Structure of the murine tissue factor gene. Chromosome location and conservation of regulatory elements in the promoter

Tissue factor (TF) is a transmembrane glycoprotein that mediates cellular initiation of the coagulation serine protease cascades. Moreover, expression of TF in human atherosclerotic plaques is likely to play a significant role in the thrombotic complications associated with plaque rupture. In this study the complete murine TF gene, Cf-3, was isolated from mouse NIH 3T3 cells and was found to consist of six exons spanning about 11 kilobase pairs (kbp) of DNA. A major transcriptional start site was located 24 bp downstream of a TATA box. Cf-3 was mapped to chromosome 3 by analysis of an intersubspecies test cross. Conserved transcription factor-binding sites were identified by comparison of 5' flanking regions of the murine and human TF genes. A region of the TF promoter required for constitutive expression exhibited 85% identity in DNA sequence and included two conserved binding sites for Sp1. Furthermore, two AP-1 sites and an NF-kappa B site were conserved in a 56-bp region necessary for transcriptional activation in response to bacterial lipopolysaccharide. These highly conserved regions of the TF promoter, which contain several binding sites for well-characterized transcription factors, are likely to be functionally important in the complex pattern of TF gene expression observed in a variety of cell types.

Comparison of the erythropoietin response in children with aplastic anemia, transient erythroblastopenia, and iron deficiency

To assess the effects of decreased erythrocyte production on the levels of serum erythropoietin in children, we measured simultaneous hemoglobin concentrations and erythropoietin in 18 children with iron deficiency anemia, 17 children with transient erythroblastopenia of childhood (TEC), and 7 children with aplastic anemia. In all but two patients (one with TEC; one with aplastic anemia), erythropoietin was measured at diagnosis, before institution of specific therapy for the anemia. There was a statistically significant inverse linear correlation between log10 erythropoietin and hemoglobin values for all patient groups (r = 0.904 to 0.912; p less than 0.005). A comparison of the slopes of the regressions for each patient group by analysis of covariance revealed a significantly steeper slope for the iron deficiency group (-0.553) versus the TEC (-0.287) and aplastic anemia (-0.256) groups (p = 0.0001). The difference in erythropoietin levels appeared greatest in patients whose presenting hemoglobin level was greater than 5 gm/dl. Decline in serum erythropoietin levels was more precipitous in the less severely anemic patients with iron deficiency anemia than in the patients with TEC or aplastic anemia. These data reveal quantitative and qualitative differences in the relationship between serum erythropoietin and hemoglobin levels when children with severe iron deficiency anemia versus those with TEC or aplastic anemia are considered, even though all three conditions are characterized by hypoproliferation of erythrocytes.

Effect of haloperidol and clozapine on the density of "perforated" synapses in caudate, nucleus accumbens, and medial prefrontal cortex

Perforated synapses, which contain a discontinuous density along the postsynaptic membrane, can increase or decrease in numbers following various behavioral and biochemical manipulations. We have previously established that 14-day treatment with haloperidol causes an increase in the number of perforated synapses within the caudate nucleus (dorsolateral region) but not the nucleus accumbens (Meshul and Casey 1989). This effect was reversed if the animals were withdrawn from the drug for an equivalent period of time. We have now further examined the effects of haloperidol administration, which is associated with a high incidence of extrapyramidal side effects (EPS) and tardive dyskinesia (TD), and assessed the effects of clozapine, which appears to have a lower potential for inducing EPS and TD. Administration of haloperidol for 2 weeks significantly increased the percentage of perforated synapses in the caudate, but not in the nucleus accumbens or layer VI of medial prefrontal cortex (MPCx). There was an increase in specific [125I]epidepride binding to D-2 receptors in the caudate nucleus and MPCx following haloperidol. Administration of clozapine for 2 weeks did not affect the percentage of perforated synapses in any of the three dopamine (DA)-rich regions that were examined. There was an increase in specific [3H]SCH 23390 binding to D-1 receptors and in specific [125I]epidepride binding to D-2 receptors only within MPCx following clozapine.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunoreactivity of leukemic lymphoblasts of T-cell and B-cell precursor origin with monoclonal anti-GD3 and anti-GM3 antibodies

The glycosphingolipids GD3, GM3, and alpha 2, 3-sialosylparagloboside (SPG) are major gangliosides of lymphoid leukemia cells. The reactivity of two monoclonal anti-ganglioside antibodies, an anti-GD3 (R24) and an antibody cross-reactive to GM3 and SPG (M2590), to blasts of patients with T-cell acute lymphoblastic leukemia (ALL) and B-cell precursor ALL (pre-B-ALL), were compared using indirect immunofluorescence and flow cytometry. Results from 23 patients with T-ALL and eight with pre-B-ALL yielded four subclasses of T-ALL and two subclasses of pre-B-ALL. Blasts from most of the patients with T-ALL were R24+M2590- whereas most of the patients with pre-B-ALL were R24-M2590-. Seven of 23 patients with T-ALL had ganglioside immunophenotypes similar to that of pre-B-ALL, i.e. R24-M2590- or R24-M2590+. These subclasses could not be further characterized by additional cell surface immunophenotypic markers or by gene (immunoglobulin and T-cell receptor) rearrangement analysis. The ratio R24/M2590 was less than 1.0 in all patients with pre-B-ALL, and was greater than 1.0 in all patients with T-ALL who were R24 positive, but was not useful in characterizing the double negative T-ALL subclass. To assess whether cryptogenicity of gangliosides due to cell surface protein could account for the low binding of either R24 or M2590, blasts were treated with trypsin before antibody analysis. Whereas the binding of R24 was unchanged after trypsin treatment, binding of M2590 was increased in a number of samples, particularly in those samples which were originally M2590-positive. The results show that comparative staining of T-ALL and pre-B-ALL cells with both anti-GD3 and anti-GM3/SPG antibodies results in a further subclassification of ALL and provides a quantitative assessment of the expression of tumor-associated gangliosides on the blasts of this disease.

Comparison of immunisation rates in general practice and child health clinics

OBJECTIVE

To compare immunisation uptake rates in general practice surgeries and community child health clinics.

DESIGN

Cohort study using data from a computerised child health system.

SETTING

Four health districts of North East Thames Regional Health Authority.

SUBJECTS

3616 children born January to March 1990 and resident in the four districts at the end of January 1991.

MAIN OUTCOME MEASURES

Immunisation uptake rates at 10-12 months of age, age at immunisation, scheduling performance at the two locations, and odds ratios of outstanding immunisations.

RESULTS

80% of children registered at general practices had completed their third dose of pertussis immunisation compared with 68% of those at health clinics. Median ages at the third dose were 24 weeks and 29 weeks at the two locations respectively. Scheduling was more effective at general practice surgeries. Unscheduled immunisations were more likely to be given after the recommended age. Overall, children resident in rural and suburban areas had greater uptakes than those in inner cities. Odds ratios for not being fully immunised among children registered at health clinics were 1.4 times those among children immunised in general practice and 3.0 times greater among children resident in inner cities than among those in rural and suburban districts. Children who moved into a district, however, were no less likely to be fully immunised than children who were born there.

CONCLUSIONS

The immunisation uptake rate was better in general practices than in child health clinics in both inner city and rural and suburban areas. Uptake may be increased with additional support to enable general practitioners to undertake immunisations, especially in inner cities.

US-guided transvaginal drainage of pelvic abscesses and fluid collections

Ultrasound (US)-guided transvaginal needle or catheter drainage was performed in 14 women for a variety of pelvic abscesses and fluid collections; tubo-ovarian abscesses and postoperative collections were most common. Diagnosis was achieved in all 14 patients (100%), including one patient with suspected ovarian carcinoma who underwent only diagnostic needle aspiration and no therapeutic drainage. Abscesses or fluid collections were evacuated in 13 of 13 patients (100%) with either needle (n = 7) or catheter (n = 6) drainage (with appropriate antibiotics). Twelve of the 14 patients (86%) were spared an operation; surgery was undertaken in two patients for a persistent tubo-ovarian phlegmon. No major complications were associated with drainage. Catheters were removed an average of 6.7 days after insertion. The success, safety, and advantages of US-guided transvaginal drainage in our early experience suggest its use as an alternative to standard percutaneous catheter procedures to diagnose and drain certain pelvic abscesses and fluid collections.

Gender gaps: who needs to be explained?

The hypothesis that explanations for differences between prototypical and nonprototypical members of categories would focus more on attributes of the latter than on those of the former was examined. Explanations for alleged gender differences in the behavior of voters, elementary school teachers, and college professors were elicited. As predicted, explanations for gender differences within the 3 categories emphasized the qualities of the "deviant" member. Ss' explanations of alleged gender gaps in the behavior of voters and college professors focused more on qualities of women than on qualities of men. In contrast, Ss' explanations of an alleged gender gap in the behavior of elementary school teachers focused more on qualities of men than on qualities of women. The results are interpreted in terms of Kahneman and Miller's (1986) norm theory.

Influence of feeding Aspergillus oryzae fermentation extract on the milk yields, eating patterns, and body temperatures of lactating cows

Trials were conducted to evaluate effects of a fermentation extract of Aspergillus oryzae (AO) on milk production and composition, diet digestibility, and rectal temperature changes in lactating dairy cows. Treatments were incorporated as a top dressing at the morning feeding and consisted of control (90 g/d of ground sorghum) or AO (3 g of culture + 87 g of ground sorghum daily). Twenty-four mid-lactation Holstein cows were paired for production in Lactation Trial 1 (LT-1). In Lactation Trial 2 (LT-2), 46 cows (20 primiparous and 26 multiparous) in early lactation were used. Trials lasted 12 wk. In LT-1, AO supplementation increased milk yields only at 2 (P less than .05) and 8 wk (P less than .10) of treatment. Rectal temperatures were lower (P less than .05) for cows fed AO for 4 of 10 readings made during summer. Supplementation of AO culture in LT-2 (early lactation cows) increased milk production and feed efficiency (P less than .05). Inner ear temperatures tended to be lower (P less than .11) for cows fed AO. Digestion trials, conducted at the end of lactation trials, used Cr2O3 as an indigestible marker. In Digestion Trial 1, digestibilities were not significantly (P greater than .10) affected by AO supplementation. However, in Digestion Trial 2, AO increased (P less than .05) digestibilities of DM, OM, CP, NDF, and ADF. Length and number of meals were not affected (P greater than .10) by feeding AO. In summary, milk yields, efficiency of milk production, and nutrient digestibilities were higher for early lactation cows fed a high-concentrate diet supplemented with 3 g of AO/d. Mid-lactation cows fed a lower-energy diet were less responsive to AO than early lactation cows, though similar trends were shown.

Hypoxia inhibits renal thromboxane and not prostacyclin release

The effect of hypoxia on renal prostanoid synthesis and renal function was studied. The kidneys of male Sprague-Dawley rats were cannulated and perfused in vitro with Krebs-Henseleit buffer with a pO2 of 460 (control) or 60 mm torr (hypoxia). The rate of perfusion was adjusted to maintain perfusion pressure at 100 mm Hg. The renal venous effluent was collected at 15, 30, 60, 120, 150, and 180 min and assayed for basal release of 6-keto-PGF1 alpha, PGE2, and thromboxane B2 by radioimmunoassay and inulin and sodium clearance. Prostanoid release was high at 15 min, decreased to a lower level up to 120 min, and then progressively increased after 150 min of perfusion. Hypoxia significantly decreased TxB2 release at 30, 60, 150, and at 180 min but not PGE2 or 6-keto-PGF1 alpha release. Hypoxia proportionally decreased both sodium and inulin clearances suggesting that the decrease in renal function was from decreased renal flow. The kidney responded to the altered renal function by increasing the ratio of vasodilator to vasoconstrictor prostanoids by inhibition of TxB2 release.

Factors affecting outcome after surgery for intracranial aneurysm in Glasgow

Two-hundred and ninety-five patients with angiographically demonstrated intracranial aneurysms presented to the Institute of Neurological Sciences, Glasgow over a 3-year period (1986-88). We have reviewed this group to assess the effect of changing patterns of management upon outcome. The overall mortality rate was 9.4%, and the surgical mortality rate was 4% in this selected series. Factors significantly associated with a poor outcome were: WFNS grades III-V on admission, presence of a haematoma on the first CT scan, delayed ischaemic deficit, and development of a post-operative haematoma. Seventy-six per cent of the patients who developed a delayed ischaemic deficit (nearly a third of those with recent subarachnoid haemorrhage) made a good recovery, in contrast to previous studies, and over two-thirds of those accepted in grades IV and V (28 patients) made a good recovery after surgery. Active management of patients in grades IV and V, and those with delayed ischaemia, together with prophylactic Nimodipine therapy and selective early surgery, offers the best prospect for further improvement in outcome after aneurysmal subarachnoid haemorrhage.

Gender gaps: Who needs to be explained?

The hypothesis that explanations for differences between prototypical and nonprototypical members of categories would focus more on attributes of the latter than on those of the former was examined. Explanations for alleged gender differences in the behavior of voters, elementary school teachers, and college professors were elicited. As predicted, explanations for gender differences within the 3 categories emphasized the qualities of the "deviant" member. Ss' explanations of alleged gender gaps in the behavior of voters and college professors focused more on qualities of women than on qualities of men. In contrast, Ss' explanations of an alleged gender gap in the behavior of elementary school teachers focused more on qualities of men than on qualities of women. The results are interpreted in terms of Kahneman and Miller's (1986) norm theory.

Biomagnetometers for unshielded and well shielded environments

The paper describes magnetometers for operation in well shielded and unshielded environments. For unshielded environments, the noise cancellation is accomplished by spatial filtering using higher-order gradiometers which are formed in software. The theory of the software formation of high-order gradiometers has been successfully tested experimentally to the second-order gradient level, using a seven-channel prototype system. An unshielded, open environment system, designed to operate with third-order noise cancellation is presently under construction. It is a whole head system, consisting of a minimum of 64 sensing channels, and is expected to be operational by late 1991. In the opposite extreme, a magnetometer is being developed for operation in a well shielded environment of a whole body superconducting shield. The high temperature superconducting shield will operate in liquid nitrogen, while the magnetometer detection system will operate in liquid helium. The high level of shielding will allow detection of biomagnetic signals using magnetometers. The whole body high temperature superconducting shielded system is presently under development and a half scale working shield already exists. The complete whole body shielded system is expected to be operational in 1994/95.

Prevention of pediatric pulmonary problems: the importance of maternal smoking

Although many factors are associated with lower respiratory illnesses in children, few can be identified as likely direct causal influences. Maternal smoking has been strongly associated with respiratory morbidity in early life. The relationship is consistent in different studies, and is dose-related. It is also resistant to attempts at statistical control for factors that might confound the association. The effect seems most marked from maternal smoking during pregnancy. Stopping young women taking up cigarette smoking is a priority preventive medical need.

"Well, was it worth it?" The value of teletutorials for bachelor of nursing students

The Deakin University Faculty of Nursing conducts a Bachelor of Nursing degree which is available via the distance education mode. The faculty has as its central focus the value of nursing practice and espouses a belief in students' active learning. This paper examines the use of teletutorials as a process for realising the philosophy of the faculty in relation to students' learning outcomes. Although expensive in terms of financial and human resources, teletutorials bridged the gap between the faculty's philosophical statements and students' perceptions and needs.

The need for black specialists in preventive medicine

The disparity in health status between black and white Americans exists chiefly because of an excess of preventable disease in blacks. This situation calls for an increase in preventive services for blacks, services which might best be implemented or directed by black specialists in preventive medicine. However, there exists both an absolute shortage of preventive medicine specialists (of all races) and a relative shortage of black preventive medicine specialists. The immediate need for additional black specialists exceeds the total U.S. preventive medicine residency corps.

The Effect of Perceived Locomotor Constraints on Distance Estimation

Two experiments were conducted to examine the ways in which the visual estimation of distance to a target is affected by constraints perceived to be placed on the subsequent locomotion to the target without vision. We hypothesized that an appraisal of impending effort would play a role in ascertaining the distance to be walked. In Experiment 1, the amount of resistance to walking was variable and unpredictable. One group of subjects performed against relatively low resistance, whereas another group performed against substantially greater resistance. In the low-resistance condition, no significant differences in CE, VE, time to target, or number of steps to target were found between any of the eight combinations of predictable or unpredictable resistances during walking. In the high-resistance condition, however, significant differences were found for CE and number of strides to target when resistance varied unpredictably during walking. Experiment 2 was similar in design but required subjects to walk with combinations of normal or short steps after they had viewed the target knowing only the gait type that would be used to begin locomotion. No differences in CE, VE, or time to target were found between four different combinations of gait type and predictability, under subjectively controlled conditions. When the step constraints were externally imposed, however, differences were found for CE. None of the results from either experiment, in which the number of strides needed to reach the target or the predictability of gait did not change from normal, supported the hypothesis that motor output requirements are necessary in forming a mental representation of the target position that can be used to walk to the target with eyes closed. Whichever locomotor technique was used to walk the estimated distance in these cases, the representation was able to be used independently. When walking mechanics were altered by externally imposed constraints, however, the success at reaching the estimated target position was reduced. These latter results are consistent with those obtained using up, down, and level walking and support the premise that mental representations used in blind walking are linked to the locomotor mechanics afforded by environmental conditions.

The effect of hypoxia on angiotensin-stimulated release of PGI2 from the splanchnic bed

The effect of hypoxia on splanchnic angiotensin II (AII)-stimulated prostaglandin (PG) release was examined in male rats. The superior mesenteric artery was cannulated and perfused in vitro with physiologic buffer at a pO2 of 460 or 60 torr. Splanchnic vessels were perfused isolated (SV) or in continuity with the small intestine (SV + SI). AII (10-300 ng) was infused as bolus injections. Quantitative analysis of SV + SI effluent by bioassay indicated the predominant PG released was PGI2. Quantitative analysis by radioimmunoassay confirmed PGI2 as the major PG released from the SV and SV + SI following AII stimulation. Relative hypoxia significantly decreased AII-stimulated release of PGI2 from the SV, and only modestly from the SV + SI. These data demonstrate two splanchnic sources of AII-stimulated vasodilator PG synthesis, the SV and SV + SI, with the SV more sensitive to relative hypoxia. Diminished release of splanchnic vascular (SV) vasodilator PGI2 may be of importance in AII-mediated splanchnic vasoconstriction seen in hypoxia and shock.

Explosive Deep Water Basalt in the Sumisu Backarc Rift

Eruption of 1-million-year-old tholeiitic basalt >1800 meters below sea level (>18 megapascals) in a backarc rift behind the Bonin arc produced a scoriaceous breccia similar in some respects to that formed during subaerial eruptions. Explosion of the magma is thought to have produced frothy agglutinate which welded either on the sea floor or in a submarine eruption column. The resulting 135-meter-thick pyroclastic deposit has paleomagnetic inclinations that are random at a scale of <2.5 meters. High magmatic water content, which is about 1.3 percent by weight after vesiculation, contributed to the explosivity.

What do school teachers know about asthma?

The results of a survey of 98 primary school teachers in inner London showed that they had only limited understanding of asthma and its management. Few teachers had received any teaching or training about the condition; the arrangements for giving antiasthmatic drugs were generally unsatisfactory and caused unnecessary disruption to the child's school life as well as preventing effective treatment. Training in the nature and treatment of common diseases like asthma should be made available for groups such as school-teachers who are responsible for children so that optimal health care is ensured.