Subjects in the study group had paradoxical septal motion but normal septal wall thickening detected by conventional two-dimensional and M-mode echocardiography. The control group had normal septal motion evident by conventional echocardiographic criteria. The percentage of systolic septal thickening was 46 +/- 4.5% and 42 +/- 5.9% in the study and control groups (p = NS). Cyclic variation was measured in parasternal long-axis views from several septal sites in each subject. Mean values of the magnitude of cyclic variation from independent septal sites were averaged to yield a regional average value for each subject. The average regional magnitude of cyclic variation was 8.3 +/- 1.0 dB and 5.7 +/- 0.4 dB in the study and control groups (p = NS). The results indicate that the measurement of cyclic variation of integrated backscatter is not distorted by altered regional wall motion, and that it reflects intrinsic contractile function.

Child↗

Microstructural properties of bone in rat vertebra after long-term clodronate treatment.

Bisphosphonates (BPs) are known to increase bone mineral density, but it is not known how this increase manifests at low hierarchic levels of the bone structure. The present study aimed to clarify the effects of the long-term use of clodronate on the microstructure and chemical composition of bone. The second lumbar vertebral body (L2) in growing rats, subjected to 32 weeks' treatment with clodronate at either a therapeutic dose of 2 mg/kg, or a high dose of 10 mg/kg, or physiological saline (control group), was studied by scanning electron microscopy for morphology, by backscattered electron image (BSE) for density, and by energy dispersive spectrometry for material analysis. BSE images showed that the degree of mineralization in the different areas of trabecular bone of the vertebral body varied in both the control and the study groups, but this variation seemed to be different in the control and study groups. BSE analysis showed that there was more high-density bone (white area) in the low-dose clodronate group than in the controls, but the difference between the high-dose clodronate group and the control group was not significant. The density of the white area (high-density bone) was slightly increased in the low-dose clodronate group. There were no differences in the density of the gray area (low-density bone) between the groups. Neither the distribution of Ca, P, or Mg, nor the total mineral content, was affected by the clodronate treatment. Our results indicate that long-term clodronate treatment at the therapeutic level increases the proportion of high-density bone in the vertebral body in non-osteoporotic rats.

Analgesics, Non-Narcotic↗