Effects of Administering Exogenous Bovine Somatotropin During the First Trimester of Pregnancy Altered Uterine Hemodynamics in Suckled Beef Cows

The objective of this study was to examine the effects of recombinant bovine somatotropin (bST) administration on uterine hemodynamics and subsequent fetal programming in suckled cows during the first trimester of gestation. Crossbred beef cows (n = 152) were stratified by breed, days postpartum, parity, cyclicity status, and body condition score (BCS) before being assigned to either receive injections of bST every other week (BST; 500-mg/14 d) starting at fixed-time artificial insemination (TAI; d 0) until d 97 or to receive no bST (CTL). Blood samples were collected until d 97 for analysis of plasma concentrations of insulin-like growth factor 1 (IGF-1). Pregnancy was assessed via transrectal ultrasonography on d 41 and 173. A subset of pregnant cows (BST, n = 24; CTL, n = 28) were selected for assessment of uterine arterial blood flow (BF), pulsatility index, and resistance index (RI) of the uterine arteries ipsilateral and contralateral to the conceptus via color Doppler ultrasonography on d 97 and 233 of gestation. No differences (P = 0.99) were detected in body weight (BW) or BCS of dams; however, plasma concentrations of IGF-1 were greater (P < 0.001) in BST-treated cows. Color Doppler ultrasonography parameters differed whereby a treatment × day interaction (P = 0.007) was detected for RI on d 97 (P = 0.048); however, on d 233, RI did not differ (P > 0.10) but ipsilateral BF for BST-treated cows was greater (P = 0.0319) than controls. Mean heart girth diameter, crown-to-rump length, and neonate BW at 7 ± 5 d of calf age did not differ (P > 0.10). Liver tissue samples from each calf were collected for analysis of mRNA expression of target insulin-like growth factor system ligands. There was no difference in gene expression of hepatic IGF-1 between treatments (P = 0.99). A treatment × sex interaction was determined, where BST heifers had increased mRNA expression of IGFR1 compared to BST bulls (P = 0.03). Bi-weekly administration of bST until d 97 of pregnancy increased plasma concentrations of IGF-1, altered uterine hemodynamics in dams, induced sex-specific changes in liver gene expression of the offspring but failed to alter calf morphometries or calf performance until weaning.

Germinal center reactions in tertiary lymphoid structures associate with neoantigen burden, humoral immunity and long-term survivorship in pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) has traditionally been thought of as an immunologically quiescent tumor type presumably because of a relatively low tumor mutational burden (TMB) and poor responses to checkpoint blockade therapy. However, many PDAC tumors exhibit T cell inflamed phenotypes. The presence of tertiary lymphoid structures (TLS) has recently been shown to be predictive of checkpoint blockade response in melanomas and sarcomas, and are prognostic for survival in PDAC. In order to more comprehensively understand tumor immunity in PDAC patients with TLS, we performed RNA-seq, single and multiplex IHC, flow cytometry and predictive genomic analysis on treatment naïve, PDAC surgical specimens. Forty-six percent of tumors contained distinct T and B cell aggregates reflective of “early-stage TLS” (ES-TLS), which correlated with longer overall and progression-free survival. These tumors had greater CD8⁺ T cell infiltration but were not defined by previously published TLS gene-expression signatures. ES-TLS⁺ tumors were enriched for IgG1 class-switched memory B cells and memory CD4⁺ T cells, suggesting durable immunological memory persisted in these patients. We also observed the presence of active germinal centers (mature-TLS) in 31% of tumors with lymphocyte clusters, whose patients had long-term survival (median 56 months). M-TLS-positive tumors had equivalent overall T cell infiltration to ES-TLS, but were enriched for activated CD4⁺ memory cells, naive B cells and NK cells. Finally, using a TCGA-PDAC dataset, ES-TLS⁺ tumors harbored a decreased TMB, but M-TLS with germinal centers expressed significantly more MHCI-restricted neoantigens as determined by an in silico neoantigen prediction method. Interestingly, M-TLS⁺ tumors also had evidence of increased rates of B cell somatic hypermutation, suggesting that germinal centers form in the presence of high-quality tumor neoantigens leading to increased humoral immunity that confers improved survival for PDAC patients.

AbbreviationsTLS: tertiary lymphoid structures; GC: germinal center(s); PDAC: pancreatic ductal adenocarcinoma; RNA-seq: RNA sequencing; BCRseq: B cell receptor sequencing; HEV: high endothelial venule; PNAd: peripheral node addressin; TMB: tumor mutational burden; TCGA: the cancer genome atlas; PAAD: pancreatic adenocarcinoma; FFPE: formalin fixed paraffin embedded; TIME: tumor immune microenvironment.

TGFβ suppresses CD8+ T cell expression of CXCR3 and tumor trafficking

Transforming growth factor beta (TGFβ) is a multipotent immunosuppressive cytokine. TGFβ excludes immune cells from tumors, and TGFβ inhibition improves the efficacy of cytotoxic and immune therapies. Using preclinical colorectal cancer models in cell type-conditional TGFβ receptor I (ALK5) knockout mice, we interrogate this mechanism. Tumor growth delay and radiation response are unchanged in animals with Treg or macrophage-specific ALK5 deletion. However, CD8αCre-ALK5flox/flox (ALK5ΔCD8) mice reject tumors in high proportions, dependent on CD8+ T cells. ALK5ΔCD8 mice have more tumor-infiltrating effector CD8+ T cells, with more cytotoxic capacity. ALK5-deficient CD8+ T cells exhibit increased CXCR3 expression and enhanced migration towards CXCL10. TGFβ reduces CXCR3 expression, and increases binding of Smad2 to the CXCR3 promoter. In vivo CXCR3 blockade partially abrogates the survival advantage of an ALK5ΔCD8 host. These data demonstrate a mechanism of TGFβ immunosuppression through inhibition of CXCR3 in CD8+ T cells, thereby limiting their trafficking into tumors.

Material Requirements for a Boron Phosphide Thermal Neutron Counter

Electrical characterization (current versus voltage and capacitance versus voltage) of nonstoichiometric amorphous boron phosphide Schottky diodes for neutron detection is presented. These results are incorporated in a Monte Carlo model of detector response to determine material requirements for a boron phosphide neutron counter.

Direct measurement of the 7Be solar neutrino flux with 192 days of borexino data

We report the direct measurement of the 7Be solar neutrino signal rate performed with the Borexino detector at the Laboratori Nazionali del Gran Sasso. The interaction rate of the 0.862 MeV 7Be neutrinos is 49+/-3stat+/-4syst counts/(day.100 ton). The hypothesis of no oscillation for 7Be solar neutrinos is inconsistent with our measurement at the 4sigma C.L. Our result is the first direct measurement of the survival probability for solar nu(e) in the transition region between matter-enhanced and vacuum-driven oscillations. The measurement improves the experimental determination of the flux of 7Be, pp, and CNO solar nu(e), and the limit on the effective neutrino magnetic moment using solar neutrinos.

Protection against fetal infection with either bovine viral diarrhea virus type 1 or type 2 using a noncytopathic type 1 modified-live virus vaccine

Two bovine viral diarrhea virus (BVDV) fetal protection studies were done using a monovalent noncytopathic (NCP) BVDV vaccine containing type 1 BVDV. In study 1, thirty-two fetuses (23 vaccinates and nine controls) were recovered following fetal challenge with the type 1a BJ strain. Twenty of twenty-three fetuses from the vaccinates were negative for BVDV type 1 while all of the controls (nine of nine) were infected. In study 2, twenty-two animals (14 vaccinates and eight controls) were challenged with the type 2 PA131 strain. Thirteen of the fourteen fetuses from the vaccinates were negative for BVDV type 2 while all of the nonvaccinated controls (eight of eight) were infected. These results indicate the efficacy of a monovalent NCP BVDV vaccine in providing excellent protection against either BVDV type 1 or 2 fetal infection.

Water systems to report drinking water quality to all customers: how can health professionals prepare for the questions that these reports will generate?

The ultimate safety of drinking water depends upon protection of source waters and construction and maintenance of reliable drinking water treatment and distribution systems. These objectives require public support. Physicians can encourage their patients to call their water suppliers and advocate for investment in effective treatment systems and support zoning that will protect water supply watersheds and wellheads. The Consumer Confidence Reports are meant to inform consumers about their drinking water supply. Consumers should use the reports to verify that their drinking water meets all health standards and to understand some of the potential threats to their drinking water quality. Physicians may use the reports as an opportunity to discuss the many types of environmental exposures and ways to reduce these exposures. As a crucial component of the public health community, this is your opportunity to encourage your patients to become more aware of their environment and its impact on their health.

Parity violation in elastic electron-proton scattering and the Proton's strange magnetic form factor

We report a new measurement of the parity-violating asymmetry in elastic electron scattering from the proton at backward scattering angles. This asymmetry is sensitive to the strange magnetic form factor of the proton as well as electroweak axial radiative corrections. The new measurement of A = -4.92+/-0.61+/-0.73 ppm provides a significant constraint on these quantities. The implications for the strange magnetic form factor are discussed in the context of theoretical estimates for the axial corrections.

Sezary cell-like leukemia with atypical immunophenotype

We describe the clinical and laboratory features of an unusual case with Sezary cell-like leukemia. Clinical manifestations were: anemia (Hb 9.4 g/dl), severe thrombocytopenia (5 x 10(9)/l), lymphocytosis (43 x 10(9)/l) and splenomegaly. There was no lymphadenopathy, hepatomegaly or skin lesions. Bone marrow trephine showed diffuse infiltration by atypical lymphoid cells. By ultrastructural analysis the cells were small to medium-size lymphocytes with nuclear features identical to Sezary cells. Immunophenotyping showed that most peripheral blood mononuclear cells were negative with B lymphoid, myeloid, and stem cell-associated markers and were also negative with most T lymphoid markers (CD2, CD4, membrane/cytoplasmic CD3, CD5 and CD8). However, they were positive with CD38 (70%), CD7 (25%) and TIA-2 (25%). Molecular analysis showed a clonal rearrangement of the TCR beta and gamma chain genes. The patient was initially treated with vincristine, doxorubicin and asparaginase and then with six cycles of CHOP, achieving a complete remission and remaining free of disease 22 months from diagnosis. Aberrant immunophenotypes are not frequent in primary T cell leukemias. This is the first case of a rare type of T cell neoplasm, Sezary cell-like leukemia, in which cells lacked most of the T cell-associated antigens.

A survey of medical directors of life insurance companies concerning use of genetic information

Rapid advances in our ability to test persons presymptomatically for genetic diseases have generated increasing concern that genetic information will be abused by insurance companies. Reasoning that the insurance companies may have the strongest interest in using genetic data and that the medical directors of those companies with responsibility for rating applicants would be a good source of information on the use of such data, we conducted a large survey of medical directors of North American life insurance companies. We received responses from 27 medical directors. Our results suggest that (1) few insurers perform genetic tests on applicants, but most are interested in accessing genetic test information about applicants that already exists; (2) the degree of insurers' interest in using genetic test results may depend on the face amount of the policy applied for and on the specificity and sensitivity of the test; (3) many companies employ underwriting guidelines with respect to certain genetic conditions but may not always have specific actuarial data in house to support their rating decisions; (4) a considerable degree of subjectivity is involved in most insurers' rating decisions; and (5) some of the medical directors who responded to our survey are not fully informed about certain basic principles of medical genetics.

Ethical issues in the care of cancer patients

Nearly all the topics considered by medical ethics generally present themselves to those caring for cancer patients. Although most attention may be given to questions of resource allocation and limiting treatment, other issues are of equal importance. Providing respect and compassion for patients may be even more important. The day-to-day treatment of the patient that recognizes the practical autonomy of the patient and legitimizes the patient's involvement in deciding about his or her own care may do more to preserve the integrity of the patient as a person than anything else that happens to someone who accepts the cancer diagnosis. The physician who can accept the patient's judgment and participation and who can help the patient find positive meaning in what can be a personally and socially devastating disease experience has enacted a highly laudatory ethical standard of patient care.

A survey of state insurance commissioners concerning genetic testing and life insurance

Rapid advances in genetic testing have stimulated growing concern about the potential for misuse of genetic data by insurance companies, employers, and other third parties. Thus far, reports of genetically based discrimination in life insurance have been anecdotal. Reasoning that state insurance commissioners were likely to be aware of (1) the extent of current use of and interest in genetic tests by life insurers and (2) consumer complaints about insurance being denied because of genetic condition or because of genetic test results, we conducted a survey of that group. We received responses from 42 of the 51 jurisdictions. Our results suggest (1) that those who regulate the life insurance industry do not yet perceive genetic testing to pose a significant problem in how insurers rate applicants, (2) that life insurers have much legal latitude to require genetic tests, and (3) that so far few consumers have formally complained to commissioners about the use of genetic data by life insurers.

Hospitals on the frontier

The concept of a limited service rural hospital recently gained nationwide attention when Montana introduced the medical assistance facility (MAF) model, which allows a hospital to have a license under less stringent rules (rather than close completely). The MAF is a down-scaled, limited-service rural hospital that makes extensive use of midlevel practitioners and has flexible staffing requirements. MAFs restrict admission to patients with low-intensity, acute illnesses who typically require short-term hospitalization. Montana currently has four MAFs certified as Medicare and Medicaid providers under the terms of a waiver agreement with the Health Care Financing Administration (HCFA). MAFs are located in four "frontier" communities--counties or regions with fewer than six residents per square mile. A 96-hour cap on inpatient stay effectively guarantees that the MAF's scope of services will be circumscribed. However, the array of services that meet the definition of low intensity and short term is potentially broad. The flexibility--and thus the real strength--of the MAF model is in the licensure rules, which relax some of the requirements that the small rural hospital has difficulty meeting (such as those regarding staffing). The demonstration project is now entering its final two years. So far, it has gained widespread interest and support. The central question is whether HCFA will extend the waiver after 1993. Another possibility is the reclassification of MAFs to rural primary care hospitals, which do not require waiver coverage to receive Medicare and Medicaid reimbursement.

Correlation between Korotkoff's sounds and ultrasonics of the brachial artery in healthy and normotensive subjects

The clinical measurement of blood pressure is generally obtained by auscultation for Korotkoff's sounds over the brachial artery using a sphygmomanometer and cuff. Real-time two dimensional ultrasound and Doppler techniques were used to study the brachial artery movements and blood flow patterns during these pressure measurements. Simultaneous recordings of Korotkoff's sounds were obtained. A strong correlation in time was demonstrated between Korotkoff's five phases, brachial artery wall movements and specific blood flow patterns. The evidence largely supports what to date has been speculation as to the origin of Korotkoff's sounds in that Korotkoff's phases 1 and 3 appear to be produced by vigorous arterial wall motion and phase 5 by cessation of this movement. Phase 2 is produced by blood flow disturbance. Furthermore, the lack of correlation between phase 4 and any specific vascular event may go some way to explaining why in clinical practice phase 5 readings are now preferred for diastolic pressure.

Evaluation of tympanic membrane thermometer for use with pediatric patients

To determine if a tympanic membrane thermometer is of benefit on a pediatric unit. Temperature readings using a tympanic membrane thermometer and an electronic thermometer were compared for 295 paired observations. The electronic temperature readings were done by rectal (n = 32), oral (n = 65), and axillary (n = 198) routes. Differences in tympanic and electronic readings were compared by paired t-tests, and the readings were also correlated. The nursing time in seconds was also compared between electronic and tympanic measurements. Parents and nurses rated their opinion of each type of measurement on a 0-5 Likert scale. Nurses rated the patient's response using the same scale. Results indicate that temperature readings differ by an average of .2- .5 degree between tympanic and electronic thermometers. Correlations are statistically significant but of low-to-moderate strength. Parents and nurses did not rate the types of instruments differently. The nurses rated the electronic axillary method as being more acceptable to toddlers. The tympanic membrane measurement took an average of 30-38 seconds less time to take. Tympanic membrane thermometry saves nursing time. Although the correlations were not strong between electronic and tympanic membrane measurements, the tympanic reading was closer to the electronic rectal reading than to axillary or oral readings.

Pathologic considerations in the high-risk breast patient

An understanding of the spectrum of benign breast changes is necessary to optimize diagnosis and treatment. To evaluate the relative risk for developing cancer with benign breast lesions, each of the entities included in the category of benign breast conditions is discussed individually.

Purification and characterization of mouse uterine estrogen receptor under conditions of varying hormonal status

Mouse uterine estrogen receptor (ER) was purified about 11,000-fold from normal mouse uteri by affinity chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified ER demonstrated a major component of 65,000 mol wt with minor fragments of the 54,000- and 37,000-dalton species, as judged by affinity labeling with [3H]tamoxifen aziridine and immunodetection with an ER monoclonal antibody (H-222). The minor fragments were not detected with additional monoclonals (H-226 or D-547), which recognize different domains on the ER molecule. Two-dimensional gel electrophoresis revealed that the major component with a mol wt of 65,000 had a pI of about 6.5. The 54,000- and 37,000-dalton components had similar pI values. Saturation binding and Scatchard plot analysis of purified ER yielded one class of binding sites with an apparent dissociation constant of about 1.4 nM. Changes in the hormonal status resulted in changes in the size of the ER even in the presence of molybdate and leupeptin.

Measurement of volume flow in the human common femoral artery using a duplex ultrasound system

A duplex ultrasound system was used to measure volumetric flow in the human common femoral artery. The accuracy of the technique was validated using a flow rig. The average resting common femoral artery flow rate in a population of subjects clinically unaffected by peripheral vascular disease was 350 +/- 141 mls min-1. Although mean common femoral artery diameter was greater in males (10 +/- 0.9 mm) than in females (7.8 +/- 0.7 mm) (p less than 0.01), there was no significant difference in resting blood flow. Repeated measurements in individual subjects showed a high variability, largely due to physiological fluctuations (75 percent of total variability). There was a close correlation between volume flow and the reciprocal of pulsatility index (100/PI). In normal subjects 100/PI represents a simpler method of determining individual changes in blood flow. The temporal variations in volume flow during periods of reactive hyperaemia had a characteristic profile, which was dependent on the duration of circulatory arrest. The data derived from the resting hyperaemia flow profile provides normal ranges for future comparison with patients suffering from peripheral vascular disease.

Metastatic basal cell carcinoma

Basal cell carcinoma rarely metastasizes. There are over 130 reported cases, 70% of which involve lymph nodes. In many cases a large, chronic, neglected or inadequately treated basal cell carcinoma preceded the metastasis. We report a case in which a basal cell carcinoma of the cheek metastasized to cervical lymph nodes.

Aspects of the design of performance measuring test objects

In order for medical ultrasonics to achieve a high and universal standard of systematic and scientific implementation, methods for assessing the imaging performance of scanners must be developed which are both rigorous and simple to use. The difficulty that has been found in this task comes from the complex interaction of the performance parameters. Measurements of parameters should not be presented in mutual isolation. Further, the performance of a scanner, as measured using electronically generated external stimuli, might not be generalised to realistic acoustic situations. If the assessment is to be relevant to the clinical situation these factors must be taken into account. Test objects employing tissue mimicking materials provide the simplest, and possibly the only way to achieving this. In this paper the authors' designs for such test objects together with an indication of a comprehensive test system are presented.

A simple calibration and evaluation phantom for ultrasound scanners

It is argued that performance measuring phantoms containing tissue mimicking material should be considered as a series of combined test features. Each test feature should be capable of yielding quantitative data if desired and the inclusion of a comprehensive set of such features in a single phantom would allow the mutual interdependence of performance parameters to be assessed. These ideas are demonstrated in scans of several phantoms which utilise new features for measuring grey scale performance and relative beam width orthogonal to the scan plane. The relation of this work to research on low contrast detectability of lesions is discussed.

Subchronic administration of caffeine and theophylline in drinking water: effects on rat liver RNA polymerase I activity

Administration of caffeine or theophylline, 0.2 mg/ml (an average of 20 mg/kg/d) of drinking water, to male CD rats, 2 months of age, over a 15 week period resulted in the elevation of liver RNA polymerase I activity by 2-3 fold as assayed in isolated nuclei. This increase in activity was already apparent by the fourth week of exposure. The changes in RNA polymerase I activity were accompanied by moderate liver hypertrophy.

Follicle-stimulating hormone-mediated induction of functional luteinizing hormone/human chorionic gonadotropin receptors during monolayer culture of porcine granulosa cells

The LH/hCG receptor content of porcine ovarian granulosa cells from 1- to 3-mm follicles can be increases to 4--5 times the preculture level during monolayer culture in serum-containing media supplemented with insulin and FSH. The binding of [125I]iodo-hCG declines during the first 2 days of culture, but then uniformly increases through 6 days, achieving a 14- to 15-fold increase relative to the 2-day level under optimal conditions. Analysis of receptor binding by autoradiography indicates that after 2 days, the number of cells specifically binding [125I]iodo-hCG increases significantly during culture, as does the intensity of binding on receptor-bearing cells. Granulosa cells in monolayer culture exhibit heterogeneous receptor induction, indicating that normalized [125I]iodo-hCG binding data cannot be used to estimate receptor concentration per cell. Receptor affinities in the initial and induced populations are identical. LH/hCG receptors induced in granulosa cells during culture are functional, as demonstrated by specific hCG-stimulated progesterone secretion. 17 beta-Estradiol produces a differential effect in vitro, generally increasing [125I]iodo-hCG binding with respect to FSH-induced levels but consistently depressing the subsequent hCG-stimulated steroidogenic response of cells bearing the induced receptor. The porcine granulosa cell monolayer system thus appears to be a useful model with which to study, in vitro, mechanisms of steroid and gonadotropin regulation of granulosa cell differentiation and overall follicular development.