Innateness, Experience, and Music Perception

Musical acculturation from infancy to adulthood was studied by testing the abilities of Western 6-month-olds and adults to notice mistunings in melodies based on native Western major, native Western minor, and non-native Javanese pelog scales. Results indicated that infants were similarly able to perceive native and non-native scales. Adults, however, were generally better perceivers of native than non-native scales. These findings suggest that infants are born with an equipotentiality for the perception of scales from a variety of cultures and that subsequent culturally specific experience substantially influences music perception.

Label-Free Protein and Pathogen Detection Using the Atomic Force Microscope

The atomic force microscope (AFM) uses a sharp micron-scale tip to scan and amplify surface features, providing exceptionally detailed topographical information with magnification on the order of ×106. This instrument is used extensively for quality control in the computer and semiconductor industries and is becoming a progressively more important tool in the biological sciences. Advantages of the AFM for biological application include the ability to obtain information in a direct, label-free manner and the ability to image in solution, providing real-time data acquisition under physiologically relevant conditions. A novel application of the AFM currently under development combines its surface profiling capabilities with fixed immuno-capture using antibodies immobilized in a nanoarray format. This provides a distinctive platform for direct, label-free detection and characterization of viral particles and other pathogens.

Temporal patterns in growth and survival of the round goby Neogobius melanostomus

Monthly, overwinter and annual instantaneous growth rates for round goby Neogobius melanostomus were calculated with maximal growth occurring in July and August and almost no growth observed between ice appearance (October) and melt (March). Annual absolute growth rates averaged 27·3 ± 1·9 mm for males and 19·8 ± 2·4 mm for females. The most parsimonious Cormack-Jolly-Seber model indicated that both the survival and recapture probabilities were dependent on sampling date, but not sex. Survival estimates remained high throughout the 13 month study with a median weekly survival probability of 0·920 (25 and 75% quartiles: 0·767 and 0·991), an overwinter survival probability of 99% and an annual survival rate of 67%. Survival probabilities were lowest for both sexes near the completion of the N. melanostomus reproductive season in July and August which supports existing evidence of higher mortality after reproduction, while challenging the paradigm that male N. melanostomus suffer comparatively higher mortality as a result of reproduction than females. Evidence indicating that growth and mortality rates are highest at the end of the reproductive season not only highlights seasonal variability in N. melanostomus natural history, but may also guide the control of this invasive species to periods when they are most vulnerable.

Absorption, distribution, metabolism, and excretion of dirlotapide in the dog

Three once-daily oral doses of 0.2 mg/kg [(14)C]dirlotapide were administered to beagle dogs to study the absorption, distribution, metabolism, and excretion of dirlotapide. Mean (14)C recovered at 2.5 and 4.5 h after the last dose was 90%. Mean (14)C in urine, bile, and feces was <1%, 1.7%, and 56% of the dose, respectively. In tissues, 26% of the (14)C dose was present in the gastrointestinal tract, 6.0% in liver, and <1% each in kidney, gall bladder, heart, and brain. To further characterize drug disposition, a single 2.5-mg/kg oral dose of [(14)C]dirlotapide was administered to beagle dogs. More than 84% of the dose had been eliminated by 72 h in feces, with 21% of the dose present in feces as parent dirlotapide. Less than 1% of the dose was excreted in urine. In bile collected during the first 24-h postdose from three dogs, 32% and 11% of the (14)C dose was present in samples from male and female dogs, respectively. Based upon metabolite profiling of plasma, excreta, and bile samples, dirlotapide was extensively metabolized to more than 20 metabolites. Biliary/fecal excretion and the potential for enterohepatic recycling of metabolites are suggested.

Pharmacokinetics of dirlotapide in the dog

An overview of the pharmacokinetics of dirlotapide in beagle dogs is presented. The following mean parameters were observed after a 0.3-mg/kg i.v. dose of dirlotapide: plasma clearance of 7.8 mL/min/kg and volume of distribution of 1.3 L/kg. Following single oral doses of 0.05, 0.3, and 1.0 mg/kg to fed dogs and 0.3 mg/kg to fasted dogs using the commercial formulation, mean C(max) of 7.5, 46, 97, and 31 ng/mL, respectively, were observed at mean t(max) of 0.8-2.0 h. AUC and C(max) increased with increasing dose, but not proportionally. Oral bioavailability was 22-41%. Exposure, as reflected by AUC, was 54% higher in the fed than fasted state. In a 14-day repeated-dose study (0.3 mg/kg dose), the mean accumulation ratio was 3.7. In a 3-month study at doses of 0.4-2.5 mg/kg, accumulation ratios ranged from 2.0 to 6.7 at day 29 and from 1.3 to 4.1 at day 87. In summary, dirlotapide exhibited low clearance, low first-pass metabolism, moderate volume of distribution, low-to-moderate oral bioavailability, a modest food effect, and variable accumulation. Large interanimal variability in systemic exposure was noted for all routes and doses, but there were no consistent sex differences.

5-Heteroatom-substituted pyrazoles as canine COX-2 inhibitors: Part 2. Structure–activity relationship studies of 5-alkylethers and 5-thioethers

Structure-activity relationship (SAR) studies of novel 2-[3-trifluoromethyl-5-alkyl(thio)ether pyrazo-1-yl]-5-methanesulfonyl pyridine derivatives for canine COX enzymes are described. The 4-cyano-5-alkyl ethers were found to have excellent potency and selectivity, whereas the 5-thioethers were potent but less selective than the ether analogs in a canine whole blood (CWB) COX-2 assay.

5-Heteroatom substituted pyrazoles as canine COX-2 inhibitors. Part 1: Structure–activity relationship studies of 5-alkylamino pyrazoles and discovery of a potent, selective, and orally active analog

Structure-activity relationship (SAR) studies of the novel 2-[3-di and trifluoromethyl-5-alkylamino pyrazo-1-yl]-5-methanesulfonyl (SO(2)Me)/sulfamoyl (SO(2)NH(2))-pyridine derivatives for canine COX enzymes are described. The studies led to the identification of 2e as lead with potent in vitro activity, selectivity, and in vivo activity in dogs and cats.

Histopathological and Behavioral Characterization of a Novel Cervical Spinal Cord Displacement Contusion Injury in the Rat

Cervical contusive trauma accounts for the majority, of human spinal cord injury (SCI), yet experimental use of cervical contusion injury models has been limited. Considering that (1) the different ways of injuring the spinal cord (compression, contusion, and transection) induce very different processes of tissue damage and (2) the architecture of the spinal cord is not uniform, it is important to use a model that is more clinically applicable to human SCI. Therefore, in the current study we have developed a rat model of contusive, cervical SCI using the Electromagnetic Spinal Cord Injury Device (ESCID) developed at Ohio State University (OSU) to induce injury by spinal cord displacement. We used the device to perform mild, moderate and severe injuries (0.80, 0.95, and 1.1 mm displacements, respectively) with a single, brief displacement of <20 msec upon the exposed dorsal surface of the C5 cervical spinal cord of female (180-200 g) Fischer rats. Characterization of the model involved the analysis of the temporal histopathological progression of the injury over 9 weeks using histochemical stains to analyze white and gray mater integrity and immunohistochemistry to examine cellular changes and physiological responses within the injured spinal cord. Accompanying the histological analysis was a comprehensive determination of the behavioral functionality of the animals using a battery of motor tests. Characterization of this novel model is presented to enable and encourage its future use in the design and experimental testing of therapeutic strategies that may be used for human SCI.

In vitro and in vivo profile of 2-(3-di-fluoromethyl-5-phenylpyrazol-1-yl)-5-methanesulfonylpyridine, a potent, selective, and orally active canine COX-2 inhibitor

The synthesis of a novel canine COX-2 selective inhibitor, 2-(3-difluoromethyl-5-phenylpyrazol-1-yl)-5-methanesulfonylpyridine, and its in vitro and in vivo profile are described. Pyrazole 8 demonstrated excellent potency and selectivity for canine COX-2 in both in vitro and ex vivo whole blood assays. This novel COX-2 inhibitor also showed a good pharmacokinetic profile (pk) following oral (po), intravenous (iv), and subcutaneous (sc) dosing and demonstrated excellent in vivo efficacy in a canine synovitis model.

BAG-1 expression in normal and neoplastic endometrium

OBJECTIVE

BAG-1 has anti-apoptotic actions and is known to bind BCL-2 and steroid receptors. High levels of BAG-1 have been implicated as a prognostic indicator in breast cancer. Whether this observation can be generalized to endometrial cancer remains unknown.

METHODS

IRB permission was obtained for use of human discarded tissue. Immunohistochemical analyses were performed on: proliferative endometrium (PEM, 6), secretory endometrium (SEM, 28), "low-grade" neoplastic lesions (complex atypical hyperplasia and grade 1 endometrial adenocarcinomas) (19), and "high-grade" cancers (grade 2 and 3 endometrial adenocarcinomas) (13). The level of total BAG-1 and its isoforms was evaluated by Western blot in lysates from Ishikawa cells (grade 1), MFE 296 cells (grade 2), and SK-UT(2) cells (grade 3).

RESULTS

The proportion of "high-grade" cancers with positive cytoplasmic staining for BAG-1 was higher than that of secretory endometrium (P = 0.006). Additionally, the proportion of specimens with positive staining for nuclear BAG-1 expression was significantly higher among high-grade carcinoma specimens compared to secretory specimens (P = 0.009). A high proportion (91%) of all specimens were positive for BCL-2, limiting the ability to subcategorize the other variables analyzed. There was no relationship between positive nuclear BAG-1 expression and either estrogen receptor (ER) or progesterone receptor (PR) expression. BAG-1 was expressed in the three cell lines evaluated and total BAG-1 level was not different among the different cell lines.

CONCLUSION

BAG-1 is expressed in the endometrium. High-grade cancers stain more frequently than secretory endometrium for both cytoplasmic and nuclear BAG-1 expression, perhaps indicating an association between expression of BAG-1 and prognosis.

Discovery of a potent, selective and orally active canine COX-2 inhibitor, 2-(3-difluoromethyl-5-phenyl-pyrazol-1-yl)-5-methanesulfonyl-pyridine

Structure-activity relationship (SAR) studies of 2-[3-di(and tri)fluoromethyl-5-arylpyrazol-1-yl]-5-methanesulfonylpyridine derivatives for canine COX enzymes are described. This led to the identification of 12a as a lead candidate for further progression. The in vitro and in vivo activity of 12a for the canine COX-2 enzyme as well as its in vivo efficacy and pharmacokinetic properties in dog are highlighted.

The effect of treating alfalfa with Lactobacillus buchneri 40788 on silage fermentation, aerobic stability, and nutritive value for lactating dairy cows

Lactobacillus buchneri 40788 and enzymes (beta-glucanase, alpha-amylase, xylanase, and galactomannase) were applied to chopped alfalfa (39% DM) to study their effects on the fermentation and nutritive value of the silage. Alfalfa was treated with nothing, or L. buchneri 40788, for a final application rate of 1 x 10(5), 5 x 10(5), or 1 x 10(6) cfu/g of fresh forage and ensiled in laboratory silos for 2, 4, 8, and 56 d. Treatment with L. buchneri 40788 had few effects on the end products of fermentation through 8 d of ensiling. However, after 56 d of ensiling, treated silages had a higher pH (4.55 vs. 4.38) and higher concentrations of acetic acid (6.40 vs. 4.24%), propionic acid (0.18 vs. 0.06%), and ammonia-N (0.35 vs. 0.29%) when compared to untreated silage. Lactic acid was also numerically lower in treated (3.51%) than untreated (4.12%). Silages treated with the moderate and highest dose of L. buchneri 40788 also resulted in greater recoveries of DM than did untreated silage. Alfalfa (43% DM) was also untreated or treated with a commercial application of L. buchneri 40788 (4 x 10(5) cfu/g, a commercial dose) in farm-scale bag silo. Holstein cows were fed a diet comprised of 32% untreated or treated alfalfa silage, 11% corn silage, 5% chopped alfalfa hay, and 52% of concentrate (DMB) for a 6-wk treatment period. Dry matter intake and milk composition were unaffected by treatment, but cows fed silage treated with L. buchneri 40788 produced 0.8 kg more milk than did cows fed untreated silage. Treated silage had a higher concentration of acetic acid (5.67 vs. 3.35%) but lower lactic acid (3.50 vs. 4.39%) than untreated silage. When exposed to air, the total mixed ration containing treated alfalfa silage remained stable for 100 h, whereas the ration containing untreated silage spoiled after 68 h. Treating alfalfa silage with L. buchneri 40788 increased the concentration of acetic acid, and when the silage was combined into a total mixed ration and fed to lactating cows, it improved the aerobic stability of the ration and increased milk production.

Synthesis and protein kinase inhibitory activity of balanol analogues with modified benzophenone subunits

A series of analogues of the protein kinase C (PKC) inhibitory natural product balanol which bear modified benzophenone subunits are described. The analogues were designed with the goal of uncovering structure-activity features that could be used in the development of PKC inhibitors with a reduced polar character compared to balanol itself. The results of these studies suggest that most of the benzophenone features found in the natural product are important for obtaining potent PKC inhibitory compounds. However, several modifications were found to lead to selective inhibitors of the related enzyme protein kinase A (PKA), and several specific modifications to the polar structural elements of the benzophenone were found to provide potent PKC inhibitors. In particular, it was found that replacement of the benzophenone carboxylate with bioisosteric equivalents could lead to potent analogues. Further, a tolerance for lipophilic substituents on the terminal benzophenone ring was uncovered. These results are discussed in light of recently available structural information for PKA.

Predictors of progression of HRCT diagnosed fibrosing alveolitis in patients with rheumatoid arthritis

BACKGROUND

Fibrosing alveolitis (FA) is the most serious pleuropulmonary extra-articular feature of rheumatoid arthritis (RA). Features that predict progression of FA in patients with RA have not yet been determined.

OBJECTIVE

To identify clinical features that predict progressive FA in patients with RA.

METHODS

An unselected cohort of 29 patients with RA and FA confirmed by high resolution computed tomography (HRCT) were studied prospectively for 24 months. Three monthly clinical assessment, four monthly pulmonary function tests, and yearly HRCT scanning was undertaken on these patients. Progressive FA was defined as >15% fall in carbon monoxide transfer factor (TLCO) with evidence of increasing FA on HRCT or death as a result of FA.

RESULTS

During 24 months of follow up 10/29 (34%) patients had progressive FA. Progression on HRCT was seen as acute ground glass exacerbations or increasing reticular pattern lung involvement. Progressive FA was associated with the presence of bibasal crackles (p=0.041), TLCO (p=0.001), and extent (p=0.026) and distribution (p=0.031) of lung involvement on HRCT at initial presentation. When multiple logistic regression was used, only TLCO remained significant. Receiver operator curve analysis was employed to identify presenting TLCO of progressive FA. A TLCO <54% of the predicted value demonstrated 80% sensitivity and 93% specificity in predicting progressive FA.

CONCLUSIONS

A TLCO <54% of the predicted value is a highly specific predictor of disease progression.

Investigation of the chronic pulmonary effects of low-dose oral methotrexate in patients with rheumatoid arthritis: a prospective study incorporating HRCT scanning and pulmonary function tests

OBJECTIVE

Methotrexate has a well-recognized side-effect of acute hypersensitivity pneumonitis. There is concern about whether chronic pulmonary toxicity can occur with methotrexate treatment. Our objective was to compare chest high-resolution computed tomography (HRCT) findings and serial pulmonary function tests in rheumatoid arthritis (RA) patients on methotrexate with findings for a control group of patients with RA who were not being treated with methotrexate.

METHODS

Study patients had an initial chest radiograph, full pulmonary function tests and chest HRCT. Pulmonary function tests were then performed regularly over a 2-yr period.

RESULTS

Fifty-five RA patients on methotrexate and 73 control patients with RA were enrolled for the study. Mean dose of methotrexate was 10.7 mg/week (S.D. 2.5 mg/week) and mean duration of treatment at entry into the study was 30 (20) months. Twenty per cent of patients with RA treated with methotrexate had pulmonary fibrosis (PF) on initial HRCT compared with 23% in the control group. When the patients with and without PF were compared, there was no statistical difference in the duration (mean difference -4.18 months, P=0.237) or dose (mean difference -0.8 mg/week P=0.52) of methotrexate therapy. Mean changes after 2 yr in forced expiratory volume, forced vital capacity, diffusion capacity for carbon monoxide and residual volumes were not different in the methotrexate group compared with the control group.

CONCLUSION

There is no evidence to suggest clinically, from HRCT assessment or serial pulmonary function tests, that low-dose methotrexate is associated with chronic interstitial lung disease.

Advanced practice issues: results of the ONS Advanced Practice Nursing survey

PURPOSE/OBJECTIVES

To ascertain the critical issues in current advanced practice nurse (APN) roles in oncology.

DESIGN

Descriptive.

SETTING

National.

SAMPLE

368 Oncology Nursing Society (ONS) APNs in oncology practice.

METHODS

Subjects completed an 11-page self-administered questionnaire comprised of 62 multiple-choice and open-ended questions. Subjects were asked to identify level of importance for ONS to address selected issues in each section.

MAIN RESEARCH VARIABLES

Demographic information and APN issues regarding practice, outcomes, prescriptive authority, reimbursement, education, continuing education, licensure and certification, legislation, and challenges facing oncology APNs.

FINDINGS

The majority of APNs were nurse practitioners working in a hematology/oncology practice in an urban setting providing direct patient care. Priority practice issues were lack of agreement among state boards of nursing related to privileges, lack of understanding of the role by patients and healthcare professionals, and lack of an APN definition. Important APN outcomes were symptom management, quality of life, patient/family satisfaction, and cost of care. Priority educational topics were oncology disease management, pharmacology, advanced physical assessment, and reimbursement. Challenges facing oncology APNs were lack of an APN definition, reimbursement issues, documentation of outcomes, prescriptive authority, variance in education, merging of current roles, certification, loss of cancer specialty, and second licensure.

CONCLUSIONS

Numerous APN issues continue to be unresolved. APN outcomes research is needed to validate the oncology APN role in cancer care.

IMPLICATIONS FOR NURSING PRACTICE

Survey results and specific recommendations have been forwarded to the ONS Steering Council and Board of Directors for implementation decisions.

Fibrosing alveolitis in patients with rheumatoid arthritis as assessed by high resolution computed tomography, chest radiography, and pulmonary function tests

BACKGROUND

Fibrosing alveolitis (FA) is a common and serious complication of rheumatoid arthritis (RA). Before the availability of high resolution computed tomographic (HRCT) scanning, it was difficult to diagnose accurately without recourse to biopsy. Prospective studies have reported a prevalence of interstitial lung disease (ILD) of 19-44%. The term ILD used by these authors encompasses a variety of appearances on HRCT scans. This prospective study used HRCT scanning to determine the true prevalence of FA in hospital outpatients with RA, and to study associated clinical characteristics.

METHODS

One hundred and fifty consecutive patients with RA were selected from a hospital outpatient department, irrespective of the presence or absence of chest disease. All underwent a detailed clinical assessment, chest HRCT scanning, and conventional chest radiography within 4 weeks of full pulmonary function tests.

RESULTS

Seventy percent of patients were current or reformed cigarette smokers. Twenty eight (19%) had FA, most frequently of reticular pattern, and 12 of this group (43%) also had emphysematous bullae. None of the previously suggested risk factors for developing FA were confirmed. Fifty four percent of patients with HRCT evidence of FA had bilateral basal chest crackles, 82% had a reduced carbon monoxide transfer factor (TLCO), 14% had restrictive pulmonary function tests, and 14% had bilateral chest radiographic signs of FA.

CONCLUSIONS

HRCT evidence of FA was present in 19% of hospital outpatients with RA. Abnormalities on chest examination or on full pulmonary function tests, even without restrictive changes or chest radiographic abnormalities, should prompt physicians to request a chest HRCT scan when investigating dyspnoea in patients with RA.

Fibrosing alveolitis in patients with rheumatoid arthritis as assessed by high resolution computed tomography, chest radiography, and pulmonary function tests

BACKGROUND

Fibrosing alveolitis (FA) is a common and serious complication of rheumatoid arthritis (RA). Before the availability of high resolution computed tomographic (HRCT) scanning, it was difficult to diagnose accurately without recourse to biopsy. Prospective studies have reported a prevalence of interstitial lung disease (ILD) of 19–44%. The term ILD used by these authors encompasses a variety of appearances on HRCT scans. This prospective study used HRCT scanning to determine the true prevalence of FA in hospital outpatients with RA, and to study associated clinical characteristics.

METHODS

One hundred and fifty consecutive patients with RA were selected from a hospital outpatient department, irrespective of the presence or absence of chest disease. All underwent a detailed clinical assessment, chest HRCT scanning, and conventional chest radiography within 4 weeks of full pulmonary function tests.

RESULTS

Seventy percent of patients were current or reformed cigarette smokers. Twenty eight (19%) had FA, most frequently of reticular pattern, and 12 of this group (43%) also had emphysematous bullae. None of the previously suggested risk factors for developing FA were confirmed. Fifty four percent of patients with HRCT evidence of FA had bilateral basal chest crackles, 82% had a reduced carbon monoxide transfer factor (Tlco), 14% had restrictive pulmonary function tests, and 14% had bilateral chest radiographic signs of FA.

CONCLUSIONS

HRCT evidence of FA was present in 19% of hospital outpatients with RA. Abnormalities on chest examination or on full pulmonary function tests, even without restrictive changes or chest radiographic abnormalities, should prompt physicians to request a chest HRCT scan when investigating dyspnoea in patients with RA.

Heavy cigarette smoking is strongly associated with rheumatoid arthritis (RA), particularly in patients without a family history of RA

OBJECTIVES

To investigate the potential relation between cumulative exposure to cigarette smoking in patients with or without rheumatoid arthritis (RA) and a positive family history of the disease.

METHODS

239 outpatient based patients with RA were compared with 239 controls matched for age, sex, and social class. A detailed smoking history was recorded and expressed as pack years smoked. Conditional logistic regression was used to calculate the association between RA and pack years smoked. The patients with RA were also interviewed about a family history of disease and recorded as positive if a first or second degree relative had RA. The smoking history at the time of the study of the patients with RA with or without a family history of the disease was compared directly with that of their respective controls. Patients with RA with or without a family history of the disease were also compared retrospectively for current smoking at the time of disease onset.

RESULTS

An increasing association between increased pack years smoked and RA was found. There was a striking association between heavy cigarette smoking and RA. A history for 41-50 pack years smoked was associated with RA (odds ratio (OR) 13.54, 95% confidence interval (95% CI) 2.89 to 63.38; p<0.001). The association between ever having smoked and RA was modest (OR 1.81, CI 1.22 to 2.19; p=0.002). Furthermore, cigarette smoking in the patients with RA without a positive family history of RA was more prevalent than in the patients with a positive family history of RA for ever having smoked (72% v 54%; p=0.006), the number of pack years smoked (median 25.0 v 4.0; p<0.001), and for smoking at the time of disease onset (58% v 39%; p=0.003).

CONCLUSIONS

Heavy cigarette smoking, but not smoking itself, is strongly associated with RA requiring hospital follow up and is markedly more prevalent in patients with RA without a family history of RA.

Development of a home-based family caregiver cancer education program

INTRODUCTION

This article describes a home-based educational program developed specifically for family caregivers of cancer patients who receive hospice and home care. The overall aim of this educational program is to specifically address family caregivers' needs for acquisition of necessary knowledge and skills to meet the physical and psychosocial demands associated with caring for a patient with advanced cancer.

PROGRAM DEVELOPMENT

Originally, components of this program were offered in a small group discussion format within hospital and community settings. The educational program was transformed to accommodate the unique needs and constraints of homebound family caregivers who have very limited time and/or opportunities for support and education outside of the home. The program is comprised of educational modules that provide hospice and home care professionals with written and audiovisual materials designed to facilitate brief, structured, educational encounters with family caregivers in the home setting.

DISCUSSION

Two hundred thirty-seven educational module kits were distributed to professionals affiliated with twenty-four home care and hospice agencies in the Greater Philadelphia area. Results of a telephone survey designed to elicit evaluation data from professional staff members who had used the educational modules are presented. Limitations, plans for future program evaluation, cost implications, and implementation recommendations related to this educational program are described.

Raised pulmonary artery pressures measured with Doppler echocardiography in rheumatoid arthritis patients

OBJECTIVE

To study the prevalence of echocardiographic abnormality and pulmonary hypertension in an unselected population of patients with rheumatoid arthritis (RA).

METHOD

One hundred and forty-six RA patients, irrespective of cardiopulmonary symptoms, were assessed clinically and by echocardiography, including pulmonary artery pressure measurement, ECG, pulmonary function tests and high-resolution computed tomography scanning of the thorax.

RESULTS

Two-dimensional echocardiography demonstrated significant cardiac disease in the form of reduced left ventricular ejection fraction (<64%) in 9% of patients, moderate mitral regurgitation in 4%, aortic stenosis in 4%, aortic regurgitation in 3% and Valsalva sinus rupture in 0.7%. In addition, 1% had detectable pericardial effusions. Thirty-one per cent of the RA patients had an estimated pulmonary artery systolic pressure of 30 mmHg or more, and 21% of all the RA patients had pulmonary hypertension without significant cardiac disease or lung disease evident on pulmonary function testing.

CONCLUSIONS

A wide and frequent variety of echocardiographic cardiac abnormalities may be found in an unselected population of patients with RA. Using Doppler echocardiography, we have found pulmonary hypertension secondary to lung disease in 6% of the population and a larger than expected prevalence of mild primary pulmonary hypertension in patients with RA. The latter observation may be relevant to the high incidence of cardiovascular-related deaths observed in patients with RA

Effect of aldehyde lipid oxidation products on myoglobin

The effects of aldehyde lipid oxidation products on myoglobin (Mb) were investigated at 37 degrees C and pH 7.2. Oxymyoglobin (OxyMb) oxidation increased in the presence of 4-hydroxynonenal (4-HNE) compared to controls (P < 0.05). Preincubation of metmyoglobin (MetMb) with aldehydes rendered the heme protein a poorer substrate for enzymatic MetMb reduction compared to controls, and the effect was inversely proportional to preincubation time; unsaturated aldehydes were more effective than saturated aldehydes (P < 0.05). The order of MetMb reduction as affected by preincubation was control > hexanal > heptanal > octanal > nonanal = decanal = hexenal > heptenal = octenal > nonenal = decenal = 4-HNE (P < 0.05). Preincubation of MetMb with 4-HNE enhanced the subsequent ability of the heme protein to act as a prooxidant in both liposomes and microsomes when compared to controls (P < 0.05); the effect was reduced in microsomes containing elevated concentrations of alpha-tocopherol (P < 0.05). MetMb preincubation with mono-unsaturated aldehydes enhanced the catalytic activity of MetMb to a greater degree than saturated aldehydes (P < 0.05). These results suggest that aldehyde lipid oxidation products can alter Mb stability by increasing OxyMb oxidation, decreasing the ability of MetMb to be enzymatically reduced and enhancing the prooxidant activity of MetMb.

Apoptosis during bone-like tissue development in vitro

We present evidence of cell death by apoptosis during the development of bone-like tissue formation in vitro. Fetal rat calvaria-derived osteoblasts differentiate in vitro, progressing through three stages of maturation: a proliferation period, a matrix maturation period when growth is downregulated and expression of the bone cell phenotype is induced, and a third mineralization stage marked by the expression of bone-specific genes. Here we show for the first time that cells differentiating to the mature bone cell phenotype undergo programmed cell death and express genes regulating apoptosis. Culture conditions that modify expression of the osteoblast phenotype simultaneously modify the incidence of apoptosis. Cell death by apoptosis is directly demonstrated by visualization of degraded DNA into oligonucleosomal fragments after gel electrophoresis. Bcl-XL, an inhibitor of apoptosis, and Bax, which can accelerate apoptosis, are expressed at maximal levels 24 h after initial isolation of the cells and again after day 25 in heavily mineralized bone tissue nodules. Bcl-2 is expressed in a reciprocal manner to its related gene product Bcl-XL with the highest levels observed during the early post-proliferative stages of osteoblast maturation. Expression of p53, c-fos, and the interferon regulatory factors IRF-1 and IRF-2, but not cdc2 or cdk, were also induced in mineralized bone nodules. The upregulation of Msx-2 in association with apoptosis is consistent with its in vivo expression during embryogenesis in areas that will undergo programmed cell death. We propose that cell death by apoptosis is a fundamental component of osteoblast differentiation that contributes to maintaining tissue organization.

Relations of motor and vocal milestones in typically developing infants and infants with Down syndrome

We measured the ages at which typically developing infants and infants with Down syndrome achieved an important vocal milestone (canonical babbling), a rhythmic motor milestone (hand-banging), and six other motor milestones. The interrelations of the milestone onsets, and their relations with Down syndrome, were assessed quantitatively. Hand-banging and canonical babbling were associated and were somewhat delayed by Down syndrome. Stepping, standing, sitting, and creeping/crawling were associated and were severely delayed by Down syndrome. Rolling and reaching were also delayed by Down syndrome, though they were not strongly associated with other milestones or with one another. These results suggest that the rhythmic behaviors (canonical babbling and hand-banging) may be internally linked by common neuromuscular underpinnings and that the postural behaviors may be similarly linked.

Contributions of experience to the development of musical processing in infancy

Full-term infants' performance in detection of melodic alterations appeared to be influenced by perceptual experience from 6 months to 1 year of age, and an experiment with infants born prematurely supported the hypothesis that experience affects music processing in infancy. These findings suggest parallel developmental tendencies in the perception of music and speech that may reflect general acquisition of perceptual abilities for processing of complex auditory patterns. This acquisition may contribute to the cultural enfranchisement of infants through perceptual experience.

Onset of speech-like vocalizations in infants with Down syndrome

Canonical babbling of infants with and without Down syndrome was compared. Infants with Down syndrome and typically developing infants began canonical babbling in the first year of life, but the infants with Down syndrome began 2 months later. Once begun, their canonical babbling was less stable than that of typically developing infants. Age at onset of canonical babbling for the infants with Down syndrome was correlated with their scores at 27 months of age on the Early Social-Communication Scales. The results of this study suggest that Down syndrome influences vocal development in the first year of life and that early vocal development is related, possibly in combination with motoric and cognitive factors, to later social and communicative functioning of children with Down syndrome.

Phrasing in prelinguistic vocalizations

Phrasing is a universal characteristic of human communication, and the present investigation explored its developmental roots in nonvegetative, prelinguistic vocalizations. Adult judges identified a hierarchical arrangement of syllables embedded within utterances and utterances embedded within prelinguistic phrases in the vocalizations of infants. Prelinguistic phrases were characterized by systematic lengthening of phrase final syllables, temporal patterning, and stable durations across development that were similar to those of some cross-culturally optimal rhythmic units from other domains. Analyses of vocalizations of infants with Down syndrome indicated similar internal structure of prelinguistic phrases to those of typically developing infants, but with longer durations. These findings suggest that relative durational characteristics of prelinguistic phrasing are stable features of early vocal behavior, although the absolute durational characteristics of prelinguistic phrases can be impacted by a complex and severe disorder such as Down syndrome.

The influence of type I collagen on the development and maintenance of the osteoblast phenotype in primary and passaged rat calvarial osteoblasts: modification of expression of genes supporting cell growth, adhesion, and extracellular matrix mineralization

Osteoblasts derived from Day 21 fetal rat calvaria grown on films of collagen type I exhibit an earlier and enhanced expression of the differentiated phenotype, compared to cells cultured on plastic. The temporal expression of genes characterizing three distinct periods of growth and differentiation are dramatically modified. During the initial proliferation period, expression of genes normally expressed at high levels on plastic (fibronectin, beta 1 integrin, and actin) was decreased from 50 to 70% in cells grown on collagen. Genes normally expressed at maximal levels in the postproliferative period (osteonectin, osteocalcin, and osteopontin) were up-regulated severalfold very early. Alkaline phosphatase enzyme activity was elevated 2- to 3-fold during the proliferation period, while mRNA levels remained low, suggesting post-transcriptional modifications. The most dramatic consequence of culture of cells on collagen is the accelerated and uniform mineralization of the matrix in contrast to the focal mineralization confined to bone nodules in cultures on plastic. Type I collagen supports maintenance of osteoblast phenotypic properties of passaged cells in the absence of glucocorticoid supplementation required for differentiation of osteoblasts subcultivated on plastic. Treatment of proliferating rat osteoblasts on plastic with 1,25(OH)2D3 blocks osteoblast differentiation and matrix mineralization. Although differentiation-related genes (alkaline phosphatase and osteocalcin) were up-regulated by vitamin D, culture on the collagen matrix could not overcome the inhibition of mineralization. Taken together, these studies define the critical role of type I collagen in mediating the signaling cascade for expression of a mature osteoblast phenotype and mineralization of the extracellular matrix in a physiological manner.

Effects of aging on processing of novel musical structure

Musical processing involves long-term memory representations of invariant properties of auditory patterns and working memory representations of patterns heard in the present moment. Musical scales are formalized sets of pitches on which much of musical composition and improvisation is based, and frequency relations among scale notes are invariant within categorical boundaries. Studies of young adults have indicated that adjustments of frequency relations are better detected when melodies are based on culturally familiar scales than on culturally unfamiliar scales. A proposed account for this finding has been that knowledge about musical frequency relations is stored in long-term memory. In the present study, old and young adults performed equivalently well in detection of frequency relation adjustments in a culturally familiar scale context, but young adults performed better than old adults in culturally unfamiliar scale contexts. The performance of old adults in a culturally unfamiliar scale context was correlated with high-frequency (8 kHz) hearing sensitivity. These findings suggest that influences of aging on processing of auditory events involve relations of auditory cognition and hearing sensitivity.

Speech-like vocalizations in infancy: an evaluation of potential risk factors

This work reports longitudinal evaluation of the speech-like vocal development of infants born at risk due to prematurity or low socio-economic status (SES) and infants not subject to such risk. Twenty infants were preterm (10 of low SES) and 33 were full term (16 of low SES), and all were studied from 0;4 through 1;6. The study provides the indication that at-risk infants are not generally delayed in the ability to produce well-formed speech-like sounds as indicated in tape-recorded vocal samples. At the same time, premature infants show a tendency to produce well-formed syllables less consistently than full terms after the point at which parents and laboratory personnel note the onset of the canonical babbling stage (the point after which well-formed syllables are well established in the infant vocal repertoires). Further, even though low SES infants produce well-formed speech-like structures on schedule, they show a reliably lower tendency to vocalize in general, as reflected by fewer utterances per minute in recorded samples.

Ifosfamide. Patient care management

Ifosfamide is an antineoplastic drug with efficacy and activity in numerous cancers. This drug can be administered safely in a hospital setting if toxicities and side effects are monitored frequently by a well-informed and educated nursing staff. Problems may occur in any bodily system, such as the kidney, central nervous system (CNS), gastrointestinal tract, and bone marrow. This article reviews appropriate ways to monitor for complications and plan correct nursing interventions. Ifosfamide (Ifex, Mead Johnson) is an alkylating agent that is not cell cycle specific. One of its metabolites, acrolein, is responsible for hematuria. Concurrent administration of mesna (Mesnex, Mead Johnson) is used to prevent this complication. The metabolite chloroacetaldehyde may be responsible for CNS toxicities. When kidney function and electrolytes are within normal limits and psychotropic medications are not given concomitantly, this rarely occurs. Gastrointestinal toxicities are usually not severe, but may include occasional nausea and vomiting. Hematologic toxicity includes platelet-sparing myelosuppression, which can be successfully supported with the administration of growth factors.

A study of perceptual development for musical tuning

Musical tuning perception in infancy and adulthood was explored in three experiments. In Experiment 1, Western adults were tested in detection of randomly located mistunings in a melody based on musical interval patterns from native and nonnative musical scales. Subjects performed better in a Western major scale context than in either a Western augmented or a Javanese pelog scale context. Because the major scale is used frequently in Western music and, therefore, is more perceptually familiar than either the augmented scale or the pelog scale are, the adults' pattern of performance is suggestive of musical acculturation. Experiments 2 and 3 were designed to explore the onset of culturally specific perceptual reorganization for music in the age period that has been found to be important in linguistically specific perceptual reorganization for speech. In Experiment 2, 1-year-olds had a pattern of performance similar to that of the adults, but 6-month-olds could not detect mistunings reliably better than chance. In Experiment 3, another group of 6-month-olds was tested, and a larger degree of mistuning was used so that floor effects might be avoided. These 6-month-olds performed better in the major and augmented scale contexts than in the pelog context, without a reliable performance difference between the major and augmented contexts. Comparison of the results obtained with 6-month-olds and 1-year-olds suggests that culturally specific perceptual reorganization for musical tuning begins to affect perception between these ages, but the 6-month-olds' pattern of results considered alone is not as clear. The 6-month-olds' better performance on the major and augmented interval patterns than on the pelog interval pattern is potentially attributable to either the 6-month-olds' lesser perceptual acculturation than that of the 1-year-olds or perhaps to an innate predisposition for processing of music based on a single fundamental interval, in this case the semitone.

Methotrexate associated Peyronie's disease in the treatment of rheumatoid arthritis

We describe two patients with rheumatoid arthritis treated with methotrexate (MTX) who developed Peyronie's disease during the course of their treatment. In one of the patients the penile fibrosis resolved on stopping the drug. The other patient's penile fibrosis partially resolved on stopping the drug. We suggest that Peyronie's disease can be a side-effect of MTX in the treatment of rheumatoid arthritis.

FFT-based digital tactile vocoder system for real-time use

A microprocessor-based real-time digital vibrotactile vocoder system has been developed to train the deaf and for artificial hearing research. The system is composed of a microcomputer module with a digital signal processor, interface units and an attenuator/driver circuit. Live or digitised (stored or synthetic) speech is presented to the skin spectrally through a belt housing eight or 16 vibrators. Speech is processed in real time using a fast Fourier transform. The system is also capable of presenting any arbitrary spatiotemporal pattern on the skin for artificial hearing experiments. A preliminary experiment with a deaf subject indicates that the system is potentially an effective device for artificial hearing.

Influences of acculturation and musical sophistication on perception of musical interval patterns

Influences of acculturation and musical sophistication on music perception were examined. Judgments for mistuning were obtained for Ss differing in musical sophistication who listened to a melody that was based on interval patterns from Western and Javanese musical scales. Less musically sophisticated Ss' judgments were better for Western than Javanese patterns. Musicians' thresholds did not differ across Western and Javanese patterns. Differences in judgments across scales are accountable to acculturation through listening exposure and musical sophistication gained through formal experience.