A Cambrian Peak in Morphological Variation Within Trilobite Species

Morphological variation within species is a raw material subject to natural selection. However, temporal change in morphological diversity has usually been studied in terms of variation among rather than within species. The distribution of polymorphic traits in cladistic character-taxon matrices reveals that the frequency and extent of morphological variation in 982 trilobite species are greatest early in the evolution of the group: Stratigraphically old and/or phylogenetically basal taxa are significantly more variable than younger and/or more derived taxa. Through its influence on evolutionary tempo, high intraspecific variation may have played a major role in the pronounced Cambrian diversification of trilobites.

The AST petal dedicated bifurcation stent: First-in-human experience

The aim of this first-in-human study was to evaluate the feasibility and safety of the novel AST petal side-access bifurcation stent. Outcomes following percutaneous coronary intervention for bifurcations remain inferior to those of nonbifurcated lesions. Even with drug-eluting stents, restenosis occurs especially at the side-branch (SB) ostium. The petal stent uniquely deploys strut elements into the SB, supporting the ostium and carina. The primary endpoint of this 13-patient prospective registry was in-hospital major adverse cardiac events (MACE). Secondary end points included acute minimum lumen diameter (MLD) at the SB ostium, lesion success, device success, procedural success, 30-day MACE, and 4-month SB ostial MLD. The study lesion was successfully treated in 13 patients with the study stent being successfully implanted in 12. Target lesions were left anterior descending coronary artery in nine subjects, left circumflex in three, and right coronary artery in one. In-hospital MACE were limited to two non-Q-wave myocardial infarctions. In-stent main branch MLD increased from a mean of 0.63 +/- 0.45 mm to 2.61 +/- 0.47 mm at the index procedure and for this initial bare metal version of the stent, 4-month mean MLD measured 1.02 +/- 0.42 mm and there was target vessel revascularization on two patients. The feasibility of safely deploying this first-generation petal stent was demonstrated in selected patients with challenging coronary bifurcation lesions. It is a promising platform for drug delivery, with unique scaffolding of the side-branch ostium.

A phase I/II trial of weekly docetaxel and cisplatin for locoregionally recurrent/metastatic squamous cell carcinoma of the head and neck (SCCHN)

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Background: Docetaxel and cisplatin are both active agents in the treatment of advanced SCCHN. In phase II trials the combination of docetaxel and cisplatin delivered on a 3 weekly schedule in recurrent/metastatic SCCHN demonstrated response rates (RR) of 33–46%, however it is associated with significant morbidities and treatment related mortalities. In a phase IB trial design we sought to determine the maximal tolerated dose (MTD) and the recommended dose for weekly docetaxel and cisplatin to further study in a phase II trial. Methods: Patients with measurable locoregionally recurrent and/or metastatic SCCHN with no prior chemotherapy for advanced disease were eligible. Four dose levels were planned, starting with docetaxel 25 mg/m2 and cisplatin 20 mg/m2 weekly (dose level 1) to docetaxel 35 mg/m2 and cisplatin 25 mg/m2 (dose level 4) for three consecutive weeks followed by a one week break (=1 cycle). Pharmacokinetics (PK) were performed during cycle 1 and 2. Response was assessed following every 2nd cycle. Patients were followed for safety, tolerability, duration of response and survival. Results: 16 patients were enrolled from Aug 2003-Oct 2005. 80% were male, median age 61 years (36–72), median PS 1 (0–2), 30% had prior platinum exposure as a radio-sensitizer, and two-thirds had metastatic SCCHN. MTD was not achieved with dose level 4. Median number of cycles delivered was 3 (1–6) with no significant dose reductions or delays. No G3/4 hematological toxicities or febrile neutropenia was seen across all the dose levels. One G3 dysphagia, one G3 emesis and three G3 metabolic toxicities were seen. There was no treatment related deaths. 1 CR, 2 PR and 7 stable diseases were seen with a median duration of response/stable disease of 3 months (2–19). Conclusions: Combination weekly docetaxel and cisplatin is a well tolerated and active regimen in recurrent/metastatic SCCHN. The recommended dose is docetaxel 35 mg/m2 and cisplatin 25 mg/m2 (3 consecutive weeks out of 4) in the planned phase II trial.

[Table: see text]

Potential for drug interactions involving cytochrome P450 in patients attending palliative day care centres: a multicentre audit

AIM

To determine the potential for drug interactions involving cytochrome P450 (CYP) in patients receiving palliative day care.

METHODS

Drugs used by patients attending four specialist palliative day care centres were reviewed to identify combinations that could result in a pharmacokinetic interaction via any of the five main human forms of CYP.

RESULTS

Of 160 patients, 145 (91%) were prescribed at least one drug that was a substrate, inhibitor or inducer of one of the five main CYP isoforms. Twenty-four drug combinations, involving 34 patients, could have given rise to a clinically important interaction.

CONCLUSIONS

Prescribers should be aware that in this group of patients, one in five are at risk of a clinically important CYP-mediated drug interaction.

Measurement of the D(s)+ lifetime

A high statistics measurement of the D(s)+ lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis of the two decay modes, D(s)+ --> phi(1020)pi+ and D(s)+ -->K*(892)0K+, used for the measurement. The measured lifetime is 507.4 +/- 5.5(stat) +/- 5.1(syst) fs using 8961 +/- 105 D(s)+ --> phi(1020)pi+ and 4680 +/- 90 D(s)+ --> K*(892)0K+ decays. This is a significant improvement over the present world average.

Impact trial: Angiographic and intravascular ultrasound observations of the first human experience with mycophenolic acid-eluting polymer stent system

The purpose of the study was to examine the safety and efficacy of two different formulations of mycophenolic acid (MPA)-eluting Duraflex stents on coronary de novo lesions. Recent data indicate that local delivery of MPA in the porcine overstretch coronary model significantly reduces neointimal hyperplasia (NIH). Patients were divided into three consecutive groups. The first (n=50) and second (n=55) groups received moderate- and slow-release MPA-eluting Duraflex stent, respectively. The last group (n=50) received the bare metal Duraflex stent. Clinical, angiographic, and intravascular ultrasound analysis were performed at 6-month follow-up. All stents were successfully deployed and patients were discharged home without clinical events. Compared to controls, 6-month in-lesion and in-stent minimum luminal diameter as well as late lumen loss were not significantly different in the moderate- and slow-release treatment groups. At follow-up, percentage obstruction and NIH volume were also similar between the three groups. At 30 days and 6 and 12 months, there were no differences noted between the three groups with respect to major adverse cardiac events as well as the individual rates of mortality, myocardial infarction, or repeat revascularization. There were no cases of subacute or late thrombosis. In this feasibility trial, the MPA-eluting Duraflex stents in either slow- or moderate-release formulations were well tolerated, but showed no benefit for treatment of coronary lesions when compared to controls. Further testing with different drug dosing or delivery rate might improve these results.

Exploring Developmental Modes in a Fossil Arthropod: Growth and Trunk Segmentation of the TrilobiteAulacopleura konincki

Trilobites offer the opportunity to explore postembryonic development within the fossil record of arthropod evolution. In contrast to most trilobites, the Silurian proetid Aulacopleura konincki from the Czech Republic exhibits marked variation in the mature number of thoracic segments, with five morphs with 18-22 thoracic segments. The combination of abundant articulated specimens available from a narrow stratigraphic interval and segmental intraspecific variation makes this trilobite singularly useful for studying postembryonic growth and segmentation. Trunk segmentation followed a hemianamorphic pattern, as seen in other arthropods and as characteristic of the Trilobita; during a first anamorphic phase, segments were accreted, while in the subsequent epimorphic phase, segmentation did not proceed further despite continued growth. Size increment during the anamorphic phase was targeted and followed Dyar's rule, a geometric progression typical of many arthropods. We consider alternative hypotheses for the control of the switch from anamorphic to epimorphic phases of development. Our analysis favors a scenario in which the mature number of thoracic segments was determined quite early in development rather than at a late stage in association with a critical size threshold. This study demonstrates that hypotheses concerning developmental pattern and control can be tested in organisms belonging to an extinct clade.

A vascular left atrial myxoma causing obstructive symptoms

A 63-year-old Chinese lady presented with acute dyspnoea, palpitations and a short history of intermittent presyncope. Her dyspnoea was worse on lying flat, improved on standing, and had an effort-related component. She had had a similar episode of positional dyspnoea 3 months earlier, while visiting relatives in China. There was no history of constitutional symptoms or signs consistent with systemic embolization.

On admission, her cardiac rhythm was an atrial tachycardia, which terminated with intravenous adenosine. A mid diastolic murmur was then heard on examination, and investigated by echocardiography (Figure 1). This demonstrated a left-sided intra-cardiac mass (5.8 cm x 4.2 cm) attached to the atrial septum, consistent with an atrial myxoma. There was obvious prolapse through the mitral valve, associated with a functional mitral inflow gradient of 9 mmHg.

A coronary angiogram (Figure 2), performed before surgical removal of the tumour the next day, demonstrated a single feeding vessel arising from the right coronary artery, supplying a large vascular mass. The left coronary system was normal.

At operation, a large, smooth, gelatinous mass was excised, including its broad-based attachment to the intra-atrial septum. The atrial septum was repaired with a pericardial patch. Histology demonstrated features typical of a cardiac myxoma. Postoperatively she has remained well.

A pilot study on the effect of oral contraceptives on electromyography and mechanomyography during isometric muscle actions

The purpose of this pilot study was to determine the influence of oral contraceptives (OC) on electromyography (EMG) and mechanomyography (MMG) during isometric (ISO) muscle actions of the rectus femoris. Two groups of women (Mean +/- SEM, 24 +/- 1 yrs, 1.68 +/- 0.02 m, 70.97 +/- 4.81 kg) were recruited and tested five times throughout one complete menstrual cycle. The first group (n=7) were not taking hormonal treatment (NOC) and the OC group (n=6) had been taking exogenous hormones for at least six months prior. Each participant performed maximal ISO muscle actions (MVC) of the leg extensors on a Cybex II isokinetic dynamometer followed by randomly assigned sub-maximal ISO muscle actions. Bipolar surface EMG electrodes were placed over the rectus femoris with a piezoelectric MMG recording device placed between the two electrodes. Three separate three way (group x day x %MVC) mixed factorial repeated measures ANOVAs were used to determine differences in torque, EMG and MMG between NOC and OC subjects. There were no significant three-way interactions involving group for normalized torque, EMG or MMG. These results indicated that OC does not have an effect on torque, EMG or MMG during ISO muscle actions of the rectus femoris.

MIGRATION, LEAKAGE AND SEEPAGE CHARACTERISTICS OF THE OFFSHORE CANNING BASIN AND NORTHERN CARNARVON BASIN: IMPLICATIONS FOR HYDROCARBON PROSPECTIVITY

RadarSat and ERS Synthetic Aperture Radar (SAR) satellite data have been used for oil slick mapping as part of a systematic interpretative study of the offshore Canning Basin, as well as part of the northern Carnarvon Basin, extending from the inner shelf to the abyssal plain. These seepage data have been integrated with regional geological data, more than 12,000 km of reprocessed Airborne Laser Fluorosensor (ALF) survey data, seismic DHI indicators, water column geochemical sniffer data, potential field data, earthquake data and 2D Petromod basin modelling, to provide new insights into the region’s petroleum prospectivity and key exploration risk factors.From a prospectivity viewpoint, this study has highlighted several areas and processes. Firstly, it is clear that overpressure in the region is principally controlled by the thickness of the Tertiary carbonate wedge and we predict that overpressure may be present in parts of the deeper water Canning Basin. Secondly, the offshore Canning Basin contains a relatively low density of SAR-mapped oil slicks, though this appears to be due to a combination of factors, namely a paucity of vertical conduits for leakage, a predominantly condensate-prone charge and a small slick size.Significantly, several as-yet untested areas emerge from our observations. In the offshore Canning Basin, a 'window' exists in about 1,500–2,500 m of water, where the Triassic source rocks are particularly well placed for liquids generation. Morever, a large area in a radius some 20–80 km outboard of the Bedout High, also appears to have significant untested liquids potential, with respect to sourcing from the Triassic. The shallow section through this region contains a vast area with abundant seismically mapped gas chimneys and other seepage indicators, supporting the conclusions from the remote sensing and basin modelling of significant hydrocarbon charge in this region. Finally, the study indicates that liquids have been generated within the Palaeozoic section of the Bedout Sub-basin.

A high statistics measurement of the Lambda(+)(c) lifetime

A high statistics measurement of the Lambda(+)(c) lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis technique with particular attention to the determination of the systematic uncertainty. The measured value of 204.6 +/- 3.4 (stat) +/- 2.5 (syst) fs from 8034 +/- 122 Lambda(+)(c)-->pK(-)pi(+) decays represents a significant improvement over the present world average.

Search for CP violation in the decays D+--> K(S)pi+ and D+-->K(S)K+

A high-statistics sample of photoproduced charm from the FOCUS experiment has been used to search for direct CP violation in the decay rates for D+-->K(S)pi+ and D+-->K(S)K+. We have measured the following asymmetry parameters relative to D+-->K-pi+pi+: A(CP)(K(S)pi+) = (-1.6+/-1.5+/-0.9)%, A(CP)(K(S)K+) = (+6.9+/-6.0+/-1.5)%, and A(CP)(K(S)K+) = (+7.1+/-6.1+/-1.2)% relative to D+-->K(S)pi+. We have also measured the relative branching ratios and found Gamma(D+-->K(0)pi+)/Gamma(D+-->K-pi+pi+) = (30.60+/-0.46+/-0.32)%, Gamma(D+-->K(0)K+)/Gamma(D+-->K-pi+pi+) = (6.04+/-0.35+/-0.30)%, and Gamma(D+-->K(0)K+)/Gamma(D+-->K(0)pi+) = (19.96+/-1.19+/-0.96)%.

INFLUENCE OF HYDROCARBON MIGRATION AND SEEPAGE ON BENTHIC COMMUNITIES IN THE TIMOR SEA, AUSTRALIA

The Ashmore Platform–Timor Sea region of Australia’s North West Shelf is an area of significant petroleum exploration potential, with several large commercial oil fields present. Moreover, exploration activity seems likely to continue at current levels for the foreseeable future, and may also extend into deeper water, given high oil prices and improved drilling technologies. The area is also one of high conservation value, with both the Cartier Marine reserve and Ashmore Reef (a Category 1 marine park), as well as numerous other genetically-rich carbonate seed bank systems, closely associated spatially with exploration activities. Balancing the conservation and resource values in this area will present a key challenge into the future.The magnitude of this challenge has been highlighted by recent work undertaken by AGSO, which involved the acquisition and interpretation of assorted remote sensing data, such as high-resolution bathymetry (including sidescan sonar), satellite synthetic aperture radar (SAR), Landsat, water column geochemical sniffer, airborne laser fluorosensor, seismic data and seafloor sediment sampling. These studies have shown that, at both a regional and local scale, the development of these important carbonate systems appears to directly relate to the geological development of the area.At a regional scale, the collision between the Australian and Eurasian crustal plates in the Pliocene (At a local scale, new data also strongly suggest that the locations of the majority of reefs and carbonate banks and build-ups in the area are associated with active and palaeo-hydrocarbon seeps. These seeps are localised over either fault systems which tap the reservoir, along migration fairways, or at the pinch-out of the regional Cretaceous top seal. Our interpretations suggest that the reefs and the build-ups formed by a sequential process. Firstly, hydrocarbon seepage (induced by collisionrelated faulting) localised small seafloor (chemolithotrophic) biological carbonate communities, which ultimately formed topographically positive features. These higher relief features were subsequently preferentially colonised by an assortment of reef-building biota, whose rapid growth progressively kept up with rising sea-level (which was driven principally by collisionrelated subsidence). The most favourable conditions for initial reef colonisation probably occurred during periods of relatively low sea-level, when the areas around the reefs were located at much shallower water depths (Clearly, the fact that the genetically rich carbonate communities in this area are probably causally related to natural hydrocarbon seepage (and the attendant processes which drove that seepage) will present a series of almost unique exploration, development (especially engineering) and conservation challenges.

Effects of neonatal inferior prefrontal and medial temporal lesions on learning the rule for delayed nonmatching-to-sample

The ability of rhesus monkeys to master the rule for delayed nonmatching-to-sample (DNMS) has a protracted ontogenetic development, reaching adult levels of proficiency around 4 to 5 years of age (Bachevalier, 1990). To test the possibility that this slow development could be due, at least in part, to immaturity of the prefrontal component of a temporo-prefrontal circuit important for DNMS rule learning (Kowalska, Bachevalier, & Mishkin, 1991; Weinstein, Saunders, & Mishkin, 1988), monkeys with neonatal lesions of the inferior prefrontal convexity were compared on DNMS with both normal controls and animals given neonatal lesions of the medial temporal lobe. Consistent with our previous results (Bachevalier & Mishkin, 1994; Málková, Mishkin, & Bachevalier, 1995), the neonatal medial temporal lesions led to marked impairment in rule learning (as well as in recognition memory with long delays and list lengths) at both 3 months and 2 years of age. By contrast, the neonatal inferior convexity lesions yielded no impairment in rule-learning at 3 months and only a mild impairment at 2 years, a finding that also contrasts sharply with the marked effects of the same lesion made in adulthood. This pattern of sparing closely resembles the one found earlier after neonatal lesions to the cortical visual area TE (Bachevalier & Mishkin, 1994; Málková et al., 1995). The functional sparing at 3 months probably reflects the fact that the temporo-prefrontal circuit is nonfunctional at this early age, resulting in a total dependency on medial temporal contributions to rule learning. With further development, however, this circuit begins to provide a supplementary route for learning.

Measurement of the branching ratios of D(+) and D(+)(s) hadronic decays to four-body final states containing a K(S)

We have studied hadronic four-body decays of D(+) and D(+)(s) mesons with a K(S) in the final state using data recorded during the 1996-1997 fixed-target run of the Fermilab high energy photoproduction experiment FOCUS. We report a new branching ratio measurement of gamma(D(+)-->K(S)K-pi(+)pi(+))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0768+/-0.0041+/-0.0032. We make the first observation of three new decay modes with branching ratios gamma(D(+)-->K(S)K+pi(+)pi(-))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0562+/-0.0039+/-0.0040, gamma(D(+)-->K(S)K+K-pi(+))/gamma(D(+)-->K(S)pi(+)pi(+)pi(-)) = 0.0077+/-0.0015+/-0.0009, and gamma(D(+)(s)-->K(S)K+pi(+)pi(-))/gamma(D(+)(s)-->K(S)K-pi(+)pi(+)) = 0.586+/-0.052+/-0.043, where in each case the first error is statistical and the second error is systematic.

The impact of intraoperative hypotension on the development of wound haematoma after breast reduction

A wound haematoma occurring after breast reduction may need to be drained surgically, and may prolong both hospital stay and the total recovery time following surgery. Intraoperative hypotension has been implicated in the development of various complications, but has not been previously studied in relation to breast reduction. A retrospective analysis of 238 breast reductions was performed with the aim of identifying risk factors for the development of wound haematoma after breast reduction. The operative time was divided into three equal periods and, in our experience, haemostasis was achieved in the middle period. In our series, 16 patients developed a postoperative wound haematoma; only four patients required operative evacuation (1.7%). Subcutaneous heparin prophylaxis, the level of the surgical team and the weight of tissue resected did not significantly affect the likelihood of wound haematoma. The lowest and the peak values of systolic blood pressure and the mean blood pressure (diastolic + 1/3 pulse) were significantly lower in the middle period of the operation in patients who developed a haematoma P values: 0.012, 0.021 and 0.005, respectively). Univariate logistic regression analysis showed the same significant findings (P values: 0.0014, 0.021 and 0.0059, respectively). Multivariate stepwise logistic regression showed that the lowest systolic blood pressure in the middle period was significantly lower in the haematoma group than in the non-haematoma group (P= 0.0007). Intraoperative hypotension in the middle period of the operation, which is usually the period when haemostasis is achieved, is associated with the development of postoperative wound haematoma.

Application of cDNA microarrays to examine gene expression differences in schizophrenia

Using cDNA microarrays we have investigated gene expression patterns in brain regions of patients with schizophrenia. A cDNA neuroarray, comprised of genes related to brain function, was used to screen pools of samples from the cerebellum and prefrontal cortex from a matched set of subjects, and middle temporal gyrus, from a separate subject cohort. Samples of cerebellum and prefrontal cortex from neuroleptic naive patients were also included. Genes that passed a 3% reproducibility criterion for differential expression in independent experiments included 21 genes for drug-treated patients and 5 genes for drug-naive patients. Of these 26 genes, 10 genes were increased and 16 were decreased. Many of the differentially expressed genes were related to synaptic signaling and proteolytic functions. A smaller number of these genes were also differentially expressed in the middle temporal gyrus. The five genes that were differentially expressed in two brain regions from separate cohorts are: tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein, eta polypeptide; sialyltransferase; proteasome subunit, alpha type 1; ubiquitin carboxyl-terminal esterase L1; and solute carrier family 10, member 1. Identification of patterns of changes in gene expression may lead to a better understanding of the pathophysiology of schizophrenia disorders.

Life events and depression in a community sample of siblings

BACKGROUND

The overall aim of the GENESiS project is to identify quantitative trait loci (QTLs) for anxiety/depression, and to examine the interaction between these loci and psychosocial adversity. Here we present life-events data with the aim of clarifying: (i) the aetiology of life events as inferred from sibling correlations; (ii) the relationship between life events and measures of anxiety and depression, as well as neuroticism; and (iii) the interaction between life events and neuroticism on anxiety/depression indices.

METHODS

We assessed the occurrence of one network and three personal life-event categories and multiple indices of anxiety/depression including General Health Questionnaire, Anhedonic Depression, Anxious Arousal and Neuroticism in a large community-based sample of2150 sib pairs, 410 trios and 81 quads. Liability threshold models and raw ordinal maximum likelihood were used to estimate within-individual and between-sibling correlations of life events. The relationship between life events and indices of emotional states and personality were assessed by multiple linear regression and canonical correlations.

RESULTS

Life events showed sibling correlations of 0-37 for network events and between 0-10 and 0.19 for personal events. Adverse life events were related to anxiety and depression and, to a less extent, neuroticism. Trait-vulnerability (as indexed by co-sib's neuroticism, anxiety and depression) accounted for 11% and life events for 3% of the variance in emotional states. There were no interaction effects.

CONCLUSIONS

Life events show moderate familiality and are significantly related to symptoms of anxiety and depression in the community. Appropriate modelling of life events in linkage and association analyses should help to identify QTLs for depression and anxiety.

GENESiS: creating a composite index of the vulnerability to anxiety and depression in a community-based sample of siblings

There is considerable evidence for a unitary and dimensional view of the genetic vulnerability to symptoms of anxiety and depression. The GENESiS (Genetic Environmental-Nature of Emotional States in Siblings) Study aims to use a multivariate approach to detect genetic loci that contribute to individual differences in this vulnerability dimension. The study used the UK General Practice Research Framework to generate a community-based sample of siblings. Questionnaire measures of anxiety/depression included the short form of the neuroticism scale from the revised Eysenck Personality Questionnaire (EPQ-N), the General Health Questionnaire (GHQ-12), and the anxious arousal and high positive affect subscales from the Mood and Anxiety Symptoms Questionnaire (MASQ-AA and MASQ-HPA). Genetic model-fitting of 2658 unselected sibships provided evidence for a single common genetic (familial) factor that accounted for a substantial proportion of the genetic variances and covariances of these four measures. Using the parameter estimates of this model, we constructed a composite index of this common genetic factor. This index, which has a sib correlation of 0.22, will be used as a quantitative phenotype in the molecular genetic phase of GENESiS.

(Ethanol-O)tris(nitrato-O,O')bis(triphenylphosphine oxide-O)cerium(III)

The title compound, [Ce(NO(3))(3)(C(2)H(6)O)(C(18)H(15)OP)(2)], contains discrete molecules with nine-coordinate Ce atoms having all nitrate groups bonded as symmetrical bidentate ligands [Ce-O(P) 2. 369 (2) and 2.385 (2), Ce-O(N) 2.549 (3)-2.596 (3) and Ce-O(Et) 2. 515 (3) A].

The stanley foundation brain collection and neuropathology consortium

The Stanley Foundation brain collection is an attempt to supplement existing brain collections for the purpose of promoting research on schizophrenia and bipolar disorder. Specimens are collected with the permission of the families in a standardized manner, with half of each specimen being frozen and half fixed in formalin. The Neuropathology Consortium is a subset of 60 specimens from the collection, well-matched groups of 15 each with diagnoses of schizophrenia, bipolar disorder, major depressive disorder without psychotic features, and normal controls. More than 75000 sections and blocks from the Consortium have been sent to over 50 research groups worldwide to carry out a wide variety of assessments. These data will be integrated to provide a more complete picture of the neuropathology of these disorders.

Bronchioloalveolar cell carcinoma: impact of histology on dominant CT pattern

The authors set out to determine how histologic variability in bronchioloalveolar cell carcinoma impacts dominant radiographic patterns shown by computed tomography (CT). Thoracic CT's of all patients with pathologically confirmed bronchioloalveolar cell carcinoma diagnosed over a 36-month period were reviewed without knowledge of underlying histologic type. The dominant CT pattern was recorded as 1) air space consolidation; 2) focal nodule or mass; and 3) multicentric nodules or masses. Nodules and masses were further characterized according to borders, distribution, and associated findings, including spiculations and air bronchograms. Histology was independently reviewed. Twenty-seven patients, 16 women and 11 men, mean age 60 years, were diagnosed with bronchioloalveolar cell carcinoma. In 6 (22%) of the 27 cases, the histology was mucinous, with malignant goblet cells identified. Five (83%) of the six mucinous neoplasms manifested as air space consolidation and three (50%) of the six presented with multiple nodules, in which two had coexisting air space consolidation. Of the remaining 21 cases (78%) with nonmucinous histology, the primary malignant cells of origin included Clara cells (n = 8), tall columnar epithelial cells (n = 7) and alveolar type II pneumocytes (n = 6). Sclerosis was a dominant histologic feature in 14 (67%) of the 21 cases. Seventeen (81%) of the nonmucinous neoplasms presented as isolated nodules or masses and four (19%) presented as multiple nodules or masses. Of these four patients with multifocal disease and nonmucinous histology, multiple bronchioloalveolar adenomas accounted for multicentricity in two of the patients. Significant correlations included air space consolidation with mucinous histology (p = 0.001) and focal nodule or mass with nonmucinous histology (p = 0.001). At CT of bronchioloalveolar cell carcinoma, the patterns of air-space consolidation correlate with mucinous histology and isolated nodules or masses with nonmucinous histology. The pattern of multiple nodules or masses, however, did not correlate with histology. Coexisting bronchioloalveolar adenomas can contribute to apparent multicentric disease in patients with nonmucinous histology.

USING INTEGRATED REMOTE SENSING TECHNOLOGIES TO EVALUATE AND CHARACTERISE HYDROCARBON MIGRATION AND CHARGE CHARACTERISTICS ON THE YAMPI SHELF, NORTHWESTERN AUSTRALIA: A METHODOLOGICAL STUDY

As part of a major interpretative study of the Yampi Shelf, northeastern Browse Basin, the Australian Geological Survey Organisation (AGSO) acquired regional seismic, water column geochemical sniffer (WaSi), RadarSat Synthetic Aperture Radar (SAR), and high resolution bathymetric data over the area between 1995 and 1998. These data have been integrated in order to better understand both the hydrocarbon charge and top seal capacity characteristics of the area, and the relative responses of assorted remote sensing technologies to hydrocarbon migration, leakage and seepage. The area investigated comprises part of a Palaeozoic to Mesozoic flexural ramp margin, which dips northwest away from the flanking cratonic Kimberley Block. The basement has a rugose topography, with some horst blocks elevated 500 m above the surrounding basement. Progressive onlap of Cretaceous post-rift seals onto the ramp causes the regional seal to become thinner and sandier margin- ward. In some of these more margin-ward locations, some prominent basement highs are 'bald' of seal, whereas in others, the seal thins dramatically onto topographically prominent, landward-dipping tilt blocks. Natural hydrocarbon seepage was confirmed independently by SAR and WaSi, though the relative response and sensitivity of each technology to seepage of varying rates and compositions are quite different. Overall, the principal seeping hydrocarbon is dry (

Transcatheter closure of a large coronary artery fistula with the Amplatzer duct occluder

We report the successful percutaneous closure of a large coronary artery fistula from the obtuse marginal artery to the right ventricle in an 8-month-old boy using the Amplatzer duct occluder. The device was positioned and deployed via the venous system, using a guidewire that had been advanced via the aorta, coronary artery, and fistula to the venous circulation. Cathet. Cardiovasc. Intervent. 48:188-190, 1999.

Fate of endoleaks after endoluminal repair of abdominal aortic aneurysms with the EVT device

OBJECTIVE

we aim to describe our medium-term follow-up of 20 patients with an endoleak following repair of their abdominal aortic aneurysms (AAA) using the Endovascular Technologies (EVT) device.

DESIGN

the experience of one centre in a prospective multicentre phase II trial.

MATERIALS AND METHODS

55 patients with an endovascular repair of their AAA and at least 6 months>> follow-up were reviewed. Intraoperative angiograms, next day duplex scans and computed tomography (CT) images were used to detect endoleaks. Follow-up with CT and duplex was performed at 3, 6, 12 and 24 months. Persistent endoleaks at 6 months were evaluated by angiography and treated by endovascular coiling.

RESULTS

there were three immediate conversions to open procedures. Twenty of 52 (38%) patients had an endoleak identified initially. One patient died from a myocardial infarction and three were not evident any longer by discharge CT. Sixteen endoleaks (31%) were present at discharge. Nine resolved spontaneously by 3-6 months and seven were still persistent at 6 months (14%). Six patients underwent coiling of their leak, all with successful radiographic seal after 1-3 sessions.

CONCLUSIONS

endoleaks are frequent after endovascular AAA repair, but the majority close spontaneously. Coiling of the leaks and radiographic seal can be achieved in all cases still persistent at 6 months. Whether this method is clinically effective awaits further follow-up.

Development of antibody isotype responses to Schistosoma mansoni in an immunologically naive immigrant population: influence of infection duration, infection intensity, and host age

We have identified the influence of host and parasite factors that give rise to characteristic antibody isotype profiles with age seen in human populations living in different areas of schistosomiasis endemicity. This is important in the immunobiology of this disease. It is also of interest in the context of human responses to chronic antigen stimulation, vaccines, allergens, and other pathogens. In populations exposed to endemic schistosomiasis, factors such as intensity and duration of infection are age dependent. They therefore confound the influence of host age on antiparasite responses. Here, we resolved these confounding factors by comparing the developing antibody responses of an immunologically naive immigrant population as they acquired the infection for the first time with those of chronically infected resident inhabitants of the same region of Schistosoma mansoni endemicity in Kenya. Recent arrival in the area strongly favored immunoglobulin G3 (IgG3) responses against the parasite. The antibody isotype responses associated with human susceptibility to reinfection after chemotherapy were elevated in those suffering high intensities of infection (IgG4 responses against worm and egg antigens) or were characteristic responses of young children irrespective of the intensity or duration of infection (IgG2 responses against egg antigen). IgE responses against the adult worm, a response associated with resistance to reinfection after chemotherapy, increased with the ages of infected individuals and were also favored in those currently suffering higher intensities of infection.

pp60(v-src) induction of cyclin D1 requires collaborative interactions between the extracellular signal-regulated kinase, p38, and Jun kinase pathways. A role for cAMP response element-binding protein and activating transcription factor-2 in pp60(v-src) signaling in breast cancer cells

The cyclin D1 gene is overexpressed in breast tumors and encodes a regulatory subunit of cyclin-dependent kinases that phosphorylate the retinoblastoma protein. pp60(c-src) activity is frequently increased in breast tumors; however, the mechanisms governing pp60(c-src) regulation of the cell cycle in breast epithelium are poorly understood. In these studies, pp60(v-src) induced cyclin D1 protein levels and promoter activity (48-fold) in MCF7 cells. Cyclin D1-associated kinase activity and protein levels were increased in mammary tumors from murine mammary tumor virus-pp60(c-src527F) transgenic mice. Optimal induction of cyclin D1 by pp60(v-src) involved the extracellular signal-regulated kinase, p38, and c-Jun N-terminal kinase members of the mitogen-activated protein kinase family. Cyclin D1 promoter activation by pp60(v-src) involved a cAMP response element-binding protein (CREB)/activating transcription factor 2 (ATF-2) binding site. Dominant negative mutants of CREB and ATF-2 but not c-Jun inhibited pp60(v-src) induction of cyclin D1. pp60(v-src) induction of CREB was blocked by the p38 inhibitor SB203580 or by mutation of CREB at Ser133. pp60(v-src) induction of ATF-2 was abolished by the c-Jun N-terminal kinase inhibitor JNK-interacting protein-1 or by mutation of ATF-2 at Thr69 and Thr71. CREB and ATF-2, which bind to a common pp60(v-src) response element, are transcriptionally activated by distinct mitogen-activated protein kinases. Induction of cyclin D1 activity by pp60(v-src) may contribute to breast tumorigenesis through phosphorylation and inactivation of the retinoblastoma protein.

Comparison of the scope of allopathic and osteopathic medical school health promotion programs for students

PURPOSE

To compare the number and scope of health promotion programs for students in allopathic and osteopathic medical schools in the U.S. and Canada.

DESIGN

A one-time cross-sectional survey design was applied in this study.

SETTING

This study was conducted in 141 accredited allopathic and 17 accredited osteopathic medical schools.

SUBJECTS

A total of 158 representatives from the allopathic and osteopathic medical schools participated in this study. The response rate for the survey was 100%.

MEASURES

A structured telephone interview was conducted to survey representatives from the medical schools. The survey contained 85 multiple-choice questions organized into four sections: administrative characteristics, types of institutional and health promotion program policies, participation incentives and facilities, and type/scope of health promotion program activities. Chi-square analysis was used to analyze survey variables by type of medical education and level of intervention.

RESULTS

Of the 158 medical schools, only 20% (n = 32) provided a health promotion program for students. Although osteopathic institutions (29.4%) had a greater percentage of programs than allopathic schools (19.2%), there was no significant difference in scope of program offerings by type of medical education. Allopathic programs offered exercise and nutrition/weight management significantly more often and at a higher level of intervention. Lastly, allopathic programs had significantly more monetary resources available for programming. Following prudent research protocol, investigators should be mindful of the limitations of this study. In this study, some school representatives chose not to answer personnel- and finance-related questions. Additionally, because of the self-report nature of the survey, the responses given to the questions may not have been accurate.

CONCLUSION

Allopathic and osteopathic medical school health promotion programs for students were very similar in scope.

Early closure of a randomized trial: surgery and postoperative radiotherapy versus radiotherapy in the management of intra-oral tumours

Tumours of the oral cavity/oropharynx occur relatively infrequently in the UK. The management of such lesions, especially the squamous cell carcinomas, is still a little controversial. Some centres advocate radiotherapy while others adopt surgery and radiotherapy. In an attempt to resolve the question of which approach gives the better results, a multicentre randomized trial was established to compare surgery plus postoperative radiotherapy with radical radiotherapy alone. It was anticipated that 350 patients would be required to give a statistically significant result, but, after 35 patients had been entered, the trial was closed prematurely with a marked difference in overall survival in favour of the combination arm (P = 0.0006). At this analysis, carried out 23 months after trial closure, the survival difference between the two arms remains statistically significant for all causes of mortality (P = 0.001; relative death rate = 0.24; 95% CI 0.10-0.59).

Reciprocal regulation of neu tyrosine kinase activity and caveolin-1 protein expression in vitro and in vivo. Implications for human breast cancer

Neu (c-erbB2) is a proto-oncogene product that encodes an epidermal growth factor-like receptor tyrosine kinase. Amplification of wild-type c-Neu and mutational activation of Neu (Neu T) have been implicated in oncogenic transformation of cultured fibroblasts and mammary tumorigenesis in vivo. Here, we examine the relationship between Neu tyrosine kinase activity and caveolin-1 protein expression in vitro and in vivo. Recent studies have suggested that caveolins may function as negative regulators of signal transduction. Our current results show that mutational activation of c-Neu down-regulates caveolin-1 protein expression, but not caveolin-2, in cultured NIH 3T3 and Rat 1 cells. Conversely, recombinant overexpression of caveolin-1 blocks Neu-mediated signal transduction in vivo. These results suggest a reciprocal relationship between c-Neu tyrosine kinase activity and caveolin-1 protein expression. We next analyzed a variety of caveolin-1 deletion mutants to map this caveolin-1-dependent inhibitory activity to a given region of the caveolin-1 molecule. Results from this mutational analysis show that this functional in vivo inhibitory activity is contained within caveolin-1 residues 32-95. In accordance with these in vivo studies, a 20-amino acid peptide derived from this region (the caveolin-1 scaffolding domain) was sufficient to inhibit Neu autophosphorylation in an in vitro kinase assay. To further confirm or refute the relevance of our findings in vivo, we next examined the expression levels of caveolin-1 in mammary tumors derived from c-Neu transgenic mice. Our results indicate that dramatic reduction of caveolin-1 expression occurs in mammary tumors derived from c-Neu-expressing transgenic mice and other transgenic mice expressing downstream effectors of Neu-mediated signal transduction, such as Src and Ras. Taken together, our data suggest that a novel form of reciprocal negative regulation exists between c-Neu and caveolin-1.

The experience of an academic medical center with endovascular treatment of abdominal aortic aneurysms

BACKGROUND

Endovascular repair of abdominal aortic aneurysms (AAA) is gaining momentum although it is not yet approved in the United States by regulatory agencies. The Endovascular Grafting System (EGS), the first device to enter clinical trials in 1993, is now in phase III testing.

METHODS

We reviewed the first 50 patients to undergo an EGS repair of AAA over 24 months at our institution. Results were compared with 69 patients who underwent open repair during the same time period by the same surgeon.

RESULTS

Devices were successfully implanted in 47 of 50 (94%) patients. Three were converted to standard repair. Although length of stay was shorter, costs were similar. Follow-up was 3 to 24 months. Perigraft flow was noted in 33% at discharge; 73% of those stopped either spontaneously or with coiling. Three graft limbs occluded, requiring thrombolytic therapy.

CONCLUSIONS

The EGS repair of AAA is feasible and effective. Cooperation between surgery and radiology is important for the success of a new endovascular program.