[Expression of melanoma-associated antigen-C2 in breast cancers and mechanism]

Objective: To analyze the expression pattern, mechanism and clinical significance of melanoma-associated antigen-C2 (MAGE-C2) in tumor-free breast specimens, breast benign disease specimens and breast cancer specimens. Methods: Reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry were used to investigate the expressions of MAGE-C2 in 60 tumor-free breast specimens, 60 breast benign disease specimens and 60 breast cancer specimens. The correlation of MAGE-C2 expression with clinicopathological parameters and prognosis of breast cancer patients were analyzed. The expression of MAGE-C2 was also detected by RT-PCR in breast cancer cell MCF-7 and MDA-MB-231 treated with DNA methylase inhibitor 5-aza-2'-deoxycytidine (5-aza-CdR) and histone deacetylase inhibitor trichostatin A (TSA). Results: The positive expression rates of MAGE-C2 mRNA and protein were 61.7% (37/60) and 58.3% (35/60) in breast cancer specimens, respectively, while negative expressed in breast and begin disease specimens. MAGE-C2 protein expression was associated with tumor grade, histological type and blood vessel invasion of breast cancer patients (P<0.05). The incidence of recurrence-free survival of patients with positive MAGE-C2 expression were lower than that of patients with negative MAGE-C2 expression (P<0.05). Multivariate Cox regression analysis showed that the clinical stage (P<0.01), lymph node metastasis (P<0.05) and MAGE-C2 expression (P<0.05) were the independent prognostic factors of breast cancer patients. The MAGE-C2 mRNA was not observed in the control and TSA treated breast cancer cells while upregulated in the 5-aza-CdR treated cells. Besides, 5-aza-CdR combined with TSA further enhanced MAGE-C2 mRNA level in breast cancer cells (P<0.05). Conclusions: MAGE-C2 is one of the tumor-specific antigen and its expression is related with the poor prognosis of breast cancer patients. DNA methylation and histone acetylation may be an important regulation mechanism of MAGE-C2 gene expression.

Selection and implementation of single nucleotide polymorphism markers for parentage analysis in crossbred cattle population

Crossbreeding is an essential way of improving herd performance. However, frequent parentage record errors appear, which results in the lower accuracy of genetic parameter estimation and genetic evaluation. This study aims to build a single nucleotide polymorphism (SNP) panel with sufficient power for parentage testing in the crossbred population of Simmental and Holstein cattle. The direct sequencing technique in PCR products of pooling DNA along with matrix-assisted laser desorption/ionization time-of-flight MS method for genotyping the individuals was applied. A panel comprising 50 highly informative SNPs for parentage analysis was developed in the crossbred population. The average minor allele frequency for SNPs was 0.43, and the cumulative probability of exclusion for single-parent and both-parent inference met 0.99797 and 0.999999, respectively. The maker-set for parentage verification was then used in a group of 81 trios with aid of the likelihood-based parentage-assignment program of Cervus software. Reconfirmation with on-farm records showed that this 50-SNP system could provide sufficient and reliable information for parentage testing with the parental errors for mother-offspring and sire-offspring being 8.6 and 18.5%, respectively. In conclusion, a set of low-cost and efficient SNPs for the paternity testing in the Simmental and Holstein crossbred population are provided.

Abstract WMP8: Results of Trevo Acute Ischemic Stroke Thrombectomy Registry: Predictors of Clinical Outcome

Background and Purpose: Recent randomized clinical trial (RCTs) demonstrated efficacy of mechanical thrombectomy using stent-retrievers in acute ischemic stroke (AIS) patients. The main purpose of TRevo ACute Ischemic StroKe (TRACK) stent-retriever thrombectomy multicenter registry is to demonstrate safety and efficacy in real life clinical practice.

Methods: The investigator-initiated TRACK multicenter registry recruited 24 sites in north America to submit demographic, clinical, site-adjudicated angiographic, and outcome data on consecutive AIS patients treated with Trevo stent-retriever device as the first treatment option. Standard clinical safety (symptomatic intracranial hemorrhage (sICH), and mortality) and efficacy (revascularization and disability) outcomes and predictors of clinical outcome were analyzed.

Results: 624 patients were enrolled in the TRACK registry. Median age was 68 years (range 16-94, 118 (18.1%) >80), male gender was 51.4%, and 67.7% were white. The median National Institutes of Health Stroke Severity Scale (NIHSS) was 17 (IQR 13-22). Transfer cases were 50.6% with IV-rtPA use in 318 cases (51.3%). Median onset to groin puncture (OTG) time was 283 min (IQR 198.5-443), and groin puncture to revascularization was 66 min (IQR 37.5-103). Anterior circulation occlusion was 86.2% (MCA/M2 in 55.2% followed by ICA in 15.9% and M2 in 12.7%). Use of GA was in 389 cases (62.3%), number of passes were ≤ 3 in 92% of the cases (1: 45.2%, 2:28%, and 3:18.7%), 291 (46.7%) had BGC use. Rescue use was seen in 21.7%. Revascularization of ≥ TIMI 2 was 81.8% and ≥ TICI 2b was 70%. The primary outcome of mRS of ≥ 2 was 48.3% in the full cohort, and 50.6% in TREVO-2 like group. sICH and mortality were 7.2%, and 20.1% in the full cohort vs 6.9% and 17.5% in the TREVO-2 like group, respectively. The independent predictors of clinical outcome were lower baseline NIHSS, younger age, use of BGC, successful recanalization, and no general anesthesia (GA).

Conclusions: The real life clinical practice Trevo registry demonstrated good clinical outcome and high rate of recanalization. Younger age, lower baseline NIHSS, use of balloon guide catheter, successful recanalization, and avoiding endotrachaeal GA independent predictors of good clinical outcome.

Aquaporin-3 Inhibition Reduces the Growth of NSCLC Cells Induced by Hypoxia

Background/Aims: Non-small cell lung cancer (NSCLC) is the leading cause of death worldwide. Although aquaporin-3 (AQP3) is widely distributed in mammalian tissues and over-expressed in NSCLC cells, there are limited studies on the effects of AQP3 knockdown on NSCLC cells under hypoxic conditions. Methods: The CCK-8 assay was used to calculate cell viability. Scratch-wound healing and transwell assays were used to detect cell migration and invasion. Apoptotic cells were measured by the TUNEL assay. mRNA expression levels were calculated via quantitative RT-PCR. Relative protein levels were determined by immunoblot assays. Results: AQP3 knockdown substantially reduced proliferation, migration, and invasion of A549 and NCI-H460 cells under hypoxic conditions. Moreover, AQP3 knockdown clearly induced cell apoptosis. Further analysis identified levels of HIF-1α, VEGF, Raf, phosphor-MEK, and phosphor-ERK, whose activities were significantly attenuated in the AQP3 knockdown group. Conclusions: These findings indicate that AQP3 knockdown retards the growth of NSCLC cells partially through inhibiting HIF-1α/VEGF and Raf/MEK/ERK signalling pathways.

Coping Strategy and Caregiver Burden Among Caregivers of Patients With Dementia

BACKGROUND

This study aims to examine whether coping strategies employed by caregivers are related to distinct symptoms of patients with dementia and to investigate the associations between burden and coping among caregivers of patients with dementia.

METHODS

A cross-sectional study design was used. A total of 57 caregivers of patients with dementia were enrolled. Coping strategies were assessed using the Ways of Coping Checklist, and burden was assessed using the Chinese version of Caregiver Burden Inventory. Correlations between coping and patients' behavior or memory problems were examined. Severities of behavior and memory problems were adjusted to examine the correlations between caregiver burden and coping strategies.

RESULTS

The patients' disruptive behavior problems were associated with avoidance, and depression problems were associated with avoidance and wishful thinking. After adjusting for severity of behavior problems, coping strategies using avoidance were positively correlated with caregiver burden.

CONCLUSIONS

Emotion-focused coping strategies are a marker of caregiver burden.

Design of charge exchange recombination spectroscopy for the joint Texas experimental tokamak

The old diagnostic neutral beam injector first operated at the University of Texas at Austin is ready for rejoining the joint Texas experimental tokamak (J-TEXT). A new set of high voltage power supplies has been equipped and there is no limitation for beam modulation or beam pulse duration henceforth. Based on the spectra of fully striped impurity ions induced by the diagnostic beam the design work for toroidal charge exchange recombination spectroscopy (CXRS) system is presented. The 529 nm carbon VI (n = 8 - 7 transition) line seems to be the best choice for ion temperature and plasma rotation measurements and the considered hardware is listed. The design work of the toroidal CXRS system is guided by essential simulation of expected spectral results under the J-TEXT tokamak operation conditions.

Edge impurity rotation profile measurement by using high-resolution ultraviolet/visible spectrometer on J-TEXT

An upgrade of the edge rotation diagnostic system is achieved by increasing the number of viewing channels to 17 on J-TEXT tokamak. With the upgrade, the spatial resolution reaches 1 cm. The bulk plasma is used as the calibration light source. And the toroidal velocity profile of C V (carbon V) at edge region is obtained by using a spatial deconvolution technique. The valid measurement region is at ρ = 0.6-0.9, corresponding to the emitting region of C V. The preliminary experimental results express that the velocity of plasma may have a zero point near ρ = 0.85.

Improvement of the edge rotation diagnostic spectrum analysis via simulation

The edge rotation diagnostic (ERD) system has been developed on the Joint Texas Experimental Tokamak to measure the edge toroidal rotation velocity by observing the shifted wavelength of carbon V (C V 227.09 nm). Since the measured spectrum is an integrated result along the viewing line from the plasma core to the edge, a method via simulation has been developed to analyze the ERD spectrum. With the necessary parameters such as C V radiation profile and the ion temperature profile, a local rotation profile at the normalized minor radius of 0.5-1 is obtained.

Upgrade of absolute extreme ultraviolet diagnostic on J-TEXT

The absolute extreme ultraviolet (AXUV) diagnostic system is used for radiation observation on J-TEXT tokamak [J. Zhang, G. Zhuang, Z. J. Wang, Y. H. Ding, X. Q. Zhang, and Y. J. Tang, Rev. Sci. Instrum. 81, 073509 (2010)]. The upgrade of the AXUV system is aimed to improve the spatial resolution and provide a three-dimensional image on J-TEXT. The new system consists of 12 AXUV arrays (4 AXUV16ELG arrays, 8 AXUV20ELG arrays). The spatial resolution in the cross-section is 21 mm for the AXUV16ELG arrays and 17 mm for the AXUV20ELG arrays. The pre-amplifier is also upgraded for a higher signal to noise ratio. By upgrading the AXUV imaging system, a more accurate observation on the radiation information is obtained.

[Improving the accuracy of caregiver-provided in-home total parenteral nutrition care]

BACKGROUND & PROBLEMS

According to current surveys conducted between September and December 2011, the accuracy of primary caregiver-administered Home Total Parenteral Nutrition Care (HTPNC) was 62.0%. Further, nursing staffs provide instruction on HTPNC to only 22.2% of caregivers responsible for administering HTPNC. Main related causes were: (1) difficult to comprehend health education tools; (2) inconsistent nursing guidelines; (3) a lack of relevant standard operating procedures; and (4) poor caregiver adoption of TPN skills.

PURPOSE

This project was developed to (1) increase the accuracy of primary caregiver-administered HTPNC to 90% and (2) increase the percentage of nurse-administered HTPNC to 90%.

RESOLUTIONS

We developed appropriate nursing guidelines, created a health education CD-ROM with input from a cross-disciplinary team and total parenteral nutrition focus group, designed reusable teaching model aids for repetitive practice, and held regular group health education sessions.

RESULTS

The nursing staff HTPNC instruction rate increased to 100%. Caregiver HTPNC implementation accuracy increased to 100% prior to patient discharge.

CONCLUSIONS

This approach was successful in achieving its stated goals. Further, using reusable teaching model aids may reduce caregiver anxiety and increase caregiver confidence. The greatest benefit of this project was its extension of teaching model aids to relevant units, allowing for routine monitoring by the department of nursing quality management.

Personal beliefs, learned resourcefulness, and adaptive functioning in depressed adults

Learned resourcefulness and personal beliefs are significant predictors of adaptive functioning. The mediating effect of personal beliefs on the relationship between learned resourcefulness and adaptive functioning was validated in adults with depression. The findings from this study may provide the basis for developing a useful nursing intervention constituting resourcefulness skills with positive personal beliefs to help patients with depression improve their ability to function well in their daily activities.

ABSTRACT

Research has shown that patients with depression have difficulty with performing daily tasks and meeting their own personal care needs. According to Beck's cognitive theory of depression, such deficits in adaptive functioning are affected by disturbances in specific personal beliefs that reflect the process of regulating cognitions. Rosenbaum's learned resourcefulness theory proposed that adaptive functioning is influenced by learned resourcefulness, while learned resourcefulness is associated with the process regulating cognitions. This study aims to test the mediating effect of personal beliefs on the relationship between resourcefulness and adaptive functioning. The study involved a cross-sectional design. Participants consisted of 187 adults with depression in southern Taiwan. The data were collected through four instruments: Cognitive Triad Inventory, Self-Control Schedule, modified Community Living Skills Scale, and a demographic questionnaire. Both resourcefulness and personal beliefs were significant predictors of adaptive functioning, and personal beliefs mediated the effect of learned resourcefulness on the adaptive functioning of the adults with depression. The results validate the role played by personal beliefs in effecting learned resourcefulness and adaptive functioning among adults with depression and provide direction for designing nursing interventions that consider personal beliefs when teaching resourcefulness skills to adults with depression.

Measurement of the edge plasma rotation on J-TEXT tokamak

A multi-channel high resolution spectrometer was developed for the measurement of the edge plasma rotation on J-TEXT tokamak. With the design of two opposite viewing directions, the poloidal and toroidal rotations can be measured simultaneously, and velocity accuracy is up to 1 km∕s. The photon flux was enhanced by utilizing combined optical fiber. With this design, the time resolution reaches 3 ms. An assistant software "Spectra Assist" was developed for implementing the spectrometer control and data analysis automatically. A multi-channel monochromatic analyzer is designed to get the location of chosen ions simultaneously through the inversion analysis. Some preliminary experimental results about influence of plasma density, different magnetohydrodynamics behaviors, and applying of biased electrode are presented.

Reduction of coil mass artifacts in high-resolution flat detector conebeam CT of cerebral stent-assisted coiling

BACKGROUND AND PURPOSE

Developments in flat panel angiographic C-arm systems have enabled visualization of both the neurovascular stents and host arteries in great detail, providing complementary spatial information in addition to conventional DSA. However, the visibility of these structures may be impeded by artifacts generated by adjacent radio-attenuating objects. We report on the use of a metal artifact reduction algorithm for high-resolution contrast-enhanced conebeam CT for follow-up imaging of stent-assisted coil embolization.

MATERIALS AND METHODS

Contrast-enhanced conebeam CT data were acquired in 25 patients who underwent stent-assisted coiling. Reconstructions were generated with and without metal artifact reduction and were reviewed by 3 experienced neuroradiologists by use of a 3-point scale.

RESULTS

With metal artifact reduction, the observers agreed that the visibility had improved by at least 1 point on the scoring scale in >40% of the cases (κ = 0.6) and that the streak artifact was not obscuring surrounding structures in 64% of all cases (κ = 0.6). Metal artifact reduction improved the image quality, which allowed for visibility sufficient for evaluation in 65% of the cases, and was preferred over no metal artifact reduction in 92% (κ = 0.9). Significantly higher scores were given with metal artifact reduction (P < .0001).

CONCLUSIONS

Although metal artifact reduction is not capable of fully removing artifacts caused by implants with high x-ray absorption, we have shown that the image quality of contrast-enhanced conebeam CT data are improved drastically. The impact of the artifacts on the visibility varied between cases, and yet the overall visibility of the contrast-enhanced conebeam CT with metal artifact reduction improved in most the cases.

Pathway analysis, engineering, and physiological considerations for redirecting central metabolism

The rate and yield of producing a metabolite is ultimately limited by the ability to channel metabolic fluxes from central metabolism to the desired biosynthesis pathway. Redirection of central metabolism thus is essential to high-efficiency production of biochemicals. This task begins with pathway analysis, which considers only the stoichiometry of the reaction networks but not the regulatory mechanisms. An approach extended from convex analysis is used to determine the basic reaction modes, which allows the determination of optimal and suboptimal flux distributions, yield, and the dispensable sets of reactions. Genes responsible for reactions in the same dispensable set can be deleted simultaneously. This analysis serves as an initial guideline for pathway engineering. Using this analysis, we successfully constructed an Escherichia coli strain that can channel the metabolic flow from carbohydrate to the aromatic pathway with theoretical yield. This analysis also predicts a novel cycle involving phosphoenolpyruvate (PEP) carboxykinase (Pck) and the glyoxylate shunt, which can substitute the tricarboxylic acid cycle with only slightly less efficiency. However, the full cycle could not be confirmed in vivo, possibly because of the regulatory mechanism not considered in the pathway analysis.In addition to the kinetic regulation, we have obtained evidence suggesting that central metabolites are involved in specific regulons in E. coli. Overexpression of PEP-forming enzymes (phosphoenolpyruvate synthase [Pps] and Pck) stimulates the glucose consumption rate, represses the heat shock response, and negatively regulates the Ntr regulon. These results suggest that some glycolytic intermediates may serve as a signal in the regulation of the phosphotransferase system, heat shock response, and nitrogen regulation. However, the role of central metabolites in these regulations has not been determined conclusively. (c) 1996 John Wiley & Sons, Inc.

Frontal function, disability and caregiver burden in elderly patients with major depressive disorder

Caregivers of patients with late-life major depressive disorder experience a significant level of general caregiver burden. Disability in patients is possibly one of the origins of caregiver burden. Frontal lobe dysfunction might be the source of disability. This study investigated if frontal lobe dysfunction (body level) of patients with late-life major depressive disorder was associated with their disability (individual level), and if it led to a high level of caregiver burden (societal level). Thirty-four unselected pairs of caregivers and their family members with late-life major depressive disorder were recruited. Frontal Assessment Battery and Timed Instrumental Activities of Daily Living (TIADL) were used to assess patients' frontal function and disability, and Caregiver Burden Inventory was used to measure caregiver burden. Frontal Assessment Battery correlated with TIADL (r= -0.47; p<0.006). TIADL score was also associated with two subscales of the Caregiver Burden Inventory: social (r = 0.38, p=0.026) and time-dependent (r= 0.37, p= 0.033). This study supported the hypothesis that frontal lobe dysfunction in elderly patients with depression is associated with their disability in instrumental activities of daily living. Disability is related to social and time-dependent aspects of caregiver burden. Further studies to examine proposed cognitive interventions are suggested to reduce patient disability and caregiver burden.

[The application of relaxation techniques and biofeedback to an outpatient with depression disorder: a nurse's experience]

This paper reports on a nurse's experience helping alleviate psychosomatic symptoms in a psychiatric outpatient suffering from depression. It was found that the OPD patient had been suffering from depression as well as long-time tension and pain. Between April 10th and July 24th, 2008, the author employed holistic nursing assessment and collected data through both observation and interview. Three major care problems were identified, including ineffective individual coping, chronic pain, and sleep disturbance. Focusing nursing care on relaxation techniques and biofeedback, the author discussed the problems with the patient and then implemented relaxation training and biofeedback training sessions as well as nursing care plans, which averaged 45~60 minutes per time for 8 times. Sessions included interviews, relaxation techniques (e.g., progressive muscular relaxation, meditative relaxation, meditation, music and abdominal breathing) and visual feedback measured by a biofeedback device with a thermistor sensor. During sessions, the patient was clearly motivated to change and participated actively. Furthermore, the patient not only became gradually aware of both the inner feeling of relaxation and etiology of psychosomatic symptoms, but also learned relaxation strategies for coping with life stressors. After therapy, the patient's self-control over relaxation had improved considerably and care problems were resolved satisfactorily. Also, the patient could increasingly incorporate relaxation into daily life routines.

Exploring the burden of the primary family caregivers of schizophrenia patients in Taiwan

AIM

The purpose of the present study was to investigate the burden of the primary family caregivers of schizophrenia patients and the factors that affect caregiver burden.

METHODS

A total of 126 pairs of patients and their primary family caregivers were recruited from the day care and acute wards of two teaching general hospitals. Demographic information was collected. All patients went through an interview with a senior psychiatrist using the Brief Psychiatric Rating Scale (BPRS). The Caregiver Burden Inventory-Brief Version and the Chinese Health Questionnaire (CHQ) were used to assess the caregiver burden and the caregivers' health condition. One-way analysis of variance and Pearson correlation were used to analyze the relationship between demographic factors and caregiver burden. Multiple regression was used to analyze predictors of burden of caregivers. Statistical significance in this study was defined as P <or= 0.05.

RESULTS

The caregiver burden scores (25.9 +/- 10.7; range, 3-61) indicated a moderate burden level. Among the five dimensions of burden, caregiver anxiety (2.13 +/- 0.86) was the highest, followed by dependency of the patient (1.85 +/- 1.02), feeling shame and guilt (1.56 +/- 1.02), and family interference (1.43 +/- 0.83). The burden level of stigmata (1.32 +/- 1.24) was the lowest. The first three rankings of burden were 'I worry about his/her safety when he/she is alone' (2.26 +/- 1.15), 'I worry that she/he will become sick at any time' (2.23 +/- 1.10), and 'I feel he/she depends on me very much' (2.02 +/- 1.29). Patient satisfaction with medical staff support (P = 0.00), CHQ scores of the caregivers (P = 0.00), and the BPRS scores of the patients (P = 0.01) were significantly associated with the caregiver burden scores.

CONCLUSIONS

The physical and mental health condition of the primary family caregiver of schizophrenia patients was the most important factor determining the caregiver burden level. Comprehensive multidisciplinary care of chronic schizophrenia patients is needed, care that supports the needs and improves the psychiatric symptoms of the patients, helps to decrease the caregiver burden level, and facilitates family participation in treatment.

Viscoelastic thin polymer films under transient residual stresses: two-stage dewetting on soft substrates

A nonmonotonic, two-stage dewetting behavior was observed for spin coated thin viscoelastic polymer films on soft elastic substrates. At times shorter than the relaxation time of the polymer (t<tau_{rep}), dewetting generated deep trenches in the soft rubbery substrate which, in turn, almost stopped dewetting. At later stages (t>>tau_{rep}), dewetting accelerated, accompanied by an unstable rim. However, holes nucleated at t<tau_{rep} showed only this second-stage behavior. Our observations are attributed to large elastic deformations in the substrate caused by transient residual stresses within the film.

Thioglycolic acid inhibits mouse oocyte maturation and affects chromosomal arrangement and spindle configuration

Previous studies have shown that thioglycolic acid (TGA) leads to potential reproductive toxicology. To clarify the exact effects of this compound on reproduction, mice oocytes were treated with different TGA doses. At the end of the culture period, the nuclear status of mice oocytes was assessed under an inverted microscope. After immunofluorescence staining, the chromosomal arrangement and spindle configuration of oocytes were evaluated. The results indicated that TGA decreases the percentage of first polar body formation but does not influence that of germinal vesicle breakdown. TGA induces abnormal chromosomal arrangement and spindle elongation. In conclusion, TGA inhibits in-vitro maturation of mice oocytes and affects chromosomal arrangement and spindle configuration. Furthermore, it probably interferes with biochemical changes that occur during meiosis, resulting in aberrant development.

Attitudes toward gay men and lesbians and related factors among nurses in Southern Taiwan

OBJECTIVES

The aims of this study were to explore different dimensions of the attitudes toward gay men and lesbians among nurses in southern Taiwan and to examine the association between attitudes and intention to provide care to homosexual individuals. The factors related to attitudes towards gay men and lesbians by nurses were also examined.

METHODS

In total, 1824 nurses from a medical centre and two regional teaching hospitals in southern Taiwan were recruited into this study. We used the Attitudes Toward Homosexuality Questionnaire (ATHQ) to examine four-dimensional concepts toward homosexuality among nurses. The association of attitudes with the intention of taking care of homosexual patients was examined. Correlations of attitudes toward homosexuality with demographic and occupational data, sexual orientation, knowledge about homosexuality, and experiences of having contact with gay men and lesbians were examined using a stepwise multiple linear regression.

RESULTS

Participants had the most negative attitude toward homosexuality in the 'contact' and 'stereotypes' dimensions, followed by the 'morality' dimension and then the 'condemnation/tolerance' dimension. Nurses with more negative attitudes toward homosexuality had lower intentions of taking care of patients with a homosexual orientation. Nurses who had friends or relatives with a homosexual orientation, had a higher educational degree, and had provided care to homosexual patients were more likely to have positive attitudes toward homosexuality. In contrast, nurses who had worked for a longer period, labelled themselves as being absolutely heterosexual, and were religious were more likely to have negative attitudes toward homosexuality.

CONCLUSIONS

The factors related to attitudes toward homosexuality identified in this study have to be taken into consideration when intervening for nurses' attitudes toward gay men and lesbians.

Correlates of Attitudes Toward Homosexuality and Intention to Care for Homosexual People Among Psychiatric Nurses in Southern Taiwan

This study examined the association between attitudes toward homosexual individuals and intention to provide care and demographic and occupational factors, sexual orientation, knowledge about homosexuality, and experiences of contact with homosexual people among psychiatric nurses in southern Taiwan. In total, 133 psychiatric nurses from a medical center, three regional teaching hospitals, and one psychiatric hospital in southern Taiwan were recruited into this study. Their attitudes toward homosexual people as recorded on the Attitudes Toward Homosexuality Questionnaire, intention to provide care to homosexual individuals, and related factors were examined. The results revealed that psychiatric nurses who had a bachelor's or master's degree, higher level of knowledge about homosexuality, and friends or relatives with a homosexual orientation had a more positive attitude toward homosexuality. These psychiatric nurses, with more positive attitudes, and who worked in the medical center or regional teaching hospitals had a higher intention to care for homosexual people. The factors related to attitudes toward homosexuality and intention to care for homosexual people identified in this study should be taken into consideration when intervening in psychiatric nurses' attitudes toward homosexuality and intention to care for homosexual people.

Molecular recoiling in polymer thin film dewetting

The molecular recoiling force stemming from nonequilibrium chain conformation was found to play a very important role in the dewetting stability of polymer thin films. Correct measurements and inclusion of this molecular force into thermodynamic consideration are crucial for analyzing dewetting phenomena and nanoscale polymer chain physics. This force was measured using a simple method based on contour relaxation at the incipient dewetting holes. The recoiling stress was found to increase dramatically with molecular weight and decreasing film thickness. The corresponding forces were calculated to be in the range from 9.0 to 28.2 mN/m, too large to be neglected when compared to the dispersive forces (approximately 10 mN/m) commonly operative in thin polymer films.

[A project to raise the participation rate in education groups by psychiatric patient family members]

The objective of this project was to increase the rate of participation in relevant educational programs of immediate relatives of individuals currently undergoing psychiatric treatment. According to statistics, the average participation rate in such educational programs averages only 23.4%; a ratio considered unacceptably low. After analysis, major problems identified included: (1) relatives were not informed in advance of meeting schedules; (2) there was no standard manner by which hospitals communicated with relatives; (3) interaction between patients and their families was, in general, poor; (4) program staff were unable to ensure that relatives knew correct meeting times; and (5) relatives generally lacked interest in health education topics. A special project group was organized and charged to improve the rate of participation of psychiatric patient relatives in health education groups. Three proposals made by this group included: (1) create an annual patient relative attendance planning schedule; (2) implement a patient "life passport" for use as a standardized tool in day hospital care; and (3) arrange time after education activities for patient-parent interaction. After measures were implemented, patient relative participation in education programs rose to 64.8% from 23.4%. Results demonstrate method feasibility and validity. As the proposed method does not require nurses to send out notifications or conduct follow-ups over the phone, it indirectly cuts down costs and manpower and improves patient-family relations, ultimately raising the quality of nursing care.

[Nurses' assertiveness training and cognitive therapy experiences with an outpatient suffering from low self-esteem]

The experiences during nine meetings with a psychotherapy outpatient suffering from low self-esteem between 1/1/02 to 4/10/02. Using comprehensive nursing assessment practices for guidance, two conclusions were arrived at regarding the patient's mental health: a) an imbalance in individual response ability, and b) long-term problems with low self-esteem. This assessment was used to help the authors practice appropriate nursing skills associated with assertiveness training and cognitive therapy and to establish a trusting, caring, and accepting relationship with the client. The treatment plan included attempts to increase personal confidence and to promote suitable skills for improving living functions, enhancing relationships, and practicing social behavior.

Alleviation of human papillomavirus E2-mediated transcriptional repression via formation of a TATA binding protein (or TFIID)-TFIIB-RNA polymerase II-TFIIF preinitiation complex

Transcription in human papillomaviruses (HPVs) is mainly regulated by cellular transcription factors and virus-encoded E2 proteins that act as sequence-specific DNA-binding proteins. Although the functions of E2 as a transcriptional activator and a repressor have been well documented, the role of cellular factors involved in E2-mediated regulation of the HPV promoters and the mechanism by which E2 modulates viral gene expression remain unclear. Using reconstituted cell-free transcription systems, we found that cellular enhancer-binding factors and general cofactors, such as TAF(II)s, TFIIA, Mediator, and PC4, are not required for E2-mediated repression. Unlike other transcriptional repressors that function through recruitment of histone deacetylase or corepressor complexes, HPV E2 is able to directly target components of the general transcription machinery to exert its repressor activity on the natural HPV E6 promoter. Interestingly, preincubation of TATA binding protein (TBP) or TFIID with HPV template is not sufficient to overcome E2-mediated repression, which can be alleviated only via formation of a minimal TBP (or TFIID)-TFIIB-RNA polymerase II-TFIIF preinitiation complex. Our data therefore indicate that E2 does not simply work by displacing TBP or TFIID from binding to the adjacent TATA box. Instead, E2 appears to function as an active repressor that directly inhibits HPV transcription at steps after TATA recognition by TBP or TFIID.

Isolation of mouse TFIID and functional characterization of TBP and TFIID in mediating estrogen receptor and chromatin transcription

TFIID is a general transcription factor required for the assembly of the transcription machinery on most eukaryotic promoters transcribed by RNA polymerase II. Although the TATA-binding subunit (TBP) of TFIID is able to support core promoter and activator-dependent transcription under some circumstances, the roles of TBP-associated factors (TAF(II)s) in TFIID-mediated activation remain unclear. To define the evolutionarily conserved function of TFIID and to elucidate the roles of TAF(II)s in gene activation, we have cloned the mouse TAF(II)55 subunit of TFIID and further isolated mouse TFIID from a murine FM3A-derived cell line that constitutively expresses FLAG-tagged mouse TAF(II)55. Both mouse and human TFIIDs are capable of mediating transcriptional activation by Gal4 fusions containing different activation domains in a highly purified human cell-free transcription system devoid of TFIIA and Mediator. Although TAF(II)-independent activation by Gal4-VP16 can also be observed in this highly purified human transcription system with either mouse or yeast TBP, TAF(II)s are strictly required for estrogen receptor-mediated activation independently of the core promoter sequence. In addition, TAF(II)s are necessary for transcription from a preassembled chromatin template. These findings clearly demonstrate an essential role of TAF(II)s as a transcriptional coactivator for estrogen receptor and in chromatin transcription.

[Group psychotherapeutic factors in a self-assertive group]

The technique of group psychotherapy has recently been introduced to the practice in self-assertiveness training group. This study aims to assess various group factors that are hypothesized to be effective in the group process in a self-assertive group. Subjects of the study were participants in a 13-member self-assertiveness training group, with 4 female nurses and 8 male employees and 1 male student. The average age of this group was 35.2 years. Assessment of the group was based on Yalom's concept of twelve therapeutic factors in the group process. The results showed that 'identification', 'The existential factor' and 'interpersonal learning-input' were the three most important factors demonstrated during the group process. There were no significant age and gender differences in the above 'identification' and 'existential' factors. However, different beneficial factors were found for each group: for subjects aged 40 and above and males, it was 'interpersonal learning-output'; while in those with aged under 40 and females, 'universality' was more important than 'interpersonal learning-input'. Comparison of therapeutic factors among different groups was attempted. The above results were found different from patient groups, or the groups of university students. The discrepancy is due to different composition and tasks of each group.

Influences of 1-dodecylazacycloheptan-2-one on permeation of membranes by weak electrolytes. 1. Theoretical analysis of weak electrolyte diffusion through membranes and studies involving silicone rubber membranes

The pH dependency of permeation of weak electrolytes allows inferences to be made about the barrier characteristics of membranes. The influences of enhancers on pH-permeation profiles promise further mechanistic enlightenment. To explore issues of weak electrolyte mass transfer, a steady-state mathematical model for a hydrophobic membrane with aqueous pores existing in series with aqueous phases, presently a popular depiction of the skin and other biological barriers, has been developed. The case in which there are no pores is then considered theoretically and in studies involving the mass transfer of benzoic acid across silicone rubber membranes. Specifically, the flux of [14C]benzoic acid across Silastic sheeting as a function of pH was investigated. This isotropic membrane's behavior conformed to expectations drawn from the model in that the un-ionized species penetrated in proportion to benzoic acid's prevailing state of ionization, the membrane being all but impenetrable to the benzoate anion. The enhancer, 1-dodecylazacyclo-heptan-2-one (Azone), was then applied to the membrane in emulsions of increasing concentration. There were two important consequences of such application. First, the un-ionized species of benzoic acid partitioned into the emulsion droplets, lowering the activity of the permeant in the emulsion's continuous phase. Second, Azone was imbibed to a degree into the polymeric membrane, significantly altering the permeability of the silicone rubber of which it is composed. The former influence had to be carefully factored out in order to delineate Azone's intrinsic enhancing effects on the membrane. The silicone rubber membrane system served well as a model for study of the enhancing effects of Azone on a wholly hydrophobic barrier, establishing a basis for the analysis of the actions of enhancers such as Azone on more complex, multiphasic biological barriers.

A mutant phosphoenolpyruvate carboxykinase in Escherichia coli conferring oxaloacetate decarboxylase activity

The phosphoenolpyruvate carboxykinase in Escherichia coli (encoded by pck) catalyzes the conversion from oxaloacetate (OAA) to phosphoenolpyruvate under gluconeogenic conditions. We report here the characterization of two mutant alleles, pck-51 and pck-53, both of which are point mutations leading to single amino acid changes (D to N at position 268 and G to S at position 284, respectively). Pck51 is an altered-activity mutant that catalyzes the conversion from OAA to pyruvate (OAA decarboxylase activity). This new activity was not detected from the wild-type Pck, and it complements the pck null mutation only in a pps+ background. Pck53 is a reduced-activity mutant that complements the pck null mutation in a strain-dependent fashion.

Transdermal delivery of narcotic analgesics: comparative metabolism and permeability of human cadaver skin and hairless mouse skin

The permeation of hairless mouse skin and human cadaver skin by narcotic analgesics was investigated to determine the interspecies variation. Permeability coefficients of morphine, fentanyl, and sufentanil across full-thickness hairless mouse skin were 1 order of magnitude higher than those found for human epidermis. The permeability coefficient of morphine for stripped hairless mouse skin was 500-fold higher than that for intact skin, showing the stratum corneum to be the principal barrier to its penetration. The permeability coefficient of fentanyl for stripped hairless mouse skin was also raised, but stripping caused an inappreciable increase in the permeation rate of sufentanil. The thick dermis of excised mouse skin obviously offered a significant resistance to the permeation of these lipophilic compounds. In comparison, the permeability coefficients of fentanyl and sufentanil through stripped cadaver epidermis (n > or = 25) were 67 and 37 higher than for intact human epidermis, respectively. The skin metabolism of the narcotics was investigated. No significant metabolic degradation of morphine, fentnayl, and sufentanil was observed in either fresh human cadaver skin or hairless mouse skin homogenates in the presence of NADPH cofactor, suggesting a low monooxygenase enzyme presence in skin. Moreover, no measurable glucuronidation of morphine took place in human skin or hairless mouse skin. Both processes proceeded rapidly in liver homogenates (mouse) under identical circumstances. It thus appears that these drugs pass through in intact form.

Membrane structural abnormalities in the stratum corneum of the autosomal recessive ichthyoses

Congenital ichthyosiform erythroderma (CIE) and classic lamellar ichthyosis (LI) are autosomal recessive disorders of cornification (DOC), distinguished previously by clinical, histologic, ultrastructural, and cell kinetic criteria. Whether there is further heterogeneity within the CIE group is uncertain. To address the issue of genetic heterogeneity, and to study the pathogenesis of these DOC, skin biopsies from eight CIE, three LI, and six normal subjects were assessed by electron microscopy, including ruthenium tetroxide postfixation with optical diffraction, to visualize and quantitate intercellular membrane domains. We found abnormal lamellar bodies in CIE and distinctive alterations in intercellular lamellar bilayer architecture among patients with CIE and three patients with LI. Two biopsies from two patients at different sites demonstrated the consistency of these findings. Moreover, in both CIE and the three LI patients, desmosomes persisted throughout the outer layers of the SC, indicative of impaired degradation. Our ultrastructural observations support the previously reported phenotypic distinction between CIE and LI, and the further likelihood of genetic heterogeneity within CIE. However, these studies do not support the division of the autosomal recessive ichthyoses into three subgroups based upon cytosolic structural abnormalities. Finally, these studies provide new insights into the pathogenesis of the autosomal recessive DOC.

Membrane structures in normal and essential fatty acid-deficient stratum corneum: characterization by ruthenium tetroxide staining and x-ray diffraction

Despite the importance of intercellular lamellar bilayers for stratum corneum (SC) barrier function, knowledge about the structure of these bilayers is limited due to their poor visualization and/or retention. Whereas substitution of ruthenium tetroxide (RuO4) for osmium tetroxide fixation provides clear images of these bilayers, the usefulness of RuO4 has been limited by its slow penetration and cytotoxicity. Utilizing a new fixation protocol for RuO4, we obtained clear images of lamellar domains at all levels of murine SC. Computer-aided image reconstructions demonstrated a lamellar spacing of 129 +/- 2 A, which agreed with x-ray diffraction data from parallel, unfixed samples (131 +/- 2 A), a spacing not affected by hydration. Furthermore, novel structures were seen in the intercellular spaces of normal SC. Finally, in murine essential fatty acid deficiency (EFAD), the overall lamellar spacing is comparable to normal [127 +/- 7 A by computer transform vs. 131.9 +/- 2 A (hydrated) and 129.6 +/- 2.2 A (dry) by x-ray diffraction]. Yet, these domains are structurally abnormal, displaying regions with either an excess or absence of lamellae. The new RuO4 protocol provides quantitative information about SC lamellar dimensions and morphologic abnormalities in bilayer distribution and substructure in EFAD stratum corneum that are not detected by either x-ray diffraction or computer-aided image reconstruction. Thus, the barrier abnormality in EFAD stratum corneum can be ascribed either to focal depletion of lamellae or abnormalities in lamellar substructure.

Avian permeability barrier function reflects mode of sequestration and organization of stratum corneum lipids: reevaluation utilizing ruthenium tetroxide staining and lipase cytochemistry

The epidermis of avians and terrestrial mammals has evolved distinct, but related mechanisms to survive in a terrestrial environment. In both phyla, stratum corneum lipids form the basis of the cutaneous permeability barrier, but barrier function is less efficient in avians. Whereas in mammals the epidermal lamellar body (LB) secretes its contents into the intercellular spaces, in the feathered epidermis of avians, its distinctive secretory organelle, the multigranular body (MGB), does not secrete its contents into the stratum corneum intercellular spaces. Yet, neutral lipid-enriched droplets, derived from the cytosolic breakdown of MGB, ultimately are squeezed through membrane pores into the stratum corneum interstices. In this study we determined: a) using ruthenium tetroxide (RuO4) fixation, whether these droplets form membrane structures after deposition in the stratum corneum interstices; and b) the similarities and differences between avian MGB and mammalian LB, using enzyme cytochemistry as a marker for secretion, and optical diffraction computer-aided image analysis and reconstruction to compare the internal structure of MGB vs. LB. MGB were shown to possess a similar lamellar substructure to LB in RuO4-fixed specimens, exhibiting comparable dimensions on optical diffraction and computer transform analysis. Moreover, the intercellular lipids of avian stratum corneum lacked membrane-substructure, as was present in parallel samples of mammalian stratum corneum. Thus, both the absence of MGB secretion, and the failure of intercellular lipids to form membrane bilayers may explain the inherent differences in barrier function in these two taxa.

Localization of lipid microdomains and thermal phenomena in murine stratum corneum and isolated membrane complexes: an electron spin resonance study

The intercellular region of the stratum corneum can be isolated in the form of membrane complexes (intercellular lipids and adjacent cornified envelopes) which are devoid of the cytoplasmic components. In this study the temperature induced phase transitions and corresponding lipid domain reorganization in isolated stratum corneum (SC) sheets and SC membrane complexes (SCM) were determined using the electron spin resonance (ESR) spin probe technique. The spin probe perdeuterated di-tert-butyl nitroxide (pdDTBN) in SC and SCM revealed less well-defined physiologic phase transitions in the SCM and a more polar lipid domain in SC. However, the ESR results show the coexistence of highly ordered domains (immobilized spin probe) and less viscous domains in intact SC, which persist in SCM. Above approximately 20 degrees C the spin probe is dissolved in a highly disordered (isotropic) lipid domain in both SC and SCM. In both solvent extracted SC and SCM, the spin probe is dissolved in a highly ordered lipophilic domain associated with the lipids complexed to the corneocyte envelope and exhibiting no thermal transitions between -23 degrees to 60 degrees C. Further, the amount of mobile spin probe is related to the amount of residual lipid. An unexpected finding was the apparent reduction of the spin probe in solvent extracted SCM, suggesting the presence of a previously unrecognized free radical reducing mechanism in these sites. The mobilities of the spin probe when dissolved in model lipids, non-hydroxy, and hydroxy containing ceramides and cholesteryl oleate, differed significantly from those observed in SC or SCM. These studies demonstrate the usefulness of ESR for the localization and characterization of lipid microenvironments in the stratum corneum.

Enhancement of hydrocortisone permeation of human and hairless mouse skin by 1-dodecylazacycloheptan-2-one

The influence of 1-dodecylazacycloheptan-2-one (Azone) on the in vitro permeation of hairless mouse skin and human epidermis by hydrocortisone was studied as a function of the amount of Azone solubilized and/or emulsified into aqueous media applied to the membranes using the infinite-dose technique. The permeability-enhancing effect of Azone increases with increasing Azone total concentrations until 0.1% is reached with mouse skin and 0.01% is reached for human epidermis. Thereafter, permeabilities for both tissues drop systematically. The maximally enhanced permeability in mouse skin approached that for mouse skin stripped of its stratum corneum. The peak permeability in human epidermis is an order of magnitude smaller than for mouse skin with the duration of Azone treatment required to achieve the full effect in human epidermis being twice that for mouse skin (approximately 20 h vs approximately 12 h). Thus, there is a profound difference in Azone's action on these two tissue types. It was also established that the affinity of an enhancer for a permeant drug can significantly offset its ability to enhance permeability. Specifically, hydrocortisone was found to partition significantly into the Azone-rich phase of the emulsion, lowering its concentration (and its thermodynamic activity) in the continuous aqueous phase and thereby reducing its flux through the skin. This physiochemical effect was profound enough to nullify the intrinsic permeability-enhancing effect of Azone as the total Azone concentration was raised to 10%.