Age of the magma chamber and its physicochemical state under Elbrus Greater Caucasus, Russia using zircon petrochronology and modeling insights

Mount Elbrus, Europe's tallest and largely glaciated volcano, is made of silicic lavas and is known for Holocene eruptions, but the size and state of its magma chamber remain poorly constrained. We report high spatial resolution U-Th-Pb zircon ages, co-registered with oxygen and hafnium isotopic values, span ~ 0.6 Ma in each lava, documenting magmatic initiation that forms the current edifice. The best-fit thermochemical modeling constrains magmatic fluxes at 1.2 km³/1000 year by hot (900 °C), initially zircon-undersaturated dacite into a vertically extensive magma body since ~ 0.6 Ma, whereas a volcanic episode with eruptible magma only extends over the past 0.2 Ma, matching the age of oldest lavas. Simulations explain the total magma volume of ~ 180 km³, temporally oscillating δ¹⁸O and εHf values, and a wide range of zircon age distributions in each sample. These data provide insights into the current state (~ 200 km³ of melt in a vertically extensive system) and the potential for future activity of Elbrus calling for much-needed seismic imaging. Similar zircon records worldwide require continuous intrusive activity by magmatic accretion of silicic magmas generated at depths, and that zircon ages do not reflect eruption ages but predate them by ~ 10³ to 10⁵ years reflecting protracted dissolution-crystallization histories.

“Hong Long” Lychee (Litchi chinensis Sonn.) Is the Optimal Pollinizer for the Main Lychee Cultivars in Israel

The lychee fruit is in high demand worldwide. However, the yields of many cultivars are low, including the high-quality cultivars “Nuomici” (NMC) and ”Fei Zi Xiao” (FZX), which are very tasty and produce large fruit with a small seed, but tend to shed their fruitlets. In a previous work, we found that cross-hand pollination of “Mauritius” (MA) with pollen of another cultivar increased fruit set and reduced fruit-drop in comparison to self-hand pollination. In the current research, we aimed to identify the optimal pollen donor for three of the main cultivars grown in Israel: MA, FZX, and “Tamuz” (TA). We compared the effect of different pollinizers and found that the Vietnamese cultivar “Hong Long” (HL), which is becoming an important cultivar in Israel, was the optimal pollinizer for the three cultivars. In addition, we found that FZX and TA were not self-fertile under the Israeli environmental conditions since they tend to shed fruitlets that originated from self-fertilization. In contrast, MA is able to fertilize itself, although cross-pollination greatly increased its fruit number and size. We also identified a new PCR marker for lychee, M3, that enabled us to distinguish between self- and cross-fertilized FZX fruits pollinated by HL. Our results indicate that cross-pollination, particularly by HL, has beneficial effects on the production of lychee and it is especially important for cultivars that generate small seeds and tend to shed their fruitlets.

Metamitron, a Photosynthetic Electron Transport Chain Inhibitor, Modulates the Photoprotective Mechanism of Apple Trees

Chemical thinning of apple fruitlets is an important practice as it reduces the natural fruit load and, therefore, increases the size of the final fruit for commercial markets. In apples, one chemical thinner used is Metamitron, which is sold as the commercial product Brevis^® (Adama, Ashdod, Israel). This thinner inhibits the electron transfer between Photosystem II and Quinone-b within light reactions of photosynthesis. In this study, we investigated the responses of two apple cultivars-Golden Delicious and Top Red-and photosynthetic light reactions after administration of Brevis^®. The analysis revealed that the presence of the inhibitor affects both cultivars' energetic status. The kinetics of the photoprotective mechanism's sub-processes are attenuated in both cultivars, but this seems more severe in the Top Red cultivar. State transitions of the antenna and Photosystem II repair cycle are decreased substantially when the Metamitron concentration is above 0.6% in the Top Red cultivar but not in the Golden Delicious cultivar. These attenuations result from a biased absorbed energy distribution between photochemistry and photoprotection pathways in the two cultivars. We suggest that Metamitron inadvertently interacts with photoprotective mechanism-related enzymes in chloroplasts of apple tree leaves. Specifically, we hypothesize that it may interact with the kinases responsible for the induction of state transitions and the Photosystem II repair cycle.

Bumblebees (Bombus terrestris) Improve 'Hass' Avocado (Persea americana) Pollination

Pollination is limiting for avocado production. We examined whether adding bumblebees (BBs; ca. 10 hives/ha) to conventional honeybees (HB; 5 hives/ha) would improve 'Hass' avocado pollination and yields. A preliminary trial (2017/18) in an avocado orchard with four consecutive rows of 'Hass' followed by one row of 'Ettinger' serving as a pollenizer (20% 'Ettinger') showed a considerable increase in 'Hass' yield in rows adjacent to (up to 80 m from) the BB hives vs. distant rows (=controls). In 2018/19, the trials were extended to three additional orchards. A significant yield increase was obtained in the BB hive-adjacent trees compared to BB hive-distant ones. Similar results were obtained in 2019/20, in experiments conducted throughout the country. The SNP analysis, to determine the parents of 'Hass' fruit at varying distances from the BB hives, showed no differences in the cross-pollination rate ('Hass' × 'Ettinger'). However, pollination rates and the number of germinating pollen grains per stigma decreased with distance from the hives, and correlated to the negative gradient in yield. Taken together, our data suggest that adding BB hives to 'Hass' avocado orchards, at ca. 10 hives/ha resulting in 0.5-1.0 BB visits/tree per min, increases pollination and, accordingly, total yield.

Geochronology and geochemistry data for the Elbrus, Tyrnyauz, and Chegem magmatic centers, Greater Caucasus, Russia

The dataset presented here is associated with the article “Young Silicic Magmatism of the Greater Caucasus, Russia with implication for its delamination origin based on zircon petrochronology and thermomechanical modeling” [1]. We present detailed sample descriptions and source locations for the rocks from the Chegem, Tyrnyauz, and Elbrus volcanic center localities presented in that study. The dataset presents extensive isotope and trace element geochemistry of zircon crystals from these rocks, major phenocrysts, and whole rock O and H isotopic and elemental compositions. Zircon ages, trace element compositions, and Hf and O isotopic compositions were obtained by both laser ablation ICP-MS and secondary ionization mass spectrometry in situ techniques and chemical abrasion isotope dilution-thermal ionization mass spectrometry techniques. We also present whole-rock major element compositions obtained by X-ray fluorescence and trace element compositions obtained by solution inductively-coupled plasma mass spectrometry. We also report δ¹⁸O analyses of phenocrysts and groundmass in samples, δ¹⁸O-δ¹³C analyses of limestones and limestone xenoliths in the Chegem ignimbrite, and coupled δ¹⁸O-δD-Δ¹⁷O analyses of glass and groundmass of rock samples from the Chegem ignimbrites that show abundant evidence of post-emplacement interaction with meteoric waters. To supplement the associated study [1], this article also includes field photographs, cathodoluminescence images of zircons, plots of trace element compositions in zircon, plots of stable isotopic variations in Chegem ignimbrites vs. stratigraphy, and selected trace elemental whole-rock diagrams.

The lithospheric-to-lower-mantle carbon cycle recorded in superdeep diamonds

The transport of carbon into Earth's mantle is a critical pathway in Earth's carbon cycle, affecting both the climate and the redox conditions of the surface and mantle. The largest unconstrained variables in this cycle are the depths to which carbon in sediments and altered oceanic crust can be subducted and the relative contributions of these reservoirs to the sequestration of carbon in the deep mantle¹. Mineral inclusions in sublithospheric, or 'superdeep', diamonds (derived from depths greater than 250 kilometres) can be used to constrain these variables. Here we present oxygen isotope measurements of mineral inclusions within diamonds from Kankan, Guinea that are derived from depths extending from the lithosphere to the lower mantle (greater than 660 kilometres). These data, combined with the carbon and nitrogen isotope contents of the diamonds, indicate that carbonated igneous oceanic crust, not sediment, is the primary carbon-bearing reservoir in slabs subducted to deep-lithospheric and transition-zone depths (less than 660 kilometres). Within this depth regime, sublithospheric inclusions are distinctly enriched in ¹⁸O relative to eclogitic lithospheric inclusions derived from crustal protoliths. The increased ¹⁸O content of these sublithospheric inclusions results from their crystallization from melts of carbonate-rich subducted oceanic crust. In contrast, lower-mantle mineral inclusions and their host diamonds (deeper than 660 kilometres) have a narrow range of isotopic values that are typical of mantle that has experienced little or no crustal interaction. Because carbon is hosted in metals, rather than in diamond, in the reduced, volatile-poor lower mantle², carbon must be mobilized and concentrated to form lower-mantle diamonds. Our data support a model in which the hydration of the uppermost lower mantle by subducted oceanic lithosphere destabilizes carbon-bearing metals to form diamond, without disturbing the ambient-mantle stable-isotope signatures. This transition from carbonate slab melting in the transition zone to slab dehydration in the lower mantle supports a lower-mantle barrier for carbon subduction.

Cytokinin treatment modifies litchi fruit pericarp anatomy leading to reduced susceptibility to post-harvest pericarp browning

Litchi (Litchi chinensis Sonn.) is a subtropical fruit known for its attractive red pericarp color, semi-translucent white aril and unique flavor and aroma. Rapid post-harvest pericarp browning strictly limits litchi fruit marketing. In the current research, we hypothesized that modification of litchi fruit pericarp anatomy by hormone application may reduce fruit susceptibility to post-harvest pericarp browning. In this context, we hypothesized that cytokinin treatment, known to induce cell division, may yield fruit with thicker pericarp and reduced susceptibility for fruit surface micro-crack formation, water loss and post-harvest pericarp browning. Exogenous cytokinin treatment was applied at different stages along the course of litchi fruit development and the effect on fruit pericarp anatomy, fruit maturation and postharvest pericarp browning was investigated. Interestingly, cytokinin treatment, applied 4 weeks after full female bloom (WFB), during the phase of pericarp cell division, led to mature fruit with thicker pericarp, reduced rate of post-harvest water loss and reduced susceptibility to post-harvest pericarp browning, as compared to non-treated control fruit. Histological sections ascribe the difference in pericarp anatomy to increased cell proliferation in the parenchymatic tissue and the highly-lignified brachysclereid cell layer. In contrast, exogenous cytokinin treatment applied 7 WFB, following the phase of pericarp cell division, significantly increased epidermal-cell proliferation but had no significant effect on overall fruit pericarp thickness and only minor affect on post-harvest water loss or pericarp browning. Interestingly, the late cytokinin treatment also significantly postponed fruit maturation-associated anthocyanin accumulation and chlorophyll degradation, as previously reported, but had no effect on other parameters of fruit maturation, like total soluble sugars and total titratable acids typically modified during aril maturation. In conclusion, exogenous cytokinin treatment at different stages in fruit development differentially modifies litchi fruit pericarp anatomy by induction of cell-type specific cell proliferation. Early cytokinin treatment during the phase of pericarp cell division may prolong litchi fruit storage by reducing fruit susceptibility to post-harvest water loss and pericarp browning.

Chemoprevention of spontaneous ovarian cancer in the domestic hen

The hen is an attractive animal model for in vivo testing of agents that thwart ovarian carcinogenesis because ovarian cancer in the domestic hen features clinical and molecular alterations that are similar to ovarian cancer in humans, including a high incidence of p53 mutations. The objective of the study was to test the potential ovarian cancer chemopreventive effect of the p53 stabilizing compound CP-31398 on hens that spontaneously present the ovarian cancer phenotype. Beginning at 79 wk of age, 576 egg-laying hens (Gallus domesticus) were randomized to diets containing different amounts of CP-31398 for 94 wk, 5 d, comprising a control group (C) (n = 144), which was fed a diet containing 0 ppm (mg/kg) of CP-31398; a low-dose treatment (LDT) group (n = 144), which was fed a diet containing 100 ppm of CP-31398; a moderate-dose treatment (MDT) group (n = 144) which was fed a diet containing 200 ppm of CP-31398; and a high-dose treatment (HDT) group (n = 144), which was fed a diet containing 300 ppm of CP-31398. Hens were killed at 174 wk of age to determine the incidence of ovarian and oviductal adenocarcinomas. Whereas the incidence of localized and metastatic ovarian cancers in the MDT and HDT groups was significantly lower (up to 77%) compared to levels in the C and LDT groups (P < 0.05), the incidence of oviductal cancer was unaffected by CP-31398. CP-31398 appears to be an effective tool for chemoprevention against ovarian malignancies, but does not appear to affect oviductal malignancies.

Identification of candidate genes mediating apple fruit-cracking resistance following the application of gibberellic acids 4 + 7 and the cytokinin 6-benzyladenine

Calyx-end cracking in 'Pink Lady' apple is treated by a solution of gibberellic acids 4 and 7 (GA₄₊₇) and the cytokinin 6-benzyladenine (BA). Although the GA₄₊₇ and BA mixture is applied early in apple fruit development, it mitigates cracking that becomes evident in the mature fruit, implying a long-term treatment effect. The reduced incidence of peel cracking is associated with increased epidermal cell density, which is maintained until fruit maturation. Presently, the expression of genes that have been previously reported to be associated with epidermal cell patterning and cuticle formation, or cracking resistance, was monitored in the peel during fruit development and following GA₄₊₇ and BA treatment. For most of the genes whose expression is naturally upregulated during fruit development, the early GA₄₊₇ and BA treatment maintained or further increased the high expression level in the mature peel. Where the expression of a gene was downregulated during development, no change was detected in the treated mature peel. Gene-networking analysis supported the interaction between gene clusters of cell-wall synthesis, cuticle formation and GA signaling. Overall, the data suggested that the GA₄₊₇ and BA treatment did not modify developmental cues, but promoted or enhanced the innate developmental program.

Benzyladenine and gibberellin treatment of developing "Pink Lady" apples results in mature fruits with a thicker cuticle comprising clusters of epidermal cells

A mixture of 6-benzyladenine (BA) and gibberellins GA4 plus GA7 applied to "Pink Lady" apple at early phenological stages was previously shown to result in an immediate increase in epidermal cell density and associated reduction in calyx-end cracking disorder in the mature fruit, implying a long-term effect of the BA + GA4+7 mixture. Here, we analyzed the anatomical changes in the mature peel at the calyx end 210 days after full bloom (DAFB), following application of the plant growth regulators (PGRs) at the cell-division phase of fruit development, 21-50 DAFB. Experiments were conducted in northern Israel, and the PGRs were applied as the commercial formulation Superlon™ (Fine Agrochemicals Ltd.), composed of 19 g l(-1) BA and 19 g l(-1) GA4+7. Trees were sprayed with 0.025, 0.1, or 0.2 % (v/v) Superlon™. The most obvious phenomenon was the presence of epidermal cell clusters within the cuticular matrix that were detached from the native epidermal layer located at the bottom of the cuticle and which could not be detected in the untreated control fruits. Treatment with 20 mg l(-1) BA + GA4+7 (0.1 % Superlon™) resulted in a markedly thicker cuticle, a higher percentage of detached epidermal cells within the cuticular membrane and a significant reduction in calyx-end cracking at harvest. The presence of cuticle-embedded epidermal cell clusters may have contributed to strengthening the peel by adding more cell-wall components, thickening the cuticle layer and possibly enhancing crack repair.

Intraperitoneal injection of the pancreatic peptide amylin potently reduces behavioral impairment and brain amyloid pathology in murine models of Alzheimer's disease

Amylin, a pancreatic peptide, and amyloid-beta peptides (Aβ), a major component of Alzheimer's disease (AD) brain, share similar β-sheet secondary structures, but it is not known whether pancreatic amylin affects amyloid pathogenesis in the AD brain. Using AD mouse models, we investigated the effects of amylin and its clinical analog, pramlintide, on AD pathogenesis. Surprisingly, chronic intraperitoneal (i.p.) injection of AD animals with either amylin or pramlintide reduces the amyloid burden as well as lowers the concentrations of Aβ in the brain. These treatments significantly improve their learning and memory assessed by two behavioral tests, Y maze and Morris water maze. Both amylin and pramlintide treatments increase the concentrations of Aβ1-42 in cerebral spinal fluid (CSF). A single i.p. injection of either peptide also induces a surge of Aβ in the serum, the magnitude of which is proportionate to the amount of Aβ in brain tissue. One intracerebroventricular injection of amylin induces a more significant surge in serum Aβ than one i.p. injection of the peptide. In 330 human plasma samples, a positive association between amylin and Aβ1-42 as well as Aβ1-40 is found only in patients with AD or amnestic mild cognitive impairment. As amylin readily crosses the blood-brain barrier, our study demonstrates that peripheral amylin's action on the central nervous system results in translocation of Aβ from the brain into the CSF and blood that could be an explanation for a positive relationship between amylin and Aβ in blood. As naturally occurring amylin may play a role in regulating Aβ in brain, amylin class peptides may provide a new avenue for both treatment and diagnosis of AD.

A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury

Mild traumatic brain injury (mTBI), also referred to as concussion, remains a controversial diagnosis because the brain often appears quite normal on conventional computed tomography (CT) and magnetic resonance imaging (MRI) scans. Such conventional tools, however, do not adequately depict brain injury in mTBI because they are not sensitive to detecting diffuse axonal injuries (DAI), also described as traumatic axonal injuries (TAI), the major brain injuries in mTBI. Furthermore, for the 15 to 30 % of those diagnosed with mTBI on the basis of cognitive and clinical symptoms, i.e., the "miserable minority," the cognitive and physical symptoms do not resolve following the first 3 months post-injury. Instead, they persist, and in some cases lead to long-term disability. The explanation given for these chronic symptoms, i.e., postconcussive syndrome, particularly in cases where there is no discernible radiological evidence for brain injury, has led some to posit a psychogenic origin. Such attributions are made all the easier since both posttraumatic stress disorder (PTSD) and depression are frequently co-morbid with mTBI. The challenge is thus to use neuroimaging tools that are sensitive to DAI/TAI, such as diffusion tensor imaging (DTI), in order to detect brain injuries in mTBI. Of note here, recent advances in neuroimaging techniques, such as DTI, make it possible to characterize better extant brain abnormalities in mTBI. These advances may lead to the development of biomarkers of injury, as well as to staging of reorganization and reversal of white matter changes following injury, and to the ability to track and to characterize changes in brain injury over time. Such tools will likely be used in future research to evaluate treatment efficacy, given their enhanced sensitivity to alterations in the brain. In this article we review the incidence of mTBI and the importance of characterizing this patient population using objective radiological measures. Evidence is presented for detecting brain abnormalities in mTBI based on studies that use advanced neuroimaging techniques. Taken together, these findings suggest that more sensitive neuroimaging tools improve the detection of brain abnormalities (i.e., diagnosis) in mTBI. These tools will likely also provide important information relevant to outcome (prognosis), as well as play an important role in longitudinal studies that are needed to understand the dynamic nature of brain injury in mTBI. Additionally, summary tables of MRI and DTI findings are included. We believe that the enhanced sensitivity of newer and more advanced neuroimaging techniques for identifying areas of brain damage in mTBI will be important for documenting the biological basis of postconcussive symptoms, which are likely associated with subtle brain alterations, alterations that have heretofore gone undetected due to the lack of sensitivity of earlier neuroimaging techniques. Nonetheless, it is noteworthy to point out that detecting brain abnormalities in mTBI does not mean that other disorders of a more psychogenic origin are not co-morbid with mTBI and equally important to treat. They arguably are. The controversy of psychogenic versus physiogenic, however, is not productive because the psychogenic view does not carefully consider the limitations of conventional neuroimaging techniques in detecting subtle brain injuries in mTBI, and the physiogenic view does not carefully consider the fact that PTSD and depression, and other co-morbid conditions, may be present in those suffering from mTBI. Finally, we end with a discussion of future directions in research that will lead to the improved care of patients diagnosed with mTBI.

A comparison of administration procedures for the Rey-Osterrieth Complex Figure: flowcharts versus pen switching

The Rey-Osterrieth Complex Figure (ROCF) is commonly used to assess visuospatial skills, visuoconstruction, visual memory, and executive functioning. Two different methods are traditionally used to record the order in which the figure is drawn: the flowchart method and the pen-switching method. Although it has been suggested that pen switching may interfere with performance, to date no research has been conducted to assess whether ROCF performance significantly differs due to administration method. As part of routine neuropsychological evaluation, 100 inpatients and outpatients were randomly assigned to either method. Using the Boston Qualitative Scoring System and the traditional 36-point scoring method, the authors unexpectedly found that the pen-switching group generally performed better than the flowchart group, and productions drawn with pen switching were also significantly faster to score.

A comparison of administration procedures for the Rey-Osterrieth Complex Figure: flowcharts versus pen switching

The Rey-Osterrieth Complex Figure (ROCF) is commonly used to assess visuospatial skills, visuoconstruction, visual memory, and executive functioning. Two different methods are traditionally used to record the order in which the figure is drawn: the flowchart method and the pen-switching method. Although it has been suggested that pen switching may interfere with performance, to date no research has been conducted to assess whether ROCF performance significantly differs due to administration method. As part of routine neuropsychological evaluation, 100 inpatients and outpatients were randomly assigned to either method. Using the Boston Qualitative Scoring System and the traditional 36-point scoring method, the authors unexpectedly found that the pen-switching group generally performed better than the flowchart group, and productions drawn with pen switching were also significantly faster to score.

A survey study of neuropsychiatric complaints in patients with Graves' disease

One hundred thirty-seven patients with treated Graves' disease completed a questionnaire pertaining to neuropsychiatric complaints. Psychiatric symptoms, especially anxiety and irritability, were common prior to treatment of hyperthyroidism. These complaints appeared to result in delays in seeking treatment as well as delays in receiving appropriate diagnosis. Subjects reported significantly worse memory, attention, planning, and productivity while hyperthyroid than prior to becoming hyperthyroid, and, although somewhat improved once euthyroid, they reported residual cognitive deficits. These results suggest that neuropsychiatric impairments are highly prevalent in Graves' disease, may lead to initial misdiagnosis or delays in diagnosis of the endocrine disorder, and may continue even once patients are believed to be euthyroid.

Visuoconstructional problems in dementia: contribution of executive systems functions

Visuoconstructional ability was assessed by asking patients diagnosed with Alzheimer's disease (AD), ischaemic vascular dementia (IVD), and Parkinson's disease (PD) and a normal control group (NC) to copy a modification of the Rey-Osterrieth Complex Figure (M-ROCF). The drawings of the NC group were superior to all dementia participants. AD patients generally outperformed IVD and PD patients; however, there were few differences between IVD and PD groups. Nonetheless, the drawings of IVD and PD patients were very fragmented and contained numerous perseverations and omissions. Despite these errors, patients with IVD and PD obtained higher delayed recognition memory scores than AD patients. Correlational analyses among dementia patients between neuropsychological tests and the copy of the M-ROCF found that accurate figure copy was most consistently correlated with tests of working memory, that is, tests requiring patients to monitor their behavior and sustain a complex mental set while performing mental manipulations. By contrast, no relationship between executive function tests related to measures of response selection/inhibition or other domains of neuropsychological functioning was found.

The Boston Qualitative Scoring System as a measure of executive functioning in Rey-Osterrieth Complex Figure performance

The Boston Qualitative Scoring System (BQSS) for the Rey-Osterrieth Complex Figure (ROCF) includes five scores (Planning, Fragmentation, Neatness, Perseveration, and Organization) developed to measure the executive aspects of ROCF productions. To assess the convergent and discriminant validity of the BQSS, these five scores were compared to scores on four traditional tests of executive functioning, as well as to three non-executive measures, in 141 adult patients. BQSS executive variables significantly correlated with the traditional executive measures and were less correlated with discriminant measures. The BQSS Organization summary score also significantly differentiated patients with either no, mild, or severe executive dysfunction. These results support the construct validity of the BQSS and demonstrate that the ROCF may be a useful measure of executive functioning.

Radiolabeling brachytherapy sources with Re-188 through chelating microfilms: stents

Rhenium-188 (Re-188, T(1/2) = 17 h) emits beta particles (E(max) = 2. 12 MeV) having an ideal range for intravascular brachytherapy and certain cancer brachytherapies. Re-188 was attached to metal wafers and stents via a chelating microfilm, and these brachytherapy sources characterized in vitro and in vivo. To prepare the sources, a siloxane film containing reactive amines was plasma deposited on the metal, a chelating microfilm conjugated to the amines, and the chelating microfilm used to attach Re-188. Re-188 was selectively bound to materials coated with the chelating microfilm. Binding correlated with the amount of radionuclide used. Wafers (1 cm(2)) bound up to 62.9 MBq (1.7 mCi) of Re-188 with yields generally near 30%. Stents bound up to 26.6 MBq (720 microCi). Typically, stents were labeled to bind 4-12 MBq and deposit 10-30 Gy at 2 mm in the arterial wall. In phantom studies, the longer nitinol stents deposited doses of 2.3 Gy/MBq (0.085 Gy/microCi), while shorter stainless steel stents deposited 4.62 Gy/MBq (0.171 Gy/microCi). After placement in arteries of pigs, only the Re-188-stents were detected by scintigraphy at times up to 24 h. Scintigraphy did not detect activity in other organs. Blood sampling (0.1-24 h) detected maximum radioactivity (up to 388 cpm/mL/100micro Ci) at 6 h. We conclude that on-demand radiolabeling of stents and other brachytherapy sources with Re-188 can be performed routinely.

Differential impact of executive dysfunction on verbal list learning and story recall

The California Verbal Learning Test (CVLT) and the Logical Memory (LM) subtest from the Wechsler Memory Scale-Revised (WMS-R) are generally thought to be interchangeable measures of verbal memory. However, little is known about the effects of executive dysfunction on these tasks. The present study involved 96 patients referred for neuropsychological evaluation who were classified as having either significant executive dysfunction (SED) or minimal executive dysfunction (MED) based on the number of impaired executive tasks. Results showed that the SED group performed significantly worse on CVLT total words learned and most of the recall conditions compared to the MED patients (p <.01). However, performance on both immediate and delayed LM did not significantly differentiate the groups. CVLT measures of semantic clustering, perseveration, intrusions, and false positive errors did not appear to account for the group differences. The current study strongly suggests that the CVLT and the LM subtest are differentially associated with executive dysfunction, and argues for the inclusion of both types of tasks in a comprehensive neuropsychological evaluation.

High versus low basal cortisol secretion in asymptomatic, medication-free HIV-infected men: differential effects of severe life stress on parameters of immune status

The authors hypothesized that HIV-infected men with high basal cortisol secretion would exhibit greater stress-related reductions in the ratio of Th1/Th2 cell-derived cytokines and numbers of CD8+ T and NK lymphocytes than low basal cortisol secretors. A semistructured interview was used to assess life stress during the preceding 6 months of 94 HIV-infected men classified as high and low cortisol secretors (n = 47/group). Increased levels of severe life stress were highly correlated with lower numbers of CD8+ T cells, CD16+ and CD56+ NK cells, CD57+ cells, and higher DHEA-S concentrations in the high cortisol group. Conversely, no significant correlations were found in the low cortisol group. No correlations were found between stress and CD4+ T helper/inducer cell counts, cytokine production, or testosterone levels in either participating group. These data suggest that severe stress in combination with high glucocorticoid activity may modify select parameters of immune status in HIV-infected men.

Visuoconstructional problems in dementia: contribution of executive systems functions

Visuoconstructional ability was assessed by asking patients diagnosed with Alzheimer's disease (AD), ischaemic vascular dementia (IVD), and Parkinson's disease (PD) and a normal control group (NC) to copy a modification of the Rey-Osterrieth Complex Figure (M-ROCF). The drawings of the NC group were superior to all dementia participants. AD patients generally outperformed IVD and PD patients; however, there were few differences between IVD and PD groups. Nonetheless, the drawings of IVD and PD patients were very fragmented and contained numerous perseverations and omissions. Despite these errors, patients with IVD and PD obtained higher delayed recognition memory scores than AD patients. Correlational analyses among dementia patients between neuropsychological tests and the copy of the M-ROCF found that accurate figure copy was most consistently correlated with tests of working memory, that is, tests requiring patients to monitor their behavior and sustain a complex mental set while performing mental manipulations. By contrast, no relationship between executive function tests related to measures of response selection/inhibition or other domains of neuropsychological functioning was found.

Rey-Osterrieth Complex Figure performance in adults with attention deficit hyperactivity disorder: a validation study of the Boston Qualitative Scoring System

Rey-Osterrieth Complex Figure (ROCF) productions from 18 adults with Attention Deficit Hyperactivity Disorder (ADHD) were compared to 18 matched controls using the Boston Qualitative Scoring System (BQSS). ADHD adults showed impairment in measures of configural accuracy, planning, and neatness. A logistic regression model resulted in 75% sensitivity and 81% specificity in discriminating ADHD from control subjects. In contrast, there was no significant difference on the traditional ROCF 36-point score, and the sensitivity and specificity for the 36-point score were lower (68% and 71%, respectively). These findings suggest persisting executive dysfunction in adults with ADHD that can be detected in ROCF productions. Thus, the BQSS may be a useful tool contributing to the neuropsychological evaluation of adults with ADHD.

Measurement of mood states in stroke patients: validation of the visual analog mood scales

OBJECTIVE

The Visual Analog Mood Scales (VAMS) were recently developed by Stern and colleagues to assess mood state in neurologically impaired patients. These brief scales require that a patient place a single pen mark along a 100mm vertical line to indicate how he or she presently feels. Although previous studies have garnered evidence in support of the validity of these brief scales when administered to psychiatric patients and healthy young adult and geriatric control subjects, it is presently unknown whether the VAMS are valid measures of internal mood state in neurologically impaired stroke patients. The purpose of the present investigation was to assess reliability and validity of the VAMS in a stroke-patient population.

PARTICIPANTS

Participants were 41 (21 men and 20 women) inpatients admitted for either acute stroke or rehabilitation following stroke.

DESIGN

Participants completed both the VAMS and a modified version of the Profile of Mood States (POMS). Nonparametric multitrait-multimethod analyses were performed using the Pearson correlations among and between the six subscales of the VAMS and the POMS.

CONCLUSION

The VAMS possess good convergent and discriminant validity when administered to stroke inpatients, providing further support for the utility of these brief, easily administered scales.

Assessment of mood states in aphasia

Depression is common in patients with stroke and other neurological conditions. Accurate assessment and diagnosis is critical in understanding the causes of mood disturbance in these patients and in establishing effective treatments. Examination of mood states, however, is difficult in patients with aphasia, impaired emotional expression, and other communication and cognitive difficulties. Most standardized measures of mood are inappropriate for this population due to the instruments' linguistic, attention, and other cognitive demands. The Visual Analog Mood Scales (VAMS) are psychometrically sound measures, developed specifically for neurologically impaired patients in general and aphasic patients in particular. These very brief scales assess eight mood states: sad, happy, tense, afraid, tired, energetic, confused, and angry. The utility of these scales in clinical practice is presented, as are specific recommendations and guidelines for the assessment of mood in patients with aphasia and other communication deficits.

Neurobehavioral functioning in asymptomatic HIV-1 infected women

Numerous reports have assessed the neuropsychological functioning of medically asymptomatic HIV-1 infected men. However, to date there have been no published studies of the neuropsychological functioning of asymptomatic HIV-1 infected women, even though women represent the fastest-growing demographic group of HIV-1 infected individuals. In this investigation, 31 women (17 asymptomatic HIV-1 seropositive, 14 seronegative) were administered a battery of neurocognitive and neuropsychiatric instruments. Participants in both groups were matched for age, education, months since injection drug use, and substance use. Group comparisons revealed no significant differences in any of the neurocognitive or neuropsychiatric measures. The results of this preliminary study suggest that clinically significant differences in neurobehavioral function are unlikely in medically asymptomatic HIV-1 infected women compared to seronegative controls. However, additional studies are needed with larger sample sizes and with careful attention to possible confounding or masking variables.

Asymptomatic HIV-infected women: preliminary study of quantitative EEG activity and performance on a continuous performance test

Several studies have examined the electrophysiological correlates of human immunodeficiency virus (HIV) infection in medically asymptomatic men. Although the rates of HIV infection are increasing at a greater rate in women than men, there have been no publications to date of electrophysiological functioning in HIV-infected women. In the present study, quantitative electroencephalographic (qEEG) activity was measured in 22 women (11 asymptomatic HIV-seropositive and 11 HIV-seronegative) utilizing a procedure comprised of three auditory continuous performance tests and a set of qEEG components derived from principal components analysis. No significant group differences were found in qEEG or in performance on the continuous performance tests; however, task-related differences were detected across groups between simple and complex language tasks in EEG fast beta power, delta power, and a left-hemisphere principal components analysis-derived EEG component. In examining the electrophysiological correlates of HIV infection, researchers might employ a similar methodology while increasing the sample size and varying the task modality or difficulty.

The clinical significance of focal active colitis

Focal crypt injury by neutrophils (cryptitis/crypt abscesses), or focal active colitis (FAC), is a common isolated finding in endoscopic colorectal biopsies. Focal active colitis is often thought of as a feature of Crohn's disease, but may also be seen in ischemia, infections, partially treated ulcerative colitis, and as an isolated finding in patients undergoing endoscopy to exclude neoplasia. Clinical, endoscopic, and pathological data were retrospectively reviewed from 49 patients with focal active colitis, who had no other diagnostic findings on colorectal biopsy and no history of chronic inflammatory bowel disease. The histological findings were correlated with clinical diagnoses. Follow-up information was available for 42 of 49 focal active colitis patients. None developed inflammatory bowel disease; however, 19 patients had an acute self-limited colitis-like diarrheal illness, 11 had incidental focal active colitis (patients without diarrhea that were endoscoped to exclude colonic neoplasia and found to have asymptomatic FAC), 6 had irritable bowel syndrome, 4 had antibiotic-associated colitis, and 2 had ischemic colitis. Twenty patients were immunosuppressed, and 19 were taking nonsteroidal anti-inflammatory drugs. No histological features predicted final diagnoses. FAC did not predict the development of chronic colitis, even when mild crypt distortion or slight basal plasmacytosis was present. The preponderance of acute self-limited colitis and antibiotic-associated colitis among the FAC patients, along with the high number of immunosuppressed patients, support the conclusion that most FAC cases are infectious. The incidental detection of FAC in patients undergoing endoscopy to exclude colonic neoplasia was not clinically significant. The role of nonsteroidal anti-inflammatory drugs in FAC deserves further study.

Severe life stress as a predictor of early disease progression in HIV infection

OBJECTIVE

Although there is evidence that stress is associated with alterations in immunity, the role of emotional factors in the onset and course of immune-based diseases such as cancer and AIDS has not been established. This prospective study was designed to test the hypothesis that stressful life events accelerate the course of HIV disease.

METHOD

Ninety-three HIV-positive homosexual men who were without clinical symptoms at the time of entry into the study were studied for up to 42 months. Subjects received comprehensive medical, neurological, neuropsychological, and psychiatric assessments every 6 months, including assessment of stressful life events during the preceding 6-month interval. Several statistical approaches were used to assess the relation between stress and disease progression.

RESULTS

The time of the first disease progression was analyzed with a proportional hazard survival method, which demonstrated that the more severe the life stress experienced, the greater the risk of early HIV disease progression. Specifically, for every one severe stress per 6-month study interval, the risk of early disease progression was doubled. Among a subset of 66 subjects who had been in the study for at least 24 months, logistic regression analyses showed that higher severe life stress increased the odds of developing HIV disease progression nearly fourfold. the degree of disease progression was also predicted by severe life stress when a proportional odds logistic regression model was used for analysis.

CONCLUSIONS

This report presents the first evidence from a prospective research study that severe life event stress is associated with an increased rate of early HIV disease progression.

Detection of human papillomavirus DNA in keratoacanthomas by polymerase chain reaction

The etiology of keratoacanthomas is unknown, but human papillomavirus (HPV) has been suspected to be involved in the pathogenesis of this lesion because koilocytic changes may be observed and because HPV has been found in cutaneous squamous-cell carcinomas and premalignant keratoses in immunosuppressed patients. We analyzed DNA extracted from 39 keratoacanthomas from 22 "at-risk" patients (nine patients undergoing UV light and/or anthralin therapy for psoriasis, 10 solid organ transplant recipients, one patient with xeroderma pigmentosa, one patient with acquired immunodeficiency syndrome, and one patient undergoing therapy for non-Hodgkin's lymphoma) for the presence of HPV. The results were compared with analyses of DNA extracted from 30 keratoacanthomas from 28 patients at no known increased risk for these lesions. Using polymerase chain reaction (PCR) primers designed to detect multiple HPV types (including 6, 11, 16, 18, 31, and 33), HPV was detected in seven keratoacanthomas from six of the at-risk patients and in eight sporadic keratoacanthomas from eight patients without risk factors. HPV was also present in one of 26 nonlesional skin controls. Statistical analysis showed a significant difference in the prevalence of HPV DNA sequences found in keratoacanthomas compared to normal control skin (p = 0.038). The presence of virus by PCR could not be predicted by histologic evaluation. Sequence analysis showed the presence of HPV types 11, 13, 24, 33, and 57. Although these results confirm the frequent presence of HPV in keratoacanthomas, the role of this virus in the etiology and pathogenesis of these lesions remains to be elucidated.

Use of thyroid hormone to diminish the cognitive side effects of psychiatric treatment

Electroconvulsive therapy (ECT) and lithium are highly effective treatments for mood disorders. Both treatments, however, are associated with cognitive side effects which reduce patient compliance and treatment satisfaction. Both therapies also have a significant effect on hypothalamic-pituitary-thyroid axis (HPT) activity. Preliminary results from a double-blind, placebo-controlled study of adjunctive thyroid hormone (T3) and ECT showed better memory function in patients receiving T3 compared with placebo. This neuroprotective effect of T3 has been confirmed using electroconvulsive shock (ECS) in rats, and shown to be independent of the number of electrical stimulations. Results of studies in patients with bipolar disorder taking lithium have demonstrated that cognitive deficits are significantly related to diminished thyroid status, but not lithium levels. Preliminary evidence also shows that adjunctive thyroid hormone improves cognitive functioning in patients taking lithium. These findings, if replicated and confirmed, indicate a potential role for adjunctive thyroid hormone in reducing the cognitive side effects of these important psychiatric treatments. This, in turn, may lead to improved treatment compliance, diminished overall morbidity, and reduced healthcare utilization.

Assessment of mood state in patients undergoing electroconvulsive therapy: the utility of visual analog mood scales developed for cognitively impaired patients

Reliable, valid, and brief measures of mood state are essential to the evaluation of electroconvulsive therapy (ECT) efficacy. However, existing measures of mood state may be inappropriate for patients with transient cognitive impairment. Stern and colleagues have recently developed a set of Visual Analog Mood Scales (VAMS) for use in neurologically impaired patients. These brief scales (including measures of sad, confused, afraid, happy, tired, angry, and energetic states) are easily administered and have documented reliability and validity in neurologically impaired patients and in healthy adult and geriatric samples. In the present study, we assessed the validity and sensitivity of the VAMS to detect ECT-related mood change. Twenty-five inpatients who were diagnosed with major depressive episode and referred for ECT were administered the VAMS and the Hamilton Depression Rating Scale (HDRS) both pre- and post-ECT. Results indicate that the VAMS are as sensitive to the therapeutic effects of ECT as is the more lengthy and verbally demanding HDRS. In addition, the VAMS were highly correlated with the clinician's Clinical Global Improvement rating and the patient's self-report using a modified Center for Epidemiological Studies-Depression scale. The VAMS are brief, reliable scales that are sensitive to the treatment effects of ECT and that are appropriate for patients with transient cognitive impairment.

Analysis of chronic endometritis for Chlamydia trachomatis by polymerase chain reaction

Chronic endometritis is characterized histologically by plasma cells infiltrating endometrial stroma. Although it has been speculated that many instances of chronic endometritis are infectious, the origin of most cases is not apparent by routine histopathologic evaluation. Chlamydia trachomatis, an obligate intracellular bacterium, is known to cause chronic endometritis in the setting of pelvic inflammatory disease. The authors analyzed 43 specimens of histopathologically diagnosed chronic endometritis from 38 patients for C trachomatis by PCR using primers for the single-copy major outer membrane protein (MOMP) gene. C trachomatis was detected in only one such case in which dense plasma cell infiltrates were present and concurrent C trachomatis infection of the cervix was documented. Using serially diluted DNA from formalin-fixed, paraffin-embedded McCoy cells, the sensitivity of this method was shown to be equivalent to a single infected cell in a paraffin section. In conjunction with the results of other studies, these data indicate a limited role, if any, of C trachomatis in the origin of mild or moderate chronic endometritis.

A guide for applying principal-components analysis and confirmatory factor analysis to quantitative electroencephalogram data

Principal-components analysis (PCA) has been used in quantitative electroencephalogram (qEEG) research to statistically reduce the dimensionality of the original qEEG measures to a smaller set of theoretically meaningful component variables. However, PCAs involving qEEG have frequently been performed with small sample sizes, producing solutions that are highly unstable. Moreover, solutions have not been independently confirmed using an independent sample and the more rigorous confirmatory factor analysis (CFA) procedure. This paper was intended to illustrate, by way of example, the process of applying PCA and CFA to qEEG data. Explicit decision rules pertaining to the application of PCA and CFA to qEEG are discussed. In the first of two experiments, PCAs were performed on qEEG measures collected from 102 healthy individuals as they performed an auditory continuous performance task. Component solutions were then validated in an independent sample of 106 healthy individuals using the CFA procedure. The results of this experiment confirmed the validity of an oblique, seven component solution. Measures of internal consistency and test-retest reliability for the seven component solution were high. These results support the use of qEEG data as a stable and valid measure of neurophysiological functioning. As measures of these neurophysiological processes are easily derived, they may prove useful in discriminating between and among clinical (neurological) and control populations. Future research directions are highlighted.

Endometrial ablation using a distensible multielectrode balloon

The VestaBlate system uses a multielectrode intrauterine balloon as a device to create effective and safe endometrial ablation (EA). The surface of the distensible balloon is impregnated with thermistors and thin, platelike electrodes. It is designed to deliver low-power electroenergy to the endometrium. Unlike the resectoscope techniques that require nonelectrolytic fluids for uterine distention, moving electrodes at high power outputs, and other variables that are operator dependent, the VestaBlate is computer controlled using a standard type electrosurgical generator. A respiratory enzyme stain, nitroblue tetrazoleum, was used to determine the extent and depth of tissue necrosis to a myometrial depth of 2 to 4 mm with uniform destruction of tissue with power setting at 45 W for a 4-minute application of energy. Sixty-nine patients have been treated, with 45 followed for at least 3 to 9 months. The amenorrhea rate is 40%; the oligomenorhea-hypomenorrhea rate is 49%.

Influence of cognitive reserve on neuropsychological functioning in asymptomatic human immunodeficiency virus-1 infection

OBJECTIVE

To evaluate the influence of cognitive reserve or brain reserve capacity on neuropsychological performance in early human immunodeficiency virus (HIV)-1 infection.

DESIGN

Cross-sectional group comparison study, based on neuropsychological performance, of HIV-1 seropositive and HIV-1 seronegative participants.

SUBJECTS

Seventy-five medically asymptomatic HIV-1-seropositive homosexual or bisexual men and 50 HIV-1-seronegative homosexual or bisexual male controls. Subjects were grouped by HIV-1 status (seropositive vs seronegative) and by cognitive reserve scores (low reserve vs high reserve).

MEASURES

Cognitive reserve scores were based on a combination of years of education, a measure of occupational attainment, and an estimate of premorbid intelligence. Performance on a battery of neuropsychological tests was summarized by empirically derived factor scores and clinical summary ratings.

RESULTS

The HIV-1-seropositive subjects with low cognitive reserve scores exhibited significantly greater deficits on measures of attention and information processing speed, verbal learning and memory, executive functioning, and visuospatial performance than did the HIV-1-seropositive subjects with high cognitive reserve scores. In contrast, there were no significant group differences on these measures between both groups of HIV-1-seronegative subjects.

CONCLUSIONS

Early neuropsychological impairments in HIV-1 infection are most evident in individuals with lower cognitive reserve. As has been found in other neurologic disorders, such as Alzheimer's disease, individuals with greater cognitive reserve may be less sensitive to the initial clinical effects of the underlying neuropathologic process.

Somatic symptoms and HIV infection: relationship to depressive symptoms and indicators of HIV disease

OBJECTIVE

This study examined the relationship of the somatic symptoms fatigue and insomnia with indicators of both psychiatric disturbance and HIV disease severity.

METHOD

Study participants were 98 asymptomatic HIV-infected and 71 uninfected homosexual men; 82 HIV-infected and 64 uninfected men had 6-month follow-up examinations. Scales from the self-reported Profile of Mood States measured fatigue and dysphoric mood. Major depression diagnosis was determined by the Structured Clinical Interview for DSM-III-R. Selected items from the Hamilton depression and anxiety scales measured insomnia and other symptoms of depression. Performance on a battery of standardized tests determined neuropsychological function ratings.

RESULTS

At study entry, complaints of fatigue and insomnia were associated with dysphoric mood, major depression, and other non-HIV-related symptoms of major depression but not with CD4 cell counts or neuropsychological functioning. Increases in levels of fatigue and insomnia over the 6-month follow-up period were associated with increases in non-HIV-related symptoms of depression and in severity of dysphoric mood. Increases in fatigue were also associated with decrements in motor functioning. Otherwise, fatigue or insomnia were not associated with HIV disease progression.

CONCLUSIONS

These findings suggest that complaints of fatigue and insomnia in otherwise asymptomatic HIV-infected patients are likely to be related to psychological disturbances and possibly major depression, which can be treated. HIV-infected patients who complain of fatigue or insomnia should routinely be assessed for major depression.

Stress-associated reductions of cytotoxic T lymphocytes and natural killer cells in asymptomatic HIV infection

OBJECTIVE

Previous research has documented a possible relation of stress and depression to cell-mediated immunity. The authors examined how stressful events and depression may affect key parameters of cellular immunity in subjects with and without HIV infection.

METHOD

Data were collected on 99 asymptomatic HIV-positive and 65 HIV-negative homosexual men as part of an ongoing, longitudinal study. Criticisms of previous studies of psychoimmunity were addressed by 1) using a comprehensive, semistructured interview to measure the objective context of stressful events, 2) double labeling of lymphocytes with monoclonal antibodies to measure subsets of cytotoxic/suppressor T lymphocytes and natural killer (NK) cells, and 3) controlling for circadian effects and methodological factors.

RESULTS

In the HIV-positive men, severe stress was significantly associated with reductions in NK cell populations and a subset of T cells thought to represent cytotoxic T effector cells, particularly the CD8+ T cells expressing the CD57 antigen. In the HIV-negative men, no clear and consistent relation between stress and immune system measures was found. Depression was not correlated with any variables in either of the groups, perhaps due to the low levels of depressive symptoms.

CONCLUSIONS

The findings suggest that stress is associated with reductions in killer lymphocytes (decreased NK cell and cytotoxic T lymphocyte phenotypes). The data provide evidence that stress may alter cell populations that provide cytotoxic defense against infection in HIV-positive men and indicate that the clinical significance of stress-related changes in cytotoxic T lymphocytes and NK cells in HIV infection warrants further study.

Variability of contact transscleral neodymium:YAG cyclophotocoagulation

PURPOSE

To study the variability of ciliary body lesions created by contact Nd:YAG cyclophotocoagulation and to evaluate modifications in probe design to reduce this variability.

METHODS

Contact transscleral Nd:YAG cyclophotocoagulation was performed on fresh, enucleated porcine eyes in three ways: using a standard, handheld fiber-optic probe (98 eyes); using the same probe with an adjunctive contact lens guide to control for probe pressure, angle, and position (69 eyes); and using a spring-loaded handpiece to control for probe pressure (148 eyes). Four laser lesions were created in each eye and were rated for size and severity of tissue response.

RESULTS

For the three groups of eyes, the mean for size differences (largest lesion minus smallest lesion in millimeters for each eye) was 2.53, 1.65, and 2.36, respectively. The mean for severity differences (most severe lesions minus least severe lesion for each eye, based on a four-part subjective rating) was 1.9, 1.1, and 1.7, respectively. These measures of size difference and severity difference were significantly lower with the lens guide than with the other two systems (P = 0.022 and P = 0.020, respectively).

CONCLUSIONS

These findings indicate that contact transscleral cyclophotocoagulation can be associated with considerable variation in the size and severity of the ciliary body reaction. This variation has a significant dependence on probe pressure and orientation against the eye and can be reduced by modification in probe design.

Quantum efficiency measurements and modeling of ion-implanted, laser-annealed charge-coupled devices: x-ray, extreme-ultraviolet, ultraviolet, and optical data

We report quantum efficiency measurements of backilluminated, ion-implanted, laser-annealed CCD's in the wavelength range 13-10,000 Å. The equivalent quantum efficiency (the equivalent photons detected per incident photon) ranges from a minimum of 5% at 1216 Å to a maximum of 87% at 135 Å. Using a simple relationship for the charge-collection efficiency of the CCD pixels as a function of depth, we present a semiempirical model with few parameters that reproduces our measurements with a fair degree of accuracy. The advantage of this model is that it can be used to predict CCD quantum efficiency performance for shallow backside implanted devices without a detailed solution of a system of differential equations, as in conventional approaches, and it yields a simple analytic form for the charge-collection efficiency that is adequate for detector calibration purposes. Making detailed assumptions about the dopant profile, we also solve the current density and continuity equations in order to relate our semiempirical model parameters to surface and bulk device properties. The latter procedure helps to better establish device processing parameters for a given level of CCD quantum efficiency performance.

The health status of women following cosmetic surgery

A retrospective study was performed to determine the frequency of new symptoms and diseases after silicone breast implantation. Questionnaires were mailed to 826 women who made up a breast implant group (n = 516) and a control group who had undergone blepharoplasty (n = 124), liposuction (n = 111), or rhinoplasty (n = 75). Responses were obtained from 370 women (45 percent); however, 68 of these patients (18 percent) were considered ineligible. The overall response rate was 59 percent for the breast implant group and 46 percent for controls. The 302 eligible women included patients with silicone breast implants (n = 222) and controls (n = 80). Women with implants were significantly younger than controls, the median age of women with breast implants being 37 years compared with 46.5 years for controls (p < 0.0001). We compared the incidence of 23 symptoms and 4 connective-tissue diseases after cosmetic surgery in the two groups. The symptoms of swollen glands under arms (p < 0.05) and tender glands under arms (p < 0.01) were statistically more frequent in the breast implant group. The symptom change in skin color was more common in the controls (p < 0.001). The Bonferroni correction for multiple (27) endpoints adjusts the 5 and 1 percent significance cutoff points to 0.00185 and 0.00037, respectively, leaving only change of skin color significant at the 5 percent level on the adjusted data. No cases of scleroderma or lupus were found, and the incidence of arthritis was not significantly different between the implant and control groups.

Mood disorders in HIV infection: prevalence and risk factors in a nonepicenter of the AIDS epidemic

OBJECTIVE

The authors studied the lifetime, initial cross-sectional, and 6-month follow-up prevalence of mood disorders in asymptomatic HIV-infected and uninfected homosexual men who lived in an area with a low prevalence of HIV. They also determined the relationship between current major depression and potential depression risk factors.

METHOD

Subjects included 98 asymptomatic HIV-infected and 71 uninfected homosexual men. Subjects underwent extensive clinical, psychiatric, neuropsychological, and laboratory evaluations.

RESULTS

Similar proportions of HIV-infected and uninfected subjects reported a lifetime (29% and 45%, respectively), an initial current (8% and 3%), and a 6-month follow-up (9% and 11%) history of major depressive disorder. Anxiety disorders were less common, with similar proportions of HIV-infected and uninfected subjects reporting a lifetime (7% and 13%, respectively), an initial current (3% and 7%), and a 6-month follow-up (2% and 5%) history of anxiety disorders. There were no differences in the severity of mood symptoms between HIV-infected and uninfected subjects. Current major depression at initial visit was significantly associated with lifetime history of major depression but not with neuropsychological function or vitamin B12 level.

CONCLUSIONS

These findings are in agreement with previous studies of areas with a high prevalence of HIV. However, the proportion of subjects with mood disorders is high compared with general population studies. Both HIV-infected and uninfected homosexual men may be at high risk for major depression, especially if they have a past history of depression. Moreover, in the asymptomatic stage of HIV infection, major depression does not appear to be secondary to HIV central nervous system effects or low vitamin B12 levels.

Thyroid and adrenal measures during late pregnancy and the puerperium in women who have been major depressed or who become dysphoric postpartum

Prior studies of thyroid, adrenal and mood measures during pregnancy and the puerperium, which we review, have not examined hormone-mood relationships over the full peripartum period during which hormone levels change nor have they compared prior depression history with hormone changes. In a pilot study we measured thyroid and adrenal hormones as well as mood at 38 weeks of pregnancy, and 1, 3, 6, 9 and 12 weeks postpartum in 12 women with major depression history and 14 women with negative psychiatric history. Subjects with prior depressions had significantly higher T3, T4, TSH and cortisol levels during the puerperium. Subjects with higher levels of postpartum dysphoria had lower T4 and free T4 levels as well as higher T3 uptake at 38 weeks of pregnancy and higher cortisol levels during the puerperium. The pathophysiological implications of these findings are discussed.

Vitamin B12 deficiency and nervous system disease in HIV infection

BACKGROUND

Vitamin B12 deficiency may result in a number of neurological and neuropsychiatric disorders. Patients with human immunodeficiency virus type 1 (HIV-1) infection may have a high rate of vitamin B12 deficiency and nervous system disease. Vitamin B12 deficiency may contribute to neurological disease in HIV-1-infected individuals.

OBJECTIVE

To evaluate the possible contribution of vitamin B12 deficiency to neurological disease in HIV-1-infected individuals.

MAIN OUTCOME MEASURES

Comparison of serum vitamin B12 levels with neurological, neuropsychological, and mood state abnormalities in 153 HIV-1-positive subjects and 57 high-risk seronegative controls. A subgroup of 67 subjects underwent additional extensive clinical neurophysiological, cerebrospinal fluid, and magnetic resonance imaging evaluations.

RESULTS

No statistically significant relationships were noted between vitamin B12 levels and abnormalities on any of the measures examined.

CONCLUSIONS

This study does not indicate an important role for vitamin B12 deficiency in the neurological disease of HIV-1 infection.

Menstrual cycle and premenstrual syndrome: modifiers of cardiovascular reactivity in women

Fifteen women prospectively diagnosed with PMS and 15 non-PMS women were each tested twice for cardiovascular stress reactivity and behavioral performance, once during the follicular phase and once during the luteal phase of their cycle. Although blood pressure and heart rate responses to stress did not differ across the menstrual cycle in either group of women, for the non-PMS women, differences in hemodynamic responses were observed across the 2 phases. The luteal phase was associated with greater stroke volume responses and lesser vascular tone. For the PMS women, none of their cardiovascular measures differed across their cycle. Instead, these women showed significantly attenuated blood pressure and heart rate responses compared with non-PMS women, irrespective of cycle phase.

Menstrual cycle and premenstrual syndrome: modifiers of cardiovascular reactivity in women

Fifteen women prospectively diagnosed with PMS and 15 non-PMS women were each tested twice for cardiovascular stress reactivity and behavioral performance, once during the follicular phase and once during the luteal phase of their cycle. Although blood pressure and heart rate responses to stress did not differ across the menstrual cycle in either group of women, for the non-PMS women, differences in hemodynamic responses were observed across the 2 phases. The luteal phase was associated with greater stroke volume responses and lesser vascular tone. For the PMS women, none of their cardiovascular measures differed across their cycle. Instead, these women showed significantly attenuated blood pressure and heart rate responses compared with non-PMS women, irrespective of cycle phase.

Subclinical hypothyroidism: a modifiable risk factor for depression?

The authors assessed the lifetime history of major depression in 16 subjects with subclinical hypothyroidism and 15 subjects whose thyroid function was completely normal. The lifetime frequency of depression was significantly higher in the subjects who met the criteria for subclinical hypothyroidism (56%) than in those who did not (20%), suggesting that subclinical hypothyroidism may lower the threshold for the occurrence of depression.

Prospects for ultrasonic spectroscopy and spectral imaging of abdominal tissues

A system for the digitization and frequency spectral analysis of radiofrequency data for ultrasonic waveforms backscattered from abdominal tissues is described. Studies of phantoms meant to simulate abdominal tissues of differing scattering characteristics indicated that frequency spectral differences due to differences in the frequency dependence of backscattering were seen with 5 MHz probes, but not with a 3.5 MHz probe. Studies of a phantom with a simulated lesion of altered scattering characteristics indicated potential for improved lesion detection and characterization, using custom circuitry developed for variable bandwidth filtering of received ultrasonic beams. The techniques discussed have potential for improved diagnosis of diffuse and focal abdominal abnormalities over that obtained with conventional ultrasonic imaging.