N-acetyl-L-leucine for Niemann-Pick type C: a multinational double-blind randomized placebo-controlled crossover study

BACKGROUND

Niemann-Pick disease type C (NPC) is a rare autosomal recessive neurodegenerative lysosomal disease characterized by multiple symptoms such as progressive cerebellar ataxia and cognitive decline. The modified amino acid N-acetyl-leucine has been associated with positive symptomatic and neuroprotective, disease-modifying effects in various studies, including animal models of NPC, observational clinical case studies, and a multinational, rater-blinded phase IIb clinical trial. Here, we describe the development of a study protocol (Sponsor Code "IB1001-301") for the chronic treatment of symptoms in adult and pediatric patients with NPC.

METHODS

This multinational double-blind randomized placebo-controlled crossover phase III study will enroll patients with a genetically confirmed diagnosis of NPC patients aged 4 years and older across 16 trial sites. Patients are assessed during a baseline period and then randomized (1:1) to one of two treatment sequences: IB1001 followed by placebo or vice versa. Each sequence consists of a 12-week treatment period. The primary efficacy endpoint is based on the Scale for the Assessment and Rating of Ataxia, and secondary outcomes include cerebellar functional rating scales, clinical global impression, and quality of life assessments.

DISCUSSION

Pre-clinical as well as observational and phase IIb clinical trials have previously demonstrated that IB1001 rapidly improved symptoms, functioning, and quality of life for pediatric and adult NPC patients and is safe and well tolerated. In this placebo-controlled cross-over trial, the risk/benefit profile of IB1001 for NPC will be evaluated. It will also give information about the applicability of IB1001 as a therapeutic paradigm for other rare and common neurological disorders.

TRIAL REGISTRATIONS

The trial (IB1001-301) has been registered at www.

CLINICALTRIALS

gov (NCT05163288) and www.clinicaltrialsregister.eu (EudraCT: 2021-005356-10). Registered on 20 December 2021.

Comparison of carcinogenic potency across life stages: implications for the assessment of transplacental cancer risk

Cancer development from in utero exposure has been documented for a variety of agents with the most commonly studied compounds exhibiting mutagenic and genotoxic carcinogen properties. Age-dependent adjustment factors (ADAFs) are applied by the US Environmental Protection Agency to many such carcinogens when assessing cancer risk from early postnatal (PN) exposures; however, this approach has not been widely considered for transplacental (TP) exposure. To explore this question and further evaluate prenatal susceptibility a database of early life animal studies developed by California Office of Environmental Health Hazard Assessment (OEHHA) enhanced with additional literature searching was evaluated. Nine genotoxic carcinogens and one mixture (cigarette smoke) have data available via TP only, PN only and adult-only protocols. Potency comparisons across these lifestages displayed similarly greater potency in male liver and brain compared to adult-only exposure. Both TP and PN exposures were not markedly different than adult-only for other targets such as female liver and blood-borne tumors. Similarity in TP and PN targets and potency for carcinogen action suggests that a 10-fold ADAF may be applied for TP exposure as is currently applied to PN exposure. A similar conclusion was reached by OEHHA. The implications of this heightened TP vulnerability are greatest for less-than-lifetime exposure and this approach might be used to assess the level of cancer risk from exposures during pregnancy. A case example employing a mutagenic flame retardant was used to exemplify application of a TP ADAF for evaluating risks during pregnancy.

Abstract S3-6: Combination Therapy of the Novel PI3K Inhibitor GDC-0941 and Dual PI3K/mTOR Inhibitor GDC-0980 with Trastuzumab-DM1 Antibody Drug Conjugate Enhances Anti-Tumor Activity in Preclinical Breast Cancer Models In Vitro and In Vivo

The receptor tyrosine kinase, HER2/ErbB2, is a validated clinical target for HER2-amplified breast cancer, as evidenced by the U.S.F.D.A. approval of the humanized HER2 antibody, trastuzumab (Herceptin®), and the dual HER2/EGFR small molecule tyrosine kinase inhibitor lapatinib (Tykerb®). An alternative approach for targeting HER2 is the direct covalent coupling of a cytotoxic drug to trastuzumab. We have previously reported the potent in vitro and in vivo efficacy of T-DM1, trastuzumab (T) linked to the microtubule polymerization inhibitory drug maytansinoid (DM1), in trastuzumab-sensitive and-refractory breast tumor models (1). Inhibition of signaling through PI3K, which is hyperactivated in HER2-amplified breast cancer due to constitutive activity of overexpressed HER2 and/or through mutation of the p110-α subunit of PI3K, also offers an additional therapeutic approach. Therefore the specific aims of our study were to determine if the combination of a novel pan-PI3K inhibitor (GDC-0941) or a dual PI3K/mTOR inhibitor (GDC-0980) enhanced the anti-tumor activity of T-DM1 in HER2-amplified breast cancer lines in vitro and as xenografts in vivo. The breast cancer cell lines tested, MCF7 neo/HER2 and KPL4, harbor the E545K and H1047R PIK3CA mutations, respectively. Combination treatment of T-DM1 with either GDC-0941 or GDC-0980 in vitro resulted in a synergistic inhibition of cellular viability. Biochemical biomarker analyses revealed inhibition of phospho-Akt and phospho-ERK by both T-DM1 and GDC-0941, decreased phosphorylation of Rb and PRAS40 by GDC-0941, and increased levels of the mitotic markers phospho-histone H3 and cyclin B1 after treatment with T-DM1. In addition, T-DM1 treatment resulted in apoptosis as determined by appearance of the 23 kDa PARP-cleavage fragment, decreased levels of Bcl-XL, as well as activation of caspases 3 and 7. Addition of GDC-0941 to T-DM1 further enhanced apoptosis induction. In vivo, increased and sustained tumor regressions were observed when GDC-0941 was combined with T-DM1 as compared to single-agent activity in the MCF7 neo/HER2 and KPL4 sub-cutaneous xenograft models in a dose-dependent fashion. Moreover, an increased number of sustained complete regressions (CRs) were observed when GDC-0980 was combined with T-DM1 in the KPL4 xenograft model when compared to the combination treatment with GDC-0941 (% CRs = 88% for GDC-0980 + T-DM1 vs. 50% for GDC-0941 + T-DM1). The results of our pre-clinical studies provides evidence for the use of rational drug combinations of PI3K inhibitors such as GDC-0941 and GDC-0980 with T-DM1 in HER2-amplified breast cancer that harbor PIK3CA mutations and may offer additional treatment options for patients whose disease progresses on trastuzumab or lapatinib-based therapy. 1. Lewis Phillips, G. et al. Cancer Res 2008; 68: (22).

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr S3-6.

Pharmacokinetics of a novel closantel/ivermectin injection in cattle

Two studies are described on the pharmacokinetics of a combination anthelmintic consisting of ivermectin and closantel for use in cattle. In the first, the pharmacokinetics of both active drugs in the combination were compared with the formulation with either ivermectin or closantel removed. No differences in the pharmacokinetics were observed, indicating that neither the absorption nor distribution of ivermectin or closantel in the combination were influenced by the presence of the other. In the second study the pharmacokinetics of ivermectin and closantel in the combination product were compared with control formulations of each. No difference was found between the closantel formulations. With ivermectin it was noted that absorption and excretion were more rapid and Cmax higher in the combination, although the AUC of both formulations were not significantly different.

The persistence of electrostatically seeded endothelial cells lining a small diameter expanded polytetrafluoroethylene vascular graft

PURPOSE

The purpose of this study was to evaluate the persistence of electrostatically seeded endothelial cells (ECs) lining an expanded polytetrafluorethylene (e-PTFE) graft after one week exposure to in vivo circulation in a canine femoral artery bypass model. This was accomplished by visualizing the PKH 26 (red fluorescent) label placed in the EC membranes prior to the seeding procedure. Furthermore, this study was performed to confirm that the source of the ECs lining the graft were those from the initial inoculum.

METHODS

This evaluation consisted of harvesting autologous, canine jugular vein ECs, PKH 26 labeling of the ECs, electrostatic EC seeding the e-PTFE grafts (4mm GORE-TEX, Length=6cm), implanting the grafts (femoral artery model) for one week, and explanting the grafts for light, fluorescent and scanning electron microscopy evaluations of the luminal surface.

RESULTS

The unseeded grafts (controls) had a mean fluorescence surface coverage of 6.82 +/- 7.19%, while the EC seeded grafts had a mean of 90.3 +/- 14.3% which is significantly (p <0.001) different from the controls. Overall, the seeding time including the EC harvesting and PKH 26 labeling protocol was approximately 75 min.

CONCLUSIONS

The electrostatically seeded ECs persisted after implantation of the graft as demonstrated by the PKH 26 labeling data. The fluorescent data also demonstrated that the neointima formed (EC luminal surface coverage) one week after implantation was in fact derived from the ECs initially seeded as determined by the abundance of the labeled ECs.

Safety, tolerability, and antiretroviral effects of ritonavir-nelfinavir combination therapy administered for 48 weeks

OBJECTIVE

To evaluate the safety, tolerability, and anti-HIV activity of ritonavir-nelfinavir (RTV-NFV).

DESIGN

Single-site, open-label, nonrandomized, multiple-dose trial of RTV combined with two doses of NFV in protease inhibitor (PI)-naive, HIV-infected patients.

METHODS

Mean baseline HIV RNA was 39,500 copies/ml; mean baseline CD4 count was 323 cells/mm3. All patients received RTV at a dosage of 400 mg twice daily. Cohorts I (N = 10) and II (N = 10) received NFV at a dosage of 500 mg and 750 mg twice daily, respectively, for the initial 12 weeks of the study before allowing intensification with reverse transcriptase inhibitors.

RESULTS

The commonest effects of RTV-NFV therapy were study drug-related moderate-to-severe diarrhea (9 patients in cohorts I and II) and drug-related moderate-to-severe nausea (4 patients in cohorts I and II). HIV RNA was suppressed in a biphasic manner. At 48 weeks in cohort I, mean HIV RNA reduction was 2.82 log10 copies/ml (standard error [SE] =.61; p =.001; N = 4); mean CD4 cell count increase was 236 cells/mm3 (SE = 67.1; p =.006; N = 4). In cohort II, mean HIV RNA reduction at Week 48 was 2.21 log10 copies/ml (SE =.430; p =. 001; N = 8); mean CD4 cell count increase was 120 cells/mm3 (SE = 47. 5; p =.03; n = 8). In cohort I patients, 2 of 4 completing Week 48 had HIV RNA <20 copies/ml; and 3 of 4 had HIV RNA <400 copies/ml. In cohort II, 2 of 8 patients completing Week 48 had HIV RNA <20 copies/ml and 4 of 8 had HIV RNA <400 copies/ml. In addition, 3 patients in cohort I withdrew because of virologic failure not thought to be related to poor compliance. Moreover, 15 patients elected to add new reverse-transcriptase inhibitors (RTIs) after week 12.

CONCLUSIONS

RTV-NFV with concomitant reverse transcriptase inhibitors is a potential dual-PI option for PI-naive patients.

Reevaluation of anaerobic blood cultures in a Veteran population

BACKGROUND

Studies suggest that the selective use of anaerobic blood cultures may represent a more cost-effective laboratory approach when anaerobic bacterial infection is suspected.

METHODS

A 5-year retrospective study was done at a Veterans' Affairs hospital to determine the utility of routinely including anaerobic blood culture when sampling for bacteremia.

RESULTS

A total of 22,075 anaerobic blood cultures were collected from our adult population. Significant anaerobic pathogens were isolated from only 0.14% of these blood cultures. An anaerobic infection could have been suspected in 92% of our patients.

CONCLUSIONS

Significant anaerobic bloodstream infections occurred in only 0.14% of blood cultures. In addition, the majority of the patients identified with anaerobic bacteremia had clinical conditions that would have suggested a high likelihood of anaerobic bacteremia. These observations suggest that selective rather than routine use of anaerobic blood cultures may be appropriate in a veteran population.

Using case management systems to integrate clinical and financial data

Integrated delivery systems can use automated case management information systems to better manage relevant clinical and financial data across the continuum of care. Effective case management systems can help caregivers track clinical and financial information; match appropriate resources to patient needs; and analyze populations to identify risk, enhance adherence to clinical guidelines, and understand provider treatment profiles.

The Genome Sequence DataBase version 1.0 (GSDB): from low pass sequences to complete genomes

The Genome Sequence DataBase (GSDB) has completed its conversion to an improved relational database. The new database, GSDB 1.0, is fully operational and publicly available. Data contributions, including both original sequence submissions and community annotation, are being accomplished through the use of a graphical client-server interface tool, the GSDB Annotator, and via GIO (GSDB Input/Output) files. Data retrieval services are being provided through a new Web Query Tool and direct SQL. All methods of data contribution and data retrieval fully support the new data types that have been incorporated into GSDB, including discontiguous sequences, multiple sequence alignments, and community annotation.

Informatics for ubiquitous sequencing

Methods and technologies currently being developed promise an increase of between one and two orders of magnitude in the practical throughputs of DNA sequencing for gene discovery, expression analysis and variant analysis. Integrated laboratories will use all of these methods as components of a molecular strategy for the functional characterization of genes and their products. This review summarizes the types of data produced by these strategies, and the analysis and management challenges that they raise.

The Genome Sequence DataBase (GSDB): meeting the challenge of genomic sequencing

The genome sequence database (GSDB) is a complete, publicly available relational database of DNA sequences and annotation maintained by the National Center for Genome Resources (NCGR) under a Cooperative Agreement with the US Department of Energy (DOE). GSDB provides direct, client- server access to the database for data contributions, community annotation and SQL queries. The GSDB Annotator, a multi-platform graphic user interface, is freely available. Automatically updated relational replicates of GSDB are also freely available.

Intraspecific variation in small-subunit rRNA sequences in GenBank: why single sequences may not adequately represent prokaryotic taxa

Small-subunit rRNA (SSU rRNA) sequencing is a powerful tool to detect, identify, and classify prokaryotic organisms, and there is currently an explosion of SSU rRNA sequencing in the microbiology community. We report unexpectedly high levels of intraspecific variation (within and between strains) of prokaryote SSU rRNA sequences deposited in GenBank. A total of 82% of the prokaryote species with two published SSU rRNA sequences had more variable positions than a 0.1% random sequencing error would predict, and 48% of these sequence pairs had more variable positions than predicted by a 1.0% random sequencing error. Other sources of sequence variability must account for some of this intraspecific variation. Given these results, phylogenetic studies and biodiversity estimates obtained by using prokaryotic SSU rRNA sequences cannot proceed under the assumption that rRNA sequences of single operons from single isolates adequately represent their taxa. Sequencing SSU rRNA molecules from multiple operons and multiple isolates is highly recommended to obtain meaningful phylogenetic hypotheses, as is careful attention to accurate strain identification.

Analysis of gene expression by tissue and developmental stage

High-throughput sequencing of cDNAs from multiple tissue- and stage-specific libraries is an efficient method for characterizing gene expression by tissue and developmental stage. When combined with functional information derived from the systematic study of transcription factors, signal transducers, and other regulatory molecules in model systems, data from expressed sequence tag projects provide an increasingly detailed picture of gene expression and its regulation. Understanding this picture will require the development of highly sophisticated databases to organize and correlate these data.

Expressed sequence tags identify a human isolog of the suil translation initiation factor

The complete cDNA sequence of a human isolog of the yeast suil translation initiation factor gene was obtained by assembling over 40 expressed sequence tags (ESTs) for this gene obtained from a variety of tissue-specific cDNA libraries. The human suilisol gene product is a 113 amino-acid polypeptide similar to proteins known from yeast, rice, mosquito, and Methanococcus. The identification of suilisol illustrates the utility of assemblies of independent ESTs for deriving full-length cDNA sequences for new human genes.

The use of deficiencies to determine essential gene content in the let-56-unc-22 region of Caenorhabditis elegans

We have investigated the possibility of using the polymerase chain reaction to detect deletions of coding elements in the unc-22-let-56 interval on chromosome IV in the nematode Caenorhabditis elegans. Our analysis of approximately 13 kb of genomic sequence immediately to the left of the unc-22 gene resulted in the identification of four possible genes. Partial cDNAs have been identified for three of them. To determine whether any of these coding elements are essential for development, we required a method for the induction and selection of mutations in these elements. Our approach was to identify a set of formaldehyde and gamma radiation induced unc-22 mutations that mapped to the unc-22-let-56 region, and then employ polymerase chain reaction methodology to identify deficiencies that affected one or more of the four identified coding elements. Two small deficiencies were identified in this manner. Characterization of these deficiencies shows that there are no coding elements between unc-22 and let-56 (the nearest mutationally identified gene to the left of unc-22), which are required in development under laboratory conditions. We conclude that the polymerase chain reaction is a practical tool for the detection of deletions of coding elements identified in this region, and that characterization of such deficiencies provides a method for assessing whether or not these elements are required for development.

A quality control algorithm for DNA sequencing projects

Heterologous DNA sequences from rearrangements with the genomes of host cells, genomic fragments from hybrid cells, or impure tissue sources can threaten the purity of libraries that are derived from RNA or DNA. Hybridization methods can only detect contaminants from known or suspected heterologous sources, and whole library screening is technically very difficult. Detection of contaminating heterologous clones by sequence alignment is only possible when related sequences are present in a known database. We have developed a statistical test to identify heterologous sequences that is based on the differences in hexamer composition of DNA from different organisms. This test does not require that sequences similar to potential heterologous contaminants are present in the database, and can in principle detect contamination by previously unknown organisms. We have applied this test to the major public expressed sequence tag (EST) data sets to evaluate its utility as a quality control measure and a peer evaluation tool. There is detectable heterogeneity in most human and C.elegans EST data sets but it is not apparently associated with cross-species contamination. However, there is direct evidence for both yeast and bacterial sequence contamination in some public database sequences annotated as human. Results obtained with the hexamer test have been confirmed with similarity searches using sequences from the relevant data sets.

Rapid cDNA sequencing (expressed sequence tags) from a directionally cloned human infant brain cDNA library

A human infant brain cDNA library, made specifically for production of expressed sequence tags (ESTs) was evaluated by partial sequencing of over 1,600 clones. Advantages of this library, constructed for EST sequencing, include the use of directional cloning, size selection, very low numbers of mitochondrial and ribosomal transcripts, short polyA tails, few non-recombinants and a broad representation of transcripts. 37% of the clones were identified, based on matches to over 320 different genes in the public databases. Of these, two proteins similar to the Alzheimer's disease amyloid precursor protein were identified.

3,400 new expressed sequence tags identify diversity of transcripts in human brain

We present the results of the partial sequencing of over 3,400 expressed sequence tags (ESTs) from human brain cDNA clones, which increases the number of distinct genes expressed in the brain, that are represented by ESTs, to about 6,000. By choosing clones in an unbiased manner, it is possible to construct a profile of the transcriptional activity of the brain at different stages. Proteins that comprise the cytoskeleton are the most abundant; however, a large variety of regulatory proteins are also seen. About half of the ESTs predicted to contain a protein-coding region have no matches in the public peptide databases and may represent new gene families.

Information contents and dinucleotide compositions of plant intron sequences vary with evolutionary origin

The DNA sequence composition of 526 dicot and 345 monocot intron sequences have been characterized using computational methods. Splice site information content and bulk intron and exon dinucleotide composition were determined. Positions 4 and 5 of 5' splice sites contain different statistically significant levels of information in the two groups. Basal levels of information in introns are higher in dicots than in monocots. Two dinucleotide groups, WW (AA, AU, UA, UU) and SS (CC, CG, GC, GG) have significantly different frequencies in exons and introns of the two plant groups. These results suggest that the mechanisms of splice-site recognition and binding may differ between dicot and monocot plants.

Splicing signals in Drosophila: intron size, information content, and consensus sequences

A database of 209 Drosophila introns was extracted from Genbank (release number 64.0) and examined by a number of methods in order to characterize features that might serve as signals for messenger RNA splicing. A tight distribution of sizes was observed: while the smallest introns in the database are 51 nucleotides, more than half are less than 80 nucleotides in length, and most of these have lengths in the range of 59-67 nucleotides. Drosophila splice sites found in large and small introns differ in only minor ways from each other and from those found in vertebrate introns. However, larger introns have greater pyrimidine-richness in the region between 11 and 21 nucleotides upstream of 3' splice sites. The Drosophila branchpoint consensus matrix resembles C T A A T (in which branch formation occurs at the underlined A), and differs from the corresponding mammalian signal in the absence of G at the position immediately preceding the branchpoint. The distribution of occurrences of this sequence suggests a minimum distance between 5' splice sites and branchpoints of about 38 nucleotides, and a minimum distance between 3' splice sites and branchpoints of 15 nucleotides. The methods we have used detect no information in exon sequences other than in the few nucleotides immediately adjacent to the splice sites. However, Drosophila resembles many other species in that there is a discontinuity in A + T content between exons and introns, which are A + T rich.

Caenorhabditis elegans expressed sequence tags identify gene families and potential disease gene homologues

A database containing mapped partial cDNA sequences from Caenorhabditis elegans will provide a ready starting point for identifying nematode homologues of important human genes and determining their functions in C. elegans. A total of 720 expressed sequence tags (ESTs) have been generated from 585 clones randomly selected from a mixed-stage C. elegans cDNA library. Comparison of these ESTs with sequence databases identified 422 new C. elegans genes, of which 317 are not similar to any sequences in the database. Twenty-six new genes have been mapped by YAC clone hybridization. Members of several gene families, including cuticle collagens, GTP-binding proteins, and RNA helicases were discovered. Many of the new genes are similar to known or potential human disease genes, including CFTR and the LDL receptor.

Sequence identification of 2,375 human brain genes

We recently described a new approach for the rapid characterization of expressed genes by partial DNA sequencing to generate 'expressed sequence tags'. From a set of 600 human brain complementary DNA clones, 348 were informative nuclear-encoded messenger RNAs. We have now partially sequenced 2,672 new, independent cDNA clones isolated from four human brain cDNA libraries to generate 2,375 expressed sequence tags to nuclear-encoded genes. These sequences, together with 348 brain expressed sequence tags from our previous study, comprise more than 2,500 new human genes and 870,769 base pairs of DNA sequence. These data represent an approximate doubling of the number of human genes identified by DNA sequencing and may represent as many as 5% of the genes in the human genome.

The effect of moderate aerobic exercise on physical fitness among women 70 years and older

This study investigated benefits of 26 weeks of moderate aerobic exercise for women 70 years or older. Sixteen healthy women with a mean age of 72.0 years were randomized into exercise (n = 10) and control groups (n = 6). The exercise group walked on a treadmill 3 times per week for 20 min, at 70% of maximum heart rate. Oxygen uptake VO2max expressed in l/min and ml.kg-1.min-1, total exercise time on the treadmill (TET), maximum heart rate (HRmax) and body mass index (BMI) were measured at baseline and 6 months. Two-way repeated measures analysis of variance (ANOVA) determined the effect of exercise intervention. Both measures of VO2max in addition to TET were significantly improved by the moderate training program, compared to the control group. VO2max in the exercise group increased by +/- 6.6% (S.E. 2.9) measured in l/min and 8.4% (S.E. 3.2) measured in ml.kg-1.min-1. TET increased by 25.4% (S.E. 4.9) in the exercise group. The ANOVA was unable to detect significance between the exercise and control groups for HRmax or BMI. All exercising subjects finished the program, apparently tolerating the intervention. The results indicate that healthy women over the age of 70 years can increase fitness measures with a moderate training program.

Estrogen therapy and variable-resistance weight training increase bone mineral in surgically menopausal women

This study was undertaken to examine the effect of estrogen replacement therapy alone and estrogen replacement therapy plus variable-resistance weight training on the bone mineral content of surgically menopausal women. A total of 20 surgically menopausal women were randomized and treated with either 0.625 mg conjugated estrogen daily or the same dose of estrogen plus a closely monitored exercise program involving the use of Nautilus muscle strengthening/endurance equipment. After 1 year's observation, the bone mineral density (BMD) of the spine determined by dual-photon absorptiometry increased in the exercising subjects by 8.3 +/- 5.3% (p = 0.004), 95% confidence limits (CL) 3.9-12.8%; the group with estrogen replacement therapy alone maintained their BMD: 1.5 +/- 12.4% (p = 0.36; 95% CL = -6.9-9.8%). The total body BMD of the exercising group increased by 2.1 +/- 1.5% (p = 0.003; 95% CL = 0.8-3.3%); the nonexercising women had a nonsignificant 0.6 +/- 2.9% change (p = 0.30; 95% CL = -1.4-2.5%). A significant increase of 4.1 +/- 4.3% (p = 0.01; 95% CL = 0.8-7.4%) in the radial midshaft BMD of the exercising group was found; the estrogen alone group recorded a nonsignificant change of -0.3 +/- 3.1% (p = 0.33; 95% CL = -1.7-2.4%). The results of this study suggest that variable-resistance training in estrogen-replete women adds bone to both the axial and appendicular skeleton.

Information content of Caenorhabditis elegans splice site sequences varies with intron length

A database of sequences of 139 introns from the nematode Caenorhabditis elegans was analyzed using the information measure of Schneider et al. (1986) J. Mol. Biol. 128: 415-431. Statistically significant information is encoded by at least the first 30 nt and last 20 nt of C. elegans introns. Both the quantity and the distribution of information in the 5' splice site sequences differs between the typical short (length less than 75 nt) and rarer long (length greater than 75 nt) introns, with the 5 sites of long introns containing approximately one bit more information. 3' splice site sequences of long and short C. elegans introns differ significantly in the region between -20 and -10 nt.

Predicting maximal oxygen uptake from treadmill testing in trained and untrained women

This study was conducted to develop an equation to predict maximal oxygen uptake from exercise time during a standardized treadmill test in women aged 29 to 75 years before and after aerobic training. Treadmill tests were administered to 181 women with measurement of maximal oxygen uptake, and an equation predicting maximal oxygen uptake was derived: maximal oxygen uptake (ml.kg-1.min-1) = 10.34 + 1.29 (exercise time), r = 0.88, standard error of the estimate = 2.1, p less than 0.0001. Thirty-three women were retested after 6 and 12 months of aerobic exercise training. Maximal oxygen uptake was predicted from the equation developed and compared with the measured values at 6 and 12 months. The predicted and measured maximal oxygen uptake values after training were not significantly different. These results indicate that it is possible to predict maximal oxygen uptake for clinical purposes with a single equation from exercise time in untrained and trained women across a wide range of ages.

Sequence comparisons of developmentally regulated collagen genes of Caenorhabditis elegans

Collagen genes col-6, col-7 (partial), col-8, col-14 and col-19 from the nematode Caenorhabditis elegans were sequenced, and compared to the previously sequenced genes col-1 and col-2. The genes are between 1.0 and 1.2 kb in length, and each includes one or two short introns. The presumptive promoter regions contain sequences similar to the eukaryotic TATA promoter element. Two distinct, conserved sequences were found in the presumptive promoter regions of, respectively, the dauer larva-specific genes col-2 and col-6, and the primarily adult-specific genes col-7 and col-19. The domain structures of the collagen polypeptides are similar: each polypeptide contains two triple-helix forming (Gly-X-Y)n domains, one of 30-33 amino acids (aa), and the other of 127-132 aa. The latter domain is interrupted by one to three short (2-8 aa) non-(Gly-X-Y)n segments that occur at relatively conserved locations in each polypeptide. Sets of cysteine residues flank the (Gly-X-Y)n domains in all of the polypeptides. The genes can be placed into three families based upon amino acid sequence similarities. Genes within a family do not always exhibit similar developmental expression programs, suggesting that structural and regulatory regions of the genes have evolved separately. The codon usage in the genes is highly asymmetrical, with adenine appearing in the third position of 85% of the glycine codons, and 93% of the proline codons.

Registered nurses and burn care facilities. Factors associated with turnover rates

The health care system in the United States is suffering from a severe shortage of registered nurses. Burn treatment facilities are no exception to this phenomenon. As a result of this shortage, institutions have begun hiring less trained personnel such as licensed practical/vocational nurses (LPNs/LVNs), nursing assistants, burn technicians, and nursing students to fill the void. This shortage is so significant that the American Medical Association (AMA) has proposed a new category of bedside care provider, a "Registered Care Technologist" (RCT). The purpose of this paper is to determine the magnitude of the registered nurse shortage in burn care facilities. A second purpose is to identify factors associated with high turnover rates and to document the reasons why registered burn nurses are leaving their positions.

Domain organization and intron positions in Caenorhabditis elegans collagen genes: the 54-bp module hypothesis revisited

The amino acid (aa) sequences of the polypeptides encoded by five collagen genes of the nematode Caenorhabditis elegans, col-6, col-7 (partial), col-8, col-14, and col-19, were determined. These collagen polypeptides, as well as those encoded by the previously sequenced C. elegans collagen genes col-1 and col-2, share a common organization into five domains: an amino-terminal leader, a short (30-33 aa) (Gly-X-Y)n domain, a non(Gly-X-Y) spacer, a long (127-132 aa) (Gly-X-Y)n domain, and a short carboxyl-terminal domain. The domain organizations and intron positions of these polypeptides were compared with those of the polypeptides encoded by Drosophila and Strongylocentrotus type IV, and vertebrate types I, II, III, IV, and IX collagen genes; the C. elegans collagen polypeptides are most similar to the vertebrate type IX collagens. It is suggested that the collagen gene family comprises two divergent subfamilies, one of which includes the vertebrate interstitial collagen genes, and the other of which includes the invertebrate collagen genes and the vertebrate type IV and type IX collagen genes. Only the vertebrate interstitial collagen genes display clear evidence of evolution via the tandem duplication of a 54-bp exon.

The effect of low-dose oral contraceptives on cardiorespiratory function, coagulation, and lipids in exercising young women: a preliminary report

A study was undertaken to determine whether low-dose oral contraceptive usage would negate the beneficial effect of exercise on cardiorespiratory fitness, lipid and lipoprotein levels, and coagulation. Twelve exercising women were randomly allocated to groups of either oral contraceptive users or non-oral contraceptive users. When compared with results in the control group, maximal oxygen uptake (ml/kg1 X min1) decreased significantly in the oral contraceptive users during the 6-month period of observation. This was associated with an 8% decrease in both the oxygen uptake (2.34 to 2.17 L/min) and the oxygen pulse (12.1 +/- 3.2 to 11.2 +/- 2.2 ml/beat). The serum cholesterol, triglycerides, high-density lipoprotein/cholesterol, and high-density lipoprotein subfractions 2a and 2b levels were not altered. A significant increase in plasminogen activity was found in the oral contraceptive users: values increased from a coherent time average of 3.8 +/- 0.5 U/ml at baseline to 5.7 +/- 0.7 U/ml at 6 months; values returned to baseline levels 1 month after stopping the oral contraceptives (coherent time average of 3.9 +/- 0.6 U/ml; p less than 0.0001). No other significant changes were noted in the coagulation and anticoagulation factors studied. Low-dose oral contraceptive usage is associated with a decrease in functional aerobic capacity, but it does not impinge on the hemostatic mechanism or lipid-lipoprotein metabolism.

Cardiorespiratory fitness evaluation in climacteric women: comparison of two methods

Middle-aged women are becoming increasingly interested in aerobic exercise. For exercise to be meaningful, training needs to be performed at 70% to 85% of VO2max for 20 minutes, three times weekly. The graded exercise test is the standard method used to determine maximum oxygen uptake, but this test is impractical for use in clinical practice. A cross-sectional study evaluated 163 women between 35 and 75 years of age by graded exercise test and compared the result with a matched group of 121 women tested by bicycle ergometer (predicted maximum oxygen uptake). Bicycle testing and the graded exercise test had a similar range of values; this was confirmed by 29 climacteric women performing both tests (r = 0.789). Menopausal status has no effect on cardiorespiratory fitness: the predicted maximum oxygen uptake of age-matched menstruating women was 27.4 +/- 6.3 ml/kg/min and that of nonmenstruating women was 25.3 +/- 4.2 ml/kg/min (p greater than 0.05). Bicycle ergometry can thus be used as a screen to determine the cardiorespiratory fitness status of climacteric women.

Experience in mass Papanicolaou screening and cytologic observations of teen-age girls

This report is based on a seven-year retrospective analysis of computerized data available from the Chicago Board of Health's Cancer Control Section and its Cytology Laboratory. All patients included were medically indigent. The cytologic specimens were obtained by the VCE technique; all Papanicolaou smears were classified with both the numerical and descriptive systems for abnormal cytology. The study cohort was composed of 33,641 teen-age patients through age 19; 58 (1.7/1,000) had abnormal cytology (Class III, IV, or V). In Chicago, from 1962 through 1969, approximately 25 per cent of the total patient load were teen-agers under the age of 19 with an extremely low yield of suspect cytology: Class III = 1.6 per month; Class IV = 0.1 per month; Class V = 0.0 per month. The Chicago Board of Health has reduced the number of Papanicolaou smears taken on young women under the age of 19; however, this conceptual approach does not exclude women under age 19 who epidemiologically and/or clinically warrant the implementation of a Papanicolaou smear with the use of Friedell's "biologic age of the cervix" formula.