Synthetic approaches to a variety of covalently linked porphyrin--fullerene hybrids

There is substantial interest in dyads in which C(60) is covalently linked to electron donors, such as porphyrins, which absorb light strongly in the visible region. We present here the details of the syntheses of such compounds, which can be broadly organized into categories depending upon the nature of the linker joining the two chromophores. The structural aspects of intramolecular electronic interaction that we have sought to explore have dictated the synthetic strategies employed to generate these classes of molecules. Flexible glycol linkers were used to allow close approach between the fullerene and porphyrin, facilitating through-space interactions. These linkers also allowed studies of the effects of metal cation complexation. Naphthalene and alkyne linkers were used to examine the possible effects a conjugated or aromatic linker might have on photophysical properties. Finally, steroids were used as linkers in dyads expected to possess a large distance between the two chromophores, in which only through-bond interactions between the fullerene and porphyrin should be possible.

Founder's Award, Society for Biomaterials. Sixth World Biomaterials Congress 2000, Kamuela, HI,May 15-20, 2000. Really smart bioconjugates of smart polymers and receptor proteins

Over the past 18 years we have been deeply involved with the synthesis and applications of stimuli-responsive polymer systems, especially polymer-biomolecule conjugates. This article summarizes our work with one of these conjugate systems, specifically polymer-protein conjugates. We include conjugates prepared by random polymer conjugation to lysine amino groups, and also those prepared by site-specific conjugation of the polymer to specific amino acid sites that are genetically engineered into the known amino acid sequence of the protein. We describe the preparation and properties of thermally sensitive random conjugates to enzymes and several affinity recognition proteins. We have also prepared site-specific conjugates to streptavidin with temperature-sensitive polymers, pH-sensitive polymers, and light-sensitive polymers. The preparation of these conjugates and their many fascinating applications are reviewed in this article.

Electroencephalographic asymmetries in adolescents with major depression: influence of comorbidity with anxiety disorders

This study examined whether adolescents with major depressive disorder (MDD) display the abnormal electroencephalographic (EEG) alpha asymmetries found in depressed adults. Resting EEG was recorded in 25 right-handed female outpatients (19 with MDD, 11 of whom also had a current anxiety disorder; 6 with anxiety disorders only) and 10 non-ill controls. In contrast to the non-ill controls, adolescents having MDD but no anxiety disorder showed alpha asymmetry indicative of less activation over right than over left posterior sites. Within the MDD patient group, comorbid anxiety disorders reduced the posterior alpha asymmetry, supporting the potential importance of evaluating anxiety in studies of regional brain activation in adolescent MDD. These preliminary findings are similar to those from adult studies that suggest that MDD is associated with right parietotemporal hypoactivation.

A clinic and community-based approach to hypertension control for an underserved minority population: design and methods

This paper describes the design and methodology of the Community Hypertension Intervention Project (CHIP). CHIP is investigating the environmental and psychosocial factors related to treatment adherence and examining the effects of combining usual hypertension care with the effects of three interventions designed to improve patient compliance with treatment for high blood pressure in a high-risk, underserved minority population. Thirteen hundred and sixty-seven inner-city hypertension patients (75% black and 25% Hispanic) have agreed to participate in the 4-year longitudinal study. These participants were randomized to usual care or one of three intervention groups: individualized counseling sessions; home visits/discussion groups; or computerized appointment-tracking system. Participants are representative of the surrounding, predominantly low-income minority community and are treated in a hospital-based clinic and in a private clinic in the community. About 65% have blood pressure levels considered to be out of control. It was concluded that structural changes at the clinic site, along with the targeted interventions, would improve patient satisfaction, increase treatment adherence, and improve blood pressure control.

Synthesis and Photophysical Properties of Steroid-Linked Porphyrin−Fullerene Hybrids

[structure: see text] The photophysical properties of porphyrin-linked fullerene hybrids have generated significant interest, and a number of these hybrids synthesized by this group and others have been extensively characterized with respect to energy and charge-transfer processes that take place upon photoexcitation. Present studies of steroid-linked dyads demonstrate the extent to which through-bond effects operate in these systems.

A community strategy for Medicaid child dental services

OBJECTIVES

The authors present second-year utilization data and first- and second-year cost data for a community-based program in Spokane County, Washington, designed to increase access to dental care for Medicaid-enrolled children from birth to 60 months of age.

METHODS

The authors used Medicaid eligibility and claims data for 18,727 children 5 years of age and younger to determine utilization of dental care from January 15, 1996, through January 15, 1997. They also used accounting records from the agencies involved to calculate the first- and second-year costs of the program.

RESULTS

A child in the ABCD program was 7.2 times as likely to have at least one dental visit as a Medicaid-enrolled child not in the program. Estimated costs per child with at least one dental visit (in 1995 dollars) were $54.30 for the first year and $44.38 for the second year, or $20.09 per enrolled child for the first year and $18.77 for the second year.

CONCLUSION

Public-private joint efforts are effective in improving access to dental care for Medicaid-enrolled children.

Response- and stimulus-related ERP asymmetries in a tonal oddball task: a Laplacian analysis

Previous studies have found greater P3 amplitude over right than left hemisphere sites in a tonal oddball task with a reaction time (RT) response. This asymmetry had a central topography, and interacted with response hand. Identification of the processes underlying these asymmetries requires the use of additional methods for separating response- and stimulus-related contributions. We applied local Hjorth and spherical spline algorithms to compute surface Laplacian topographies of ERP data recorded from 30 scalp electrodes in a pooled sample of 46 right-handed healthy adults. For both methods, the current sources underlying the late positive complex were largest at medial parietal regions, but were asymmetric at central and frontocentral sites. Although a frontocentral sink contralateral to the response hand contributed to the asymmetry of the classic P3 peak, the source asymmetry was most robust after the sink had resolved. The late source was largest at electrode C4 for right hand responses, and was further enhanced in subjects showing a dichotic left ear advantage, but was unrelated to response speed. We conclude that the right hemisphere source reflects an interaction of response-related asymmetries with right hemisphere processes responsible for pitch discrimination.

Brain ERPs of depressed patients to complex tones in an oddball task: relation of reduced P3 asymmetry to physical anhedonia

Event-related potentials to binaural complex tones were recorded from 40 depressed outpatients and 22 normal control participants at 30 electrode sites. Patients did not differ from control participants in N1 or P3 amplitude but showed greater N2. N2 was greater over right than over the left hemisphere at lateral sites in patients and control participants. A P3 asymmetry was found for control participants and patients with low scores on a physical anhedonia scale, but not for patients with high anhedonia scores. Topographic (local Laplacian) maps corresponding to P3 showed greater radial current flow over right than over left central regions in control participants. Patients with high anhedonia did not show this asymmetry, whereas patients with low anhedonia showed an intermediate asymmetry. These findings support the hypothesis that anhedonic depression is associated with dysfunction of right hemisphere mechanisms mediating the processing of complex pitch information.

The pharmacologic treatment of anxiety and depression in African Americans. Considerations for the general practitioner

A growing pool of recent research points to the importance of ethnicity in psychopharmacologic management of depression and anxiety disorders, with sometimes profound implications for efficacy and safety. Such research has provided provocative findings that illustrate important interethnic pharmacogenetic, pharmacokinetic, and pharmacodynamic differences, especially for African Americans. We did a systematic literature review of psychopharmacologic treatment considerations among African Americans with anxiety and mood disturbance seen by primary care physicians, who provide most psychopharmacologic treatment. The findings commonly point to a greater percentage of "poor metabolizers" among African Americans compared with Euro-Americans. General treatment considerations include greater attention to adverse effects and better clinical response and poorer compliance for a given dose, potential need for lower starting doses and slower increases, use of plasma drug levels if available, determination of past responses to a similar drug, and integration of pharmacogenetic information into an overall socioculturally and ethnically sensitive approach to assessment and treatment.

Regional brain asymmetries in major depression with or without an anxiety disorder: a quantitative electroencephalographic study

Studies of brain activity in affective disorders need to distinguish between effects of depression and anxiety because of the substantial comorbidity of these disorders. Based on a model of asymmetric hemispheric activity in depression and anxiety, it was predicted that anxious and nonanxious depressed patients would differ on electroencephalographic (EEG) measures of parietotemporal activity. Resting EEG (eyes closed and eyes open) was recorded from 44 unmedicated outpatients having a unipolar major depressive disorder (19 with and 25 without an anxiety disorder), and 26 normal controls using 30 scalp electrodes (13 homologous pairs over the two hemispheres and four midline sites). As predicted, depressed patients with an anxiety disorder differed from those without an anxiety disorder in alpha asymmetry. Nonanxious depressed patients showed an alpha asymmetry indicative of less activation over right than left posterior sites, whereas anxious depressed patients showed evidence of greater activation over right than left anterior and posterior sites. The findings are discussed in terms of a model in which specific symptom features of depression and anxiety are related to different patterns of regional brain activity.

[The application of transmeatal exploratory tympanotomy]

Transmeatal exploratory tympanotomy has been used traditionally for the surgical treatment of conductive deafness. With 8 cases of the middle and inner ear diseases diagnosed and surgical managed successfully with this approach, the extended applications of this procedure were illustrated, which included: 1. conductive deafness with cause undetermined, 2. post traumatic conductive deafness with intact tympanic membrane, 3. suspected primary space occupying lesion of tympanum. 4. perilymphatic fistula, and 5. cerebrospinal fluid otorrhea. The key consideration and advantage of this approach were also discussed in this paper.

The mental health of Asian and Pacific Island elders: implications for research and mental health administration

According to the 1990 census, the highly diverse Asian and Pacific Islander (API) American population has doubled in size from 1980 to 1990, and is now the nation's fastest growing minority group. Several studies have documented this population's comparative underuse of mental health services. A review of recent studies on the mental health of Asian and Pacific Island elders identifies a number of risk factors and protectors. Elder APIs appear to have poorer mental health compared to white counterparts, but not the poorest mental health within their own ethnic group. Within-group differences emerge, with recent immigrant groups and colonized populations appearing as most at-risk for mental health problems. A critical variable on this population's mental health status appears to be socioeconomic status,and yet an analysis of other demographic variables, notably nativity and gender, remain contradictory. A research agenda is proposed and implications for mental health administrators are suggested.

Assessing the responsiveness of health services to ethnic minorities of color

Ethnic minorities of color are disadvantaged on most indicators of health and wellness, yet, health services have not been adequately responsive to this group's needs. This paper explores the improvement of health services for this population by discussing common criteria for the assessment of responsiveness: availability, accessibility, and acceptability. Illustrative examples drawn from different ethnic minority groups will be utilized in the discussion of assessment criteria and ideas for cultural responsiveness highlighted.

Class II HLA antigens in multiple sclerosis

HLA typing in Wellington revealed a stronger association of multiple sclerosis with DR2 than with DQw1. The association with DQw1 appeared to be due to linkage disequilibrium of this antigen with DR2. These results, when considered in conjunction with other studies, are most easily explained by the hypothesis that susceptibility to multiple sclerosis is influenced by multiple risk factors, with DR2 being an important risk factor in Caucasoid populations.

Transfusion related HIV infection: the Wellington experience

A case of transfusion-related AIDS is described which is believed to be the first published case to occur in New Zealand in a nonhaemophiliac patient. The human immunodeficiency virus (HIV) positive donor was shown to be the source of infection in five further HIV positive recipients.

Aspects of the microbe: host relationship in staphylococcal hematogenous osteomyelitis

Nasal carriage of staphylococci, and some in vitro tests of host antimicrobial defense were studied in a group of children who had recovered from staphylococcal hematogenous osteomyelitis at least one year previously. The same studies were carried out in a group of first degree relatives, and in age- and sex-matched controls. Nasal carriage was significantly more common (P = .039) in these children than in age- and sex-matched controls, and commoner (P = .19) in the first degree relatives than in controls. Total immunoglobulin G (IgG) levels were significantly lower in the children studied than in controls (P = .022), and in relatives than in controls (P = .032), but the levels remained within an accepted normal range. IgG levels were also significantly lower in carriers of Staphylococcus aureus than in non carriers (P = .033). Other immunoglobulin levels, complement levels, leukocyte phagocytic and killing power, leukocyte chemotaxis, and leukocyte migration inhibition, were indistinguishable between the children, their relatives, and controls. No statistically significant association between histocompatibility antigen profile and previous history of osteomyelitis, or nasal carriage of staphylococci, was found. More detailed studies are required to confirm and clarify the associations.