Self report and performance-based hand function tests as correlates of dependency in the elderly

Preventing or minimizing functional dependency in older adults rests, in part, upon the ability to predict who is at risk. The purpose of this study was to compare the ability of five tests of hand function to discriminate the degree of dependency in older adults. Seven hundred sixty four subjects were assessed for hand function on performance-based (Williams Test of Hand Function, a test of Williams Board items only, Jebsen Test of Hand Function, grip strength), and self-reported (Dexterity Scale of the Geriatrics-Arthritis Impact Measurement Scale (GERI-AIMS] measures of hand function, and self-reported multidimensional functional status (GERI-AIMS). A trichotomous variable representing a continuum of dependency based upon living site (independent living, home-bound, institutional) was used as the measure of dependency. Sixty-two cases were dropped for incomplete data. Discriminant function analyses of the 702 subjects (age X = 76.78 years, SD = 8.79) showed that basic demographic variables explain 40.8% of the variance in dependency; all hand function tests significantly correlated with dependency; the Williams Board correlated best (additional 12.5% variance explained). However, a multidimensional functional status measure explains substantially more variance in dependency (16.9%) after controlling for demographic variables and performance on the Williams Board. This comparison of methods and tests available for measuring hand function was made to provide criteria for selecting an instrument for a given setting.

Intravenous immunoglobulin for Flavobacterium-induced thrombocytopenia in a premature infant

Gram-negative septicemia at times causes morbidity and mortality in newborn nurseries. Prophylactic intravenous immunoglobulin results in a significant decrease in incidence and severity of septicemia resulting from infection in infants. The present case report describes the successful use of high-dose intravenous immunoglobulin in a Flavobacterium-induced thrombocytopenia in a premature infant.

Inhibition of sialyl transferase activity by gossypol acetic acid in human seminal plasma

Seventeen aliquots of 15 microliters seminal plasma of human origin were incubated with 25 micrograms, 15 micrograms, 5 micrograms and 2.5 micrograms gossypol acetic acid (GAA), dissolved in BWW containing 0.9% sodium chloride and 0.9% benzyl alcohol, at 37 degrees C for 60 minutes. Following incubation, activity of sialyl transferase (S.T.) was determined by a procedure involving incorporation of radioactive sialic acid into asialofetuin. The activity of S.T., expressed as cpm per hour per 15 microliters seminal plasma was compared to controls consisting in incubation of sperm in BWW containing 0.9% benzyl alcohol and 0.9% sodium chloride. The activity of S.T. in controls represented 61.3 +/- 8.0%-67.7 +/- 8.9% of the activity obtained by incubation with BWW only. GAA was found to exert a dose-dependent inhibition of S.T. activity, ranging from 38.3 +/- 20.6% to 53.4 +/- 19.4% (with 25 micrograms) and from 11.3 +/- 14.8% to 21.9 +/- 14.8% (with 2.5 micrograms).

Low energy narrow band non-coherent infrared illumination of human semen and isolated sperm

Sixty-two samples of human normal and abnormal semen and 23 samples of washed sperm were illuminated for 4 minutes with a narrow band non-coherent infrared device (BioBeam). Immediately after illumination the following parameters were examined in comparison with appropriate controls: motility, viability and morphology, fructose content of semen, acrosome reaction of sperm, viscosity of seminal plasma and analysis of the protein pattern. The mean value of motility grade calculated for the total number of 62 semen samples was 2.58 +/- 0.79 versus 2.17 +/- 0.75 (non illuminated controls), P less than 0.005. The mean value of motility grade of 23 samples of washed sperm was 2.89 +/- 0.77 versus 2.43 +/- 0.62, respectively (P less than 0.01). In two illuminated seminal plasma specimens, the viscosity was decreased by 8.8% and 14.8%, the protein content and pattern remained, however, unchanged. Neither the percentages of motile, viable and morphologically normal sperm, nor the fructose content of semen were found to be affected by the illumination.

Semen volume and fructose content of human semen. Survey of the years 1980-1989

The communication presents percentages of semen with low (less than 1 ml) and high (greater than or equal to 6 ml) volume and of semen with decreased fructose content (less than 1 ml) in the total number of 8,128 human specimens analyzed during the years 1980-1989. Percentages of low volume specimens and of specimens with decreased fructose content were found to increase with time. High volume semen lacked such trend.

Upper Eocene Gilled Mushroom from the Dominican Republic

Coprinites dominicana gen.nov., spec.nov. (Coprinaceae) found in amber from the Dominican Republic is the earliest known gilled mushroom, the first fossil fleshy agaric determinable, and the only kiiown fossil "mushroom" (Agaricales) from the tropics. This find is of significance with respect to the evolutionary development of the Basidiomycetes. Because the appearance of this fossil is quite modern, it suggests that mushrooms as a group probably arose much earlier than the early to mid-Tertiary.

Separation of sub-populations of sperm with higher fertility potential from normal and pathological semen by peanut agglutinin

Incubation of human sperm from semen with counts below 20 x 10(6)/ml with peanut agglutinin (PNA) resulted in agglutination of about 70% of sperm. An inverse correlation was found between non-agglutinating (PNA) sperm and sperm density (r = 0.48, p less than 0.01) and a direct correlation with acrosome-damaged sperm (r = 0.83, p less than 0.001). Binding of 125I-PNA to sperm revealed high, and possibly also low affinity binding sites on sperm from both normozoospermic and oligozoospermic origins. Quantitative transmission electron microscopy analysis revealed that agglutinated, PNA+, sperm had lower frequency of acrosomeless spermatozoa than PNA(-)-sperm (44% versus 77%) and higher fertility score (+0.18 +/- 0.1 and -1.5 +/- 0.87 respectively, p less than 0.01). Removal of PNA- sperm from oligozoospermic semen may increase the fertility score of the remaining sperm.

Andrological parameters in men with high sperm counts and possible correlation with age

Two hundred eighty six human semen samples with sperm counts above 200 million/ml, were divided into 3 groups according to semen volume: (1) less than 1 ml (low), (2) 1 ml-5 ml (normal), and (3) greater than or equal to 6 ml (high). Each group was examined for routine andrological parameters. Also examined was a possible correlation between sperm counts, semen volumes, and ages of patients. The quality of motility (percent and grade) and viability of sperm were generally lowest in specimens with a volume below 1 ml and highest in those of normal volume. Proportions of morphological normality exhibited a similar trend, lacking, however, statistical significance. The mean fructose content of low-volume semen was significantly decreased in comparison with those of normal volume. Patients with low-volume semen and sperm counts above 200 million/ml were older than those with similar sperm counts and normal volume. The mean ages of all patients with high sperm counts of semen were higher than of those with lower sperm counts. It was assumed that in contradiction to specimens with high sperm counts and low volume, those whose volumes range from 1 ml-5 ml should be considered normal with respect to motility, viability, and morphological normality.

The safety and tolerability of quinapril

Quinapril, a new angiotensin-converting enzyme (ACE) inhibitor with an intermediate duration of action, has been extensively studied in patients with hypertension and congestive heart failure (CHF) during a worldwide clinical development program. A comprehensive safety data base was established to allow appropriate analyses of the extensive patient safety data. The safety of quinapril has been evaluated in 2,697 patients with hypertension and CHF, including 451 elderly patients (greater than or equal to 65 years), and has been compared with safety data from a total of 1,058 patients receiving a comparative therapy. A comparison of the double-blind studies demonstrated that quinapril has a lower incidence of adverse events and/or withdrawals than reported for captopril or enalapril. An analysis of the onset of adverse events did not show either an increase with time on quinapril therapy or a dose relationship. The proportion of patients who experienced orthostatic hypotension or hypotension was less than that of patients who were treated with captopril or enalapril. An analysis of all events (from both double-blind and long-term, open-label studies) showed no increase in the incidence of events reported in patients with CHF compared with hypertensive patients. When the data for all studies were combined, an age analysis showed no increase in the total reporting of adverse events in elderly patients compared with the younger patients studied. The incidence of adverse events was lower in those patients not receiving concomitant diuretic therapy. An overall analysis of clinical laboratory data indicated that quinapril did not have significant adverse effects on clinical laboratory parameters when compared with captopril, enalapril, or placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunosuppressive activity and polyamine levels of seminal plasma in azo-ospermic, oligospermic, and normospermic men

Seventy specimens of human seminal plasma obtained from azo-ospermic, oligospermic, and normospermic men were tested for immunosuppressive activity on normal donor lymphocytes. Spermine and spermidine levels in acidic extracts were determined in 32 specimens of seminal plasma from the three groups. The original seminal plasma as well as the neutralized spermine extracts were examined for their effect on the functional activity of the lymphocytes. Seminal plasma obtained from the normospermic and oligospermic semen showed significant immunosuppressive activity, whereas no immunosuppressive activity was induced by seminal plasma from azo-ospermic semen. The latter finding was in accordance with the low spermine levels in azo-ospermic semen, which were about 50% of those found in normospermic and oligospermic seman. Acidic extraction of the seminal plasma of azo-ospermic origin resulted in an increase in spermine levels and also in immunosuppressive activity, demonstrating that in azo-ospermic men spermine is bound probably to a protein and is released after acidification, exerting its immunosuppressive activity only when unbound.

Andrological parameters in human semen of high (greater than or equal to 6 ml) and low (less than or equal to 1 ml) volume

A study was carried out to evaluate 792 semen of high (greater than or equal to 6 ml) and low (less than or equal to 1 ml) volume and sperm counts ranging from 0.1 to 200 x 10(6) per ml. Particularly emphasized were: motility percentage and grade, percentage viability, morphologically normal sperm and immature cells, and the concentration of fructose in semen (mg/ml). The Duncan multiple range test and the Kruskal-Wallis test with multiple comparison of ranks were used in the statistical analyses. The results show that abnormal semen volume influence neither the basic tendency of andrological parameters to change in accordance with sperm counts of semen nor to correlate with each other. The quality of motility was significantly higher in specimens of high semen volume as compared to those of low semen volume. The concentration of fructose in semen was generally higher in specimens of high volumes than in those of low volumes, including semen devoid of sperm. It was assumed that in general increased semen volume does not affect the quality of other andrological parameters, thus being probably unrelated with fertility potential. The considerably lower values of both motility and viability characterizing the semen of low volume would suggest a lower fertility potential of specimens affected by this type of abnormality.

The influence of seminal plasma and polyaminic substances on the motility of isolated human sperm

The purpose of the study was to examine the influence on the motility patterns of isolated human sperm of seminal plasma originating from semen of high and low motility, as well as of seminal plasma of azoospermic origin. Also assessed was the effect of incubation of sperm in the presence of solutions of the polyamines spermine, spermidine, and putrescine. The mean values of the obtained motility percentage and grade were related to the quality of sperm motility in semen and the quality of seminal plasma in that respect. The best results were obtained with specimens containing greater than or equal to 50% motile sperm and having a motility grade greater than or equal to 2. No relationship was found between the concentrations of polyamines in the seminal plasma and sperm motility of respective semen, as well as between the levels of polyamines and their effect on isolated sperm motility. It appears that the participation of polyaminic substances in the process of motility could be contributive and dependent on additional factors present in the semen.

Beta-endorphin and calcitonin in human semen

The levels of beta-endorphin (beta-E) and calcitonin were estimated in 36 samples of seminal plasma from semen of normospermic, oligozoospermic, and azoospermic origins and in pools of isolated sperm. The mean levels in plasma calculated for all samples examined were 192 +/- 224 pg/ml for beta-E and 754 +/- 397 pg/ml for calcitonin. The amounts in sperm were as follows: for beta-E in pools with sperm counts of 0.1-10 x 10(6)/ml, 157.2 +/- 99.7 pg/10(8) and 27.9 +/- 23.6 pg/ml protein; in pools of greater than 10-30 x 10(6)/ml, 71.2 +/- 41.5 pg/10(8) and 6.5 +/- 1.2 pg/mg protein; in pools of greater than 30-200 x 10(6)/ml, 24.9 +/- 9.7 pg/10(8) and 61 +/- 1.9 pg/mg protein. For calcitonin the amounts were: 501.2 +/- 170.8 pg/10(8) and 27.4 +/- 21.5 pg/mg protein, correspondingly. It was suggested that beta-E and calcitonin present in seminal plasma are synthesized mostly in a compartment of the male reproductive system. The high cellular beta-E and calcitonin levels would be involved in the process of motility through their effect on calcium transport.

The evaluation of routine andrological parameters in human serum

A study was carried out to evaluate the andrological parameters in 540 human semen specimens divided into groups according to sperm counts. The parameters were: motility percentage and grade, percentage of viability and of morphologically normal sperm and immature cells. The Duncan multiple range test and the Kruskal-Wallis test with multiple comparison of ranks were used in the statistical analyses. Of particular interest, among other our findings, were the significant differences obtained by comparing the group with sperm counts up to 5 x 10(6) per ml semen and that with counts ranging from 5.1 to 10 x 10(6) per ml semen. This was true for all parameters with the exception of semen volume. Comparison of the oligozoospermic groups (up to 20 x 10(6)/ml) with those having higher sperm counts also showed significant differences. There was a trend towards improvement of the examined parameters with the increase in sperm density, but with a remarkable heterogeneity particularly within the oligozoospermic groups. In all groups motility, viability and morphological normality of sperm showed a positive correlation with each other. "Normal values" of the parameters studied could be derived from scatterplot charts over the entire range of sperm counts and from the statistical evaluation of the grouped material.

Laboratory evaluation of the Du Pont "Dimension Clinical Chemistry System"

We evaluated the analytical performance of the Du Pont Dimension Clinical Chemistry System to assess its suitability as a replacement for the Du Pont aca III, currently routinely used for analysis of pediatric, high-risk, and emergency specimens. Twenty-six analyses were studied. These generally fulfilled pre-set analytical goals for precision based on biological variation or "state of the art." Significant economies were achieved and we found the Dimension to be reliable, easy to operate, and simple to maintain. It also fulfilled safety requirements for analysis of specimens of high risk to laboratory staff.

Pulse oximeter in the ambulatory aesthetic surgical facility

One-hundred consecutive patients undergoing aesthetic surgical procedures with adjunctive intravenous sedation in an office-based ambulatory surgical facility were monitored by an anesthesiologist with an ECG, stethoscope, automatic sphygmomanometer, and pulse oximeter. The pulse oximeter detected hypoxemia occurring intraoperatively and in the recovery room earlier than the traditional methods of monitoring. By detecting early drops in the SAO2 with the pulse oximeter, appropriate corrective measures could be instituted and titration of intravenous anesthetics adjusted, avoiding progression to more profound hypoxemia and thus resulting in the safer delivery of anesthesia. The pulse oximeter is a useful and recommended adjunct to the traditional methods of monitoring in an office-based ambulatory surgical facility.

Methodology of forensic neurotoxicity evaluation: PCB case

Many scientists and doctors are not aware that the level of certainty for litigation purposes differs from that usually associated with scientific studies. Although the 0.05 probability level is commonly used in scientific studies ("beyond a reasonable doubt"), in U.S. civil litigation the diagnostic criteria is "more probable than not" (greater than 0.50 or chance probability level). The following case of PCB neurotoxicity will be discussed within the context of a forensic evaluation. A number of workers were employed by a metal salvage company to strip copper coils from used electrical transformers. Symptoms of neurotoxicity developed in the men, which were evaluated by questionnaire, interview and psychological examination. Neuropsychological and nerve conduction tests were administered. Results showed deficits in nervous system function related to PCB exposure. An individual case is described in detail.

Sialyl transferase in human semen

The activity of the enzyme sialyl transferase, which is responsible for the transfer of sialic acid, has been examined in the following human seminal plasma: (1) originating from semen with sperm counts above 30 X 10(6)/ml and exhibiting normal values of other andrological parameters; (2) from semen with sperm counts below 25 X 10(6)/ml and with other andrological parameters of poor quality; (3) from semen devoid of sperm. Additionally, enzyme activity was examined in fractionated (split) semen. The activity in plasma based on measurement of radioactivity incorporated into asialofetuin, following incubation in the presence of 14C sialic acid, was expressed as cpm both per volume and per mg protein. There was a tendency for decreased activity with the decrease in sperm density of semen. The difference, however, lacked statistical significance. Enzyme activity in split semen was significantly lower in the first than in the second fraction.