M3 muscarinic receptors on rat colonocytes are coupled to particulate guanylate cyclase activation

The ability of muscarinic receptor antagonists to compete with (-)-[3H]quinuclidinyl benzilate ([3H]QNB) binding was compared with their ability to block carbachol-mediated stimulation of particulate guanylate cyclase activity in rat colonocytes. The binding of [3H]QNB to membranes was inhibited by antagonists with the following rank order of potencies (inhibitory constants, nM): atropine (2.5) approximately 4-diphenylacetoxy-N-methylpiperidine iodide (4-DAMP) [4.6] >> pirenzepine (121) > methoctramine (385). 4-DAMP (IC50 = approximately 10 nM) was also more potent in blocking carbachol-induced stimulation of guanylate cyclase activity than either pirenzepine (IC50 = approximately 700 nM) or methoctramine (IC50 = approximately 1500 nM).

Measurement of normal renal artery blood flow: cine phase-contrast MR imaging vs clearance of p-aminohippurate

OBJECTIVE

The purpose of this study was to compare cine phase-contrast MR imaging with renal clearance of p-aminohippurate for measuring normal renal blood flow. A reliable technique for evaluation of renal hemodynamics would be useful for studying renal vascular diseases and the effects of treatment. Measurements of renal blood flow based on renal clearance of p-aminohippurate are limited in that the kidneys are not studied separately, temporal resolution is poor, and normal renal function is required.

SUBJECTS AND METHODS

Bilateral oblique sagittal cine phase-contrast MR images were obtained simultaneously in 10 healthy adult volunteers, with the imaging planes oriented perpendicular to the left and right renal arteries in order to measure through-plane flow. Velocity encoding was 150 cm/sec (seven of 10 volunteers) and 100 cm/sec (eight of 10 volunteers). Axial cine phase-contrast images of the abdominal aorta above and below the origins of the renal arteries were obtained in six volunteers. In these cases, renal blood flow was determined by measuring the difference between suprarenal and infrarenal aortic flow. For all volunteers, renal clearance of p-aminohippurate was determined immediately after MR measurements.

RESULTS

Renal blood flow measurements determined by using cine phase-contrast MR imaging were in close agreement with those determined by using clearance of p-aminohippurate. At a velocity encoding of 150 cm/sec, the mean difference was 69 ml/min (95% confidence interval, -31 to 169 ml/min). At a velocity encoding of 100 cm/sec, the mean difference was 39 ml/min (95% confidence interval, -100 to 177 ml/min). Aortic flow measurements using cine phase-contrast MR imaging appeared to be less reliable for determining renal blood flow than measurements in the individual renal arteries, with a mean difference of -75 ml/min (95% confidence interval, -381 to 231 ml/min) compared with renal blood flow determined by using clearance of p-aminohippurate.

CONCLUSION

We conclude that cine phase-contrast MR imaging is a promising technique for noninvasive measurement of renal blood flow. Measurements agreed closely with those obtained by using clearance of p-aminohippurate. In addition, the MR technique is faster, can be used to measure unilateral or bilateral renal blood flow, and does not depend on renal function.

1,25-Dihydroxycholecalciferol rapidly activates rat colonic particulate guanylate cyclase via a protein kinase C-dependent mechanism

The present studies were performed to determine whether the major biologically active metabolite of vitamin D3, 1,25-dihydroxycholecalciferol [1,25(OH)2D3], could influence the activities of rat colonic particulate guanylate cyclase and adenylate cyclase. To address these issues, colonocytes were harvested from Sprague-Dawley rats and suspended in Krebs-Ringer bicarbonate buffer. The cells were then treated with 1,25(OH)2D3 or other agents (see below) and crude membranes were prepared and analyzed for particulate guanylate cyclase and adenylate cyclase activities. The results of these studies demonstrated that: 1) 1,25(OH)2D3, in a concentration-dependent manner, rapidly (within minutes) stimulated guanylate, but not adenylate cyclase activity; 2) preincubation of the cells with staurosporine, a protein kinase inhibitor, or U73122, an inhibitor of phosphoinositide-phospholipase C-dependent processes, blocked the increase in guanylate cyclase activity induced by 1,25(OH)2D3; and 3) 12-O-tetradecanoyl phorbol 13-acetate and 1,2-dioctanoyl-sn-glycerol, known activators of protein kinase C, also rapidly stimulated rat colonic particulate guanylate cyclase activity. Taken together, these results demonstrate that 1,25(OH)2D3 rapidly stimulates together, these results demonstrate that 1,25(OH)2D3 rapidly stimulates rat colonic particulate guanylate cyclase, at least in part, via a protein kinase C-dependent mechanism.

Renal stone disease in autosomal dominant polycystic kidney disease

Nephrolithiasis is an important manifestation of autosomal dominant polycystic kidney disease (ADPKD), which occurs in approximately 20% of patients. It should always enter the differential diagnosis of flank pain in patients with ADPKD. The diagnosis is hindered by the distorted anatomy of the polycystic kidneys and the frequent occurrence of parenchymal and cyst wall calcifications, and requires demonstration of the relationship to the collecting system by intravenous urography and/or computed tomography. Computed tomography is the most sensitive imaging technique for detection of stones or calcifications, whereas intravenous urography is the most sensitive for visualization of the intrarenal collecting system. Precaliceal tubular ectasia can be detected in 15% of patients with ADPKD and nephrolithiasis, but this association may not be specific to ADPKD. The composition of the stones is most frequently uric acid and/or calcium oxalate. Metabolic factors are important in their pathogenesis. Distal acidification defects may be important in a few patients, while an abnormal transport of ammonium, low urine pH, and hypocitruria are the most common abnormalities. The treatment of nephrolithiasis in patients with ADPKD is not different from that in patients without ADPKD. Extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy in patients with early disease and normal renal function are not contraindicated.

Protein-osmolality ratio for the quantitative assessment of proteinuria from a random urinalysis sample

Proteinuria evaluation is important for the differential diagnosis of renal disease and the assessment of prognosis and response to therapy. Qualitative proteinuria correlates poorly with quantitative 24-hour protein levels because of hydration and methodologic problems associated with observer error. The authors automated quantitative urinary protein and osmolality measurements and evaluated whether a urinary protein-osmolality ratio (mg/L/mOsm/kg) in the random urinalysis predicts the 24-hour urine protein level. They compared this ratio with the (1) 24-hour protein levels in 78 normal women and 53 normal men; (2) 24-hour protein levels in 129 proteinuric patients; and (3) urinary protein-creatinine ratio in 131 normal patients and 105 proteinuric patients. The normal urinary protein-osmolality ratio was less than 0.12 (sensitivity, 96%; specificity, 93%). This compared to a urinary protein-creatinine ratio of less than 0.05 (sensitivity, 96%; specificity, 90%). A urinary protein-osmolality ratio of greater than 2.5 indicates a level of more than 3.0 g/24 hour (sensitivity, 91%; specificity, 98%). The urinary protein-osmolality ratio = 1.12x + 0.05 (r = 0.88), where x = 24-hour protein. The authors conclude that the quantitative urinary protein-osmolality ratio is better than a qualitative urinalysis and urinary protein-urinary creatinine ratio for detecting or assessing abnormal proteinuria and allows for a reasonable prediction of 24-hour protein levels.

Production and hormonal regulation of insulin-like growth factor binding proteins in bovine chondrocytes

Linear growth results from proliferation and differentiation of chondrocytes within the growth plates and is regulated, in part, by the insulin-like growth factors (IGFs). IGF binding proteins (IGFBPs) also appear to play a significant, but yet unclear, role. To examine IGFBP production by chondrocytes, we isolated bovine chondrocytes from adult articular, fetal articular, and fetal growth plate cartilage, and maintained them in primary culture as high-density monolayers or encapsulated in alginate beads. Cells were cultured in serum-free conditions with human GH (hGH), insulin, hIGF-I, or hIGF-II. Human IGF-I resulted in higher DNA content in all three of the chondrocyte types. Conditioned medium samples were analyzed for IGFBPs by Western ligand blotting. Chondrocytes released IGFBPs of 24, 29, 33, 39, and 43 kilodaltons (kDa). Deglycosylation and immunoblotting identified the 39/43-kDa doublet as IGFBP-3 and the 33-kDa band as IGFBP-2. All chondrocyte types released 29- and 24-kDa IGFBP bands constitutively. Adult articular chondrocytes increased production all IGFBPs in response to IGF-I, but particularly the 29-kDa band (17-fold increase). Fetal articular chondrocytes showed a similar pattern, but with less of an increase when treated with IGF-I. Fetal growth plate chondrocytes primarily showed increases in IGFBP-3 and the 24-kDa form (4.7- and 2.7-fold, respectively) in response to IGF-I. Although the role of IGFBPs in IGF mediation of articular and growth plate chondrocyte metabolism requires further research, we show here that bovine chondrocytes produce IGFBPs, and the IGFs regulate this production.

Urinary oxalate and glycolate excretion patterns in the first year of life: a longitudinal study

To determine the range of normal values, we studied urinary excretion of oxalate and glycolate prospectively and longitudinally in a cohort of 30 healthy term infants. Random urine samples were obtained at 2 days, 2 weeks, and 2, 4, 6, and 9 months of age. The results had a log-normal distribution. The mean oxalate/creatinine ratio, as determined by the oxalate oxidase method, was 0.08 (in milligrams of oxalate to milligrams of creatinine) with a normalized range of 0.02 to 0.31. The mean ratio when oxalates were measured by using the Olthuis assay was 0.13 (range 0.03 to 0.53). The mean glycolate/creatinine ratio was 0.07 (range 0.02 to 0.26). These values did not correlate with increasing age. The oxalate/creatinine ratios were higher in formula-fed infants than in those who were fed human milk (0.14 +/- 0.16 vs 0.08 +/- 0.04; p < 0.01).

Toxicity evaluations of L-cysteine and Procysteine, a cysteine prodrug, given once intravenously to neonatal rats

Decreased enzymatic production of cysteine in premature and newborn infants may limit the synthesis of glutathione. Unfortunately, cysteine supplementation is limited by associated toxicity and product instability. Procysteine (L-2-oxothiazolidine-4-carboxylate) is a prodrug of cysteine that is inert until metabolized to cysteine intracellularly, thus stimulating glutathione synthesis. The potential toxicities of cysteine and Procysteine were compared in two studies with neonatal rats (10 per group; 3 +/- 1 days of age) after a single intravenous administration. In one study, acute high dosage survivorship was compared for approximately equimolar cysteine dosages of L-cysteine and Procysteine. Mortality at 7 days after single intravenous dosages of L-cysteine at 1.52 or 1.14 g/kg or Procysteine at 1.80 or 1.35 g/kg was 80, 50, 10 and 0%, respectively. Clinical pathology parameters and body and organ weights were compared in a second study, following a moderate dosage of Procysteine or equimolar or lower dosages of L-cysteine. No differences were observed in clinical pathology parameters nor body or organ weights at 14 days following single intravenous dosages of L-cysteine at 369, 185 or 37 mg/kg or Procysteine at 450 mg/kg. Also, Procysteine solutions were considerably more stable than L-cysteine solutions (months vs. hours, respectively). These studies indicated that cysteine supplementation in infants may be enhanced by Procysteine administration.

An attempt to modify unhealthful eating attitudes and weight regulation practices of young adolescent girls

This is the first long-term, controlled study evaluating the effectiveness of a prevention curriculum designed to modify the eating attitudes and unhealthful weight regulation practices of young adolescent girls. Nine hundred sixty-seven sixth and seventh-grade girls were randomized to experimental healthy weight regulation curriculum or no-treatment control classes. A prevention intervention was developed around three principal components: (1) Instruction on the harmful effects of unhealthful weight regulation; (2) promotion of healthful weight regulation through the practice of sound nutrition and dietary principles and regular aerobic physical activity; (3) development of coping skills for resisting the diverse sociocultural influences that appear linked to the current popular obsessions with thinness and dieting. The intervention failed to achieve the hoped-for impact. We did observe a significant increase in knowledge among girls receiving the intervention and among high-risk students only, there was a small albeit statistically significant effect on body mass index. These findings question the wisdom of providing a curriculum directed at all young adolescents, most of whom are not at risk to develop an eating disorder. Rather than targeting the entire population, a healthy weight curriculum designed to modify the eating attitudes and unhealthful weight regulation practices of young adolescent girls might better focus on "at risk" students.

The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study

The magnitude of the health problem from diabetic neuropathies remains inadequately estimated due to the lack of prospective population-based studies employing standardized and validated assessments of the type and stage of neuropathy as compared with background frequency. All Rochester, Minnesota, residents with diabetes mellitus on January 1, 1986, were invited to participate in a cross-sectional and longitudinal study of diabetic neuropathies (and also of other microvascular and macrovascular complications). Of 64,573 inhabitants on January 1, 1986 in Rochester, 870 (1.3%) had clinically recognized diabetes mellitus (National Diabetes Data Group criteria), of whom 380 were enrolled in the Rochester Diabetic Neuropathy Study. Of these, 102 (26.8%) had insulin-dependent diabetes mellitus (IDDM), and 278 (73.2%) had non-insulin-dependent diabetes mellitus (NIDDM). Approximately 10% of diabetic patients had neurologic deficits attributable to nondiabetic causes. Sixty-six percent of IDDM patients had some form of neuropathy; the frequencies of individual types were as follows: polyneuropathy, 54%; carpal tunnel syndrome, asymptomatic, 22%, and symptomatic, 11%; visceral autonomic neuropathy, 7%, and other varieties, 3%. Among NIDDM patients, 59% had various neuropathies; the individual percentages were 45%, 29%, 6%, 5%, and 3%. Symptomatic degrees of polyneuropathy occurred in only 15% of IDDM and 13% of NIDDM patients. The more severe stage of polyneuropathy, to the point that patients were unable to walk on their heels and also had distal sensory and autonomic deficits (stage 2b) occurred even less frequently--6% of IDDM and 1% of NIDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Moderate exercise exacerbates the osteoarthritic lesions produced in cartilage by meniscectomy: a morphological study

Unilateral medial meniscectomy was performed on two groups of sheep. At 1 week post-operatively, one group (N = 5) underwent a regimen of moderate walking exercise (24 km/week), while the other group (N = 5) received no exercise. Two groups (N = 6 and 8) of unoperated sheep were used as exercised and unexercised controls for the respective meniscectomized groups. Six months post-surgery all groups were sacrificed and their knee joints were examined macroscopically using established scoring systems. In both groups, meniscectomy induced cartilage and bone changes typical of early hypertrophic osteoarthritis. However, meniscectomized animals subjected to the exercise program developed more severe cartilage lesions and osteophytes than their unexercised counterparts. While the cell density in femoral cartilage of the meniscectomized and exercised group was similar to controls, that of the meniscectomized but unexercised animals was higher. We conclude form these data that in this animal model exercise exacerbated the lesions induced in articular cartilage by meniscectomy.

Does television viewing increase obesity and reduce physical activity? Cross-sectional and longitudinal analyses among adolescent girls

To examine the relationships between hours of television viewing and adiposity and physical activity among female adolescents, a cohort study with follow-up assessments 7, 14, and 24 months after baseline was conducted. All sixth- and seventh-grade girls (N = 971) attending four northern California middle schools were eligible to participate. Six hundred seventy-one students had sufficient data for baseline cross-sectional analyses, and 279 students in a no-intervention cohort had sufficient data for longitudinal analyses. The baseline sample had a mean age of 12.4 years and was 43% white, 22% Asian, 21% Latino, 6% Pacific Islander, 4% black, 2% American Indian, and 2% other. Hours of after-school television viewing, level of physical activity, and stage of sexual maturation were assessed with self-report instruments. Height, weight, and triceps skinfold thickness were measured and body mass index (ratio of weight [in kilograms] to height [in meters] squared) and triceps skinfold thickness were adjusted by level of sexual maturity for the analyses. Baseline hours of after-school television viewing was not significantly associated with either baseline or longitudinal change in body mass index or triceps skinfold thickness. Baseline hours of after-school television viewing was weakly negatively associated with level of physical activity in cross-sectional analyses but not significantly associated with change in level of physical activity over time. All results were essentially unchanged when adjusted for age, race, parent education, and parent fatness. Among adolescent girls, television viewing time appears to have only weak, if any, meaningful associations with adiposity, physical activity, or change in either over time.

Knowledge reuse: temporal-abstraction mechanisms for the assessment of children's growth

Currently, many workers in the field of medical informatics realize the importance of knowledge reuse. The PROTEGE-II project seeks to develop and implement a domain-independent framework that allows system builders to create custom-tailored role-limiting methods from generic reusable components. These new role-limiting methods are used to create domain- and task-specific knowledge-acquisition tools with which an application expert can generate domain- and task-specific decision-support systems. One required set of reusable components embodies the problem-solving knowledge to generate temporal abstractions. Previously, members of the PROTEGE-II project have used these temporal-abstraction mechanisms to infer the presence of myelotoxicity in patients with AIDS. In this paper, we show that these mechanisms are reusable in the domain of assessment of children's growth.

Effects of estrogen on growth hormone following clonidine stimulation

OBJECTIVE

To test the usefulness of estrogen priming to enhance the growth hormone (GH) response following stimulation with clonidine hydrochloride in short children.

DESIGN

Randomized and patient series.

SETTING

Pediatric endocrine clinic in a referral center.

SUBJECTS

Seventy-three children (63% male) between 1.8 and 15.4 years of age (mean age, 8.8 years) with growth problems who underwent clonidine GH stimulation tests were randomly assigned to receive either estrogen pretreatment or no pretreatment. An additional 49 subjects, seen before or after the randomized study and who did not receive conjugated estrogen, are also described.

SELECTION PROCEDURE

Consecutive sample.

INTERVENTION

Estrogen pretreatment consisted of 2.5 mg of conjugated estrogen (Premarin) to be taken the evening before and the morning of the clonidine GH stimulation test. Growth hormone concentrations were determined before and 60 and 90 minutes after the subjects received oral clonidine hydrochloride (5 micrograms/kg) by a laboratory blinded to the subject's estrogen status. Growth hormone concentrations greater than 10 micrograms/L were considered normal.

RESULTS

Eight of the 73 subjects failed both clonidine and arginine-insulin GH stimulation tests. We analyzed the GH data from the 65 GH-sufficient subjects to determine the effect of estrogen pretreatment on the specificity of the clonidine GH stimulation test. There were no statistically significant differences in the mean GH concentrations between the two groups at any time point during the test.

CONCLUSIONS

Our data demonstrate that estrogen priming does not improve the diagnostic yield of clonidine GH stimulation tests.

Prolactin message in brain and pituitary of adult male rats is identical: PCR cloning and sequencing of hypothalamic prolactin cDNA from intact and hypophysectomized adult male rats

Prolactin (PRL), or a PRL-like molecule has been identified in the central nervous system and other tissues by numerous investigators. The previous finding of PRL in brain persisting for weeks following hypophysectomy led us, and others, to conclude the brain and central nervous system PRL is synthesized locally. Also, our previous results showing PRL mRNA in hypothalamic and extra-hypothalamic brain regions using reverse transcription-polymerase chain reaction (RT-PCR) techniques, along with this report that the sequence of the PRL message in the brain is identical to that found in the anterior pituitary solidifies our, and others, hypothesis that PRL is synthesized in many locations other than the traditional one (anterior pituitary). The actual sequencing of hypothalamic PRL cDNA produced from RT-PCR of mRNA from intact or hypophysectomized rats demonstrates unequivocally that brain PRL mRNA is identical to anterior pituitary prolactin mRNA.

Determination of aflatoxins in food products by chromatography

Several chromatographic methods for the determination of aflatoxins in agricultural and food products are reviewed. During the past two decades, identification and determination of aflatoxins were done by thin-layer chromatography (TLC) because it was easy, fast and inexpensive. However, high-performance liquid chromatography (HPLC) using fluorescence detection is now the method of choice for determining aflatoxins and is also growing in popularity for their identification. The reasons for selecting HPLC over TLC can be summarized as the ability to analyze for a wide variety of compounds, including compounds that are easily degraded by heat, light or air, the ease of adaptation to confirmatory procedures, the potential for automation and the dramatic improvement in instrumentation, including the development of increasingly sensitive fluorescence and electrochemical detectors and short, high-resolution, reversed-phase columns.

Two-year results of treatment with depot leuprolide acetate for central precocious puberty

We report results from 2 years of therapy with the long-acting form of the gonadotropin-releasing hormone (GnRH) analog leuprolide acetate, which was previously reported in short-term trials to be efficacious in the treatment of central precocious puberty. Thirteen girls and two boys, aged 1.9 to 9.7 years, who satisfied clinical criteria including GnRH-stimulated luteinizing hormone (LH) greater than 10 IU/L (mean radioimmunoassay LH, 29.1 +/- 5.54 IU/L), received depot leuprolide, 6 to 15 mg intramuscularly every 4 weeks. Estradiol (or testosterone), insulin-like growth factor I, and GnRH-stimulated gonadotropins were obtained at baseline, at 2 months, and at 6-month intervals with bone age determinations. Pubertal progression ceased in all patients, and menses did not occur. Mean increase in height during therapy was 5.77 +/- 2.0 cm/yr. Predicted adult height increased over baseline by 5.52 +/- 1.16 cm at 18 months. Mean estradiol values in the girls declined from 3.3 +/- 0.6 to 0.60 +/- 0.03 ng/dl, with no overlap of baseline and treatment values. The mean basal LH value was unchanged by therapy; mean basal and peak LH values for all follow-up GnRH stimulation tests were 4.05 +/- 0.57 and 4.95 +/- 0.70 IU/L, respectively. Basal and peak follicle-stimulating hormone (FSH) values were suppressed from 4.10 +/- 0.62 and 10.06 +/- 1.34 IU/L, respectively, to generally undetectable levels (< 1). Comparison with untreated control patients suggested that basal LH did not completely return to prepubertal levels, whereas FSH levels were suppressed below prepubertal levels. Estradiol, FSH, and LH levels reached their nadir by 2 months; in contrast, mean serum levels of insulin-like growth factor I progressively declined from +0.57 +/- 0.19 SD score to -0.06 +/- 0.22 SD score at 24 months. Two girls were withdrawn from the study because of reactions at injection sites, with apparent sterile abscess formation in one patient. This study provides evidence that (1) long-term treatment with depot leuprolide is characterized by immediate and sustained laboratory and clinical suppression, (2) GnRH-stimulated LH and random FSH and estradiol concentrations are useful laboratory measures of efficacy, and (3) the progressive increase in predicted adult height is temporally associated with decreased serum levels of insulin-like growth factor I and striking deceleration of bone age advancement.

Ethical concerns in a long-term tube feeding study

Five ethical concerns about decision-making in relation to tube feeding were determined through secondary analysis of findings from a chart review study examining long-term tube feeding practices. The five ethical concerns are: (1) who should make the decision to tube feed? (2) how should tube feeding decisions be made? (3) what are valid reasons for initiating and continuing tube feeding? (4) is it permissible to withdraw tube feeding once it is initiated? and (5) is tube feeding an effective and appropriate life supporting technology? Ethical concerns are described, using examples from research data. Implications for health care follow.

Clinical actions of growth hormone

Although biotechnology has provided physicians with essentially unlimited supplies of growth hormone (GH), there are currently only a few clear-cut indications for exogenous GH therapy. Data now support the use of GH in the treatment of children with GH deficiency and short girls with Turner syndrome. Tantalizing preliminary data suggest that GH therapy has a role in the management of short, poorly growing children with other causes for their growth failure. Recent studies have examined the utility of GH therapy in GH-deficient adults, whereas other studies suggest that GH improves the clinical status of GH-sufficient older adults. This article explores the recent data underlying these claims.

Pubertal stage and panic attack history in sixth- and seventh-grade girls

OBJECTIVE

Although the incidence of first panic attacks appears to peak during adolescence, little is known about which features of adolescence contribute to the risk of a first panic episode. The purpose of this study was to compare the relative importance of age and pubertal stage in explaining the occurrence of panic attacks in adolescents.

METHOD

From a school-based sample of sixth- and seventh-grade girls, 754 subjects completed both a structured clinical interview determining history of one or more panic episodes and a self-assessment of Tanner stages of pubertal development. A multiple logistic regression analysis was performed with panic attack history as the dependent variable and pubertal stage, age, and their interaction as the independent variables.

RESULTS

A history of one or more four-symptom panic attacks was found in 5.3% of the girls (N = 40). After age was controlled for, pubertal stage was significantly related to panic attack history. At each age, higher rates of panic attacks were found in the more physically mature girls.

CONCLUSIONS

Pubertal stage, after adjustment for the effects of age, appears to predict panic attack occurrence in young adolescent girls. Understanding the link between puberty and panic may offer clues regarding the onset and etiology of panic attacks.

Family Physicians and Exercise Counseling: Can they be influenced to provide more?

This trial took 22 volunteer family physicians and randomly exposed some to training intervention and some to no training to study the effect on frequency and quality of exercise prescription to ambulatory adults. During the 6 weeks after training, the trained physicians addressed the issue of exercise with 35.3% of patients. The untrained physicians discussed exercise with only 8.6% of their patients.

Cardiovascular evaluation in Turner syndrome: utility of MR imaging

Forty patients with karyotypically proven Turner syndrome were prospectively studied using magnetic resonance imaging (MRI) and echocardiography in order to determine the frequency of cardiovascular anomalies and to assess the utility of both imaging modalities as methods for cardiovascular evaluation in Turner syndrome. Cardiovascular anomalies were found in 45% of patients. A high absolute prevalence of bicuspid aortic valve (17.5%) and aortic coarctation (12.5%) were observed relative to comparable series. Of clinically significant abnormalities, three of five aortic coarctations and four of five ascending aortic dilatations were solely MRI detected and not evident at echocardiographic examination. MRI is thus seen as a valuable adjunct to echocardiography in the cardiovascular evaluation of Turner syndrome patients. The usefulness of MRI primarily relates to its ability to provide excellent visualisation of the entire thoracic aorta where a large proportion of clinically significant anomalies occur in Turner syndrome.

Asp-51 and Asp-120 are important for the transport function of the Escherichia coli melibiose carrier

Asp-51 and Asp-120 of the Escherichia coli melibiose carrier on plasmid pKKMB were separately replaced by amber codons and transformed into eight amber suppressor strains, producing eight amino acid substitutions for each site. Glu-51 and Glu-120 were the only replacements in the carrier that allowed the cells to ferment melibiose and that showed transport of melibiose against a concentration gradient. Revertants to Glu-51 and Glu-120 show less activity than the wild type. The Asp-51 position is more crucial for Na(+)-stimulated melibiose accumulation than is the Asp-120 site.

Insulin-like growth factor binding protein-3 in normal pubertal girls

IGFBP-3 concentrations rise in the second decade of life. To test the hypothesis that the stage of pubertal development, independent of chronological age, was associated with these increases we measured serum IGFBP-3 concentrations by radioimmunoassay in 324 sixth and seventh grade girls (12.3 +/- 0.7 years) at the beginning of a multisite school-based health curriculum. The mean (+/- SD) serum IGFBP-3 among the 242 girls with complete data was 4.0 +/- 0.7 mg/l. Pubertal stage was significantly associated with IGFBP-3 (p less than 0.0001, ANOVA). Mean concentrations rose from 3.5 +/- 0.7 mg/l among those with the earliest pubertal stages to 4.2 +/- 0.7 mg/l among the mature girls. IGF-I and IGFBP-3 concentrations were significantly correlated (Spearman's r = 0.43, p less than 0.0001). After controlling for the association between pubertal development and IGFBP-3 concentrations, only the waist/hip ratio, among the various measures of body composition, was significantly associated with IGFBP-3 concentration (Spearman's r = -0.23, p = 0.0002). Likewise, none of the measures of nutrition: intake of total calories, protein, fat and carbohydrate; serum iron; red cell mean corpuscular volume; or cholesterol; were significantly associated with IGFBP-3 concentrations. There was, however, a small, but significant association between IGFBP-3 concentrations and both serum transferrin and blood hemoglobin concentrations. Pubertal stage has a significant impact on IGFBP-3 concentrations and those attempting to utilize IGFBP-3 concentrations during adolescence should be cognizant of the subject's pubertal stage.