Coping with failure: relationship with self-concept discrepancy and attributional style

In the relationship of attributional style and self-concept discrepancy with coping behavior among 10th-grade Hong Kong Chinese students, 3 significant canonical variate pairs were identified. The total criterion redundancy showed that self-concept discrepancy and attributional style predicted about 20% of the variance of coping behavior. The 1st variate pair indicated that students with small self-concept discrepancy and low-depressive attributional style tended to cope with failure by planful problem solving and by positive reappraisal. The 2nd variate pair showed that students, particularly girls, with small self-concept discrepancy in verbal ability and same-sex peer relations tended to cope with failure by seeking social support. The last variate pair showed that students with great self-concept discrepancy in same-sex peer relations and parent relations tended to cope with failure by avoiding or escaping. The 3 canonical variate pairs also suggested a new taxonomy for coping behavior: mobilization of internal coping resources, mobilization of external coping resources, and the inability to mobilize any coping resources.

Conservative medical and surgical management of interstitial ectopic pregnancy

OBJECTIVE

To review the definition and diagnosis of interstitial and heterotopic interstitial pregnancy and to evaluate the conservative management of these conditions.

DESIGN

A MEDLINE computer search was used to identify relevant studies. The mean values for the duration of amenorrhea, serum beta-hCG level, size of the ectopic mass, and success rates of the various treatment modalities were calculated from the raw data in the original publications.

RESULT(S)

A review of 41 patients with interstitial pregnancy who were treated with methotrexate systemically, locally, or in combination revealed an overall success rate of 83%. The mean duration of amenorrhea, mean serum beta-hCG level, and mean size of the ectopic mass were 54 days, 15,127 mIU/mL, and 23 mm, respectively. Among 22 patients with interstitial pregnancy who were treated with conservative laparoscopic techniques, the overall success rate was 100%. In this group, the mean duration of amenorrhea, mean serum beta-hCG level, and mean size of the ectopic mass were 54 days, 7,572 mIU/mL, and 31 mm, respectively. There were nine cases of heterotopic interstitial pregnancy. Seven patients were managed with potassium chloride injected into the ectopic pregnancy, and two patients were treated by laparoscopy. Overall, 67% of the coexisting intrauterine pregnancies resulted in successful deliveries and the remainder ended in spontaneous abortions.

CONCLUSION(S)

Cornual resection or hysterectomy with a laparotomy should no longer be the first line of treatment for a hemodynamically stable patient with an interstitial pregnancy. In selected cases, methotrexate and laparoscopy can be used successfully in treating early interstitial pregnancy.

DNA methylation pattern of a tandemly repeated LacZ transgene indicates that most copies are silent

The Pgk-1,2-lacZ transgene consists of the ubiquitously-expressed Pgk-1 promoter driving expression of the E. coli lacZ reporter gene. We studied the expression of this transgene in a mouse strain carrying 8-9 tandem copies of this construct. When inherited through the male germ line, the transgene was expressed in all tissues examined but when inherited through the female germ line, the transgene became irreversibly inactivated. The lacZ region is a CpG-rich island that was essentially entirely methylated in all copies of the silent, maternally-inherited transgene. At the active transgenic locus, all but one of the copies were entirely methylated. This one unmethylated copy was adjacent to the cellular DNA and was presumed to be the expressed transgene copy. These results suggest that the tandem repeats of transgenes become silenced by a mechanism associated with DNAmethylation and that proximity to the cellular genome may be important in maintaining expression against the spread of inactivation from the adjacent silent transgenes.

Sustained gene expression in transplanted skin fibroblasts in rats

Retrovirus-mediated gene transfer into adult skin fibroblasts has provided measurable amounts of therapeutic proteins in animal models. However, the major problem emerging from these experiments was a limited time of vector encoded gene expression once transduced cells were engrafted. We hypothesized that sustained transduced gene expression in quiescent fibroblasts in vivo might be obtained by using a fibronectin (Fn) promoter. Fibronectin plays a key role in cell adhesion, migration and wound healing and is up-regulated in quiescent fibroblasts. Retroviral vectors containing human adenosine deaminase (ADA) cDNA linked to rat fibronectin promoter (LNFnA) or viral LTR promoter (LASN) were compared for their ability to express ADA from transduced primary rat skin fibroblasts in vivo. Skin grafts formed from fibroblasts transduced with LNFnA showed strong human ADA enzyme activity from 1 week to 3 months. In contrast, skin grafts containing LASN-transduced fibroblasts tested positive for human ADA for weeks 1 and 2, were faintly positive at week 3 and showed no human ADA expression at 1, 2 and 3 months. Thus, a fibronectin promoter provided sustained transduced gene expression at high levels for at least 3 months in transplanted rat skin fibroblasts, perhaps permitting the targeting of this tissue for human gene therapy.

The acceptance of lonely others: effects of loneliness and gender of the target person and loneliness of the perceiver

The reactions of lonely people toward other lonely people and the relationship between loneliness and self-concepts were examined. The 2-way and 3-way interaction effects showed that low lonely perceivers reacted more negatively toward the lonely target person. The relationship between loneliness and self-concept was examined using a multidimensional measure of self-concept. Results showed that loneliness correlated negatively with self-concept. In multiple regression analyses, the most significant predictors of loneliness were self-concept of relations with same gender and opposite gender peers and general self-concept.

Serum IgE levels during the first 6 years of life

OBJECTIVE

Total serum IgE percentiles were derived for a population-based sample of 4082 white children from Germany by weighted analysis of measurements from the Multicenter Allergy Study cohort.

METHODS

The children of a prospective birth cohort were selected from a complete 1-year sample of newborns in 6 obstetric departments in 1990. Total IgE was determined at 1, 2, 3, 5, and 6 years of age in 1160 newborns of the cohort. By weighting these measurements for sex, atopic family history, and elevated cord blood IgE, total serum IgE percentiles were estimated for the original population-based sample of 4082 children.

RESULTS

IgE levels increased by age (P <.0001). We found statistically significant higher total IgE values in boys than in girls at each age (P <.05). Within the group of atopic children, this sex difference was not statistically significant.

CONCLUSION

Our estimates of total serum IgE levels for a large population-based sample were lower than most values previously reported. We suggest that for both clinical and epidemiologic and genetic studies, IgE values should be expressed with percentiles.

Effect of pre- and postnatal tobacco smoke exposure on specific sensitization to food and inhalant allergens during the first 3 years of life. Multicenter Allergy Study Group, Germany

BACKGROUND

The study aimed to assess the effect of pre- and postnatal tobacco smoke exposure on specific sensitization to food allergens and inhalant allergens during the first 3 years of life.

METHODS

A total of 342 children of a prospective and observational birth cohort study on atopy (MAS) were included on the basis of a complete follow-up of specific IgE measurements at the ages of 1, 2, and 3 years with available questionnaire information about the parental smoking habit at birth, 18 months, and 3 years of age. Study children were grouped into four exposure categories representing in utero and postnatal environmental tobacco smoke (ETS) exposure, and according to the number of cigarettes smoked by the parents. The effect on the development of allergic sensitization to food, outdoor, and indoor allergens by 3 years of age was determined by multiple logistic regression analyses.

RESULTS

At the age of 3, children who were pre- and postnatally exposed to tobacco smoke had a significantly higher risk of sensitization to food allergens (odds ratio: 2.3, 95% C.I.: 1.1-4.6) than unexposed children. Children who were only postnatally exposed by a smoking mother also had a 2.2 times higher risk (95% C.I.: 0.9-5.9) of sensitization than unexposed children. These two categories (pre- and/or postnatal exposure) contribute to the significant overall effect of the tobacco smoke exposure (P< or =0.02). No significant association between tobacco smoke exposure and specific sensitization to inhalant allergens was observed. The determining risk factors for this type of sensitization were atopic family history and mite- and cat-allergen exposure levels.

CONCLUSIONS

During the first 3 years of life, both prenatal and postnatal tobacco smoke exposure has an adjuvant effect on allergic sensitization which seems to be restricted to allergens to which children are mainly exposed, in combination with the peak of the ETS exposure around the first birthday.

Stomach implant for long-term erythropoietin expression in rats

To approach the goal of consistent long-term erythropoietin (Epo) expression in vivo, we developed an implantation procedure in which transduced autologous vascular smooth muscle was introduced into rats in a chamber created from a polytetrafluoroethylene (PTFE) ring placed under the serosa of the stomach. The implant became vascularized and permitted the long-term survival of smooth muscle cells expressing Epo. Hematocrits of treated animals increased rapidly and monitored over 12 months gave a mean value of 56.0 +/- 4. 0% (P < .001; n = 9), increased from a presurgery mean of 42.3 +/- 1. 6%. Hemoglobin levels rose from a presurgery mean of 15.2 +/- 0.4 g/dL and for 12 months were significantly elevated with a mean value of 19.5 +/- 1.3 g/dL (P < .001; n = 9). The hematocrit and hemoglobin levels of control animals receiving human adenosine deaminase (ADA)-expressing cells were not significantly different from baseline (P > .05; n = 5). In response to tissue oxygenation, kidney, and (to a lesser extent) liver are specific organs that synthesize Epo. Treated animals showed downregulation of endogenous Epo mRNA in kidney over a 12-month period. The PTFE implant provides sustained gene delivery, is safe, and is minimally invasive. It allows easy engraftment of transduced cells and may be applied generally to the systemic delivery of therapeutic proteins such as hormones and clotting factors.

Penetrating pencil injury: an unusual case of child abuse

OBJECTIVE

We report an unusual case of penetrating pencil injury in a young child that turned out to be a case of physical abuse.

METHOD

This is a case report with review of the literature.

RESULTS

A 4-year-old boy was brought by his mother to the accident and emergency department for a penetrating wound of the right hand. He was said to have injured himself during a fall at home while holding a sharpened lead pencil. The pencil broke after penetrating the hypothenar eminence, leaving the graphite tip embedded in the palm. On surgical exploration, a piece of graphite measuring 1.3 cm was removed. The injury was actually inflicted by his mother because he failed to complete his homework properly. Deep penetrating injuries associated with the lead pencil are uncommon events in the medical literature. They are often reported as accidental and usually involve the oropharynx and the orbit.

CONCLUSION

Deep penetrating injury with a pencil is unusual in childhood and the public should be made aware of the possibility of nonaccidental injury.

Accumulation of heavy metals in freshwater molluscs

Heavy metals in the aquatic environment have to date come mainly from naturally occurring geochemical materials. However, this has been enhanced by human activity such as gold mining in the case of heavy metal pollution in Sg Sarawak Kanan. The high suspended solid loads in the river have quite efficiently removed most soluble metals from the water and trapped them in the bottom sediment. Three freshwater mollusc species were collected at the point source of the heavy metal pollutants and analysed for the heavy metal contents in their tissues and shells. Two of the mollusc species (Brotia costula and Melanoides tuberculata) are purely freshwater species while the Clithon sp. nr retropictus is able to survive in fresh and brackish water environments. The Brotia costula and the Clithon sp. are the edible species which are sold in the market. Accumulation of As, Cu, Fe, Se and Zn in all the three mollusc species were determined and the level of As in the tissues of Brotia costula and the Clithon sp. was much higher than the permissible level for human consumption. The mollusc species also demonstrated different preferences for the uptake of different metals. Variations in the heavy metal contents in the shell and tissues of the same species were also observed.

Examining and reexamining the structure of Chinese-English bilingual memory

The asymmetry model of bilingual memory proposed by Kroll and Stewart assumes that translation from a first language (L1) into a second language (L2), or forward translation, is mediated by an underlying conceptual memory, whereas L2-to-L1, or backward, translation is lexical and direct. Lexical links from L2 to L1 are hypothesized to be stronger than those from L1 to L2, but conceptual links are stronger for L1 than L2. These assumptions were evaluated in this study, which used stimulus items with similar recognition thresholds. Proficient Chinese-English bilinguals were tested on picture naming, word naming, word translation and category matching. The translation asymmetry effect predicted by the model (i.e., backward being faster than forward translation) was demonstrated; matching an L1 item to a category name was also faster than matching an L2 item. This pattern of results, nevertheless, did not completely hold after an adjustment procedure which sought to control for variations in response production and concept retrieval times due to stimulus types. The present findings are consistent with previous ones which show increased L2 conceptual processing for the proficient bilingual. They also suggest that an extended version of the asymmetry model should take into account possible biasing effects associated with some conventionally used bilingual tasks.

Comparison of intracoronary Doppler guide wire and transesophageal echocardiography in measurement of flow velocity and coronary flow reserve in the left anterior descending coronary artery

BACKGROUND

The intracoronary Doppler tipped guide wire has been shown to be highly accurate in the measurement of coronary flow velocity (CFV). Recent studies have indicated that blood flow velocity in the left anterior descending coronary artery (LAD) can be determined by transesophageal echocardiography (TEE). The purpose of this study was to compare flow velocity recordings and coronary flow reserve measurements in the LAD by TEE with those obtained by Doppler guide wire.

METHODS AND RESULTS

The study population consisted of 14 patients with chest pain and normal coronary arteriograms. After routine coronary arteriography was performed, a 0.014-inch Doppler guide wire was advanced into the proximal part of the LAD. After baseline measurement of coronary flow velocity (CFV) was obtained, 140 microg/kg/min adenosine was administered intravenously for 3 minutes, and the flow velocity was recorded. TEE was performed within 24 hours of the cardiac catheterization. After baseline measurements of CFV in the LAD, heart rate, and blood pressure were obtained, 140 microg/kg/min adenosine was administered intravenously, and the CFV was recorded. Coronary flow reserve was calculated as the ratio of the peak diastolic CFV during adenosine infusion to the peak diastolic CFV at baseline. A good correlation was found (r = 0.91, p < 0.0001) between CFV by Doppler guide wire and that determined by TEE. A good correlation was also found between the coronary flow reserve assessed by Doppler guide wire and that determined by TEE (r = 0.92, p < 0.0001).

CONCLUSION

Our data indicate that CFV and coronary flow reserve in the LAD can be accurately measured by transesophageal echocardiography.

A sequence-ready physical map of a region of 12q24.1

We developed a sequence-ready map of a part of human chromosome 12q24.1. We utilized a number of sequence-tagged site (STS) markers from 12q24.1 to screen large insert bacterial chromosome libraries and a chromosome 12-specific cosmid library. The clones were assembled into contiguous sets (contigs) by STS-content analysis. Contigs were extended by obtaining end sequences of bacterial clones, generation of additional STSs, rescreening the libraries, and screening the additional clones for the presence of STSs. The resulting contig covers nearly 2 Mb of DNA and provides an average marker resolution of 16 kb. Based on the STS content, we developed fingerprints of a subset of clones. The STS content and fingerprint data allowed us to define a minimal tiling path of clones. These clones are being used to sequence this part of chromosome 12. This contig contains the Ataxin 2 gene, and it covers the interval harboring the gene responsible for Darier disease.

Simultaneous overexpression of two stress proteins in rat cardiomyocytes and myogenic cells confers protection against ischemia-induced injury

BACKGROUND

Mitochondria are known to be a major target during ischemic cardiac injury. Previous studies have shown that in rodent myogenic cells and in the hearts of transgenic mice in which the heat shock or stress protein 70 is increased, there is a marked tolerance to ischemia/reperfusion injury. Two other heat shock proteins (HSP60 and HSP10) are known to form, within the mitochondria, a chaperonin complex that is important for mitochondrial protein folding and function. We were then interested in investigating whether increased expression of these two stress proteins is able to protect myogenic cells against ischemia/reperfusion injury.

METHODS AND RESULTS

We generated recombinant adenoviral vectors containing HSP60, HSP10, or a combination of the two genes. These adenoviral constructs overexpress significant amounts of these stress proteins in both rat neonatal cardiomyocytes and the myogenic H9 c2 cell line. Cells infected with an adenoviral construct overexpressing both HSP60 and HSP10 were found to be protected against simulated ischemia, whereas cells infected with adenoviral constructs overexpressing only HSP60 or HSP10 alone were not rendered tolerant to simulated ischemic injury.

CONCLUSIONS

These results suggest that the simultaneous expression of these two proteins that form a chaperonin complex in the mitochondria plays an important role in the survival of myogenic cells after ischemia/reperfusion injury.

Indoor allergen exposure is a risk factor for sensitization during the first three years of life

BACKGROUND

The purpose of the study was to investigate the influence of environmental allergen exposure on allergic sensitization in infancy and early childhood.

METHODS

A cohort of 1314 newborns was recruited and followed up prospectively at the ages 12, 24, and 36 months. The levels of major mite (Der p 1 and Der f 1) and cat (Fel d 1) allergens were determined from domestic carpet dust samples by sandwich ELISA. Specific serum IgE antibodies to mite and cat allergens were determined by CAP fluoroimmunoassay (Pharmacia). Logistic regression was used to assess the effects of allergen exposure, age, family history, and cord blood IgE simultaneously on the risk of sensitization.

RESULTS

Children, who had been found to be sensitized at least once during the first 3 years of life, were found to be exposed to significantly higher house dust mite (median, 868 ng/gm vs 210 ng/mg; p = 0.001) and cat (median, 150 ng/gm vs 64 ng/gm; p = 0.011) allergen concentrations in domestic carpet dust compared with the group without sensitization. In homes with low (< or = 25th percentile) dust concentrations, the risk of sensitization to mite (1.6%), and cat (2.0%) is low, compared with 6.5% for mite and 6.3% for cat if the domestic exposure is above the 75th percentile. The dose-response relationships between allergen levels and sensitization indicate that the increase in sensitization risk at low allergen levels is more pronounced in cat allergy (p = 0.002) than in mite allergy (p = 0.026). In the group with a positive family history, lower mite and cat allergen concentrations are needed to achieve specific sensitization compared with the group with a negative family history.

CONCLUSION

Our data indicate that avoidance measures in the domestic environment aimed at the primary prevention of allergen-driven sensitization should be introduced at the earliest possible stage, if possible during infancy.

Sensitization to hen's egg at the age of twelve months is predictive for allergic sensitization to common indoor and outdoor allergens at the age of three years

BACKGROUND

Specific predictors for atopic sensitization in early infancy are prerequisites for preventive intervention studies.

OBJECTIVE

To identify predictors of allergic sensitization to common aeroallergens in infancy, 1314 children in five German cities were followed up from birth (1990) to the age of 3 years.

METHODS

Blood samples were taken from cord blood and at follow-up visits at the ages of 1, 2, and 3 years. Total serum IgE and specific IgE antibodies to common food and inhalant allergens were determined.

RESULTS

Among our study population, risk factors for sensitization to indoor and/or outdoor allergens at the age of 3 years were a positive family history, the presence of hen's egg-specific IgE antibodies (> or = 0.35 kU/L), and increased log- [total IgE] levels at the age of 12 months. Elevated cord blood IgE was not associated with sensitization to inhalant allergens at the age of 3 years. Egg-specific IgE greater than 2 kU/L in combination with a positive family history of atopy was a highly specific (specificity, 99%) and predictive (positive predictive value, 78%) marker for sensitization to inhalant allergens at 3 years of age.

CONCLUSIONS

Hen's egg-specific IgE at the age of 12 months is a valuable marker for subsequent allergic sensitization to allergens that cause asthma, allergic rhinitis, and atopic dermatitis.

Human immunodeficiency virus: early steps in management

Although articles concerning AIDS care and its complexities are increasing in number, the nursing literature still does not adequately address the management of asymptomatic HIV disease. This paper presents the management of an asymptomatic client using a case study format. Management and treatment options are discussed as they relate to the problems arising from the assessment of the client on the initial visit to the outpatient clinic. Suggestions for follow-up care also are provided.

AICL: a new activation-induced antigen encoded by the human NK gene complex

The NK gene complex on mouse chromosome 6 and its human homologue on chromosome 12 encode type II transmembrane proteins with a C-type lectin domain which trigger or inhibit target cell lysis by NK cells (NKR-P1, Ly49, NKG2, CD94) or function as cellular activators of various hematopoietic cells (CD69). We herein report the cDNA cloning of a new molecule, designated activation-induced C-type lectin (AICL), whose gene maps to the human NK gene complex proximal to the CD69 gene. AICL is a 149-amino acid (aa) polypeptide with a short cytoplasmic part of seven aa and a C-type lectin domain separated from the transmembrane region by only nine aa. The highest sequence similarity is found to the C-type lectin domains of CD69 and the chicken lectin 17.5. The presence of AICL transcripts in different cell types of hematopoietic origin, a rapid increase of gene transcription during lymphocyte activation, and a short half-life of the mRNA characterize AICL as a new, broadly expressed activation antigen.

Does benzyl benzoate prevent colonization of new mattresses by mites? A prospective study

In 12 house-dust-mite-infested double beds, one of the mattresses was replaced by a new one, the other being regarded as a mite source. All new mattresses were treated in a double-blind fashion, with either benzyl benzoate or placebo before being placed on the bed as well as 1 year later. They were examined for mites and allergen concentrations over a period of 18 months. This period of time covered two mite seasons. Dust samples were taken bimonthly and analyzed by guanine test strip, microscopic mite counting, and determination of the mite allergens Der p 1 (Dermatophagoides pteronyssinus) and Der f 1 (D. farinae) by ELISA. Although, at the end of the observation period, the new mattresses still had significantly lower mite and allergen levels than the old mattresses, there were no significant differences between the placebo and the benzyl benzoate groups. In our setting, benzyl benzoate plus frequent cleansing was not significantly more effective in controlling mites than frequent cleansing alone.

Severe transitory encephalopathy with reversible lesions of the claustrum

Reversible bilateral lesions of the claustrum and external capsule in a 12-year-old girl suffering from a severe, transitory encephalopathy are reported. After a prodromal stage of feeling uncomfortable a sudden onset of status epilepticus occurred, followed by recurrent complex partial and myoclonic seizures for 3 weeks, with psychotic symptoms and temporary loss of vision, speech and hearing. After treatment with phenytoin the patient became free of seizures and recovered completely without neurological deficit. The initial cranial CT was normal; however, cranial MRI 7 days later showed bilateral selective lesions of the claustrum and external capsule, which disappeared completely 5 weeks later. The aetiology of these lesions remains obscure; repeated cerebrospinal fluid and blood tests were negative for herpes simplex virus and other infectious agents. The clinical and radiological improvement were concomitant. This may indicate a functional disturbance of the claustrum grey matter, rather than lesions of the white matter of the external and extreme capsules.

Granulocyte colony-stimulating factor expression from transduced vascular smooth muscle cells provides sustained neutrophil increases in rats

Granulocyte colony-stimulating factor (G-CSF) regulates granulocyte precursor cell proliferation, neutrophil survival, and activation. Cyclic hematopoiesis, a disease that occurs both in humans and grey collie dogs is characterized by cyclical variations in blood neutrophils. Although the underlying molecular defect is not known, long-term daily administration of recombinant G-CSF eliminates the severe recurrent neutropenia, indicating that expression of G-CSF by gene therapy would be beneficial. As a prelude to preclinical studies in affected collie dogs, we monitored hematopoiesis in rats receiving vascular smooth muscle cells transduced to express G-CSF. Cells transduced with LrGSN, a retrovirus expressing rat G-CSF, were implanted in the carotid artery and control animals received cells transduced with LASN, a retrovirus expressing human adenosine deaminase (ADA). Test animals showed significant increases in neutrophil counts for at least 7 weeks, with mean values of 3,670 +/- 740 cells/microliter in comparison to 1,870 +/- 460 cells/microliter in controls (p < 0.001). Thus, in rats G-CSF gene transfer targeted at vascular smooth muscle cells initiated sustained production of 1,800 neutrophils/microliter, a cell number that would provide clinical benefit to patients. Lymphocytes, red cells and platelets were not different between control and test animals (p > 0.05). These studies indicate that retrovirally transduced vascular smooth muscle cells can provide sustained clinically useful levels of neutrophils in vivo.

Outlook on life: how adolescents and children view the life-style of parents, adults and self

A new Outlook on Life measure was constructed to identify how adolescents and children see their lives. Three scales were formed and named the View of Parents, View of Adults and View of Self scales. The three scales were found to correlate highly with subjects' emotional state: the more positive views they had of their parents, adults and their own life, the less depressed they felt.

Respiratory syncytial virus infection: its role in aeroallergen sensitization during the first two years of life

Our aim was to study the influence of infection with the respiratory syncytial virus (RSV) in non-hospitalized infants on sensitization to aeroallergens and the early manifestation of atopy. Six hundred and nine infants from the prospective German Multicenter Cohort Study on Atopy were included, 38% of whom had an elevated atopic risk. RSV IgG and IgM antibodies were tested by ELISA with gradient purified RSV antigen. Specific IgE against mites, cat dandruff, birch and grass pollens and relevant nutritional antigens were tested with CAP-RAST-FEIA (Pharmacia, Sweden). Of the cord sera 99% were positive for RSV-IgG, 44.7% at one year and 64.2% (n = 265) at two years of age. The positivity rate after 12 months varied with the season of birth, the number of siblings and the degree of exposure to tobacco smoke; and correlated closely with attacks of wheezing during infancy. Twenty (2.8%) children were found to be sensitized against at least one aeroallergen at one year, and 28 (10.5%) at two years. By the first birthday, mite sensitization (n = 3) could only be seen in the RSV-infected children; grass pollen sensitization (n = 9) was associated with RSV seropositivity (logistic regression model including the confounders mentioned above: with RSV IgG < p = 0.048 > and IgM < p = 0.0006 >), as was birch sensitization (n = 5) with RSV IgM (p = 0.009). No such differences could be detected at two years. No correlation of RSV seropositivity to any allergic manifestation could be found. We conclude, that it is only in the first year of life, that RSV infection plays a significant role in promoting sensitization against aeroallergens, which do not at this time produce allergic symptoms.

High-level expression from a cytomegalovirus promoter in macrophage cells

To identify vectors that provide optimal gene expression in human hematopoietic cells, we investigated retroviruses containing the adenosine deaminase (ADA) gene under the transcriptional control of the promoters/enhancers of Moloney murine leukemia virus and the human cytomegalovirus (CMV) immediate-early gene. ADA expression was monitored in transduced human multipotential promyelocytic leukemic HL-60 cells and human monocytic leukemic THP-1 cells. HL-60 cells can be induced by phorbol ester to differentiate into macrophage lineage cells and by retinoic acid into granulocytic cells. THP-1 cells undergo phorbol ester-induced differentiation to macrophage cells. In LNCA-transduced HL-60 derived macrophage cells, ADA controlled by the CMV promoter was expressed at 100.0 mumol/hr.mg, in contrast to 1.2 mumol/hr.mg from LN-transduced control cells. LNCA-transduced THP-1 macrophage cells showed a similar increase in ADA activity over control cells. These elevated enzyme activities were confirmed by Northern blots, which showed substantial increases in ADA mRNA derived from the CMV promoter. This suggests use of the CMV promoter for gene therapy targeted at macrophages, as, for example, in the treatment of lysosomal storage disorders such as Gaucher disease. These inducible cell lines have allowed the evaluation of transduced gene expression in proliferating and differentiating hematopoietic cells that may serve as an in vitro model of bone marrow-targeted gene therapy.

Gene therapy for long-term expression of erythropoietin in rats

The injection of recombinant erythropoietin (Epo) is now widely used for long-term treatment of anemia associated with chronic renal failure, cancer, and human immunodeficiency virus infections. The ability to deliver this hormone by gene therapy rather than by repeated injections could provide substantial clinical and economic benefits. As a preliminary approach, we investigated in rats the expression and biological effects of transplanting autologous vascular smooth muscle cells transduced with a retroviral vector encoding rat Epo cDNA. Vector-derived Epo secretion caused increases in reticulocytes, with peak levels of 7.8-9.6% around day 10 after implantation. The initial elevation in reticulocytes was followed by clinically significant increases in hematocrit and hemoglobin for up to 11 weeks. Ten control and treated animals showed mean hematocrits of 44.9 +/- 0.4% and 58.7 +/- 3.1%, respectively (P < 0.001), and hemoglobin values of 15.6 +/- 0.1 g/dl and 19.8 +/- 0.9 g/dl, respectively (P < 0.001). There were no significant differences between control and treated animals in the number of white blood cells and platelets. Kidney and to a lesser extent liver are specific organs that synthesize Epo in response to tissue oxygenation. In the treated animals, endogenous Epo mRNA was largely down regulated in kidney and absent from liver. These results indicate that vascular smooth muscle cells can be genetically modified to provide treatment of anemias due to Epo deficiency and suggest that this cell type may be targeted in the treatment of other diseases requiring systemic therapeutic protein delivery.

Determinants of cord-blood IgE concentrations in 6401 German neonates

For screening atopy risk in 6401 (84%) of all infants born during the year 1990 in six obstetric departments of five German cities, cord-blood IgE values were determined with CAP-RAST-FEIA. After cases with elevated IgA values had been excluded, 25% of the values were above the detection limit of 0.35 kU/l, and 8.5% were above 0.9 kU/l. Boys had significantly higher values than girls (P < 0.001). The distribution of values was significantly different for different nationalities of mothers (P < 0.001). The percentage of elevated values (> 0.9 kU/l) increased significantly with the number of close family members with atopic history (P < 0.001). Regarding the atopic history of the father, siblings, and mother separately, only the mother's history had a significant association with the cord-blood IgE class (P < 0.001). The IgE values of 81 twin pairs correlated significantly with a coefficient of r = 0.4909 (P < 0.001). The smoking history of the parents during pregnancy showed an association with cord-blood IgE values (P < 0.02). No significant association could be shown between cord-blood IgE distribution and other variables, i.e., gestational age, birth size, birth modus, Apgar score, cord-blood pH value, neonatal problems, parity, age of the mother, medication during pregnancy, educational level of mother or father, time of year, or obstetric department. It is hypothesized that, in addition to some postpartum contamination or placental transfer of maternal IgE, cord-blood IgE values are also determined by the fetal immunologic reaction to intrauterine exposure to allergens and trigger factors, and by genetic influences.

Mechanistic study on toxicity of positively charged liposomes containing stearylamine to blood

We studied the interaction of stearylamine (SA) containing liposomes (SA-liposomes) with erythrocyte ghost (EG) or platelets, utilizing the Tb/dipicolinate (Tb/DPA) assay for the mixing of aqueous contents and a resonance energy transfer (RET) assay for the mixing of lipid. The results demonstrate that SA-liposomes and EG, after aggregation, have a great tendency to mix their lipid before the mixing of the internal contents. The mixing of their contents takes place inside the vesicles due to the fusion of SA-liposomes and EG, followed by the leakage of the contents from the vesicles. In the presence of carboxymethyl chitin (CM-chitin), SA-liposomes-EG interaction was inhibited, indicating that CM-chitin reduces the tendency of SA-liposomes to interact with EG. The lipid mixing between SA-liposomes and platelets was not affected by CM-chitin or phagocytosis inhibitors: EDTA, cytochalasin B, or 2,4-dinitrophenol and iodoacetate, indicating the importance of glycoproteins on the platelet membrane surface in the interaction of SA-liposomes with platelets.

Report from Hong Kong

Hong Kong is a territory of only 400 square miles in size, but with a large population of six million people. We have excellent medical facilities in both the public and private sector and the general health indices of the population are good, with low infant mortality rates (5 per 1000) and long life expectancies (75 years for men and 80 for women).

Gene transfer in baboons using prosthetic vascular grafts seeded with retrovirally transduced smooth muscle cells: a model for local and systemic gene therapy

Prosthetic vascular grafts containing retrovirally transduced autologous vascular smooth muscle cells were studied as a model for introduction of human genes into baboons. Retroviral vectors encoding beta-galactosidase (beta-Gal) (LNPoZ) or human purine nucleoside phosphorylase (LPNSN-2), a control gene, were used for ex vivo transduction of autologous baboon smooth muscle cells obtained from vein biopsies. Transduced cells were placed into a collagen solution and seeded into the interstices of polytetrafluoroethylene vascular grafts. Endothelial cells were then seeded onto the luminal surface of the grafts to reduce thrombus formation. One LNPoZ-seeded graft and one LPNSN-2-seeded control graft were implanted bilaterally into the aorto-iliac circulation of each of 4 animals. All grafts remained patent until they were removed after 3-5 weeks and examined histochemically for vector-expressing cells. All histological cross-sections from the beta-Gal vector seeded grafts contained cells staining blue with the X-Gal chromogen. For the four grafts, the mean fraction of LNPoZ expressing cells was 10%, with a range of 2-20%, while no sections from the control grafts contained stainable cells. Smooth muscle cells expressing the reporter gene were localized within the graft wall but not in the newly forming intima or outer capsule of fibrous tissue. Implantation of transduced cells within this type of vascular graft may provide a useful approach for long-term local and systemic gene therapy.

Extramedullary plasmacytoma of the heart presenting as cardiac emergency. Review of literature

A case of extramedullary plasmacytoma of the heart was described and the literature was reviewed. Prompt surgical intervention is recommended to patients with mechanical obstruction leading to severe hemodynamic disturbance. Systemic chemotherapy or radiotherapy should be considered after the emergency has been settled.

Constitutive mucin secretion linked to CFTR expression

Mucus plugging is a hallmark of cystic fibrosis, but the link between the defective gene product, the cystic fibrosis transmembrane conductance regulator, and the abnormal mucus phenotype is unclear. To demonstrate CFTR involvement in mucin glycoprotein secretion in epithelial cells, a retroviral vector was used to overexpress CFTR in gallbladder epithelial cells, and constitutive mucin labeling and secretion were monitored. Achievement of high-level vector expression was confirmed by transduction with marker genes. Cells transduced with vectors carrying CFTR cDNA showed 5-fold increased expression of CFTR by Western blotting. Mucin labeling and secretion were 4-fold elevated in transduced cells. These results suggest constitutive mucin synthesis and secretion in gallbladder epithelial cells are regulated by CFTR.

Cardiac arrhythmia after infusion of cryopreserved stem cells

A retrospective study of the cardiovascular side-effects of 17 patients during and after receiving unpurged cryopreserved autologous bone marrow and/or peripheral blood stem cells was performed. Fourteen (82%) patients developed cardiac arrhythmia, of which 11 (65%) developed sinus bradycardia, four (24%) second degree heart block and one patient had complete heart block. The onset of sinus bradycardia occurred at 15-513 (median 56) min and the onset of heart block ranged from 30 to 680 (median 234) min after starting the stem cell infusion. Hypertension was noted in seven patients (41%) and usually occurred within 2 hours of infusion. There was no mortality or symptoms associated with these findings. Since some of these arrhythmias could be quite severe as assessed electrophysiologically, continuous cardiac monitoring should be considered during and after the infusion of cryopreserved stem cells.

Influence of glycosphingolipids on the release of histamine and sulfidopeptide leukotrienes from human basophils

Glycosphingolipids (GSLs) are physiological membrane components known to modulate various cellular functions. In order to study their influence on basophil mediator release washed leukocytes obtained from allergic asthmatics and nonatopics were preincubated with varying concentrations of different GSLs. Cells were washed and stimulated with anti-IgE, allergen, and calcium ionophore A23187. None of the GSLs induced mediator release by itself. Preincubation with the acidic gangliosides GM2, GM3, and GD1a significantly enhanced the release of both mediators when stimulated with anti-IgE or allergen but not with calcium ionophore A23187. Highest enhancement was seen with ganglioside GM2. Mediator release was higher in asthmatics than in nonatopics. The acidic galactosylceramide-sulfate (sulfatide) showed a significantly enhanced mediator release as well, whereas the neutral GSLs lactosyl ceramide and asialo GM2 did not influence mediator release. It is concluded that IgE receptor-dependent mediator release could be modulated by acidic GSLs.

Prevalence of cognitive impairment and associated factors among elderly Hong Kong Chinese aged 70 years and over

The prevalence of cognitive impairment was determined in a random age- and sex-stratified sample of 2,011 elderly Hong Kong Chinese, aged 70 years and over, consisting of subjects living in the community and in institutions. The Information/Orientation Section of the Clifton Assessment Procedure was used as the screening instrument using a cutoff point of 7. The overall age-adjusted prevalence was 5% for men and 22% for women, and 15% for both sexes combined. Univariate analysis identified the following associated factors in order of magnitude of the odds ratio: age; history of Parkinson's disease; functional disability; female sex; low educational level; low social class; history of stroke, and low monthly income. Other diseases, such as heart disease, hypertension, chronic lung diseases or diabetes, were not associated factors. In multivariate analysis, all the above factors remained significant with the exception of a history of stroke. The prevalence figures are comparable to other Caucasian and Chinese studies, and the associated factors identified suggest that there may be room for prevention.

A smoking cessation pilot program

National health-care costs are continuing to climb and employers in Hawaii and across the nation are forced to increase their share of the burden. To limit these costs, worksite health promotion programs are increasing in number and in scope. Smoking control programs in particular now rank as the most prevalent type of worksite program; as the disability, absenteeism, and early death on the part of smokers have been well-documented as contributing to the cost of health care. Our research describes a year-long, pilot smoking-cessation program implemented at Hawaiian Telephone Company. Our program used a combination of behavioral-modification, social support and incentives technique to assist people to stop smoking or to maintain their nonsmoking behavior. The 12 volunteer participants provided a multiethnic, long-term, heavy smoker employee sample. Survey results at 1 year demonstrated that 4 of them quit smoking (quit rate = 50%), 2 reduced their tobacco intake, 2 dropped out of the program and continued to smoke. The 4 who had entered the program for maintenance purposes remained smoke-free. Cost-benefit analysis yielded conservative estimates indicating that the program had paid for itself and saved an additional $350 a year per participant who remained a nonsmoker.

High-level human adenosine deaminase expression in dog skin fibroblasts is not sustained following transplantation

Primary skin fibroblasts are an attractive target tissue for retroviral-mediated gene therapy; however, transient expression of therapeutic genes has been a recurrent problem in several rodent models. The gradual decrease in gene expression could be tissue or species specific. To investigate the phenomenon further, human adenosine deaminase (ADA) expression was monitored in genetically modified skin fibroblasts transplanted in beagle dogs. In culture, transduced canine fibroblasts expressed high levels of human ADA activity (33.6 mumoles adenosine metabolized per hour per milligram of soluble protein) in comparison to canine ADA in untreated control cells (1.3 mumol/hr.mg protein) and for 2 weeks following transplantation, the graft contained up to four-fold more enzyme activity from human ADA than the endogenous canine enzyme. However, by 10 weeks, human ADA expression was undetectable. At the time when human ADA expression was greatly reduced, DNA analysis showed the presence of vector sequences. These results directly parallel those observed in rodent models and suggest retroviral vector inactivation is a tissue-specific rather than species-specific mechanism.

Development of the Multi-Trait Personality Inventory (MTPI): comparison among four Chinese populations

Anemic approach was adopted to develop a culture-specific instrument for the assessment of Chinese personality. The Multi-Trial Personality Inventory (MTPI) was administered to 1,673 men and 944 women in four major Chinese populations. It was found that Chinese in mainland China, Taiwan, Hong Kong, and the United States possess some common traits deeply rooted in the Chinese culture characterized by Confucian thoughts (e.g., self-discipline and moderation) and some additional traits nurtured by their respective environments. Consequently, findings of this study lent support to the hypothesis that, in spite of superficial discontinuities, there are basic continuities in the personality traits of mainland and overseas Chinese. The cross-cultural differences in personality were examined from a political-social perspective and also explained with a cultural-ecological model. In the development of the MTPI, a new methodology that relies on forming factor-consistent clusters was employed to deal successfully with the problem of complex factor space.

Relations with parents and school and Chinese adolescents' self-concept, delinquency, and academic performance

Current research and theory have suggested that the relational domains of family and school experiences are important to children's development. The present study thus examined how relations with parents and school were related to Chinese students' psychosocial and cognitive development in self-concept, delinquency, and academic performance. A total of 1668 secondary school students were studied, and results showed that better relation with parents was associated with higher general, academic, appearance, social, and physical ability self-concepts. Better relation with school was associated with higher academic performance, as shown in higher class rank, higher grand total exam scores, and higher scores in Chinese, English, mathematics, physical education, and music. Both poorer relations with parents and school were found to associate with more self-reported delinquency as well as more school records of misconduct.

Effect of Endotoxin on Serum Granulocyte and Granulocyte-Macrophage Colony-Stimulating Factor Levels in Dogs

The biologic effects of endotoxin are attributed to the release of several cytokines, including interleukin-1, interleukin-6, tumor necrosis factor, and the colony-stimulating factors. To investigate the mechanism of endotoxin-induced neutrophilia in dogs, several cell lines known to proliferate selectively in response to recombinant human colony-stimulating factors were examined to determine their responses to recombinant canine granulocyte colony-stimulating factor (rcG-CSF) or recombinant canine granulocyte-macrophage colony-stimulating factor (rcGM-CSF). The murine cell line NFS-60 was found to respond well to rcG-CSF and the human cell line TALL-101 to rcGM-CSF, and these responses were neutralized by antibodies to these recombinant proteins. These bioassays were then used to determine G-CSF and GM-CSF levels in dogs after intravenous endotoxin administration. G-CSF levels increased by 2 h, peaked at 4 h, and had not returned to normal by 24 h after endotoxin. In contrast, GM-CSF was not detectible before or after endotoxin administration.