Association between patterns of nucleotide variation across the three fibrinogen genes and plasma fibrinogen levels: the Coronary Artery Risk Development in Young Adults (CARDIA) study

BACKGROUND

Previous genotype-phenotype association studies of fibrinogen have been limited by incomplete knowledge of genomic sequence variation within and between major ethnic groups in FGB, FGA, and FGG.

METHODS

We characterized the linkage disequilibrium patterns and haplotype structure across the human fibrinogen gene locus in European- and African-American populations. We analyzed the association between common polymorphisms in the fibrinogen genes and circulating levels of both 'functional' fibrinogen (measured by the Clauss clotting rate method) and total fibrinogen (measured by immunonephelometry) in a large, multi-center, bi-racial cohort of young US adults.

RESULTS

A common haplotype tagged by the A minor allele of the well-studied FGB-455 G/A promoter polymorphism (FGB 1437) was confirmed to be strongly associated with increased plasma fibrinogen levels. Two non-coding variants specific to African-American chromosomes, FGA 3845 A and FGG 5729 G, were each associated with lower plasma fibrinogen levels. In European-Americans, a common haplotype tagged by FGA Thr312Ala and several other variant alleles across the fibrinogen gene locus was strongly associated with decreased fibrinogen levels as measured by functional assay, but not by immunoassay. Overall, common polymorphisms within the three fibrinogen genes explain < 2% of the variability in plasma fibrinogen concentration.

CONCLUSIONS

In young adults, fibrinogen multi-locus genotypes are associated with plasma fibrinogen levels. The specific single nucleotide polymorphism and haplotype patterns for these associations differ according to population and also according to phenotypic assay. It is likely that a substantial proportion of the heritable component of plasma fibrinogen concentration is due to genetic variation outside the three fibrinogen genes.

Local Hydration Environments of Amino Acids and Dipeptides Studied by X-ray Spectroscopy of Liquid Microjets

The nitrogen K-edge spectra of aqueous proline and diglycine solutions have been measured by total electron yield near-edge X-ray absorption fine structure (NEXAFS) spectroscopy at neutral and high pH. All observed spectral features have been assigned by comparison to the recently reported spectrum of aqueous glycine and calculated spectra of isolated amino acids and hydrated amino acid clusters. The sharp preedge resonances at 401.3 and 402.6 eV observed in the spectrum of anionic glycine indicate that the nitrogen terminus is in an "acceptor-only" configuration, wherein neither amine proton is involved in hydrogen bonding to the solvent, at high pH. The analogous 1s --> sigma(NH) preedge transitions are absent in the NEXAFS spectrum of anionic proline, implying that the acceptor-only conformation observed in anionic glycine arises from steric shielding induced by free rotation of the amine terminus about the glycine CN bond. Anionic diglycine solutions exhibit a broadened 1s --> pi(CN) resonance at 401.2 eV and a broad shoulder resonance at 403 eV, also suggesting the presence of an acceptor-only species. Although this assignment is not as unambiguous as for glycine, it implies that the nitrogen terminus of most proteins is capable of existing in an acceptor-only conformation at high pH. The NEXAFS spectrum of zwitterionic lysine solution was also measured, exhibiting features similar to those of both anionic and zwitterionic glycine, and leading us to conclude that the alpha amine group is present in an acceptor-only configuration, while the end of the butylammonium side chain is fully solvated.

Physiological and biomechanical responses while running with and without a stroller

AIM

This study examined the effects of pushing a jogging stroller on biomechanical and physiological variables. The hypothesis was that running with a stroller for 30 minutes would shorten stride length and increase physiological indices of exercise.

METHODS

EXPERIMENTAL DESIGN

this was a repeated measures design.

SETTING

participants were recruited from road races in the Dallas/Fort Worth, TX area. Graded exercise tests were performed in a laboratory setting, field tests were performed on a 400 m all-weather outdoor track.

PARTICIPANTS

5 males and 5 females were assessed.

INTERVENTIONS

participants performed a graded exercise test and 2 field tests. The 1st field test involved running at 75% VO2max for 30 minutes without a stroller and the 2nd involved running at the same speed with the stroller.

MEASURES

VO2, stride length, heart rate, lactate, ventilation, and RPE were evaluated.

RESULTS

No differences for VO2 or stride length were evident. Heart rate (p=0.0001), lactate concentration (p=0.025), ventilation (p=0.009), and RPE (p=0.002) increased from 10 to 30 minutes while running with the stroller. Heart rate (p=0.002), lactate concentration (p=0.0001), ventilation (p=0.006), and RPE (p=0.001) were significantly higher while running with the stroller after 30 minutes compared to running without it.

CONCLUSION

These results indicate that pushing a stroller affects some indices of exercise intensity while running. Gait does not change. These data do not support an association between stroller use during running and an increase risk of orthopedic injury. Further studies should examine these variables at lower intensities that are run by most recreational joggers.

A study of the prevalence of significant increases in serum creatinine following angiotension-converting enzyme inhibitor administration

Angiontension-converting enzyme inhibitors (ACEIs) are beneficial in the treatment of diabetic and nondiabetic kidney disease, coronary artery disease and congestive heart failure. One adverse effect of ACEIs use is a rise in serum creatinine and potential renal failure. This paper attempts to quantify this risk and assess the need for pre- and post-ACEI serum creatinine measurements. A computerized search of Kaiser Permanente Northwest's electronic medical record was conducted to find patients over the age of 40 years taking lisinopril between July 1, 2000 and June 30, 2002. Patient demographic information and presence in diabetes and coronary artery disease registries was collected. A subsequent search for pre- and postlisinopril serum creatinine levels within 6 months of initial lisinopril prescription was conducted. Patients with prelisinopril creatinine < or = 1.2 mg/dl and postlisinopril creatinine > 2.5 mg/dl underwent chart review to discern adverse events associated with the rise in serum creatinine. A total of 18,977 patients were prescribed lisinopril between July 1, 2000 and June 30, 2002. In all 13 166 patients had a pre- and postlisinopril creatinine checked. In all, 31 patients had a rise in creatinine from < or = 1.2 mg/dl to > 2.5 mg/dl (0.2%). Possible contributors to rise in creatinine included congestive heart failure, dehydration and infection. No patients developed end-stage renal disease, although three died. In conclusion, end-stage renal disease is an unlikely outcome among patients prescribed lisinopril and is most likely associated with other events.

[Fetal neurological evaluation]

AIM

To review recent advances in the procedures and techniques that have made possible to evaluate the anatomy and function of the central nervous system (CNS) in the fetus.

DEVELOPMENT

The neurological evaluation of the fetus can be performed at different levels: clinical, anatomical and functional. At a clinical level the analysis of body, ocular or respiratory fetal movements, as well as fetal heart rate, defines 4 behavioural states: 1F and 2F correspond to the quiet and active sleep, respectively. States 3F and 4F occur during wakefulness in the newborn, but there is no scientific evidence that the fetus is awake. Behavioral states probably play an important role in the process of CNS maturation and development. Anatomic evaluation of the CNS to rule out brain malformations can be performed with ultrasound since week 7-8 of gestational age and with magnetic resonance imaging (MRI) since week 18-20. Both techniques are also useful in the diagnosis of acquired fetal neurological diseases. Both modalities are concordant in the majority of cases, but in others each of them provides additional, different information. Computed tomography should only be used in selected cases that involve bone structures. Functional evaluation of fetal CNS can be performed with proton MR spectroscopy, which determines the cerebral content of inositol, choline, creatine and N-acetylaspartate. Other techniques to functionally study the fetal brain are functional MRI (fMRI), near infrared spectroscopy, and magnetoencephalography.

CONCLUSIONS

Fetal neurology is a discipline that will continue to develop fast in the immediate future. Technological advances will facilitate the possibility of a more rapid and reliable diagnosis of anatomic or functional abnormalities of the fetal CNS.

Measurement of the flux of ultrahigh energy cosmic rays from monocular observations by the High Resolution Fly's Eye experiment

We have measured the cosmic ray spectrum above 10(17.2) eV using the two air-fluorescence detectors of the High Resolution Fly's Eye observatory operating in monocular mode. We describe the detector, phototube, and atmospheric calibrations, as well as the analysis techniques for the two detectors. We fit the spectrum to a model consisting of galactic and extragalactic sources.

The evolving experience using everolimus in clinical transplantation

Everolimus is a derivative of sirolimus, a macrocyclic lactone, originally isolated from Streptomyces hygroscopicus. Both everolimus and sirolimus have a similar mechanism of action, exerting potent inhibition of growth factor-induced proliferation of lymphocytes, as well as other hematopoietic and nonhematopoietic cells of mesenchymal origin. Each agent complexes with the FK506 binding protein 12 to inhibit cyclin dependent kinase(s), collectively termed the target of rapamycin (TOR), causing G1-S phase cell cycle arrest. Safety and efficacy have been documented in large-scale, blinded, randomized, international clinical renal and cardiac transplant trials. Everolimus is more hydrophilic, exhibits a shorter elimination half-life (approximately 30 hours), and demonstrates greater relative bioavailability compared to sirolimus. However, similar to the calcineurin inhibitors and sirolimus, everolimus is biotransformed by the cytochrome P450, 3A4 isozyme. Also similar to sirolimus, clinical experiences identified biologically relevant side effects including hyperlipidemia and exacerbation of cyclosporine (CsA)-associated nephrotoxicity. However, also similar to sirolimus, accumulating evidence suggests that the hyperlipidemia can be controlled and the CsA-associated renal effects appear reduced with a low incidence of acute rejection when everolimus is administered in combination with reduced CsA doses. The experience using everolimus in cardiac transplantation has also provided potentially important insights into the consequences of antiproliferative effects on vascular smooth muscle cells and fibroblasts where reduction in intimal expansion was identified by intravascular coronary ultrasound examination among those patients receiving everolimus. Therefore, available results suggest that the introduction of everolimus as the newest TOR inhibitor should enhance therapeutic options for immunosuppression after organ transplantation.

Management of allergic rhinitis: a common part of practice in primary care clinics

BACKGROUND

Allergic rhinitis (AR) is an extremely common disease worldwide and one of the top-ten reasons for a visit to primary care clinics. This study aimed to investigate the understanding of current guidelines and concepts of management for AR among general practitioners (GPs) in Singapore.

METHODS

A postal questionnaire was designed to survey the dispensing practice and understanding of current guidelines in the management of AR among Singapore GPs.

RESULTS

Two hundred GPs completed the questionnaire. AR was estimated to be 10-40% of total patient visits in 50% of the primary care clinics surveyed. There was no significant difference in diagnosis and management of AR among GPs practicing solo, as a group or in polyclinics. The use of allergy tests (skin or in vitro tests) was <50%. Most physicians understood correctly the efficacy, side-effects, and cost effectiveness of first and newer generation H1-antihistamines and nasal glucocorticosteroids. However, first generation H1-antihistamines and oral/nasal decongestants are commonly used to reduce the cost of medication and to achieve quick relief from nasal obstruction.

CONCLUSION

Management of allergic rhinitis is common in primary care clinics. Quick symptomatic relief with low-cost medications is a major concern for GPs in the management of AR, as it will affect a patient's compliance and perception of efficacy. However, inappropriate use of decongestants and other nonevidence-based therapies should not be recommended. Implementing the current evidence-based international guidelines for AR needs to be improved.

Nanoscale solid-state quantum computing

Most experts agree that it is too early to say how quantum computers will eventually be built, and several nanoscale solid-state schemes are being implemented in a range of materials. Nanofabricated quantum dots can be made in designer configurations, with established technology for controlling interactions and for reading out results. Epitaxial quantum dots can be grown in vertical arrays in semiconductors, and ultrafast optical techniques are available for controlling and measuring their excitations. Single-walled carbon nanotubes can be used for molecular self-assembly of endohedral fullerenes, which can embody quantum information in the electron spin. The challenges of individual addressing in such tiny structures could rapidly become intractable with increasing numbers of qubits, but these schemes are amenable to global addressing methods for computation.

Sirolimus-based immunosuppression with reduce dose cyclosporine or tacrolimus after renal transplantation

Sirolimus (SRL), a fermentation product of Streptomyces hygroscopicus, complexes with the FKBP12 to inhibit cyclin dependent kinase(s), collectively termed the target of rapamycin (TOR), causing G(1)-S phase cell cycle arrest. Safety and efficacy have been documented in clinical renal transplantation, but concerns were raised due to important biologically relevant side effects. Hyperlipidemia was identified, beginning with early clinical experiences, and the unexpected findings that SRL may exacerbate CsA associated nephrotoxicity was observed during the pivotal phase III studies. This report details results of our experience using SRL (target trough concentration, 10-15 ng/mL) with low dose CsA (target trough concentration, 50-100 ng/mL), seeking to determine whether this approach might provide effective immunosuppression while reducing associated nephrotoxicity. Among 121 renal transplant recipients, 62 received the SRL based regimen and 59 received MMF with all patients receiving CsA and prednisone. Similar to earlier clinical experiences, hematopoeitic abnormalities and hyperlipidemia were observed among patients who received SRL, and those abnormalities were readily controlled. However, unlike observations from the phase III SRL studies, renal function was not adversely affected. These findings support the growing body of evidence indicating that SRL based immunosuppression in combination low dose calcineurin inhibitors and corticosteroids is safe, efficacious, and without associated renal toxicity.

Virulence of Rhizoctonia oryzae on Wheat and Barley Cultivars from the Pacific Northwest

Rhizoctonia oryzae (teleomorph = Waitea circinata) causes sheath spot of rice and root rot of wheat and barley. R. oryzae commonly is isolated from barley, wheat, and pea plants in eastern Washington and Idaho. Eight representative isolates were tested for virulence on spring barley (Hordeum vulgare cv. Baronesse), soft white winter wheat (Triticum aestivum cv. Madsen), and hard red spring wheat (cv. Scarlet) planted in natural soil in the greenhouse and maintained at 16°C. All isolates caused significant reduction of emergence in barley, but only seven of the eight isolates and one of the eight isolates reduced emergence of winter wheat and spring wheat, respectively. All isolates caused significant stunting and reduction in the number of seminal roots, root length, and number of root tips on wheat and barley. Some isolates also reduced the frequency of fine secondary roots, resulting in a reduction of the average root diameter. Spring barley was more susceptible to R. oryzae than winter or spring wheat. The main effects of both cultivar and isolate were significant, and there was a significant isolate-cultivar interaction. R. oryzae isolate 80042 was the most virulent on barley, whereas R. oryzae isolate 801387 was the most virulent on wheat. The two isolates from pea were intermediate in virulence on wheat and barley. When screening germ plasm for potential resistance, isolates exhibiting the maximum virulence for each host should be used.

Increased amyloid- levels in APPSWE transgenic mice treated chronically with a physiological high-fat high-cholesterol diet

Although plasma cholesterol levels are not generally associated with Alzheimer disease (AD) incidence, in vitro studies have found that increased cellular cholesterol levels are associated with increases in -amyloid (A ) production, with a concomitant decrease in sAPPa, the secreted non amyloidogenic fragment of the amyloid precursor protein (APP). In two previous studies using a mouse model for AD-like pathology, non-physiological high-cholesterol diet has been shown to increase plasma and cerebral cholesterol levels, but have resulted in conflicting results on cerebral A levels. In the present study APPSWE male transgenic mice were fed either a chow diet or a physiological high-fat high-cholesterol Western-type diet until the mice reached 1 year of age. Mice fed the Western type diet, compared to the low-fat chow diet, had increased body weight, plasma and cerebral cholesterol levels, as well as a 50% increase in cerebral A levels. Cerebral levels of total APP were not altered while cerebral apoE levels were increased in the mice fed the Western-type diet, versus the chow-fed mice. These data demonstrate that chronic intake of a non-toxic high-cholesterol diet, which is similar to a human diet in fat and cholesterol content, was effective in increasing A levels and further suggests that dietary cholesterol and/or fat may be a risk factor for AD.

Energy and phase velocity considerations required for attenuation and velocity measurements of anisotropic composites

Viscoelastic fibre-reinforced composite materials have a number of possible advantages for use in underwater acoustic applications. In order to exploit these materials it is important to be able to measure their complex stiffness matrix in order to determine their acoustic response. Ultrasonic transmission measurements on parallel-sided samples, employing broadband pulsed transducers at 2.25 MHz and an immersion method, have been used to determine the viscoelastic properties of a glass-reinforced composite with uniaxially aligned fibres. The composite measured was constructed from Cytecfiberite's CYCOM 919 E-glass. The theory of acoustic propagation in anisotropic materials shows that the direction of energy propagation is, in general, different from that given by Snell's Law. At 15 degrees incidence, Snell's Law implies a refracted angle of 40 +/- 2 degrees, whereas the energy direction is observed to be 70 +/- 2 degrees. Despite this, the experimental data indicates that the position of the receiving transducer has relatively little effect on the apparent phase velocity measured. The phase velocities measured at positions determined from the refracted angle and energy direction are 3647 and 3652 +/- 50 m s(-1), respectively. However, the amplitude of the received signal, and hence estimate of attenuation, is highly sensitive to the receiver position. This indicates that the acoustic Poynting vector must be considered in order to precisely determine the correct position of the receiving transducer for attenuation measurements. The beam displacement for a 17.6 mm sample at 15 degrees incidence is 9.5 and 40 mm by Snell's Law and Poynting's Theorem, respectively. Measured beam displacements have been compared with predictions derived from material stiffness coefficients. These considerations are important in recovering the complex stiffness matrix.

Rhinitis: do diagnostic criteria affect the prevalence and treatment?

BACKGROUND

Rhinitis is one of the world's most common health problems. Diagnostic criteria used in community surveys may affect reported prevalence and treatment.

METHODS

A proportionately stratified random sample study was performed to investigate the prevalence, comorbidities and management of community-based patients with rhinitis in the tropical urban city of Singapore.

RESULTS

The prevalence of at least one, two, three, or four nasal symptoms on most days during the past year in our study population was 25.5%, 13.1%, 6.5%, and 3.0%, respectively. Based on the definition of 'rhinitis' by the International Consensus Report (ICR), the prevalence was 13.1% in Singapore. There was significantly higher prevalence of self-reported allergy, asthma, and common cold/influenza-like illness among the rhinitis group. In the 53% of rhinitis subjects seeking for medical help, 71% visited a primary care physician and 20% an otolaryngologist. Treatments as reported by patients were decongestants (topical or oral) 27%, antibiotics 12%, antihistamines 6%, nasal steroids 3%, surgery 2%, traditional methods 28%, and 22% did not know what medication they had. Subjects considered the effectiveness of treatment unsatisfactory because the majority of them had only partial or no relief with any treatment.

CONCLUSIONS

The standardization of the definition of rhinitis in epidemiological studies is of crucial importance, especially when comparing the prevalence between studies. Appropriate patient education by physicians with a good understanding of the nature of rhinitis and the available treatment options (e.g. evidenced-based efficacy, safety, and a good cost-benefit ratio) will maximize patient compliance and treatment outcomes.

Cyclic stretch induces the expression of vascular endothelial growth factor in vascular smooth muscle cells

OBJECTIVE

Accumulating evidence links the release of vascular endothelial growth factor (VEGF) by vascular smooth muscle cells (VSMC) to normal endothelial cell (EC) function, repair and maintenance. Using an in vitro model we investigate the role of cyclic stretch on both the release of VEGF by VSMC and the phosphorylation of a VEGF receptor on EC.

METHODS

Bovine VSMC and EC were exposed to 10% cyclic strain for 4 hours. VEGF mRNA steady-state levels of VSMC were analysed by northern blot hybridisation. The presence of secreted VEGF from VSMC was determined by assaying the migration of EC. VEGF receptor phosphorylation on stretched EC was assayed by immunoblotting.

RESULTS

The steady-state level of VEGF mRNA in stretched VSMC increased 3.3 (+/- 0.6) fold above that of unstretched VSMC (p < 0.005). Migration of EC was stimulated 8.3 (+/- 1.1) and 14.6 (+/- 1.3) fold by media from unstretched and stretched VSMC respectively, demonstrating a 1.8 fold increase due to stretch alone (p < 0.05). Cyclic stretch resulted in phosphorylation of the VEGF receptor KDR.

CONCLUSION

Exposure of VSMC to physiological levels of stretch induces a biologically significant increase in VEGF secretion and may provide an arterial stimulus for maintenance of steady state levels of VEGF essential for EC survival.

Stably transfected ABCA1 antisense cell line has decreased ABCA1 mRNA and cAMP-induced cholesterol efflux to apolipoprotein AI and HDL

Using a sensitive real time fluorescent PCR assay, ABCA1 mRNA levels were induced by approximately 50-70-fold following 8Br-cAMP treatment of the RAW264 murine macrophage cell line, concomitant with the induction of cholesterol efflux to apoAI and HDL. A stably transfected ABCA1 antisense cDNA cell line was created, which led to approximately 50-70% reductions in ABCA1 mRNA levels in basal and 8Br-cAMP-treated cells, and diminished to the same extent the 8Br-cAMP-mediated efflux of cholesterol to apolipoprotein AI and HDL. These data demonstrate that ABCA1 is necessary for the cAMP-induced lipid efflux to both apoAI and HDL.

Adaptive immune responses of patients with asthma to the attachment (G) glycoprotein of respiratory synctial virus

A history of acute bronchiolitis in infancy caused by respiratory syncytial virus is a risk factor for recurrent wheezing in early childhood. Because the attachment (G) protein sensitizes mice for pulmonary eosinophilia and because Th2 cells are central in the pathogenesis of asthma, plasma and peripheral blood mononuclear cells (PBMC) from donors with asthma and from healthy donors were evaluated for anti-G protein responses. A significant trend connecting severity of asthma with anti-G protein IgG1 and IgG2 titers was observed. The correlation between anti-F protein IgG3 titers and asthma severity approached significance. Peptide mapping studies revealed that more positive recall responses (interferon-gamma and interleukin-10 secretion) occurred after PBMC from donors with asthma were stimulated with peptides representing the nonglycosylated domain of G protein. The same peptides elicited more positive recall responses (proliferation and interferon-gamma secretion) in the PBMC of healthy donors. These data suggest that a mechanism may exist whereby adaptive immune responses against G protein contribute to wheezing.

Journey to the center of the category: the dissociation in amnesia between categorization and recognition

The authors' theoretical analysis of the dissociation in amnesia between categorization and recognition suggests these conclusions: (a) Comparing to-be-categorized items to a category center or prototype produces strong prototype advantages and steep typicality gradients, whereas comparing to-be-categorized items to the training exemplars that surround the prototype produces weak prototype advantages and flat typicality gradients; (b) participants often show the former pattern, suggesting their use of prototypes; (c) exemplar models account poorly for these categorization data, but prototype models account well for them; and (d) the recognition data suggest that controls use a single-comparison exemplar-memorization process more powerfully than amnesics. By pairing categorization based in prototypes with recognition based in exemplar memorization, the authors support and extend other recent accounts of cognitive performance that intermix prototypes and exemplars, and the authors reinforce traditional interpretations of the categorization-recognition dissociation in amnesia.

Genetic modifiers of atherosclerosis in mice

Common atherosclerosis has a genetic component, but it is difficult to determine the specific genes that play a role in atherosclerosis susceptibility in humans. We have used the apoE-deficient mouse as a model system to examine the effects of candidate genes on atherosclerosis as well as to perform genomic experiments to map and isolate other genes giving rise to atherosclerosis susceptibility. We have tested the effects of mutations in the MCSF and VCAM-1 genes on atherosclerosis, and in both of these cases mutations led to gene dosage-dependent decreases in atherosclerosis. By successive back breeding, we have established apoE-deficiency on the C57BL/6 and FVB/N inbred mouse strains. Lesions in C57BL/6 mice are about eightfold larger than those in FVB/ N mice, and lesions in F1 hybrids are intermediate in size. We have performed quantitative trait locus mapping on two F2 cohorts and discovered atherosclerosis susceptibility loci on chromosomes 10, 14, and 19.