Assessment of clinical partner violence screening tools

OBJECTIVE

To compare the Women's Experience with Battering Scale (WEB) with the Index of Spouse Abuse-Physical Scale (ISA-P) as screening tools to identify intimate partner violence (IPV).

METHODS

We conducted a large cross-sectional survey of women age 18 to 65 attending one of two family practice clinics from 1997 to 1998. All women completed both the WEB and the ISA-P and a telephone interview. We figured agreement estimates between the two tools, used stratified analyses to evaluate attributes of those more likely to screen as battered or physically assaulted, and compared associations between the WEB and ISA-P and a range of mental and physical health indicators known to be associated with IPV.

RESULTS

18% of 1152 eligible women surveyed had experienced IPV in a current or most recent intimate relationship with a male partner; 17% had been battered (WEB+), and 10% had been physically assaulted (ISA-P+). Had we used the ISA-P alone to assess IPV, we would have missed almost 45% of IPV. As anticipated, the ISA-P was more strongly associated with IPV-associated injuries and number of physician visits in the last year. The WEB was more strongly associated with self-perceived mental health, anxiety, depression, drug abuse, and low social support.

CONCLUSION

Clinicians need validated screening tools to rapidly and reliably screen patients for IPV. Most screening tools assess physical violence and injury without considering the more chronic experience of battering and the psychological terror associated with this violence. The WEB may identify more abused women than tools measuring physical assaults.

Comparison of the fine structure of cortical and collicular terminals in the rat medial geniculate body

Neurons throughout the rat medial geniculate body, including the dorsal and ventral divisions, display a variety of responses to auditory stimuli. To investigate possible structural determinants of this variability, measurements of axon terminal profile area and postsynaptic dendrite diameter were made on inferior colliculus and corticothalamic terminal profiles in the medial geniculate body identified by anterograde tracer labeling following injections into the inferior colliculus or cortex. Over 90% of the synapses observed were axodendritic, with few axosomatic synapses. Small (<0.5 microm(2)) and large (>1.0 microm(2)) collicular profiles were found throughout the medial geniculate, but were smaller on average in the dorsal division (0.49+/-0.49 microm(2)) than in the ventral division (0.70+/-0.64 microm(2)). Almost all corticothalamic profiles were small and ended on small-caliber dendrites (0.57+/-0.25 microm diameter) throughout the medial geniculate. A few very large (>2.0 microm(2)) corticothalamic profiles were found in the dorsal division and in the marginal zone of the medial geniculate. GABA immunostaining demonstrated the presence of GABAergic profiles arising from cells in the inferior colliculus. These profiles were compared with GABAergic profiles not labeled with anterograde tracer, which were presumed to be unlabeled inferior colliculus profiles or thalamic reticular nucleus profiles. The distributions of dendritic diameters postsynaptic to collicular, cortical and unlabeled GABAergic profiles were compared with dendritic diameters of intracellularly labeled medial geniculate neurons from rat brain slices. Our results demonstrate a corticothalamic projection to medial geniculate body that is similar to other sensory corticothalamic projections. However, the heterogeneous distributions of excitatory inferior collicular terminal sizes and postsynaptic dendritic diameters, along with the presence of a GABAergic inferior collicular projection to dendrites in the medial geniculate body, suggest a colliculogeniculate projection that is more complex than the ascending projections to other sensory thalamic nuclei. These findings may be useful in understanding some of the differences in the response characteristics of medial geniculate neurons in vivo.

Detection of synchrony in the activity of auditory nerve fibers by octopus cells of the mammalian cochlear nucleus

The anatomical and biophysical specializations of octopus cells allow them to detect the coincident firing of groups of auditory nerve fibers and to convey the precise timing of that coincidence to their targets. Octopus cells occupy a sharply defined region of the most caudal and dorsal part of the mammalian ventral cochlear nucleus. The dendrites of octopus cells cross the bundle of auditory nerve fibers just proximal to where the fibers leave the ventral and enter the dorsal cochlear nucleus, each octopus cell spanning about one-third of the tonotopic array. Octopus cells are excited by auditory nerve fibers through the activation of rapid, calcium-permeable, alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionate receptors. Synaptic responses are shaped by the unusual biophysical characteristics of octopus cells. Octopus cells have very low input resistances (about 7 M Omega), and short time constants (about 200 microsec) as a consequence of the activation at rest of a hyperpolarization-activated mixed-cation conductance and a low-threshold, depolarization-activated potassium conductance. The low input resistance causes rapid synaptic currents to generate rapid and small synaptic potentials. Summation of small synaptic potentials from many fibers is required to bring an octopus cell to threshold. Not only does the low input resistance make individual excitatory postsynaptic potentials brief so that they must be generated within 1 msec to sum but also the voltage-sensitive conductances of octopus cells prevent firing if the activation of auditory nerve inputs is not sufficiently synchronous and depolarization is not sufficiently rapid. In vivo in cats, octopus cells can fire rapidly and respond with exceptionally well-timed action potentials to periodic, broadband sounds such as clicks. Thus both the anatomical specializations and the biophysical specializations make octopus cells detectors of the coincident firing of their auditory nerve fiber inputs.

Maximal androgen blockade: final analysis of EORTC phase III trial 30853. EORTC Genito-Urinary Tract Cancer Cooperative Group and the EORTC Data Center

OBJECTIVES

This prospective, randomized phase III study was initiated to compare the efficacy and side effects of bilateral orchiectomy versus a combination of a luteinizing hormone-releasing hormone agonist depot formulation, goserelin acetate (3.6 mg s.c. once every 4 weeks) and flutamide (250 mg 3 x daily) in patients with metastatic prostate cancer.

METHODS

Relative treatment efficacy was assessed by comparing the two treatment groups with respect to response, time to first progression, progression-free survival, duration of survival and time to death due to malignant disease.

RESULTS

There was a difference in response only with respect to a more frequent decrease to normal of the serum prostate acid phosphatase in patients assigned to maximal androgen blockade treatment. Additionally, maximal androgen blockade treatment showed significantly better results for duration of survival (p = 0.04), time to death due to malignant disease (p = 0.008), time to first progression (p = 0.009) and progression-free survival (p = 0.02). The most frequent side effects for both treatments included hot flushes and gynaecomastia.

CONCLUSIONS

Increased time to progression and duration of survival is achieved by the combination of flutamide and goserelin when compared to bilateral orchiectomy.

Identification of the messenger RNA for human cutaneous fatty acid-binding protein as a metastasis inducer

Using our recently developed systematic differential display and complete comparison of gene expression approaches combined with other methods, we have identified a large number of mRNAs that are expressed differentially between benign and malignant human cells. One such mRNA that is common to prostate and breast carcinoma cell lines encodes the human cutaneous fatty acid-binding protein (C-FABP). Northern and slot blot analyses confirm that the expression levels of C-FABP mRNA in the malignant prostate and breast carcinoma cell lines are 4.9+/-0.9- to 16.9+/-2.1-fold higher than those expressed in the benign cell lines. A similar difference between the benign and malignant cell lines was also detected at the protein level. In situ hybridization experiments have detected overexpression of the mRNA for C-FABP in human prostate carcinoma tissues. Transfection of a C-FABP expression construct into the benign, nonmetastatic rat mammary epithelial cell line Rama 37 and inoculation of the C-FABP expression transfectants into syngeneic Wistar-Furth rats produce a significant number (P < 0.05) of animals with metastases (6 of 26 animals), whereas the control transfectants generated by the vector alone yield no such metastases. Measurements of mRNA and protein levels with Northern and Western blotting show that C-FABP is not expressed in the control transfectant cells produced by the vector alone but is highly expressed in the pool of C-FABP transfectants and-the sublines established from their metastases. Immunocytochemical staining with antibodies to C-FABP shows that C-FABP is not expressed in the primary tumors developed from the control transfectants that have failed to metastasize, but it is expressed in both the primary tumors developed from the C-FABP transfectants and their metastases. Reinoculation of the sublines established from metastases in syngeneic rats has produced a higher proportion (50%) of animals (7 of 14 animals) with metastases than that obtained in the first-round inoculations, indicating that the metastatic clones have been preferentially selected from the original pool of metastatic and nonmetastatic transfectant clones. These results have demonstrated that elevated expression of C-FABP can induce metastasis and that metastatic capability has been transferred in a genetically dominated manner in this Rama 37 model. Thus, we suggest that C-FABP is a metastasis-inducing gene, and under suitable conditions, it may induce metastasis of some human cancers.

Anatomy, physiology, and synaptic responses of rat layer V auditory cortical cells and effects of intracellular GABA(A) blockade

The varied extracortical targets of layer V make it an important site for cortical processing and output, which may be regulated by differences in the pyramidal neurons found there. Two populations of projection neurons, regular spiking (RS) and intrinsic bursting (IB), have been identified in layer V of some sensory cortices, and differences in their inhibitory inputs have been indirectly demonstrated. In this report, IB and RS cells were identified in rat auditory cortical slices, and differences in thalamocortical inhibition reaching RS and IB cells were demonstrated directly using intracellular GABA(A) blockers. Thalamocortical synaptic input to RS cells was always a combination of excitation and both GABA(A) and GABA(B) inhibition. Stimulation seldom triggered a suprathreshold response. IB cell synaptic responses were mostly excitatory, and stimulation usually triggered action potentials. This apparent difference was confirmed directly using intracellular chloride channel blockers. Before intracellular diffusion, synaptic responses were stable and similar to control conditions. Subsequently, GABA(A) was blocked, revealing a cell's total excitatory input. On GABA(A) blockade, RS cells responded to synaptic stimulation with large, suprathreshold excitatory events, indicating that excitation, while always present in these cells, is masked by GABA(A). In IB cells that had visible GABA(A) input, it often masked an excitatory postsynaptic potential (EPSP) that could lead to additional suprathreshold events. These findings indicate that IB cells receive less GABA(A)-mediated inhibitory input and are able to spike or burst in response to thalamocortical synaptic stimulation far more readily than RS cells. Such differences may have implications for the influence each cell type exerts on its postsynaptic targets.

Physical health consequences of physical and psychological intimate partner violence

BACKGROUND

Past studies that have addressed the health effects of intimate partner violence (IPV) have defined IPV as violence based on physical blows that frequently cause injuries. To our knowledge, no epidemiologic research has assessed the physical health consequences of psychological forms of IPV.

OBJECTIVE

To estimate IPV prevalence by type and associated physical health consequences among women seeking primary health care.

DESIGN

Cross-sectional survey.

SETTING AND PARTICIPANTS

A total of 1152 women, aged 18 to 65 years, recruited from family practice clinics from February 1997 through January 1999 and screened for IPV during a brief in-clinic interview; health history and current status were assessed in a follow-up interview.

RESULTS

Of 1152 women surveyed, 53.6% ever experienced any type of partner violence; 13.6% experienced psychological IPV without physical IPV. Women experiencing psychological IPV were significantly more likely to report poor physical and mental health (adjusted relative risk [RR], 1.69 for physical health and 1.74 for mental health). Psychological IPV was associated with a number of adverse health outcomes, including a disability preventing work (adjusted RR, 1.49), arthritis (adjusted RR, 1.67), chronic pain (adjusted RR, 1.91), migraine (adjusted RR, 1.54) and other frequent headaches (adjusted RR, 1.41), stammering (adjusted RR, 2.31), sexually transmitted infections (adjusted RR, 1.82), chronic pelvic pain (adjusted RR, 1.62), stomach ulcers (adjusted RR, 1.72), spastic colon (adjusted RR, 3.62), and frequent indigestion, diarrhea, or constipation (adjusted RR, 1.30). Psychological IPV was as strongly associated with the majority of adverse health outcomes as was physical IPV.

CONCLUSIONS

Psychological IPV has significant physical health consequences. To reduce the range of health consequences associated with IPV, clinicians should screen for psychological forms of IPV as well as physical and sexual IPV.

A matched cohort comparison of a criminal justice system's response to child sexual abuse: a profile of perpetrators

OBJECTIVE

This study was undertaken to examine whether alleged child sexual abuse perpetrators are handled differently by the courts than other alleged felony perpetrators. Comparisons were made from the time of prosecutorial case acceptance through prosecution to sentencing, with emphasis on judicial and prosecutorial decision-making and plea-bargaining.

METHOD

Data were retrospectively abstracted on the entire defendant population of cases of sexual abuse of children and adolescents (ages 2-17) over a 5-year period. Using a case-flow analysis, comparisons were made between a child sexual abuse cohort and a cohort of matched felony cases from a single jurisdiction.

RESULTS

Three important findings emerged. First, compared to other felons, abuse perpetrators were employed, had been married, were mostly European American, and were older than 30 years of age. Second, in the abuse cohort, as many as 14% had a previous sexual or violent record compared to 2% in the comparison group. Third, similar percentages of perpetrators in both groups were released on their own recognizance, had the charges against them dropped, and were found guilty. As well, no differences between groups were found in the proportion of individuals sentenced to jail, probation, counseling, or work release.

CONCLUSIONS

Although the treatment of perpetrators of child sexual abuse was similar to the treatment of perpetrators of other felonies, the profile of the child abuse perpetrator was quite different. Knowledge about this profile may impact prosecution or treatment and recidivism rates, to the extent that recidivism is related to characteristics of the abuse perpetrator.

Frequency and correlates of intimate partner violence by type: physical, sexual, and psychological battering

OBJECTIVES

This study estimated the frequency and correlates of intimate partner violence by type (physical, sexual, battering, or emotional abuse) among women seeking primary health care.

METHODS

Women aged 18 to 65 years who attended family practice clinics in 1997 and 1998 took part. Participation included a brief in-clinic survey assessing intimate partner violence. Multiple polytomous logistic regression was used to assess correlates of partner violence by type.

RESULTS

Of 1401 eligible women surveyed, 772 (55.1%) had experienced some type of intimate partner violence in a current, most recent, or past intimate relationship with a male partner; 20.2% were currently experiencing intimate partner violence. Among those who had experienced partner violence in any relationship, 77.3% experienced physical or sexual violence, and 22.7% experienced nonphysical abuse. Alcohol and/or drug abuse by the male partner was the strongest correlate of violence.

CONCLUSIONS

Partner substance abuse and intimate partner violence in the woman's family of origin were strong risk factors for experiencing violence. Efforts to universally screen for partner violence and to effectively intervene to reduce the impact of such violence on women's lives must be a public health priority.

Application of draft European Commission reference levels to a regional CT dose survey

A survey of CT doses in Northern Ireland in the period between October 1995 and March 1997 was carried out. The survey included all but one of the 10 scanners in use at the time, and, additionally, two others that were replacement machines. The method used was to study standard protocols and calculate doses to the NRPB mathematical phantom, so that a direct comparison could be made with other surveys carried out in a similar fashion elsewhere. The survey addressed the patient radiation dose but not image quality or clinical outcomes. It is estimated that in Northern Ireland the contribution to collective dose to the population from CT is about 40% of that from all medical X-rays. The proposed European Commission reference quantities, weighted CT dose index and dose-length product were computed and their potential use evaluated. A full study of mean values of effective dose per examination revealed the average dose per examination was not significantly different from that found in the 1989 UK survey, although several procedures gave rise to doses that were high enough to be investigated with a view to justification or reduction. One of the scanners was found to give consistently high doses. It is likely that a revision of the mAs values used on this scanner will produce a significant reduction in patient doses without compromising image quality. When compared with the draft EC reference levels, fewer procedures were found to have excessively high dose values. The proposed EC reference levels would therefore be useful for continual monitoring of CT dose status, but do not appear to provide as comprehensive an assessment of patient exposure as that given by consideration of effective doses.

Artists as scientists: nature and realism in early modern Europe

In about 1400, northern European artists suddenly began to depict the natural and human world in a 'realistic' or 'naturalistic' manner. At about the same time, new ideas about how to describe nature realistically emerged among scholars investigating the natural world. Over the next two centuries, this new approach to nature (which eventually became known as 'science') and the belief that it could provide a realistic depiction of nature transformed human attitudes to nature and the material world. Artisans or craftspeople were central to this transformation and thus more important than is usually recognized in forming the new attitudes that characterized the Scientific Revolution.

Science and taste. Painting, passions, and the new philosophy in seventeenth-century Leiden

This article argues that the art collection owned by Franciscus dele Boë, Sylvius, a professor of practical medicine at the University of Leiden from 1658 to 1672, gives insight into some aspects of the character and significance of the new philosophy in the midseventeenth century. Through his teaching, his advocacy, and his practice of the new experimental philosophy, Sylvius played a role in shaping and institutionalizing the practices of the new philosophy that spread throughout Europe in the late seventeenth and eighteenth centuries. Sylvius's house design and large painting collection also exemplified the consumption and taste of the northern Netherlands in the seventeenth century. An examination of both Sylvius's science and his taste can help us understand what was at stake for Sylvius and his contemporaries in their practice of the new philosophy. This article finds that Sylvius's taste and his science both involved practices of social distinction, demarcation, and control. Moreover, both were enmeshed in controversy about the epistemological status of knowledge gained through the senses and about the practices by which that knowledge was gathered.

Anatomic, intrinsic, and synaptic properties of dorsal and ventral division neurons in rat medial geniculate body

Anatomic, intrinsic, and synaptic properties of dorsal and ventral division neurons in rat medial geniculate body. Presently little is known about what basic synaptic and cellular mechanisms are employed by thalamocortical neurons in the two main divisions of the auditory thalamus to elicit their distinct responses to sound. Using intracellular recording and labeling methods, we characterized anatomic features, membrane properties, and synaptic inputs of thalamocortical neurons in the dorsal (MGD) and ventral (MGV) divisions in brain slices of rat medial geniculate body. Quantitative analysis of dendritic morphology demonstrated that tufted neurons in both divisions had shorter dendrites, smaller dendritic tree areas, more profuse branching, and a greater dendritic polarization compared with stellate neurons, which were only found in MGD. Tufted neuron dendritic polarization was not as strong or consistent as earlier Golgi studies suggested. MGV and MGD cells had similar intrinsic properties except for an increased prevalence of a depolarizing sag potential in MGV neurons. The sag was the only intrinsic property correlated with cell morphology, seen only in tufted neurons in either division. Many MGV and MGD neurons received excitatory and inhibitory inferior colliculus (IC) inputs (designated IN/EX or EX/IN depending on excitation/inhibition sequence). However, a significant number only received excitatory inputs (EX/O) and a few only inhibitory (IN/O). Both MGV and MGD cells displayed similar proportions of response combinations, but suprathreshold EX/O responses only were observed in tufted neurons. Excitatory and inhibitory postsynaptic potentials (EPSPs and IPSPs) had multiple distinguishable amplitude levels implying convergence. Excitatory inputs activated alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and N-methyl-D-aspartate (NMDA) receptors the relative contributions of which were variable. For IN/EX cells with suprathreshold inputs, first-spike timing was independent of membrane potential unlike that of EX/O cells. Stimulation of corticothalamic (CT) and thalamic reticular nucleus (TRN) axons evoked a GABAA IPSP, EPSP, GABAB IPSP sequence in most neurons with both morphologies in both divisions. TRN IPSPs and CT EPSPs were graded in amplitude, again suggesting convergence. CT inputs activated AMPA and NMDA receptors. The NMDA component of both IC and CT inputs had an unusual voltage dependence with a detectable DL-2-amino-5-phosphonovaleric acid-sensitive component even below -70 mV. First-spike latencies of CT evoked action potentials were sensitive to membrane potential regardless of whether the TRN IPSP was present. Overall, our in vitro data indicate that reported regional differences in the in vivo responses of MGV and MGD cells to auditory stimuli are not well correlated with major differences in intrinsic membrane features or synaptic responses between cell types.

Urinary concentrations of the soluble adhesion molecule E-cadherin and total protein in patients with bladder cancer

Reduced expression of the adhesion molecule E-cadherin has been associated with increased invasiveness and poorer survival in patients with bladder cancer. We have examined soluble E-cadherin (sE-cadherin) and total protein concentrations in urine from patients with bladder cancer (n = 34), non-neoplastic benign urological diseases (n = 14) and healthy controls (n = 21) to determine their diagnostic and prognostic significance. Soluble E-cadherin concentrations of the cancer group were significantly higher (P < 0.001) than those of the controls but the benign group was not significantly different from either the cancer group or the controls. When sE-cadherin concentrations were adjusted for creatinine, similar but more statistically significant results were obtained and the benign group was significantly elevated compared with the controls (P < 0.01). No differences were apparent between the invasive (pT1-4) and non-invasive (pTa) cancers. Urinary total protein concentrations in the cancer group were significantly higher than the controls (P < 0.001) and the benign group (P < 0.05) although no difference was seen between the benign group and patients with non-invasive (pTa) cancer or between the benign group and controls. When expressed as the protein/creatinine index, results were similar but more statistically significant and a significant difference was seen between invasive and non-invasive cancers (P < 0.01). Only the protein/creatinine index correlated significantly with stage of the tumour (P < 0.01). It is concluded that urinary sE-cadherin measurements are of no greater value than urinary total protein.

Systematic comparison of gene expression through analysis of cDNA fragments within or near to the protein-coding region

Life is controlled by the timely and ordered expression of genes. Identification of important genes involved in specific physiological and pathological conditions requires efficient methods to analyse differential gene expression. We describe a novel strategy, namely complete comparison of gene expression (CCGE), for a systematic assessment of differentially expressed genes. Using the CCGE method, double-stranded cDNA is digested with two restriction enzymes that cut with different frequencies, the representative cDNA fragments are generated within or near to the protein-coding region. After being flanked by two different types of adapters, and amplified by a nested suppression PCR, the selected cDNA fragments, representing entire cDNA population, can be divided into 256 subsets; amplified and compared in a systematic manner.

Temporal and binaural properties in dorsal cochlear nucleus and its output tract

The dorsal cochlear nucleus (DCN) is one of three nuclei at the terminal zone of the auditory nerve. Axons of its projection neurons course via the dorsal acoustic stria (DAS) to the inferior colliculus (IC), where their signals are integrated with inputs from various other sources. The DCN presumably conveys sensitivity to spectral features, and it has been hypothesized that it plays a role in sound localization based on pinna cues. To account for its remarkable spectral properties, a DCN circuit scheme was developed in which three inputs converge onto projection neurons: auditory nerve fibers, inhibitory interneurons, and wide-band inhibitors, which possibly consist of Onset-chopper (Oc) cells. We studied temporal and binaural properties in DCN and DAS and examined whether the temporal properties are consistent with the model circuit. Interneurons (type II) and projection (types III and IV) neurons differed from Oc cells by their longer latencies and temporally nonlinear responses to amplitude-modulated tones. They also showed evidence of early inhibition to clicks. All projection neurons examined were inhibited by stimulation of the contralateral ear, particularly by broadband noise, and this inhibition also had short latency. Because Oc cells had short-latency responses and were well driven by broadband stimuli, we propose that they provide short-latency inhibition to DCN for both ipsilateral and contralateral stimuli. These results indicate more complex temporal behavior in DCN than has previously been emphasized, but they are consistent with the recently described nonlinear behavior to spectral manipulations and with the connectivity scheme deduced from such manipulations.

Anatomy and physiology of principal cells of the medial nucleus of the trapezoid body (MNTB) of the cat

We have recorded from principal cells of the medial nucleus of the trapezoid body (MNTB) in the cat's superior olivary complex using either glass micropipettes filled with Neurobiotin or horseradish peroxidase for intracellular recording and subsequent labeling or extracellular metal microelectrodes relying on prepotentials and electrode location. Labeled principal cells had cell bodies that usually gave rise to one or two primary dendrites, which branched profusely in the vicinity of the cell. At the electron microscopic (EM) level, there was a dense synaptic terminal distribution on the cell body and proximal dendrites. Up to half the measured cell surface could be covered with excitatory terminals, whereas inhibitory terminals consistently covered about one-fifth. The distal dendrites were very sparsely innervated. The thick myelinated axon originated from the cell body and innervated nuclei exclusively in the ipsilateral auditory brain stem. These include the lateral superior olive (LSO), ventral nucleus of the lateral lemniscus, medial superior olive, dorsomedial and ventromedial periolivary nuclei, and the MNTB itself. At the EM level the myelinated collaterals gave rise to terminals that contained nonround vesicles and, in the LSO, were seen terminating on cell bodies and primary dendrites. Responses of MNTB cells were similar to their primary excitatory input, the globular bushy cell (GBC), in a number of ways. The spontaneous spike rate of MNTB cells with low characteristic frequencies (CFs) was low, whereas it tended to be higher for higher CF units. In response to short tones, a low frequency MNTB cell showed enhanced phase-locking abilities, relative to auditory nerve fibers. For cells with CFs >1 kHz, the short tone response often resembled the primary-like with notch response seen in many globular bushy cells, with a well-timed onset component. Exceptions to and variations of this standard response were also noted. When compared with GBCs with comparable CFs, the latency of the MNTB cell response was delayed slightly, as would be expected given the synapse interposed between the two cell types. Our data thus confirm that, in the cat, the MNTB receives and converts synaptic inputs from globular bushy cells into a reasonably accurate reproduction of the bushy cell spike response. This MNTB cell output then becomes an important inhibitory input to a number of ipsilateral auditory brain stem nuclei.

Translocation of PKC delta by insulin in a rat hepatoma cell line

The aim of this study was to examine the effects of insulin and phorbol 12-myristate 13-acetate (PMA), an activator of classic and novel PKCs, on the translocation of PKC from cytosol to membrane in H4IIE (H4) rat hepatoma cells. Six PKC isoforms were expressed, including PKC-mu and PKC-lambda, identified for the first time in this hepatoma-cell line. Insulin induced translocation of PKC-delta from the cytosol to the membrane fraction as early as 15 min and maximally at 60 min with levels returning to that of controls by 180 min. Insulin also decreased levels of PKC-zeta in membranes at 5, 10, 15, and 30 min, but had no effect on cytosol levels. Ten minutes of PMA treatment translocated PKC-delta completely, and 24 h of PMA treatment downregulated PKC-delta. Neither acute nor chronic PMA had any effect on PKC-zeta. These studies establish the ability of both insulin and PMA to activate PKC-delta in H4 cells, and coupled with our previous work demonstrating a diminution of the effect of insulin on gene transcription in PKC downregulated cells, suggest that insulin may exert specific effects, in part, through a PKC-dependent pathway.

Results from the Mars Pathfinder camera

Images of the martian surface returned by the Imager for Mars Pathfinder (IMP) show a complex surface of ridges and troughs covered by rocks that have been transported and modified by fluvial, aeolian, and impact processes. Analysis of the spectral signatures in the scene (at 440- to 1000-nanometer wavelength) reveal three types of rock and four classes of soil. Upward-looking IMP images of the predawn sky show thin, bluish clouds that probably represent water ice forming on local atmospheric haze (opacity approximately 0.5). Haze particles are about 1 micrometer in radius and the water vapor column abundance is about 10 precipitable micrometers.

Overview of the Mars Pathfinder mission and assessment of landing site predictions

Chemical analyses returned by Mars Pathfinder indicate that some rocks may be high in silica, implying differentiated parent materials. Rounded pebbles and cobbles and a possible conglomerate suggest fluvial processes that imply liquid water in equilibrium with the atmosphere and thus a warmer and wetter past. The moment of inertia indicates a central metallic core of 1300 to 2000 kilometers in radius. Composite airborne dust particles appear magnetized by freeze-dried maghemite stain or cement that may have been leached from crustal materials by an active hydrologic cycle. Remote-sensing data at a scale of generally greater than approximately 1 kilometer and an Earth analog correctly predicted a rocky plain safe for landing and roving with a variety of rocks deposited by catastrophic floods that are relatively dust-free.

Differential expression of acidic and basic fibroblast growth factors in benign prostatic hyperplasia identified by immunohistochemistry

OBJECTIVE

To detect the expression and to determine the relative cellular locations of the two peptide growth factors, acidic fibroblast growth factor (a-FGF) and basic (b)-FGF in tissues from human benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS

A series of 50 sequential and unselected cases of human BPH tissues, obtained after transurethral prostatectomy, was examined. Adjacent sections of formalin-fixed and paraffin wax-embedded tissues were stained immunohistochemically for expression of a-FGF and b-FGF using well-characterized and commercially available antibodies. The stained tissue sections were assessed for the cellular distribution of immunohistochemical products and analysed according to the relative intensity of staining as well as the spatial relationships of positively stained cells.

RESULTS

Acidic-FGF was weakly expressed with a pancytoplasmic distribution within luminal glandular epithelial cells in regions of prostatic intra-epithelial neoplasia (both PIN I and II) but not by non-dysplastic normal or hyperplastic tissues. No expression of a-FGF was detected in basal epithelial cells or in the stromal compartment of any tissue examined. In contrast, b-FGF was strongly expressed within the cytoplasm of all basal epithelial cells, but not by luminal epithelial cells, in morphologically normal regions of all cases examined. Basal expression of b-FGF was diminished, or absent, in regions of mild epithelial dysplasia, particularly those strongly expressing a-FGF. Extensive nuclear and cytoplasmic expression of b-FGF occurred predominantly in smooth muscle-type stromal cells but not in all types of stromal cells.

CONCLUSIONS

This study confirmed both a differential and a reciprocal expression of a- and b-FGF in non-dysplastic prostatic hyperplasia and in mildly dysplastic regions of prostatic tissues. While only small amounts of a-FGF were expressed in BPH, exclusively in the luminal epithelial compartment, its consistent appearance in PIN I and II suggests that it might contribute to the early stages of PIN. Conversely, b-FGF may be an important mediator of stromal-epithelial interaction during the pathogenesis of BPH. These results provide new information about the relative expression of these growth factors, particularly in the architectural relationships between different cell-types within normal and non-malignant prostatic tissues.

Measuring battering: development of the Women's Experience with Battering (WEB) Scale

Measuring only the physical markers of violence (e.g., slapping, beating) fails to capture the chronic vulnerability and gendered nature of battered women's experiences. Instruments that measure only observable discrete events may mask the continuous nature of battering and the relation between events and experience. Our approach to measuring battering operationalizes the experiences of battered women rather than the abusive behaviors they encounter. This alternative approach emphasizes the meanings battered women attach to the violence and to battering as an enduring presence in their lives. Focus groups with 22 battered women generated qualitative data for developing scale items (Smith, Tessaro, & Earp, 1995) and a known-groups survey with 185 battered and 204 nonbattered women determined the final scale items. Factor analysis of 40 initial items revealed a strong single-factor solution. The resulting 10-item Women's Experiences with Battering (WEB) Scale demonstrated high internal consistency reliability, was significantly correlated with known-group status, exhibited good construct validity, and was not significantly correlated with a measure of social desirability. The WEB Scale provides researchers with a valid and concise measure for studying relations between battering and health or health behavior, as well as evaluating the impact of interventions on battered women or prevalence.

A monosynaptic GABAergic input from the inferior colliculus to the medial geniculate body in rat

The goal was to investigate possible monosynaptic GABAergic projections from the inferior colliculus (IC) to thalamocortical neurons of the medial geniculate body (MGB) in the rat. Although there is little evidence for such a projection in other sensory thalamic nuclei, a GABAergic, ascending auditory projection was reported recently in the cat. In the present study, immunohistochemical and tract-tracing methods were used to identify neurons in the IC that contain GABA and project to the MGB. GABA-positive projection neurons were most numerous in the central nucleus and less so in the dorsal and lateral cortex. They were rare in the lateral tegmental system and brachium of the IC. The dorsal nucleus of the lateral lemniscus also contained GABA-positive projection neurons. In brain slices, stimulation of the brachium produced monosynaptic inhibitory postsynaptic potentials in morphologically identified thalamocortical relay neurons. The inhibitory potentials cannot originate locally, because they persisted when ionotropic glutamatergic transmission was blocked. Typically, brachium stimulation elicited a GABAA-mediated inhibitory potential followed by an excitatory potential and a longer latency GABAB-mediated inhibitory potential. We conclude that the GABA-containing neurons of the IC make short-latency, monosynaptic inputs to the thalamocortical projection neurons in the MGB. Such inputs may distinguish the main auditory pathway from indirect or tegmental auditory pathways as well as from other sensory systems. Monosynaptic inhibitory inputs to the medial geniculate may be important for the regulation of firing patterns in thalamocortical neurons.

The effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: a further report with 7 years of follow up

PURPOSE

We determined the role, if any, of 1 and 5 instillations of intravesical mitomycin C in the treatment of newly diagnosed superficial bladder cancer.

MATERIALS AND METHODS

A multicenter randomized clinical trial was done involving 502 patients with newly diagnosed superficial bladder cancer. After complete transurethral resection patients with newly diagnosed superficial bladder cancer. After complete resection patients were randomized into 1 of 3 treatment arms: no further treatment, 1 instillation of mitomycin C at resection and 1 instillation at resection and at 3-month intervals for 1 year (total 5 instillations). The dose of mitomycin C used was 40 mg./40 ml. water. End points were interval to first superficial recurrence, recurrence rate (defined as the number of positive cystoscopies per year) and progression-free interval rate (progression defined as the development of muscle invasive or metastatic disease, or death from bladder cancer).

RESULTS

After median followup of 7 years 1 and 5 instillations of mitomycin C resulted in decreased recurrence rates and increased recurrence-free interval. The benefit of mitomycin C was observed in patients at low, medium and high risk for subsequent recurrence. There was suggestive but not conclusive evidence that 5 instillations of mitomycin C offered a slight advantage over 1 instillation.

CONCLUSIONS

Our analysis confirms the positive benefit of mitomycin C to decrease the number of subsequent recurrences and increase the recurrence-free interval.

Neutropenia does not prevent etodolac- or indomethacin-induced gastrointestinal damage in the rat

Neutrophils have been implicated in the acute formation of gastric mucosal erosions induced by nonsteroidal antiinflammatory drugs. The aims of the present study were to determine, in rats, the role of neutrophils in the pathogenesis of etodolac- and indomethacin-induced gastrointestinal ulceration and blood loss. Both drugs caused gastrointestinal ulceration, which was associated with increased blood loss, a rise in plasma haptoglobin concentration, and a rise in the number of circulating neutrophils. A marked infiltration of neutrophils occurred only in ileal tissue. Pretreatment with a selective antineutrophil serum induced a significant neutropenia, which failed to inhibit either etodolac- or indomethacin-induced gastrointestinal ulceration and blood loss. A further study demonstrated that the antineutrophil serum did not prevent gastric erosions induced by indomethacin, but it inhibited carrageenan paw edema, which is dependent, in part, on neutrophil infiltration and activation. It is concluded that neutrophils do not contribute to gastrointestinal ulceration and blood loss induced by nonsteroidal antiinflammatory drugs. Furthermore, in contrast with previous studies, our results provide no evidence that neutrophils contribute to indomethacin-induced acute gastric erosion formation.

[Renaissance of estrogen therapy in advanced prostate carcinoma?]

Oestrogen therapy or orchidectomy reigned supreme for the treatment of metastatic prostatic cancer for almost 40 years. In the last 15 years many alternative agents have been tested alone and more recently in combination. This contribution evaluates the results of some of these newer therapies considering relief of symptoms, toxicity, quality of life, survival, and benefit to the community. The results are compared with those of oestrogen therapy and with the way in which such treatment might be amended in light of more modern knowledge.

Structural and functional differences distinguish principal from nonprincipal cells in the guinea pig MSO slice

1. Principal cells in the medial superior olive (MSO) receive low-frequency information from both ears via left and right cochlear nuclei. In vivo extracellular records suggest that some MSO neurons respond optimally only when the binaural acoustic signal has a precise interaural delay. Thus MSO cells, in particular principal cells, are thought to be the first stage in the processing of interaural time difference cues that provides information as to the location of a low-frequency sound in space. 2. Despite this proposed fundamental role for the MSO, certain features of this nucleus make in vivo recordings from any cell type here very difficult to obtain. Only a small number of extracellular records and no intracellular recordings are reported in the literature. Using sharp, neurobiotin-filled glass electrodes to record intracellularly from cells in an in vitro brain slice of the guinea pig superior olivary complex, I have begun to assess the anatomic and physiological features of cells in the MSO that might be relevant to such a functional role in vivo. 3. Two basic MSO cell types, designated principal and nonprincipal, could be distinguished on the basis of certain anatomic and physiological differences. 4. Labeled principal cell bodies were located at all dorsoventral location within the MSO. Labeled nonprincipal cells were located in or around the dorsal aspects of the nucleus. Principal cells typically had thick bipolar dendrites (1 directed medially, 1 laterally) that did not taper or branch significantly except at their terminations. Nonprincipal cells were multipolar with three to nine thinner primary dendrites that did not branch preferentially in a mediolateral direction. Principal cell axons gave off collaterals terminating in and around the dorsal MSO. Nonprincipal cells also had axon in and around the dorsal MSO. Nonprincipal cells also had axon collateral branches innervating dorsal MSO, but these axons could branch more extensively and project further down the dorsoventral aspect of the nucleus. 5. Principal cells typically responded to depolarizing current pulses with one or a few spikes at current onset. When bathed in saline containing 4-aminopyridine (4-AP), they fired repetitively to the same depolarizing current pulses. This would indicate a depolarization-induced nonlinearity similar to that seen in principal cell types of two other auditory brain stem nuclei, the anteroventral cochlear nucleus and medial nucleus of the trapezoid body. Nonprincipal cells normally fired repetitively to depolarizing current pulses even close to spike threshold. Both cell types could show a sag in the membrane potential to hyperpolarizing current pulses.(ABSTRACT TRUNCATED AT 400 WORDS)

Soluble forms of the adhesion molecule E-cadherin in urine

The adhesion molecule E-cadherin is essential for maintaining epithelial intercellular adhesion. Loss or reduced expression of E-cadherin has been related to invasive behaviour in a wide range of carcinomas. Using immunoblotting techniques, the existence of multiple soluble forms of E-cadherin was demonstrated in urine from healthy volunteers and patients with benign urinary tract disorders or bladder cancer. The existence of soluble forms of E-cadherin in the urine may reflect shedding from the urinary tract epithelium as part of the normal turnover of this molecule. The possibility that enhanced shedding may contribute to the loss of E-cadherin expression/function in malignancy is discussed.

Oestrogens reconsidered

Oestrogen therapy or orchidectomy reigned supreme for the treatment of metastatic prostatic cancer for almost 40 years. In the last 15 years many alternative agents have been tested alone and more recently in combination. This contribution evaluates the results of some of these newer therapies considering relief of symptoms, toxicity, quality of life, survival, and benefit to the community. The results are compared with those of oestrogen therapy and with the way in which such treatment might be amended in light of more modern knowledge.

Tryptophan metabolites, pyridoxine (vitamin B6) and their influence on the recurrence rate of superficial bladder cancer. Results of a prospective, randomised phase III study performed by the EORTC GU Group. EORTC Genito-Urinary Tract Cancer Cooperative Group

This double-blind randomised phase III trial was designed to assess the effect of pyridoxine administration on the recurrence of Ta and T1 transitional cell tumours of the bladder. The trial accrued 291 patients and showed no significant difference between the pyridoxine and placebo treatment groups with respect to the time to first recurrence or the recurrence rate. Adjustment for the main prognostic factors, namely the recurrence rate prior to entry, the number of tumours at entry, the G grade and the levels of the tryptophan metabolites kynurenine plus acetyl kynurenine at entry do not change the overall conclusions.

Psychological consequences of battering. Implications for women's health and medical practice

Battering means more than just physical assault. It means pain and injury from physical assault plus continuous psychological degradation, sustained fear, diminished power and control, and loss of identity and self-esteem. Women often feel trapped in violent relationships because of their partners' threats to kill them if they leave, and because police, medical, and social services systems often inadequately protect and help them. Battering is best understood as a continuous traumatic experience and, like many other forms of trauma, it takes a considerable psychological toll on its victims. Battered women are at risk for chronic physical and psychological health problems including PTSD, depression, chronic pain, and substance abuse. The high prevalence of battering, and its psychological and physical consequences, means that battered women present with a multitude of acute and chronic symptoms and are not easily identified. The most practical and effective way to identify battering is to routinely ask all women patients about it. Identification gives physicians a way to understand complex and confusing symptoms and an opportunity to help battered women undertake the difficult and dangerous process of leaving abusive partners. In addition, doctors, in collaboration with battered women patients and other professionals, can help develop comprehensive plans to reduce this complex public health problem.

Early catheter removal following transurethral prostatectomy--impact on length of hospital stay

OBJECTIVE

To investigate whether early catheter removal following transurethral prostatectomy (TURP) is safe and whether it has any effect on the length of hospital stay.

PATIENTS AND METHODS

Following transurethral prostatectomy 59 patients were randomized into one of two groups: those whose catheter was removed on day 1 after surgery and those whose catheter was removed on day 2. The incidence of complications and the duration of post-operative hospital stay were assessed.

RESULTS

Catheter removal on day 1 led to a significantly shorter post-operative hospital stay (2.3 days versus 3.3 days) and did not incur a higher incidence of complications.

CONCLUSIONS

Removal of the catheter on the first day following TURP is safe in selected patients and leads to a shorter post-operative hospital stay.

Cavitating pulmonary metastases from superficial transitional cell carcinoma of urinary bladder. Case report

Multiple cavitary pulmonary metastases from bladder carcinoma are rare. We present a case of superficial transitional cell carcinoma of the bladder with multiple cavitating lung secondaries treated by systemic chemotherapy.

Enhancement of neural synchronization in the anteroventral cochlear nucleus. II. Responses in the tuning curve tail

1. Discharges of neurons in the peripheral auditory system contain information about the temporal features of acoustic stimuli. Phase-locking of neurons in the anteroventral cochlear nucleus (AVCN) is usually reported to be less robust than in auditory nerve (AN) fibers, which provide their major input. In a companion paper we reported that some cells in AVCN of the cat show enhanced phase-locking compared with the AN when stimulated at the frequency to which they are most sensitive [characteristic frequency (CF)]. We called neurons "high-sync" when they showed vector strengths (R, a measure of phase-locking) > or = 0.9. Here we report phase-locking properties to stimuli at frequencies below CF. 2. Horseradish peroxidase-filled glass micropipettes or metal microelectrodes were inserted into the trapezoid body (TB), which is the large output tract of the AVCN. Acoustically driven fibers were classified on the basis of the shape of the poststimulus time (PST) histograms to short tone bursts at CF. We then presented low-frequency tones of increasing SPL and determined the maximum R value at 500 Hz (R500) for each fiber. Using the same experimental protocol we studied phase-locking in the ANs of two animals because maximal R values at the tuning curve tail have not been reported for AN fibers. 3. Although phase-locking in AN fibers is usually assumed to be independent of CF, we found that fibers with CF > 2 kHz tended to have higher R500 values than fibers with CF < or = 2 kHz. Moreover, R500 was > or = 0.9 in 20% (42 of 196) of the fibers studied and could be as high as 0.95. This population of fibers was defined as having "high-sync tails" and consisted almost entirely of fibers with low or medium spontaneous rate. 4. High-CF TB fibers stimulated at 500 Hz showed very high phase-locking. High-sync tails (R500 > or = 0.9) were found in 41 of 70 TB fibers. For a subset of these fibers (1/3 in total: 23 of 70) phase-locking was higher than is ever observed in the AN (R500 > or = 0.95); these fibers were defined as showing synchronization "enhancement." Virtually all fibers showing synchronization enhancement had primary-like-with-notch (PLN) PST histograms. Chopper and primary-like fibers showed high-sync tails for CFs > 3 kHz. 5. Synchronization filter functions were obtained for high-CF AN fibers by determining maximum synchronization for a range of stimuli below CF.(ABSTRACT TRUNCATED AT 400 WORDS)

Enhancement of neural synchronization in the anteroventral cochlear nucleus. I. Responses to tones at the characteristic frequency

1. Encoding temporal features of the acoustic waveform is an important attribute of the auditory system. Auditory nerve (AN) fibers synchronize or phase-lock to low-frequency tones and transmit this temporal information to cells in the anteroventral cochlear nucleus (AVCN). Phase-locking in the AVCN is usually reported to be similar to or weaker than in the AN. We studied phase-locking in axons of the trapezoid body (TB), which is the output tract of the AVCN, and found, to our surprise, that most TB axons exhibited enhanced synchronization compared with AN fibers. 2. Responses from axons in the TB of the cat were obtained with horseradish peroxidase (HRP)- or Neurobiotin-filled micropipettes or metal microelectrodes. A series of short tone bursts at increasing sound pressure level (SPL) was presented at the characteristic frequency (CF) of the fiber and phase-locking was quantified with the vector strength R at each SPL. For each fiber the maximum R value (Rmax) was then determined. 3. Low-frequency fibers in the TB showed very precise phase-locking: Rmax values could approach 0.99. For the majority of fibers (33/44, 75%) with CF < 700 Hz, Rmax was > or = 0.9 and therefore higher than is ever observed in the AN. We define such fibers as "high-sync." Most of these fibers also entrained to the stimulus, i.e., they fired a precisely timed action potential to almost every stimulus cycle. Some fibers showed perfect entrainment, with maximum discharge rates equaling the stimulus frequency. 4. To exclude the possibility that stimulus paradigms or acoustic and recording equipment were the source of this enhancement, we obtained additional data on low-frequency AN fibers using the same experimental protocol as in our TB experiments. These AN data agree well with published reports. 5. The morphological class of some of the cells studied was identified on the basis of anatomic features revealed by intra-axonal injection of HRP or Neurobiotin. Labeled low-CF axons (N = 7), which were all high-sync, originated from AVCN bushy cells: five were globular and two were spherical bushy cell axons. 6. Spontaneous rate of high-sync fibers covered a range from 0 to 176 spikes/s but were biased toward low values (mean 16 spikes/s). Responses to broadband clicks and sinusoidally amplitude-modulated signals provided additional evidence of improved timing properties.(ABSTRACT TRUNCATED AT 400 WORDS)

Proposal for changes in cystoscopic follow up of patients with bladder cancer and adjuvant intravesical chemotherapy

A famous surgeon observed that the most important instrument for the management of superficial bladder cancer was a typewriter because it facilitated the organisation of the regular follow up examinations that are so important in controlling this disease. Cystoscopic follow up must be lifelong, and the cost, in the broadest sense, to both patient and health service is considerable. A recent study has suggested that the conventional frequency of bladder examinations may not be necessary and that most patients could be spared many cystoscopies. Instillation of cytotoxic drugs in the bladder has been shown to reduce the recurrence of tumours destroyed endoscopically and the development of new tumours elsewhere in the bladder. Because intravesical instillations are inconvenient, expensive, and may be toxic they have been reserved for patients thought to be at greatest risk of recurrence. However, two clinical trials have shown that a single cytotoxic instillation may be beneficial for low risk patients. If this is verified in everyday practice, the routine use of intravesical chemotherapy for all patients at the time of initial treatment could reduce the need for cystoscopies even further. Such changes should improve the quality of life of the 7000 new patients with superficial bladder cancer each year in England and Wales and allow savings to be made in the NHS.

Hyperpolarization-activated cation current (Ih) in neurons of the medial nucleus of the trapezoid body: voltage-clamp analysis and enhancement by norepinephrine and cAMP suggest a modulatory mechanism in the auditory brain stem

1. Principal cells in the medial nucleus of the trapezoid body (MNTB) are part of a circuit in the superior olivary complex (SOC) that processes binaural information important for sound localization. MNTB cells have two voltage-dependent currents active near rest that contribute to these cells' highly nonlinear membrane properties and shape their responses to synaptic input. One of these currents, a low-threshold, 4-aminopyridine (4-AP)-sensitive K+ current, has been studied previously under current clamp. Using the single-electrode voltage-clamp technique, we have investigated the other of these currents, a hyperpolarization-activated, mixed cation current (Ih), in brain slices of the rat SOC. 2. Ih is responsible for a prominent "sag" in the voltage response to a steady hyperpolarizing current recorded under current clamp in MNTB cells. In voltage-clamp recordings, hyperpolarizing voltage steps from the resting potential elicited a large inward current that activated and deactivated with biexponential kinetics. Activation time constants were voltage dependent, with tau 1 and tau 2 = 246 and 1620 ms at -75 mV and 107 and 560 ms at -100 mV. 3. Ih was blocked by 1-5 mM cesium and had a reversal potential of -43 mV. Steady-state activation curves derived from tail currents yielded a half-activation voltage of -75.7 mV and slope factor of 5.7 mV, corresponding to < 10% activation of Ih at rest. 4. Application of norepinephrine (15-20 microM) or 8-bromoadenosine 3',5'-cyclic monophosphate (8-Br-cAMP) (1 mM) caused a depolarizing shift in the steady-state activation curve and decreased the activation time constants. The shift in the activation curve resulted in a large increase in the activation of Ih at rest, an inward shift in the holding current, and an increase in the resting membrane conductance. In current-clamp recordings, this increase in the resting activation level of Ih resulted in membrane depolarization of 2-3 mV in the absence of 4-AP, and 5-10 mV in the presence of 4-AP, an increase in the input conductance, and a reduction in the voltage sag in response to hyperpolarizing currents. 5. The resulting change in the resting point of MNTB cells exposed to norepinephrine or 8-Br-cAMP is likely to alter the responses of these cells to synaptic input, both via the direct effect on the resting membrane conductance and by changing the activation of the low-threshold, 4-AP-sensitive potassium current.(ABSTRACT TRUNCATED AT 400 WORDS)

Identification and quantification of juvenile hormone biosynthesized by larval and adult Australian sheep blowfly Lucilia cuprina (Diptera: Calliphoridae)

Recent evidence indicates that higher dipterans biosynthesize predominantly the novel juvenile hormone (JH) bisepoxide, methyl (2E,6trans)-6,7,10,11-bisepoxy-3,7,11-trimethyl-2-dodecen oate (JHB3), together with a small proportion of methyl (2E,6E)-10,11-epoxy-3,7,11-trimethyl-2,6-dodecadienoate (JHIII) and possibly its 6,7-epoxy isomer. A strategy of gas chromatography-mass spectrometry (GC-MS) involving cool on-column GC and negative-ion chemical ionization MS has enabled the selective analysis of underivatized JH-like products released in vitro by ring glands and corpora allata of Lucilia cuprina. JHB3 is released to the exclusion of mono-epoxidized and unepoxidized esters. The rate of JHB3 release in adult females increases dramatically after protein feeding from 0.2 to 5.2 pmol/h/gland. Values agree well with the rate of JH biosynthesis determined by radiochemical assay. As revealed by thin-layer chromatography, the radiolabel is predominantly incorporated into JHB3, of which only 2% is retained in the corpus allatum indicating almost immediate release from the gland. Approximately 5% of radioactive material retained in the glands co-migrates with JHIII and may be an intermediate in JHB3 synthesis. We conclude that JHB3 is the only juvenile hormone biosynthesized in vitro by L. cuprina. The data suggest that JHB3 may be the exclusive JH synthesized by higher dipterans.

Projections of physiologically characterized spherical bushy cell axons from the cochlear nucleus of the cat: evidence for delay lines to the medial superior olive

Bushy cells in the anteroventral cochlear nucleus (AVCN) receive their principal excitatory input from the auditory nerve and are the primary source of excitatory input to more centrally located brainstem auditory nuclei. Despite this pivotal position in the auditory pathway, details of the basic physiological information being carried by axons of these cells and their projections to more central auditory nuclei have not been fully explored. In an attempt to clarify these details, we have physiologically characterized and anatomically labeled individual axons of the spherical bushy cell (SBC) class of the cat AVCN. The characteristic frequencies (CFs) of our injected SBC population are low, all less than 12 kHz and primarily (83%) less than 3 kHz, while their spontaneous activity is comparatively high (mean of 59 spikes/sec). In response to short tone bursts at CF, low CF (< 1 kHz) SBC units can phase-lock better than auditory nerve fibers. SBCs with CFs above 1 kHz have primary-like responses at all stimulus levels and can show robust phase-locking to an off-CF, 500 Hz tone. When compared with our previously reported population of labeled globular bushy cells (GBC; Smith et al., 1991, J. Comp. Neurol. 304:387-407), some similarities and differences are apparent in both physiological response properties and axonal projection pattern. GBCs show no low frequency bias in CFs, have lower spontaneous rates, and the high CF units exhibit a primary-like-with-notch response at high stimulus levels as a consequence of a very well timed onset component. Low CF, GBC short tone responses are indistinguishable from those of SBCs. Anatomically, the axons of SBCs cross the midline in the dorsal component of the trapezoid body and typically innervate the medial superior olive (MSO) on both sides, the ipsilateral lateral superior olive (LSO), and the contralateral ventral nucleus of the lateral lemniscus (VNLL). The projections to the contralateral, but not the ipsilateral MSO, show a rostral to caudal delay line configuration, similar to the scheme first proposed by Jeffress (1948, J. Comp. Psychol. 41:35-39). The form of this delay line is consistent with the topographic map of interaural time delays reported by Yin and Chan (1990, J. Neurophysiol. 64:465-488). Projections to the ipsilateral LSO often take an indirect route. In contrast, GBC axons travel in the ventral component of the trapezoid body, never innervate the MSO, rarely innervate the ipsilateral LSO, and always innervate the contralateral medial nucleus of the trapezoid body. The terminal specializations of both SBC and GBC axons contain round vesicles.

Deferred therapy in patients with advanced disease

Disease that is known to have extended beyond the prostatic capsule is unlikely to be cured by radical surgical excision, although the primary tumor may be controlled by external irradiation. The development of progressive (metastatic) disease is common and may be retarded by hormonal therapy. The timing of such treatment and the debate about monotherapy versus total androgen ablation has not been resolved fully. It is considered further in this article.

Adjuvant therapy in prostatic cancer

BACKGROUND

Prostatic cancer is an unusual malignancy because, commonly, it is slowly progressive and occurs at an age where the patient's life expectancy is short as a result of considerable competing mortality rates from other diseases. In addition, the place of radical surgery, i.e., radical prostatectomy is still not defined completely or established uniformly.

METHODS

This article attempts to offer comparisons of the initial forms of primary therapy and to determine the way in which adjuvant therapy may be tested and its results assessed.

RESULTS AND CONCLUSION

Additional information should come from large-scale randomized clinical trials involving several hundred patients in each treatment arm.