Relationship quality moderates the effect of social support given by close friends on cardiovascular reactivity in women

We examined the role of the type of support provided, gender of support provider, and relationship quality in predicting how social support might influence cardiovascular reactivity during acute stress in women. A group of 88 women received either emotional, instrumental, or no support from a close female or male friend while performing a series of speech tasks. Results suggest that the effectiveness of social support for women depended primarily on the quality of the friendship (i.e., purely positive, or ambivalent). More specifically, women who interacted with a female, ambivalent friend had the largest changes in diastolic blood pressure, total peripheral resistance (TPR), and pre-ejection period compared to the other conditions. Furthermore, receiving emotional support from a purely positive friend was related to lower increases in cardiac output (CO) compared to a no-support condition. In contrast, receiving emotional support from an ambivalent friend was related to larger increases in CO and only small changes in TPR when compared to individuals in the no-support condition. These data are discussed in light of the psychosocial processes underlying social support effects in women, and the importance of a more comprehensive view of how close relationships influence cardiovascular function.

Market age live weight, carcass yield, and liver characteristics of broiler offspring from breeder hens fed diets differing in fat and energy contents

The effects of energy level, fat type, and fat level in breeder hen diets on subsequent offspring market age live BW, carcass yield, and liver characteristics from breeder hens at 29 and 36 wk of age were evaluated. At 22 wk of age, six dietary treatments were imposed. Dietary treatments contained: 1) 3.0%, added poultry fat (PF) and 467 (high energy) kcal/hen per day at peak production (CPP), 2) no added fat and high energy, 3) 3.0% added PF and 430 (low energy) CPP, 4) no added fat and low energy, 5) 1.5% added PF and 449 (moderate energy) CPP, and 6) 3.0% added corn oil (CO) and moderate energy. Breeder age influenced Day 43 broiler live BW, percentage total carcass and front-half yields, and liver moisture contents. Furthermore, wet and dry liver weights were higher in female broilers compared to those of male broilers from 29-wk-old breeder hens. Live BW was higher in broilers from hens fed low-energy diets compared with moderate-energy diets and 3.0% compared to 1.5% PF diets. Percentage liver DM was higher in females compared to male broilers from hens fed 3.0% CO and moderate energy and was highest in male and female broilers from hens fed 1.5% PF and moderate energy. Percentage wet liver weight and liver DM were higher and liver moisture content was lower in broilers from hens fed 1.5% compared to 3.0% PF diets. Overall, energy and fat levels in breeder diets had subsequent influences on market age weight and liver characteristics of broilers.

Functional evaluation of the modified Elmslie-Trillat procedure for patello-femoral dysfunction

A series of 28 knees in 27 patients were evaluated at an average of 36 months following surgical treatment for patella dislocation, patello-femoral pain, or a combination of both. All cases were treated by the modified Elmslie-Trillat procedure, which involves a lateral retinacular release and medialisation of the tibial tubercle on a distal pedicle. The evaluation included subjective, objective (Fulkerson and Kujala functional knee scores) and radiographic assessments. Subjectively, eight knees (28%) had excellent results, nine knees (33%) good results and seven knees (25%) fair results, accounting for an overall improvement of 86% over the preoperative status. All the knees in patients with a primary symptom of patella dislocation had an excellent or good subjective result, whilst only four knees (40%) in those patients with a primary symptom of pain and four knees (44%) in those with both pain and dislocation had a good or excellent result. The mean objective knee score was excellent for patients with dislocation only, and fair for those with only pain or both pain and dislocation. There have been no further episodes of dislocation in all patients. Six knees (21%) required later screw removal. The modified Elmslie-Trillat procedure produces a favourable outcome in patients with patella dislocation.

Subacute diencephalic angioencephalopathy: biopsy diagnosis and radiological features of a rare entity

Subacute diencephalic angioencephalopathy (SDAE) is a rare and fatal disease of unknown etiology that involves the thalami bilaterally. To date, there have been four cases reported, in which the diagnosis was established only after post mortem examination of the brain. We report two male patients, ages 69 and 41 years, who presented with progressive dementia and somnolence. Radiological evaluation revealed enhancing lesions involving both thalami. The differential diagnosis included a number of neoplastic, inflammatory and vascular processes. In both cases, pathological evaluation of biopsy specimens suggested the diagnosis of SDAE. Despite supportive care, the disease progressed rapidly and both patients died within weeks after initial presentation. The diagnosis was confirmed at autopsy in both cases. SDAE is a rare cause of bithalamic disease that can be mistaken for a neoplasm as well as a number of conditions that necessitate different treatment choices. The histopathological findings can establish the diagnosis when combined with radiological and clinical information. This report emphasizes the utility of stereotactic biopsy in early diagnosis of SDAE.

Absence of hippocampal sclerosis in children with multiple daily seizures since infancy

We report a series of nine children with multiple daily seizures since infancy who underwent functional hemispherectomy that included en bloc resection of the hippocampus and the temporal neocortex. In all cases, the hippocampi were normal by conventional histology despite the fact that these patients had suffered from recurrent seizures over a long period of time. This observation suggests that extremely frequent seizures in childhood are not invariably associated with the development of hippocampal sclerosis.

Expression of the p20 gene from Bacillus thuringiensis H-14 increases Cry11A toxin production and enhances mosquito-larvicidal activity in recombinant gram-negative bacteria

Experimental analyses with recombinant Escherichia coli and Pseudomonas putida transformed with plasmids bearing genes coding for the Cry11A toxin and P20 protein from Bacillus thuringiensis H-14 showed that cells producing both proteins were more toxic when fed to third-instar Aedes aegypti larvae than were cells expressing cry11A alone; the 50% lethal concentrations were in the range of 10(4) to 10(5) cells/ml. Western blots revealed a higher production of Cry11A when the p20 gene was coexpressed. Cry11A was detected primarily in insoluble form in recombinant cells. Cry11A was not detected in P. putida when P20 was not coproduced, and these recombinants were not toxic to larvae, whereas P. putida recombinants producing both proteins were toxic at concentrations similar to those for E. coli. A coelution experiment was conducted, in which a p20 gene construct producing the P20 protein with an extension of six histidines on the C terminus was mixed with the Cry11A protein. The results showed that Cry11A bound to the P20(His(6)) on a nickel chelating column, whereas Cry11A produced without the P20(His(6)) protein was washed through the column, thus indicating that Cry11A and P20 physically interact. Thus, P20 protein either stabilizes Cry11A or helps it attain the folding important for its toxic activity.

Inter-laboratory comparison of DNA preservation in archival paraffin-embedded human brain tissue from participating centres on four continents

DNA extracted from formalin-fixed and paraffin-embedded brain tissue is known to contain as yet ill-characterized inhibitors of the PCR process. As part of a project that aims to clarify the role of mitochondrial DNA sequence variation in human neurodegenerative diseases using DNA from various ethnic backgrounds, we have investigated factors that influence the preservation of archival DNA and its suitability for PCR. In this study, neuropathological tissue samples were analysed that had been routinely processed in 18 international centres on four continents. Following DNA extraction, PCR amplification of mitochondrial and nuclear DNA sequences was performed with and without additional purification of the template DNA. In addition, the DNA used for PCR was analysed by HPLC. Phosphate-buffered formalin proved to be a superior fixative compared with unbuffered aldehyde: DNA extraction resulted in greater yields, the molecular weight of the isolated DNA was higher and PCR was more successful. PCR inhibitors were identified as (1) high concentrations of small (<300 bp) DNA fragments that competitively compete with template DNA and (2) contaminants of the DNA template solution including denatured protein that cannot be completely removed by phenolic extraction. HPLC analysis did not reveal significant qualitative differences between DNA isolated from fresh-frozen tissue samples and DNA recovered from formalin-fixed, paraffin-embedded brain tissue. The fact that DNA could be amplified from the majority of tissue specimens in this study suggests that rare diseases and diseases where ethnic background plays an important role can be sampled for genetic polymorphism analysis on a global scale using archival neuropathological collections.

Distinguishing narcissism and hostility: similarities and differences in interpersonal circumplex and five-factor correlates

Narcissism and hostility are both characterized by dysfunctional social interactions, including tendencies to perceive slights, experience anger, and behave aggressively. The aim of this study was to examine the similarities and differences of narcissism and hostility, using 2 conceptual tools-the interpersonal circumplex and the Five-factor model. In a sample of 292 undergraduate men and women, composite measures of hostility (i.e., Buss-Perry Aggression Questionnaire [Buss & Perry, 1992] and Cook-Medley Hostility [Cook & Medley, 1954] total scores) were inversely correlated with affiliation and unrelated to dominance. In contrast, composite narcissism scores (i.e., Narcissistic Personality Inventory) were positively correlated with dominance and inversely correlated with affiliation. Examination of components of these traits revealed additional similarities and differences, as did associations with other dimensions of the Five-factor model. These findings suggest that the traits of narcissism and hostility are distinguishable by their interpersonal referents, as are their components.

Disruption of Ini1 leads to peri-implantation lethality and tumorigenesis in mice

SNF5/INI1 is a component of the ATP-dependent chromatin remodeling enzyme family SWI/SNF. Germ line mutations of INI1 have been identified in children with brain and renal rhabdoid tumors, indicating that INI1 is a tumor suppressor. Here we report that disruption of Ini1 expression in mice results in early embryonic lethality. Ini1-null embryos die between 3.5 and 5.5 days postcoitum, and Ini1-null blastocysts fail to hatch, form the trophectoderm, or expand the inner cell mass when cultured in vitro. Furthermore, we report that approximately 15% of Ini1-heterozygous mice present with tumors, mostly undifferentiated or poorly differentiated sarcomas. Tumor formation is associated with a loss of heterozygocity at the Ini1 locus, characterizing Ini1 as a tumor suppressor in mice. Thus, Ini1 is essential for embryo viability and for repression of oncogenesis in the adult organism.

Breeder age influences embryogenesis in broiler hatching eggs

The effects of dietary fat and broiler breeder age on egg and embryo characteristics during incubation were investigated. Breeders were fed diets containing no added fat or 3.0% added poultry fat (PF) for peak energy intakes of 430 and 467 kcal/hen day (pC/d), or 1.5% PF or 3.0% corn oil at 449 pC/d. Feeding of diets was initiated at 22 wk, and eggs were collected for incubation at 27 and 36 wk of age. Percentage incubational egg weight loss was determined between day of set and Days 6, 12, and 18. Percentage wet and dry embryo weights, embryo moisture content, and eggshell weights were determined at 6, 12, and 18 d of incubation. Percentage yolk sac weight and wet and dry liver weights and moisture content were determined on Days 12 and 18. Percentage gall bladder weight was determined on Day 18. There were no observed effects due to breeder diet. However, eggshell weight at Days 6, 12, and 18 was higher in 27-wk-old hens compared with 36-wk-old hens. Conversely, egg weight loss between Day 0 and Days 6, 12, and 18 and yolk sac weight across Days 12 and 18 of incubation were lower in eggs at 27 wk of age compared with 36 wk. At Day 18, dry embryo weight was higher and wet liver weight was lower at 27 wk compared with 36 wk. A slower rate of DM accumulation in embryos at Week 36 compared to Week 27 was associated with increased incubational water loss and decreased embryo moisture content, eggshell percentage, and yolk sac absorption rate. These data demonstrate that changes in eggshell characteristics with broiler breeder age can alone impact yolk uptake, growth, and body composition in subsequent embryos.

Vigilance, active coping, and cardiovascular reactivity during social interaction in young men

This study of 72 undergraduate men examined the effects of two determinants of cardiovascular response-active coping and vigilance-on blood pressure and heart rate responses to social stressors. Observation of a future debate partner (i.e., vigilance) evoked larger increases in blood pressure than did observation of a less relevant person, apparently through the combination of increases in cardiac output and vascular resistance. Preparation and enactment of efforts to exert social influence (i.e., active coping) evoked heightened blood pressure and heart rate responses through increased cardiac contractility and output. Thus, both vigilance and active coping in social contexts increased cardiovascular reactivity, but apparently through different psychophysiological processes.

Periadventitial extracranial vertebral artery hemorrhage in a case of shaken baby syndrome

We report a case of a two-month-old boy who became unresponsive in the sole custody of his father. Resuscitation efforts on route to the hospital were able to restore the infant's heart beat. However, neurologic function never recovered. Autopsy revealed massive cerebral edema, recent subdural, and subarachnoid hemorrhages, bilateral retinal hemorrhages, and cervical spine ligament hemorrhages. Separation of individual cervical vertebrae showed extensive, bilateral, periadventitial vertebral artery hemorrhages between C1 and C4, with corresponding luminal compression of the vertebral arteries. The importance of this previously unreported phenomena of periadventitial vertebral artery hemorrhage in the setting of shaken baby syndrome is discussed.

Vigilance, active coping, and cardiovascular reactivity during social interaction in young men

This study of 72 undergraduate men examined the effects of two determinants of cardiovascular response-active coping and vigilance-on blood pressure and heart rate responses to social stressors. Observation of a future debate partner (i.e., vigilance) evoked larger increases in blood pressure than did observation of a less relevant person, apparently through the combination of increases in cardiac output and vascular resistance. Preparation and enactment of efforts to exert social influence (i.e., active coping) evoked heightened blood pressure and heart rate responses through increased cardiac contractility and output. Thus, both vigilance and active coping in social contexts increased cardiovascular reactivity, but apparently through different psychophysiological processes.

The Viladot implant in flatfooted children

In 1991, Viladot described an implant for the treatment of painless flatfeet in children. This was inserted through a double approach to allow the talus to function while limiting its ability to slide off the calcaneus. The wineglass shaped prosthesis was inserted into the sinus tarsi with a tibialis posterior advancement and soft tissue correction to allow the foot to adopt a neutral position. This is in keeping with other procedures described for the correction of flatfoot. Viladot reported excellent results in 234 feet operated on in such a manner using clinical, radiological and photopodographic parameters. In Sheffield, over three years, 22 implants were inserted for similar painless flatfeet in children. The results were assessed using clinical, radiological and pedobarographic parameters. Viladot was able to demonstrate an improvement in all cases, clinically, radiologically and photopodographically with little or no discomfort and a return to preoperative levels of activity including sport. We found that in all cases, postoperative pain was a major feature which limited activity in all but 2 feet and which reduced the ability to take part in sport and other preoperative pastimes. Unlike Viladot, we were unable to demonstrate consistent improvements radiologically. Pedobarographically, the loading of the first metatarsal head remained unchanged and the centre of pressure was corrected in only 14%.

Cardiovascular and electrodermal responses to support and provocation: interpersonal methods in the study of psychophysiological reactivity

This study examined the joint and independent effects of experimentally manipulated social contexts and individual differences in hostility and perceived social support on physiological responses to a social stressor, while illustrating the use of the interpersonal circumplex for integrative social psychophysiological research. Undergraduate women completed a speech task in a supportive, neutral, or provoking context and completed measures of hostility and perceived social support. The provoking context evoked the largest blood pressure and heart rate (HR) responses, followed by the neutral and the supportive context. Social context also influenced HR and electrodermal reactivity during task preparation. Hostility elicited higher systolic blood pressure (SBP) reactivity during preparation, speech, and recovery. Perceived social support interacted with context to affect SBP and HR during speech and preparation. The roles of interpersonal characteristics and contexts in the physiological stress response and the utility of interpersonal methods in studying these associations are discussed.

Effects of breeder age and dietary fat source and level on broiler hatching egg characteristics

The effects of breeder age and added dietary fat source and level on broiler hatching egg characteristics were evaluated. Diets included no added fat (NAF) or 3.0% added poultry fat (PF) for peak energy intakes of 430 and 467 kcal/hen-day (PCD) or 1.5% PF or 3.0% corn oil (CO) at 449 PCD. As added dietary fat was changed from CO to PF, the percentage of unsaturated dietary fatty acids, including linoleic acid, decreased. Feeding of experimental diets was initiated when breeders were 22 wk old. Total fresh egg weight; eggshell weight; percentages of yolk (PYK), albumen (PAB), and eggshell (PSHL) weights; and yolk:albumen ratio were measured at various weeks between 26 and 47 wk of age. Egg weight increased progressively with hen age. Significant increases in yolk:albumen ratio occurred between Weeks 26 and 31 and between Weeks 31 and 35. Low (430 PCD) dietary energy levels significantly reduced PYK at 35 wk and increased PAB across breeder age. Eggshell weight was lower in birds fed moderate (449 PCD) compared to low energy levels at Week 26, moderate compared to high (467 PCD) energy levels at Week 41, and PF compared to CO across fat level at Week 31. At Weeks 31 and 41, PSHL was increased by the use of 3.0% PF compared to 1.5%, and PSHL was increased at Weeks 26 and 41 by using added PF compared to CO across fat level. Increased dietary energy decreased PAB and the use of added dietary CO rather than PF decreased PSHL in broiler breeders between 26 and 47 wk of age.

Effects of dietary fat type and level on broiler breeder performance

The effects of added dietary fat type and level on broiler breeder performance were evaluated in two trials. In Trial 1, diets included no added fat (NAF) or 3.0% added poultry fat (PF) for individual bird energy intakes of 430 and 467 kcal/d at peak production (PCD), or 1.5% PF or 3.0% corn oil (CO) at 449 PCD. In Trial 2, diets contained NAF, 1.5 or 3.0% added CO or PF, or 3.0% lard (LA) for peak energy intakes of 463 PCD. All diets in Trial 2 were isocaloric and isonitrogenous. Feeding of experimental diets was initiated when breeders were 22 wk old in both trials, and hen BW was measured at various weeks between 22 and 47 wk in Trial 1 and between 27 and 65 wk in Trial 2. Egg production, egg weight (EW), eggshell quality, and hatchability were recorded at various weeks between 24 and 48 wk in Trial 1 and between 27 and 64 wk in Trial 2. Body weights and EW increased progressively, and eggshell quality fluctuated variably with age. Egg production peaked between Weeks 32 and 35, and hatchability was significantly depressed at Week 63. Egg weight and hatchability were not affected by dietary treatment; however, BW increased with energy level in the diet between Weeks 27 and 47. Body weight was also higher in birds fed 1.5 or 3.0% added fat compared with NAF and was higher in birds fed LA compared with CO at the 3.0% level. Egg specific gravity and shell weight per unit of surface area at Week 41 were increased by feeding low or high energy compared with moderate energy, and relative eggshell conductance was increased by using moderate compared with high energy diets and by feeding 1.5% PF compared with 3.0% PF. Egg specific gravity was increased by PF when compared with CO across fat level at Weeks 26 and 47 and by LA when compared with PF across fat level and breeder age. These data suggest that certain dietary energy and fat regimens may affect BW and eggshell quality without associated effects on EW and hatchability at various breeder ages.

Positive CSF HSV PCR in patients with GBM: a note of caution

Because two patients with temporal lobe glioblastomas had herpes simplex (HSV) DNA detected in CSF using PCR at the time of their presentation, we reviewed our laboratory's experience and performed PCR on a bank of 159 frozen CSF samples from patients with glioblastoma multiforme and other neurologic disorders. Based on the inability to detect HSV in any other tumor sample, we conclude that the positive HSV PCR in our two index patients most likely represented false-positive results. A diagnosis of HSE should not be made by PCR alone when the clinical presentation is atypical.

Optic nerve damage in shaken baby syndrome: detection by beta-amyloid precursor protein immunohistochemistry

BACKGROUND

Rapid acceleration-deceleration of an infant's head during intentional shaking should in theory exert stretch or shear forces upon the optic nerves sufficient to cause axonal injury. beta-Amyloid precursor protein (beta-APP) immunohistochemistry recently has been shown to be a highly effective method for identifying diffuse axonal injury in the brains of infants with shaken baby syndrome. In this study, we investigated the utility of beta-APP in identifying optic nerve damage in infants who have sustained fatal whiplash shaking.

MATERIALS AND METHODS

beta-Amyloid precursor protein immunohistochemistry was performed on formalin-fixed, paraffin-embedded sections of eyes (including optic disc and distal optic nerve) from infants less than 1 year of age with shaken baby syndrome (5 cases), combined shaken baby syndrome/blunt head trauma (3 cases), and "pure" blunt head trauma (1 case). Nontraumatic control cases included infants who died of suffocation (1 case), sudden infant death syndrome (1 case), and positional asphyxia (1 case) and an enucleation from a child with a retinoblastoma (1 case). Matched hematoxylin-eosin-and neurofilament-stained sections were used for comparison.

RESULTS

Three of the 5 shaken baby cases and all 3 combined shaken baby/blunt head trauma cases had optic nerve axonal injury identified by the presence of strongly beta-APP-immunoreactive beaded or swollen axonal segments. Axonal injury could not be detected in the corresponding hematoxylin-eosin-or neurofilament-stained sections. Optic nerve axonal injury was not seen in the case involving pure blunt head trauma or in the nontraumatic control cases.

CONCLUSIONS

Optic nerve axonal injury is a prominent feature of intentional fatal whiplash head trauma in infants less than 1 year of age. beta-Amyloid protein precursor immunohistochemistry appears to be the most effective method for demonstrating axonal damage in the optic nerve.

Deposition of beta-amyloid subtypes 40 and 42 differentiates dementia with Lewy bodies from Alzheimer disease

BACKGROUND

Alterations in the metabolism of the amyloid precursor protein and the formation of beta-amyloid (Abeta) plaques are associated with neuronal death in Alzheimer disease (AD). The plaque subtype Abeta(x-42) occurs as an early event, with Abeta(x-40) plaques forming at a later stage. In dementia with Lewy bodies (DLB), an increase in the amount of cortical Abeta occurs without severe cortical neuronal losses.

OBJECTIVE

To advance our understanding of the natural history of Abeta in neurodegenerative diseases.

DESIGN

We evaluated the expression of Abeta(x-40) and Abeta(x-42) in DLB using monoclonal antibodies and immunohistochemical techniques in 5 brain regions. The data were compared with those elicited with normal aging and from patients with AD.

SETTING AND PATIENTS

A postmortem study involving 19 patients with DLB without concurrent neuritic degeneration, 10 patients with AD, and 17 aged persons without dementia for control subjects.

RESULTS

The Abeta plaques were more numerous in patients with DLB than in controls in most brain regions, although the Abeta(x-42) plaque subtype was predominant in both conditions. Overall, Abeta(x-42) plaque density was similar in patients with DLB and those with AD, but Abeta(x-40) plaques were more numerous in persons with AD than in those with DLB. The ratio of Abeta(x-40) to Abeta(x-42) plaques was significantly reduced in persons with DLB compared with patients with AD.

CONCLUSIONS

The Abeta plaques were more numerous in patients with DLB than persons with normal aging, but the plaque subtypes were similar. The relative proportion of the 2 Abeta plaque subtypes in DLB is distinguishable from that in AD.

Myasthenic crisis after resection of an isolated metastatic thymoma of the cervical spine

A 73-year-old man presented with cervical cord compression resulting from a metastatic spindle cell thymoma 10 years after undergoing thymectomy for thymoma-associated myasthenia gravis. After being virtually asymptomatic following thymectomy, his myasthenic symptoms returned 3 months after removal of the spinal metastasis, culminating in myasthenic crisis that required immunosuppression and plasma exchange This case shows that isolated, extrathoracic metastases without any mediastinal tumor may occur many years after apparent surgical cure of primary thymoma, and that myasthenia gravis may recur after surgical resection of a thymic metastasis.

Dementia with Lewy bodies: choline acetyltransferase parallels nucleus basalis pathology

The biological substrate underlying the reduced cortical choline acetyltransferase (ChAT) in dementia with Lewy bodies (DLB) is incompletely understood. We compared cortical ChAT levels with Lewy body densities and neuronal loss in the nucleus basalis of Meynert (nbM) and cerebral cortex in six DLB, seven Alzheimer's disease (AD), and six control cases. We found greater neuronal loss in the nbM in DLB compared to AD (U = 9.500, p = 0.049). Mean ChAT levels in the cortex were lower in dementia patients than controls (t = 17.500, p = 0.001), and DLB cases had slightly lower ChAT levels than AD cases, but this difference was not significant (t = -0.332, p = 0.746). Overall, cortical ChAT levels correlated inversely with neuronal loss in the nbM (Spearman rank correlation coefficient = -0.53). The correlation between ChAT level and the combined factor of nbM LBs and neuronal loss was -0.59. A similar correlation between ChAT level and the combined factor of nbM neurofibrillary tangles and neuronal loss was -0.72. The correlation between ChAT and the combined factor of nbM LBs and neuronal loss was -0.81 when AD cases were excluded from the analysis. Local cortical pathology was not related to ChAT level. We conclude that neuronal loss and Lewy body formation in the nbM may contribute to the reduction in cortical ChAT in DLB.

Neuronal and glial DNA fragmentation in Pick's disease

Pick's disease (PD) is characterized by severe neuronal loss and gliosis in a frontotemporal lobar distribution, often associated with Pick bodies and ballooned neurons. Abnormal tau metabolism has been implicated in the pathogenesis of PD; however, the underlying mechanism of neuronal degeneration remains poorly understood. Evidence from other neurodegenerative diseases has suggested that DNA damage and apoptosis may play a major role in cellular degeneration and death. In the present study, an in situ nucleotidyl transferase assay (ISNTA) was used to identify DNA fragmentation in three cases of classical PD with Pick bodies and ballooned neurons, and two PD "variants", one with ballooned neurons only and the other without Pick bodies or ballooned neurons. In all cases large numbers of ISNTA-positive neurons were present in anatomic regions having obvious degenerative changes (neuronal atrophy and loss, gliosis, cytoplasmic inclusions) by conventional histology. There was no clear association between neuronal DNA fragmentation and the presence of structural abnormalities such as Pick bodies or ballooned cytoplasm. ISNTA-positive glia were present in both cortex and subcortical white matter. Morphologic evidence of apoptosis was not detected in either neurons or glial cells. We suggest that DNA fragmentation in PD and probably other neurodegenerative disorders most likely specifies a population of potentially vulnerable cells in which both cell death and repair mechanisms have been activated. It is likely that only a very small number of these vulnerable cells at a given time will proceed to cell death; however, it is uncertain whether this occurs by apoptosis or some other mechanism.

Hostility and cardiovascular reactivity during marital interaction

OBJECTIVE

Prior studies demonstrate that hostile persons respond to social stressors with heightened cardiovascular responses. This study examined the effects of individual differences in hostility and two experimentally manipulated social stressors on cardiovascular reactivity during marital interaction.

METHODS

Sixty couples participated in a discussion task under conditions of high or low evaluative threat and while either agreeing or disagreeing with each other. Individual differences in hostility were assessed with the Buss-Perry Aggression Questionnaire. Participants' appraisal of their spouses' behavior during the interaction task was assessed with a standardized measure. Systolic and diastolic blood pressure and heart rate responses were recorded.

RESULTS

Among husbands, hostility was associated with greater systolic blood pressure reactivity under high, but not low, threat. Appraisals suggested that this might be due to husbands' efforts to assert dominance in the interaction. Wives' hostility scores were unrelated to cardiovascular reactivity, but wives disagreeing with hostile husbands showed greater heart rate reactivity.

CONCLUSIONS

Heightened cardiovascular reactivity to stressful marital interactions among hostile men provides additional evidence of the viability of this psychophysiologic mechanism as a link between hostility and health. The lack of effects among wives suggests sex differences in the social psychophysiology of hostility. Interpersonal concepts and methods are useful in the study of psychosocial risk factors and mechanisms.

Effects of larval mosquitoes (Aedes triseriatus) and stemflow on microbial community dynamics in container habitats

The dynamics of the microbial food sources for Aedes triseriatus larvae in microcosms were found to be strongly influenced by larval presence. The total abundance of bacteria in water samples generally increased in response to larvae, including populations of cultivable, facultatively anaerobic bacteria. Additionally, a portion of the community shifted from Pseudomonaceae to Enterobacteriaceae. Bacterial abundance on leaf material was significantly reduced in the presence of actively feeding larvae. Principle-component analysis of whole community fatty acid methyl ester (FAME) profiles showed that larvae changed the microbial community structure in both the water column and the leaf material. Cyclopropyl FAMEs, typically associated with bacteria, were reduced in microcosms containing larvae; however, other bacterial fatty acids showed no consistent response. Long-chain polyunsaturated fatty acids characteristic of microeukaryotes (protozoans and meiofauna) declined in abundance when larvae were present, indicating that larval feeding reduced the densities of these microorganisms. However, presumed fungal lipid markers either increased or were unchanged in response to larvae. Larval presence also affected microbial nitrogen metabolism through modification of the physiochemical conditions or by grazing on populations of bacteria involved in nitrification-denitrification. Stemflow primarily influenced inorganic ion and organic compound concentrations in the microcosms and had less-pronounced effects on microbial community parameters than did larval presence. Stemflow treatments diluted concentrations of all inorganic ions (chloride, sulfate, and ammonium) and organic compounds (total dissolved organic carbon, soluble carbohydrates, and total protein) measured, with the exceptions of nitrite and nitrate. Stemflow addition did not measurably affect larval biomass in the microcosms but did enhance development rates and early emergence patterns of adults.

Perceptions of spouse dominance predict blood pressure reactivity during marital interactions

Cardiovascular reactivity (CVR) has been identified as a potential mechanism linking a variety of psychosocial processes to the development of cardiovascular disease. Although the effects of hostile and supportive social stimuli on CVR have been studied extensively, less is known about the effects of a second major dimension of social relations--dominance versus submissiveness. In the present study, 45 married couples participated in an interaction task involving the assertion of differing opinions. Subjects also provided ratings of their typical level of dominance versus submissiveness in relation to their spouse. Consistent with predictions derived from related conceptual models of psychological determinants of CVR, blood pressure reactivity was positively associated with perceptions of the spouse as dominant. At the highest level of perceived spouse dominance, CVR was attenuated, again consistent with prediction. Results are discussed in terms of the usefulness of conceptual models of interpersonal relations and motivation as guides in studying the social determinants of CVR, as well as the value of marital interactions as a context for understanding CVR.

Cutaneous melanoma-associated paraneoplastic retinopathy: histopathologic observations

PURPOSE

To describe the retinal histopathology of paraneoplastic retinopathy associated with cutaneous melanoma.

METHODS

A 59-year-old man had visual loss attributable to paraneoplastic retinopathy and died of metastatic cutaneous melanoma. His eyes were studied by conventional histopathologic techniques.

RESULTS

Histopathologic examination of both eyes disclosed a marked reduction in the density of bipolar neurons in the inner nuclear layer; photoreceptor cell neurons in the outer nuclear layer were normal. Ganglion cells were present, although many showed evidence of transsynaptic atrophy.

CONCLUSION

The histopathologic changes observed are consistent with clinical, immunologic, and electrophysiologic data that implicate the bipolar cell as the major site of the paraneoplastic process in cutaneous melanoma-associated retinopathy.

Orthopaedic management in four cases of mucolipidosis type III

Four patients with mucolipidosis type III, three of them brothers, were seen initially in the first two decades of life. Their main symptoms were carpal tunnel syndrome, trigger fingers and generalized joint stiffness. Radiographs showed spinal deformities and hip dysplasia, but these were not causing pain. Carpal tunnel syndrome was treated surgically but joint stiffness and hip and knee contractures were managed by physiotherapy. Up to the age of 24 none of these patients has had pelvic osteotomy for hip dysplasia; this operation, not yet reported in mucolipidosis type III, may eventually be necessary.

Initial experience with a steerable intracardiac echocardiographic catheter

INTRODUCTION

Intracardiac echocardiography (ICE) has been used to guide radiofrequency catheter ablation procedures and transseptal punctures. The ability to position current ICE catheters is limited. In this study, we report on the initial experience with a steerable ICE catheter in a canine model and in man.

METHODS

In a canine model, we compared the image quality and maneuverability of a 9 French (Fr), 9 MHz ICE catheter and a custom 9 Fr, 9 MHz steerable ICE catheter. Imaging was attempted at 7 intracardiac sites. Non-steerable catheter positioning was attempted with the catheter alone or with the curved, long 10 Fr vascular sheath. Steerable catheter positioning was attempted with the catheter alone after the vascular sheath was withdrawn into the inferior vena cava. The steerable ICE catheter was also used to help guide catheter ablation in a patient with right ventricular outflow tract (RVOT) tachycardia.

RESULTS

The steerable ICE catheter was easily positioned at all 7 predetermined sites without the need for a long vascular sheath. In contrast, the non-steerable catheter was much more difficult to position. Image quality was similar for both catheters; depths of imaging were 4-8 cm, depending on catheter location. Multiple image planes could be achieved at a single site with tip deflection of the steerable catheter. In man, the steerable catheter was easily positioned to the RVOT. ICE imaging was helpful in positioning the ablation catheter below the pulmonic valve and ensuring good electrode-tissue contact during energy delivery.

CONCLUSION

Steerability improved maneuverability and added multiple image planes compared to a non-steerable ICE catheter. Steerability may enhance the utility of ICE in guiding catheter ablation procedures.

Effects of breeder age and dietary fat on subsequent broiler performance. 2. Slaughter yield

The effects of breeder age (35, 51, and 63 wk) and added dietary fat on subsequent broiler slaughter yield were evaluated. Beginning at 22 wk of age, diets included 0, 1.5, or 3.0% added poultry fat (PF), 1.5 or 3.0% added corn oil (CO), or 3.0% added lard (LA). Slaughter yields were greatest in broilers from 63-wk-old breeders. Added CO in broiler breeder diets significantly increased subsequent 43-d live BW and chilled carcass yields compared to LA. Furthermore, CO diets significantly increased relative front-half yields compared to PF diets; and compared to the 3.0% fat level, 1.5% added fat significantly increased 43-d live BW, regardless of fat type. In conclusion, breeder age influenced broiler slaughter yield, and fat added at the 1.5% level to breeder hen diets was an effective energy source. However, less saturated fat improved subsequent slaughter yield.

Effects of breeder age and dietary fat on subsequent broiler performance. 1. Growth, mortality, and feed conversion

The effects of breeder age (35, 51, and 63 wk) and added dietary fat on subsequent broiler growth, mortality, and feed conversion through 42 d were evaluated. Beginning at 22 wk of age, diets included 0, 1.5, or 3.0% added poultry fat (PF), 1.5 or 3.0% added corn oil (CO), or 3.0% added lard (LA). Broilers from hens 35 wk of age performed better between 0 and 21 d than those from 51- and 63-wk-old hens. Conversely, between 22 and 42 d, broilers from hens 51 wk of age performed better than those at 35 and 63 wk. In relation to PF, CO added to breeder diets increased 0 to 21 d BW gain in broilers; whereas, feed conversion between 22 and 42 d was reduced in broilers from hens fed PF compared to those fed CO. In conclusion, breeder age influenced broiler performance differently throughout the growout period. Fat added at the 1.5% level to breeder hen diets was an effective energy source. However, less saturated fat improved growout performance.

Agency, communion, and cardiovascular reactivity during marital interaction

The concepts of agency and communion have been used to describe sex differences in vulnerability to specific stressor domains. This study examined blood pressure and heart rate responses of 60 married couples to experimental manipulations of disagreement (i.e., communion stressor) and achievement challenge (i.e., agency stressor). Consistent with predictions, disagreement elicited heightened cardiovascular reactivity among wives, but not husbands. In contrast, the achievement challenge elicited heightened cardiovascular reactivity among husbands, but not wives. Participants' responses to a circumplex measure of interpersonal appraisal were consistent with the interpretation of differential responses to agency and communion stressors. Results are congruent with a situational approach to sex differences in cardiovascular reactivity and illustrate the utility of interpersonal methods in the explication of psychosocial risk for cardiovascular disease.

Diffuse axonal injury in infants with nonaccidental craniocerebral trauma: enhanced detection by beta-amyloid precursor protein immunohistochemical staining

OBJECTIVE

Accurate identification of diffuse axonal injury is important in the forensic investigation of infants who have died from traumatic brain injury. beta-Amyloid precursor protein (beta-APP) immunohistochemical staining is highly sensitive in identifying diffuse axonal injury. However, the effectiveness of this method in brain-injured infants has not been well established. The present study was undertaken to assess the utility of beta-APP immunohistochemistry in detecting diffuse axonal injury in infants with either shaken baby syndrome or blunt head trauma.

MATERIALS AND METHODS

Archival formalin-fixed, paraffin-embedded blocks from infants (<1 year old) with shaken baby syndrome (7 cases) and blunt head trauma (3) and blocks from 7 control cases that included nontraumatic cerebral edema (1), acute hypoxic-ischemic encephalopathy (1), and normal brain (5) were immunostained for beta-APP. A semiquantitative assessment of the severity of axonal staining was made. Corresponding hematoxylin-eosin-stained sections were examined for the presence of axonal swellings.

RESULTS

Immunostaining for beta-APP identified diffuse axonal injury in 5 of 7 infants with shaken baby syndrome and 2 of 3 infants with blunt head trauma. Immunoreactive axons were easily identified and were present in the majority of the sections examined. By contrast, hematoxylineosin staining revealed axonal swellings in only 3 of 7 infants with shaken baby syndrome and 1 of 3 infants with blunt head trauma. Most of these sections had few if any visible axonal swellings, which were often overlooked on initial review of the slides. No beta-APP immunoreactivity was observed in any of the 7 control cases.

CONCLUSIONS

Immunostaining for beta-APP can easily and reliably identify diffuse axonal injury in infants younger than 1 year and is considerably more sensitive than routine hematoxylin-eosin staining. We recommend its use in the forensic evaluation of infants with fatal craniocerebral trauma.

Ki-67 (clone MIB-1) proliferation index in recurrent glial neoplasms: no prognostic significance

BACKGROUND

To determine if the Ki-67 (MIB-1 clone) proliferative index (PI) has prognostic potential in patients with recurrent astroglial neoplasms.

METHODS

We conducted a retrospective review of 27 patients whose initial and recurrent specimens were available. Histopathology was determined according to the World Health Organization classification. Proliferation index was calculated on formalin-fixed tissue using the Ki-67 (MIB-1 clone) antibody. Morphometric data were analyzed in conjunction with clinical data and Cox Proportionate Hazards Analysis, Spearman's correlation coefficient and Mann-Whitney Test.

RESULTS

Initial histopathology included 14 glioblastoma multiforme, 7 anaplastic astrocytoma, 3 oligoastrocytoma, and 3 astrocytoma. Recurrent specimens showed changes consistent with treatment. While univariate analysis shows initial histology correlated with survival (p<0.036), PI did not correlate with survival after either initial (p = 0.86) or recurrent (p = 0.46) surgery for any tumor type. PI difference between specimens also did not correlate with survival (p = 0.91). Initial PI did not correlate with recurrent PI either (p = 0.43).

CONCLUSIONS

Ki-67 PI does not confer additional prognostic information for patients with recurrent astroglial neoplasms. One possible explanation for this observation is that treatment may alter the PI independent of its effect on tumor growth.

Sudden unexpected death from primary posterior fossa tumors

We report 2 cases of sudden death in which hospital autopsies revealed unsuspected primary posterior fossa neoplasms. The first case was a 3-year-old girl who was found apneic and pulseless in bed and was brought to the hospital moribund and could not be resuscitated. Autopsy revealed a 3-cm ganglioglioma that infiltrated nearly the entire medulla. The second case involved a 39-year-old man who was found asystolic and unresponsive in bed. He was resuscitated and maintained on a ventilator for a few hours, after which life support was withdrawn. Autopsy showed a 5-cm pilocytic astrocytoma arising from the ventral cerebellum and extending into the fourth ventricle and compressing the brain stem. Previously reported cases of clinically unsuspected primary posterior fossa tumors presenting with sudden death are reviewed. Hypotheses for the mechanism of sudden death are presented.

Intracranial leiomyosarcoma: a neuro-oncological consequence of acquired immunodeficiency syndrome

Leiomyosarcoma has recently been identified as an AIDS-related tumor, usually occurring in children in the chest or abdomen. We describe a case of intracranial leiomyosarcoma in an adult with AIDS. An enhancing mass adjacent to the right occipital cortical surface was diagnosed during a work-up for left arm weakness. Imaging characteristics were suggestive of a malignant neoplasm versus meningioma. The patient had a craniotomy for total excision of the lesion. Pathology showed a leiomyosarcoma. Metastatic work-up was negative. The patient refused radiation therapy, but is well without evidence of recurrence at 8 months follow-up. The differential diagnosis for intracranial lesions in AIDS should be expanded to include leiomyosarcoma. Surgical resection of the lesion is recommended.

The gender gap in reporting household gun ownership

OBJECTIVES

This study examined errors in estimating household gun ownership that result from interviewing only 1 adult per household.

METHODS

Data from 2 recent telephone surveys and a series of in-person surveys were used to compare reports of household gun ownership by husbands and wives.

RESULTS

In the telephone surveys, the rate of household gun ownership reported by husbands exceeded wives' reports by an average of 12 percentage points; husbands' reports also implied 43.3 million more guns. The median "gender gap" in recent in-person surveys is 7 percentage points.

CONCLUSIONS

Future research should focus on respondents' reports about personally owned guns.

Agency, communion, and cardiovascular reactivity during marital interaction

The concepts of agency and communion have been used to describe sex differences in vulnerability to specific stressor domains. This study examined blood pressure and heart rate responses of 60 married couples to experimental manipulations of disagreement (i.e., communion stressor) and achievement challenge (i.e., agency stressor). Consistent with predictions, disagreement elicited heightened cardiovascular reactivity among wives, but not husbands. In contrast, the achievement challenge elicited heightened cardiovascular reactivity among husbands, but not wives. Participants' responses to a circumplex measure of interpersonal appraisal were consistent with the interpretation of differential responses to agency and communion stressors. Results are congruent with a situational approach to sex differences in cardiovascular reactivity and illustrate the utility of interpersonal methods in the explication of psychosocial risk for cardiovascular disease.

Comparative study of fluoroscopy and intracardiac echocardiographic guidance for the creation of linear atrial lesions

BACKGROUND

Recently, attempts have been made to cure atrial fibrillation by creating multiple linear atrial lesions with radiofrequency energy. Intracardiac echocardiography (ICE) offers imaging of endocardial anatomy and the ablation electrode-tissue interface not available with standard fluoroscopy. This study sought to prospectively compare fluoroscopic with ICE guidance for the creation of linear atrial lesions in a canine model.

METHODS AND RESULTS

The creation of 3 linear atrial lesions was attempted in each of 10 dogs, half guided by fluoroscopy alone and half by ICE. Coil-tissue contact was prospectively graded. After ablation, animals were euthanized, and the location and continuity of lesions were evaluated. ICE guidance led to a higher percentage of successful applications (P=0.02) and mean achieved temperature (P=0. 004). The contact scores of excellent, fair, and poor correlated well with successful energy delivery, mean temperature, and efficiency of heating (P<0.0001). In 25% of the blinded energy deliveries, the location, as determined by the ablation operator, differed from that of ICE. Pathological evaluation revealed improved lesion formation in the ICE-guided compared with the ICE-blinded group. Lesions were found outside the target areas in the ICE-blinded but not the ICE-guided group.

CONCLUSIONS

Compared with fluoroscopy, ICE guidance improved targeting, energy delivery, and lesion formation in this canine model. This study suggests that ICE guidance improves lesion formation and prevents energy delivery to potentially dangerous sites.