Diesel exhaust is a pulmonary carcinogen in rats exposed chronically by inhalation

Male and female F344 rats were exposed 7 hr/day, 5 day/week for up to 30 months to automotive diesel engine exhaust at soot concentrations of 0.35, 3.5, or 7.0 mg/m3 or were sham-exposed to clean air. Rats were terminated at 6-month intervals to measure lung burdens of diesel soot and for histopathology. Other rats either died or were terminated after 30 months of exposure. Lungs were fixed, sectioned into 3-mm slices, and examined by a dissecting microscope to detect tumors. Lesions were stained and examined by light microscopy. Survival and body weight were unaffected by exposure. Focal fibrotic and proliferative lung disease accompanied a progressive accumulation of soot in the lung. The prevalence of lung tumors was significantly increased at the high (13%) and medium (4%) dose levels above the control prevalence (1%). Four tumor types, all of epithelial origin, were observed: adenoma, adenocarcinoma, squamous cyst, and squamous cell carcinoma. Logistic regression modeling demonstrated a significant relationship between tumor prevalence and both exposure concentration and soot lung burden. These results demonstrate that diesel exhaust, inhaled chronically at a high concentration, is a pulmonary carcinogen in the rat.

The Effect of Previous Crop Residues and Tillage on Fusarium Head Blight of Wheat

Effects of previous crop residues and tillage practices on Fusarium head blight (FHB) of wheat were examined. Fusarium head blight was monitored in plots of the FHB-susceptible spring wheat cultivar Norm following crops of corn, wheat, and soybeans in 1995, 1996, and 1997. Moldboard plow, chisel plow, and no-till treatments were imposed perpendicular to crop strips to establish a range of residue levels in each of the previous crop residues. Fusarium head blight incidence and severity were greatest when wheat followed corn and least when wheat followed soybeans. Incidence and severity were lower in moldboard plowed plots than in either chisel plowed or no-till plots, although differences among chisel plow and no-till treatments were not apparent. Yields of wheat were approximately 15% lower in plots where wheat followed corn or wheat than in wheat following soybeans and were 10% greater in moldboard plowed plots than in either chisel plowed or no-till treatments. The deoxynivalenol (DON) content of harvested grain was significantly correlated with FHB incidence and severity. The DON level in wheat following soybeans, averaged across tillage treatments, was 25% lower than in wheat following wheat and 50% of the level in wheat following corn. These findings suggest that changes in regional tillage practices, principally the move toward conservation tillage and reduced-till systems, contributed to the recent FHB epidemics in the Upper Midwest. Because differences in the type and quantity of crop residues in small plots affected disease development, it is likely that local sources of inoculum, such as those within a grower's field, contribute directly to the inoculum load and disease potential. The implication of these findings is that selection of cultural practices aimed to reduce inoculum-borne residues will assist in the control of FHB.

Foot kinematics during walking measured using bone and surface mounted markers

The aim was to compare kinematic data from an experimental foot model comprising four segments ((i) heel, (ii) navicular/cuboid (iii) medial forefoot, (iv) lateral forefoot), to the kinematics of the individual bones comprising each segment. The foot model was represented using two different marker attachment protocols: (a) markers attached directly to the skin; (b) markers attached to rigid plates mounted on the skin. Bone data were collected for the tibia, talus, calcaneus, navicular, cuboid, medial cuneiform and first and fifth metatarsals (n=6). Based on the mean differences between the three data sets during stance, the differences between any two of the three kinematic protocols (i.e. bone vs skin, bone vs plate, skin vs plate) were >3 degrees in only 35% of the data and >5 degrees in only 3.5% of the data. However, the maximum difference between any two of the three protocols during stance was >3 degrees in 100% of the data, >5 degrees in 73% of the data and >8 degrees in 23% of the data. Differences were greatest for motion of the combined navicular/cuboid relative to the calcaneus and the medial forefoot segment relative to the navicular/cuboid. The differences between the data from the skin and plate protocols were consistently smaller than differences between either protocol and the kinematic data for each bone comprising the segment. The pattern of differences between skin and plate protocols and the actual bone motion showed no systematic pattern. It is unlikely that one rigid body foot model and marker attachment approach is always preferable over another.

New approaches for the evaluation of pulmonary toxicity: bronchoalveolar lavage fluid analysis

Analysis of bronchoalveolar lavage fluid (BAL) is an effective method of detecting an inflammatory response in the lungs of animals in toxicological studies. Alterations in BAL that are the most sensitive indications of an inflammatory response are an increased content of serum proteins and an influx of neutrophils (PMNs). Elevation of the cytoplasmic enzyme lactate dehydrogenase (LDH) is a useful indicator of cytotoxicity. The pulmonary inflammatory response to particles (either mineral dusts or soot) in the lung includes greatly increased activities of such lysosomal enzymes as beta-glucuronidase and beta-N-acetylglucosaminidase in BAL. Examination of alterations in BAL in rats and mice during chronic exposure to high levels of diluted diesel exhaust revealed that steadily increasing levels of LDH, beta-glucuronidase, and hydroxyproline in BAL correlated better with the development of pulmonary fibrosis than did measures of an inflammatory response (protein, PMNs). Analysis of BAL has proven useful, both for detection of lung injury in toxicological screening tests and for determination of the mechanisms of developing chronic lung disease. Future work shows promise of developing assays for BAL analysis to identify the specific site or type of pulmonary injury present.

Apoptosis and bcl-2 expression in normal human endometrium, endometriosis and adenomyosis

Apoptosis has been implicated in the pathogenesis of several diseases and is partly regulated by bcl-2, which blocks the apoptotic pathway and promotes cell survival. Apoptosis and bcl-2 expression were examined in paired eutopic and ectopic endometrium from women with endometriosis (n = 30 samples) or adenomyosis (n = 15 samples) and compared with control endometrium (n = 30 samples). Apoptotic cells were detected using the dUTP nick-end labelling (TUNEL) assay for DNA fragmentation; bcl-2 expression was demonstrated with a streptavidin-biotin peroxidase immunohistochemical technique. Apoptotic cells were rare in eutopic, ectopic and control endometrium; there were no significant differences between subject groups nor between eutopic and ectopic endometrium. Stromal bcl-2 expression increased in the late secretory phase in control and eutopic endometrium in endometriosis; double labelling studies revealed that most stromal bcl-2+ cells were leukocytes. Stromal bcl-2 expression in endometriotic foci was significantly increased compared with the paired eutopic endometrium, did not vary with menstrual cycle and included a significant population of non-leukocytic bcl-2+ stromal cells. In contrast, stromal bcl-2 expression in adenomyosis remained at low levels and did not show significant cyclical variation. Glandular epithelial bcl-2 expression also varied with menstrual cycle phase and peaked in the proliferative phase; in contrast, surface epithelial bcl-2 expression increased in the late secretory phase. Elevated stromal bcl-2 expression in ovarian endometriotic lesions could have implications for the growth and survival of ectopic endometrial tissue at these sites.

Immunohistochemical characterization of proliferation, oestrogen receptor and progesterone receptor expression in endometriosis: comparison of eutopic and ectopic endometrium with normal cycling endometrium

Recent studies examining oestrogen and progesterone receptor status and the proliferative activity of endometriotic lesions have produced conflicting reports. This study aimed to clarify the receptor status and proliferative activity of eutopic and ectopic endometrium from women with endometriosis and endometrium from normal women. Progesterone and oestrogen receptor expression and proliferative activity were studied in eutopic and ectopic endometrium from 30 women with endometriosis and in endometrium from 30 normal cycling women using microwave-pretreated paraffin-embedded sections stained with an avidin-biotin peroxidase technique. Progesterone and oestrogen receptor expression in the control endometrium did not differ from that of eutopic endometrium from women with endometriosis. Oestrogen receptor expression in ectopic endometrium increased from the proliferative to the late secretory phase. Epithelial progesterone receptor expression decreased during the cycle. Oestrogen receptor expression in both epithelium and stroma of ectopic endometrium was significantly higher than in eutopic endometrium throughout the cycle. In contrast, stromal progesterone receptor expression tended to be reduced in ectopic endometrium compared with eutopic tissue. Epithelial progesterone receptor expression was increased in ectopic endometrium but only in the late secretory phase. Although proliferative activity in the epithelium of control and eutopic endometrium was reduced from the proliferative to the late secretory phase, stromal activity did not vary. The proliferative activity in ectopic endometrium remained low and constant throughout the cycle. In the proliferative and early secretory phases, the proliferative activity of eutopic endometrium was increased compared with ectopic endometrium, but in the late secretory phase, levels were comparable. These findings challenge previous reports which have suggested that oestrogen receptors are reduced in ectopic tissue. This may have clinical implications for the development of novel treatments for endometriosis.

Why two eyes are better than one: the two views of binocular vision

Despite centuries of research on the topic, the answer to the question "'Are two eyes significantly better than one, independent of stereopsis?" is still uncertain. In this investigation, steps are taken toward answering the question in a behavioral context. Three sets of experiments are reported in which human binocular and monocular performance are compared in a variety of exteroceptive and visuomotor tasks. In all of the experiments, two eyes facilitated performance. The findings suggest that the binocular system is able to detect the matching information, that is, the concordance, in the monocular optic arrays and to use that information to increase visual efficiency. Furthermore, stereopsis was not found to be important in the performance of visuomotor skills in three dimensions when the subjects were free to move their heads. Thus, the results indicate that an important ecological benefit of binocular frontal vision is having binocular concordance, rather than having binocular disparity.

Phenotypic and functional studies of leukocytes in human endometrium and endometriosis

The aetiology of endometriosis, a common and disabling disorder, is presently unknown, although immune dysfunction could allow ectopic endometrial fragments to survive outside the uterine cavity. These studies investigate the relationship between leukocyte populations, steroid hormone receptor expression, proliferative activity, bcl-2 expression and apoptosis in eutopic and ectopic endometrium from women with endometriosis or adenomyosis at different phases of the menstrual cycle. Significantly increased oestrogen receptor expression, bcl-2 expression and numbers of CD8+ leukocytes were found in ectopic compared with eutopic endometrium in endometriosis, and CD56+ endometrial granulated lymphocytes (eGLs) were significantly reduced in ectopic endometrium. Apoptotic cells were rarely found in control and subject endometria. In contrast with endometriosis, adenomyotic lesions showed identical steroid hormone receptor expression, proliferative activity, bcl-2 expression and leukocyte subpopulations to eutopic endometrium, indicating different aetiologies for these disorders. The unusual CD56+ CD16- eGLs present in large numbers in late secretory phase eutopic endometrium were highly purified (>98%) by immunomagnetic separation. Except for a negligible cytotoxic activity of eGLs from early proliferative samples, cytotoxic activity of eGLs from non-pregnant endometrium during the menstrual cycle was comparable with those in peripheral blood, predominantly CD56+ CD16+ natural killer cells. eGLs from non-pregnant endometrium and early pregnancy showed a variable proliferative response to 5 and 100 U/ml interleukin-2 over 48-h and 120-h time courses. eGLs are evidently functionally important in the eutopic endometrium. Their absence in endometriotic lesions together with increased CD+8 T-cell numbers and increased oestrogen receptor and bcl-2 expression may have significant effects on the development and progression of endometriosis.

Response of rodents to inhaled diluted diesel exhaust: biochemical and cytological changes in bronchoalveolar lavage fluid and in lung tissue

The effect of long-term (24 months) inhalation of diesel exhaust on the bronchoalveolar region of the respiratory tract of rodents was assessed by serial (every 6 months) analysis of bronchoalveolar lavage fluid (BALF) and of lung tissue from F344/Crl rats and CD-1 mice (both sexes) exposed to diesel exhaust diluted to contain 0, 0.35, 3.5, or 7.0 mg soot/m3. The purpose of the study was twofold. One was to assess the potential health effects of inhaling diluted exhaust from light-duty diesel engines. The second was to determine the usefulness of BALF analysis in detecting the early stages in the development of nononcogenic lung disease and differentiating them from the normal repair processes. No biochemical or cytological changes in BALF or in lung tissue were noted in either species exposed to the lowest, and most environmentally relevant, concentration of diesel exhaust. In the two higher levels of exposure, a chronic inflammatory response was measured in both species by dose-dependent increases in inflammatory cells, cytoplasmic and lysosomal enzymes, and protein in BALF. Histologically, after 1 year of exposure, the rats had developed focal areas of fibrosis associated with the deposits of soot, while the mice, despite a higher lung burden of soot than the rats, had only a fine fibrillar thickening of an occasional alveolar septa in the high-level exposure group. Higher increases in BALF beta-glucuronidase activity and in hydroxyproline content accompanied the greater degree of fibrosis in the rat. BALF levels of glutathione (GSH) and glutathione reductase activity increased in a dose-dependent fashion and were higher in mice than in rats. Lung tissue GSH was depleted in a dose-dependent fashion in rats but was slightly increased in mice. This depletion may have played a role in the greater fibrogenic response observed in rats. Other tissue changes in enzymatic activity were small compared to changes observed in BALF. The exposure did not increase the cytochrome P-450 content of the lung in either species. The results suggest that, for the noncarcinogenic health effects reported in this paper, there is a threshold of exposure below which adverse effects were not observed. This threshold was well above environmentally relevant levels of diesel exhaust but may be in the range of some occupational exposures. The analysis of BALF proved a useful adjunct to the chronic toxicity study to quantitate the inflammatory changes accompanying the development of pulmonary disease.

A comparison of knee braces during walking for the treatment of osteoarthritis of the medial compartment of the knee

In this cross-over study, we evaluated two types of knee brace commonly used in the conservative treatment of osteoarthritis of the medial compartment. Twelve patients confirmed radiologically as having unilateral osteoarthritis of the medial compartment (Larsen grade 2 to grade 4) were studied. Treatment with a simple hinged brace was compared with that using a valgus corrective brace. Knee kinematics, ground reaction forces, pain and function were assessed during walking and the Hospital for Special Surgery scores were also determined.

Significant improvements in pain, function, and loading and propulsive forces were seen with the valgus brace. Treatment with a simple brace showed only significant improvements in loading forces. Our findings suggest that although both braces improved confidence and function during gait, the valgus brace showed greater benefit.

Ankle motion influences the external knee adduction moment and may predict who will respond to lateral wedge insoles?: an ancillary analysis from the SILK trial

OBJECTIVE

Lateral wedge insoles are a potential simple treatment for medial knee osteoarthritis (OA) patients by reducing the external knee adduction moment (EKAM). However in some patients, an increase in their EKAM is seen. Understanding the role of the ankle joint complex in the response to lateral wedge insoles is critical in understanding and potentially identifying why some patients respond differently to lateral wedge insoles.

METHOD

Participants with medial tibiofemoral OA underwent gait analysis whilst walking in a control shoe and a lateral wedge insole. We evaluated if dynamic ankle joint complex coronal plane biomechanical measures could explain and identify those participants that increased (biomechanical non-responder) or decreased (biomechanical responder) EKAM under lateral wedge conditions compared to the control shoe.

RESULTS

Of the 70 participants studied (43 male), 33% increased their EKAM and 67% decreased their EKAM. Overall, lateral wedge insoles shifted the centre of foot pressure laterally, increased eversion of the ankle/subtalar joint complex (STJ) and the eversion moment compared to the control condition. Ankle angle at peak EKAM and peak eversion ankle/STJ complex angle in the control condition predicted if individuals were likely to decrease EKAM under lateral wedge conditions.

CONCLUSIONS

Coronal plane ankle/STJ complex biomechanical measures play a key role in reducing EKAM when wearing lateral wedge insoles. These findings may assist in the identification of those individuals that could benefit more from wearing lateral wedge insoles.

Intraepithelial leukocytes in endometriosis and adenomyosis: comparison of eutopic and ectopic endometrium with normal endometrium

Intraepithelial leukocytes (IEL) are recognized as an important component of most mucosal surfaces but have received scant attention in the human female reproductive tract. The aim of the present study was to characterize, quantify and compare IEL populations in normal endometrium (n = 30) and in eutopic and ectopic (endometriotic or adenomyotic lesions) endometrium from women with endometriosis (n = 30) or adenomyosis (n = 15) at different menstrual cycle phases in order to assess the role of IEL in these common but poorly understood disorders. IEL populations were examined in formalin-fixed, paraffin-embedded sections using a streptavidin-biotin-peroxidase complex technique and quantified in relation to epithelial cell numbers. IEL in control endometrium and eutopic endometrium in endometriosis and adenomyosis varied during the menstrual cycle, with CD45+, CD43+ and CD56+ cells increasing from the proliferative to the late secretory phase. IEL were elevated in surface compared with glandular epithelium in the proliferative and early secretory phases. Throughout the menstrual cycle there were no significant differences in IEL between eutopic and ectopic endometrium in adenomyosis. Endometriotic foci, however, contained elevated levels of CD45+, CD3+ and CD8+ cells and reduced numbers of CD56 + cells compared with the corresponding eutopic endometrium and these did not vary with menstrual cycle phase. In contrast, ectopic endometrium in adenomyosis showed some cyclical changes with CD56+ cells increasing significantly in the late secretory phase. It is possible these differences may play a role in the pathogenesis of endometriosis and the associated complications.

Orbital decompression for thyroid eye disease: methods, outcomes, and complications

PurposeTo determine the safety and effectiveness of orbital decompression for thyroid eye disease (TED) in our unit. To put this in the context of previously published literature.Patients and methodsA retrospective case review of all patients undergoing orbital decompression for TED under the care of one orbital surgeon (SMS) between January 2009 and December 2015. A systematic literature review of orbital decompression for TED.ResultsWithin the reviewed period, 93 orbits of 55 patients underwent decompression surgery for TED. There were 61 lateral (single) wall decompressions, 17 medial one-and-a-half wall, 11 two-and-a-half wall, 2 balanced two wall, and 2 orbital fat only decompressions. For the lateral (single) wall decompressions, mean reduction in exophthalmometry (95% confidence interval (CI) was 4.2 mm (3.7-4.8), for the medial one-and-a-half walls it was 2.9 mm (2.1-3.7), and for the two-and-a-half walls it was 7.6 mm (5.8-9.4). The most common complications were temporary postoperative numbness (29% of lateral decompressions, 17% of other bony decompressions, OR 0.50, 95% CI 0.12-2.11) and new postoperative diplopia (9% of lateral decompressions, 39% of other bony decompressions, OR 6.8, 95% CI 1. 5-30.9). Systematic literature searching showed reduction in exophthalmometry for lateral wall surgery of 3.6-4.8 mm, with new diplopia 0-38% and postoperative numbness 12-50%. For other bony decompressions, reduction in exophthalmometry was 2.5-8.0 mm with new diplopia 0-45% and postoperative numbness up to 52%.ConclusionDiffering approaches to orbital decompression exist. If the correct type of surgery is chosen, then safe, adequate surgical outcomes can be achieved.

The physiological cost index of walking with mechanical and powered gait orthosis in patients with spinal cord injury

OBJECTIVES

Mechanical orthoses, such as the hip knee ankle foot orthosis (HKAFO) and the isocentric reciprocating gait orthosis (IRGO), are both used for walking in spinal cord injury (SCI) patients. The aim of this study was to analyze the energy expenditure during walking with these orthoses compared with a powered gait orthosis (PGO) in patients with SCI.

METHODS

Five patients with SCI who were experienced users of HKAFOs participated in this study. Subjects were also fitted with an IRGO and PGO and underwent a specific gait training program. Patients walked along a flat walkway using the three types of orthosis at their self-selected walking speed. A stop watch and a polar heart rate monitor were used to measure the speed of walking and heart rate.

RESULTS

Walking speed, the distance walked and the physiological cost index (PCI) all improved with both the new PGO and the IRGO as compared with the HKAFO.

CONCLUSIONS

A PGO can improve walking speed and the distance walked and reduce the PCI of walking as compared with mechanical orthoses, probably due to the activated movements of the lower limb joints.

The energetic costs of load-carrying and the evolution of bipedalism

The evolution of habitual bipedalism is still a fundamental yet unsolved question for paleoanthropologists, and carrying is popular as an explanation for both the early adoption of upright walking and as a positive selection pressure once a terrestrial lifestyle had been adopted. However, to support or reject any hypothesis that suggests carrying efficiency was an important selective pressure, we need quantitative data on the costs of different forms of carrying behavior, especially infant-carrying since reduction in the grasping capabilities of the foot would have prevented infants from clinging on for long durations. In this study, we tested the hypothesis that the mode of load carriage influences the energetic cost of locomotion. Oxygen consumption was measured in seven female participants walking at a constant speed while carrying four different 10-kg loads (a weighted vest, 5-kg dumbbells carried in each hand, a mannequin infant carried on one hip, and a 10-kg dumbbell carried in a single hand). Oxygen consumption was also measured during unloaded standing and unloaded walking. The results show that the weighted vest requires the least amount of energy of the four types of carrying and that, for this condition, humans are as efficient as mammals in general. The balanced load was carried with approximately the predicted energy cost. However, the asymmetrical conditions were considerably less efficient, indicating that, unless infant-carrying was the adaptive response to a strong environmental selection pressure, this behavior is unlikely to have been the precursor to the evolution of bipedalism.

Quality Parameters in Small Grains from Minnesota Affected by Fusarium Head Blight

Recent epidemics of Fusarium head blight (FHB) severely damaged the hard red spring wheat and barley crops in Minnesota. Samples of commercial grain were analyzed in 1993 and 1994 to determine the effects of FHB on several quality parameters. Wheat test weight (TW) averaged 832 kg m^-3 (55.4 lb/bu), thousand kernel weight (TKW) averaged 27.4 g, and the proportion of visually scabby kernels (VSK) averaged 11.0%. Deoxynivalenol (DON) was detected in 493 of 500 samples (98.6%). The mean concentration was 8.3 μg/g (range = 0.0 to 44.7 μg/g). Scab in wheat could rapidly be estimated using easy-to-prepare visual comparison standards. Scores of percent VSK were correlated with DON concentration at r = 0.897 and 0.908 in 1993 and 1994, respectively. TW and TKW were less effective estimators of DON (r = -0.622 and -0.550, respectively). DON was detected in 100 of 100 six-row barley samples collected during the survey and averaged 10.4 μg/g (range = 0.5 to 39.7 μg/g). DON concentration in barley could not be effectively estimated with grading parameters including TW, TKW, percent plump kernels, or a visual index of kernel discoloration. In 28 samples of oats, DON averaged 1.4 μg/g (range = 0.0 to 6.4 μg/g). Nivalenol was not detected in any of the 628 samples analyzed during the two-year study.

Assessments of Fusarium Head Blight of Wheat and Barley in Response to Fungicide Treatment

Benomyl and tebuconazole reduced head blight incidence, head blight severity, and the percentage of visually scabby kernels (VSK) in harvested grain when applied to the susceptible spring wheat cv. Norm at anthesis. Deoxynivalenol (DON) concentration was also reduced. Fungicide treatment increased head weight, test weight, thousand kernel weight, and yield. Fludioxonil reduced certain parameters associated with the disease in barley, including incidence, severity, and deoxynivalenol concentration, while increasing the percentage of plump kernels and yield. In vitro, isolates of Fusarium graminearum were sensitive to fludioxonil, benomyl, tebuconazole, and mancozeb (concentrations that give 50% growth inhibition of 7.4 × 10^-3, 3.5 × 10^-1,9.9 × 10^-1, and 7.3 mg a.i./liter, respectively). No evidence for insensitivity (resistance) was found. Prospects for chemical control of Fusarium head blight (FHB), however, remain limited. The repeatability of assessment methods used in evaluating host response to fungicides and to the damage caused by F. graminearum is discussed. Disease incidence, disease severity, VSK, and DON were identified as key variables that best measure the effects of FHB.

Cytotoxic activity of endometrial granulated lymphocytes during the menstrual cycle in humans

CD56+ CD16- granulated lymphocytes, termed endometrial granulated lymphocytes (eGLs), have been suggested to play a role in the maintenance of human pregnancy, although their in vivo function in both pregnant and nonpregnant endometrium remains unknown. The present study compared the cytotoxic activity of CD56+ CD16- eGLs (> 98% purity) positively selected from early and late proliferative-phase, early and late secretory-phase, and menstrual-phase endometrium with that of CD56+ CD16- eGLs purified from first-trimester decidua and CD56+ predominantly CD16+ cells from peripheral blood. From the late proliferative phase onwards, the major histocompatibility complex (MHC)-nonrestricted cytotoxic activity of eGLs was comparable between phases of the menstrual cycle. In contrast, eGLs from early proliferative-phase endometrium displayed significantly lower cytotoxic activity. With the exception of eGLs purified from early proliferative-phase endometrium, the cytotoxic activity of CD56+ CD16- eGLs purified from nonpregnant endometrium was comparable to that of CD56+ CD16- eGLs in decidua and CD56+ predominantly CD16+ cells from peripheral blood. No endogenous lymphokine-activated killer cell activity was detected in eGLs from endometrium or decidua. The present study using highly purified eGLs demonstrates that, with the exception of early proliferative-phase samples, CD56+ CD16- eGLs from nonpregnant endometrium and early pregnancy decidua have cytotoxic activity comparable to that of "classical" natural killer cells from peripheral blood.

Women's lay knowledge of cervical cancer/cervical screening: accounting for non-attendance at cervical screening clinics

An assessment of women's knowledge of cervical screening and cervical cancer was considered important as up to 92% of those dying from this form of cancer had never been tested. What were the reasons which determined their non-attendance? Issues to be addressed were reactions to invitation, women's knowledge of screening, and the possible factors which they envisaged as being associated with cervical cancer. Other issues to be considered were practical problems associated with attendance, and preference for the sex and professional status of the health professionals involved; 187 women in a general practitioner practice in Lothian, Scotland were targeted by questionnaire. As with other studies in this field 50% of those contacted were ineligible for a variety of reasons. Seventy-two women completed the questionnaire, providing a mix of qualitative and quantitative data. Although the majority of women felt the invitation to attend screening was clear and easy to understand, there was a lack of knowledge with regard to both the screening itself and the possible causes of cervical cancer. The main 'causes' were seen as higher sexual activity among those aged under 37 and smoking and a virus by those over 37. The majority of women showed preference for a female professional to take the smear. Practical problems of time and venue were not considered insurmountable. The main reasons cited for non-compliance were the fear and dislike of the test itself.

The unsolicited diary as a qualitative research tool for advanced research capacity in the field of health and illness

In this article, the place of diary method is examined in the context of qualitative tools. Although much neglected in qualitative methodology, there is considerable support for its use, and it is argued that unsolicited diary analysis as a qualitative tool has value as a social research method. Although it is commissioned or solicited diaries that are increasingly popular in health research, different kinds of diary usage are examined together with certain possible biases and weaknesses. Although framework analysis was originally developed for analyzing interview data, it is seen as an appropriate qualitative tool for the analysis of unsolicited diaries. The analysis of an unsolicited diary account of a patient suffering from cancer of the larynx is explored as a potential data source.

Why two eyes are better than one: the two views of binocular vision

Despite centuries of research on the topic, the answer to the question "'Are two eyes significantly better than one, independent of stereopsis?" is still uncertain. In this investigation, steps are taken toward answering the question in a behavioral context. Three sets of experiments are reported in which human binocular and monocular performance are compared in a variety of exteroceptive and visuomotor tasks. In all of the experiments, two eyes facilitated performance. The findings suggest that the binocular system is able to detect the matching information, that is, the concordance, in the monocular optic arrays and to use that information to increase visual efficiency. Furthermore, stereopsis was not found to be important in the performance of visuomotor skills in three dimensions when the subjects were free to move their heads. Thus, the results indicate that an important ecological benefit of binocular frontal vision is having binocular concordance, rather than having binocular disparity.

Phenotypic analysis and proliferative responses of human endometrial granulated lymphocytes during the menstrual cycle

The in vivo function of the unusual population of CD56+ CD16- endometrial granulated lymphocytes (eGLs) in human endometrium is unknown; their increased numbers in the secretory phase of the menstrual cycle suggests that they may play a role in the immunobiology of nonpregnant endometrium. In the present study, the phenotype and proliferative responses of eGLs at various phases of the menstrual cycle were compared with those in early pregnancy. Endometrial GLs were highly purified (> 98% CD56+) using immunomagnetic separation, and the expression of cell surface antigens was examined in smears using a double immunohistochemical labeling technique. Proliferative responses to mitogens and interleukin 2 (IL-2) were assessed in hanging drops in 60-well Terasaki plates. There was low to no expression of CD3, CD8, CD16, HML-1, L-selectin, and CD25 (IL-2 receptor alpha) on CD56+ cells isolated from nonpregnant and pregnant endometrium. The expression of CD2, CD49a, and CD122 (IL-2 receptor beta, IL-2Rbeta), however, increased from the proliferative to the late secretory phase of the menstrual cycle. In contrast, CD11a, CD69, and CD49d expression was high and did not vary with menstrual cycle phase; CD49d levels were significantly reduced in early pregnancy. Unlike early-pregnancy eGLs, none of the CD56+ eGL cultures throughout the menstrual cycle displayed phytohaemagglutinin (PHA)-induced lymphoproliferation. In contrast, eGLs from nonpregnant endometrium in the presence of 5 or 100 U/ml IL-2 after 48- and 120-h incubation showed significant proliferative responses, as did eGL cultures from early pregnancy. A significantly reduced number of proliferative phase eGL cultures proliferated in response to IL-2 compared to secretory phase and early-pregnancy eGL cultures. The IL-2-induced proliferative responses of CD56+ eGLs were associated with increased IL-2Rbeta (CD122) expression. These findings demonstrate 1) differential eGL expression of CD2, CD49a, and CD122 during the menstrual cycle; 2) differential IL-2-induced eGL proliferative responses during the menstrual cycle; and 3) differences between eGLs from nonpregnant and pregnant endometrium in CD49d expression and their ability to respond to PHA.

Apoptosis, bcl-2 expression, and proliferative activity in human endometrial stroma and endometrial granulated lymphocytes

Human endometrial leukocytes undergo regular cyclical changes during the menstrual cycle, with a striking increase in the phenotypically unusual population of CD56+ CD16- endometrial granulated lymphocytes (eGLs) in the late secretory phase and early pregnancy. The factors that regulate this increase in eGL numbers are unclear; their unusual morphology, however, has led to the suggestion that they undergo apoptosis at the end of the menstrual cycle. Apoptosis, bcl-2 expression, and proliferative activity were examined in the stroma of normal cycling, progesterone-treated, and early-pregnancy endometrium. The expression of bcl-2 and the Ki67 proliferation marker by highly purified (> 98% CD56+) eGLs from endometrium during the menstrual cycle and from first-trimester decidua was also studied. Apoptotic cells were rarely observed in the endometrial stroma of any of the samples examined. Stromal bcl-2 expression, however, increased from the proliferative to the premenstrual phase, and double immunohistochemical labeling demonstrated large numbers of bcl-2+ CD56+ eGLs. In contrast, Ki67 expression was high in the endometrial stroma during the proliferative phase, fell during the secretory phase, and rose again premenstrually, because of expression by eGLs. Isolated CD56+ eGLs also showed high bcl-2 and Ki67 expression at the end of the menstrual cycle. Unlike premenstrual endometrium, progesterone-treated endometrium and first-trimester decidua contained few proliferating cells, expressed high levels of bcl-2, and showed no evidence of apoptosis. Thus, eGLs do not undergo apoptosis in premenstrual endometrium, and their regulatory mechanisms remain to be clarified.