Whole mount immunofluorescence analysis of placentas from normotensive versus preeclamptic pregnancies

INTRODUCTION

Defects in placental angiogenesis and spiral artery remodeling have been proposed to play essential roles in the development of preeclampsia. However, the specific molecular mechanism(s) responsible for aberrant placental angiogenesis in preeclampsia are incompletely understood. The vascular endothelial growth factor receptors (VEGFR1, R2, R3) and STAT3 have critical functions in normal blood vessel development, but their potential roles in preeclampsia are currently unclear. In this study, we utilized a novel whole mount immunofluorescence (WMIF) method to compare expression of VEGFR1, R2, R3 and activated, phosphorylated STAT3 (pSTAT3) in placentas of preeclamptic (PE) versus normotensive (NT) pregnancies.

METHODS

Placental biopsies collected from NT and PE pregnant women were fixed and stained with fluorochrome-conjugated antibodies to identify specific cell populations as follows: CD31 for blood vessel endothelial cells, cytokeratin-7 for trophoblast cells, and CD45 for immune cells. Expression of the VEGFRs and pSTAT3 were subsequently characterized by WMIF in conjunction with confocal microscopy.

RESULTS

A total of 18 PE and 18 NT placentas were evaluated. No significant differences in the cell type-specific expression patterns or expression levels of VEGFR1, VEGFR2 or VEGFR3 were detected between NT and PE placentas. In contrast, statistically significant increases in pSTAT3 staining were detected in endothelial cells of PE placentas versus NT controls.

DISCUSSION

Our study demonstrates that increased pSTAT3 expression in placental endothelial cells is associated with PE. We speculate that elevated pSTAT3 expression in the blood vessels of PE placentas may be due to aberrant angiogenesis, increased pro-inflammatory cytokine expression, and/or placental stress.

The effects of three days of sub-maximal-intensity mountain biking on sleep

Objectives. We determined the effect of three consecutive days of sub-maximal-intensity mountain biking (4.5 hours per day, ~64 km per day), on the sleep of ten healthy, trained male and female mountain bikers. Methods. The sleep of the mountain bikers was assessed both subjectively (visual analogue scales and sleep questionnaires) and objectively (activity data logger) on each night of mountain biking and for seven nights when they were not cycling (pre-exercise, mean of seven nights). The cyclists’ mood and muscular pain were assessed each night using visual analogue scales. The cyclists slept at home in their normal environment. Results. There was no significant difference between the mountain bikers’ muscular pain and mood (calm/anxious visual analogue scale) measured during the pre-exercise stage and their pain and mood measured on each of the mountain biking nights (p>0.05). However, compared with the pre-exercise stage, the mountain bikers reported that they were significantly more tired (tired/energetic visual analogue scale) on each night of cycling (p<0.01). The sleep of the mountain bikers was disrupted on the night of the third day of mountain biking only. On this night, compared with the pre-exercise stage, the mountain bikers reported that they woke up more during the night (double the number of times) (p<0.001), and an activity data logger recorded that they were awake for about half an hour longer during the night (p<0.05). Conclusion. We have shown that three days of repeated, endurance sub-maximal mountain biking disrupted the sleep of the mountain bikers on the third night of cycling.

Cannabinoid activation of PPAR alpha; a novel neuroprotective mechanism

BACKGROUND AND PURPOSE

Although CB(1) receptor activation evokes neuroprotection in response to cannabinoids, some cannabinoids have been reported to be peroxisome proliferator activated receptor (PPAR) ligands, offering an alternative protective mechanism. We have, therefore, investigated the ability of a range of cannabinoids to activate PPAR alpha and for N-oleoylethanolamine (OEA), an endogenous cannabinoid-like compound (ECL), to evoke neuroprotection.

EXPERIMENTAL APPROACH

Assays of PPAR alpha occupancy and gene transactivation potential were conducted in cell-free and transfected HeLa cell preparations, respectively. In vivo estimates of PPAR alpha activation through fat mobilization and gene transcription were conducted in mice. Neuroprotection in vivo was investigated in wild-type and PPAR alpha gene-disrupted mice.

KEY RESULTS

The ECLs OEA, anandamide, noladin ether and virodhamine were found to bind to the purified PPAR alpha ligand binding domain and to increase PPAR alpha-driven transcriptional activity. The high affinity synthetic CB(1/2) cannabinoid agonist WIN 55212-2 bound to PPAR alpha equipotently with the PPARalpha agonist fenofibrate, and stimulated PPARalpha-mediated gene transcription. The phytocannabinoid delta 9 tetrahydrocannabinol was without effect. OEA and WIN 55212-2 induced lipolysis in vivo, while OEA pre-treatment reduced infarct volume from middle cerebral artery occlusion in wild-type, but not in PPAR alpha-null mice. OEA treatment also led to increased expression of the NFkappa B-inhibitory protein, Ikappa B, in mouse cerebral cortex, while expression of the NFkappa B-regulated protein COX-2 was inhibited.

CONCLUSIONS AND IMPLICATIONS

These data demonstrate the potential for a range of cannabinoid compounds, of diverse structures, to activate PPAR alpha and suggest that at least some of the neuroprotective properties of these agents could be mediated by nuclear receptor activation.

Prospective study of grapefruit intake and risk of breast cancer in postmenopausal women: the Multiethnic Cohort Study

In vitro and in vivo studies have shown that cytochrome P450 3A4 (CYP3A4) is involved in the metabolism of oestrogens. There is evidence that grapefruit, an inhibitor of CYP3A4, increases plasma oestrogen concentrations. Since it is well established that oestrogen is associated with breast cancer risk, it is plausible that regular intake of grapefruit would increase a woman's risk of breast cancer. We investigated the association of grapefruit intake with breast cancer risk in the Hawaii-Los Angeles Multiethnic Cohort Study, a prospective cohort that includes over 50 000 postmenopausal women from five racial/ethnic groups. A total of 1657 incident breast cancer cases were available for analysis. Grapefruit intake was significantly associated with an increased risk of breast cancer (relative risk=1.30, 95% confidence interval 1.06-1.58) for subjects in the highest category of intake, that is, one-quarter grapefruit or more per day, compared to non-consumers (P(trend)=0.015). An increased risk of similar magnitude was seen in users of oestrogen therapy, users of oestrogen+progestin therapy, and among never users of hormone therapy. Grapefruit intake may increase the risk of breast cancer among postmenopausal women.

Nutritional changes among premenopausal women undertaking a soya based dietary intervention study in Hawaii

BACKGROUND

We conducted a 2-year nutritional intervention among premenopausal women. The goal was to incorporate two daily servings of soya into the regular diet. This report describes the dietary modifications and assesses their nutritional adequacy with regard to major nutrients.

METHODS

In this analysis of 100 intervention and 106 control subjects, women completed a validated food-frequency questionnaire at baseline; throughout the study, they participated in at least three unannounced 24-h recalls.

RESULTS

At randomization, both groups were similar in age and body weight, reported low soya intake, and did not differ by intake of major nutrients and foods. According to the 24-h recalls, women in the intervention group consumed nearly two servings of soya per day, while the control women remained at 0.2 servings. In comparison with the control group, the intervention group consumed fewer dairy products, primarily milk, but also less meat, nuts and seeds. As a result of the dietary modification, the intervention women consumed less-saturated fat and cholesterol and more protein, dietary fibre, calcium and vitamins than the control group.

CONCLUSION

These results suggest that women in the intervention group improved the overall quality of their diet by adding two servings of soya per day.

Plastic bottles as spacers for a pressurized metered-dose inhaler: in vitro characteristics

Homemade spacer devices are commonly used by children with asthma to improve aerosol deposition from pressurized metered dose inhalers (pMDI); however, the efficacy and efficiency of these devices are not fully characterized. We determined the quality of fine particle fraction (< 4.7 microns) and ultrafine particle fraction (< 3.3 microns) of three bottles (from 280 ml to 500 ml) commonly used as spacers in Trinidad and Tobago and compared their performance to the commercially available valved holding chamber (OpT) and pMDI. These data were obtained in vitro using a cascade impactor. All 3 bottles and the OpT were similar (p > 0.05) in reducing the amount of albuterol emitted as large particles (> 4.7 microns) to less than 10 micrograms. The different sized bottles (from 280 ml to 500 ml) produced identical quantities of albuterol in the fine particle and ultrafine particle ranges (p > 0.05). All of the sample bottle spacers emitted a higher amount (p < 0.002) of fine and ultrafine particles than the OpT and pMDI alone. The OpT resulted in a significantly higher fraction of fine particles (p < 0.05) and a greater quantity of drug (p < 0.05) in the ultrafine range as compared to the MDI only. The sizes of particles obtained from the bottle spacers are those that have a high probability of reaching the lower airway; however, the clinical relevance of these findings remains to be determined.

Evaluation of validity of items for a food behavior checklist

OBJECTIVES

To evaluate the validity of food behavior items, using a biological measure (serum carotenoids) as the criterion for validity of fruit and vegetable intake, and the results from multiple 24-hour recalls to test convergent validity with nutrient intake.

DESIGN

Participants responded to 39 food-behavior questions and later completed three 1-day dietary recalls. Serum carotenoid levels were determined for a 59% randomly selected subsample.

SUBJECTS/SETTING

A convenience sample of 100 English-speaking, low-income women participating in a Food Stamp Nutrition Education Program in 8 California counties. Statistical analyses Spearman correlation coefficients were calculated between responses to the food behavior items and (a) serum carotenoid levels and (b) mean nutrient intakes from the 24-hour recalls. Cronbach's coefficient alpha was determined for items within broad food behavior topics.

RESULTS

Responses to 10 food behavior items were significantly correlated with serum carotenoid levels (correlations greater than 0.45 were found for choosing low-fat foods and a self-evaluation of overall dietary quality). An additional 12 items showed hypothesized associations with the 24-hour recall data (with a maximum correlation 0.50 for number of eggs per week and dietary cholesterol). Cronbach's coefficient alpha ranged from 0.28 (for 5 fat and cholesterol items) to 0.79 (for 9 fruit and vegetable items).

APPLICATIONS/CONCLUSIONS

Nutrition professionals can use these methods to validate items for food behavior checklists for specific populations. The items described here may be useful when designing instruments to administer to low-income women in a community setting.

Food insecurity is positively related to overweight in women

Although individuals with poor food security might be expected to have reduced food intake, and thus reduced body fat and less likelihood of being overweight, these associations have not been adequately studied. The purpose of the current study was to examine the relationship between food insecurity and overweight as measured by body mass index (BMI) using data from the nationally representative 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII). Overweight was defined as BMI >27.3 kg/m(2) for women and 27.8 kg/m(2) for men. Food insecurity was related to overweight status for women (n = 4509, P < 0.0001), but not for men (n = 4970, P = 0.44). Excluding the 11 severely insecure women, the prevalence of overweight among women increased as food insecurity increased, from 34% for those who were food secure (n = 3447), to 41% for those who were mildly food insecure (n = 966) and to 52% for those who were moderately food insecure (n = 86). Food insecurity remained a significant predictor of overweight status, after adjustment for potentially confounding demographic and lifestyle variables (P < 0.01). In a logistic regression analysis, mildly insecure women were 30% more likely to be overweight than those who were food secure [odds ratio (OR) 1.3, P = 0.005]. Thus, food insecurity had an unexpected and paradoxical association with overweight status among women with a higher prevalence of overweight among the food insecure, and a resulting potential for increased incidence of obesity-related chronic diseases. Given that the rates of both overweight and food insecurity are on the rise, this research area warrants further investigation.

Living arrangements affect dietary quality for U.S. adults aged 50 years and older: NHANES III 1988-1994

The number and proportion of older U.S. adults who live alone have increased dramatically in the past three decades, and there is concern that these individuals may have particularly poor dietary quality. We examined the association of four living arrangements (living with a spouse only, with a spouse plus someone else, with someone other than a spouse or living alone) with dietary quality (the number of low nutrients out of a possible 15, with low defined as <67% of the recommended dietary allowance) among 6525 U.S. adults aged 50-64 y and those >/=65 y in the third National Health and Nutrition Examination Survey (NHANES III 1988-1994). Among non-Hispanic Caucasian adults, those who lived with a spouse only had better dietary quality, with significant differences ranging from 0.8 to 1.5 fewer low nutrients compared with those with other living arrangements. Effects of living arrangements on dietary quality were also seen among non-Hispanic African-Americans, Mexican-Americans, and those of "other" races, but differences were significant only for African-American men aged >65 y living with a spouse plus others (1.6 additional low nutrients compared with those living with a spouse only). Energy intake was strongly associated with dietary quality, but did not account for the associations between living arrangements and dietary quality. Although middle-aged and older adults with living arrangements other than living with a spouse only (including those living alone) tended to have poorer dietary quality, the effects varied substantially across age, gender and ethnic categories.

Exhaled nitric oxide as an indicator of severity of asthmatic inflammation

Traditional assessment of severity of asthma relies on an evaluation of signs and symptoms and pulmonary function tests. These pulmonary function tests, such as peak expiratory flow rates, forced vital capacity, and forced expiratory flow rates, are indirect measures of airway caliber only, and not inflammation. Since asthma is an inflammatory disease, a measure of the degree of inflammation would be helpful in quantitating severity and titrating of anti-inflammatory therapy. A noninvasive method for measuring pulmonary inflammation would therefore be helpful to assist the emergency physician in initial treatment and assist in titration of anti-inflammatory therapy during repeat visits. Exhaled nitric oxide (NO) assays are convenient and practical and may fulfill this role. In this review, we discuss the role of NO in asthmatic inflammation and the role that exhaled NO values may play in the emergency management of asthma.

FE(NO): relationship to exhalation rates and online versus bag collection in healthy adolescents

Measurement of exhaled nitric oxide (FE(NO)) is a noninvasive and practical method for assessing airway inflammation. We conducted this investigation to determine the most appropriate flow rate for FE(NO) measurement and to obtain normal values for FE(NO). We determined which expiratory flow was easy to sustain, generated reproducible values, and provided good correlation between offline and online measurements. Thirty-two healthy subjects (15- 18 yr old) underwent spirometry and FE(NO) measurements, using a chemiluminescent NO analyzer at expiratory flow rates of 46, 31, 23, 15, 10, 7, 5, and 4 ml/s. The major findings were as follows: (1) FE(NO) increased as flow rates decreased, with strong correlation between FE(NO) values and flow rates at the four highest flows (0. 85- 0.93, p < 0.001); (2) there were no significant differences and good agreement between offline bag and online FE(NO) values for the four highest flows (p < 0.09-0.83); (3) online FE(NO) values increased with age 15-17 yr at all flow rates, but decreased at age 18 yr; and (4) using multiple regression, significant predictors of FE(NO) were flow, body surface area, age, and FEF(25-75). On the basis of these results, we provide FE(NO) values for healthy adolescents and propose that the ideal flow rate for children is between 30 and 50 ml/s.

Intake of flavonoids and lung cancer

BACKGROUND

To investigate the possible relationship between intake of flavonoids-powerful dietary antioxidants that may also inhibit P450 enzymes-and lung cancer risk, we conducted a population-based, case-control study in Hawaii.

METHODS

An in-person interview assessed smoking history and usual intake of 242 food items for 582 patients with incident lung cancer and 582 age-, sex-, and ethnicity-matched control subjects. Subjects who donated a blood sample were genotyped for the P450 enzyme variant allele CYP1A1*2 by use of a polymerase chain reaction-based method. Logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). All P values are two-sided.

RESULTS

After adjusting for smoking and intakes of saturated fat and beta-carotene, we found statistically significant inverse associations between lung cancer risk and the main food sources of the flavonoids quercetin (onions and apples) and naringin (white grapefruit). The lung cancer OR for the highest compared with the lowest quartile of intake was 0.5 (95% CI = 0.3-0.9) for onions (P for trend =.001) and 0.6 (95% CI = 0.4-1.0) for apples (P for trend =.03). The OR for the highest compared with the lowest tertile of intake for white grapefruit was 0.5 (95% CI = 0.2-0.9) (P for trend =.02). No association was found for important food sources of other flavonoids. Using published food-composition data for flavonoids, we found an inverse association between intake of quercetin and risk of lung cancer (P for trend =.07) that appears consistent with associations for its food sources. The effect of onions was particularly strong against squamous cell carcinoma (a cell type specifically associated with CYP1A1*2 in our study) and was modified by the CYP1A1 genotype, suggesting that CYP1A1 may play a role in this association.

CONCLUSION

If replicated, particularly in prospective studies, these findings would suggest that foods rich in certain flavonoids may protect against certain forms of lung cancer and that decreased bioactivation of carcinogens by inhibition of CYP1A1 should be explored as underlying mechanisms.

Apoptosis induced by DNA uptake limits transfection efficiency

Electrotransfection is an effective method for transfecting lymphoid cells. However, the transfection efficiency of certain lymphoid cells is low. L1210 subclones and NFS-70 pro-B cells, which are highly refractory to various transfection methods, were used to identify the limiting factors. Cells were electrotransfected with plasmids coding for green fluorescence protein or luciferase. The luciferase expression of L1210 subclone 3-3 was found to increase 6-12 h after electroporation, but decreased significantly from 12 to 48 h. The lower level of luciferase activity at later time periods correlated with decreases in cell viability, which was shown to be due to apoptosis, as determined by propidium iodide/acrindine orange staining, DNA laddering, and prevention of cell death by addition of caspase inhibitors. Similar results were observed with NFS-70 pro-B cells and select L1210 subclones. In contrast, L1210 parental and L1210 subclone 7-15.6 cells undergo only low levels of apoptosis (< or = 5%). Apoptosis occurred only when DNA (plasmids or salmon sperm DNA) was present during electroporation, but was not dependent on the conformation of the DNA used or the expression of transgenes. Cells pulsed in the presence of dextran sulfate (MW 500,000) did not apoptose. Similar results were observed when L1210 subclone 3-3 was transfected using the cationic lipid 1, 2-dioleoyl-3-trimethylammonium propane, although the transfection efficiency and corresponding rate of apoptosis were significantly lower. Applying the caspase inhibitor fluoromethyl ketone (Boc-ASP-FMK) dramatically improved cell viability and transgene expression of select L1210 subclones and NFS-70 pro-B cells.

Absence of MHC class II antigen expression in trophoblast cells results from a lack of class II transactivator (CIITA) gene expression

Although the mechanism(s) underlying the failure of the maternal immune system to reject the semiallogeneic fetus have not been clearly defined, the absence of MHC class II antigen expression by fetal trophoblast cells very likely plays a critical role in the maintenance of normal pregnancy. However, the regulation of class II antigen expression in trophoblast cells is poorly understood. Class II transactivator (CIITA) is a transacting factor that is required for both constitutive and IFN-gamma-inducible class II gene transcription. In this report we demonstrate that the inability of trophoblast cells to express class II antigens is due to a lack of CIITA gene expression. Trophoblast cell lines derived from human, mouse, and rat do not express CIITA, and expression is not inducible by IFN-gamma. The absence of CIITA gene expression in trophoblasts treated with IFN-gamma does not result from a defect in the IFN-gamma receptor or the JAK/STAT pathway, because the classical IFN-gamma inducible gene encoding the guanylate-binding protein is expressed. Transfection of CIITA expression vectors into trophoblast cells results in activation of class II promoters, endogenous class II mRNA expression, and subsequent expression of class II antigens on the cell surface. In contrast, class I mRNA is not expressed in human trophoblast cells transfected with CIITA expression vectors. Thus, trophoblast cells contain all of the DNA binding factors necessary for class II transcription, and ectopic expression of CIITA is sufficient to activate class II, but not class I expression. The failure of trophoblast cells to express CIITA, and therefore class II antigens, provides a potential mechanism by which the fetus is protected from the maternal immune system during pregnancy.

Inflammatory events at the blood brain barrier: regulation of adhesion molecules, cytokines, and chemokines by reactive nitrogen and oxygen species

Recruitment of inflammatory cells into the CNS during pathological processes associated with neurodegeneration, trauma, autoimmune disease, and infection involves the generation of signaling molecules that are both cell-associated and soluble. Alteration in the permeability of the blood brain barrier, adhesion of blood-borne leukocytes to cerebral vessels, activation of chemoattractants and their receptors, and migration of inflammatory cells into the CNS are events that have been proposed to be regulated by cytokines and reactive oxygen and nitrogen species. In this review we propose associative connections between these events and the molecules involved as they may relate to CNS inflammation, placing illustrative emphasis on multiple sclerosis and the animal model for MS, experimental allergic encephalomyelitis.

FDG-PET appearance of pelvic Castleman's disease

We report a case of Castleman's disease demonstrating 18F-fluorodeoxyglucose (FDG) localization by whole-body PET imaging in a pelvic soft-tissue mass shown on abdominopelvic CT. In this case, there is mild FDG localization within pelvic Castleman's disease with standard uptake values lower than in many cases of low-grade and intermediate-grade lymphomas previously reported. FDG-PET may be of value as an imaging modality for differentiating Castleman's disease from lymphoma.

Repression of MHC class II gene transcription in trophoblast cells by novel single-stranded DNA binding proteins

The maintenance of the fetus during pregnancy has been attributed to the absence of major histocompatibility complex (MHC) class II antigens on fetal trophoblastic cells that make contact with the maternal immune system. However, the mechanism(s) by which class II genes are regulated in trophoblast cells is unclear. We have identified a negative regulatory element (IA alpha NRE) in the promoter of the mouse class II gene IA alpha that represses IA alpha transcription in trophoblast cells. IA alpha NRE, located from-839 to -828, binds transacting factors from rat, mouse and human trophoblast cells, but not from 18 other cell lines tested. These results indicate that IA alpha NRE binding proteins (IA alpha NRE BPs) are conserved in species with hemochordial placentas, and suggest that IA alpha NRE binding activity is restricted primarily to trophoblast cells. Interestingly, the IA alpha NRE BPs bind to the IA alpha NRE antisense strand in a sequence-specific manner. IA alpha NRE represses transcription from the IA alpha promoter in a position-dependent manner, and has a minor down-regulatory effect on the activity of the SV40 promoter/enhancer. Our results demonstrate that MHC class II gene transcription is repressed in fetal trophoblast cells by sequence-specific, single-stranded DNA binding proteins, and suggest a possible mechanism by which the conceptus is protected from immune rejection during pregnancy.

Regulation of gene expression in the nervous system by reactive oxygen and nitrogen species

Reactive oxygen and nitrogen species function as direct and indirect modulators of gene expression through their interactions with transcription factors and also key enzymes in receptor-activated signalling pathways. This regulatory role may become displaced under certain circumstances such as aging, autoimmune responses and viral infection, leading to the pathological outcome associated with inflammatory and degenerative diseases in the CNS.

Inducible nitric oxide synthase and nitric oxide production by oligodendrocytes

It has been previously demonstrated that microglia and astrocytes produce micromolar amounts of nitric oxide in vitro. In this study, we demonstrate that primary rat oligodendrocytes can be stimulated to produce iNOS mRNA as detected by Northern blot and in situ hybridization analysis and a 131-kDa iNOS protein by Western blot analysis; protein was also detected in cells by single- and double-label immunohistochemistry for iNOS and the oligodendrocyte-specific marker CNPase. NO/NOS are produced as a consequence of activation of the gene encoding the inducible nitric oxide synthase as determined by inhibition with actinomycin D and cyclohexamide. The iNOS is functional, leading to calcium/calmodulin-independent NO production in these in vitro cultures.

Neurogenically derived nitrosyl factors mediate sympathetic vasodilation in the hindlimb of the rat

Skeletal muscle vasculature of the hindlimb is innervated by a sympathetic noncholinergic vasodilator system. The aim of this study was to determine whether this vasodilator system may represent postganglionic lumbar sympathetic neurons that synthesize and release nitric oxide (NO) or related NO-containing factors. We examined whether NO synthase (NOS)-positive postganglionic lumbar nerves innervate the hindlimb vasculature of the rat and whether the hindlimb vasodilation produced by electrical stimulation of the lumbar sympathetic chain of anesthetized rats is reduced after the systemic administration of the specific inhibitor of neuronal NOS 7-nitroindazole (7-NI). Subpopulations of lumbar sympathetic cell bodies stained intensely for NOS. Postganglionic fibers and varicosities within the iliac and femoral arteries also stained for NOS. Double ligation of the lumbar chain demonstrated that NOS was transported from the cell bodies toward the peripheral terminals. Low-intensity electrical stimulation of the lumbar chain produced a pronounced hindlimb vasodilation that was markedly diminished by pretreatment with 7-NI (45 mg/kg i.v.). In contrast, the vasodilator potency of acetylcholine and S-nitrosocysteine were augmented by 7-NI. These results suggest that postganglionic lumbar sympathetic neurons may synthesize and release NO-containing factors.

Nitric oxide synthase type II expression by different cell types in MHV-JHM encephalitis suggests distinct roles for nitric oxide in acute versus persistent virus infection

Intranasal inoculation with mouse hepatitis virus strain JHM (MHV-JHM) results in acute meningoencephalitis. We found NOS II mRNA expression in brains of acutely infected animals on days 5 through 7 after infection. In situ hybridization and immunohistochemistry demonstrated NOS II message and protein in infiltrating macrophages. Persistent infection with MHV-JHM results in chronic demyelinating encephalomyelitis. NOS II mRNA was detected in persistently infected spinal cords. In situ hybridization and immunohistochemistry showed expression of NOS II in astrocytes in and around demyelinated lesions. These results suggest the role of NO release in acute versus persistent infection with this virus, and its contribution to the resulting pathology, may be different.

Comparison of transtracheal and extravascular Doppler determinations of stroke volume and cardiac output at various states of volume loading in piglets

OBJECTIVE

To assess the applicability of a new technology in neonates. Transtracheal Doppler and extravascular Doppler determinations of stroke volume and cardiac output were compared with thermodilution measurements at various states of volume loading in an animal model.

DESIGN

Prospective, descriptive study.

SETTING

Animal research laboratory at a university medical center.

SUBJECTS

Fourteen newly weaned piglets, weighing 2.8 to 6.5 kg.

INTERVENTIONS

Doppler probes were placed on the endotracheal tube tip (transtracheal Doppler) and directly on the aortic adventitia (extravascular Doppler). A 4-Fr thermodilution catheter was inserted in the pulmonary artery. Stroke volume and cardiac output determinations were recorded at baseline, after a 15-mL/kg volume load and after successive 15-mL/kg blood withdrawals to exsanguination or a systolic blood pressure of < 20 mm Hg.

MEASUREMENTS AND MAIN RESULTS

Transtracheal and extravascular Doppler measurements of cardiac output were not significantly different from thermodilution at any physiologic state. These techniques were able to measure stroke volumes and cardiac outputs at the low levels seen in severe hemorrhagic shock.

CONCLUSIONS

Transtracheal Doppler and extravascular Doppler measurements of cardiac output compare favorably with thermodilution. These methods effectively followed trends from alterations in intravascular volume, even at very high heart rates and small stroke volumes. Transtracheal Doppler and extravascular Doppler should yield useful information in critically ill neonatal patients, where data regarding stroke volume and cardiac output may be useful in clinical management.

Activation of multiple transcription factors and fos and jun gene family expression in cells exposed to a single electric pulse

We report that exposure of cells to a single electric pulse (250-1250 V/cm) results in the rapid and persistent activation of the DNA binding activities of a number of transcription factors, including AP-1, SP1, AP-2, and NF-kappa B, and the transient expression of select members of the fos and jun gene families. Induction of gene expression occurs primarily at the level of transcription, although c-jun expression also appears to be regulated posttranscriptionally. Interestingly, maximal induction of gene expression is detected at electrical field strengths that do not result in pore formation in the plasma membrane and that do not significantly affect cell viability. Exposure of cells to electric pulses does not result in the activation of HSF1 DNA binding activity, or the induction of hsp70 or p53 protein synthesis, indicating that the induction of fos and jun gene expression is not coincident with protein or DNA damage. The results of these studies suggest that electrical pulses may represent a novel mechanism for inducing the activities of multiple transcription factors and the expression of select members of the fos and jun gene families.

Comparative antimicrobial activity and spectrum of CP-99,219, a novel fluoroquinolone, tested against ciprofloxacin-resistant clinical isolates

The fluoroquinolones have an established role in treatment of infection with aerobic gram negative rods. The increased importance of gram positive nosocomial infection and of acquired fluoroquinolone resistance has stimulated a search for new compounds with enhanced potency and spectrum. CP-99,219 is a novel compound in this class with enhanced activity against gram positive organisms. We have studied the activity of CP-99,219 relative to ciprofloxacin, fleroxacin, ofloxacin, and sparfloxacin using test panels of organisms with a high proportion of ciprofloxacin resistance. CP-99,219 is more potent than any of the other four compounds against both gram positive and gram negative bacteria. The activity of CP-99,219 against many bacteria resistant to the established agents, warrants further in vitro and clinical studies.

Schoolchildren have similar predicted prevalences of inadequate intakes as toddlers in village populations in Egypt, Kenya, and Mexico

OBJECTIVES

To examine the probability of inadequacy of schoolchild nutrient intakes; to compare the predicted adequacy of schoolchild diets to previously published data for toddler diets and to examine the relative adequacy of the diets of sibling pairs.

DESIGN

Food consumption data were measured 2 days per month across approximately one year. Mean nutrient intakes were calculated and compared to international standards using a probability approach.

SETTING

Villages in Egypt, Kenya, and Mexico.

SUBJECTS

285 school-age children (7-9 years of age) and 255 toddlers (18-30 months of age) including 94 sibling pairs.

RESULTS

Within a country, there was a striking similarity between the nutrients predicted to be inadequate in schoolchild and toddler diets across all nutrients except vitamin B12, which was more likely to be inadequate among schoolchildren. Nutrients of concern for both ages in one or more countries included iron, zinc, calcium, riboflavin, and vitamins B12, D, E, and A. For 94 toddler-schoolchild pairs, siblings at high risk of nutrient inadequacy could be identified from an indicator child with a sensitivity of 43-100% and a specificity of 59-100%.

CONCLUSIONS

Nutrient adequacy tends to be a household characteristic for these two ages of children. Nutritional interventions that target the household have a high probability of benefitting multiple age groups of children.

Cloning and subcellular localization of human mitochondrial hsp70

We report the cloning, nucleotide sequence, and localization of mitochondrial hsp70, a member of the human hsp70 multi-gene family. The human mthsp75 gene was cloned by screening an expression library with monoclonal antibody 3A3 that recognizes three members of the human hsp70 family (hsp70, hsc70, and a 75-kDa protein with characteristics identical to that previously established for mitochondrial hsp70). The identity of the 75-kDa protein was confirmed by subcellular fraction of HeLa cells and the demonstration that the 3A3-reactive 75-kDa protein co-fractionates with mitochondrial localized proteins. The nucleotide sequence of the respective cDNA clone revealed an open reading frame of 679 amino acids with extensive sequence identity with members of the human hsp70 family. The derived amino-terminal pre-sequence shares features common to other mitochondrial targeting sequences. The identity of the cDNA was unequivocally established by introduction of an epitope-tag at the carboxyl terminus of the cloned gene, transfection and analysis by immunofluorescence. The tagged 75-kDa protein localizes to mitochondria, thus providing conclusive evidence that it corresponds to the human mitochondrial hsp70, referred to here as mthsp75.

Small subclass of rat olfactory neurons with specific bulbar projections is reactive with monoclonal antibodies to the HSP70 heat shock protein

As part of a study of turnover of rat olfactory receptor neurons we have been examining immunohistochemical expression of members of the 70 kD heat shock protein (HSP70) family in the olfactory epithelium. Expression of HSP70 family members is up-regulated in many cells following exposure to physiologically stressing conditions. Because dying neurons are likely to undergo some sort of physiological stress before the onset of frank degeneration, we hoped that anti-HSP70 monoclonal antibodies would prove to be useful markers for early stages of olfactory neuron cell death. Two anti-human HSP70 monoclonal antibodies were used, Mabs 2A4 and 3a3. Two-dimensional gel electrophoresis/western blot analysis indicates that these Mabs are reactive with the HSC70 and HSP70 members of the rat HSP70 family. Immunohistological observations show that both Mabs are strongly reactive with a widely dispersed subpopulation of olfactory receptor neurons. Morphological, immunohistological, and autoradiographic birthdating analyses demonstrate that reactive cells are fully mature receptor neurons. Their reactivity, however, does not appear to be stress-related. More significantly, axons of reactive neurons show intense anti-2A4 reactivity. This has allowed us to trace these axons to their target glomeruli in the olfactory bulb, demonstrating that the reactive neurons project to just one to two glomeruli on either side of each bulb via consistent and predictable pathways. This is the first subpopulation of olfactory receptor neurons to be traced to such a small number of glomeruli. Given this extremely small number, it seems likely that the reactive receptor cell subpopulation serves some specific olfactory function. In addition, axonal 2A4 reactivity should also prove useful in defining the relative roles of receptor neurons and glomeruli in the establishment of epithelial-glomerular connections.

Cefquinome (HR 111V). In vitro evaluation of a broad-spectrum cephalosporin indicated for infections in animals

Cefquinome (formerly HR 111V), an aminothiazolyl cephalosporin, was compared with cefepime, cefpirome, cefotaxime, and ceftazidime against 681 clinical cultures and a challenge set of bacteria with well-characterized resistance mechanisms. Cefquinome minimum inhibitory concentrations (MIC90) for the enterobacteriaceae ranged from < or = 0.12-2 micrograms/ml with the highest MIC (4 micrograms/ml) obtained among Citrobacter freundii, Enterobacter cloacae, and Providencia stuartii strains. A total of 90% of the Pseudomonas aeruginosa were inhibited by cefquinome at < or = 8 micrograms/ml. Cefquinome activity of particular note for Gram-positive isolates included Corynebacterium jeikeium (MIC90, 8 micrograms/ml) and enterococci (MIC50, 4-8 micrograms/ml). Oxacillin-resistant Staphylococcus aureus was 32-fold less susceptible (MIC90, 16 micrograms/ml) to cefquinome than oxacillin-susceptible (MIC90, 0.5 micrograms/ml) strains. Cefquinome was very potent against fastidious isolates such as Moraxella catarrhalis (MIC90, 0.25-2 micrograms/ml); Haemophilus influenzae (MIC90, 0.06-1 micrograms/ml), Neisseria gonorrhoeae (MIC90, 0.06-0.5 micrograms/ml), and Streptococcus species (MIC90, < or = 0.03-006 micrograms/ml). When tested against organisms possessing Bush group 2 enzymes (including extended spectrum beta-lactamases), cefquinome remained active (MIC, < or = 8 micrograms/ml) against the majority of strains. This compound should be very active against pathogens generally found in animal infections and possesses a potency and spectrum comparable to the "fourth-generation" cephalosporins (cefepime and cefpirome) being investigated for human infectious diseases.

Deficient induction of human hsp70 heat shock gene transcription in Y79 retinoblastoma cells despite activation of heat shock factor 1

One of the basic features of the inducible heat shock response is the activation of heat shock factor which results in the rapid transcriptional induction of the heat shock genes. Although it is widely considered that the heat shock response is ubiquitous, several reports have indicated that the transcriptional response can vary in both intensity and kinetics and often in a tissue-specific manner. Of interest have been studies on the expression of heat shock genes in the brain, particularly observations that certain cultured neuronal cells exhibit a diminished heat shock response. We demonstrate that transcription of the gene encoding a 70-kDa heat shock protein (hsp70) is diminished upon heat shock in Y79 human retinoblastoma cells (which are of neuronal origin) despite both the activation of heat shock factor 1 and induced transcription of another heat shock gene, hsp90 alpha. This uncoupling of stress-induced transcription of the hsp70 and hsp90 alpha genes, which are typically coordinately regulated in response to stress, appears to be due to the selective inability of trans-acting factors, including heat shock factor 1, to bind in vivo to the hsp70 promoter as the result of a chromatin-mediated effect.

Transtracheal Doppler in infants and small children following surgery for congenital heart disease: rational use of an improved technology

OBJECTIVE

To compare measurements of cardiac output utilizing an improved transtracheal Doppler technology with measurements obtained using two-dimensional echocardiography.

DESIGN

Prospective, descriptive study.

SETTING

Cardiovascular intensive care unit at a university medical center.

PATIENTS

Fourteen children ranging in age from 14 days to 3 yrs (mean 1.3 +/- .97 yrs) following surgery for complex congenital heart disease.

INTERVENTIONS

Simultaneous cardiac output determinations using transtracheal Doppler and two-dimensional echocardiography were compared. Cardiac output was determined using measurement of blood velocity and diameter of the ascending aorta following surgery. Direct aortic diameter measurements made at operation were compared with measurements obtained by transtracheal Doppler, two-dimensional echocardiography and angiography.

RESULTS

The mean difference in aortic root diameter between measurements made directly at operation and transtracheal Doppler was 5%, compared with 13% by two-dimensional echocardiography, and 21% by angiography, a significant difference by analysis of variance (F[3,31],p < .007). Post hoc comparisons demonstrated significant (p < .05) differences between echocardiography and angiographic aortic diameters. The mean difference between transtracheal Doppler and echocardiographic determination of cardiac output was 10.9% (t[10] = -1.37, p = .007).

CONCLUSIONS

An improved transtracheal Doppler technology compares favorably with echocardiographic determination of cardiac output in infants and young children. This improved technology may provide a useful means to assess cardiac output and may allow titration of therapy in critically ill infants and children.

Characterization of constitutive HSF2 DNA-binding activity in mouse embryonal carcinoma cells

Two distinct murine heat shock transcription factors, HSF1 and HSF2, have been identified. HSF1 mediates the transcriptional activation of heat shock genes in response to environmental stress, while the function of HSF2 is not understood. Both factors can bind to heat shock elements (HSEs) but are maintained in a non-DNA-binding state under normal growth conditions. Mouse embryonal carcinoma (EC) cells are the only mammalian cells known to exhibit HSE-binding activity, as determined by gel shift assays, even when maintained at normal physiological temperatures. We demonstrate here that the constitutive HSE-binding activity present in F9 and PCC4.aza.R1 EC cells, as well as a similar activity found to be present in mouse embryonic stem cells, is composed predominantly of HSF2. HSF2 in F9 EC cells is trimerized and is present at higher levels than in a variety of nonembryonal cell lines, suggesting a correlation of these properties with constitutive HSE-binding activity. Surprisingly, transcription run-on assays suggest that HSF2 in unstressed EC cells does not stimulate transcription of two putative target genes, hsp70 and hsp86. Genomic footprinting analysis indicates that HSF2 is not bound in vivo to the HSE of the hsp70 promoter in unstressed F9 EC cells, although HSF2 is present in the nucleus and the promoter is accessible to other transcription factors and to HSF1 following heat shock. Thus trimerization and nuclear localization of HSF2 do not appear to be sufficient for in vivo binding of HSF2 to the HSE of the hsp70 promoter in unstressed F9 EC cells.

Health behaviors and survival among middle-aged and older men and women in the NHANES I Epidemiologic Follow-up Study

BACKGROUND

Since the 1960s there has been a decline in mortality rates for older U.S. adults, suggesting the importance of examining the role of prevention and health promotion in improving the health and survival of older adults. Epidemiologic studies of age and gender differences in the impact of health behaviors on survival for older U.S. adults are needed to provide information for intervention and health promotion efforts for older Americans.

METHODS

We examined whether health behavior risk factors (smoking, drinking, physical activity, and body weight) for mortality vary by age and gender among 6,109 adults 45-74 years old in the National Health and Nutrition Examination Survey 1971-1975 (NHANES I) who were traced during the 1982-1984 NHANES I Follow-up Survey.

RESULTS

For middle-aged men (45-54 years old) and for older men (65-74 years old), both smoking and nonrecreational physical activity were predictors of survival time. Additionally, for older men, drinking and low body mass index were associated with shorter survival time. Among women, there was less consistency of associations across age groups. As with men, nonrecreational physical activity and low body mass index were associated with shorter survival among older women.

CONCLUSIONS

These findings suggest that health behaviors are associated with survival in older adults as well as in middle-aged adults, although the specific behavioral risk factors may vary by age and gender.

Estimated vitamin intakes of toddlers: predicted prevalence of inadequacy in village populations in Egypt, Kenya, and Mexico

Vitamin intakes of 255 toddlers (aged 18-30 mo) were estimated from food consumption recorded during 1 y at sites in Egypt, Kenya, and Mexico. Mean intakes were compared with requirements standards by using a probability approach to estimate the prevalence of inadequate intakes. There were predicted inadequacies for vitamin A (32%) and riboflavin (20%) in Egypt, vitamins A (68%) and C (63%) and riboflavin (52%) in Mexico, and vitamin B-12 (44%) in Kenya. Vitamin E was inadequate in all diets, but in relation to polyunsaturated fatty acids only the intake in Mexico was low. No diet provided the recommended amount of vitamin D, but its dietary requirement is uncertain. Correlations among nutrient intakes suggest factors that may contribute to reported associations of consumption of animal products with improved growth or development among these children: provision of vitamin B-12 and available minerals, displacement of fiber and phytate-rich energy sources, and increased energy density.

Changes in energy intakes during pregnancy and lactation in a national sample of US women

Increases in energy intakes during pregnancy and lactation were evaluated by examining dietary data for 458 pregnant women who participated in the Continuing Surveys of Food Intakes by Individuals conducted in 1985 and 1986. Energy intakes were well below recommendations during all reproductive states; however, increases during pregnancy approximated recommendations, while increases during lactation were low. Postpartum non-lactating intakes did not return to prepregnancy levels for Black women or women with lower incomes.

Activation of heat shock gene transcription by heat shock factor 1 involves oligomerization, acquisition of DNA-binding activity, and nuclear localization and can occur in the absence of stress

The existence of multiple heat shock factor (HSF) genes in higher eukaryotes has promoted questions regarding the functions of these HSF family members, especially with respect to the stress response. To address these questions, we have used polyclonal antisera raised against mouse HSF1 and HSF2 to examine the biochemical, physical, and functional properties of these two factors in unstressed and heat-shocked mouse and human cells. We have identified HSF1 as the mediator of stress-induced heat shock gene transcription. HSF1 displays stress-induced DNA-binding activity, oligomerization, and nuclear localization, while HSF2 does not. Also, HSF1 undergoes phosphorylation in cells exposed to heat or cadmium sulfate but not in cells treated with the amino acid analog L-azetidine-2-carboxylic acid, indicating that phosphorylation of HSF1 is not essential for its activation. Interestingly, HSF1 and HSF2 overexpressed in transfected 3T3 cells both display constitutive DNA-binding activity, oligomerization, and transcriptional activity. These results demonstrate that HSF1 can be activated in the absence of physiological stress and also provide support for a model of regulation of HSF1 and HSF2 activity by a titratable negative regulatory factor.

Variation in late potentials and the reproducibility of their measurement

The usefulness of a test depends on its reproducibility. This determines how closely the test result indicates the actual pathophysiologic state, how well it will predict that state in the future, and if interventions or further pathologic changes are reflected by the test. There is a variation in the parameters of the signal-averaged ECG, more so with spectral than with time domain measurements. These must be accounted for when estimating risk. If one presumes that risk is proportional to the extent of abnormality, then the variation in measurements simply means that only borderline cases can potentially be miscategorized. More important, the lack of reproducibility of measurements made from the signal-averaged ECG indicates that changes noted in an individual after an intervention, such as a surgical intervention, must be viewed with a jaundiced eye. Group changes are perhaps meaningful, and indicate a physiologic effect, but clinical decisions cannot be made unless the changes observed in an individual patient exceed the confidence limits of expected variation. There has been debate as to the usefulness of measurements made from the signal-averaged ECG in predicting antiarrhythmic drug effects (the effect of drugs is discussed elsewhere in this symposium). Here an analogy must be made to the suppression of asymptomatic ventricular ectopy. First, we cannot make a statement that there has been a drug effect unless the parameter measured changes beyond the confidence limits of normal variation or reproducibility. Second, we cannot translate a change in a measurement into a change in risk for arrhythmic events without subjecting that hypothesized relationship to a long-term placebo-controlled clinical trial, albeit acute electrophysiologic trials correlating changes in the signal-averaged ECG to ventricular tachycardia induction provide some insight. And perhaps the relationship must be tested independently for each drug assessed. In the same regard, there is much excitement about the benefits of thrombolytic therapy, but when diagnosing benefit to the individual patient we have to remember the lack of reproducibility of the measurements and also keep in mind that an improved signal-averaged ECG cannot be translated into an improved prognosis without long-term controlled studies. In summarizing the variation and reproducibility of measurements made from the signal-averaged ECG we avoided providing more than a sense of the extent of variation expected because precise confidence intervals depend on the particular techniques used to make the measurements.(ABSTRACT TRUNCATED AT 400 WORDS)

Demographic and economic factors associated with dietary quality for adults in the 1987-88 Nationwide Food Consumption Survey

Data for 5,884 adults (19 years of age and older) who participated in the 1987-88 Nationwide Food Consumption Survey (1987-88 NFCS) were used to investigate demographic and economic factors associated with dietary quality. Although the low response rate for the 1987-88 NFCS has raised concerns about possible bias, it is appropriate to use this extensive data set for analyses that do not attempt to generalize the results to the US population as a whole. Two aspects of quality were calculated for the mean of the 3-day reported intakes: number of nutrients below two thirds of the 1989 Recommended Dietary Allowance (RDA) (low-intake nutrients) and percent of energy from fat. Few adults reported mean intakes that met suggested guidelines: 22% of diets were above two thirds of the RDA for all 15 nutrients and 14% were below 30% fat, but only 2% met both criteria. Energy intake was a strong negative predictor of number of low-intake nutrients and a weak positive predictor of percent of energy from fat. Results of multivariate regression analyses identified few demographic or economic predictors of either the number of low-intake nutrients or percent of energy from fat. According to these data, diets of most adults do not conform to current dietary guidelines. Nutrition education efforts should be directed to all adults, and research should be undertaken to determine more effective ways to help adults improve their overall dietary quality.

Estimated mineral intakes of toddlers: predicted prevalence of inadequacy in village populations in Egypt, Kenya, and Mexico

Intakes of minerals and factors that might affect their bioavailability were estimated for 255 toddlers aged 18-30 mo living in villages in Egypt, Kenya, and Mexico. Mean intakes over 1 y were compared with international-requirement estimates by using a probability approach. The prevalence of iron intakes likely to be inadequate to prevent anemia was estimated as 35% in Egypt, 13% in Kenya, and 43% in Mexico. The prevalence of zinc intakes likely to be inadequate to meet basal requirements was estimated as 57% and 25% in Kenya and Mexico, respectively, but only 10% in Egypt, where the use of yeast-leavened breads was judged to have improved zinc availability. There was no suggestion that estimated copper or magnesium intakes were inadequate, but calcium intakes in Kenya and Egypt were well below recommended amounts. Studies of factors affecting mineral bioavailability in the diets of these countries' populations could suggest dietary changes that might improve effective mineral intake with minimal cost.

The human heat shock protein hsp70 interacts with HSF, the transcription factor that regulates heat shock gene expression

Transcriptional regulation of the human hsp70 gene in response to heat shock and other forms of physiological stress occurs through the activation of heat shock transcription factor (HSF). Exposure of cells to a heat shock temperature of 42 degrees C results in transient activation of HSF; its DNA-binding activity increases rapidly, plateaus, and attenuates, during which the intracellular levels of hsp70 increase. In an effort to understand whether HSF is regulated negatively by hsp70, we have examined whether HSF associates with hsp70. We show that activated HSF associates with hsp70 and that the interaction is detected as the levels of hsp70 increase in the cell. Addition of ATP and other hydrolyzable nucleotides results in the dissociation of hsp70 from HSF while nonhydrolyzable nucleotide analogs do not disrupt the complex. We demonstrate that exogenous recombinant wild-type hsp70 can associate with activated HSF, whereas no association is observed with an amino-terminal or a carboxy-terminal deletion mutant of hsp70. We also show that hsp70 blocks the in vitro activation of HSF from its cryptic non-DNA-binding state to a DNA-binding form; this inhibitory effect of hsp70 is abolished by ATP. We suggest that hsp70 may negatively regulate the activation of HSF.

Estimated protein intakes of toddlers: predicted prevalence of inadequate intakes in village populations in Egypt, Kenya, and Mexico

This paper presents a probability assessment of the adequacy of protein intakes of toddlers (aged 18-30 mo) in study communities in Egypt, Kenya, and Mexico judged in relation to FAO/WHO/UNU estimates of requirements. Effects of supplementing amino acid intakes, or of assuming lower bioavailability for lysine are also considered. In Egypt and Mexico existing protein intakes of toddlers were adequate. In Kenya existing intakes were marginal. Total protein intake was low and often lysine or tryptophan concentration was low. If Kenyan intakes met estimated energy requirements, protein intakes would be adequate. We conclude that protein intake is unlikely to be a primary limiting factor for toddler growth and development, and the benefit to be expected from increasing the intake of limiting amino acids is marginal. Reported associations of animal-source protein and energy with growth, size, and psychologic function of these toddlers are unlikely to be causally attributable to inadequacy of protein intakes.

Age and sex differences in variation of nutrient intakes among U.S. adults

Studies assessing associations of diet with health frequently use multi-day dietary records to estimate usual dietary intakes. We examined variation in intakes of 13 nutrients for 13,388 U.S. adults using 3 days of dietary data from the 1977-1978 Nationwide Food Consumption Survey. Ratios of within-person variability to between-person variability in intakes were large and would result in attenuated linear regression estimates of diet-health associations. For many nutrients, the magnitude of the attenuation decreased with age for both sexes but particularly for men, implying that fewer days of dietary intake per person would correctly assess diet-health associations among older adults than have been suggested for younger adults.

Evaluation of auditory brain-stem response in full-term infants of cocaine-abusing mothers

The purpose of this study was to examine the association between perinatal cocaine exposure and the prevalence of hearing deficit in the newborn. Auditory brain-stem response testing was performed on 50 infants of cocaine-abusing mothers and 50 control infants. All infants were born at full term. Cocaine-exposed infants had lower birth weights and a greater incidence of maternal tobacco and alcohol use. No differences were found in size, method of delivery, Apgar scores, or use of other illicit substances. Four infants of cocaine-abusing mothers and two control infants failed initial auditory brain-stem response testing. There were no differences in absolute or interpeak latencies of waveforms noted between the two groups. These data suggest that there is no increased incidence of hearing deficit as determined by auditory brain-stem response in newborns of cocaine-abusing mothers born at term and without other risk factors.

Living arrangements and dietary quality of older U.S. adults

The association between living arrangement and dietary quality of older U.S. adults was investigated in 4,402 adults aged 55 years or older who participated in the Nationwide Food Consumption Survey, 1977 to 1978. Dietary quality was based on percent of Recommended Dietary Allowances for 3-day intakes of nine nutrients. More men living alone consumed a poor-quality diet than did men living with a spouse, particularly those 75 years or older; for women, this effect was seen only in the 55- to 64-year-old group. In general, more women than men had poor-quality diets. A number of factors (economic, employment, health status, energy intake, body mass index, and nutrient supplement use) were examined for their importance in accounting for differences in dietary quality of older men and women living alone compared with those living with a spouse. Energy intake was the most important variable accounting for the association of living arrangement with dietary quality. Evidence indicated that older adults living alone did not make poorer food choices than those living with a spouse, but rather that they consumed fewer calories.