Pleistocene geochronology and palaeothermometry from protein diagenesis in ostrich eggshells: implications for the evolution of modern humans

Proteinaceous residues incorporated within the crystal structure of ostrich eggshells (OES) are retained without loss over geological time exceeding 10 million years. Degradation of the polypeptides, including hydrolysis to smaller peptide fragments and eventual release of free amino acids, decomposition, and racemization and epimerization occur at regular, predictable rates dependent on ambient temperature. The extent of isoleucine epimerization (alle/Ile ratio) in OES follows linear first-order reversible kinetics in controlled-temperature laboratory simulations of time up to an alle/Ile ratio in excess of 1.0. The hydrolysis of leucine also follows a predictable pattern, but deviates from first-order kinetics. A nonlinear mathematical model has been developed that adequately describes the pattern of leucine hydrolysis through a wide temperature range. Arrhenius parameters were derived from laboratory experiments combined with rate constant values found for 14 C-dated OES from stratified caves in southern Africa. These parameters for isoleucine epimerization and leucine hydrolysis differ by ca . 10%, allowing the simultaneous solution of the two equations for temperature, independent of sample age. Although the uncertainty of the simultaneous temperature is relatively high (± 10°C), it provides an effective means of identifying burned samples. If sample age is known, palaeotemperatures (the integrated thermal history experienced by an eggshell as opposed to an ‘instantaneous’ temperature) can be calculated with a precision of better than ± 1°C. The ages of levels at Border Cave, South Africa, from which anatomically modern human skeletal remains have been recovered, are dated by the extent of isoleucine epimerization in associated OES. The reaction is calibrated in the upper levels by a series of concordant radiocarbon dates on charcoal at 38 ka before present (BP). The amino acid dates on deeper levels indicate that the Howiesons Poort stratum at Border Cave is more than 70 ka old, and that anatomically modern humans occupied the site as early as 100 ka ago.

Combined finasteride and flutamide therapy in men with advanced prostate cancer

OBJECTIVES

To evaluate the efficacy of combined finasteride and flutamide therapy in men with advanced prostate cancer by determining (1) the short-term tolerability of finasteride monotherapy and its effect on serum prostate-specific antigen (PSA) and hormone (testosterone, dihydrotestosterone) levels, and (2) the effects of the addition of flutamide on tolerability and on serum PSA and hormone levels.

METHODS

Thirteen hormone-naive men with advanced prostate cancer (4 with Stage D2, 1 with Stage D1, 1 with Stage D0, and 7 with rising PSA levels after radical prostatectomy [n = 2] or definitive radiation therapy [n = 5]) were initially treated with 5 mg finasteride daily. Flutamide (250 mg three times a day) was added after serum PSA levels stabilized.

RESULTS

Finasteride alone (median 5 weeks) had no significant effect on serum PSA levels (P > 0.05). Combined finasteride and flutamide resulted in a mean 91% reduction in serum PSA levels, with 85% of men achieving a nadir serum PSA level of less than 4.0 ng/mL and 46% achieving undetectable levels (0.2 ng/mL or less). Finasteride alone had no significant effect on serum testosterone levels (P > 0.05) but did result in a mean 74% reduction in serum dihydrotestosterone levels. Combined finasteride and flutamide resulted in a mean 56% increase in serum testosterone levels but had no additional effect on serum dihydrotestosterone levels (P > 0.05). Side effects occurred in 85% (gynecomastia or breast tenderness in 62% [8 of 13] and diarrhea in 23% [3 of 13]) of men on combined therapy. Potency was preserved in 66%. Combined finasteride and flutamide therapy was withdrawn from 15% (2 of 13) because of flutamide-induced diarrhea and from 23% (3 of 13) because of disease progression. All remaining patients (8 of 13) have serum PSA levels below 4.0 ng/mL and 4 of these 8 have undetectable levels. These men have received combined finasteride and flutamide for a median 11 months (range 6 to 19).

CONCLUSIONS

Finasteride monotherapy is inadequate therapy for advanced prostate cancer, but combined finasteride and flutamide may be a reasonable alternative for men with advanced prostate cancer who refuse conventional hormone therapy.

IL-1 beta stimulates superoxide and delayed peroxynitrite production by pulmonary vascular smooth muscle cells

Our previous studies have shown that rat pulmonary microvascular smooth muscle cells (RPMSMC) upregulate inducible nitric oxide synthase (iNOS) and produce nitric oxide (NO) when treated with interleukin-1 beta (IL-1 beta). We now report that an additional effect of IL-1 beta stimulation in RPMSMC is an increase in production of superoxide (O2-) that results in the formation of peroxynitrite (ONOO-). IL-1 beta produced a rapid (within 1 h) concentration-dependent increase in O2-, as detected by ferricytochrome c reduction and lucigenin-enhanced chemiluminescence. O2- production was sensitive to quinacrine and diphenyliodinium, suggesting that NADH and NADPH oxidoreductases were responsible. After induction of iNOS and production of iNOS-derived NO, ONOO- was detected by luminol-enhanced chemiluminescence and was found to cause lipid peroxidation and to form nitrotyrosine in the cytoskeleton, detected by immunostaining. Cell viability, however, appeared to be unaffected. IL-1 beta-mediated induction of RPMSMC-derived ONOO- may have significant effects on pulmonary vascular function in sepsis and inflammatory states.

Glycine regulation of synaptic NMDA receptors in hippocampal neurons

1. Although glycine has been identified as a required coagonist with glutamate at N-methyl-D-aspartate (NMDA) receptors, the understanding of glycine's role in excitatory synaptic neurotransmission is quite limited. In the present study, we used the whole cell patch-clamp technique to examine the ability of glycine to regulate current flow through synaptic NMDA receptors at excitatory synapses between cultured hippocampal neurons and in acutely isolated hippocampal slices. 2. These studies demonstrate that the glycine modulatory site on the synaptic NMDA receptor is not saturated under baseline conditions and that increased glycine concentrations can markedly increased NMDA-receptor-mediated excitatory postsynaptic currents (EPSCs) in hippocampal neurons in both dissociated cell culture and in slice. Saturation of the maximal effect of glycine takes place at different concentrations for different cells in culture, suggesting the presence of heterogenous NMDA receptor subunit compositions. 3. Bath-applied glycine had no effect on the time course of EPSCs in either brain slice or culture, indicating that desensitization of the NMDA receptor is not prevented by glycine over the time course of an EPSC. 4. When extracellular glycine concentration is high, all miniature EPSCs recorded in the cultured hippocampal neurons contained NMDA components, indicating that segregation of non-NMDA receptors at individual synaptic boutons does not occur.

High-speed exercise history and catastrophic racing fracture in thoroughbreds

OBJECTIVE

To investigate the relation between several racing speed history characteristics and risk of fatal skeletal injury (FSI) in racing Thoroughbreds.

ANIMALS

64 Thoroughbreds euthanatized during a 9-month period in 1991 at a California racemeet because of a catastrophic fracture incurred while racing (cases), identified retrospectively. For each race in which an FSI occurred, 1 control horse was randomly selected from the noncatastrophically injured participants.

PROCEDURE

Racing and officially timed workout histories were obtained for each horse. Several history characteristics were calculated to summarize racing career patterns and high-speed exercise schedules prior to date of injury and included age at first race, proportion of career spent laid up, average duration of laid up periods, average lifetime racing frequency, time from last lay up to date of injury, and total and rate of distance accumulated 1 to 6 months prior to date of injury. History characteristics associated with FSI were screened by paired t-test and studied in detail, using conditional logistic regression.

RESULTS

High total and high average daily rates of exercise distance accumulation within a 2-month period were associated with higher risks for FSI during racing, yet career patterns, such as age at first race or total proportion of career spent laid up, were not found to be associated with risk for FSI. A horse that had accumulated a total of 35 furlongs of race and timed-work distance in 2 months, compared with a horse with 25 furlongs accumulated, had an estimated 3.9-fold increase in risk for racing-related FSI (95% confidence interval = 2.1, 7.1). A horse that had accumulated race and timed-work furlongs at an average rate of 0.6 furlong/d within a 2-month period, compared with a horse with an average of 0.5 furlong/d, had an estimated 1.8-fold increase in risk for racing-related FSI (95% confidence interval = 1.4, 2.6).

CONCLUSIONS AND CLINICAL RELEVANCE

Thoroughbred racehorses that either accumulate large total high-speed distances or rapidly accumulate high-speed distances within a 2-month period may be at increased risk for FSI during racing.

Flowable networks as DNA sequencing media in capillary columns

A novel class of materials that self-assemble in water into equilibrium network structures with a well-defined mesh size consist of polyethylene glycols (PEG's) end-capped with micelle-forming fluorocarbon tails. These micellar systems form flowable aqueous gel-like networks that permit electrophoretic DNA sequencing in capillary columns. The gels have unusual rheological properties, including network breakdown under shear, resulting in plug flow that allows columns refill with complete ejection of byproducts of the previous sequencing analysis. In this system, DNA fragment electrophoretic mobilities are unaffected by the hydrophobicity of the polymer tails. Low molecular weight (M) PEG chains (M 8000) show catastrophic resolution loss for DNA fragments larger than 100 bases due to band broadening. For a longer PEG segment (M 35000) separating the end groups, band broadening occurs for DNA fragments larger than 300 bases, implying that the PEG segment length controls the mesh size in the equilibrium network structure. Optimum sequencing results were obtained from a 6% solution of a 1:1 mixture of C6F13 end-capped- and C8F17 end-capped PEG 35,000. The resolution limit of fluorescent-dye-labeled sequencing products in this formulation was 450 bases in 75 microns capillaries at 200 V/cm.

Quantitative EEG differences in a nonclinical sample of children with ADHD and undifferentiated ADD

OBJECTIVE

To use quantitative electroencephalographic (EEG) techniques to identify electrophysiological differences between children with distinct disorders of attention and/or hyperactivity.

METHOD

Forty children from a prescreened community sample were evaluated by means of both spectral EEG and evoked response potential (ERP) techniques. The children were 7 to 13 years of age and were selected on the basis of membership in one of the following DSM-III-R categories: attention-deficit hyperactivity disorder (ADHD) (n = 16), undifferentiated attention deficit disorder (UADD) (n = 12), or no disruptive disorder diagnosis (n = 12).

RESULTS

Spectral EEG revealed that UADD subjects had less delta band relative percent power (RPP) (p < .01), more beta band RPP (p < .01), and ERP findings of a decreased rare tone P300 amplitude (p < .02) compared with the control group. ADHD subjects had spectral EEG findings of increased beta band RPP (p < .05) and ERP findings of an increased common tone N100 latency (p < .02) and a decreased rare tone P300 amplitude (p < .02). Interhemispheric asymmetries appeared to distinguish the groups: the UADD group had spectral EEG asymmetries; the ADHD group had only ERP asymmetries; and the control group had no asymmetries.

CONCLUSION

Quantitative EEG techniques may prove useful in differentiating specific subtypes of ADHD.

Intrathecal ketorolac tromethamine produces analgesia after chronic constriction injury of sciatic nerve in rat

PURPOSE

The study compared analgesic efficacy of intrathecally administered ketorolac tromethamine (K) and morphine hydrochloride (M) (in equimolar doses) in the chronic neuropathic pain model, induced by chronic constriction injury (CCI) of the sciatic nerve in rat.

METHODS

Male Sprague-Dawley rats (n = 30) were anaesthetized with halothane and an intrathecal catheter was inserted to the mid-lumbar level of the spinal cord. On the 5th post-operative day, rats were anaesthetized with halothane and four ligatures were loosely applied around the right sciatic nerve. Seven days later, those animals were randomly divided into three groups and were injected with either saline, M (20 nmoles) or K (20 nmoles). Two pain responses (foot-withdrawal delay and hind paw elevation time) were measured on both sides using the radiant heat method. Further, thermal ("cold") allodynia was assessed by measuring of the total time of hind paw elevation in animals placed on the cold metal plate.

RESULTS

Twenty nmoles of M and K injected intrathecally produced decrease of differential pain score calculated for both measured responses (hind paw withdrawal and hind paw elevation), compared with saline injected animals (P < 0.05). The reduction in pain response produced by K was less (P < 0.05). than the reduction in pain response observed in the animals receiving intrathecal M. Measurement of cold allodynia revealed that the animals in M and K injected groups demonstrated decreases in the total hind paw elevation time, when compared with saline-injected animals (P < 0.05).

CONCLUSION

M and K produced hypoalgesia after intrathecal administration in rats with CCI, with M being more potent than K at an equimolar dose range. The analgesic effect of K was equal to equimolar doses of M for alleviation of cold allodynia.

Variability of regurgitation in Björk-Shiley mitral valves and relationship to disc occluder design: an in vitro two-dimensional color-Doppler flow mapping study

BACKGROUND AND AIMS OF THE STUDY

Normal prosthetic valves have regurgitation that varies according to valve type and design. The Björk-Shiley prosthetic mitral valve is a tilting disc valve that has undergone design changes since its introduction. From 1969 to 1981, Delrin, was used to make the disc occluder. After 1971, the occluder was made from Pyrolite (i.e. Conical and Radiopaque-Spherical valves). Our aim was to quantify the regurgitation of Delrin and Radiopaque-Spherical Björk-Shiley prosthetic mitral valves with color-Doppler flow mapping in an in vitro model that simulates transesophageal echocardiography imaging.

MATERIALS AND METHODS

Normal unimplanted Björk-Shiley Delrin (BSD), Björk-Shiley Radiopaque-Spherical (BSS) and explanted (17 +/- 3 yrs) BSD valves (25, 27, and 29 mm) were studied in a pulse duplication system. The regurgitant leakage volume of the valves was measured with an electromagnetic flow probe at flow rates of 3.0, 5.0, and 7.0 L/min, a pulse rate of 70 beats/min, and a mean systemic pressure of 100 mmHg. Color-Doppler flow mapping was performed with a 3.7 MHz transducer positioned on the atrial chamber at an image depth of eight centimeters. The maximal regurgitant jet areas were measured offline and averaged from three beats.

RESULTS

Maximal jet area, measured with color-Doppler flow mapping, correlated with regurgitant leakage volume (r = 0.82). Normal unimplanted and explanted BSD valves had greater regurgitant leakage volumes and jet areas than BSS valves for all sizes and flow rates studied. Regurgitant jet areas of normal unimplanted and explanted BSD valves were similar.

CONCLUSION

Knowledge of the type of Björk-Shiley valve is important in the clinical evaluation of regurgitation severity by transesophageal echocardiography. The echocardiographic appearance of regurgitation of BSD valves does not necessarily imply valve dysfunction.

Diagnosis of oleander poisoning in livestock

Since mid-1989, 37 cases of oleander poisoning in livestock have been diagnosed at the California Veterinary Diagnostic Laboratory System. The most frequent source for oleander exposure was plant clippings. Sudden death was the most common presenting complaint. Other signs reported included diarrhea, pulmonary edema, tachycardia, cardiac arrhythmias, colic, and lethargy. In the past, a presumptive diagnosis of oleander poisoning could be based only on matching clinical signs with evidence of consumption of oleander. A new 2 dimensional Thin-layer chromatography analysis of ingesta for oleandrin and an awareness of lesions in heart muscle have greatly improved the ability to diagnose oleander toxicosis.

Physiotherapy and occupational therapy for juvenile chronic arthritis: custom and practice in five centres in the UK, USA and Canada

Physiotherapy and occupational therapy are widely accepted as being of central importance for the treatment of juvenile chronic arthritis (JCA). However, these approaches have rarely been subject to critical scrutiny. The aims of this report are to highlight some of the inter-centre similarities and differences observed in the implementation of physical and occupational therapy for JCA, and to emphasize the need for scientifically controlled research in this area. During a series of visits to several paediatric rheumatology units in the UK, USA and Canada, three aspects of the service were noted: treatment philosophy, physical interventions used for the treatment of JCA and quality-of-life and independence training activities. There was general consensus with the philosophy that early physical intervention was a vital part of the treatment plan for JCA, although all therapists were concerned that compliance with treatment modalities was poor. Differences between units in the approach to acute arthritis, the use of foot orthoses and wrist splints, the treatment of joint contractures and the use of general quality-of-life training activities were noted. Although it was widely recognized that controlled research into the efficacy of physical intervention was needed, no centre had a co-ordinated plan for such investigations.

Closing of a psychiatric intensive care unit: a manifestation of lost values

TOPIC

A psychiatric intensive care unit shown to be of value to patients and staff was closed within a year, ostensibly for economic reasons.

PURPOSE

To examine the usefulness of psychiatric intensive care units, and the importance of thinking through the ramifications of downsizing

SOURCE

A case study of a psychiatric ICU in Northern Ontario, Canada and a review of the literature.

CONCLUSIONS

When downsizing is considered, a careful examination of values must take place, remembering patient care comes first.

Subclavian artery injury caused by a screw in a clavicular compression plate

A 22-year-old man presented with left-arm ischaemia, 22 months after placement of a clavicular compression plate for a fractured left clavicle. Digital subtraction angiography revealed a distal subclavian artery injury which, during surgery, was found to be caused by a screw in the compression plate. Ligation of the subclavian artery followed by carotid-axillary bypass resulted in a symptom-free left arm.

Toxicity profile of the investigational new biotherapeutic agent, B43 (anti-CD19)-pokeweed antiviral protein immunotoxin

The investigational biotherapeutic agent, B43(anti-CD19)-pokeweed antiviral protein (PAP) immunotoxin, has shown substantial anti-leukemic activity in SCID mouse models of human B-lineage leukemia and lymphoma. In this report, we describe the results of a comprehensive preclinical toxicity study which determined the toxicity profile of B43-PAP in BALB/c mice. Administration of unconjugated B43 monoclonal antibody was not associated with any toxicity, whereas B43-PAP caused dose-limiting and cardiac and renal toxicities which were fatal. In addition, B43-PAP also caused multifocal skeletal myofiber necrosis, which was associated with abnormal gait and lethargy. Notably, parenteral administrations of methylprednisolone, pentoxyphylline, or dopamine were able to markedly reduce B43-PAP related toxicity. This study provides a basis for further evaluation of the toxicity of B43-PAP in monkeys and humans.

Heavy metal concentrations in injured racehorses

Records were reviewed of horses that had fatal injuries at California racetracks over a 16-mo period. Horses were categorized based on injury type, sex, age and breed. Arsenic, cadmium, copper, iron, lead, molybdenum and zinc concentrations were measured in the liver and kidneys from each horse. Arsenic and lead were not detected in any tissues. Liver heavy metal concentrations were not related to the injury type. Kidney iron concentrations were significantly (P < 0.05) higher in horses with ligament ruptures and in horses with fractured sesamoid, carpus or metacarpus/metatarsus bones. Liver cadmium, kidney cadmium, and liver iron were higher (P < 0.05) in horses > 2 y old than in 2-y-olds. Liver cadmium concentrations were higher (P < 0.05) in Thoroughbreds than in Quarter Horses.

Top management culture and performance in Canadian, UK and US hospitals

This study examines the role of top management team culture in hospitals located in Canada, the UK and the USA. Clan, developmental, empirical, and rational cultures were identified using the competing values framework. This study was organized around three basic questions. The first question asked whether hospital management teams in the USA, Canada and the UK have different management cultures given the differences in their political economies. The second question asked whether management culture was associated with differences in performance? The third question addressed the issue of the legitimacy of culture type as an independent variable. If culture type has legitimacy, other organizational variables such as structure, conflict resolution style, market strategy, and stakeholder priorities should be manifested differently in each culture type. The findings support the legitimacy of the culture variable and the premise that the political economy influences the distribution of culture types. The dominant cultures of the hospital management teams studied were positively and significantly related to organizational performance for clan, rational, and developmental cultures. The implications for management theory, professional practice and public policy are discussed.

Purification of the growth hormone releasing hormone receptor with a C-terminal, biotinylated affinity ligand

The receptor for growth hormone-releasing hormone (GHRH) has been purified from bovine pituitary tissue and HEK293 cells transfected with human or porcine receptor using a retrievable biotinylated GHRH analog. Custom synthesized [His1, Nle27, Biotin-Lys41]-human GHRH-(1-41)-NH2 (GHRHb) bound to pituitary membranes with affinity comparable to human GHRH. GHRHb which has the biotinyl group on the C-terminus of the peptide allowed simultaneous binding to both the receptor and streptavidin agarose. This analog was used directly in the purification of the receptor from pituitary tissue or was modified by incorporation of the photoaffinity group ANBNOS (GHRHlambdab), radioiodinated and used to demonstrate purification of the GHRH receptor from transfected HEK293 cell membranes. Membranes were prepared and prebound with the respective ligand followed by CHAPS-solubilization and application of the solubilized complex to a streptavidin agarose column. Analysis of eluates from the pituitary tissue purification by silver stained SDS PAGE or of autoradiographs of gels from HEK293 eluates revealed specific bands of 52 and 55 kDa, respectively. The higher size of the latter band is expected for the ligand-crosslinked receptor. Both bands displayed similar mobility shifts of 10 kDa upon treatment with N-glycosidase, a method previously used to characterize this receptor. A 45 kDa band corresponding to the size of the Gs alpha subunit was also detected in eluates of the silver stained gels, suggesting that the GHRH receptor was retrieved as a heterotrimeric complex. Fold purification and yield for this procedure were estimated to be greater than 50,000 and 2.6-9%, respectively.

Persistent pain associated with long-term intrathecal morphine administration

A 32-year-old man with chronic intractable right lower extremity pain unresponsive to multiple neurosurgical and pharmacologic treatments, including intrathecal morphine administration, was successfully treated with sciatic nerve block, discontinuance of opioid therapy, and psychologic interventions. Plasma and urine ratios of morphine metabolites morphine-3-glucuronide and morphine-6-glucuronide were analyzed at the beginning of our interventions, and the results indicated that morphine-3-glucuronide levels were significantly higher than morphine-6-glucuronide levels. The possible association between the observed morphine metabolite ratio and the intractable pain in patients resistant to opioids may have potential clinical implications.

Efficacy of quantitative digital subtraction radiography using radiographs exposed in a multicenter trial

Digital subtraction radiography (DSR) has been shown to be a sensitive and specific method for the detection of small bony changes in periodontitis. The purpose of this study was to perform a multicenter validation of the DSR in human subjects. Seventeen subjects were enrolled at 3 centers. Feather-edged hydroxyapatite chips (approximately 1, 7 and 10 mg) were used to simulate osseous lesions. Bilateral radiographs were taken with and without chips. Geometry was standardized using a cephalostat and the order of radiographs was determined using a randomization plan. Radiographs were subtracted, lesions isolated, and quantified at a single center without knowledge of the randomization code or location of the chips used in each subject. The overall sensitivity and specificity in detecting 1 mg changes was 87.8% and 100%, respectively. Sensitivity and specificity in detecting 7 mg and 10 mg chips was 100%. A strong linear relationship between actual lesion mass and calculated mass was observed (R2 = 0.94, slope = 0.98, p < 0.0001). No significant differences were observed by center. These data indicate that the DSR is a valid technique for the assessment of alveolar bone changes in multicenter trials.

Circulating concentrations of proinflammatory cytokines in mild or moderate heart failure secondary to ischemic or idiopathic dilated cardiomyopathy

Proinflammatory cytokines are capable of modulating cardiovascular function by a variety of mechanisms. These cytokines are elevated in patients with severe heart failure, but changes in mild or moderate heart failure have not been reported. Therefore, simultaneous arterial and coronary sinus concentrations of interleukin-1alpha, soluble interleukin-2 receptor, interleukin-6, and tumor necrosis factor-alpha were measured in 78 patients with New York Heart Association functional class II to IV heart failure and compared with 17 healthy volunteers. Concentrations of interleukin-1alpha, soluble interleukin-2 receptor, and interleukin-6 were determined by a "sandwich" enzyme-linked immunosorbent assay and tumor necrosis factor-alpha by tissue culture technique. There were no statistical differences in interleukin-1alpha, soluble interleukin-2 receptor, or tumor necrosis factor-alpha concentrations in mild to moderate heart failure versus control subjects. Interleukin-6 was significantly elevated, 75 +/- 16 versus 0.4 +/- 0.4pg/ml (p = 0.002). Cytokine concentrations did not differ by heart failure etiology. Paired arterial and coronary sinus concentrations were not significantly different. Soluble interleukin-2 receptor concentrations were significantly correlated with New York Heart Association functional class (r = 0.59, p = 0.04) and negatively associated with exercise tolerance time (r = -0.59, p = 0.007). Thus, interleukin-6 is significantly elevated in mild or moderate heart failure.