Visualization of iontophoretic transport paths in cultured and animal skin models

Physiological structures associated with iontophoretic paths in hairless mouse skin and two cultured skin models ("EpiDerm" by Mattek, Corp., and "SKIN2" by Advanced Tissue Sciences, Inc.) are reported. Visualization of ionic paths at current densities between 20 and 100 microA/ cm2 is accomplished by the counterdirectional transport of Fe(CN)6(4-) and Fe3+, resulting in the controlled precipitation of colloidal Prussian blue, Fe4[Fe(CN)6]3, at sites of high ionic conductivity. Examination of the Fe4[Fe(CN)6]3-stained tissues using optical microscopy allows unequivocal assignment of iontophoretic paths to physiological structures in the stratum corneum. Deposition of Fe4[Fe(CN)6]3 occurs exclusively at hair follicles in hairless mouse skin, indicating that these appendages provide highly conductive porous paths during iontophoresis. In contrast, the counterdirectional transport of Fe(CN)6(4-) and Fe3+ across cultured skin models, which lack appendages, results in the deposition of Fe4-[Fe(CN)6]3 along the boundaries of corneocytes. This observation suggests that paracellular iontophoretic transport through lipid bilayer regions is the predominant transport path in the absence of low-resistance pores.

Comparison of eight microcomputer dietary analysis programs with the USDA Nutrient Data Base for Standard Reference

OBJECTIVE

To compare the general operating features and nutrient databases of eight microcomputer dietary analysis programs.

DESIGN

A 3-day food record with 73 food items was entered into each program by the authors. The general operating features of the program were summarized and evaluated. The nutrient database was evaluated by comparing the nutrient analysis output with the 1993 US Department of Agriculture (USDA) Nutrient Data Base for Standard Reference (NDB), full version, release 10, for microcomputers.

RESULTS

The programs varied in cost, number of foods and nutrients in the database, use of non-USDA data, and inputting of data for missing values. We also found differences in the quality of user manuals and help screens, ease of food entry and averaging of 3-day nutrient intake, speed of analyzing and printing results, quality and number of print/export options, and overall ease of learning and using the program. All but one of the programs were within 15% of the USDA NDB for energy, protein, total fat, and total carbohydrates. However, there was some difference in the number of other nutrients and food components varying more than 15% from the USDA NDB. These differences occurred because of variations in the number of food items included in each programs' database and the number of missing nutrient values in the database.

APPLICATIONS

Our results demonstrate the importance of carefully choosing a microcomputer dietary analysis program that is suitable to the user's specific and predetermined needs.

In vitro metabolism of terfenadine by a purified recombinant fusion protein containing cytochrome P4503A4 and NADPH-P450 reductase. Comparison to human liver microsomes and precision-cut liver tissue slices

The metabolism of terfenadine was studied with a cDNA-expressed/purified recombinant fusion protein containing human liver microsomal cytochrome P4503A4 (CYP3A4) linked to rat NADPH-P450 reductase (rF450[mHum3A4/mRatOR]L1) and was compared with that observed in the presence of human liver microsomes and precision-cut human liver tissue slices. In all three cases, [3H]terfenadine was metabolized to at least three major metabolites. LC/MS (electrospray) analysis confirmed that these metabolites were alpha, alpha-diphenyl-4-piperidinomethanol (M5), t-butyl hydroxy terfenadine (M4), and t-butyl carboxy terfenadine (M3), although the level of M5 detected in the presence of fusion protein was greater than that found with microsomes or tissue slices. Two additional metabolites, M1 (microsomes and tissue slices) and M2 (fusion protein), were also detected, but remain uncharacterized. Consumption of parent drug (microsomes: KM = 9.58 +/- 2.79 microM, Vmax = 801 +/- 78.3 pmol/min/nmol CYP; fusion protein: KM = 14.1 +/- 1.13 microM, Vmax = 1670 +/- 170 pmol/min/nmol CYP) and t-butyl hydroxylation to M4 (microsomes: KM = 12.9 +/-3.74 microM, Vmax = 643 +/- 62.5 pmol/min/nmol CYP, ; fusion protein: KM = 30.0 +/- 2.55 microM, Vmax = 1050 +/- 141 pmol/min/nmol CYP) obeyed Michaelis-Menten kinetics over the terfenadine concentration range of 1-200 microM. Ketoconazole, a well-documented CYP3A inhibitor, effectively inhibited terfenadine metabolism in all three models. The conversion of M4 to M3, studied with human liver microsomes and fusion protein, was NADPH-dependent and inhibited by ketoconazole. It is concluded that cDNA-expressed CYP3A4, in the form of a NADPH-P450 reductase-linked fusion protein, may also serve as a model for studying the metabolism of terfenadine in vitro and many other drugs.

Disaggregation in population forecasting: do we need it? And how to do it simply

"We have described a method for reducing the dimensionality of the forecasting problem by parsimoniously modeling the evolution over time of the age schedules of vital rates. This method steers a middle course between forecasting aggregates and forecasting individual age specific rates: we reduce the problem to forecasting a single parameter for fertility and another one for mortality. We have described a number of refinements and extensions of those basic methods, which preserve their underlying structure and simplicity. In particular, we show how one can fit the model more simply, incorporate lower bounds to the forecasts of rates, disaggregate by sex or race, and prepare integrated forecasts of rates for a collection of regions. We also discuss alternate approaches to forecasting the estimated indices of fertility and mortality, including state-space methods. These many versions of the basic method have yielded remarkably similar results." (SUMMARY IN FRE)

Stochastic population forecasts for the United States: beyond high, medium, and low

"This article presents and implements a new method for making stochastic population forecasts that provide consistent probability intervals. We blend mathematical demography and statistical time series methods to estimate stochastic models of fertility and mortality based on U.S. data back to 1900 and then use the theory of random-matrix products to forecast various demographic measures and their associated probability intervals to the year 2065. Our expected total population sizes agree quite closely with the Census medium projections, and our 95 percent probability intervals are close to the Census high and low scenarios. But Census intervals in 2065 for ages 65+ are nearly three times as broad as ours, and for 85+ are nearly twice as broad. In contrast, our intervals for the total dependency and youth dependency ratios are more than twice as broad as theirs, and our ratio for the elderly dependency ratio is 12 times as great as theirs. These items have major implications for policy, and these contrasting indications of uncertainty clearly show the limitations of the conventional scenario-based methods."

[Modeling and projecting mortality in Chile]

"In a recent paper, Lee and Carter developed a new method for analyzing and forecasting time series of age specific mortality, and applied it to the U.S. population. In this paper, we extend that method to deal with various problems of incomplete data common in Third World populations, and then apply the method to forecast mortality in Chile." (SUMMARY IN ENG)

Fertility decline in Prussia: estimating influences on supply, demand, and degree of control

Change in marital fertility in 407 Prussian Kreise from 1875 to 1910 is modeled to depend on the gap between the number of desired surviving births, N*, divided by child survival, s, and the number that would be born under natural marital fertility, M, given the age at marriage. Some fraction of this gap is averted, depending on the propensity to avert unwanted births, D. Although none of these components is observed directly, we can estimate each indirectly under strong assumptions. Decline in N*/s accounts for twice as much of the decline in fertility as does an increase in D. Natural fertility rose during the period. Unwanted births increased slightly, despite a tripling of births averted. The most important causes of decline in N* were increases in female labor supply, real income, and health workers. A rising level of education is the most important cause of increasing propensity to avert births. Demand-side changes were important causes of the transition, but changes in readiness to contracept also were important, as was the interaction of the two.

Famine, revolt, and the dynastic cycle: population dynamics in historic China

"Historians have long noticed that population declines in ancient China often coincided with dynasty changes, and that most of these declines were the result of internecine wars which, in turn, were often initiated by famine or density pressure. Since the interactions between density pressure, internecine wars, and dynasty changes cannot be explained by the traditional age-specific density-dependent population structure, we propose to use a bandit/peasant/ruler occupation-specific population model to interpret the dynamic socio-economic transitions of ancient Chinese population, and provide econometric support to our model. We also highlight the rich dynamics of the composition of human population, a factor which was often neglected in previous research on general populations."

Visual laser ablation of the prostate: clinical experience in 108 patients

Visual laser ablation of the prostate was performed on 108 patients (ages 44 to 84 years) as an outpatient procedure from May 1992 to October 1992. Preoperatively, the patients underwent digital rectal examinations, determination of prostate specific antigen levels and transrectal ultrasound guided biopsies when necessary to rule out the presence of prostate cancer. The Urolase laser fiber delivery system was used to transmit laser energy from a neodymium: YAG generator. For the 97 patients with preoperative and postoperative American Urological Association symptom index testing, scores decreased by an average of 12.59 (p < 0.001). For the 75 patients with preoperative and postoperative uroflow rates an average increase of 4.92 ml. per second (p < 0.001) was noted following the procedure. Only 3 patients required hospitalization for an average of 1.33 days. No patient required a blood transfusion. There have been no fluid or electrolyte abnormalities following visual laser ablation of the prostate. There have been no recognizable urethral strictures, deaths or postoperative sepsis. Only 3 patients experienced retrograde ejaculation. We found visual laser ablation of the prostate to be a cost-effective and less morbid alternative to traditional transurethral resection of the prostate.

Modeling and forecasting U.S. sex differentials in mortality

"This paper examines differentials in observed and forecasted sex-specific life expectancies and longevity in the United States from 1900 to 2065. Mortality models are developed and used to generate long-run forecasts, with confidence intervals that extend recent work by Lee and Carter (1992). These results are compared for forecast accuracy with univariate naive forecasts of life expectancies and those prepared by the Actuary of the Social Security Administration."

Stochastic demographic forecasting

"This paper describes a particular approach to stochastic population forecasting, which is implemented for the U.S.A. through 2065. Statistical time series methods are combined with demographic models to produce plausible long run forecasts of vital rates, with probability distributions. The resulting mortality forecasts imply gains in future life expectancy that are roughly twice as large as those forecast by the Office of the Social Security Actuary.... Resulting stochastic forecasts of the elderly population, elderly dependency ratios, and payroll tax rates for health, education and pensions are presented."

Comparison of six microcomputer dietary analysis systems with the USDA Nutrient Data Base for Standard Reference

We compared the general operating features and nutrient databases of six microcomputer dietary analysis systems. A 3-day food record with 73 food items was entered into each program; nutrient averages were compared with the US Department of Agriculture Nutrient Data Base for Standard Reference (USDA NDB), full version, release 9, for microcomputers. The six programs were found to vary widely in cost, number of foods and nutrients in the database, use of non-USDA data and imputation of data for missing values, number of print/export options, time to analyze the 3-day food record, and overall ease of use. Although all of the microcomputer dietary analysis systems were within 7% of the USDA NDB for energy, protein, total fat, and total carbohydrates, the proportion of other nutrients varying more than 15% from the USDA NDB varied considerably between programs. Variance among programs for 3-day food record nutrient values occurred because of differences in the number of food items included in the database (leading to varying degrees of substitution), the recency of the nutrient data (whether or not the most recent USDA releases had been incorporated), and the number of missing values (the degree to which non-USDA sources or estimated calculations were used to fill in the blanks from the USDA standard). Our results demonstrate that it is important for each dietitian to carefully choose a microcomputer dietary analysis system that is suitable to specific and predetermined needs.

Submucosal ureteral calculi: a new entity?

We describe 3 patients with ureteral calculi who failed multiple extracorporeal shock wave lithotripsy treatments and whose stones could not be visualized by ureteroscopy despite radiological confirmation. We contend that these ureteral stones migrated submucosally and are refractory to the aforementioned treatment modalities. Each patient had a common presenting complaint of intermittent flank pain 5 years in duration, leading us to believe that long-standing stone impaction is a prerequisite for this entity. Our experience is reviewed.

Stereoselective synthesis of the diunsaturated metabolites of valproic acid

Two diene metabolites of valproic acid (VPA), (E)-2-n-propyl-2,4-pentadienoic acid and (E)-2-(1'-propenyl)-(E)-2-pentenoic acid, were stereoselectively synthesized. Mesylate elimination in the final step to produce the unsaturation at position 2 was stereospecific for the (E)-configuration in the case of 2. Gas chromatography-mass spectroscopy and NMR were used to confirm the configuration of each diene including the minor isomers, (Z)-2-n-propyl-2,4-pentadienoic acid and (Z)-2-(1'-propenyl)-(E)-2-pentenoic acid. Analysis of the dienes, as PFB derivatives by negative chemical ionization GC-MS from a serum extract of a patient on VPA therapy, revealed the presence of four peaks that in order of elution correspond to 9, 18, 1, and 2.

U.S. births and limit cycle models

Lee's (1974) formal demographic feedback models summarize the implications for births and age-structure of neo-Malthusian theories of baby booms such as those of Easterlin. For some parameter values, such models imply sustained cycles, so-called "limit cycles", in births. Frauenthal and Swick recently reestimated a continuous-age version of Lee's basic cohort model with U.S. series and, contrary to Lee's original findings, concluded that "limit cycles oscillations have been occurring in U.S. births." This article disputes their conclusion, ascribing it to an inconsistency in detrending procedures. Furthermore, it corrects Lee's original conclusion by showing that his alternative period labor-force feedback model, estimated from U.S. series, leads to cycles of implausibly long period. This article thus reopens the question of whether any feedback model could account for the observed cycles in U.S. births.

Induced population growth and induced technological progress: their interaction in the accelerating stage

"A simple model of Malthusian population growth combined with population-induced technological progress generates accelerating growth. The model may be relevant for a first stage of growth in which natural resource limitations can be overcome through technological progress; it is not applicable to a later stage in which resource constraints are more resistant. Parameter values are roughly inferred from historical experience." (SUMMARY IN FRE)

Population dynamics of humans and other animals

Human population dynamics, at least until the past century, have probably been governed by homeostasis and in this resembled those of other animals. Because human population homeostasis was probably substantially weaker than among large mammals, its operation has been less obvious. Nonetheless, the empirical evidence for advanced agriculturalists is compelling. Unlike animals, the human population has tended toward equilibria that have been tending upward at an accelerating rate. The acceleration might reflect long-run positive feedback between density and technological progress, as Boserup has suggested. Because homeostasis was weak, its role in shorter run historical explantation is limited; its force was gentle and easily overwhelmed by other particular influences. Malthusian oscillation, in the sense of distinctive medium-run dynamics arising from homeostasis, probably did not occur. And because homeostasis was weak, density dependence can in principle explain only a minute proportion of the annual variation in population growth rates. Yet homeostasis plays an essential role in demographic theory. Without it, we are incapable of explaining population size and change over time except by recounting a mindless chronology of events back to the beginning of humanity--whenever that was. Without it, we cannot explain the response of population growth to economic growth. Without it, we cannot explain recovery from catastrophe or the rapid natural increase in many frontier regions. Without it, we cannot properly analyze the influence of climatic variation and other partially density-independent factors. Our basic understanding of human history requires a grasp of what homeostasis can explain and what it cannot. A homeostatic approach to population dynamics also leads to questions about the roles of reproductive norms and institutions, not just whether they encourage high or low fertility, but whether they make natural increase responsive to resource abundance. And if they do, whether they strike the balance of population and the means of subsistence at a relatively prosperous or impoverished level. Such considerations may contribute to an understanding of broad preindustrial differences among the regions of the world in densities, average levels of vital rates, and living standards--which was very much how Malthus viewed the matter. Ordinary homeostatic tendencies essentially vanish in the course of economic development, and they were probably all but gone from much of Europe by the end of the 19th century.(ABSTRACT TRUNCATED AT 400 WORDS)

Scrotal fat necrosis

A case of scrotal fat necrosis is presented. The clinical presentation usually is characteristic and the condition can be managed nonoperatively.

Necrobiotic xanthogranuloma of the eyelid

Necrobiotic xanthogranuloma with paraproteinemia is characterized by multiple nodules or plaques that involve the periorbital area along with other parts of the body. A dysproteinemia due to an IgG paraprotein is associated with the condition; low serum complement, cryoglobulinemia, leukopenia, and hyperlipemia are also sometimes seen. Multiple myeloma is present in some cases. Two cases of necrobiotic xanthogranuloma with IgG monoclonal gammopathy were seen. Both initially had ocular symptoms and in the second case, the ocular manifestations have dominated the clinical picture. Histologically, these granulomas are characterized by collagen necrobiosis and by the presence of many foamy histiocytes and Touton giant cells. Because necrobiotic xanthogranuloma with monoclonal gammopathy frequently has prominent manifestations in the orbital region, may result in dysfunction of the eyelids or extraocular muscles, and is associated with potentially life-threatening systemic conditions, its recognition by the ophthalmologist is important.

Laser surgery in the medically compromised patient

Dermatology has entered a new dimension with the introduction of the laser. There are expanding clinical indications for laser excision. The CO2 laser in the cutting mode can incise tissue as sharply as finely honed steel, yet its photocoagulative properties allow rapid sealing of blood vessels and lymphatics. The physician can thereby perform in a relatively bloodless surgical field. Minimal adjacent normal tissue is injured, there is less local postoperative edema, and fewer postoperative analgesics are required. Since there is no need to use epinephrine as a local vasoconstrictive agent and there is no need to use electrocoagulation for control of hemorrhage, CO2 laser excision presents less risk to the medically compromised patient. The CO2 laser may also diminish the risk of seeding or spreading neoplastic cells in the perioperative field.

Target fertility, contraception, and aggregate rates: toward a formal synthesis

This paper develops a stock adjustment model relating total expected births to conventional aggregate fertility rated for married women over 25. Each year, cohorts bear about 20 percent of their additional expected births. Aggregate U.S. rates have been consistent with expectations as expressed in surveys between 1955 and 1975; indeed, total expected births may be inferred from aggregate fertility behavior. A peculiar empirical finding is that the additional expected fertility of nonterminators has not changed since 1955, despite the dramatic decline in total expected and actual fertility. The model leads to a dynamic expression for the duration pattern of current and cumulative fertility and for the proportion of couples who have terminated childbearing. The model is also used to analyze the effects of changing contraceptive failure rates on fertility patterns. For example, a decline in "timing" failure rates increases duration-specific fertility five years later.

Effect of probenecid on penetration of oxacillin into fibrin clots in vitro

Probenecid significantly enhanced the in vitro penetration of oxacillin into fibrin clots suspended in rabbit serum or normal saline.