Sexual activity, contraception, genital infections, and cervical cancer: support for a sexually transmitted disease hypothesis

A case-control study was conducted in Utah between 1984 and 1987 to examine risk factors for cervical cancer. Interviews were completed with 266 histologically confirmed carcinoma in situ and invasive squamous cell cervical cancer cases who were categorically matched by age to 408 controls. Among the factors identified as altering risk for cervical cancer, after adjustment for age, education, church attendance, and cigarette smoking, were: having numerous sex partners (odds ratio (OR) = 8.99 for 10 or more partners); the current mate having several sex partners (adjusted OR for 10 or more partners = 8.62); using foam or jelly as a contraceptive method (OR, adjusted for number of sex partners, = 0.44); reported Trichomonas infection (OR, adjusted for number of sex partners, = 2.10); and herpes simplex virus type 2 infection as determined by 2:1 neutralization index values above 100 (OR = 2.70). A protective effect was noted from the use of diaphragms (OR = 0.67) or condoms (OR = 0.53) in women who reported more than one sex partner. These data support the hypothesis that cervical cancer is a sexually transmitted disease.

Differences of Ca2+ regulation in skin fibroblasts from blacks and whites

Black people have a higher propensity than caucasians toward essential hypertension. To explore the possibility that this racial difference relates to cellular Ca2+ metabolism, we measured 45Ca2+ washout and uptake and cytosolic free concentration of Ca2+ [Ca2+]i in serially passed skin fibroblasts from normotensive black and white males. Depending on the experimental conditions, 45Ca2+ washout in these cells was described by either two or three exponential functions, whereas 45Ca2+ uptake was described only by a two-exponent function. There were no racial differences in 45Ca2+ uptake and washout of unstimulated fibroblasts. However, stimulation by human serum resulted in an increase in the 45Ca2+ washout that was higher in fibroblasts from blacks than from whites. The racial differences were expressed primarily by higher values of the apparent washout rate constant (k1) of 45Ca2+ from the largest and most rapidly exchangeable cellular pool. The effect of human serum was not related to its origin (blacks vs. whites). In 2 mM Ca2+ medium and 10% serum from blacks, the respective k1 (mean +/- SEM; x 10(-2)/min) values for fibroblasts from blacks and whites were 89.68 +/- 5.23 and 73.29 +/- 4.0; in the presence of 10% serum from whites, the k1 values for cells from blacks and whites were 84.14 +/- 2.80 and 76.36 +/- 3.23 (overall significance of P less than .01). In Ca2+-deficient medium in the presence of 10% human serum, the k1 for fibroblasts from blacks and whites were 115.57 +/- 3.76 and 102.15 +/- 3.30 (P less than .05). Serum substantially increased the 45Ca2+ uptake in fibroblasts from both blacks and whites; however, racial differences were not observed. Basal levels of [Ca2+]i were not different in fibroblasts of blacks vs. whites (46.8 +/- 6.8 and 43.2 +/- 7.1 nM for blacks and whites, respectively). However, the peak response of Cai2+ transients for cell stimulated by 5% human serum was significantly higher in blacks than whites (blacks = 963 +/- 213, whites = 481 +/- 162 nM; P = .0286). We conclude that Ca2+ regulation is different in serum-stimulated fibroblasts from blacks and whites and that, at least in part, this difference may relate to a greater agonist-induced mobilization of Ca2+ in fibroblasts from blacks.

Accuracy of recalled smoking data

Validity of recalled cigarette data was assessed among 87 middle-aged adults by comparing recall to longitudinal records. Agreement on smoking status and amount smoked 20 years ago occurred for 87 per cent and 71 per cent of subjects, respectively. Corresponding proportions for 32-year recall were 84 per cent and 55 per cent. Gender did not influence recall accuracy. Ex-smokers tended to make the most errors. Accuracy of recalled smoking information 20 years ago was comparable to that of alcohol status and consumption frequency category.

The greeting behavior of fragile X males

Mentally retarded males with a fragile site on the X chromosome (Xq27) were observed to exhibit a highly idiosyncratic but well-coordinated, stereotypic form of gaze avoidance during greeting ceremonies that involved the whole upper body. A comparison group of persons with other etiologically defined syndromes of mental retardation did not. Results suggest that the aberrant greeting behavior may be uniquely associated with one syndrome of mental retardation with a defined genetic etiology. The behavior pattern does not appear until middle childhood, however, and its developmental induction remains to be explained.

Cauda equina syndrome secondary to disseminated zygomycosis

We describe a case of cauda equina syndrome secondary to disseminated zygomycosis. A 52-year-old man had myelodysplastic syndrome, progressive weakness of the lower extremities, and incontinence. Neuroradiological findings were consistent with lumbar stenosis and probable disk herniation. A lung lesion was also discovered on the chest roentgenogram. The patient's condition rapidly deteriorated after surgical decompression. Attempts at determining other etiologies were unsuccessful. At autopsy, disseminated zygomycosis was found affecting the lung and the vasculature of the cauda equina and lumbosacral nerve roots, with resultant focal demyelination of these structures. Ribbon-like hyphal elements were also present in the caudal roots. This opportunistic pathogen is discussed along with the diagnostic challenge presented by its unusual clinical presentation.

Variable expression of the fragile X syndrome in heterozygous females of normal intelligence

The cognitive, linguistic and memory functions of non-retarded fragile X heterozygotes and matched controls were examined by a detailed protocol of neuropsychological measures in order to determine the incidence of specific learning disabilities in this subgroup, and to compare their performance profiles with those of control subjects (mothers of Down syndrome sons). There were no group differences in psychometric intelligence, but the heterozygotes scored significantly lower than controls on most academic achievement tests, as well as on language-based neuropsychological measures. By neuropsychological criteria, 8 of the 15 heterozygotes, but only one of the controls, exhibited performance profiles consistent with a diagnosis of specific learning disability, and similar to cognitive profiles commonly seen in individuals from the general population with developmental dyslexia.

Recall of childhood illnesses

Recall of eight childhood communicable diseases and other illnesses was validated among 95 adults by comparison to longitudinal childhood health records. Self-reports at age 50 of several illnesses were highly accurate; however, German measles was correctly recalled by only 34% of subjects. Similar levels of accuracy were consistently found among a subset who also completed health history interviews 8 and 20 years earlier. Over-reporting of some health events was common. Past exposure to viral or bacterial agents is sometimes assessed in case-control studies by self-reports. Misclassification of prior exposure due to faulty recall may distort true associations between childhood illness and chronic disease in later life.

Heterogeneous cytogenetic abnormalities in small cell lung cancer cell lines

Ten cell lines were established from different biopsies from nine patients with small cell lung cancer (SCLC). These were established from metastases in the marrow (7), breast (1), pleural fluid (1), and spinal cord (1) and had been in culture for periods varying from 1 to 11 months. All cell lines exhibited typical cytological features of SCLC, and produced neuron specific enolase. All lines examined (5) contained dense core granules and were tumorigenic when injected intracranially into nude mice. None of the six cell lines tested had an amplified oncogene (c-myc or n-myc) previously reported to be amplified in SCLC. Detailed chromosome analyses were undertaken and showed that a structural abnormality of chromosome 3(p11p23) was a frequent (6 of 10) but not invariable finding. Our study and one other indicate that there is not a unique chromosome abnormality present in all cases of SCLC, although loss of chromosome 13 and structural abnormalities of chromosome 3 were frequently found. A feature of these SCLC cell lines established from metastatic deposits was the complexity of the karyotypes due to numerical and structural chromosomal abnormalities.

Linkage of cystic fibrosis locus and polymorphic DNA markers in 14 families

Linkage relationships between the cystic fibrosis (CF) locus and three polymorphic DNA markers were examined in 14 families, five of which were of Hispanic origin. Tight linkage was found between the CF locus and MET (maximum lod score = 7.16 at theta = .001), and between CF and pJ3.11 (maximum lod score = 3.87 at theta = .001). We observed two recombinations between CF and collagen, yielding a maximum lod score of 0.359 at theta = .125, and one recombination in the cluster CF-MET-pJ3.11. Analysis by the seriation method indicates the order COL-pJ3.11-CF-MET.

Immunohistochemical identification of proliferating cells in organ culture using bromodeoxyuridine and a monoclonal antibody

The ability to measure cell proliferation is important in the study of cancer biology. The usual technique for quantitating proliferating cells in tissue explant and organ culture by detection of [3H]-thymidine incorporation into DNA by autoradiography is tedious and time-consuming. We have developed a technique for identification and quantitation of bromodeoxyuridine (an analogue of thymidine) in cultured tissue explants. Fetal mouse colon explants were exposed in vitro to bromodeoxyuridine (BUdR) or [3H]-thymidine for 3 to 72 hr and then for various periods to unlabeled thymidine. The tissues were stained with a monoclonal anti-bromodeoxyuridine antibody and in parallel [3H]-thymidine incorporation was detected by autoradiography. Incorporation of BUdR was measured by quantitating the amount of pigment deposited over nuclei after immunohistochemical staining, using an optical data digitizer. It was found that both techniques identified proliferating cells. Dividing cells were present both in crypts and in the surrounding stroma in Day 14 fetal mouse colon cultures. The immunohistochemical technique was more rapid and less cumbersome than autoradiography.

Ascitic fluid cytology in a case of metastatic malignant mixed mesodermal tumor of the ovary

The cytologic features of the abdominal fluid from a patient with a malignant mixed mesodermal tumor (MMMT) of the ovary are presented. Both malignant epithelial and stromal elements were cytologically appreciated and confirmed by histologic examination. Other ovarian neoplasms that can present with malignant sarcomatous elements or mixed epithelial and sarcomatous elements are discussed; this case documents the importance of recognizing these features when staging patients with unusual ovarian neoplasms. To our knowledge, this is the first complete report of the ascitic fluid cytology of an MMMT of either ovarian or uterine origin.

Tolerance following the repeated administration of high doses of phencyclidine: no relation to central catecholamine depletion

The tolerance which develops following the repeated administration of phencyclidine has been attributed to both pharmacological and behavioral adaptations. In the present study, the possibility that neurochemical alterations induced by the repeated administration of phencyclidine might account for some portion of the observed tolerance was examined. Specifically, it was postulated that the repeated administration of high doses of phencyclidine might result in long lasting depletion of central catecholamine stores and that this neurochemical perturbation might result in tolerance to the drug's effects. It was observed that phencyclidine disrupted the performance of rats on a fixed-interval schedule maintained by water presentation. The repeated administration of high doses of phencyclidine (but not of a comparable volume of saline) during a period when subjects were not engaged in the fixed-interval task resulted in the development of a long lasting tolerance, but this tolerance could not be accounted for in terms of a depletion of central catecholamine stores.

HLA associations in sarcoidosis: a study of two ethnic groups

We report results of HLA-A, B, C, and DR typing in groups of white Caucasians of English descent and black West Indians of African descent with sarcoidosis. In the English patients we found a significantly increased frequency of Cw7, which was not found in the West Indian patients. Our results also suggest that DR3 and, in particular, inheritance of the B8/Cw7/DR3 haplotype is associated with good prognosis in English patients with sarcoidosis. There was no association between any HLA antigen and prognosis in the West Indian patients in this study.

Long term care facilities: the benefits of having a dietitian

This article describes the improvements made by a dietitian in two long term care facilities. Neither facility had previously employed a dietitian. Nutritional status of residents was improved by menu revisions that included more dairy products. Accurate serving of calculated diets was instigated. Administrative tools such as policy and procedure manuals and standardized recipes were introduced. It is to be hoped that the positive experiences of these long term care facilities in employing dietitians will encourage other facilities to follow suit.

Changes over thirty years in an index of gynaecological health

The gynaecological index (GYNDEX) was developed to facilitate observing differences in gynaecological health among and between groups of women. It takes into account menstrual characteristics, premenstrual changes, and gynaecological diagnoses and treatments. The objective of this study is to contribute to knowledge of the changes in gynaecological health at different times in the reproductive life cycles of women and to develop a measurement technique which can be used in future studies in women's health. In this investigation a GYNDEX is determined for each of the first three decades postmenarche in a sample of 54 women who have been followed in a longitudinal study since birth, and the characteristics of the changes in the GYNDEX over time are analysed. There is a significant increase in the GYNDEX (P less than 0.05) in each successive decade. Further studies are being done to determine to what extent factors that occurred in the childhood and adolescence act as predictors of adult gynaecological health. Knowledge of these relationships will provide a rationale for planning health care programmes for women of all ages.

Adolescent menstrual characteristics as predictors of gynaecological health

Ina sample of 54 women who have participated in a longitudinal study since birth there is a significant relationship between adolescent menstrual characteristics and gynaecological health as measured by GYNDEX (Gardner 1982) in the second and third decades postmenarche. The menstrual characteristics were recorded in health histories taken in the 1940s as part of a yearly evaluation of growth, development and health status. Using stepwise multiple regression analysis, the measures of regularity and dysmenorrhoea in adolescence explain 46% of the variation in GYNDEX from 11 to 20 years postmenarche (P less than 0.001). These variables are still significant predictors 21 to 30 years postmenarche, explaining 26% of the variance (P less than 0.005). The risk of having poor gynaecological health (high GYNDEX) is greatly increased for women experiencing both dysmenorrhoea and irregularity in the first few years postmenarche.

Hormonal responses during intense exercise preceded by glucose ingestion

In this study the metabolic and endocrine responses during and after intense exercise (80% VO2max) were investigated under a) normal conditions b) diminished intra-muscular carbohydrate supplies, and c) an augmented supply of blood glucose. For this purpose four experimental conditions were employed, rest (R), rest with glucose ingestion (RG), exercise (E), and exercise with glucose ingestion (EG). On the exercise days the subjects exercised twice for 30 min with 2 hour rest between each bout. When glucose was ingested 15 min prior to exercise an accelerated glucose decrease occurred in the first 15 min of exercise (-35 mg/100 ml) (P less than 0.05). Insulin concentrations also decreased sharply throughout this exercise period (EG) (P less than 0.05). After exercise, an insulin rebound occurred in EG that was not observed after exercise in E. In EG, min (180-210) the exercise-induced GH increase was diminished (P less than 0.05) in comparison to the response observed during E. No differences were found in the cortisol responses during or after E and EG. (P greater than 0.05). It is concluded that moderate muscle and hepatic glycogen loss, induced several hours prior to exercise, does not alter the responses of cortisol, GH and insulin during exercise. Increasing the available glucose prior to exercise does not alter the cortisol or insulin responses during exercise but the diminished GH concentrations suggest that the release of this hormone is attenuated directly or indirectly by glucose and/or insulin.

Solid-phase synthesis of porcine vasoactive intestinal peptide

The 28-residue sequence of porcine vasoactive peptide (VIP) was assembled on a benzhydrylamine resin support, cleaved by HF treatment, and purified by ion-exchange and partition chromatography. In addition to the normal criteria, the homogeneity of the final material, obtained in 16% yield, was assessed by reverse-phase high performance liquid chromatography and the isolation and examination of cyanogen bromide cleavage fragments by the same technique. The purified VIP possessed characteristic inhibitory effects on pentagastrin-induced gastric acid release in the dog. Upon storage, even as the lyophilized powder in vacuo, HPLC revealed the slow formation of a contaminant possibly representing deamidated peptide.

Lateral differences and head-turning responses to somesthetic stimulation in premature human infants

Head-turning responses to somesthetic stimulation of the perioral region were studied at weekly intervals in 25 prematurely born infants. No regular changes associated with age were evident. The premature infants were more likely to turn towards than away from a stimulus; however, they were less so than are full-term infants. The infants were as likely to turn towards the stimulus when it was on the left as when it was on the right; however, they were more likely to turn away from a stimulus on the left than on the right. Comparisons with full-term infants indicated reduced lateral differences in responding. Such a reduction is in sharp contrast with the previous finding of marked postural asymmetry in a comparable sample of prematurely born infants. These data indicate a possible sequence in the development of head-turning responses to somesthetic stimulation and the assumption and maintenance of an asymmetrical head posture which consists of (1) a right-turning postural bias, (2) contralateral responding to somesthetic stimulation, (3) lateral differentiation of contralateral responding, (4) ipsilateral responding, and (5) lateral differentiation of ipsilateral responding.

Preparation of 125iodine-labelled methotrexate and its use in a magnetisable particle solid-phase radioimmunoassay

Two techniques for the iodination of methotrexate are describes, involving covalent linkage to the drug of 125I-labelled N-succinimidyl-3-(4-hydroxyphenyl)propionate (Bolton and Hunter reagent), or to 125I-labelled histamine. A rapid highly specific radioimmunoassay for methotrexate was developed, employing a specific antiserum covalently linked to magnetisable particles, and 125I-labelled methotrexate as tracer. Incubation times for the assays were 60 and 10 min for the Bolton and Hunter reagent-linked methotrexate and 125I-labelled histamine-linked methotrexate respectively. Separation of bound from free antigen was achieved by a rapid magnetic separation system. Results obtained for serum samples correlated closely with those using an enzymatic (dihydrofolate reductase) competitive protein binding assay for methotrexate. A major advantage of the assay is its potential for processing large numbers of samples rapidly, making it highly suitable for routine clinical use.

Radioimmunoassay of digoxin employing charcoal entrapped in magnetic polyacrylamide particles

Charcoal and magnetisable ferric oxide were entrapped in a polyacrylamide gel and, after lyophilisation and micronisation, empolyed for the uptake of free antigen in a radioimmunoassay for digoxin. The results obtained were similar to those using a conventional charcoal separation method.

A new approach to the problem of retinal neovascularization

Tumor cells introduced into the rabbit vitreous produced a form of retinal neovascularization, but only when the tumor cells were in direct contact with the vascularized retina. This contrasted with the production of neovascularization at a distance of several millimeters in other angiogenesis models. An extract of adult rabbit vitreous was found to inhibit the growth of limbal neovascularization induced by tumors implanted in the rabbit corneal stroma. The experimental model of retrolental fibroplasia provides a bioassay to investigate further the apparent inhibitory substances in the vitreous.

Relationship between process and outcome in ambulatory care

The outcomes of a series of some 410 acute episodes from two family practice centers were rated on the degree to which the patient regained his usual functional status and his satisfaction with the outcome and the process of care. A portion of outcomes (251) were then compared to process scores obtained using explicit criteria and the rest to implicit process ratings based on the problem-oriented record. In both instances those cases with good outcomes had better process scores than those with bad outcomes; neither measure of satisfaction had a consistent relationship with either process measure.

Development of postural asymmetry in premature human infants

The head position of 95 infants, born between 30 and 37 weeks gestational age, was observed every 15 min for 2 hr weekly from birth until 39 weeks conceptional age. At 35 weeks and increasingly thereafter, significantly more time was spent with the head to the right than to the left. By 39 weeks the infants were similar to term infants: almost 90% spent 80% or more time with their heads to the right. The increase appeared independent of intra- or extrauterine experience; neither age at birth nor time since birth was consistently related to head position. Unlike term infants, prematures were equally likely to turn left as right and have their heads left as right 15 min after release from a midline position. These findings suggest complex determinants of asymmetry including factors intrinsic to the fetus and those contributed by the uterine environment.

Inducibility of transferrin receptors on friend erythroleukemic cells

The ability of Friend erythroleukemic cells to bind transferrin and take up its iron increases substantially as a result of dimethyl sulfoxide-stimulated differentiation. Although transferrin-binding activity is also demonstrable in another mouse cell line of hematopoietic origin, the lymphoma cell, it does not increase on exposure to dimethyl sulfoxide. Gel filtration studies corroborate that the binding of transferrin to the erythroleukemic cells is due to the formation of a specific complex of transferrin and a membrane receptor. Thus, the specific interaction of transferrin with its receptor is another expression of dimethyl sulfoxide-induced differentiation in the Friend cell.

Tissue culture studies of possible uremic neurotoxins: myoinositol

Organotypic cultures of dorsal root ganglion cells revealed neuronal toxicity when exposed to myoinositol at doses of 1090 to 109 micrometer (500 to 50 microgram/ml). The ultrastructural changes consisted of membranous cytoplasmic bodies at high concentrations and dense bodies at lower concentrations. There were no changes at 0 to 22 micrometer (0 to 10 microgram/ml). This range of neurotoxicity parallels the levels of myoinositol found in the serum of uremic patients. Myelin loss occurred in a pattern suggesting "secondary demyelination," similar to the pattern seen in uremic neuropathy. The relevance as a possible model for uremic neuropathy is discussed.

Observations on the use of solid-phase-coupled antibodies in the radioimmunoassay of human placental lactogen

A detailed comparative assessment was made of the use of solid-phase-coupled antibodies in radioimmunoassay, by using an assay for human placental lactogen as a model system. The major advantages of the solid-phase technique are: (1) in common with the use of a second antibody, it is universally applicable; (2) separation can be carried out rapidly; (3) in contrast with some other techniques, the separation of antibody-bound and free antigen is virtually complete. The disadvantages when compared with other procedures are: (1) a considerable proportion of the antibody may be lost during the initial coupling reaction; (2) the tubes must be continuously mixed during incubation, and much effort is expended in removing and replacing the caps; (3) there is a decrease in the apparent affinity constant of the antibody after coupling, which is reflected in a lower sensitivity of the assay system. It is concluded that solid-phase antibodies are of greatest value in those systems in which the supply of antiserum is abundant, and in which the achievement of high sensitivity is not a requirement.