p53 and related proteins in epithelial ovarian cancer

We conducted a retrospective immunohistochemical evaluation of the prognostic significance of the expression of p53 and the related proteins Bax, Bcl-2, growth arrest and DNA damage (Gadd45), murine double minute 2 (Mdm2) and p21(WAF1/CIP1) in chemonaive tumours taken from 66 patients with ovarian cancer. Ki-67 expression (a marker of cell proliferation) was also evaluated immunohistochemically, while apoptosis within malignant cells was determined with the terminal deoxynucleotidyltransferase-mediated dUTP nick-end labelling (TUNEL) assay. The expression of each of the following proteins was significantly associated in the tumours (P < 0.05 unless otherwise stated): Bax with Bcl-2 (P < 0.01); Bax with Mdm2; p21(WAF1/CIP1) with Gadd45 (P < 0.01); p21(WAF1/CIP1) with p53; p53 with Mdm2. Univariate analysis showed that expression of p53, Bax, bulk residual disease and International Federation of Gynecology and Obstetricians (FIGO) stage were all strongly correlated with response to chemotherapy (P < 0.01). Similarly, the FIGO stage and Ki-67 expression (P < 0.01), as well as pathological subtype and bulk residual disease (P < 0.05), were prognostic factors for disease progression. The FIGO stage and Ki-67 expression were significant prognostic factors for overall survival (P < 0.01), with Gadd45 expression and pathological subtype also significant (P < 0.05) in a univariate analysis. Multivariate analysis for response to chemotherapy showed that expression of p53, Bax and FIGO stage were all independent prognostic factors (P < 0.01). The FIGO stage was the most important independent prognostic factor for progression and survival on multivariate analysis (P < 0.01). However, Ki-67 expression was also an independent prognostic factor for disease progression (P < 0.05) and approached significance for survival (P = 0.055). Taken together, these data suggest that determination of Ki-67 expression could supplement established prognostic factors.

The memory enhancing effects of a Ginkgo biloba/Panax ginseng combination in healthy middle-aged volunteers

The effects of capsules containing 60 mg of a standardised extract of Ginkgo biloba (GK501) and 100 mg of a standardised extract of Panax ginseng (G115) on various aspects of cognitive function were assessed in healthy middle-aged volunteers. A double blind, placebo controlled, 14 week, parallel group, repeated assessment, multi-centre trial of two dosing regimens, 160 mg b.i.d. and 320 mg o.d. was conducted. Two hundred and fifty-six healthy middle-aged volunteers successfully completed the study. On various study days (weeks 0, 4, 8, 12 and 14) the volunteers performed a selection of tests of attention and memory from the Cognitive Drug Research computerised cognitive assessment system prior to morning dosing and again, at 1, 3 and 6 h later. The volunteers also completed questionnaires about mood states, quality of life and sleep quality. The Ginkgo/ginseng combination was found significantly to improve an Index of Memory Quality, supporting a previous finding with the compound. This effect represented an average improvement of 7.5% and reflected improvements to a number of different aspects of memory, including working and long-term memory. This enhancement to memory was seen throughout the 12-week dosing period and also after a 2-week washout. This represents the first substantial demonstration of improvements to the memory of healthy middle-aged volunteers produced by a phytopharmaceutical.

Interpersonal competency in sex offenders

The major theoretical frameworks all invoke, often implicitly, social competency deficits as part of their causal explanations for sexual aggression. In this article, the authors review the evidence for this general position, noting both that social competency is not best seen as being equivalent to social skill and that domain specificity is likely to be important. They argue that intimacy, empathy, and cognitive distortions are likely to be the most salient domains in the area of sexual aggression. Recent use of attachment theory to conceptualize intimacy suggests that this approach may have more utility in both classification and intervention planning. An information processing view of empathy, together with likelihood of situational constraints on deficits, has usefully advanced this area. The possible relationships between such deficits and cognitive distortions are noted. Current literature on cognitive distortions is also briefly reviewed. Finally, suggestions for a helpful research agenda are made.

Sexual offenders' implicit planning: a conceptual model

In recent years empirical research, clinical observation, and theoretical models about sexual offending have emphasized the importance of problem solving and decision making throughout different phases in the offense chain. This work suggests that sometimes offense planning is explicit, systematic, and analytical, while at other times it appears to be implicit and intuitive. The latter style of decision making has been called seemingly unimportant decisions. We attempt to provide an explanation of offenders' implicit decision making and suggest two social cognitive mechanisms capable of generating these types of decisions. We believe that implicit decision making in offenders has the appearance of automaticity, that is, decision making that is implicit, fast, relatively autonomous, frequently associated with a lack of control, effortless, and occurring without conscious awareness. Drawing from diverse theoretical sources, we hypothesize that these types of decisions are generated by underlying automatic goal dependent action plans. More specifically, we suggest that there are at least two types of automatic goal dependent plans evident in offenders' decision making: offense scripts and mental simulations. We draw implications for generating future hypotheses and provide suggestions for future research.

BRCA2-null embryonic survival is prolonged on the BALB/c genetic background

Women who inherit mutations in the BRCA2 cancer susceptibility gene have an 85% chance of developing breast cancer. The function of the BRCA2 gene remains elusive, but there is evidence to support its role in transcriptional transactivation, tumor suppression, and the maintenance of genomic integrity. Individuals with identical BRCA2 mutations display a different distribution of cancers, suggesting that there are low-penetrance genes that can modify disease outcome. We hypothesized that genetic background could influence embryonic survival of a Brca2 mutation in mice. Brca2-null embryos with a 129/SvEv genetic background (129(B2-/-)) died before embryonic day 8. 5. Transfer of this Brca2 mutation onto the BALB/cJ genetic background (BALB/c(B2-/-)) extended survival to embryonic day 10.5. These results indicate that the BALB/c background harbors genetic modifiers that can prolong Brca2-null embryonic survival. The extended survival of BALB/c(B2-/-) embryos enabled us to ask whether transcriptional regulation of the Brca1 and Brca2 genes is interdependent. The interdependence of Brca1 and Brca2 was evaluated by studying Brca2 gene expression in BALB/c(B1-/-) embryos and Brca1 gene expression in BALB/c(B2-/-) embryos. Nonisotopic in situ hybridization demonstrated that Brca2 transcript levels were comparable in BALB/c(B1-/-) embryos and wild-type littermates. Likewise, reverse transcriptase-polymerase chain reactions confirmed Brca1 mRNA expression in embryonic day 8.5 BALB/c(B2-/-) embryos that was comparable to Brca2-heterozygous littermates. Thus, the Brca1 and Brca2 transcripts are expressed independently of one another in Brca1- and Brca2-null embryos. Mol. Carcinog. 28:174-183, 2000.

Mice heterozygous for a Brca1 or Brca2 mutation display distinct mammary gland and ovarian phenotypes in response to diethylstilbestrol

Women who inherit mutations in the breast cancer susceptibility genes, BRCA1 and BRCA2, are predisposed to the development of breast and ovarian cancer. We used mice with a Brca1 mutation on a BALB/cJ inbred background (BALB/cB1+/- mice) or a Brca2 genetic alteration on the 129/SvEv genetic background (129B2+/- mice) to investigate potential gene-environment interactions between defects in these genes and treatment with the highly estrogenic compound diethylstilbestrol (DES). Beginning at 3 weeks of age, BALB/cB1+/-, 129B2+/-, and wild-type female mice were fed a control diet or a diet containing 640 ppb DES for 26 weeks. DES treatment caused vaginal epithelial hyperplasia and hyperkeratosis, uterine inflammation, adenomyosis, and fibrosis, as well as oviductal smooth muscle hypertrophy. The severity of the DES response was mouse strain specific. The estrogen-responsive 129/SvEv strain exhibited an extreme response in the reproductive tract, whereas the effect in BALB/cJ and C3H/HeN(MMTV-) mice was less severe. The Brca1 and Brca2 genetic alterations influenced the phenotypic response of BALB/cJ and 129/SvEv inbred strains, respectively, to DES in the mammary gland and ovary. The mammary duct branching morphology was inhibited in DES-treated BALB/cB1+/- mice compared with similarly treated BALB/cB1+/+ littermates. In addition, the majority of BALB/cB1+/- mice had atrophied ovaries, whereas wild-type littermates were largely diagnosed with arrested follicular development. The mammary ductal architecture in untreated 129B2+/- mice revealed a subtle inhibited branching phenotype that was enhanced with DES treatment. However, no significant differences were observed in ovarian pathology between 129B2+/+ and 129B2+/- mice. These data suggest that estrogenic compounds may modulate mammary gland or ovarian morphology in BALB/cB1+/- and 129B2+/- mice. These observations are consistent with the hypothesis that compromised DNA repair processes in cells harboring Brca1 or Brca2 mutations lead to inhibited growth and differentiation compared with the proliferative response of wild-type cells to DES treatment.

Echovirus infection of rhabdomyosarcoma cells is inhibited by antiserum to the complement control protein CD59

A number of echoviruses use decay accelerating factor (DAF) as a cellular receptor or attachment protein for cell infection. Binding of echovirus 7 to DAF at the cell surface, but not to soluble DAF in solution, triggers the formation of virus particles exhibiting an altered sedimentation coefficient ('A' particles) which are considered indicative of the particle uncoating process. We have previously demonstrated that antibodies to beta(2)-microglobulin block cell infection at a stage prior to 'A' particle formation and suggested that this reflects the involvement of beta(2)-microglobulin (or the associated MHC-I) in a virus-receptor complex that forms at the cell surface. We demonstrate here that antiserum to CD59 specifically blocks infection of rhabdomyosarcoma cells by a range of echoviruses, including viruses that bind DAF (e. g. echovirus 7) and those that use currently unidentified receptors other than DAF. The block occurs prior to 'A' particle formation and is cell-type specific. The potential role of CD59 as an active member, or passive participant, in the virus-receptor complex is discussed.

Fatty acid-depleted albumin induces the formation of echovirus A particles

Picornavirus infection requires virus uncoating, associated with the production of 135S "A" particles and 80S empty particles from 160S mature virions, to release the RNA genome into the cell cytoplasm. Normal albumin inhibits this process. We now show that when depleted of fatty acids, albumin induces the formation of echovirus A particles.

Correcting pretentious pronouns

If pronouns following prepositions or verbs sound lofty or pretentious, they probably are. Without attention to grammar rules, nurse authors and editors can make common mistakes by selecting the wrong form of the pronoun. Pronouns following prepositions and transitive verbs should be the objective form of the pronoun, not the subjective form. These experienced editors describe the rule, suggest a quick-fix tip, and provide several practice items followed by answers.

A theory of mind perspective on cognitive, affective, and intimacy deficits in child sexual offenders

Previous work in the area of sexual offending has suggested that factors such as intimacy deficits, problems empathizing with victims, and cognitive distortions have all been associated with the genesis and maintenance of sexual abuse. While researchers have constructed theories to account for the role of these variables in sexual offending, a framework that unites their study is lacking. Recently Ward, Keenan, and Hudson have proposed that sexual offenders may suffer from a deficit in their ability to understand and attribute mental states to others. Their review of the literature on the etiology of sexual offending suggested that intimacy deficits, empathy deficits, and cognitive distortions all point to a lack of awareness of other peoples' beliefs, desires, perspectives, and needs, what is commonly referred to in the developmental literature as a theory of mind. In this paper, we expand on this argument, illustrating some of the developmental pathways by which deficits in one's theory of mind can explain the pattern of deficits exhibited by many sexual offenders.

Primary renal hypoplasia in humans and mice with PAX2 mutations: evidence of increased apoptosis in fetal kidneys of Pax2(1Neu) +/- mutant mice

PAX2 mutations cause renal-coloboma syndrome (RCS), a rare multi-system developmental abnormality involving optic nerve colobomas and renal abnormalities. End-stage renal failure is common in RCS, but the mechanism by which PAX2 mutations lead to renal failure is unknown. PAX2 is a member of a family of developmental genes containing a highly conserved 'paired box' DNA-binding domain, and encodes a transcription factor expressed primarily during fetal development in the central nervous system, eye, ear and urogenital tract. Presently, the role of PAX2 during kidney development is poorly understood. To gain insight into the cause of renal abnormalities in patients with PAX2 mutations, kidney anomalies were analyzed in patients with RCS, including a large Brazilian kindred in whom a new PAX2 mutation was identified. In a total of 29 patients, renal hypoplasia was the most common congenital renal abnormality. To determine the direct effects of PAX2 mutations on kidney development fetal kidneys of mice carrying a Pax2 (1Neu)mutation were examined. At E15, heterozygous mutant kidneys were approximately 60% of the size of wild-type littermates, and the number of nephrons was strikingly reduced. Heterozygous 1Neu mice showed increased apoptotic cell death during fetal kidney development, but the increased apoptosis was not associated with random stochastic inactivation of Pax2 expression in mutant kidneys; Pax2 was shown to be biallelically expressed during kidney development. These findings support the notion that heterozygous mutations of PAX2 are associated with increased apoptosis and reduced branching of the ureteric bud, due to reduced PAX2 dosage during a critical window in kidney development.

The Brn-3b POU family transcription factor represses expression of the BRCA-1 anti-oncogene in breast cancer cells

The BRCA-1 tumour supressor gene was identified on the basis of mutations which occur in familial breast cancer indicating that its inactivation can cause this disease. Although BRCA-1 does not appear to be mutated in sporadic breast cancer, its expression has been shown to be reduced in tumour material from such cases. We show here that mammary tumours which have reduced levels of BRCA-1 expression show enhanced expression of the Brn-3b POU family transcription factor at both the mRNA and protein levels. This elevated expression of Brn-3b is not found in normal mammary cells, benign tumours or in malignant tumour samples which do not exhibit reduced levels of BRCA-1. In contrast, no correlation was noted between BRCA-1 and expression of the related factor Brn-3a. Moreover, Brn-3b but not Brn-3a can strongly repress the BRCA-1 promoter approximately 20-fold in mammary tumour cells. To our knowledge, this is the first report of a transcription factor which regulates BRCA-1 expression. Thus, Brn-3b may play an important role in regulating expression of BRCA-1 in mammary tumours with enhanced expression of Brn-3b resulting in reduced BRCA-1 expression and thereby being potentially important in tumour development.

Mental disorder and cross-cultural psychology: a constructivist perspective

The predominant Western approach to understanding mental disorder, as indicated in the Diagnostic and Statistical Manual of Mental Disorders (DSM), is based on a biomedical perspective which sees mental disorders as "natural kinds" or discrete entities which manifest as dysfunction within individuals. Following from this is the view that the DSM's primary syndromes are universal, based on the assumption that this dysfunction is similar across diverse human populations. The cross-cultural literature, however, reveals significant differences in the manifestation of these syndromes across ethnic groups, thereby challenging the universalist position. In response to this shortcoming of the predominant contemporary conceptualization of mental disorder, a constructivist approach is offered which, it is argued, has a number of important advantages over the traditional view. Finally, the implications of a constructivist definition are discussed, demonstrating the important connection between theory and practice.

Tension-free mesh hernia repair: recovery and recurrence after one year

The outcome of 200 consecutive patients with inguinal hernias repaired by the tension-free mesh technique at a specialist clinic was assessed one year after operation. There were no recurrences and no major complications. The wound infection rate was 1%. Less than 10% of patients had only minor complaints and 99% of patients were satisfied or very satisfied with the operation and its outcome. Low recurrence rates after one year imply low long-term recurrence and testify to the benefits of a specialist approach.

Serum albumin inhibits echovirus 7 uncoating

Echoviruses induce a wide spectrum of diseases in man, the most severe being meningitis. In neonates, however, a severe systemic infection can be observed, leading to death. Serum albumin is the most abundant protein in plasma and most interstitial fluids, and its functions include osmoregulation and transport and delivery of hydrophobic molecules such as fatty acids and steroids. The results of cold-synchronized one-step growth analysis of echovirus 7 infection and sucrose-gradient analysis of A-particles suggest that physiological concentrations of albumin block echovirus 7 infection by inhibiting uncoating. The blockage was reversible and was still effective when albumin was added 30 min after virus adsorption. Inhibition of uncoating was confirmed by using rhodanine, a known specific inhibitor of echovirus uncoating. After removal of the albumin blockage, addition of rhodanine perpetuated the inhibition. Serum and interstitial albumin concentrations may limit echovirus infection in vivo and thereby act as an extracellular determinant for echovirus tropism.

Culture and classification: the cross-cultural application of the DSM-IV

Changes incorporated into the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) include a number of features designed to enhance its cross-cultural applicability. However, the overt move toward a culture-sensitive nosology is undermined by an implicit assumption of the universality of its primary syndromes. In this review we argue that the DSM-IV's underlying thesis of universality based on Western-delineated mental disorders is problematic and has limited cross-cultural applicability. Research on the cross-cultural manifestation of schizophrenia and depression shows that presentation of these disorders varies significantly across cultures. We conclude by discussing the research and clinical implications of these findings.

Characterization of echoviruses that bind decay accelerating factor (CD55): evidence that some haemagglutinating strains use more than one cellular receptor

Several echoviruses (EVs) have previously been shown to use decay accelerating factor (DAF) as a cellular receptor. Since DAF is expressed on erythrocytes, EVs that use this receptor cause haemagglutination. Here we show that all EVs that haemagglutinate do so via attachment to DAF and that this interaction can be inhibited by a monoclonal antibody (MAb) specific for DAF domain SCR3. Although the viruses haemagglutinate via DAF some can bind to rhabdomyosarcoma cells from which DAF has been removed and infect in the presence of a MAb against DAF. This suggests that some EVs have the capacity to interact with more than one cellular receptor.

MerMade: an oligodeoxyribonucleotide synthesizer for high throughput oligonucleotide production in dual 96-well plates

We have designed and constructed a machine that synthesizes two standard 96-well plates of oligonucleotides in a single run using standard phosphoramidite chemistry. The machine is capable of making a combination of standard, degenerate, or modified oligos in a single plate. The run time is typically 17 hr for two plates of 20-mers and a reaction scale of 40 nM. The reaction vessel is a standard polypropylene 96-well plate with a hole drilled in the bottom of each well. The two plates are placed in separate vacuum chucks and mounted on an xy table. Each well in turn is positioned under the appropriate reagent injection line and the reagent is injected by switching a dedicated valve. All aspects of machine operation are controlled by a Macintosh computer, which also guides the user through the startup and shutdown procedures, provides a continuous update on the status of the run, and facilitates a number of service procedures that need to be carried out periodically. Over 25,000 oligos have been synthesized for use in dye terminator sequencing reactions, polymerase chain reactions (PCRs), hybridization, and RT-PCR. Oligos up to 100 bases in length have been made with a coupling efficiency in excess of 99%. These machines, working in conjunction with our oligo prediction code are particularly well suited to application in automated high throughput genomic sequencing.

Role for beta2-microglobulin in echovirus infection of rhabdomyosarcoma cells

A monoclonal antibody (MAb) that blocks most echoviruses (EVs) from infecting rhabdomyosarcoma (RD) cells has been isolated. By using the CELICS cloning method (T. Ward, P. A. Pipkin, N. A. Clarkson, D. M. Stone, P. D. Minor, and J. W. Almond, EMBO J. 13:5070-5074, 1994), the ligand for this antibody has been identified as beta2-microglobulin (beta2m), the 12-kDa protein that associates with class I heavy chains to form class I HLA complexes. A commercial MAb (MAb 1350) against beta2m was also found to block EV7 infection without affecting binding to its receptor, DAF, or replication of EV7 viral RNA inside cells. Entry of EV7 into cells was reduced by only 30% by antibody and cytochalasin D, an inhibitor of endocytosis mediated by caveolae and clathrin-coated pits, but was not significantly reduced by sodium azide. The block to virus entry by cytochalasin D was additive to the block induced by antibody. We suggest that EV7 rapidly enters into a multicomponent receptor complex prior to entry into cells and that this initial entry event requires beta2m or class I HLA for infection to proceed.

[Avascular femur head necrosis as severe complication after femoral intramedullary nailing in children and adolescents]

Nailing of femoral fractures before closure of the growth plates may lead to avascular necrosis of the femoral head in 3-4% of cases. In addition to the 14 cases described in the literature we present 3 more. Analysis of these cases reveals a common pathogenesis. The nails were all inserted anterograde and were designed for the adult femur. The problem appears to be related to the large diameter of the nail and its entry point in the relatively small femoral neck basis, close to the vessels supplying the femoral head. The role of the open physis remains unclear. Even though the complication of femoral head necrosis is rare, it is a severe complication. Therefore we do not recommend anterograde femoral nailing, using the classic entry point, in children or adolescents. We believe that there is a need for a new design of femoral nail. If both femoral head necrosis and coxa valga are to be avoided, we suggest that the entry point of the nail should be dorsolateral, below the trochanteric physis.

Patellofemoral contact forces and pressures during intramedullary tibial nailing

Patellofemoral joint forces and pressures were measured in a cadaver model during intramedullary nailing of the tibia. A significant increase in contact pressures was found at the lateral facet of the patellofemoral articulation using the medial paratendinous approach (P = 0.01) and at the medial facet when using the trans-patellar tendon approach (P = 0.001) to the proximal tibia. Increased contact pressures at the patello-femoral joint may result in chondral injury, which in turn may cause anterior knee pain, a common complication of tibial nailing.

Hemagglutination inhibition of Cromer blood group antibodies with soluble recombinant decay-accelerating factor

BACKGROUND

Cromer blood group antigens are located on decay-accelerating factor (DAF, CD55), which contains four short consensus repeats (SCRs). Cromer system antibodies may be of clinical significance in blood transfusion.

STUDY DESIGN AND METHODS

Soluble recombinant DAF (srDAF) constructs, consisting of all four SCRs or of only two SCRs, were expressed in the yeast Pichia pastoris. They are used in hemagglutination-inhibition tests with Cromer system antibodies and with DAF-specific monoclonal antibodies.

RESULTS

The srDAF inhibited hemagglutination by all Cromer system alloantibodies in undiluted serum. Antibodies to antigens of other blood group systems were not inhibited by the srDAF. Hemagglutination-inhibition tests with domain-deleted srDAF showed that UMC is on SCR-4 and confirmed that Tca, TcaTcb, and WESb are on SCR-1; Dra is on SCR-3; and Cra is on SCR-4.

CONCLUSIONS

Hemagglutination inhibition with srDAF is useful in the recognition of antibodies that belong to the Cromer blood group system and facilitates pretransfusion testing. This use of domain-deleted srDAF provides an easy method of determining epitope location on DAF and is an aid to more precise identification of Cromer system antibodies.

Acyclovir use and survival among human immunodeficiency virus-infected patients with CD4 cell counts of < 500/mm3. The Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA)

To examine the relationship between acyclovir use and survival in AIDS, we performed a retrospective analysis of data collected through an observational cohort of the 17-site Community Program for Clinical Research on AIDS (CPCRA), under the sponsorship of the National Institute of Allergy and Infectious Diseases. Data were analyzed regarding 2,368 patients with CD4+ lymphocyte counts of < 500/mm3, and 7,836 follow-up visits were conducted from September 1990 to July 1994. Factors associated with use of acyclovir were studied by stratified analysis of variance and Mantel-Haenzel chi 2 tests. The association between acyclovir and survival was studied with use of the proportional hazards regression model. Individuals reporting acyclovir use were more likely to be white, male, and homosexual; to have a history of herpes simplex and zoster; and to have lower CD4+ T cell counts than those who did not. After adjustments for differences in baseline factors, acyclovir use was not associated with prolonged survival.

Real time confocal laser scanning microscopy: potential applications in space medicine and cell biology

Photodynamic therapy (PDT), in which tissues may be rendered fatally light-sensitive represents a relatively novel treatment for cancer and other disorders such as cardiovascular disease. It offers significant application to disease control in an isolated environment such as space flight. In studying PDT in the laboratory, low energy lasers such as HeNe lasers are used to activate the photosensitized cellular target. A major problem associated with these studies is that events occurring during actual exposure of the target cells to the system cannot be examined in real time. In this study HeLa cells were photosensitized and photodynamic activation was accomplished using the scanning microbeam from a confocal laser scanning microscope. This form of activation allowed for simultaneous photoactivation and observation and facilitated the recording of events at a microscopic level during photoactivation. Effects of photodynamic activation on the target cells were monitored using the fluorophores rhodamine 123 and ethidium homodimer-1. Potential applications of these forms of analyses to space medicine and cell biology are discussed.

Interaction between echovirus 7 and its receptor, decay-accelerating factor (CD55): evidence for a secondary cellular factor in A-particle formation

Soluble forms of decay-accelerating factor (DAF) (CD55), the receptor for echovirus 7, were synthesized in the yeast Pichia pastoris. Purified recombinant protein containing SCR domains 2, 3, and 4, but lacking the serine/threonine rich region, was shown to block infection of susceptible cells by echovirus 7. In contrast to the situation with poliovirus and its receptor, the neutralization of echovirus 7 by soluble DAF was completely reversible and did not lead to the formation of 135S A-particles. Binding of virus to susceptible cells, by contrast, did lead to the formation of A particles, mainly from virus that had been internalized. The data suggest that a secondary factor(s) may contribute to A-particle formation and uncoating of echovirus 7.

A note of caution for clinicians using the Paced Auditory Serial Addition Task

In this study, a group of 30 university students were administered the Paced Auditory Serial Addition Task (PASAT) and their performance compared with that of an older group matched for ability on the National Adult Reading Test (NART). They were also compared on measures of memory (forwards and backwards digit span) and a timed visual search task. The younger participants showed significantly inferior performance on the PASAT. This is counter-intuitive considering that the test is viewed primarily as a measure of speed of processing. There were no differences on measures of short-term memory, but the older participants found fewer targets on the visual search task. The implications of this result for clinicians using the PASAT are discussed.

Evaluation of stress prevention and management workshops in the community

Little emphasis has been placed by clinicians on the need for routine evaluation of outcomes of community mental health nursing interventions. Although numerous descriptive studies exist, there is little systematic evaluation of the work of community mental health nurses, and this problem is particularly acute in the field of preventative work. This paper presents the results of a small initiative to incorporate outcome evaluation into the clinical work of a community mental health team. Ninety-nine participants in a series of stress management workshops completed stress questionnaires before a series of 2-day workshops and were followed up at between 3 and 6 months afterwards. At follow-up, participants reported greater gains in terms of stress management than did no-treatment controls. The study offers tentative evidence for the effectiveness of community mental health nurses in offering effective preventative interventions and also indicates that such interventions are amenable to outcome evaluation within the context of routine clinical practice.

Electric field-enhanced activation of hematoporphyrin derivative: effects on a human tumour cell line

In a recent report we described the effects of combined electroactivation and photoactivation of hematoporphyrin derivative (HPD) on human erythrocytes and established that activation-induced cell lysis was more pronounced when both modes of activation were sequentially applied to the system. Here we demonstrate that electric field-induced activation of HPD-treated HeLa cells results in cell death. This effect is shown to be dependant on both electric field strength and on HPD concentration. In addition, we demonstrate that exposure of HPD-treated cells to short and intense electric pulses prior to photoactivation, results in increased cell mortality. The results confirm our earlier suggestion that HPD may be activated in the presence of an applied electric field. The results further suggest that activation of photosensitizers using combined exposure to electric fields and light may play an important role in increasing the efficiency of photodynamic therapy (PDT) in the treatment of cancer.

Rape and rapists: theory and treatment

The sexual assault of adult women is noteworthy by its huge social and personal cost to the victims, their families, and ultimately society as a whole. The past decade has seen burgeoning research and clinical interest regarding child molesters but a lack of equivalent effort concerning rapists. Rapists are significantly different from child molesters. While considerable heterogeneity exists within this group, there is a lack of distinctiveness when compared to the wider population of serious criminal offenders. These two features of rapists have implications both for research and treatment. We also argue that despite the advances of the last decade this has been in terms of theory proliferation rather than integration, and that major explanatory gaps remain. In particular, there is a need for more middle-level theory that articulates mechanisms and can underpin treatment. Current treatment approaches have typically been developed for child molesters, and while there has been a significant increase in comprehensiveness and sophistication, the evidence for treatment efficacy with rapists remains tentative. Treatment programs need to be tailored to the specific needs of rapists and to the issues of treatment engagement and completion. We conclude with a variety of suggestions for the research agenda over the next decade.

Localization of BRCA1 and a splice variant identifies the nuclear localization signal

Inherited mutations in BRCA1 confer susceptibility to breast and ovarian neoplasms. However, the function of BRCA1 and the role of BRCA1 in noninherited cancer remain unknown. Characterization of alternately spliced forms of BRCA1 may identify functional regions; thus, we constructed expression vectors of BRCA1 and a splice variant lacking exon 11, designated BRCA1 delta 672-4095. Immunofluorescence studies indicate nuclear localization of BRCA1 but cytoplasmic localization of BRCA1 delta 672-4095. Two putative nuclear localization signals (designated NLS1 and NLS2) were identified in exon 11; immunofluorescence studies indicate that only NLS1 is required for nuclear localization. RNA analysis indicates the expression of multiple, tissue-specific forms of BRCA1 RNAs; protein analysis with multiple antibodies suggests that at least three BRCA1 isoforms are expressed, including those lacking exon 11. The results suggest that BRCA1 is a nuclear protein and raise the possibility that splicing is one form of regulation of BRCA1 function by alteration of the subcellular localization of expressed proteins.

Cognitive distortions in sex offenders: an integrative review

Clinicians and researchers have noted that maladaptive beliefs and distorted thinking play an important role in facilitating or justifying sexual offenses. There have been a number of attempts to describe the nature of these beliefs and to develop ways of measuring them, but in the absence of any integrating theory. We suggest that an understanding of the cognitive processes underlying the initiation, maintenance, and justification of sexual offending is a vital prerequisite to the development of successful treatment programs. In this paper, we use a social cognition framework to review the literature on the role of cognition in sexual offending. Pertinent research in the sexual offending domain, specifically cognitive products, information processing, cognitive change, and the impact of affective and motivational factors on cognitive processes, is described and related to the social cognitive approach. Implications for future research and clinical practice are discussed in light of the major issues and problems highlighted in our review.

Cognitions of restrained and unrestrained eaters under fasting and nonfasting conditions

It has recently been suggested that the cognitions of unrestrained eaters and those of individuals with eating disorders are at opposing ends of a continuum, with restrained eaters occupying an intermediate position. The present study explored the everyday cognitions of 10 restrained and 10 unrestrained eaters under fasting and nonfasting conditions using a random thought-sampling technique. Analysis of the thought transcripts yielded a number of categories related to food, self, and others. The results revealed no differences between restrained and unrestrained eaters in terms of their relative percentages of thoughts about food and self. Differences were evident, however, in the nature of their cognitions. The results from this study suggest that the continuum hypothesis may hold only when it is the nature of cognitions, not their frequency, that is considered.

The structure of normal human attention: The Test of Everyday Attention

A range of tests of everyday attention is described, based on ecologically plausible activities such as searching maps, looking through telephone directories, and listening to lottery number broadcasts. An age-, sex- and IQ-stratified sample of 154 normal participants was given these tests, along with a number of existing tests of attention. The factor structure revealed by this data set matched well contemporary evidence for a set of functionally independent attentional circuits in the brain, and included factors for sustained attention, selective attention, attentional switching and auditory-verbal working memory. The Test of Everyday Attention (TEA), which was developed and standardized on the basis of these subtests, has three parallel forms, high test-retest reliability, and correlates significantly with existing measures of attention. Furthermore, selected subtests successfully discriminate among a number of brain-impaired groups, including closed head injury versus age-matched controls, minimal versus mild Alzheimer's disease, and progressive supranuclear palsy patients versus age-matched controls.

The effects of electric fields on photosensitized erythrocytes: possible enhancement of photodynamic activation

In this study it has been found that exposure of photosensitized erythrocytes to short, intense electric pulses, resulted in cell lysis. When erythrocytes were photosensitized with increasing concentrations of the photosensitizer, hematoporphyrin derivative (HPD), and subjected to electric pulses in the absence of light, cell lysis increased with increasing photosensitizer concentration. In addition, it has been shown that exposure of photosensitized erythrocytes to electric field pulses of increasing field strength resulted in increased cell lysis. Light activation of photosensitized erythrocytes, pre-treated with electric pulses, also resulted in increased cell lysis. The results presented here suggest that HPD may be activated in the absence of light using electric pulses. We suggest that enhancement of activation by electric field stimulation may find application in increasing the overall efficiency of photodynamic therapy.

Use of real-time confocal laser scanning microscopy to study immediate effects of photodynamic activation on photosensitized erythrocytes

With a view towards the design of systems capable of combining the use of chemotherapy and photodynamic therapy in the treatment of cancer and other disorders, it has been proposed that photosensitized erythrocytes might be employed as carriers/vehicles for agents such as cancer chemotherapeutics. In studying the light dependent release of entrapped agents from such a system, the efficacy of light induced release is usually studied by measuring release of an entrapped component into centrifugation supernatants following photoactivation. It has hitherto been extremely difficult to examine what occurs upon immediate irradiation at the microscopic level in real-time. In this study we demonstrate that, using real-time confocal laser scanning microscopy, it is possible to directly observe immediate short-term events occurring during direct irradiation with the visualizing beam. Following irradiation of photosensitized erythrocytes with the visualizing beam form the confocal scanning system, it was noticed that some from of cell-disruptive event occurred. In this study we demonstrate a dose dependent response between this relatively immediate, light induced disruptive event with respect to both irradiation exposure and photosensitizer concentration. We suggest that this system may provide a novel means of observing, at a microscopic level, events occurring in real-time during photodynamic therapy.

Alkalophilic Bacillus sp. strain LG12 has a series of serine protease genes

Four tandem subtilisin-like protease genes were found on a 6,854-bp DNA fragment cloned from the alkalophilic Bacillus sp. strain LG12. The two downstream genes (sprC and sprD) appear to be transcribed independently, while the two upstream genes (sprA and sprB) seem to be part of the same transcript.

Characterization of the echovirus 7 receptor: domains of CD55 critical for virus binding

CD55, or decay-accelerating factor (DAF), is a cell surface glycoprotein which regulates complement activity by accelerating the decay of C3/C5 convertases. Recently, we and others have established that this molecule acts as a cellular receptor for echovirus 7 and related viruses. DAF consists of five domains: four short consensus repeats (SCRs) and a serine/threonine-rich region, attached to the cell surface by a glycosylphosphatidyl inositol anchor. Chinese hamster ovary cells stably transfected with deletion mutants of DAF or DAF-membrane cofactor protein recombinants were analyzed for virus binding. The results indicate that the binding of echovirus 7 to DAF specifically requires SCR2, SCR3, and SCR4. There is also a nonspecific requirement for the S/T-rich region which probably functions to project the binding region away from the cell membrane. The three nonpeptide modifications of DAF, N-linked glycosylation, O-linked glycosylation, and the glycosylphosphatidyl inositol anchor, are not required for virus binding. The SCRs of membrane cofactor protein, the closest known relative of DAF, cannot substitute for those of DAF with retention of virus binding activity. The monoclonal antibody used to identify DAF as an echovirus receptor, and which inhibits binding of the virus (monoclonal antibody 854), binds to SCR3.

The proper focus of nursing: a critique of the "caring" ideology

Some nurse educators in the United Kingdom are following the lead of North American theorists by asserting that caring "is" the core of nursing. This paper offers a focused critique of the caring ideology, through an examination of: (a) the views of a founding figure in the "caring" movement, and (b) a proposal for the integration of a "caring curriculum" within Project 2000. An overview of the "caring" literature prefaces an examination of Watson's notion of a "science of caring". Finally, Kirby and Slevin's recent proposals for a "curriculum of care" are examined in terms of their necessity and practicality.

Mycoprotein reduces glycemia and insulinemia when taken with an oral-glucose-tolerance test

This study investigated the effects of mycoprotein, a food produced by the continuous fermentation of Fusarium graminearum (Schwabe), on acute glycemia and insulinemia in normal healthy individuals. Subjects participated in two single-meal study periods in a crossover design. After an overnight fast, subjects were given milkshakes containing mycoprotein or a control substance, which were isoenergetic and nutrient balanced. Each milkshake contained 75 g carbohydrate, equivalent to a standard World Health Organization oral-glucose-tolerance test. Blood samples were taken fasting and at 30, 60, 90, and 120 min postprandially for the measurement of serum glucose and insulin. Glycemia was reduced postmeal after mycoprotein compared with the control and was statistically significant at 60 min (13% reduction). Insulinemia was reduced postmeal after mycoprotein compared with the control and was statistically significant at 30 min (19% reduction) and 60 min (36% reduction) postmeal. These results may be significant in the dietary treatment of diabetes.

Decay-accelerating factor CD55 is identified as the receptor for echovirus 7 using CELICS, a rapid immuno-focal cloning method

Using an anti-receptor mAb that blocks the attachment of echovirus 7 and related viruses (echoviruses 13, 21, 29 and 33), we have isolated a complementary DNA clone that encodes the human decay-accelerating factor (CD55). Mouse cells transfected with the CD55 clone bind echovirus 7, and this binding is blocked by the anti-receptor mAb. The method used (CELICS) allows rapid and direct cloning of genes encoding cell surface receptors. It is based on episomal replication and high efficiency expression of complementary DNA clones in the vector pCDM8 in COS or WOP cells, in conjunction with a sensitive immuno-focal screen that uses antibody probes linked to beta-galactosidase. Receptor positive cells were identified by a colour change and isolated individually using a micromanipulator. DNA extracted from a small number of cells was then cloned directly in Escherichia coli.

Contribution of secondaries to the radiation environment on space missions

Calculations to predict the radiation environment for spacecraft in low earth orbit sometimes ignore the contribution from secondary radiation products. However, the contribution of secondaries, particularly neutrons, on heavy spacecraft or in planetary bodies can be of concern for biological systems. The Shuttle Activation Monitor (SAM) and Cosmic Radiation Effects and Activation Monitor (CREAM) experiments provide valuable data on secondary (as well as primary) radiation effects. Comparisons have been made between induced activity from flight-exposed samples, induced activity in a ground-irradiated sample, and Monte Carlo-derived predictions with and without secondaries. These comparisons show that for a flight-exposed sample, predictions which omit the secondary contribution result in a spectrum that is too low by a factor of 2. The addition of the secondaries results in a predicted spectrum that closely matches the measured data.

The abstinence violation effect in child molesters

The reformulation of the abstinence violation effect (AVE) is briefly described together with the empirical support for the construct. Twenty-six incarcerated male child molesters were assessed, using the Differential Emotions Scale and the Attributional Dimension Scale, at three points (high-risk, lapse, and relapse) while they listened to an audiotaped recording of a description of their most typical offense chain. Eighteen Ss experienced an AVE at the point of relapse and 7 as a result of lapse. There were significant increases in most negative emotions and decreases in interest over the relapse chain. There were significantly higher disgust, contempt, hostility, fear, shame, shyness and anger scores reported by those showing an AVE. Conversely, the AVE group showed significantly lower scores for joy and surprise. There were no significant differences on any of the 4 attributional dimensions across the relapse process but those showing an AVE reported significantly more uncontrollability and higher stability scores. The significance of these results for clinical practice are discussed.

'Corynebacterium ulcerans': a potential cause of diphtheria

Symptoms similar to those of diphtheria may occasionally be caused by micro-organisms other than Corynebacterium diphtheriae, such as zoonotic corynebacteria. A case of pharyngitis caused by toxigenic 'C. ulcerans' in a 9 year old girl illustrates the importance of including diphtheroids in the differential diagnosis. The presenting symptoms may have been attenuated by previous immunisation against C. diphtheriae. 'C. ulcerans' should be considered in the differential diagnosis of pharyngitis, especially in patients with a history of contact with farm animals or the consumption of raw dairy products.

The relevance of drug injectors' social and risk networks for understanding and preventing HIV infection

Focusing on the social environment as well as the individual should both enhance our understanding of HIV transmission and assist in the development of more effective prevention programs. Networks are an important aspect of drug injectors' social environment. We distinguish between (1) risk networks (the people among whom HIV risk behaviors occur) as vectors of disease transmission, and (2) social networks (the people among whom there are social interactions with a mutual orientation to one another) as generators and disseminators of social influence. These concepts are applied to analyses of data from interviews with drug injectors in two studies. In the first study drug injectors' risk networks converge with their social networks: 70% inject or share syringes with a spouse or sex partner, a running partner, or with friends or others whom they know. Qualitative data from interviews with injectors in the second study also show that the social relationships between drug injectors and members of their risk network are often based on long-standing and multiplex relationships, such as those based on kinship, friendship, marital and sexual ties, and economic activity. In the first study the vast majority of injectors, over 90%, have social ties with non-injectors. Injectors with more frequent social contacts with non-injectors engage in lower levels of injecting risk behavior. Risk settings may function as risk networks: injectors in this study who inject at shooting galleries are more likely than those who do not to rent used syringes, borrow used syringes and inject with strangers. Since the adoption of a network approach is relatively new, a number of issues require further attention. These include: how to utilize social networks among drug injectors to reduce risk through peer pressure; how to promote risk reduction by encouraging ties between injectors and non-injectors; and how to integrate biographical and historical change into understanding network processes. Appropriate methodologies to study drug injectors' networks should be developed, including techniques to reach hidden populations, computer software for managing and analyzing network data bases, and statistical methods for drawing inferences from data gathered through dependent sampling designs.

The abstinence violation effect in bulimia nervosa

Bulimia nervosa often follows a chronic and relapsing course. To understand relapse in this disorder, we highlight cognitive processes underlying the binge/purge cycle. Links are drawn between cognitions, causal perceptions, and the binge/purge cycle in a reformulation of the abstinence violation effect with a special focus on attributions. This reformulation is then applied to the lapse-relapse transition in bulimia nervosa. Finally, theoretical and clinical implications of the reformulation are presented.

A comparison of 5-fluorouridine and 5-fluorouracil in an experimental model for the treatment of vitreoretinal scarring

5-Fluorouridine (5-FUR), a ribonucleotide metabolite of 5-Fluorouracil (5-FU), is a more potent inhibitor of cellular proliferation and cell-mediated contraction in vitro than 5-FU. We compared the efficacy of these two drugs in a cell injection model of proliferative vitreoretinopathy using New Zealand albino rabbits. Forty-five eyes were divided into three groups and injected intravitreally with homologous fibroblasts. Eyes were examined at the time of injection and 7, 14, 21 and 28 days thereafter. By day 28, 70.5% (12 of 17) of 5-FUR treated eyes demonstrated no appreciable proliferative or tractional activity compared with 41.7% (5 of 12) of 5-FU treated eyes and 10% (1 of 10) of control eyes (p < 0.006). Medullary ray puckers developed in 29.4% (5 of 17) and 25% (3 of 12) of 5-FUR and 5-FU treated eyes respectively. No 5-FUR treated eye developed extensive tractional or combined tractional and rhegmatogenous retinal detachment compared with 33.3% (4 of 12) of 5-FU treated eyes and 80% (8 of 10) of control eyes (p < 0.001). These results suggest that 5-Fluorouridine may be more effective than 5-FU for the treatment of vitreoretinal scarring.