Nutritional value of suckler beef from temperate pasture systems

The role of beef in human diets has been questioned over the last few decades, due largely to its typically high mass-based carbon footprint. However, recent advancements in sustainability literature challenge this paradigm based on the new theory that climate impacts of food commodities should be measured relative to their overall nutritional value rather than their nominal mass. This shift has opened a new opportunity for the global beef industry, and especially for pasture-based systems that can avoid food-feed competition for land and other resources, as beef is a nutritionally dense food. Nonetheless, the sector's true capability to supply a wide range of nutrients for humans, consistently across multiple systems under multiple weather patterns, has not been well-documented. Using whole-system datasets from the North Wyke Farm Platform in the South West of England, we investigated the nutritional value of beef produced from the three most common pasture systems in temperate regions: permanent pasture (PP), grass and white clover (GWC) and a short-term monoculture grass ley (MG). Beef produced from these three pasture systems was analysed for key nutrients (fatty acids, minerals and vitamin E) over three production cycles (2015-2017) to determine potential differences between systems. Fatty acid, mineral and vitamin E profiles of the pasture and silage fed to each group were also assessed, with subtle differences between pastures reported. For beef, subtle differences were also observed between systems, with GWC having higher omega-6 polyunsaturated fatty acid (PUFA) concentrations than PP and MG. However, the overall nutritional quality of beef was found to be largely comparable across all systems, suggesting that temperate pasture-based beef can be classified as a single commodity in future sustainability assessments, regardless of specific sward types. A 100 g serving of temperate pasture-based beef was found to be a high source (>20% recommended daily intake: RDI) of protein, monounsaturated fatty acids, saturated fatty acids, vitamins - B2, B3, B12 and minerals - Fe, P, Zn; a good source (10-19% RDI) of vitamin - B6 and mineral - K; and a complementary source (5-9% RDI) of omega-3 PUFA, vitamin - B9 and minerals - Cu, Mg, Se. The nutritional value of a food item should be used in defining its environmental cost (e.g. carbon footprint) to make fair comparisons across different food groups (e.g. protein sources). Here, we showed that pasture-based beef had a nutrient indexed carbon footprint of between 0.19 and 0.23 Kg CO2-eq/1% RDI of key nutrients.

Enhanced anxiety-like behavior emerges with weight gain in male and female obesity-susceptible rats

Epidemiological data suggest that body mass index and obesity are strong risk factors for depression and anxiety. However, it is difficult to separate cause from effect, as predisposition to obesity may enhance susceptibility to anxiety, or vice versa. Here, we examined the effect of diet and obesity on anxiety-like behaviors in male and female selectively bred obesity-prone and obesity-resistant rats, and outbred Sprague-Dawley rats. We found that when obesity-prone and obesity-resistant rats do not differ in weight or fat mass, measures of anxiety-like behavior in the elevated plus maze and open field are similar between the two groups. However, once weight and fat mass diverge, group differences emerge, with greater anxiety in obesity-prone relative to obesity-resistant rats. This same pattern was observed for males and females. Interestingly, even when obesity-resistant rats were "forced" to gain fat mass comparable to obesity-prone rats (via prolonged access to 60% high-fat diet), anxiety-like behaviors did not differ from lean chow fed controls. In addition, a positive correlation between anxiety-like behaviors and adiposity were observed in male but not in female obesity-prone rats. Finally, diet-induced weight gain in and of itself was not sufficient to increase measures of anxiety in outbred male rats. Together, these data suggest that interactions between susceptibility to obesity and physiological alterations accompanying weight gain may contribute to the development of enhanced anxiety.

Urban cat (Felis catus) movement and predation activity associated with a wetland reserve in New Zealand

Context. House cats are increasingly suggested as having major ecological impacts in semiurban environments. Information on the activity of house cats is relatively scarce, especially in habitats such as wetlands. Aims. This study examines the movement and foraging behaviour of house cats living on the periphery of a wetland reserve in Christchurch city, New Zealand. Methods. Twenty-one domestic cats living in a suburban residential area were studied using radiotelemetry to determine home-range size, mean and maximum distances travelled into the adjacent wetland, and the proportion of time spent in the wetland over a 12-month period. Surveys of prey retrieval for 88 cats were also carried out by cat owners over the same 12-month period. Key results. Cat age and the distance of the cat’s home from the periphery of the wetland were highly correlated with cat movement and hunting activity. These movements were not markedly influenced by season or time of day. Younger cats (<6 years of age) living on the periphery of the wetland had larger home-range sizes, moved significantly further into the wetland and spent a significantly greater proportion of time in the wetland. Cats living close to the wetland also brought a greater diversity and a greater total number of prey items to their home-site. Rates of predation were not significantly influenced by sex or whether the cat was wearing a bell. The most common prey items were introduced rodents and birds; however, 172 of 981 prey items were identified as a native common skink. Conclusions.Consequently, cats living in households on the wetland periphery currently pose a predation risk for the wetland species, and the impact of cats on the native skink population warrants further investigation. Implications. This study suggests that domestic cats will exploit wild habitats but that their potential impact will have both positive (predation of introduced pest species) and negative (occasional direct predation) effects on native wildlife.

Visfatin expression is elevated in normal human pregnancy

Visfatin is a novel-secreted 52kDa adipokine that appears to mimic the action of insulin, inducing glucose transport into mammalian cells. We examined visfatin expression in a cohort of pregnant women to determine if pregnancy influenced visfatin gene expression, circulating levels of visfatin, or local concentrations of visfatin in either omental fat or placenta. Samples of female omental fat, blood and placenta were collected over a 2-year period and frozen at -80 degrees C until they were employed in a series of various assays. Samples were collected during delivery in pregnant women, at hysterectomy in lean women and at bariatric surgery in obese and obese diabetic women. Visfatin expression and concentrations were measured in four cohorts of women: lean controls, pregnant women at term, obese (BMI>40) and obese diabetic women (BMI>40). Visfatin expression was seven times higher in omental fat of pregnant women than in lean women. Immunohistochemistry (IHC) demonstrated that the visfatin gene transcript was translated to protein. An immunoblot confirmed that visfatin protein was much higher in pregnant women than in obese women. Serum visfatin was 20.8ng/ml (n=7) in lean women as compared to 40.3ng/ml in pregnant women (n=4); thus the increased visfatin mRNA levels in omental fat were not reflected in increased serum visfatin. We measured visfatin mRNA content of human placenta and found that placenta expresses substantial amounts of visfatin. GAP-DH, a housekeeping gene that is highly expressed in most human cells had a threshold value (Ct) of 20.9 versus a Ct of 22.4 for visfatin. Again, IHC confirmed that placental visfatin mRNA was translated into visfatin protein. [(3)H] 2-deoxyglucose transport was measured in partially differentiated 3T3-L1 preadipocytes. At a concentration of 2nM, visfatin and insulin produced nearly identical increases in glucose transport. Taken together, these data suggest there is a selective increase in visfatin gene expression in pregnant women at term. Since visfatin also potently and efficaciously induced glucose transport in a cell culture model, any hypothetical role for visfatin in pregnancy should include the possibility that it may function in regulation of maternal/fetal glucose metabolism or distribution.

Lung cancer outcomes at a UK cancer unit between 1998–2001

There are few data published on lung cancer survival in the UK. Survival rates for lung cancer at a UK Hospital between 1998-2001 are described.

METHODS

Analysis of data collected from multidisciplinary team (MDT) meetings, lung cancer registrations and hospital coding.

RESULTS

835 new lung cancers were diagnosed comprising 597 non-small cell lung cancers (NSCLC) (71%), 133 small cell (SCLC) (16%), and 105 clinical diagnoses (13%). Stage at diagnosis; stage I (25%), II (9%), IIIA (8%), IIIB (23%), IV (35%). Surgery was undertaken in 12%, radical radiotherapy (RT) in 4%, palliative RT in 32%, chemotherapy in 8% and best supportive care (BSC) in 36%. The 3-year cumulative survival for NSCLC was: stage I 39%, stage II 30%, stage III 6%, stage IV 0.5%. Only 46% of patients with stage I-IIIA disease received radical treatment. Reasons included poor lung function (32%), unresectable (24%), co-morbidities (17%), performance status (8%), patient choice (8%), unclear (6%), advanced age (5%).

CONCLUSIONS

Survival figures are similar to other UK studies but do not compare favourably with US and European data. This may be because a large proportion of patients with early stage disease receive palliative care only.

Quantitative test of thermal field theory for Bose-Einstein condensates

We present numerical results from a second-order quantum field theory of Bose-Einstein condensates applied to the 1997 JILA experiment [Phys. Rev. Lett. 78, 764 (1997)]]. Good agreement is found for the energies and decay rates for both the lowest-energy m=2 and m=0 modes. The anomalous behavior of the m=0 mode is due to experimental perturbation of the noncondensate. The theory is gapless and includes the coupled dynamics of the condensate and thermal cloud, the anomalous pair average, and all relevant finite size effects.

Vaccination of ewes for prevention of vertical transmission of Neospora caninum

OBJECTIVE

To evaluate the immunologic response of a killed tachyzoite vaccine against Neospora caninum and its effectiveness in preventing vertical transmission of N caninum in sheep.

ANIMALS

40 Dorset ewes seronegative for N caninum.

PROCEDURE

Group-A ewes (n = 20) were vaccinated on days 1 and 126 with a killed N caninum tachyzoite preparation in a commercially available adjuvant. Group-B ewes (n = 20) were sham vaccinated. Blood samples were collected from ewes every 2 weeks and a recombinant ELISA (rELISA) was used to determine serum antibody titers against N caninum. During pregnancy, ewes were challenged with live N caninum tachyzoites. Precolostral serum was collected from lambs and tested for antibodies against N caninum by use of an indirect fluorescence antibody test and the rELISA. Tissue specimens from stillborn lambs or lambs that died within 2 weeks of birth were collected and examined for N caninum antigen and DNA by use of immunohistochemistry and polymerase chain reaction assay, respectively.

RESULTS

Serum antibody titers against N caninum were significantly higher in group-A ewes, compared with group B ewes, following vaccination. Serum antibodies against N caninum were detected in 100% (33/33) of group-B lambs and 75% (18/24) of group-A lambs. In tissue specimens, N caninum DNA was detected in 9 of 11 group-B lambs and 0 of 10 group-A lambs. Histologically, N caninum tachyzoites were observed in 4 group-A lambs and 3 group-B lambs.

CONCLUSIONS AND CLINICAL RELEVANCE

The killed tachyzoite vaccine against N caninum stimulated a humoral immune response in sheep and provided partial protection against vertical transmission.

Simulations of Bose fields at finite temperature

We introduce a time-dependent projected Gross-Pitaevskii equation to describe a partially condensed homogeneous Bose gas, and find that this equation will evolve randomized initial wave functions to equilibrium. We compare our numerical data to the predictions of a gapless, second order theory of Bose-Einstein condensation [S. A. Morgan, J. Phys. B 33, 3847 (2000)], and find that we can determine a temperature when the theory is valid. As the Gross-Pitaevskii equation is nonperturbative, we expect that it can describe the correct thermal behavior of a Bose gas as long as all relevant modes are highly occupied. Our method could be applied to other boson fields.

Second order theory of excitations in trapped bose condensates at finite temperatures

We present a finite temperature field theory for collective excitations of trapped Bose condensates which includes the dynamics of the thermal cloud. In spherical traps we show that excitations couple strongly to a small number of modes, giving resonance structure in their frequency spectra. Where possible, we derive energy shifts and lifetimes of excitations. For the l = 0 mode we show that the simple picture of a decay rate fails, which should be observable in suitable experiments. It also suggests a possible explanation for the anomalous behavior of the m = 0 mode observed in anisotropic traps.

Optical sensor to monitor and control temperature and build height of the laser direct-casting process

A nonintrusive optical sensor system is applied to real-time process control of the recently developed laser direct-casting process, in which a stream of metal powder is introduced into the beam of a high-power (500-W) cw laser to fabricate complex three-dimensional structures. The sensor system allows two critical parameters, temperature and build height, associated with this process to be monitored and controlled continuously. We achieved a height-sensing resolution of ?0.25 mm and temperature control with a resolution of ?10 degrees C at a typical working temperature of 1500 degrees C with an evident improvement in process quality, especially for complex workpieces comprising relatively high, thin walls at which the conductive heat transfer varies substantially as the process proceeds.

Reducing waiting times in lung cancer

BACKGROUND

Concern exists over delays in the management of lung cancer patients. Maximum waiting times and a multidisciplinary team (MDT) approach have been recommended in several recent national reports.

OBJECTIVE

Having implemented a MDT approach, we wished to assess whether national recommendations were achievable and to identify the major factors causing delays.

METHODS

Prospective survey over five months of all new referrals with suspected lung cancer, documenting waiting times at all stages from referral to definitive treatment.

RESULTS

Of the total of 92 patients, 57 were outpatients (67% seen within one week, 89% within two weeks of receipt of referral) and 35 were inpatients (all seen within two working days). Patient age did not influence waiting times to first being seen or to investigation. The result of the initial diagnostic test was received within two weeks of first being seen in 86% of patients. All patients received definitive treatment within recommended times from diagnosis. Delays in the early part of the care pathway were largely due to potentially remediable service factors, but unavoidable patient related factors were important in some prolonged diagnostic delays.

CONCLUSIONS

National recommendations on waiting times are achievable in a high proportion of cases. The probable importance of the MDT approach is discussed.

The cold clinic: a collaborative nursing effort to benefit students

Collaboration between a nurse educator and nurse administrator paired beginning baccalaureate nursing students and the university health center's self-care cold clinic to benefit all involved in the project. Nursing students assisted clients through the cold clinic's five stations, establishing relationships and practicing communication and assessment skills. The health center benefited from exposure to the new techniques brought to the experience by nursing students, clients benefited from having a personal care provider during their cold-clinic experience, and nursing students benefited from being able to practice nursing skills that emphasized critical thinking over high-tech skills as they worked with clients of their own age. In sum, students were educated, wellness was promoted, and self-care behavior was enhanced.

A low-fat diet supplemented with monounsaturated fat results in less HDL-C lowering than a very-low-fat diet

OBJECTIVE

The purpose of this study was to compare the effects of a very-low-fat diet with a low-fat diet supplemented with monounsaturated oil on plasma lipid levels in subjects with hypercholesterolemia.

DESIGN

The 8-week study was divided into one 2-week baseline diet and two 3-week intervention periods in a randomized crossover design.

SETTING

The study was conducted in an outpatient setting at the Deakin Institute of Human Nutrition, Deakin University, Geelong, Australia.

SUBJECTS

Twenty-four free-living subjects with hypercholesterolemia participated in and completed the study.

INTERVENTION

After a 2-week baseline period of a self-selected diet, subjects were assigned to one of two dietary interventions: a very-low-fat (10% of energy from fat), high-carbohydrate diet or a low-fat (26% of energy from fat) diet supplemented with olive oil and an olive oil-based margarine.

MAIN OUTCOME MEASURES

Lipid measurements included total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride concentrations. Plasma cholesteryl esters were measured to monitor compliance.

STATISTICAL ANALYSES

A paired t test was used to assess differences between treatment periods for each subject. The dependence of the difference between treatment periods on the covariates of age, sex, initial cholesterol concentration, and energy intake was analyzed using repeated measures and analysis of covariance.

RESULTS

The low-fat diet supplemented with monounsaturated fat resulted in significantly less high-density lipoprotein cholesterol lowering than the very-low-fat diet (P=.005). Both interventions resulted in significant reductions in both low-density lipoprotein cholesterol and total cholesterol compared with the baseline diet.

APPLICATIONS

This study suggests that a low-fat diet enriched with olive oil provides advantages over a very-low-fat diet in the control of serum lipoproteins among persons with hypercholesterolemia.

Diagnosis of X-linked adrenal hypoplasia congenita by mutation analysis of the DAX1 gene

OBJECTIVE

To develop a rapid diagnostic approach to individuals with the X-linked cytomegalic form of adrenal hypoplasia congenita (AHC) and hypogonadotropic hypogonadism (HH) due to mutations in DAX1, a new member of the nuclear hormone receptor gene superfamily.

DESIGN

Molecular genetic diagnostic investigations of individuals with AHC and their relatives included polymerase chain reaction amplification of DAX1 for identification of intragenic mutations and fluorescence in situ hybridization with a cosmid containing the DAX1 gene for evaluation of larger deletions.

PARTICIPANTS

Families that had males affected with AHC were evaluated for mutations involving the DAX1 gene.

RESULTS

DAX1 mutations were identified in four families that had males affected with AHC. Two apparently independent pedigrees had an identical frame-shift mutation due to a single base pair deletion, and a third had a larger deletion involving the entire DAX1 locus. The fourth family was evaluated by fluorescence in situ hybridization for prenatal diagnosis, and both the DAX1 locus and the contiguous glycerol kinase region were deleted.

CONCLUSIONS

Molecular genetic and molecular cytogenetic techniques represent rapid and complementary approaches to the diagnosis of mutations in the DAX1 gene responsible for AHC and the associated HH. Specific diagnosis of the cause of adrenal insufficiency in these boys permits anticipatory management of the HH and prenatal counseling for parents of the affected child and other members of their families.

Effect on serum lipids of addition of safflower oil or olive oil to very-low-fat diets rich in lean beef

The cholesterol-lowering effect of very-low-fat diets rich in lean beef has previously been shown to be reversed with the addition of beef fat. The aim of this study was to determine the effect on serum lipid levels of the addition of safflower oil or olive oil to a very-low-fat diet rich in lean beef. Subjects were assigned to either the safflower oil or the olive oil group. In the first week the subjects ate their usual diet; in the second and third weeks all subjects ate a very-low-fat (9% of energy) diet rich in lean beef. In the fourth and fifth weeks the fat content of the diet was increased in a stepwise fashion to 20% and 30% of energy, respectively, by substituting safflower oil or olive oil for carbohydrate. Low-density lipoprotein cholesterol (LDL-C) concentrations decreased by 13% to 14%, and high-density lipoprotein cholesterol (HDL-C) concentrations decreased by 20% to 25% in subjects after 2 weeks of the very-low-fat, lean-beef diet. The LDL-C concentrations remained low after the addition of safflower oil or olive oil to the very-low-fat diet. These results indicate that a reduction in saturated fat, not total fat, is required to reduce serum total cholesterol and LDL-C levels. Provided that the total diet is low in saturated fat, these serum lipid responses can be achieved even when the diet is rich in fat-trimmed lean beef.

Teaching activities of clinical instructors during the direct client care period: a qualitative investigation

The lack of substantial research in the area of clinical teaching would suggest that this 'heart' of the nursing student's professional education has long been neglected. Employing a qualitative descriptive methodology, this study explored the teaching activities that nine clinical instructors said they implemented during the direct client care period and the teaching activities that these nine clinical instructors said they would implement in response to a specific scenario of a clinical teaching event. The unstructured interviews revealed that clinical instructors: (a) noted role modelling the greatest number of times as a teaching activity but implemented it less frequently; (b) used verbalizations in the form of telling, asking, saying, discussing or talking as the primary teaching activity in the clinical area and in response to the specific scenario; (c) do not have opportunities to see other clinical instructors teaching in the clinical area; (d) have difficulty separating teaching activities and evaluation activities; (e) are eclectic in their use of learning theories; and (f) find articulating teaching activities that they implement during the direct client care period to be a complex task.

Detection of multidrug resistance and quantification of responses of human tumour cells to cytotoxic agents using flow cytometric spectral shift analysis of Hoechst 33,342-DNA fluorescence

We describe the application of a flow cytometric technique for assessing the radiation or drug sensitivity characteristics of human tumour cells. The technique makes use of the phenomenon that a red shift occurs in the fluorescence emission spectrum of a DNA-specific dye (Hoechst 33,342) as an increasing number of dye molecules bind to nuclear DNA. Intact, viable cells undergo a time-dependent spectral shift that can be distinguished from the rapid shift observed in cells with damaged membranes by the use of multiparametric flow cytometry. The responses of various human cell lines were compared, namely, those of normal and ataxia-telangiectasia (A-T) lymphoblastoid lines, a small-cell lung carcinoma line and its (in vitro) derived multidrug-resistant variants. A close correlation was found between dye toxicity and the degree of DNA binding of Hoechst 33,342 independent of cellular DNA content, with lymphoblastoid and multidrug-resistant small-cell lung cancer cells showing enhanced and restricted dye-binding rates, respectively. VP16- and radiation-induced cell kill was found to result in a quantifiable increase in the fraction of cells undergoing a rapid spectral shift and was capable of detecting the increased radiation sensitivity of A-T-derived cells. Spectral shift analysis provides a rapid method for assessing the responses of tumour cells to cytotoxic agents and for determining the general ability of cells to protect cellular DNA from a model DNA-binding agent (Hoechst 33,342) that participates in the multidrug resistance phenotype.

Reduced nuclear binding of a DNA minor groove ligand (Hoechst 33342) and its impact on cytotoxicity in drug resistant murine cell lines

The reduced cellular uptake, and subsequent reduced nuclear availability, of cytotoxic agents is a factor in the resistance of mammalian cells to anti-cancer drugs that act by interaction with DNA. The whole cell uptake, nuclear binding and cytotoxicity of a DNA-specific ligand, Hoechst dye number 33342 (Ho342), has been studied in cytotoxic drug resistant variants of a murine tumour cell line. Cell lines showing various degrees of cross-resistance to adriamycin as a part of the phenotype of classical multi-drug resistance (MDR) demonstrated a reduction in intranuclear Ho342 content, up to a maximum of 35% of the level found in the parent as assessed by flow cytometry, despite similar levels of whole cell uptake determined using radiolabelled ligand. Ability to limit nuclear accessibility of Ho342 correlated closely with cellular resistance to Ho342 and to adriamycin. All drug resistant cell lines showed a significant increase in nuclear accessibility to Ho342 after verapamil treatment, including a methotrexate resistant cell line. The methotrexate resistant variant, not demonstrating MDR, showed reduced nuclear binding of Ho342 but increased cell kill associated with a propensity to develop a population of cells showing extra DNA replication in response to Ho342 exposure. Differences between cell lines in the relationship between Ho342-induced cell cycle perturbation and cell kill supported the conclusion that modulation of several pathways of response to cytotoxic agents had occurred in the development of drug resistance.

Mitoxantrone-DNA binding and the induction of topoisomerase II associated DNA damage in multi-drug resistant small cell lung cancer cells

The cytotoxicity anti-tumour intercalating agents such as the anthraquinone mitoxantrone is thought to relate to DNA binding and the trapping of DNA topoisomerase II complexes on cellular DNA. We have studied the uptake, nuclear location, DNA binding mode and DNA damaging capacity of mitoxantrone in a small cell lung carcinoma cell line (NCI-H69) compared with an in vitro-derived variant subline (NCI-H69/LX4) that exhibits "classical" multi-drug resistance (MDR). Variant cells maintained under doxorubicin selection showed reduced RNA levels that returned to control values within 7 days of growth under non-selective conditions. Variant cells released from selection stress showed resistance to DNA cleavage by doxorubicin, mitoxantrone, 4'-epidoxorubicin, 4'-deoxy-doxorubicin but reduced resistance to aclacinomycin A and a 9-alkyl substituted anthracycline in broad agreement with the cross-resistance patterns for cytotoxicity. Mitoxantrone treated NCI-H69 cells were found to accumulate DNA-protein crosslinks during a 4 hr post-treatment incubation period whereas variant cells maintained depressed levels of crosslinking. There was no apparent abnormality in the availability or drug sensitivity of topoisomerase II assayed in crude nuclear extracts of NCI-H69/LX4 cells. Whole cell uptake of radiolabelled mitoxantrone was depressed (50%) in NCI-H69/LX4 compared with NCI-H69, whereas assessment of nuclear-bound drug in individual cells by a fluorescence quenching technique showed at least a 10-fold greater level of target protection. The quenching results provide evidence of a high affinity, saturable mode of drug binding, favoured at low drug concentrations, that correlated with DNA cleavage capacity. We propose that the cytotoxic action of mitoxantrone is dependent upon a restricted and persistent form of binding to DNA that favours the long-term or progressive trapping of topoisomerase II complexes.

Development of a videotape on adverse drug reactions

A pharmacy department's development and evaluation of a 20-minute videotape on adverse drug reaction (ADR) reporting is described. At the University of Mississippi Medical Center Hospital, a 545-bed hospital, it was determined that inadequate education of staff was a major contributing factor to the failure of ADR-reporting programs. Since no videotape educational program on ADRs was available, the pharmacy department developed its own at a cost of approximately $400. The videotape demonstrates a variety of ADRs that occur in adult inpatients and provides instructions on how to report ADRs. The description of each ADR includes manifestations of the reaction, drugs associated with the reaction, and implications for the patient. During a three-month evaluation period on four patient-care units, nine ADRs were reported by nurses who were shown the videotape, while no ADRs were reported by nurses who were provided with only an oral presentation on ADR reporting. The videotape is now used hospitalwide, primarily with nurses and new pharmacy personnel. The videotape developed by the pharmacy department proved to be an effective means for demonstrating clinical manifestations of ADRs and explaining procedures for voluntary reporting.

Flow cytometric analysis of Hoechst 33342 uptake as an indicator of multi-drug resistance in human lung cancer

Cytotoxic drug resistance developing after chemotherapy is thought to be the main cause of treatment failure in several human tumours, including small cell lung cancer (SCLC). Cell lines showing drug resistance following prolonged exposure to a single agent frequently acquire resistance to several functionally unrelated drugs, the phenomenon of multi-drug resistance (MDR). Classical MDR is thought to arise from changes effecting a reduction in intracellular availability of cytotoxic drugs. We describe a flow cytometry (FCM) technique to monitor the MDR phenotype in drug resistant variants of SCLC and non-SCLC cell lines. The technique is based on a multiparametric analysis of the nuclear binding of a model chemotherapeutic agent, the fluorescent dye Hoechst 33342 (Ho342), which is capable of supra-vital staining of DNA in intact, viable cells. A laboratory derived drug resistant SCLC cell line, H69/LX4, showed a significant (30%) reduction in nuclear binding compared to the parental line H69/P. Exposure to verapamil (VPL) rapidly increased (within 2 min) nuclear binding of Ho342, and the new equilibrium of nuclear staining, attained within 20 min, remained lower than the level achieved in the parental cell line, suggesting some ability of H69/LX4 to limit the effect of the drug efflux blocker. A drug resistant large cell carcinoma line showed only a small reduction (10%) in nuclear binding when compared to the parent line, and this difference was not altered by VPL. A drug resistant adenocarcinoma line showed less than 10% difference in nuclear binding compared with the parental line and neither line was significantly affected by VPL treatment. Our findings suggest that different mechanisms of resistance may occur in lung tumours of different tissue types. This technique may be extended to the rapid and direct examination of biopsy specimens of human solid tumours for evidence of multi-drug resistance.

The severity of late skin damage related to fraction size in women treated by radiotherapy after mastectomy

A retrospective study has been undertaken to test the NSD formula as a predictor of isoeffective schedules in women treated after mastectomy by parasternal radiotherapy using fraction sizes of 2-3 Gy. Forty three women were identified who have been treated on the same orthovoltage unit 8-18 years previously and the severity of overall skin changes and telangiectasia were assessed by three observers using a 4-point categorical scale. At each level of skin damage, radiotherapy schedules delivered using fraction sizes of 250 R or 300 R were associated with lower TDF values than schedules using 225 R fraction. The difference between TDF factors for isoeffective regimes using small (225 R) and large (250 R and 300 R) fraction sizes is highly significant for both overall skin damage and telangiectasia (p = 0.004 by rank sum test). Care should be exercised when using current empirical formulae to calculate regimes isoeffective for late skin damage, even when modest changes in fraction size from 2 to 3 Gy are contemplated.

Prospective evaluation of a watch policy in patients with inoperable non-small cell lung cancer

The requirement for palliative chest radiotherapy in patients with non-small cell lung cancer (NSCLC) was assessed in a study of 134 inoperable patients not suitable for radical radiotherapy. Immediate chest radiotherapy was judged necessary in 86 (64%) because of significant symptoms from intrathoracic tumour or involvement of proximal airways. Forty-eight patients were monitored regularly without initial radiotherapy and of these, 26 (54%) required later chest irradiation because of progressive and significant symptoms due to intrathoracic disease. Median symptom-free survival in this group was 10 months. The requirement for immediate or delayed chest irradiation could not be predicted from either patient or tumour characteristics. The proportion of patients with NSCLC requiring palliative chest irradiation may have been overestimated from this study population; even so 22 of 134 patients (16%) did not at any stage in their illness require radiotherapy for chest symptoms.

Absence of the septum pellucidum. Overlapping clinical syndromes

A patient with absence of the septum pellucidum, optic hypoplasia, congenital nystagmus, hemiatrophy, and seizures fulfilled clinical and radiological criteria for diagnosis of both septo-optic dysplasia and the syndrome of absent septum pellucidum with porencephalies. The anatomical and clinical similarities between these two syndromes suggest a common embryological basis. Their simultaneous presence in this case further supports this explanation. Clinically mild forms of both septo-optic dysplasia and the syndrome of absent septum pellucidum with porencephalies are now detected with the aid of computed tomographic scanning in patients with unexplained hemiatrophy, congenital nystagmus, seizures, and short stature.

Three assessment tools for family therapy

In this paper the authors attempt to utilize existing knowledge of the family and family therapy in order to develop a universal tool for family analysis. The assessment tools represent a conceptualization of the three phases of family analysis. Using a simplistic guide, such as these assessment tools, should aid the therapist in organizing the overwhelming volume of information that is obtained in a short amount of interviewing time. Again the assessment tools are only as applicable as the family therapist is imaginative and creative.

Kinetics of labeling of the S-adenosylmethionine pool of Saccharomyces cerevisiae

A method has been developed for studying the specific activity of the pool of S-adenosylmethionine in yeast. The pool reaches half-maximal specific activity within 30 s after the addition of [methyl-3H]methionine. After addition of an excess of nonradioactive methionine, the specific activity of S-adenosylmethionine is reduced by half within 20 s. During that period there is a substantial expansion of the pool. A logarithmically growing cell in synthetic medium contains about 2 X 10(6) molecules of S-adenosylmethionine, of which only 10% is used for the methylation of ribonucleic acid molecules.