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Functional compensation by Egr4 in Egr1-dependent luteinizing hormone regulation and Leydig cell steroidogenesis.

The Egr family of zinc finger transcription factors, whose members are encoded by Egr1 (NGFI-A), Egr2 (Krox20), Egr3, and Egr4 (NGFI-C) regulate critical genetic programs involved in cellular growth, differentiation, and function. Egr1 regulates luteinizing hormone beta subunit (LHbeta) gene expression in the pituitary gland. Due to decreased levels of LHbeta, female Egr1-deficient mice are anovulatory, have low levels of progesterone, and are infertile. By contrast, male mutant mice show no identifiable defects in spermatogenesis, testosterone synthesis, or fertility. Here, we have shown that serum LH levels in male Egr1-deficient mice are adequate for maintenance of Leydig cell steroidogenesis and fertility because of partial functional redundancy with the closely related transcription factor Egr4. Egr4-Egr1 double mutant male mice had low steady-state levels of serum LH, physiologically low serum levels of testosterone, and atrophy of androgen-dependent organs that were not present in either Egr1- or Egr4-deficient males. In double mutant male mice, atrophic androgen-dependent organs and Leydig cell steroidogenesis were fully restored by administration of exogenous testosterone or human chorionic gonadotropin (an LH receptor agonist), respectively. Moreover, a normal distribution of gonadotropin-releasing hormone-containing neurons and normal innervation of the median eminence in the hypothalamus, as well as decreased levels of LH gene expression in Egr4-Egr1-relative to Egr1-deficient male mice, indicates a defect of LH regulation in pituitary gonadotropes. These results elucidate a novel level of redundancy between Egr4 and Egr1 in regulating LH production in male mice.

Animals↗

Blood pressure in head-injured patients.

OBJECTIVE: To determine the statistical characteristics of blood pressure (BP) readings from a large number of head-injured patients. METHODS: The BrainIT group has collected high time-resolution physiological and clinical data from head-injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of 1 min from 200 patients is examined. The distributions of BP measurements and their relationship with simultaneous ICP measurements are described. RESULTS: The distributions of mean, systolic and diastolic readings are close to normal with modest skewing towards higher values. There is a trend towards an increase in blood pressure with advancing age, but this is not significant. Simultaneous blood pressure and ICP values suggest a triphasic relationship with a BP rising at 0.28 mm Hg/mm Hg of ICP, for ICP up to 32 mm Hg, and 0.9 mm Hg/mm Hg of ICP for ICP from 33 to 55 mm Hg, and falling sharply with rising ICP for ICP >55 mm Hg. CONCLUSIONS: Patients with head injury appear to have a near normal distribution of blood pressure readings that are skewed towards higher values. The relationship between BP and ICP may be triphasic.

Adolescent↗

Numerical simulation of film coating process in a novel rotating fluidized bed.

In this study, numerical simulation of film coating process in a novel rotating fluidized bed (RFB) was conducted by using a Discrete Element Method (DEM)-Computational Fluid Dynamics (CFD) coupling model. Particle movements and fluid motions in a centrifugal force field were simulated at three-dimensional cylindrical coordinate, and this model was applied to film coating process. Film coating process in a RFB was numerically analyzed by using a simplified assumption that a particle was coated only when a particle existed within a spray zone. The experiments were also conducted and uniformity of sprayed material was evaluated by investigating color difference of the coated particles. As a result of the numerical simulation, three-dimensional bubble movements and particle circulation could be well simulated. In addition, mass of the sprayed material on a single particle in a RFB could be visualized by using our proposed model. The relationship between distribution of the sprayed material and the coating time was also analyzed. Calculated mass distributions of the sprayed material could be expressed by a normal distribution function, showing qualitative good agreement with the previous studies. Effect of the operating parameters, such as gas velocity and centrifugal acceleration, on the uniformity of the sprayed material was also investigated by both numerical and experimental approaches. Comparison of the coating process in a RFB with that in a conventional fluidized bed was also conducted by the numerical simulation. The result showed that uniformity of the sprayed material was greatly improved in a RFB due to the much smaller circulation time.

Chemistry, Pharmaceutical↗

Distribution of movement time in a target-aiming task.

Various characteristics of the distribution of movement time were analyzed for a task involving serial and rotary arm movements aimed at a target. For experimental data generated from five Ss, (a) the distribution tended to be unimodal and more peaked than a normal distribution, (b) the skewness of the distribution was predominantly positive and (c) the standard deviation, in addition to the mean, of movement time was significantly affected by the complexity of the task as measured by Fitts' index of difficulty, while the skewness and the kurtosis were not. For the average results for the Ss, a first-order linear model with the standard deviation of movement time as the dependent variable and Fitts' index as the independent one explained 67% of the variation in standard deviation as compared to 98% of the variation in mean movement time accounted for by the Fitts' index.

Adult↗

[Development and evaluation of a photo-rhinometer for clinical use].

We developed a photo-rhinometer (PRM) which is a modification of the Glatzel nasal mirror, and which can promptly evaluate nasal patency under natural respiration without any facial apparatus. We also investigated the clinical applications of the PRM. In PRM operation, moisture deposits resulting from expiratory nasal flow onto a glass plate are visualized for the right and left nostrils separately with an image analyzing computer at a television scan rate of 1/30 of a second. These visualized moisture deposits are averaged over the initial 1 second and differentiated for the initial 90 milliseconds to obtain an average moisture deposit area (AMDA) and the velocity of the moisture deposit (VMD), respectively. The resulting PRM chart, a graphic presentation of the moisture deposit area versus time was expected to be useful for the visual evaluation of nasal patency. PRM measurements were performed on 100 adult volunteers who were selected without knowing whether they had any nasal symptoms or disorders. Results showed that statistical distributions of both AMDA and VMD were equivalent to the normal distribution. A significant correlation was observed between nasal conductance as determined by a rhinomanometer and AMDA as determined by the PRM, and also between the nasal conductance and the VMD, which is r = 0.66 and r = 0.78 respectively. In addition to the 100 cases, five cases of chronic sinusitis and ten cases of acute sinusitis, which had been conservatively treated, were investigated by using the PRM. In some of these cases where improvements in the nasal conditions and reduction of subjective nasal obstruction were recognized, increases in the AMDA and VMD showed a good correlation with improvements in the nasal disorder.

Adult↗

[Development of a scale of attitudes toward the roles of liberated men (SARLM)].

A ten-item Scale of Attitudes toward the Roles of Liberated Men (SARLM) based on the factor analysis was developed in order to provide a measure of attitudes toward the roles of liberated and traditional men. The scale was administered to 109 men and 93 women and was examined for its reliability and validity. The goodness-of-fit test indicated that the distribution of the scale scores was very close to the normal distribution. The reliability coefficient was .75, the test-retest coefficient with a four-week interval was .94, and the coefficients of the item-total correlations ranged from .43 to .62. These results support the reliability of SARLM. Evidence of the construct validity was derived from the confirmation of five hypotheses regarding sex, educational attainment, age, women's employment status, and husbands' participation in household tasks. SARLM appears to provide a reliable and valid measure for assessing attitudes toward the roles of liberated and traditional men.

Adult↗

Fatigue strength testing of hip stems with statistical analysis.

Component fatigue testing, the final step in the development of total joint replacements, is performed to validate the safety of these components against fatigue failure before clinical use. Fatigue test prediction can aid the design of an efficient fatigue-testing program. The objective of this study was to perform an efficient and accurate statistical analysis of component fatigue test results, for the validation of future fatigue test predictions. Testing was performed with two aims: first, to determine the local component stress-force relationship using strain gauges; and second, to provide a statistical description of the fatigue test results. Forty-nine hip stems, in three sizes, were tested in a series of static and fatigue tests. Through effective planning and analysis, a statistical description of the component fatigue test results was determined including, 3-parameter Weibull distributions of life at two stress levels and log-Normal distributions of fatigue strength at various lives up to 5 million cycles.

Analysis of Variance↗

[Reference values for the central motor conduction time and silent period obtained by the transcranial magnetic stimulation].

INTRODUCTION: Normal values of reference to transcranial magnetic stimulation for the motor central conduction time (CCT) and silent period (SP) is recorded in 30 healthy control subjects over abductor pollicis brevis. MATERIAL AND METHODS: We get for the CCT four measurements: two with low intensity of stimulus, 5% plus the motor threshold, with and without facilitation (CCT1 and CCT1 fac.); and two with high intensities of stimulus, elevating the magnetic stimulation intensity to 1.5 times the threshold (CCT2 and CCT2 fac.). RESULTS AND CONCLUSIONS: The mean and standard deviation of each measurement are: CCT1: 9.34 +/- 1.19, CCT1 fac.: 7.12 +/- 1.1. CCT2: 8.84 +/- 1.05 and CCT2 fac.: 6.57 +/- 1.05. Given that the CCT and SP doesn't follow a normal distribution, the medium and the 5-95% percentiles for the normal values of reference are calculated; there are: CCT1: 7.15-11.32, CCT1 fac: 5.27-9.42. CCT2: 7.05-10.73 and CCT2 fac: 4.91-9.14. For the silent period gets only one measurement employing high intensities. These last measurement were recorded in two localizations: on vertex and on motor area, selecting the greater duration. Given the great individual variability of this period in normal population absolute and ratio for the difference duration of SP between both sides are calculated. The latency of the SP is 50.2 +/- 5.99, 95 percentiles 39.1-64.63, the duration 151 +/- 32.51, 95 percentiles 102.63-239.55. The total SP measured from the discharge of the stimulus to the end of the silent period is 201.71 +/- 33.27; 95 percentiles: 151.39-296.4. The comparison of both hemispheres would give us pathological security for the 99.99% of the population for more than 14.94 ms of absolute difference, and for less of the 79.81% of ratio difference. A summary of the discoveries of the silent period in different pathologies is contributed in the discussion.

Adult↗

The reaction time of single motor units in the human muscle.

The reaction time for activating a single motor unit (MU) with one impulse only, upon visual and auditory feed-back was studied in six healthy subjects. Use was made of MUs from m.abductor dig.V. The subjects were trained until they achieved more than 50% correct performances. One hundred responses were investigated in each series of experiments. The stimulus to which the subjects should have to respond was a beam presented on the screen of a "Disa" 14A30 electromyograph. Simultaneously with the beam the stimulator switched on a digital chronometer which was switched off by the MU impulse. Another two series of experiments were also performed in which the subjects responded with a train of impulses from the MU or with a burst of impulses from the whole muscle. It was been found that the mean reaction time for one impulse from one MU is longer (300 ms), for a train of impulses from one MU it is shorter (260 ms) and for a burst of impulses it is the shortest (200 ms). The histogram of distribution in the first series of experiments deviated from the normal distribution and showed a second maximum at 120 ms after the first maximum. The latter did not differ from the maxima in the distributions of the second and third series of experiments--about 200 ms after the visual stimulus presentation. The difference in the mean reaction time for the three series of experiments is due to the differences in the motor tasks connected with different velocity of increase of the muscle tension, as increasing velocity decreases the MU recruitment thresholds. The separate MUs might be activated in the same short periods as the whole muscle but they showed some specificities in the time distribution of the responses which might be due to some discrete mechanisms of the motor control system.

Adult↗

[Estimation of the number of necessary beds for tuberculosis patients, in Japan].

OBJECTIVE: To estimate the number of necessary beds for tuberculosis patients in Japan from the view point of isolation of the source of infection. METHODS: We calculated the number of necessary beds for tuberculosis cases separately for the initial phase and for the chronic excreters. For the initial phase we calculated by multiplying the number of detected tuberculosis cases and the duration of hospitalization. The number of detected cases is based on the figures in 2002 and the duration of hospitalization is assumed to be 90 days for sputum smear positive cases and 60 days for sputum smear negative cases. We calculated the number of necessary beds using the Monte Carlo simulation for each prefecture on the assumption that the incidence and the duration of diseases will be under the effect of random fluctuation with the Poisson's distribution for the number of cases and with the log normal distribution for the duration of hospitalization. We also considered the seasonal fluctuation. RESULTS: Our calculation revealed that around 6,413 beds would be necessary for the initial phase and 200-400 beds for chronic excreters in Japan. There are several prefectures which only requires less than 30 beds. DISCUSSION: Currently, Japan has around 17,000 beds secured for tuberculosis patients. Our calculation showed that this was much more than needed. In many areas, one ward will provide more than sufficient number of tuberculosis beds. Specialist consultation system must be improved because of the reduction in the number of TB cases treated at hospitals with TB wards and TB specialists. For the treatment of non-infectious TB, ambulatory DOT system, TB shelter and nursing care facilities would be necessary to guarantee compliance to treatment.

Directly Observed Therapy↗

The Social Functioning Questionnaire: a rapid and robust measure of perceived functioning.

BACKGROUND: The Social Functioning Questionnaire (SFQ), an eight-item self-report scale (score range 0-24), was developed from the Social Functioning Schedule (SFS), a semi-structured interview which has been used primarily with non-psychotic patients and has good test-retest and inter-rater reliability as well as construct validity. The SFQ was developed following the need for a quick assessment of perceived social function. AIMS: To give further details of old and new data sets from studies involving over 4000 subjects assessed with the SFQ illustrating its epidemiological and clinical associations. METHOD: New data were analysed from a national epidemiological study, a comparison of key-worker and subject versions of the SFQ, and reanalysis of data from three earlier clinical studies, of psychiatric emergencies, general practice psychiatric patients and those with recurrent psychotic illnesses. These data were examined further to determine their range, their relationship to other clinical measures, and change over time in clinical trials. RESULTS: The population mean score in 4164 subjects was 4.6 and the data from all studies suggested that a score of 10 or more indicated poor social functioning. Those presenting as psychiatric emergencies had the poorest social function (mean 11.4) and psychiatric patients from general practice the best function (mean 7.7) of the clinical populations. The eight item scores had a normal distribution in psychiatric populations and a skewed one in a normal population; scores were relatively stable over the short (weeks) and long-term (months), and were high in the presence of acute mental health disturbance and personality disorder, giving support to the validity of the scale. The results from a UK sample of a randomly selected population specifically weighted for ethnic minorities showed similar social function across groups.

Ethnicity↗

The probability distribution of attendance to hospital emergency units for school students in Alexandria.

The present work is a retrospective study designed to examine the assumption that emergency arrivals at the Sporting Students' Hospital in Alexandria follow a Poisson distribution. Data about all arrivals at the emergency room (ER) for the year, 2000 (43076 arrivals) was extracted from the records of the emergency department and classified by age, sex, school, reason for visit, date and time of visit. Data analysis revealed that 12.9% of the total arrivals indicated hospital admission either to the inpatient units (12.5%) or the ICU (0.4%). Goodness of fit test showed that admissions to the ICU fit the Poisson distribution but those admitted to the inpatient units did not follow the assumed distribution. However the latter group did not fit exactly the normal distribution which indicated that deviance from the Poisson is due to the large mean non-elective admissions (14.74% per day). Hence the Poisson assumption is not excluded as the inpatient emergency admissions are still randomly distributed and independent. Univariate and multivariate Poisson regression of the daily emergency admissions gave another clue to the goodness of fit of emergency admissions to the Poisson process. Regression analysis showed significantly higher loge number of emergency admissions among the age group 12 or more, male students, medical conditions in contrast to injuries, governmental schools, and at 04:00-11:59 pm in contrast to midnight to 07:59 am. Results of the present study indicated the random nature of demand for emergency admission which affects use of bed stock. A prospective study of these admissions on daily basis is needed.

Adolescent↗

Development and validation of a simple tape-based measurement tool for recording cervical rotation in patients with ankylosing spondylitis: comparison with a goniometer-based approach.

OBJECTIVE: To compare a tape-based tool for measuring cervical mobility in patients with ankylosing spondylitis (AS) with the widely practiced goniometer-based approach. METHODS: We developed a novel tape-based approach to measurement of lateral cervical rotation of the neck that is minimally affected by flexion/extension movements of the neck. This requires measurement of the difference between a mark at the suprasternal notch and the tragus of the ear. Rotation score is measured in centimeters and constitutes the difference in length between the 2 extremes of cervical rotation (http://www.arthritisdoctors.org/researcher.html). We assessed the tape-based and goniometer-based methods in a total of 263 patients from 3 countries, Canada (n = 205), Australia (n = 29), and Colombia (n = 29), that included patients from community and tertiary-based practice. Intra- and interobserver reliability was assessed in a subset of 44 patients by ANOVA and a 2-way mixed effects model. The Bath AS Disease Activity (BASDAI) and Function (BASFI) Indices, and the modified Stoke AS Spinal Score (mSASSS), were also recorded to assess construct validity by correlation coefficient and regression analysis. Responsiveness was assessed in a subset of 33 patients that were either randomized to anti-tumor necrosis factor-a therapy:placebo (n = 22) or received open label infliximab (n = 4) or pamidronate (n = 7) over a period of 24 weeks. RESULTS: Scores obtained with the tape-based method were normally distributed, while those obtained using the goniometer were skewed towards normal values. Reliability for the goniometer-based approach was excellent [intraclass correlation coefficient (ICC) > 0.90] and very good for the tape-based approach (ICC > 0.80). Significant correlations were noted between age, disease duration, function and structural damage scores, and scores obtained with both methods. Responsiveness was high using raw scores obtained with the goniometer (standardized response mean > 0.80) but was not evident when the grading scheme proposed for the Bath AS Metrology Index (BASMI) was employed. CONCLUSION: The tape-based approach we describe provides a simple, feasible, and reliable index of cervical rotation that is comparable to the information obtained from the use of a goniometer. If the goniometer-based approach is used, raw scores should be used in the calculation of responsiveness rather than the grading scheme suggested in the BASMI.

Anthropometry↗

Immortalization in culture of rat cells: a genealogic study.

The process of immortalization of cultured rat liver epithelial-like cells from JAR-2 rats was studied by time-lapse cinemicrography. This process was shown to be multistep. First (in the F-phase), cells were similar to those in a finitely proliferative population. Most cells terminated their proliferative life in the F-phase, while a few gained additional proliferative potential and subsequently entered into the T (transitional)-phase. In the T-phase, a population of cells maintained proliferative potential with a large fluctuation: Some cells further gained additional proliferative potential while others lost it. After a period in the T-phase, continuously dividing cells emerged (in the I-phase). The interphase period of the dividing cells in both the T- and the F-phases showed cells to distribute exponentially, consistent with transitional probability models. However, cells in the I-phase were distributed much more narrowly and were frequently close to a normal distribution. Hypothetical mechanisms of immortalization were presented on the basis of these observations.

Animals↗

[Atopy screening: prick multitest, total IgE or RAST? On the value of allergologic testing of the staff of an industrial bakery].

The predictive value of diagnostic tests for the recognition and differentiation of allergic diseases of the immediate type has been evaluated on the basis of the results of a non-selective allergologic-pneumologic examination of the staff of an industrial bakery. Out of the 314 subjects tested, 22 (7%) had a respiratory allergy against flour (flour rhinitis and/or flour asthma), and 21 (6.7%) a preexistent atopic disease without actual symptoms of flour allergy. Thus the predominance of atopy in the group examined was 13.7%. A prick-multitest was carried out in all 314 subjects on each forearm and allowed simultaneous and easy application of twice eight test substances ("atopy-screening" and "bakery-line"). 50% of the bakers with flour allergy also showed positive skin tests with non-occupational inhalative allergens (housedust, housedust mite, pollen) while only 9.2% of the subjects without respiratory allergy to flour did so. 17.1% of the heavily exposed, asymptomatic bakers showed a positive immediate reaction to the highly sensitive intracutaneous test with wheat flour. Here the problem of latent sensitization arises. With histamine the prick-multitest resulted - compared to the intracutaneous test - in 1.6% "false negative" and 3.2% only questionably positive results. Furthermore, 6.1% of the subjects showed a strong, and 3.2% a very strong, nonspecific reaction to the control solution glycerin. Despite these restrictions the prick-multitest proved far superior to measurement of total serum IgE for screening of atopy. Technical improvements have been made in the meantime by the manufacturer. Specific IgE was detected in RAST screening in 59 of the 306 subjects who underwent blood tests. The geometric mean of total IgE values was only 75 U/ml, and for the RAST-negative subjects 23.3 U/ml, while their 95% confidence level was 225 U/ml. This logarithmic-normal distribution of the measured values, together with the excessive normal-atopic overlap, makes it impossible to lay the test cutoff point in a way which results in an acceptable relation between sensitivity and specificity. For the population examined the sensitivity of the total IgE measurement was already below 50% at a cutoff point of 80 U/ml, while the positive predictive value did not yet reach 50% at 160 U/ml. This diagnostic test is at present certainly used too often and without sufficient awareness of its very limited predictive value. As a screening method the RAST is too expensive. Furthermore, the problem of a latent sensitization also exists for the RAST.

Adolescent↗

[Labelling index in breast cancer and in upper respiratory and digestive tract cancer (author's transl)].

The labelling index (LI) of 96 breast adenocarcinomas and of 43 upper respiratory and digestive tract cancers has been measured. For the two histological groups, the distribution of individual values is found to be log-normal, with a mean value depending on the tumour type. Our data have been compared with other authors results. The dispersion of individual values within a same histological type suggests that the LI is interesting as an individual value depending on the patient and his own cancer. For breast adenocarcinomas the LI values obtained have been separated in two groups depending upon the patient age, the age of 53 has been chosen to separate premenopausal from post-menopausal patients. A test of significance showed that the two corresponding log-normal distributions were different, even at the 0.01 level of significance, a mean LI value thus characterizing each distribution.

Breast Neoplasms↗

Leukopenia in anorexia nervosa. Lack of increased risk of infection.

To determine whether patients with anorexia nervosa (AN) and leukopenia have an increased risk of infection, we reviewed the incidence of leukopenia and infection in 68 cases of AN and studied the mechanism of profound neutropenia in one. Compared with controls, patients with AN had substantially lower total leukocyte counts and absolute neutrophil, lymphocyte, and monocyte counts. Despite frequent and often severe panleukopenia, the patients with AN had no more infections than did the control subjects. The patient with severe neutropenia ahd a hypocellular bone marrow biopsy specimen showing relative myeloid hyperplasia, normal distribution of neutrophils between the marginal and circulating pools, and normal bone marrow neutrophil reserves as estimated by response to hydrocortisone sodium succinate. We conclude that patients uith AN and associated leukopenia do not have increased infection propensity.

Adolescent↗

On the natural history and comparative pathology of the blue naevus.

In man the epidermis is the final destination for most of the melanocytes which are of neural crest origin, and they migrate to a variety of sites. Dermal melanocytic distribution, conspicuous in some lower animals, has a very restricted normal distribution in man, and of the variety of anomalies which exist the blue naevus is the most frequently encountered. It is comparable to the common melanocytoma of dog and hamster. More widespread dermal melanocytoses are rare, and a unique case in which death from melanoma supervened, recently recorded by the author, is an example of a syndrome the only parallel to which appears to be equine melanotic disease, a disorder of aging, greying horses. It is argued on comparative grounds that the newly described syndrome and equine melanotic disease are examples of a neurochristic disorder involving the cephalad segments and dermal melanocytes.

Adult↗