Light and electron microscopical observations of the effects of high-density lipoprotein on growth of Plasmodium falciparum in vitro

Human serum high-density lipoprotein (HDL) is necessary and sufficient for the short-term maintenance of Plasmodium falciparum in in vitro culture. However, at high concentrations it is toxic to the parasite. A heat-labile component is apparently responsible for the stage-specific toxicity to parasites within infected erythrocytes 12-42 h after invasion, i.e. during trophozoite maturation. The effects of HDL on parasite metabolism (as determined by nucleic acid synthesis) are evident at about 30 h after invasion. Parasites treated with HDL show gross abnormalities by light and electron microscopy.

Evaluation of Arm-Leg Coordination in Flat Breaststroke

This study proposes a new method to evaluate arm-leg coordination in flat breaststroke. Five arm and leg stroke phases were defined with a velocity-video system. Five time gaps quantified the time between arm and leg actions during three paces of a race (200 m, 100 m and 50 m) in 16 top level swimmers. Based on these time gaps, effective glide, effective propulsion, effective leg insweep and effective recovery were used to identify the different stroke phases of the body. A faster pace corresponded to increased stroke rate, decreased stroke length, increased propulsive phases, shorter glide phases, and a shorter T1 time gap, which measured the effective body glide. The top level swimmers showed short time gaps (T2, T3, T4, measuring the timing of arm-leg recoveries), which reflected the continuity in arm and leg actions. The measurement of these time gaps thus provides a pertinent evaluation of swimmers' skill in adapting their arm-leg coordination to biomechanical constraints.

Role of early anthracycline dose-intensity according to expression of Philadelphia chromosome/BCR-ABL rearrangements in B-precursor adult acute lymphoblastic leukemia

INTRODUCTION

The use of anthracycline antibiotics in adult acute lymphoblastic leukemia (ALL) has resulted in an improved outcome to remission induction therapy. However,the exact role of these drugs in consolidation therapy is less clear, especially in specific ALL subsets.

MATERIALS AND METHODS

A retrospective analysis was conducted on the outcome of 308 patients (median age 35 years, range 13-75) with the most frequent subtype, early-B ALL, treated between 1974 and 1998 on eight consecutive protocols. Anthracycline-related effects were assessed by evaluating the impact of planned anthracycline dose-intensity (A-DI) on long-term outcome. A-DI (in mg/m(2)/week) during the first twelve weeks of consolidation therapy was classified as either "high" (doxorubicin>20, idarubicin>7) or "low".

RESULTS

Complete remission was achieved in 78% of cases. With a median follow-up of 6.5 years, on multivariate analysis, disease-free survival (DFS) correlated only with expression of the Philadelphia (Ph) chromosome and/or associated BCR-ABL rearrangements (Ph/BCR(+)) (P=0.0001) and planned A-DI (P<0.0001). On this basis, four major prognostic groups with significantly different DFS could be identified: (1) Ph/BCR(-), "high" A-DI (n=102), median 3.5 years and 41% at five years, respectively; (2) Ph/BCR(-), "low" A-DI (n=64), 1.3 years and 16%; (3) Ph/BCR(+), "high" A-DI (n=35), 1.7 years and 20%; (4) Ph/BCR(+), "low" A-DI (n=39), 0.75 years and 0%. When analyzed separately for Ph/BCR(-) (n=166) and Ph/BCR(+) (n=74) patients, the A-DI effect on DFS was preserved in the former (P=0.018) whereas, in Ph/BCR(+) patients, only age <50 years (P=0.004) and blast count <25 x 10(9)/l (P=0.02) correlated with better DFS. However, Ph/BCR(+) patients with the best prognostic profile (age <50 years and blast count <25 x 10(9)/l; n=21) who were treated on "high" A-DI regimens experienced a median DFS of 2.2 years with DFS 21% at five years, compared to 0.67-1 years and 0-10% in other cases (n=53, P<0.01).

CONCLUSION

A "high" A-DI may act as a positive treatment-related prognostic factor in early B-lineage ALL. Although mainly restricted to patients with Ph/BCR(-) ALL, A-DI could also influence the outcome in Ph/BCR(+) patients with other favorable prognostic factors.

Nurse managers' use of a computer decision support system. Differences in nursing labor costs per patient day

To control nursing labor cost, nurse managers (NMs) need access to productivity indicators and financial performance information on a daily basis. Labor cost and hour reports after the fact are no longer acceptable for making crucial management/labor decisions. The purpose of this study was to determine if there was a mean difference in nursing labor cost per patient day (PPD) when a nurse manager used a labor computer decision support system (CDSS) compared to an NM who did not use this system. This descriptive study was implemented on a study and comparison unit in both a psychiatric and a medical hospital. The CDSS provided the NMs with daily labor cost information on which to base labor decisions. Study findings indicate that with the use of the labor CDSS, nurse managers achieved better cost performance per patient day compared to the nurse managers who did not use the labor CDSS.

Genetic abnormalities detected in ependymomas by comparative genomic hybridisation

Using comparative genomic hybridisation, we have analysed genetic imbalance in a series of 86 ependymomas from children and adults. Tumours were derived from intracranial and spinal sites, and classified histologically as classic, anaplastic or myxopapillary. Ependymomas showing a balanced profile were significantly (P<0.0005) more frequent in children than adults. Profiles suggesting intermediate ploidy were common (44% of all tumours), and found more often (P<0.0005) in tumours from adults and the spinal region. Loss of 22q was the most common specific abnormality, occurring in 50% of spinal (medullary) ependymomas and 26% of tumours overall. Genetic profiles combining loss of 22q with other specific abnormalities--gain of 1q, loss of 6q, loss of 10q/10, loss of 13, loss of 14q/14--varied according to site and histology. In particular, we showed that classic ependymomas from within the cranium and spine have distinct genetic profiles. Classic and anaplastic ependymomas with gain of 1q tended to occur in the posterior fossa of children and to behave aggressively. Our extensive data on ependymomas demonstrate significant associations between genetic aberrations and clinicopathological variables, and represent a starting point for further biological and clinical studies.

Consumer health information. What the research is telling us

BACKGROUND

Consumer health information is a necessary component of patient care and consumer participation.

OBJECTIVE

To outline the findings of the 'Assessing the Quality of Consumer Health Information Project' and discuss strategies for improving consumer information.

DISCUSSION

The pamphlets identified in this study were not developed with consumer input with consequent deficits apparent. Providers and consumers appeared to use the information for very different purposes but both groups were critical of the ambiguous terminology and lack of quantified data. The provision of relevant information is a fundamental prerequisite of consumer participation in decision making in health care. Such information needs to be available, accurate, and understandable.

Consuming the evidence: consumers and evidence-based medicine

Consumers have varying expectations and knowledge about evidence-based medicine (EBM), but expect the healthcare system to offer best practice based on the latest evidence. With the increasing power of the consumer movement, EBM has the potential to promote informed participation in health decision making by individual consumers and carers. To more effectively incorporate consumer experiences, views and concerns into the evidence base, there needs to be greater value put on qualitative research and acknowledgement of its importance. Consumers would like the research agenda to reflect population health needs, and for there to be more consultation about evidence-based decisions on access to care and rationing, and greater understanding of consumers' attitudes in decisions about treatment. Consumers want patient-centred healthcare and therefore must be involved collaboratively in the way EBM is used by health services and health practitioners.

From open air to high tech care: orthopaedic nursing at Oswestry, 1921-2000

A previous article in the September/October 2000 issue of Orthopaedic Nursing outlined the early career of Agnes Hunt, the opening of the Baschurch Home on October 1, 1900, and its evolution into an orthopaedic hospital. This article describes the development of the hospital on its new site near Oswestry, from 1921 to the present day. It describes the further development of orthopaedic nursing and orthopaedics through the war years and up to the present day.

Psychiatric bed utilization: 1896 and 1996 compared

BACKGROUND

The 1896 and 1996 populations of North West Wales are similar in number, ethnic and social mix and rurality, enabling a study of the comparative incidence and prevalence of service utilization over the course of a century.

METHODS

We collected records on all psychiatric admissions from North-West Wales in 1894-1896 and 1996. These were assessed and diagnosed by the responsible sector area consultant.

RESULTS

The data reveal substantially more patients admitted for all diagnoses in 1996. even when comparisons are restricted to detained patients. The incidence of hospitalization by detention for schizophrenia is slightly lower 1996 than in 1896 but the incidence of hospitalization is higher now than in 1996. The incidence of hospitalization by detention for non-affective disorder psychoses is the same in both 1896 and 1996 but there is a doubling of incidence of hospitalization. The incidence of hospitalization for bipolar disorders is similar in the two periods. Modern mental health services admit large numbers of personality disordered patients, where none were admitted 100 years ago.

CONCLUSIONS

Factors general to changing health care and expectations and others specific to mental health would appear to have led to the increase in rates of admissions observed in the modern period.

Indazolylamino quinazolines and pyridopyrimidines as inhibitors of the EGFr and c-erbB-2

Described herein is the design and synthesis of indazolylaminopyridopyrimidines and quinazolines as inhibitors of the class 1 tyrosine kinase receptor family. Data is presented for N(4)-(1-benzyl-1H-indazol-5-yl)-N(6),N(6)-dimethylpyrido[3,4-d]pyrimidine-4,6-diamine 3B. This compound inhibited EGFr and c-erbB-2 enzymes selectively over other kinases. It inhibited the proliferation of a range of tumour cell lines in vitro and the growth of BT474 xenografts in SCID mice.

Long-term outcome of patients surviving for more than ten years following treatment for acute leukaemia

Between 1972 and 1988, 832 consecutive patients were treated for acute leukaemia at St. Bartholomew's Hospital; a retrospective analysis has been conducted to determine the clinical course and outcome for 101 who have survived > or = 10 years following treatment. At a median follow-up of 16 years (range 10-28 years), 86 patients (86 out of 834 total, 11%) were still alive. Long-term follow-up of patients who have survived > or = 10 years following treatment for acute leukaemia revealed that most patients were in normal health, although a significant number of complications had occurred.

Surgical confirmation of ProstaScint abnormalities in two patients with high risk prostate cancer

We describe our initial experience using ProstaScint scanning in addition to conventional imaging modalities for staging of high risk prostate cancer. Using our protocol, ProstaScint images detected abnormalities in pelvic lymph nodes not seen on CT scan or magnetic resonance imaging (MRI) in two patients. Subsequent surgical pelvic lymphadenectomy confirmed these abnormalities. Further patients will be accrued on this study to estimate the sensitivity and specificity of ProstaScint scanning.

Validation of molecular markers for wheat breeding

Five sets of markers were assessed for their usefulness in breeding, two linked to wheat stem rust gene Sr2, several markers linked to a chromosome segment conferring Yr17/Lr37/Sr38 resistance, two reported markers for the linked genes Lr35 andSr39, one for Lr28, and one linked to flour colour. The gene for Sr2 confers adult plant resistance to stem rust (Puccinia graminis f.sp. tritici) and was originally transferred to bread wheat from the tetraploid emmer (‘Yaroslav’) to the cultivars Hope and H-44. The gene is located on the short arm of chromosome 3B and confers a durable adult plant resistance to stem rust usually expressed only in the field. The chromosome segment carrying the Lr37, Sr38, Yr17 resistance genes is located on 2AS and was originally introduced into wheat through an Aegilops ventricosa Triticum persicum cross, followed by a cross to the cultivar Marne (VPM1). The flour colour quantitative trait locus was originally described in a Yarralinka Schomburg cross and is located on chromosome 7A. The primers as originally developed required optimisation for more routine use in a breeding program.

Development of robust PCR-based DNA markers for each homoeo-allele of granule-bound starch synthase and their application in wheat breeding programs

The absence of expression of the granule-bound starch synthase I (GBSSI) allele from chromosome 4A of wheat is associated with improved starch quality for making Udon noodles. Several PCR-based methods for the analysis of GBSS alleles have been developed for application in wheat. A widely applied approach has involved a simple PCR followed by electrophoretic separation of DNA products on agarose gels. The PCR amplifies one band from each of the loci on chromosomes 4A (Wx-B1), 7A (Wx-A1), and 7D (Wx-D1), and the band from the Wx-B1 locus is diagnostic for the occurrence of the null Wx-B1 allele that is associated with improved starch quality. The reliable detection of the null Wx-B1 allele has been important in identifying wheat breeding lines. Allele-specific PCR has also been used to successfully detect the occurrence of the null Wx-B1 allele. In the present paper the various protocols were evaluated by testing a segregating double haploid population from a cross between Cranbrook and Halberd and the tests gave good agreement in different laboratories. The application of the DNAbased tests applied in wheat breeding programs provides one of the first examples of a molecular marker selection for a grain quality trait being successfully applied in an Australian wheat breeding program.

Implementation of markers in Australian wheat breeding

Genetic associations of morphological, biochemical, and DNA markers with economically important traits can be used for indirect selection of the traits. Chromosomal linkage between pseudo-black chaff and the stemrust resistance gene Sr2, and between the red glume gene (Rg1) and the stripe rust resistance gene Yr10, have been used in this way for many years. Similarly, linkages between disease resistance genes, such as Sr38,Lr37, and Yr17, have been used to achieve resistance to multiple diseases while selection is performed for resistance to one disease. Alleles at the Glu loci, assessed as protein differences, have been used as predictors of dough strength. More recently, DNA markers have been developed and used, especially to select for resistance to cereal cyst nematode, a trait which is difficult and expensive to assess with conventional bioassays. We found that the major use of DNA markers was for selection for traits of substantial economic importance, which were primarily determined by a single gene, and where the non-marker assay was expensive and unreliable. The other uses of markers were for pyramiding several genes influencing one trait, or for rapid backcrossing.

Implementation of probes for tracing chromosome segments conferring barley yellow dwarf virus resistance

Two PCR-based assays were examined for tracing the presence of a Thinopyrum chromosome segment (Tc6 or Tc14) conferring barley yellow dwarf virus (BYDV) resistance in wheat breeding lines. The microsatellite gwm37 was used to assay the Thinopyrum chromosome segment or its wheat, Group 7, homoeologous segment, and was effective in characterising breeders material since heterozygous lines could be identified. A new set of primers derived from a Thinopyrum-specific DNA segment (csTiB1) provided a dominant marker that was readily scored by agarose gel electrophoresis. It was also demonstrated that the csTiB1 primers could be used to establish a solid phase PCR assay that avoided the requirement for gel electrophoresis and was amenable to use in a high-throughput, microtitre plate format. Depending on the number of DNA samples to be assayed, both primer pairs appear to have a place in breeding programs.

An autosomal recessive, lethal, neurologic disease of Gordon Setter puppies

This report details clinical, necropsy, and pedigree data on an inherited, lethal, neurologic disease of young Gordon Setters. This disorder is characterized by an early age of onset, gait and postural abnormalities, progressive weakness, and recumbency by 5-6 weeks of age. Although clinically distinctive, postmortem changes in affected pups were minimal. Gross lesions were not observed. Microscopic changes were subtle and consisted of astrocyte swelling, primarily in the cerebrocortical and cerebellar white matter, and white matter tracts of the brainstem. Immunohistochemistry for glial fibrillary acidic protein revealed a marked increase in the number and staining intensity of astrocyte cytoplasmic processes in affected pups compared with age-matched controls. Neither cerebral inflammation nor neuronal necrosis was identified. Pedigree analysis of affected litters demonstrated an autosomal recessive mode of inheritance. A diagnosis of this heritable disease should be based on the early age of onset (3-4 weeks of age), characteristic clinical signs, rapid progression to recumbency by 5-6 weeks of age, identification of swollen astrocytes primarily in the cerebellar and cerebrocortical white matter and white matter tracts of the brainstem, and the exclusion of other disease processes.