Intraperitoneal chemotherapy following neoadjuvant chemotherapy and optimal interval tumor reductive surgery for advanced ovarian cancer

OBJECTIVES

Intraperitoneal (IP) chemotherapy following neoadjuvant chemotherapy (NACT) and interval tumor reductive surgery (TRS) for advanced ovarian cancer is feasible, however, the impact on disease outcomes remains unclear. We compare outcomes of patients treated with IP chemotherapy versus intravenous (IV) chemotherapy following NACT and interval TRS.

METHODS

In this retrospective review, patients with advanced ovarian cancer were included if they received NACT followed by optimal interval TRS between 1/2004 and 4/2017. Patients were excluded if they had an ECOG PS >1, received >6 cycles of NACT or postoperative chemotherapy, and/or received bevacizumab during primary therapy. Primary outcomes were progression free survival (PFS) and overall survival (OS).

RESULTS

There were 134 patients included in this study, 37 (28%) received IP and 97 (72%) received IV chemotherapy postoperatively. Patients in the IV group were older (median 66.3 vs 59.7 years, p = 0.0039) though there were no differences in BMI, race, BRCA status, stage, or histology. Median PFS was 3 months longer in the IP group (14.5 versus 11.5 months, p = 0.028) however there was no significant difference in OS. On univariate analysis, increasing number of NACT cycles (HR 1.914, 95% CI 1.024-3.497) and residual disease at completion of TRS (HR 1.541, 95% CI 1.042-2.248) were associated with decreased PFS; IP chemotherapy was associated with increased PFS (HR 0.633, 95% CI 0.414-0.944). These associations remained on multivariate analysis. Toxicity was comparable between the groups.

CONCLUSIONS

IP after NACT and optimal interval TRS was associated with in improved PFS compared to IV chemotherapy without significant differences in toxicity.

94 β-Decay Half-Lives of Neutron-Rich _{55}Cs to _{67}Ho: Experimental Feedback and Evaluation of the r-Process Rare-Earth Peak Formation

The β-decay half-lives of 94 neutron-rich nuclei ^{144-151}Cs, ^{146-154}Ba, ^{148-156}La, ^{150-158}Ce, ^{153-160}Pr, ^{156-162}Nd, ^{159-163}Pm, ^{160-166}Sm, ^{161-168}Eu, ^{165-170}Gd, ^{166-172}Tb, ^{169-173}Dy, ^{172-175}Ho, and two isomeric states ^{174m}Er, ^{172m}Dy were measured at the Radioactive Isotope Beam Factory, providing a new experimental basis to test theoretical models. Strikingly large drops of β-decay half-lives are observed at neutron-number N=97 for _{58}Ce, _{59}Pr, _{60}Nd, and _{62}Sm, and N=105 for _{63}Eu, _{64}Gd, _{65}Tb, and _{66}Dy. Features in the data mirror the interplay between pairing effects and microscopic structure. r-process network calculations performed for a range of mass models and astrophysical conditions show that the 57 half-lives measured for the first time play an important role in shaping the abundance pattern of rare-earth elements in the solar system.

DNA metabarcoding of insects and allies: an evaluation of primers and pipelines

Metabarcoding, the coupling of DNA-based species identification and high-throughput sequencing, offers enormous promise for arthropod biodiversity studies but factors such as cost, speed and ease-of-use of bioinformatic pipelines, crucial for making the leapt from demonstration studies to a real-world application, have not yet been adequately addressed. Here, four published and one newly designed primer sets were tested across a diverse set of 80 arthropod species, representing 11 orders, to establish optimal protocols for Illumina-based metabarcoding of tropical Malaise trap samples. Two primer sets which showed the highest amplification success with individual specimen polymerase chain reaction (PCR, 98%) were used for bulk PCR and Illumina MiSeq sequencing. The sequencing outputs were subjected to both manual and simple metagenomics quality control and filtering pipelines. We obtained acceptable detection rates after bulk PCR and high-throughput sequencing (80-90% of input species) but analyses were complicated by putative heteroplasmic sequences and contamination. The manual pipeline produced similar or better outputs to the simple metagenomics pipeline (1.4 compared with 0.5 expected:unexpected Operational Taxonomic Units). Our study suggests that metabarcoding is slowly becoming as cheap, fast and easy as conventional DNA barcoding, and that Malaise trap metabarcoding may soon fulfill its potential, providing a thermometer for biodiversity.

Highly spectrum-selective ultraviolet photodetector based on p-NiO/n-IGZO thin film heterojunction structure

Ultraviolet photodetector with p-n heterojunction is fabricated by magnetron sputtering deposition of n-type indium gallium zinc oxide (n-IGZO) and p-type nickel oxide (p-NiO) thin films on ITO glass. The performance of the photodetector is largely affected by the conductivity of the p-NiO thin film, which can be controlled by varying the oxygen partial pressure during the deposition of the p-NiO thin film. A highly spectrum-selective ultraviolet photodetector has been achieved with the p-NiO layer with a high conductivity. The results can be explained in terms of the "optically-filtering" function of the NiO layer.

Droplet spreading on a two-dimensional wicking surface

The dynamics of droplet spreading on two-dimensional wicking surfaces were studied using square arrays of Si nanopillars. It was observed that the wicking film always precedes the droplet edge during the spreading process causing the droplet to effectively spread on a Cassie-Baxter surface composed of solid and liquid phases. Unlike the continual spreading of the wicking film, however, the droplet will eventually reach a shape where further spreading becomes energetically unfavorable. In addition, we found that the displacement-time relationship for droplet spreading follows a power law that is different from that of the wicking film. A quantitative model was put forth to derive this displacement-time relationship and predict the contact angle at which the droplet will stop spreading. The predictions of our model were validated with experimental data and results published in the literature.

Dynamics of wicking in silicon nanopillars fabricated with interference lithography and metal-assisted chemical etching

The capillary rise of liquid on a surface, or "wicking", has potential applications in biological and industrial processes such as drug delivery, oil recovery, and integrated circuit chip cooling. This paper presents a theoretical study on the dynamics of wicking on silicon nanopillars based on a balance between the driving capillary forces and viscous dissipation forces. Our model predicts that the invasion of the liquid front follows a diffusion process and strongly depends on the structural geometry. The model is validated against experimental observations of wicking in silicon nanopillars with different heights synthesized by interference lithography and metal-assisted chemical etching techniques. Excellent agreement between theoretical and experimental results, from both our samples and data published in the literature, was achieved.

Effect of thermal annealing on the efficiency of heterojunction photovoltaic cells fabricated using poly(3-hexylthiophene) and methanofullerene, [6,6]-phenyl C61-butyric acid methyl ester

The effects of thermal annealing on the efficiency of heterojunction photovoltaic (PV) cells that were fabricated using poly(3-hexylthiophene) (P3HT) and methanofullerene, [6,6]-phenyl C61-butyric acid methyl ester (PCBM) were investigated. The absorption spectra showed that the absorption intensity of the P3HT:PCBM layer that was annealed for 5 min had the highest value among the several samples with different annealing temperatures. The atomic force microscopy image showed that the P3HT:PCBM layer that was annealed for 5 min had the best surface morphology. The X-ray photoelectron spectroscopy demonstrated that the P3HT:PCBM layer that was annealed at 140 degrees C for 10 min enhanced the PCBM aggregation on the surface Al layer that was covered by the P3HT:PCBM layer. The efficiencies of the PV cells that were annealed at 3, 5, and 10 min were approximately 2.7, 4.2, and 3.5%, respectively. Based on the experiment results, the variations in the efficiency of the PV cells due their thermal treatment were described.

Covalent assembly of gold nanoparticles for nonvolatile memory applications

This work reports a versatile approach for enhancing the stability of nonvolatile memory devices through covalent assembly of functionalized gold nanoparticles. 11-mercapto-1-undecanol functionalized gold nanoparticles (AuNPs) with a narrow size distribution and particle size of about 5 nm were synthesized. Then, the AuNPs were immobilized on a SiO(2) substrate using a functionalized polymer as a surface modifier. Microscopic and spectroscopic techniques were used to characterize the AuNPs and their morphology before and after immobilization. Finally, a metal-insulator-semiconductor (MIS) type memory device with such covalently anchored AuNPs as a charge trapping layer was fabricated. The MIS structure showed well-defined counterclockwise C-V hysteresis curves indicating a good memory effect. The flat band voltage shift was 1.64 V at a swapping voltage between ±7 V. Furthermore, the MIS structure showed a good retention characteristic up to 20,000 s. The present synthetic route to covalently immobilize gold nanoparticles system will be a step towards realization for the nanoparticle-based electronic devices and related applications.

Electronic Health Record Goes Personal World-wide

Objective Increasing patient demand for convenient access to their own healthcare data has led to more personal use of the Electronic Health Record (EHR). With “consumer empowerment” being an important issue of EHR, we are seeing a more “patient-centric” approach of EHR from countries around the world. Researchers have reported on issues in EHR sharing including concerns on privacy and security, consumer empowerment, competition among providers, and content standards. This study attempts to analyze prior research and to synthesize comprehensive, empirically-based conceptual models of EHR for personal use.

Methods We use “B2C(2B)” to represent this new behavior of EHR sharing and exchange, with “consumer” in the center stage.

ResultsBased on different information sharing mechanisms, we summarized the “B2C(2B)” behavior into three models, namely, the Inexpensive data media model, the Internet patient portal model and the Personal portable device model. Models each have their own strengths and weaknesses in their ways to share patient data and to address privacy and security concerns.

Conclusion Personal use of EHR under the B2C(2B) model does look promising based on our study. We started to observe a trend that governments around the world are embarking on related projects. With multiple stake-holders involved, we are only beginning to understand the complexity of such undertakings.

Electronic health record goes personal world-wide

OBJECTIVE

Increasing patient demand for convenient access to their own healthcare data has led to more personal use of the Electronic Health Record (EHR). With "consumer empowerment" being an important issue of EHR, we are seeing a more "patient-centric" approach of EHR from countries around the world. Researchers have reported on issues in EHR sharing including concerns on privacy and security, consumer empowerment, competition among providers, and content standards. This study attempts to analyze prior research and to synthesize comprehensive, empirically-based conceptual models of EHR for personal use.

METHODS

We use "B2C(2B) " to represent this new behavior of EHR sharing and exchange, with "consumer" in the center stage.

RESULTS

Based on different information sharing mechanisms, we summarized the "B2C(2B) " behavior into three models, namely, the Inexpensive data media model, the Internet patient portal model and the Personal portable device model. Models each have their own strengths and weaknesses in their ways to share patient data and to address privacy and security concerns.

CONCLUSION

Personal use of EHR under the B2C(2B) model does look promising based on our study. We started to observe a trend that governments around the world are embarking on related projects. With multiple stake-holders involved, we are only beginning to understand the complexity of such undertakings.

Enhanced charge storage capability of Ge/GeO(2) core/shell nanostructure

A Ge/GeO(2) core/shell nanostructure embedded in an Al(2)O(3) gate dielectrics matrix was produced. A larger memory window with good data retention was observed in the fabricated metal-insulator-semiconductor (MIS) capacitor for Ge/GeO(2) core/shell nanoparticles compared to Ge nanoparticles only, which is due to the high percentage of defects located on the surface and grain boundaries of the GeO(2) shell. We believe that the findings presented here provide physical insight and offer useful guidelines to controllably modify the charge storage properties of indirect semiconductors through defect engineering.

Immunogenicity and safety profiles of genetic vaccines against human Her-2/neu in cynomolgus monkeys

Her-2/neu is a well-characterized tumor-associated antigen, the overexpression of which in human carcinomas correlates with a poor prognosis. Here, we evaluated Her-2/neu-specific humoral and cellular immune responses in immunized monkeys after immunization with nonreplicating adenovirus (AdHM) expressing the extracellular and transmembrane domain of human Her-2/neu (HM) and/or naked DNA vaccine (pHM-hGM-CSF) expressing human granulocyte-macrophage colony-stimulating factor together with HM. Priming of monkeys with AdHM generated Her-2/neu-specific long-lasting antibody production. Furthermore, these Her-2/neu-specific antibodies produced by AdHM immunization, some of which shared epitope specificity with Herceptin, were able to induce antibody-dependent cellular cytotoxicity against Her-2-expressing target cells. Cellular immune responses were elicited in all monkeys immunized with Her-2/neu-expressing vaccine; interferon-gamma was secreted when these splenocytes were restimulated with Her-2/neu-expressing autologous cells, and immunization with AdHM induced Her-2/neu-specific lymphoproliferative responses. Further, immunization with pHM-hGM-CSF before AdHM immunization noticeably enhanced cytotoxic T-lymphocyte activity. In addition, we observed no abnormalities that would indicate that the genetic vaccines had toxic effects in the immunized monkeys. Thus, we can conclude that our genetic vaccines efficiently elicited Her-2/neu-specific humoral and cellular immune responses without causing severe adverse effects in nonhuman primates and that as such they warrant further clinical investigation.

Direct sequencing analysis of transmembrane region of human Neu gene by polymerase chain reaction

The neu gene in rat neuro/glioblastoma was found to be activated by a single point mutation in the DNA sequence encoding the transmembrane region of the neu-encoded p185 protein. The human homologue of the rat neu gene, termed c-erbB-2 or HER-2, can also be activated in vitro by a similar mutation in the corresponding region. Although the human neu gene was shown to be amplified/overexpressed in a large portion of human breast and ovarian cancer, no reports indicate that the human neu gene is activated by a point mutation in human tumor. To study the possible point mutation of neu gene in human tumors, we characterized the genomic structure in the transmembrane region of human neu gene, which in turn allowed us to determine DNA sequence in this region directly following DNA amplification by polymerase chain reaction. We analyzed 7 tumor cell lines (2 breast cancer, 1 neuroblastoma, 1 rhabdomyosarcoma, and 3 glioma) and 11 tumor tissue samples (8 breast and 3 ovarian cancers). No mutation was found in the transmembrane region of human neu gene. Our results suggest that unlike the rat neuro/glioblastoma, the single point mutation in the transmembrane region of the human neu gene is a rare event in human tumors. In this study, we developed a technique for direct DNA sequencing of the transmembrane region of the human neu gene. This technique makes it possible to screen a large number of tumor samples.

Ki-ras gene mutations, LOH of the APC and DCC genes, and microsatellite instability in primary colorectal carcinoma are not associated with micrometastases in pericolonic lymph nodes or with patients' survival

AIMS

The primary aim of this study was to look for possible correlations between molecular genetic changes in primary colorectal cancer and the presence or absence of micrometastases in the accompanying pericolonic lymph nodes. The secondary aim was to correlate the data on these molecular genetic changes and micrometastases with survival.

METHODS

One hundred and twenty five Dukes's stage B colorectal cancers from 1989 to 1992 were analysed. The primary tumours were evaluated for Ki-ras mutation, adenomatous polyposis coli (APC) loss of heterozygosity (LOH), deleted in colon cancer (DCC) LOH, and microsatellite instability using standard molecular techniques. All available lymph nodes were immunohistochemically stained for micrometastases.

RESULTS

Micrometastases were present in 41% of patients. There were significantly more lymph nodes removed in the patients with micrometastases. Micrometastases were not associated with Ki-ras mutation, APC LOH, DCC LOH, or microsatellite instability, even when controlling for the number of lymph nodes removed. None of the molecular variables considered had a significant impact on either overall survival or on death with disease.

CONCLUSIONS

There are insufficient data to justify using molecular genetic changes in primary colorectal carcinomas as prognostic markers. Micrometastases do not provide prognostic information on survival. There is value in increasing the numbers of lymph nodes removed and analysed along with the primary tumour.

Defining "occludable" angles in population surveys: drainage angle width, peripheral anterior synechiae, and glaucomatous optic neuropathy in east Asian people

BACKGROUND

/aim: A current consensus in epidemiological studies of primary angle closure (PAC) is to diagnose the condition only if the posterior (usually pigmented) trabecular meshwork is seen for less than 90 degrees of the angle circumference, termed an "occludable angle." The authors sought to assess the validity of this epidemiological classification by exploring the relation between drainage angle width, peripheral anterior synechiae (PAS) and glaucomatous optic neuropathy (GON).

METHODS

918 Mongolians and 995 Chinese Singaporeans, both groups aged 40 years and older were examined in two population based surveys. Gonioscopic angle width was graded in five categories (0 = closed to 4 = wide open) according the scheme described by Shaffer. Cases with secondary PAS were excluded.

RESULTS

The rate of PAS was between 0.3% and 1.7% in people with wide angles (grades 3 and 4). In those with grade 2 angles, PAS were seen in between 8% of eyes. In eyes with grade 1 angles, the rate rose to 17% in Chinese Singaporeans, and 31% in Mongolians. The odds of PAS were higher in people with narrower angles. However, there was a greater absolute number of people with PAS whose drainage angles were classified as "not occludable" than those classified "occludable."

CONCLUSIONS

The traditional view that primary angle closure becomes a significant possibility in drainage angles of < or = grade 2 (approximately 20 degrees ) is valid in east Asians. The definition of an "occludable" angle examined here excludes many people with PAS. This probably serves to underemphasise the role of PAC in population surveys of glaucoma prevalence in Asian people.

Prevalence of glaucoma in Thailand: a population based survey in Rom Klao District, Bangkok

AIM

To determine prevalence, demography, mechanism, and visual morbidity of glaucoma in urban Thai people.

METHODS

790 subjects aged 50 years or older from Rom Klao district, Bangkok, Thailand, were enumerated in a population based cross sectional study. Each subject underwent the following investigations: visual acuity, visual field testing, slit lamp examination, applanation tonometry, gonioscopy, and an optic disc examination after mydriasis. Main outcome measures included visual acuity (logMAR), visual fields, intraocular pressure (IOP), gonioscopic characteristics, vertical cup/disc ratio (VCDR), prevalence of types of glaucoma. Glaucoma was diagnosed on the basis of optic disc appearance and visual field defects. In eyes in which the optic disc could not be examined, glaucoma was diagnosed when visual acuity was <3/60 and either IOP >99.5th percentile or there was evidence of previous glaucoma surgery.

RESULTS

701 subjects were examined (response rate 88.7%). In eyes with "normal" suprathreshold visual fields, the mean IOP was 13.3 mm Hg (97.5th percentile = 20 mm Hg). The 97.5th and 99.5th percentiles of VCDR were 0.72 and 0.86 respectively. Of the 701 subjects examined in the clinic, 27 had glaucoma (3.8%, 95% CI: 2.5 to 5.6), 16 had primary open angle glaucoma (POAG, prevalence 2.3%, 95% CI: 1.3 to 3.7), six were primary angle closure glaucoma (PACG, prevalence 0.9%, 95% CI: 0.3 to 1.9), and five were secondary glaucoma (SecG, prevalence 0.7%, 95% CI: 0.2 to 1.7). Among the 43 unilaterally blind subjects, glaucoma was the cause in five subjects (12%). One subject was bilaterally blind due to glaucoma (prevalence 11%, 95% CI: 0.3 to 61.9). 28 people (4%) were glaucoma suspects on the basis of optic disc appearance and six on the basis of visual fields only. 98 subjects (14%) had "occludable angles" in either eye, 22 of whom had primary angle closure (PAC, prevalence 3.1%, 95% CI: 1.9 to 4.7); 14 had peripheral anterior synechiae in either eye and eight had ocular hypertension (OHT).

CONCLUSIONS

POAG accounted for 67% of all glaucoma, PACG 21%, and secondary glaucomas 12%. Glaucoma was the second most common cause of severe unilateral visual loss.

Primary giant cell malignant fibrous histiocytoma of the kidney with staghorn calculi

Malignant fibrous histiocytomas (MFH) as primary renal tumours are rare, with less than 50 cases described in the literature. We report a case of primary renal MFH of giant cell type in a 56-year-old man, who presented with bilateral dull flank pain, intermittent gross haematuria and body weight loss (6 kg in 3 months). Intravenous urography, computerized tomography (CT) and magnetic resonance image (MRI) showed right ureteral stones with mild hydronephrosis, and a solid mass at the lower pole of the left kidney associated with staghorn calculi, as well as tumour thrombi in the left renal vein and inferior vena cava. Left radical nephrectomy and evacuation of tumour thrombi from the left renal vein and inferior vena cava were performed. Histopathologic examination revealed malignant fibrous histiocytoma (MFH) of giant cell type. To the best of our knowledge, this is the first report of primary renal MFH associated with staghorn calculi.

Case report: diabetic mastopathy

Diabetic mastopathy is a source of confusion with breast carcinoma. The association between mastopathy and Type I diabetes of long duration has been reported, but this clinical condition is poorly recognized since breast examination is not routinely performed in young diabetic patients. Radiologists' awareness of the constellation of findings in diabetic mastopathy may spare patients from undergoing unwarranted surgical biopsies.

Assessment of the genotoxic potential of ISIS 2302: a phosphorothioate oligodeoxynucleotide

ISIS 2302, a phosphorothioate oligodeoxynucleotide with antisense activity against human ICAM-1 mRNA, was evaluated in a battery of tests to assess genotoxic potential. There was no evidence of genotoxicity in three in vitro studies performed: (i) a bacterial reverse mutation test; (ii) a chromosomal aberration test in Chinese hamster ovary cells; (iii) a mammalian cell gene mutation assay in L5187Y cells. Additionally, there was no in vivo evidence of genetic toxicity in a bone marrow micronucleus study in male and female mice. For all tests, top concentrations or doses assessed met harmonized regulatory guidelines. The cellular uptake of ISIS 2302 into target cells was confirmed using capillary gel electrophoresis and immunohistochemistry. Intracellular uptake into CHO cells, L5187Y cells, Salmonella typhimurium TA98 and bone marrow was concentration- and time-dependent. Consistent with what is known about the physical and chemical properties of phosphorothioate oligodeoxynucleotides, there was no evidence of genotoxicity in any of the assessed end-points. Furthermore, the absence of genotoxicity could not be ascribed to test system insensitivity or to an absence of exposure of the test system to ISIS 2302.

Breath hydrogen responses in infants using lactose-rice formula and regular lactose formula

Starch thickened infant formulas have been shown to relieve regurgitation and increase caloric retention. We compared the completeness of digestion of the carbohydrates in lactose-rice formula (study formula) with routine infant formula in infants with GER. A prospective open study of 30 normal, well-nourished infants with simple regurgitation was conducted. The clinical history on regurgitation, stool pattern and baseline breath hydrogen (bH2) test were obtained at entry, with the infants still using their original routine infant formula, and after a wash out period of 7 days, during which they were fed only with study formula. Analysis of bH2 results showed lower levels of bH2 at 1, 2 and 3 hours with study formula compared with the original formula at the 2nd and 3rd hour (p<0.05). The effectiveness of the study formula in managing GER was demonstrated by the fact that 26 out of 30 had either "some improvement" or a "good response." Hardening of the stool pattern was reported in 13 of the 30 infants after 1 week of study formula. The mean of peak bH2 in study formula fed subjects with formed and firm/hard stool was significantly lower than in those with soft and pasty stool. In conclusion, this study has shown the effectiveness of rice thickened infant formulas in managing infants with GER. Rice-starch has an additional advantage of ease of digestion. The hardening of stool pattern was also frequently observed.

Women's health issues in haemodialysis patients

OBJECTIVES

To describe reproductive health issues in women with end-stage renal disease (ESRD) treated with haemodialysis.

STUDY DESIGN

Cross-sectional survey based on structured interviews.

SETTING

Nephrology units of two major metropolitan tertiary referral hospitals in Victoria and their satellite dialysis centres between 1 November 1998 to 30 June 1999.

METHODS

Women aged 20 years or over in haemodialysis programs.

OUTCOME MEASURES

Menstrual status; prevalence of menstrual and climacteric symptoms; use of gynaecological screening; and prevalence of comorbidities that may benefit from hormone replacment therapy.

RESULTS

48 women completed the survey. They were similar to the 485 women undergoing haemodialysis in Victoria in age (mean age, 55.5 years; range, 20-84 years), years on dialysis (mean age, 3.9 years; range, 1 month-17 years) and primary diagnosis. Eleven of the 15 premenopausal women reported menstrual cycles of 22-35 days, 13 reported common premenstrual symptoms, and six reported dysmenorrhoea that interfered with daily activities. Average age at menopause was 47.7 years (95% CI, 45.6-49.9 years), and six of the 31 postmenopausal women underwent menopause before 45 years. Eight had ever been prescribed hormone replacement therapy (oral in all cases). Over half the women (26) had not had a Pap smear in the last two years, and 12 of those aged over 50 (38%) had not had a mammogram in the same period.

CONCLUSION

Despite their risk of early menopause, cardiovascular disease and bone fracture, few women undergoing haemodialysis were offered hormone replacement therapy. Nor were they adequately screened for gynaecological cancers. Women's health issues seem to be neglected among haemodialysis patients.

Polyacene and cyclacene geometries and electronic structures: bond equalization, vanishing band gaps, and triplet ground states contrast with polyacetylene

The ground-state geometries and excited singlet and lowest triplet energies of polyacenes from benzene through nonacene are predicted with B3LYP/6-31G* calculations and compared to experimental data where available. The results are compared to these data for cyclacenes and polyenes. The polyacenes and cyclacenes have geometries consisting of two fully delocalized nonalternating ribbons joined by relatively long bonds. Polyacenes are predicted to have smaller band gaps than the corresponding polyenes and triplet ground states for nine or more benzene rings. The fully delocalized nonalternating nature of polyacenes differs from the bond alternation resulting from Peierls distortion in polyenes. The differences are rationalized in terms of a simple MO model, and the results are compared to extensive prior theoretical work in the literature. Predictions about the electronic structure of analogues containing polyacene units are made.

Protein tyrosine phosphatase phi regulates paxillin tyrosine phosphorylation and mediates colony-stimulating factor 1-induced morphological changes in macrophages

Removal of colony-stimulating factor 1 (CSF-1) causes macrophages to round up and to increase their expression of protein tyrosine phosphatase phi (PTP phi). This is accompanied by the disruption of focal complexes and the formation of ruffles. Here we have overexpressed wild-type (WT) PTP phi and a phosphatase-inactive (C325S) mutant in a macrophage cell line in the presence and absence of CSF-1. In the presence of CSF-1, WT PTP phi induces cell rounding and ruffle formation, while C325S PTP phi has no effect. In contrast, in CSF-1-starved cells, C325S PTP phi behaves in a dominant negative fashion, preventing rounding and ruffling. Furthermore, C325S PTP phi increases adhesion in cycling cells, while WT PTP phi enhances motility. In WT PTP phi-overexpressing cells, the focal contact protein paxillin is selectively depleted from focal complexes and specifically dephosphorylated on tyrosine. In contrast, paxillin is hyperphosphorylated in C325S PTP phi-expressing cells. Moreover, a complex containing PTP phi, paxillin, and a paxillin-associated tyrosine kinase, Pyk2, can be immunoprecipitated from macrophage lysates, and the catalytic domain of PTP phi selectively binds paxillin and Pyk2 in vitro. Although PTP phi and Pyk2 do not colocalize with paxillin in focal complexes, all three proteins are colocalized in dorsal ruffles. The results suggest that paxillin is dephosphorylated by PTP phi in dorsal ruffles, using Pyk2 as a bridging molecule, resulting in a reduced pool of tyrosine-phosphorylated paxillin available for incorporation into focal complexes, thereby mediating CSF-1 regulation of macrophage morphology, adhesion, and motility.

Genetic toxicology testing of the antimalarial drugs chloroquine and a new analog, AQ-13

AQ-13 ([N1-(7-chloro-quinolin-4yl)-3-(N3,N3-diethylamino)propylamine] dihydrochloride trihydrate) is an aminoquinoline antimalarial drug that is effective against chloroquine-resistant strains of Plasmodium falciparum. It is structurally similar to the widely used chloroquine diphosphate (CQ). We evaluated these drugs in the three assays currently recommended by the International Conference on Harmonization (ICH): bacterial mutagenesis in Salmonella typhimurium and Escherichia coli, mammalian cell mutagenesis in L5178Y mouse lymphoma cells, and micronucleus induction in rat bone marrow. A small but statistically significant increase in revertant colonies was produced by CQ with Salmonella tester strain TA98 without metabolic activation (MA) and by AQ-13 with strain TA1537 both with and without MA. In L5178Y cells, testing of CQ and AQ-13 up to cytotoxic concentrations with and without MA produced no increase in mutant colonies and no increase in the numbers of small colonies. Slight decreases in the ratio of polychromatic erythrocytes (PCE) to red blood cells (RBC) were observed in male and female rats treated with CQ and in females only treated with AQ-13; however, none of these changes was statistically significant. No increases in the frequency of micronucleated PCE were observed at any dose level of CQ or AQ-13. Although both CQ and AQ-13 showed weak bacterial mutagenicity, this mutagenic effect was not confirmed in either the mouse lymphoma mutagenesis assay or the micronucleus assay. These results indicate that CQ and AQ-13 should pose minimal risk of genotoxic damage in human populations being administered these drugs.

Genomic analysis

Advances in genomic analysis include improved technology for DNA sequencing, routine use of DNA microarray technology for the analysis of gene expression profiles at the mRNA level and improved informatic tools to organize and analyze such data. At the same time, new developments in chip-based analysis of samples and the emergence of models of gene networks hold promise for the future of the 'Genomic Era'.

Molecular evidence that the stromal and epithelial cells in pleomorphic adenomas of salivary gland arise from the same origin: clonal analysis using human androgen receptor gene (HUMARA) assay

Salivary gland pleomorphic adenomas are characterized by a biphasic growth of "epithelial" and "stromal" regions. The "epithelial" region is a compactly organized mixture of both luminal and nonluminal cells, whereas the stromal region is composed predominantly of the nonluminal cells. Using the polymerase chain reaction (PCR)-based HUMARA assay on DNA from formalin-fixed, paraffin-embedded tissues from pleomorphic adnomas of female patients, we intend to clarify the clonal relation between the luminal and nonluminal cells and the clonal nature of the morphologically diverse nonluminal cells in this tumor. HUMARA, the human androgen receptor gene, is located on the X chromosome and contains a segment of polymorphic CAG tandem repeats in exon 1. Several methylation-sensitive HhaI restriction sites are located 5' to these CAG repeats. It is an ideal tool to study clonality of female tissues by examining the methylation pattern. Of the 13 cases analyzed, 3 were homozygous at the HUMARA locus and therefore noninformative. The remaining 10 cases were informative. All 10 cases showed a monoclonal pattern in the stromal area, indicating that the morphologically diverse nonluminal cells are monoclonal. Eight of the 10 cases showed monoclonality in the "epithelial" areas, suggesting a common clonality between luminal and nonluminal cells. Of the remaining 2 samples, 1 was polyclonal for the "epithelial" region, and the other was not amplifiable. Our data provide the first molecular evidence that the luminal and nonluminal cells in pleomorphic adenomas arise from the same clone in most cases, and the morphologically diverse nonluminal cells are monoclonal.

Anterior chamber depth measurement as a screening tool for primary angle-closure glaucoma in an East Asian population

OBJECTIVE

To evaluate anterior chamber depth measurement as a method of screening for primary angle-closure glaucoma in an East Asian population.

DESIGN

Two-phase, cross-sectional, community-based study.

SETTING

Rural and urban locations in the Hovsgol and Omnogobi provinces, Mongolia.

PARTICIPANTS

Nine hundred forty-two (94.2%) of 1000 individuals in Hovsgol(1995) and 775 (96.9%) of 1000 individuals in Omnogobi (1997) aged 40 years or older were examined.

MAIN OUTCOME MEASURES

Anterior chamber depth was measured by optical pachymetry, slitlamp-mounted A-mode ultrasound, and handheld ultrasound. Gonioscopy was used to detect occludable angles, defined as one in which the trabecular meshwork was visible for less than 90 degrees of angle circumference. Primary open-angle glaucoma was diagnosed in subjects with an occludable angle and glaucomatous optic neuropathy with visual morbidity. The area under the curve in a receiver operating characteristic plot was used to compare test performance.

RESULTS

Optical pachymetry outperformed the slitlamp-mounted ultrasound method of anterior chamber depth measurement (area under the curve, 0.93 and 0.90, respectively; z test, P = .001). Handheld ultrasound (area under the curve, 0.86) was inferior to optical measurement (z test, P = .001) but did not differ significantly from slitlamp ultrasound (z test, P = .06). The optical method gave sensitivity of 85% and specificity of 84% at a screening cutoff of less than 2.22 mm for detecting occludable angles.

CONCLUSIONS

Measurement of axial anterior chamber depth can detect occludable angles in this Asian population and therefore may have a role in population screening for primary angle-closure glaucoma.

Detection of gonioscopically occludable angles and primary angle closure glaucoma by estimation of limbal chamber depth in Asians: modified grading scheme

AIM

To evaluate the performance of limbal chamber depth estimation as a means of detecting occludable drainage angles and primary angle closure, with or without glaucoma, in an east Asian population, and determine whether an augmented grading scheme would enhance test performance.

METHOD

A two phase, cross sectional, community based study was conducted on rural and urban areas of Hövsgöl and Omnögobi provinces, Mongolia. 1800 subjects aged 40 to 93 years were selected and 1717 (95%) of these were examined. Depth of the anterior chamber at the temporal limbus was graded as a percentage fraction of peripheral corneal thickness. An "occludable" angle was one in which the trabecular meshwork was seen in less than 90 degrees of the angle circumference by gonioscopy. Primary angle closure (PAC) was diagnosed in subjects with an occludable angle and either raised pressure or peripheral anterior synechiae. PAC with glaucoma (PACG) was diagnosed in cases with an occludable angle combined with glaucomatous optic neuropathy and consistent visual morbidity.

RESULTS

Occludable angles were identified in 140 subjects, 28 of these had PACG. The 15% grade (equivalent to the traditional "grade 1") yielded sensitivity and specificity of 84% and 86% respectively for the detection of occludable angles. The 5% grade gave sensitivity of 91% and specificity of 93% for the detection of PACG. The interobserver agreement for this augmented grading scheme was good (weighted kappa 0.76).

CONCLUSIONS

The traditional limbal chamber depth grading scheme offers good performance for detecting occludable drainage angles in this population. The augmented scheme gives enhanced performance in detection of established PACG. The augmented scheme has potential for good interobserver agreement.

A mutant oncolytic adenovirus targeting the Rb pathway produces anti-glioma effect in vivo

Effective anti cancer strategies necessitate the use of agents that target tumor cells rather than normal tissues. In this study, we constructed a tumor-selective adenovirus, Delta24, that carries a 24-bp deletion in the E1A region responsible for binding Rb protein. Immunoprecipitation analyses verified that this deletion rendered Delta24 unable to bind the Rb protein. However, titration experiments in 293 cells demonstrated that the Delta24 adenovirus could replicate in and lyse cancer cells with great efficiency. Lysis of most human glioma cells was observed within 10 - 14 days after infection with Delta24 at 10 PFU/cell. In vivo, a single dose of the Delta24 virus induced a 66.3% inhibition (P<0.005) and multiple injections, an 83.8% inhibition (P<0.01) of tumor growth in nude mice. However, normal fibroblasts or cancer cells with restored Rb activity were resistant to the Delta24 adenovirus. These results suggest that the E1A-mutant Delta24 adenovirus may be clinically and therapeutically useful against gliomas and possibly other cancers with disrupted Rb pathway.

The Cbl protooncoprotein stimulates CSF-1 receptor multiubiquitination and endocytosis, and attenuates macrophage proliferation

Colony-stimulating factor-1 (CSF-1) activation of the CSF-1 receptor (CSF-1R) causes Cbl protooncoprotein tyrosine phosphorylation, Cbl-CSF-1R association and their simultaneous multiubiquitination at the plasma membrane. The CSF-1R is then rapidly internalized and degraded, whereas Cbl is deubiquitinated in the cytoplasm without being degraded. We have used primary macrophages from gene-targeted mice to study the role of Cbl. Cbl-/- macrophages form denser colonies and, at limiting CSF-1 concentrations, proliferate faster than Cbl+/+ macrophages. Their CSF-1Rs fail to exhibit multiubiquitination and a second wave of tyrosine phosphorylation previously suggested to be involved in preparation of the CSF-1-CSF-1R complex for endocytosis. Consistent with this result, Cbl-/- macrophage cell surface CSF-1-CSF-1R complexes are internalized more slowly, yet are still lysosomally degraded, and the CSF-1 utilization by Cbl-/- macrophages is reduced approximately 2-fold. Thus, attenuation of proliferation by Cbl is associated with its positive regulation of the coordinated multiubiquitination and endocytosis of the activated CSF-1R, and a reduction in the time that the CSF-1R signals from the cell surface. The results provide a paradigm for studies of the mechanisms underlying Cbl attenuation of proliferative responses induced by ligation of receptor tyrosine kinases.

Retinal manifestations of HIV-1 and HIV-2 infections among hospital patients in The Gambia, west Africa

BACKGROUND

In developed countries, 50-75% of AIDS patients develop retinal complications and about 20-40% acquire cytomegalavirus (CMV) retinitis. We conducted a cross-sectional survey to determine prevalence of these in The Gambia where both HIV-1 and HIV-2 infection are present and the prevalence of HIV-1 is rising.

METHOD

All patients attending hospital whose percentage CD4+ cells (CD4%) was below 14, the level associated typically with an AIDS diagnosis, and one half of those whose CD4% was 14 or above were asked to join the study. Fifty-six HIV-1, 52 HIV-2 and 12 dually infected patients were recruited. Photographs of the fundi were taken and interpreted independently. The findings were related to the patients' percentage CD4+ cells.

RESULTS

The CD4% was < 14 in 40 patients and < 7 in 17 patients. Thirty-six patients were male. No cases of CMV retinitis were found. Four patients whose CD4% were 4, 5, 11 and 23 had cotton wool spots ranging in number from 1 to 14 for any one patient. The prevalence of cotton wool spots was 8% (95% CI, 0-16%) among patients with CD4% below 14 and 12% (95% CI, 0-27) among patients with CD4% below 7. One of the 4 patients had associated microaneurysm and blot haemorrhages typical of more advanced HIV microvasculopathy.

CONCLUSION

CMV retinitis is less common in The Gambia than in developed countries. Non-infectious retinopathy may also be less common.

Effects of blood glucose levels on performance in activities of daily living: a case example of a diabetic man with an acquired brain injury

Dysfunctional blood glucose regulation and sequelae of acquired brain injury (ABI) can affect behavioural training in brain injury rehabilitation. The relationship is examined between blood glucose levels and performance in three activities of daily living (ADL) skills (showering, toileting, and dressing) in a 21-year-old male with ABI and Type I diabetes mellitus. Multiple daily glucometer readings were obtained both pre- and post-treatment. Skills training involved graduated prompting and reinforcement to develop independence in ADLs. Assessment and teaching occurred initially in hospital, and then was presented at home. Results show a strong negative relationship between daily fluctuations in blood glucose levels and performance; no relationship was found between daily mean levels and performance. Implications for treatment approaches for diabetic individuals with ABI are discussed.

Trachoma in The Gambia

BACKGROUND

As part of the second National Survey of Blindness and Low Vision in the Gambia carried out in 1996, all survey participants were examined for signs of trachoma. The findings were compared with the results of the first survey in 1986, which used the same sampling strategy.

METHODS

A multistage stratified cluster random sample, with proportional probability sampling, was obtained. Stratification included settlement size (less than 400 residents, and 400 and more residents). All subjects were examined for trachoma using the simplified WHO grading system.

RESULTS

Of the sample of 14,110 people, 13,047 (92.5%) were examined. Active inflammatory trachoma (grade TF or TI) was found in 3.0% of all age groups and 5.9% of children aged 0-9 years old. Trichiasis was found in 3.3% and trachomatous corneal opacities in 0.9% of adults aged 30 and over. The prevalence of blinding trachomatous corneal opacities was 0.02%, compared with 0.10% 10 years previously.

CONCLUSION

Compared with a previous national survey undertaken in 1986, prevalence of active trachoma has fallen by 54%. There has been an 80% relative reduction in blinding trachomatous corneal opacities over the 10 year period.

Colony-stimulating factor-1 stimulates the formation of multimeric cytosolic complexes of signaling proteins and cytoskeletal components in macrophages

Stimulation of macrophages with colony-stimulating factor-1 (CSF-1) results in the protein tyrosine phosphorylation of the CSF-1 receptor (CSF-1R) and many other, primarily cytosolic, proteins. Stimulation by CSF-1 at 4 degreesC was used to facilitate the purification and identification of the proteins of the cytosolic anti-phosphotyrosine (PY)-reactive fraction (alphaPY-RF) involved in downstream signaling pathways. Confocal microscopy revealed that the PY proteins are in close proximity to the CSF-1R at the plasma membrane. The alphaPY-RF contained pre-existing complexes of PY proteins and non-PY proteins which generally increased in size and PY protein content following CSF-1 stimulation. PY proteins identified by microsequencing and Western blotting include Cbl, STAT3, STAT5a, STAT5b, SHP-1, Shc, and two novel proteins pp57 and pp37. Other proteins included cytoskeletal/contractile proteins (paxillin, vimentin, elongation factor-1alpha, F-actin, tropomyosin, and myosin regulatory light chain), Ras family signaling proteins (p85 (phosphoinositide 3-kinase), Vav, Ras-GTPase-activating protein SH3 domain-binding protein, and Grb2), DnaJ-like protein, and glyceraldehyde-3-phosphate dehydrogenase. CSF-1 induced the de novo recruitment of Cbl, STAT3, STAT5a, STAT5b, p85, SHP-1, Shc, vimentin, and Grb2 to complexes and caused pre-existing complexes involving Vav, elongation factor-1alpha, and F-actin to increase in size. These studies indicate that CSF-1-induced protein tyrosine phosphorylation is associated with the reorganization of complexes of cytoskeletal, signaling, and other proteins that mediate CSF-1-regulated motility and growth.

Lentiviral vectors for gene therapy of cystic fibrosis

A replication-defective vector based on human immunodeficiency virus (HIV) was evaluated for gene transfer directed to the lung. The tropism of this vector has been expanded through the incorporation of the vesticular stomatitis virus G protein into its envelope. The HIV vector effectively transduced nondividing airway epithelial cells in vitro whereas a murine-based retroviral vector did not. Experiments in a human bronchial xenograft model demonstrated high-level gene transduction with a cystic fibrosis transmembrane conductance regulator (CFTR) HIV vector into undifferentiated, cystic fibrosis (CF)-derived cells of the xenograft. CFTR expression was stable and capable of functional correction of the CF defect after the graft matured. The HIV vector did not effectively transduce cells of the xenograft when instilled after the epithelium had differentiated. This block to transduction appears to be at the level of entry, although post entry restrictions cannot be ruled out. Further development of this vector system for CF gene therapy should focus on a better understanding of potential entry and post entry blocks.

Mechanisms involved in ATP-evoked Ca2+ oscillations in isolated human granulosa-luteal cells

Using single-cell microfluorimetry, we have shown that ATP evoked repetitive Ca2+ oscillations in intact Fura-2 loaded human granulosa-luteal cells (hG/LCs) in the absence of extracellular Ca2+. Sustained increases in [Ca2+]i required extracellular Ca2+ and ATP depleted stores were refreshed by brief (2 min) incubation with external Ca2+. Basal [Ca2+]i was unaffected by caffeine (1 mM), but 20 mM caffeine inhibited ATP-evoked Ca2+ release in the absence of external Ca2+. Thimerosal (10 microM) evoked repetitive Ca2+ spikes, under Ca(2+)-free conditions, which fused to form an elevated plateau when external Ca2+ was replaced. Thimerosal-induced changes in [Ca2+]i were reversibly inhibited by the thiol reducing agent dithiothreitol (1 mM). The periodicity and amplitude of the [Ca2+]i oscillations produced by thimerosal and ATP differ. ATP- or thimerosal-evoked changes in [Ca2+]i were unaffected by dantrolene sodium (10 microM). The Ca(2+)-ATPase inhibitor thapsigargin (1 microM) increased [Ca2+]i and attenuated subsequent ATP-evoked changes in [Ca2+]i. We conclude that ATP stimulates an oscillatory release of Ca2+ from InsP3-sensitive stores in hG/LCs.

Postoperative color Doppler flow ultrasonographic assessment of ureteral patency in gynecologic oncology patients

Our objective was to assess postoperative ureteral patency in gynecologic oncology patients with color Doppler flow ultrasonographic assessment of ureteral jets. Forty-five consecutive gynecologic oncology patients meeting inclusion criteria prospectively underwent postoperative transabdominal color Doppler flow ultrasonographic assessment of ureteral jets to establish patency; 48 consecutive women undergoing transabdominal ultrasonographic studies for benign gynecologic conditions served as a control group. Statistical analysis included two-tailed t-test, with P < 0.05 considered significant. Bilateral ureteral jets were successfully demonstrated by color Doppler flow ultrasonography in all study patients and control patients. The mean time required to visualize bilateral ureteral jets was significantly different between the study group and control group (mean, 5.8 min +/- 0.6 min versus 2.6 min +/- 0.2 min, respectively) (P < 0.05). We conclude that postoperative ureteral patency in gynecologic oncology patients can be easily demonstrated by transabdominal color Doppler flow ultrasonographic assessment of ureteric jets.

Biology and action of colony--stimulating factor-1

Colony-stimulating factor-1 (CSF-1), also known as macrophage colony-stimulating factor, controls the survival, proliferation, and differentiation of mononuclear phagocytes and regulates cells of the females reproductive tract. It appears to play an autocrine and/or paracrine role in cancers of the ovary, endometrium, breast, and myeloid and lymphoid tissues. Through alternative mRNA splicing and differential post-translational proteolytic processing, CSF-1 can either be secreted into the circulation as a glycoprotein or chondroitin sulfate-containing proteoglycan or be expressed as a membrane-spanning glycoprotein on the surface of CSF-1-producing cells. Studies with the op/op mouse, which possesses an inactivating mutation in the CSF-1 gene, have established the central role of CSF-1 in directly regulating osteoclastogenesis and macrophage production. CSF-1 appears to preferentially regulate the development of macrophages found in tissues undergoing active morphogenesis and/or tissue remodeling. These CSF-1 dependent macrophages may, via putative trophic and/or scavenger functions, regulate characteristics such as dermal thickness, male fertility, and neural processing. Apart from its expression on mononuclear phagocytes and their precursors, CSF-1 receptor (CSF-1R) expression on certain nonmononuclear phagocytic cells in the female reproductive tract and studies in the op/op mouse indicate that CSF-1 plays important roles in female reproduction. Restoration of circulating CSF-1 to op/op mice has preliminarily defined target cell populations that are regulated either humorally or locally by the synthesis of cell-surface CSF-1 or by sequestration of the CSF-1 proteoglycan. The CSF-1R is a tyrosine kinase encoded by the c-fms proto-oncogene product. Studies by several groups have used cells expressing either the murine or human CSF-1R in fibroblasts to pinpoint the requirement of kinase activity and the importance of various receptor tyrosine phosphorylation sites for signaling pathways stimulated by CSF-1. To investigate post-CSF-1R signaling in the macrophage, proteins that are rapidly phosphorylated on tyrosine in response to CSF-1 have been identified, together with proteins associated with them. Studies on several of these proteins, including protein tyrosine phosphates 1C, the c-cbl proto-oncogene product, and protein tyrosine phosphatase-phi are discussed.

P2-purinoreceptor evoked changes in intracellular calcium oscillations in single isolated human granulosa-lutein cells

In this study, we have demonstrated that P2-purinoreceptor agonists evoke oscillatory intracellular calcium ([Ca2+]i) responses in human granulosa-lutein cells (GLCs). Intracellular calcium was measured using microspectrofluorimetric techniques. ATP at concentrations of 1-100 microM increased [Ca2+]i, whereas neither adenosine nor AMP evoked changes in [Ca2+]i. The nonhydrolysable ATP analogue, ATP gamma S, also elevated [Ca2+]i with an efficacy similar to that of ATP, indicating that the changes in Ca2+ were not due to ATP hydrolysis, but that human GLCs possess functional P2-purinoreceptors. Uridine triphosphate (UTP) was equipotent to ATP at stimulating [Ca2+]i, and both ATP and UTP were consistently more effective at eliciting a response than ADP, suggesting that human GLCs possess the P2U class of purinergic receptors (ATP = UTP > > ADP > > AMP = adenosine). We have demonstrated that the purinergic agonist-induced changes in [Ca2+]i involve both Ca2+ influx and Ca2+ mobilization from cytosolic stores. Prolonged ATP treatment in Ca(2+)-free buffer (1 mM EGTA) still evokes transient oscillatory changes in [Ca2+]i in a pertussis toxin-insensitive manner. In Ca(2+)-containing conditions, the sustained phase of the response was generally unaffected by verapamil (10 microM), suggesting that influx is not occurring through voltage-dependent Ca(2+)-channels. These findings are consistent with the hypothesis that ATP and other P2-purinergic receptor agonists elicit changes in [Ca2+]i in human ovarian cells and that these events are initiated by the release of Ca2+ from cytosolic stores, and sustained by extracellular calcium ([Ca2+]e) influx. This is the first time that oscillatory patterns of [Ca2+]i have been reported in human GLCs.

A heteromorphic protein-tyrosine phosphatase, PTP phi, is regulated by CSF-1 in macrophages

A novel protein-tyrosine phosphatase, PTP phi, was cloned from a murine macrophage cDNA library. As a result of alternative splicing, macrophage PTP phi mRNAs are predicted to encode two membrane-spanning molecules and a cytosolic enzyme with identical catalytic domains. The membrane-spanning forms differ in the juxtamembrane region, while a start codon downstream of this region is utilized in the translation of the putative cytosolic form. Expression of PTP phi mRNA is low and restricted to macrophage cell lines, macrophage-rich tissues, and brain, kidney, and heart. The mRNA in macrophages and heart is approximately 2.8 kilobases (kb). However, a approximately 5.5-kb transcript in brain and kidney indicates a fourth isoform encoding a large extracellular domain. The approximately 5.5-kb PTP phi brain mRNA encodes the mouse homolog of GLEPP1, a recently reported glomerular epithelial protein. The level of expression of the mRNA encoding the cytosolic form was very low, and only the membrane-spanning proteins (43 and 47 kDa) could be detected in macrophages. Following addition of colony stimulating factor-1 to quiescent BAC1.2F5 macrophages, PTP phi mRNA and protein were down-regulated. The restricted expression of the shorter isoforms of PTP phi and their regulation by colony stimulating factor-1 in macrophages suggest that PTP phi may play a role in mononuclear phagocyte survival, proliferation, and/or differentiation.

Measuring the psychosocial impact of urinary incontinence: the York Incontinence Perceptions Scale (YIPS)

OBJECTIVE

The York Incontinence Perceptions Scale (YIPS) was developed to measure the psychosocial aspects of urinary incontinence and its management.

DESIGN

Testing of internal consistency and validity of the YIPS.

SETTING AND PARTICIPANTS

Subjects were 101 female rural community residents (mean age = 67.4 years) diagnosed with urinary incontinence and participating in a 25-week longitudinal randomized control study testing the efficacy of treating incontinence with a behavioral/educational intervention.

MEASUREMENTS

Participants completed the YIPS, a bladder chart monitoring daily incontinence episodes, the Aids to Living Scale, the Incontinence Impact Questionnaire, and single-item ratings of self-perceptions of amount of leakage, continence status, and overall health status.

MAIN RESULTS

The YIPS had high internal consistency (a = .78). Positive adjustment on the YIPS was correlated with lower frequency of incontinence (r = -.44), and self-ratings of improvement in amount of leakage (r = .60), improved continence status (r = .38), and overall health status (r = .32). At the end of the 25-week treatment period, the participants in the treatment group reported a more positive adjustment on the YIPS than did participants in the control group (t[99] = 4.78, P < .001), which was concordant with a reduction in the incidence of incontinence in the treatment group (F[1,91] = 6.95, P < .01).

CONCLUSIONS

The YIPS is a brief, yet reliable, instrument that addresses such psychosocial issues as coping, control, and acceptance of incontinence.