FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Lathers, DMR Young, MRI AF Lathers, DMR Young, MRI TI Analyses of squamous cell carcinoma-recruited T-cells SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2004 Meeting CY APR 17-21, 2004 CL Washington, DC C1 Med Univ S Carolina, Charleston, SC USA. Med Univ S Carolina, Dept Med, Charleston, SC USA. Ralph H Johnson VA Med Ctr, Res Serv, Charleston, SC 29401 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD MAR 23 PY 2004 VL 18 IS 4 SU S BP A66 EP A66 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 806ZA UT WOS:000220470600328 ER PT J AU Lee, JA Sinkovits, R Mocks, D Rab, EL Cai, J Yang, P Saunders, B Hsuch, RC Choi, S Roach, TIA Subramaniam, S Scheuermann, RH AF Lee, JA Sinkovits, R Mocks, D Rab, EL Cai, J Yang, P Saunders, B Hsuch, RC Choi, S Roach, TIA Subramaniam, S Scheuermann, RH TI Molecular components of B cell antigen receptor-mediated endocytosis revealed by a tool for functional classification of microarray gene clusters SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2004 Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Texas, SW Med Ctr, Dallas, TX 75390 USA. Univ Calif San Diego, San Diego Supercomp Ctr, San Diego, CA 92103 USA. AfCS, Dallas, TX USA. CALTECH, Div Biol, Pasadena, CA 91125 USA. San Francisco VAMC, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD MAR 23 PY 2004 VL 18 IS 4 SU S BP A51 EP A51 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 806ZA UT WOS:000220470600253 ER PT J AU Macey, TA Buck, DC Neve, KA AF Macey, TA Buck, DC Neve, KA TI Differences in the interaction of the dopamine D2 receptor and endogenous beta-arrestin1 and 2 in primary striatal cultures and D2 NS20Y cells SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2004 Meeting CY APR 17-21, 2004 CL Washington, DC C1 Oregon Hlth Sci Univ, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR 97239 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD MAR 23 PY 2004 VL 18 IS 4 SU S BP A588 EP A588 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 806ZA UT WOS:000220470602821 ER PT J AU Neve, KA Buck, DC Wang, CH AF Neve, KA Buck, DC Wang, CH TI Dopamine D2 receptor-mediated stimulation of mitogen-activated protein kinases by transactivation of receptor tyrosine kinases SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2004 Meeting CY APR 17-21, 2004 CL Washington, DC C1 Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland, OR 97239 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD MAR 23 PY 2004 VL 18 IS 4 SU S BP A588 EP A588 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 806ZA UT WOS:000220470602820 ER PT J AU Rossen, RD Trial, J Rubio, JA Birdsall, HH AF Rossen, RD Trial, J Rubio, JA Birdsall, HH TI Monocyte activation by circulating fibronectin fragments in HIV-1 infected patients SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2004 Meeting CY APR 17-21, 2004 CL Washington, DC C1 Baylor Coll Med, Houston, TX 77030 USA. Houston VAMC, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD MAR 23 PY 2004 VL 18 IS 4 SU S BP A89 EP A89 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 806ZA UT WOS:000220470600438 ER PT J AU Rumbaut, RE Randhawa, JK Burns, AR AF Rumbaut, RE Randhawa, JK Burns, AR TI Endotoxin enhances platelet thrombi formation in mouse cremaster microvessels SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2004 Meeting CY APR 17-21, 2004 CL Washington, DC C1 Houston VA Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD MAR 23 PY 2004 VL 18 IS 4 SU S BP A621 EP A621 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 806ZA UT WOS:000220470602980 ER PT J AU Wang, JH Yu, SH Liu, C Zhou, JL Liu, ZY Zhang, LM Hsu, HC Mountz, JD Zhang, HG AF Wang, JH Yu, SH Liu, C Zhou, JL Liu, ZY Zhang, LM Hsu, HC Mountz, JD Zhang, HG TI Dysregulation of ubiquitination and phosphorylation of AKT is essential for development of apoptosis resistance in rheumatoid synovial fibroblasts SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2004 Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Birmingham VAMC, Birmingham, AL 35294 USA. Univ Alabama, Vet Adm Med Ctr, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD MAR 23 PY 2004 VL 18 IS 4 SU S BP A470 EP A470 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 806ZA UT WOS:000220470602267 ER PT J AU Yang, PA Hsu, HC Zhang, HG Mountz, JD AF Yang, PA Hsu, HC Zhang, HG Mountz, JD TI Resistance to poxvirus virulence is associated with IL-18 production in genetically diverse strains of mice SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2004 Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Alabama, Birmingham, AL 35294 USA. UAB, Birmingham, AL USA. Birmingham VAMC, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD MAR 23 PY 2004 VL 18 IS 4 SU S BP A91 EP A91 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 806ZA UT WOS:000220470600447 ER PT J AU Peng, CC Glassman, PA Trilli, LE Hayes-Hunter, J Good, CB AF Peng, CC Glassman, PA Trilli, LE Hayes-Hunter, J Good, CB TI Incidence and severity of potential drug-dietary supplement interactions in primary care patients - An exploratory study of 2 outpatient practices SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID UNITED-STATES; SAFETY ISSUES; HEALTH; MEDICINE; HYPERKALEMIA; POPULATION; REMEDIES; PATTERNS; PRODUCTS; WARFARIN AB Background: To explore the incidence and severity of potential interactions between prescription medications and dietary supplements. Methods: A survey was conducted on dietary supplement use in 458 veteran outpatients currently taking prescription medications. Self-reported dietary supplement use was cross-referenced with each patient's prescription medication list, and potential interactions were identified from several tertiary sources and medical literature searches. Results: One hundred ninety-seven patients (43%) were currently taking at least I dietary supplement with prescription medication(s). The most common products included vitamins and minerals, garlic, Ginkgo biloba, saw palmetto, and ginseng. Among these, 89 (45%) had a potential for drug-dietary supplement interactions of any significance. Most of these interactions (n=84 [94%]) were not serious based on limited available evidence, giving an incidence of 6% (5/89) of potentially severe interactions among patients taking interacting drugs and dietary supplements and 3% (5/197) among patients taking coincident dietary supplements and medications. Conclusions: Although the use of dietary supplements appears to be very common among patients who also take prescription medications, most potential drug-dietary supplement interactions found were not serious. However, literature support was sparse at best. Health care providers should continue to inquire about dietary supplement use and consider the potential for interactions, regardless of their severity. C1 Univ So Calif, Sch Pharm, Dept Pharm, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Univ Pittsburgh, Sch Med, Dept Med & Pharm, Pittsburgh, PA USA. Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15261 USA. Vet Affairs Pittsburgh Healthcare Syst, Div Gen Internal Med, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Serv Pharm, Pittsburgh, PA USA. RP Glassman, PA (reprint author), Vet Affairs Greater Los Angeles W Los Angeles, Div Gen Internal Med 111G, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Peter.glassman@med.va.gov NR 41 TC 63 Z9 69 U1 5 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD MAR 22 PY 2004 VL 164 IS 6 BP 630 EP 636 DI 10.1001/archinte.164.6.630 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 804QQ UT WOS:000220313600007 PM 15037491 ER PT J AU Chang, JT Morton, SC Rubenstein, LZ Mojica, WA Maglione, M Suttorp, MJ Roth, EA Shekelle, PG AF Chang, JT Morton, SC Rubenstein, LZ Mojica, WA Maglione, M Suttorp, MJ Roth, EA Shekelle, PG TI Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials SO BRITISH MEDICAL JOURNAL LA English DT Article ID NURSING-HOME RESIDENTS; RISK-FACTORS; MULTIFACTORIAL INTERVENTION; ELDERLY-PATIENTS; COMMUNITY; PEOPLE; BALANCE; FRAILTY; QUALITY; INJURY AB Objective To assess the relative effectiveness of interventions to prevent falls in older adults to either a usual care group or control group. Design Systematic review and meta-analyses. Data sources Medline, HealthSTAR, Embase, the Cochrane Library, other health related databases, and the reference lists from review articles and systematic reviews. Data extraction Components of falls intervention: multifactorial falls risk assessment with management programme, exercise, environmental modifications, or education. Results 40 trials were identified. A random effects analysis combining trials with risk ratio data showed a reduction in the risk of falling (risk ratio 0.88, 95% confidence interval 0.82 to 0.95), whereas combining trials with incidence rate data showed a reduction in the monthly rate of failing (incidence rate ratio 0.80, 0.72 to 0.88). The effect of individual components was assessed by meta-regression. A multifactorial falls risk assessment and management programme was the most effective component on risk of falling (0.82,0.72 to 0.94, number needed to treat 11) and monthly fall rate (0.63, 0.49 to 0.83; 11.8 fewer falls in treatment group per 100 patients per month). Exercise interventions also had a beneficial effect on the risk of falling (0.86, 0.75 to 0.99, number needed to treat 16) and monthly fall rate (0.86, 0.73 to 1.01; 2.7). Conclusions Interventions to prevent falls in older adults are effective in reducing both the risk of falling and the monthly rate of falling. The most effective intervention was a multifactorial falls risk assessment and management programme. Exercise programmes were also effective in reducing the risk of falling. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90095 USA. RAND Corp, Hlth, So Calif Evidence Based Practice Ctr, Santa Monica, CA 90407 USA. Greater Los Angeles VA Med Ctr, Sepulveda, CA 91343 USA. RP Chang, JT (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Gen Internal Med & Hlth Serv Res, 911 Broxton Ave, Los Angeles, CA 90095 USA. EM johnchang@mednet.ucla.edu FU BHP HRSA HHS [PE-19001] NR 40 TC 507 Z9 534 U1 14 U2 75 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0959-535X J9 BRIT MED J JI Br. Med. J. PD MAR 20 PY 2004 VL 328 IS 7441 BP 680 EP 683 DI 10.1136/bmj.328.7441.680 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 805VB UT WOS:000220392700019 PM 15031239 ER PT J AU Riley, DE Krieger, JN AF Riley, DE Krieger, JN TI Simple repeat replacements support similar functions of distinct repeats in inter-species mRNA homologs SO GENE LA English DT Article DE short tandem repeats; STRs; UTRs; aquaporin; biglycan; Igsf-9; Tnfr-21 ID SHORT TANDEM REPEATS; SECONDARY STRUCTURE; PROTEIN; GENE; PREDICTION; SEQUENCES; DISEASE; EXPRESSION; EXPANSION; EVOLUTION AB Simple repeats are ubiquitous in metazoan genomes, but function has been elusive. We reported that distinct, short tandem repeats (STRs) were coupled with rigorous polarity and register, suggesting order in simple repeat usage. Several STRs that lacked internal, canonical base pairs were associated with mRNAs encoding membrane functions and transcription factors. We hypothesized that diverse, simple repeats, such as (AC)n, (GU)n, (AG)n, (CU)n and (CUUU)n, had similar functions. The hypothesis predicts that closely related mRNAs would sometimes exhibit STR replacements. Comparing aquaporin 3 mRNAs, in rodents and humans, (GU)20 replaced (AG)29. Comparing biglycan mRNAs, (GU)25 replaced (CA)12. Comparing immunoglobulin superfamily member 9 mRNAs, the STR-couple, (CU)17 (GU)9 replaced the STR-couple, (GU)19 (GC)4. Comparing tumor necrosis factor receptor-21 mRNAs, (GU)24 replaced (CUUU)16. In a collection of 52 rodent-H. sapiens homologous mRNAs that had STRs, six (11.5%) STR-STR replacements occurred, significantly more than expected based on an STR frequency of 0.13% in all reported UTRs (p < 0.001). Database studies and the observation of STR replacements among transcript homologs independently support the hypothesis that diverse repeat sequences, such as (AG)n, (AC)n, (GU)n, (CU)n and (CUUU)n, have similar usage that is consistent with analogous functions. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Washington, Dept Urol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Vet Affairs Med Ctr, Dept Res 151, Seattle, WA 98012 USA. RP Riley, DE (reprint author), VA Puget Sound Hlth Care Syst, Vet Affairs Med Ctr, Dept Res 151, Room 517,Bldg 1,1660 S Columbian Way, Seattle, WA 98012 USA. EM dri@u.washington.edu FU NIDDK NIH HHS [R01 DK38955] NR 31 TC 7 Z9 7 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-1119 J9 GENE JI Gene PD MAR 17 PY 2004 VL 328 BP 17 EP 24 DI 10.1016/j.gene.2003.12.036 PG 8 WC Genetics & Heredity SC Genetics & Heredity GA 807YS UT WOS:000220537400002 PM 15019980 ER PT J AU Heidenreich, PA Gubens, MA Fonarow, GC Konstam, MA Stevenson, LW Shekelle, PG AF Heidenreich, PA Gubens, MA Fonarow, GC Konstam, MA Stevenson, LW Shekelle, PG TI Cost-effectiveness of screening with B-type natriuretic peptide to identify patients with reduced left ventricular ejection fraction SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID CONGESTIVE-HEART-FAILURE; SYSTOLIC DYSFUNCTION; CLINICAL-TRIALS; PREVALENCE; MANAGEMENT; POPULATION; ENALAPRIL; COMMUNITY; MORTALITY; METAANALYSIS AB OBJECTIVES This study was designed to evaluate the cost-effectiveness of screening patients with a B-type natriuretic peptide (BNP) blood test to identify those with depressed left ventricular systolic function. BACKGROUND Asymptomatic patients with depressed ejection fraction (EF) may have less progression to heart failure if they can be identified and treated. METHODS We used a decision model to estimate economic and health outcomes for different screening strategies using BNP and echocardiography to detect left ventricular EF <40% for men and women age 60 years. We used published data from community cohorts (gender-specific BNP test characteristics, prevalence of depressed EF) and randomized trials (benefit from treatment). RESULTS Screening 1,000 asymptomatic patients with BNP followed by echocardiography in those with an abnormal test increased the lifetime cost of care ($176,000 for men, $101,000 for women) and improved outcome (7.9 quality- adjusted life years [QALYs] for men, 1.3 QALYs for women), resulting in a cost per QALY of $22,300 for men and $77,700 for women. For populations with a prevalence of depressed EF of at least 1%, screening with BNP followed by echocardiography increased outcome at a cost <$50,000 per QALY gained. Screening would not be attractive if a diagnosis of left ventricular dysfunction led to significant decreases in quality of life or income. CONCLUSIONS Screening populations with a 1% prevalence of reduced EF (men at age 60 years) with BNP followed by echocardiography should provide a health benefit at a cost that is comparable to or less than other accepted health interventions. (C) 2004 by the American College of Cardiology Foundation. C1 Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. Brigham & Womens Hosp, Boston, MA 02115 USA. Tufs New England Med Ctr, Boston, MA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. VA Palo Alto Hlth Care Syst, Palo Alto, CA USA. RP Heidenreich, PA (reprint author), VAMC, 111C Cardiol,3801 Miranda Ave, Palo Alto, CA 94034 USA. EM heiden@stanford.edu OI Heidenreich, Paul/0000-0001-7730-8490 NR 34 TC 115 Z9 120 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 17 PY 2004 VL 43 IS 6 BP 1019 EP 1026 DI 10.1016/j.jacc.2003.10.043 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 803DS UT WOS:000220212400016 PM 15028361 ER PT J AU Wu, SS Zhou, LQ Rose, M Xiao, X Graham, SH AF Wu, SS Zhou, LQ Rose, M Xiao, X Graham, SH TI c-FLIP-L recombinant adeno-associated virus vector infection prevents Fas-mediated but not nerve growth factor withdrawal-mediated cell death in PC12 cells SO MOLECULAR BRAIN RESEARCH LA English DT Article DE c-FLIP-L; caspase 8; rAAV; Fas; NGF withdrawal; FADD ID DOMAIN-CONTAINING PROTEIN; SIGNALING COMPLEX DISC; SYMPATHETIC NEURONS; INHIBITORY PROTEIN; CD95-MEDIATED APOPTOSIS; CASPASE-8 ACTIVATION; GENE-TRANSFER; EXPRESSION; RECEPTOR; CD95 AB Fas is a cell surface death receptor that may play an important role in regulating cell death in neuronal cell types by activation of caspase 8. Cellular FLICE inhibitory protein-long (c-FLIP-L) is an endogenous inhibitor of the activation of caspase 8 by Fas. The current study addresses the role of c-FLIP-L in regulation of cell death in PC12 cells induced by nerve growth factor (NGF) withdrawal and Fas antibody, which acts as a Fas ligand and activates the Fas receptor. A recombinant adeno-associated virus (rAAV) vector that expresses c-FLIP-L was constructed. PC12 cells infected with the c-FLIP-L rAAV were resistant to apoptosis induced by treatment with Fas antibody compared to cells infected with enhanced green fluorescent protein (EGFP) expressing rAAV. Overexpression of c-FLIP-L rAAV inhibited cleavage of caspase 8 induced by Fas antibody treatment. In contrast, treatment with the c-FLIP-L rAAV did not protect PC12 cells from cell death induced by NGF withdrawal. In conclusion, overexpression of c-FLIP-L rAAV inhibits Fas antibody-mediated cell death, but not NGF withdrawal-mediated cell death in PC12 cells. Published by Elsevier B.V. C1 VA Pittsburgh Hlth Syst, ACOS RD, Res Serv 151, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Mol Genet & Biochem, Pittsburgh, PA 15213 USA. RP Graham, SH (reprint author), VA Pittsburgh Hlth Syst, ACOS RD, Res Serv 151, Geriatr Res Educ & Clin Ctr, Univ Dr C, Pittsburgh, PA 15240 USA. EM sgra@pitt.edu NR 52 TC 2 Z9 2 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0169-328X J9 MOL BRAIN RES JI Mol. Brain Res. PD MAR 17 PY 2004 VL 122 IS 1 BP 79 EP 87 DI 10.1016/j.molbrainres.2003.12.007 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 804BD UT WOS:000220273300009 ER PT J AU Smetana, GW Cohn, SL Lawrence, VA AF Smetana, GW Cohn, SL Lawrence, VA TI Update in perioperative medicine SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID POSTOPERATIVE PULMONARY COMPLICATIONS; MAJOR NONCARDIAC SURGERY; CARDIAC RISK; MYOCARDIAL-INFARCTION; VASCULAR-SURGERY; DISEASE; SMOKING; INDEX C1 Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA. Harvard Univ, Sch Med, Boston, MA 02215 USA. SUNY Hlth Sci Ctr, Med Ctr, Brooklyn, NY USA. S Texas Vet Hlth Care Syst, VERDICT, San Antonio, TX USA. Univ Texas, Ctr Hlth, San Antonio, TX 78285 USA. RP Smetana, GW (reprint author), Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Shapiro 621D,330 Brookline Ave, Boston, MA 02215 USA. NR 18 TC 9 Z9 10 U1 1 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD MAR 16 PY 2004 VL 140 IS 6 BP 452 EP 461 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 803AU UT WOS:000220204800006 PM 15023711 ER PT J AU Simon, JA Murtaugh, MA Gross, MD Loria, CM Hulley, SB Jacobs, DR AF Simon, JA Murtaugh, MA Gross, MD Loria, CM Hulley, SB Jacobs, DR TI Relation of ascorbic acid to coronary artery calcium - The Coronary Artery Risk Development in Young Adults Study SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE antioxidants; ascorbic acid; calcium; cardiovascular diseases ID CARDIOVASCULAR-DISEASE PREVALENCE; LOW-DENSITY-LIPOPROTEIN; VITAMIN-E CONSUMPTION; HEART-DISEASE; US ADULTS; PROSPECTIVE POPULATION; MYOCARDIAL-INFARCTION; PLASMA-CONCENTRATIONS; ANTIOXIDANT VITAMINS; POSTMENOPAUSAL WOMEN AB Ascorbic acid is an antioxidant nutrient possibly related to the development of atherosclerosis. To examine the relation between ascorbic acid and coronary artery calcium, an indicator of subclinical coronary disease, the authors analyzed data from 2,637 African-American and White men and women aged 18-30 years at baseline who were enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-2001). Participants completed diet histories at enrollment and year 7, and plasma ascorbic acid levels were obtained at year 10. Coronary artery computed tomography was performed at year 15. The authors calculated odds ratios in four biologically relevant plasma ascorbic acid categories, adjusting for possible confounding variables. When compared with men with high plasma ascorbic acid levels, men with low levels to marginally low levels had an increased prevalence of coronary artery calcium (multivariate odds ratio = 2.68, 95% confidence interval: 1.31, 5.48). Among women, the association was attenuated and nonsignificant (multivariate odds ratio = 1.50, 95% confidence interval: 0.58, 3.85). Ascorbic acid intakes from diet alone and diet plus supplements were not associated with coronary artery calcium. Low to marginally low plasma ascorbic acid levels were associated with a higher prevalence of coronary artery calcium among men but not among women. C1 Vet Affairs Med Ctr, Med Serv, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ Utah, Sch Med, Dept Family & Prevent Med, Salt Lake City, UT 84112 USA. Univ Minnesota, Sch Publ Hlth, Div Epidemiol, Minneapolis, MN 55455 USA. NHLBI, NIH, Bethesda, MD 20892 USA. Univ Oslo, Inst Nutr Res, Oslo, Norway. RP Simon, JA (reprint author), San Francisco VA Med Ctr, Gen Internal Med Sect 111A1, 4150 Clement St, San Francisco, CA 94121 USA. EM jasimon@itsa.ucsf.edu OI Murtaugh, Maureen/0000-0001-5281-0302 FU NHLBI NIH HHS [HL 53359, HC 48047, HC 48050, HC 48049, HC 48048] NR 37 TC 16 Z9 17 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD MAR 15 PY 2004 VL 159 IS 6 BP 581 EP 588 DI 10.1093/aje/kwh079 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 802RM UT WOS:000220180600007 PM 15003962 ER PT J AU Subramanian, U Filn, SD Weinberger, M Plue, L Smith, FE Udris, EM McDonell, MB Eckert, GJ Temkit, M Zhou, XH Chen, LW Tierney, WM AF Subramanian, U Filn, SD Weinberger, M Plue, L Smith, FE Udris, EM McDonell, MB Eckert, GJ Temkit, M Zhou, XH Chen, LW Tierney, WM TI A controlled trial of including symptom data in computer-based care suggestions for managing patients with chronic heart failure SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID QUALITY-OF-LIFE; CLINICAL-PRACTICE GUIDELINES; CONTINUING MEDICAL-EDUCATION; ACUTE MYOCARDIAL-INFARCTION; PREVENTIVE CARE; HOSPITALIZED-PATIENTS; ELDERLY PATIENTS; HEALTH-STATUS; PHYSICIAN PERFORMANCE; CRITICAL-APPRAISAL AB BACKGROUND; Heart failure is common and associated with considerable morbidity and cost, yet physician adherence to treatment guidelines is suboptimal. We conducted a randomized controlled study to determine if adding symptom information to evidence-based, computer-generated care suggestions would affect treatment decisions among primary care physicians caring for outpatients with heart failure at two Veterans Affairs medical centers. METHODS: Physicians were randomly assigned to receive either care suggestions generated with electronic medical record data and symptom data obtained from questionnaires mailed to patients within 2 weeks of scheduled outpatient visits (intervention group) or suggestions generated with electronic medical record data alone (control group). Patients had to have a diagnosis of heart failure and objective evidence of left ventricular systolic dysfunction. We assessed physician adherence to heart failure guidelines, as well as patients' New York Heart Association (NYHA) class, quality of life, satisfaction with care, hospitalizations, and outpatient visits, at 6 and 12-months after enrollment. RESULTS: Patients in the intervention (n = 355) and control (n = 365) groups were similar at baseline. At 12 months, there were no significant differences in adherence to care suggestions between physicians in the intervention and control groups (33% vs. 30%, P = 0.4). There were also no significant changes in NYHA class (P = 0.1) and quality-of-life measures (P > 0.1), as well as no differences in the number of outpatient visits between intervention and control patients (6.7 vs. 7.1 visits, P = 0.48). Intervention patients were more satisfied with their physicians (P = 0.02) and primary care visit (P = 0.02), but had more all-cause hospitalizations at 6 months (1.5 vs. 0.7 hospitalizations, P = 0.0002) and 12 months (2.3 vs. 1.7 hospitalizations, P = 0.05). CONCLUSION: Adding symptom information to computer-generated care suggestions for patients with heart failure did not affect physician treatment decisions or improve patient outcomes. (C) 2004 by Excerpta. Medica Inc. C1 Richard L Roudebush Vet Adm Med Ctr, Indianapolis, IN 46202 USA. Indiana Univ, Sch Med, Div Gen Internal Med, Indianapolis, IN USA. Indiana Univ, Sch Med, Div Biostat, Indianapolis, IN USA. Indiana Univ, Sch Med, Dept Med, Indianapolis, IN USA. Regenstrief Inst Healthcare, Indianapolis, IN USA. NW Hlth Serv, Res & Dev Ctr Excellence, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Div Gen Internal Med, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Rochester, Div Cardiol, Rochester, NY USA. Univ Rochester, Dept Med, Rochester, NY USA. RP Tierney, WM (reprint author), Wishard Mem Hosp, Div Gen Internal Med & Geriatr, 1001 W 10th St,M200-OPW, Indianapolis, IN 46202 USA. EM wtierney@iupui.edu NR 80 TC 27 Z9 27 U1 2 U2 3 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD MAR 15 PY 2004 VL 116 IS 6 BP 375 EP 384 DI 10.1016/j.amjmed.2003.11.021 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 802MC UT WOS:000220166600003 PM 15006586 ER PT J AU Fultz, SL McGinnis, KA Skanderson, M Ragni, MV Justice, AC AF Fultz, SL McGinnis, KA Skanderson, M Ragni, MV Justice, AC TI Association of venous thromboembolism with human immunodeficiency virus and mortality in veterans SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID PROTEIN-S DEFICIENCY; AGING COHORT 3-SITE; HIV-INFECTION; THROMBOSIS; RISK; AIDS; DIAGNOSIS; DISEASE; CANCER C1 Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Ctr Res Hlth Care, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Hematol & Oncol, Pittsburgh, PA USA. Hemophilia Ctr Western Penn, Pittsburgh, PA USA. RP Justice, AC (reprint author), Vet Affairs Connecticut Healthcare Syst, Bldgd 2,Room 7-133,11-ACSLG,950 Campbell Ave, West Haven, CT 06516 USA. EM Amy.Justice2@med.va.gov FU NIA NIH HHS [AG00826]; NIAAA NIH HHS [AA13566] NR 20 TC 42 Z9 42 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD MAR 15 PY 2004 VL 116 IS 6 BP 420 EP 423 DI 10.1016/j.amjmed.2003.10.011 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 802MC UT WOS:000220166600009 PM 15006592 ER PT J AU Flemons, WW Douglas, NJ Kuna, ST Rodenstein, DO Wheatley, J AF Flemons, WW Douglas, NJ Kuna, ST Rodenstein, DO Wheatley, J TI Access to diagnosis and treatment of patients with suspected sleep apnea SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article ID POSITIVE AIRWAY PRESSURE; TRIAL; CPAP C1 Univ Calgary, Fac Med, Calgary, AB T2N 2T9, Canada. Foothills Med Ctr, Calgary, AB T2N 2T9, Canada. Royal Infirm, Edinburgh, Midlothian, Scotland. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Catholique Louvain, Dept Pneumol, Clin Univ St Luc, B-1200 Brussels, Belgium. Westmead Hosp, Dept Resp Med, Wentworthville, NSW, Australia. RP Flemons, WW (reprint author), Univ Calgary, Fac Med, 1403 29th St NW, Calgary, AB T2N 2T9, Canada. EM flemons@ucalgary.ca RI Douglas, Neil/B-1491-2013 NR 17 TC 250 Z9 256 U1 0 U2 4 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD MAR 15 PY 2004 VL 169 IS 6 BP 668 EP 672 DI 10.1164/rccm.200308-1124PP PG 5 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 802YP UT WOS:000220199100006 PM 15003950 ER PT J AU Sekine, H Watanabe, H Gilkeson, GS AF Sekine, H Watanabe, H Gilkeson, GS TI Enrichment of anti-glomerular antigen antibody-producing cells in the kidneys of MRL/MpJ-Fas(lpr) mice SO JOURNAL OF IMMUNOLOGY LA English DT Article ID SYSTEMIC LUPUS-ERYTHEMATOSUS; DNA ANTIBODIES; MURINE LUPUS; B-CELLS; SOMATIC HYPERMUTATION; LPR MICE; NEPHRITIS; AUTOANTIBODIES; SERUM; SELECTION AB Lupus nephritis is characterized by immune complex deposition and infiltration of inflammatory cells into the kidney including Ab-producing cells (AbPCs). Although AbPCs play a central role in the pathogenesis of immune complex glomerulonephritis in lupus, the specificity and pathogenic role of AbPCs infiltrating into the kidneys in Inputs are poorly understood. To characterize AbPCs present in lupus kidneys, we isolated AbPCs from diseased MRL/MpJ-Fas(lpr) (MRL/lpr) mouse kidneys. ELISPOT assays, using glomerular Ag (GA) extracts as Ag, demonstrated significant enhancement of anti-GA AbPCs in the kidneys as compared in peripheral blood or spleen of the same mouse. We isolated hybridomas with anti-GA specificity from MRL/lpr mouse kidneys. All the anti-GA mAbs had polyreactive binding to ssDNA, dsDNA, and IgG (i.e., rheumatoid factor), but not to histories or Sm. Sequence analysis of anti-GA Abs suggested the occurrence of somatic mutations and amino acid replacement in complementarity-determining regions with a high replacement to silent ratio resulting in charged amino acids. Intravenous administration of the monoclonal anti-GA Abs into BALB/c mice resulted in graded deposition in glomeruli paralleling their ELISA anti-GA reactivity. These results suggest that AbPCs infiltrating the kidneys in MRL/lpr mice accumulate as a result of Ag selection and likely play a pathologic role in lupus nephritis. C1 Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Med Res Serv, Div Rheumatol & Immunol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Gilkeson, GS (reprint author), Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Med Res Serv, Div Rheumatol & Immunol, 96 Jonathon Lucas St,Suite 912,POB 250623, Charleston, SC 29425 USA. EM gilkeson@musc.edu NR 47 TC 31 Z9 34 U1 0 U2 1 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD MAR 15 PY 2004 VL 172 IS 6 BP 3913 EP 3921 PG 9 WC Immunology SC Immunology GA 801KY UT WOS:000220096000069 PM 15004199 ER PT J AU Lathers, DMR Young, MRI AF Lathers, DMR Young, MRI TI Increased aberrance of cytokine expression in plasma of patients with more advanced squamous cell carcinoma of the head and neck SO CYTOKINE LA English DT Article DE cancer; cytokine; HNSCC; Th1; Th2 ID COLONY-STIMULATING FACTOR; IMMUNE SUPPRESSION; PERIPHERAL-BLOOD; CD34(+) CELLS; GENE-THERAPY; IFN-GAMMA; T-CELLS; CANCER; TUMOR; IL-10 AB Patients with head and neck squamous cell carcinoma (HNSCC) are biased toward the Th2 phenotype as they have increased levels of the Th2 cytokines 11-4, IL-6 and IL-10 and diminished levels of the Th1 cytokine IFN-gamma. However, this bias is incomplete since levels of the Th1 cytokines IL-2 and GM-CSF are increased. This study examined the interrelationship among the plasma levels of Th1 and Th2 cytokines in 101 HNSCC patients and 40 age-matched controls without a known malignancy. Control subjects showed extensive interrelationships among levels of IL-1, IL-2, IL-4, and IFN-gamma, as well as between GM-CSF and TGF-beta. HNSCC patients showed an interrelationship in levels of IL-2, IL-4, IFN-gamma and GM-CSF, but to a less significant degree. What was prominent was a decline in correlation among cytokine levels with increased disease burden, such that there were no relationships among any of the cytokines in stage T4 patients. Nodal involvement also was associated with cytokine levels being more independent of each other, although the impact of nodal disease was less prominent than tumor burden. These results show a partial Th2 cytokine bias in HNSCC patients and a progressively more aberrant expression of cytokines with more advanced disease. (C) 2004 Elsevier Ltd. All rights reserved. C1 Ralph H Johnson Vet Affairs Med Ctr, Res Serv 151, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Otolaryngol, Charleston, SC USA. Med Univ S Carolina, Dept Otolaryngol, Charleston, SC USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Young, MRI (reprint author), Ralph H Johnson Vet Affairs Med Ctr, Res Serv 151, 109 Bee St, Charleston, SC 29401 USA. EM Rita.Young@med.va.gov FU NCI NIH HHS [CA85266, CA78262, CA79768] NR 24 TC 57 Z9 58 U1 0 U2 1 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1043-4666 J9 CYTOKINE JI Cytokine PD MAR 7 PY 2004 VL 25 IS 5 BP 220 EP 228 DI 10.1016/j.cyto.2003.11.005 PG 9 WC Biochemistry & Molecular Biology; Cell Biology; Immunology SC Biochemistry & Molecular Biology; Cell Biology; Immunology GA 803HP UT WOS:000220222500004 PM 15036248 ER PT J AU Shrank, WH AF Shrank, WH TI Effect of incentive-based formularies on drug utilization and spending SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. RP Shrank, WH (reprint author), Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. EM shrankw@aol.com NR 2 TC 4 Z9 4 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC/NEJM PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAR 4 PY 2004 VL 350 IS 10 BP 1057 EP 1057 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 780GH UT WOS:000189363600030 PM 14999122 ER PT J AU Bruce, ML Ten Have, TR Reynolds, CF Katz, II Schulberg, HC Mulsant, BH Brown, GK McAvay, GJ Pearson, JL Alexopoulos, GS AF Bruce, ML Ten Have, TR Reynolds, CF Katz, II Schulberg, HC Mulsant, BH Brown, GK McAvay, GJ Pearson, JL Alexopoulos, GS TI Reducing suicidal ideation and depressive symptoms in depressed older primary care patients - A randomized controlled trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID LATE-LIFE DEPRESSION; LOGISTIC-REGRESSION MODELS; IMPROVING PRIMARY-CARE; BINARY RESPONSE DATA; MAJOR DEPRESSION; GERIATRIC DEPRESSION; CONSENSUS STATEMENT; QUALITY IMPROVEMENT; MINOR DEPRESSION; TERM TREATMENT AB Context Suicide rates are highest in late life; the majority of older adults who die by suicide have seen a primary care physician in preceding months. Depression is the strongest risk factor for late-life suicide and for suicide's precursor, suicidal ideation. Objective To determine the effect of a primary care intervention on suicidal ideation and depression in older patients. Design and Setting Randomized controlled trial known as PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) with patient recruitment from 20 primary care practices in New York City, Philadelphia, and Pittsburgh regions, May 1999 through August 2001. Participants Two-stage, age-stratified (60-74, greater than or equal to75 years) depression screening of randomly sampled patients; enrollment included patients who screened positive and a random sample of screened negative patients. This analysis included patients with a depression diagnosis (N=598). Intervention Treatment guidelines tailored for the elderly with care management compared with usual care. Main Outcome Measures Assessment of suicidal ideation and depression severity at baseline, 4 months, 8 months, and 12 months. Results Rates of suicidal ideation declined faster (P=.01) in intervention patients compared with usual care patients; at 4 months, in the intervention group, raw rates of suicidal ideation declined 12.9% points (29.4% to 16.5%) compared with 3.0% points (20.1% to 17.1% in usual care [P=.01]). Among patients reporting suicidal ideation, resolution of ideation was faster among intervention patients (P=.03); differences peaked at 8 months (70.7% vs 43.9% resolution; P=.005). Intervention patients had a more favorable course of depression in both degree and speed of symptom reduction; group difference peaked at 4 months. The effects on depression were not significant among,, patients with minor depression unless suicidal ideation was present. Conclusions Evidence of the intervention's effectiveness in community-based primary care with a heterogeneous sample of depressed patients introduces new challenges related to its sustainability and dissemination. The intervention's effectiveness in reducing suicidal ideation, regardless of depression severity, reinforces its role as a prevention strategy to reduce risk factors for suicide in late life. C1 Univ Pittsburgh, Dept Psychiat, WPIC, Sch Med, Pittsburgh, PA 15213 USA. Cornell Univ, Weill Med Coll, Dept Psychiat, White Plains, NY USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. VA Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. NIMH, Div Intervent & Serv Res, Bethesda, MD 20892 USA. RP Reynolds, CF (reprint author), Univ Pittsburgh, Dept Psychiat, WPIC, Sch Med, Room 1135-E,3811 Ohara St, Pittsburgh, PA 15213 USA. EM ReynoldsCF@msx.upmc.edu FU NIMH NIH HHS [K01 MH01613, K02 MH01634, P30 MH52129, P30 MH52247, P30 MH68638, R01 MH59366, R01 MH59380, R01 MH59381] NR 76 TC 554 Z9 561 U1 6 U2 40 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 3 PY 2004 VL 291 IS 9 BP 1081 EP 1091 DI 10.1001/jama.291.9.1081 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 780AQ UT WOS:000189348900025 PM 14996777 ER PT J AU Hu, JC Machuca, K DePeralta, S Singh, B Feliciano, Z AF Hu, JC Machuca, K DePeralta, S Singh, B Feliciano, Z TI Ibutilide improves cardioversion success rates in patients on chronic amiodarone therapy with persistent atrial fibrillation SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 54th Annual Scientific Session of the American-College-of-Cardiology CY MAR 07-10, 2004 CL New Orleans, LA SP Amer Coll Cardiol C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 3 PY 2004 VL 43 IS 5 SU A BP 136A EP 136A DI 10.1016/S0735-1097(04)90573-6 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 780NW UT WOS:000189388500575 ER PT J AU Rumsfeld, JS Jones, P Whooley, MA Sullivan, MD Pitt, B Weintraub, WS Spertus, JA AF Rumsfeld, JS Jones, P Whooley, MA Sullivan, MD Pitt, B Weintraub, WS Spertus, JA TI Depression predicts mortality and hospitalization in patients with acute myocardial infarction complicated by heart failure: Data from the EPHESUS trial SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 54th Annual Scientific Session of the American-College-of-Cardiology CY MAR 07-10, 2004 CL New Orleans, LA SP Amer Coll Cardiol C1 Denver VA Med Ctr, Denver, CO USA. Univ Missouri, Kansas City, MO 64110 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 3 PY 2004 VL 43 IS 5 SU A BP 179A EP 180A DI 10.1016/S0735-1097(04)90765-6 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 780NW UT WOS:000189388500767 ER PT J AU Staszewsky, L Wong, ML Barlera, S Carretta, E Masson, S Latini, R Maggioni, AR Cohn, JN Tognoni, G AF Staszewsky, L Wong, ML Barlera, S Carretta, E Masson, S Latini, R Maggioni, AR Cohn, JN Tognoni, G TI Comparative yield of clinical, laboratory, echocardiographic, and neurohormonal predictors of outcome in heart failure patients (Val-HeFT data) SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 54th Annual Scientific Session of the American-College-of-Cardiology CY MAR 07-10, 2004 CL New Orleans, LA SP Amer Coll Cardiol C1 Ist Ric Farmacol, Milan, Italy. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 3 PY 2004 VL 43 IS 5 SU A BP 199A EP 199A DI 10.1016/S0735-1097(04)90845-5 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 780NW UT WOS:000189388500847 ER PT J AU Tajjaj, JA Mirza, S Rayburn, BK Pinderski, LJ Benza, RL Foley, BA Pamboukian, S Bourge, RC AF Tajjaj, JA Mirza, S Rayburn, BK Pinderski, LJ Benza, RL Foley, BA Pamboukian, S Bourge, RC TI Outcomes of peripartum cardiomyopathy in the current era of heart failure management SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 54th Annual Scientific Session of the American-College-of-Cardiology CY MAR 07-10, 2004 CL New Orleans, LA SP Amer Coll Cardiol C1 Univ Alabama, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 3 PY 2004 VL 43 IS 5 SU A BP 205A EP 205A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 780NW UT WOS:000189388500874 ER PT J AU Ebrahimi, R Wolf, C Saleh, J AF Ebrahimi, R Wolf, C Saleh, J TI Beneficial effect of oral acetylcysteine for prevention of contrast-induced nephropathy in patients with renal insufficiency: A meta-analysis SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 54th Annual Scientific Session of the American-College-of-Cardiology CY MAR 07-10, 2004 CL New Orleans, LA SP Amer Coll Cardiol C1 W Los Angeles VA, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 3 PY 2004 VL 43 IS 5 SU A BP 509A EP 510A DI 10.1016/S0735-1097(04)92158-4 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 780NW UT WOS:000189388502161 ER PT J AU Bradley, KA Kivlahan, DR Zhou, XH Sporleder, JL Epler, AJ McCormick, KA Merrill, JO McDonell, MB Fihn, SD AF Bradley, KA Kivlahan, DR Zhou, XH Sporleder, JL Epler, AJ McCormick, KA Merrill, JO McDonell, MB Fihn, SD TI Using alcohol screening results and treatment history to assess the severity of at-risk drinking in Veterans Affairs primary care patients SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcohol screening; alcohol drinking; primary care ID DISORDERS IDENTIFICATION TEST; RANDOMIZED CONTROLLED TRIAL; BRIEF PHYSICIAN ADVICE; TEST AUDIT; PROBLEM DRINKERS; BRIEF INTERVENTIONS; CONSUMPTION; QUESTIONNAIRES; DEPENDENCE; MORTALITY AB Background: Primary care providers need, practical methods for managing patients who screen positive for at-risk drinking. We evaluated whether scores on brief alcohol screening questionnaires and patient reports of prior alcohol treatment reflect the severity of recent problems due to drinking. Methods: Veterans Affairs general medicine outpatients who screened positive for at-risk drinking were mailed questionnaires that included the Alcohol Use Disorders Identification Test (AUDIT) and a question about prior alcohol treatment or participation in Alcoholics Anonymous ("previously treated"). AUDIT questions 4 through 10 were used to measure past-year problems due to drinking (PYPD). Cross-sectional analyses compared the prevalence of PYPD and mean Past-Year AUDIT Symptom Scores (0-28 points) among at-risk drinkers with varying scores on the CAGE (0-4) and AUDIT-C (0-12) and varying treatment histories. Results: Of 7861 male at-risk drinkers who completed questionnaires, 33.9% reported PYPD. AUDIT-C scores were more strongly associated with Past-Year AUDIT Symptom Scores than the CAGE (p < 0.0005). The prevalence of PYPD increased from 33% to 46% over the range of positive CAGE scores but from 29% to 77% over the range of positive AUDIT-C scores. Among subgroups of at-risk drinkers with the same screening scores, patients who reported prior treatment were more likely than never-treated at-risk drinkers to report PYPD and had higher mean Past-Year AUDIT Symptom Scores (p < 0.0005). We propose a simple method of risk-stratifying patients using AUDIT-C scores And alcohol treatment histories. Conclusions: AUDIT-C scores combined with one question about prior alcohol treatment can help estimate the severity of PYPD among male Veterans Affairs outpatients. C1 VA Puget Sound Hlth Care Syst, HSR&D 152, NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Ctr Excellence Substance Abuse Treatment & Educ, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Sci, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. RP Bradley, KA (reprint author), VA Puget Sound Hlth Care Syst, HSR&D 152, NW Hlth Serv Res & Dev Ctr Excellence, 1660 S Columbian Way, Seattle, WA 98108 USA. EM willi@u.washington.edu FU NIAAA NIH HHS [K23AA00313] NR 39 TC 47 Z9 48 U1 4 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAR PY 2004 VL 28 IS 3 BP 448 EP 455 DI 10.1097/01.ALC.0000117893.38108.38 PG 8 WC Substance Abuse SC Substance Abuse GA 808CQ UT WOS:000220547600011 PM 15084903 ER PT J AU Tsuang, DW DiGiacomo, L Bird, TD AF Tsuang, DW DiGiacomo, L Bird, TD TI Familial occurrence of dementia with Lewy bodies SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article ID PARKINSONS-DISEASE; BODY-DISEASE; ALZHEIMERS-DISEASE; ALPHA-SYNUCLEIN; VASCULAR DEMENTIA; PATHOLOGY; DIAGNOSIS; LOCUS; DLB; CORRELATE AB Objective: The authors investigated the validity of the designation ''familial dementia with Lewy bodies (DLB)" by evaluating the clinical, neuropathological, and genetic characteristics of previously reported families exhibiting both familial parkinsonism and dementia. Methods: Several families, including multiple individuals with parkinsonism as well as prominent dementia, were identified through a literature search. Selected families bad at least one member with dementia with autopsy evidence of neocortical and/or limbic Lewy-body (LB) pathology. Clinical and neuropathological evidence from reports of families with prominent dementia as well as parkinsonism was reviewed to further define familial DLB. Results: All selected families bad at least one affected individual with dementia and autopsy-proven DLB. Therefore, these families might be considered examples of familial DLB. Individuals in the first six families typically presented with parkinsonian features, whereas cognitive decline did not appear until years later In contrast, in the other six families, affected individuals typically presented with cognitive decline, and parkinsonism developed later Conclusions: Families exist in which one or more persons meet both clinical and neuropathological criteria for DLB. They differ as to whether the signs of parkinsonism precede or follow signs of dementia. It remains to be determined whether this clinical distinction is biologically important. Susceptibility to developing LB pathology may be determined by the interaction between genetic predisposition and environmental risk factors. C1 VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr 116, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Med Genet, Seattle, WA 98195 USA. RP Tsuang, DW (reprint author), VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr 116, 1660 S Columbian Way, Seattle, WA 98108 USA. EM dwt1@u.washington.edu RI Tsuang, Debby/L-7234-2016 OI Tsuang, Debby/0000-0002-4716-1894 FU NINDS NIH HHS [R01 NS048595] NR 40 TC 15 Z9 15 U1 1 U2 2 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAR-APR PY 2004 VL 12 IS 2 BP 179 EP 188 DI 10.1176/appi.ajgp.12.2.179 PG 10 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 776MQ UT WOS:000189120100009 PM 15010347 ER PT J AU Hayes-Lattin, B Seipel, TJ Gatter, K Heinrich, MC Maziarz, RT AF Hayes-Lattin, B Seipel, TJ Gatter, K Heinrich, MC Maziarz, RT TI Pure red cell aplasia associated with parvovirus B19 infection occurring late after allogeneic bone marrow transplantation SO AMERICAN JOURNAL OF HEMATOLOGY LA English DT Article DE anemia; pure red cell aplasia; parvovirus B19; allogeneic stem cell transplantation ID PERIPHERAL-BLOOD; ANEMIA; RECIPIENT; ANTIGEN; THERAPY; PATIENT AB Differential diagnosis for anemia late after allogeneic stem cell transplantation is broad. In this report, we describe a case of severe anemia secondary to pure red cell aplasia associated with human parvovirus B19 infection over 8 years after allogeneic bone marrow transplantation. Characteristics of parvovirus B19 infection and the immunosuppressed state after allogeneic stem cell transplantation are reviewed. Am. J. Hematol. 75:142-145, 2004. (C) 2004 Wiley-Liss, Inc. C1 Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Adult Bone Marrow Transplanat Program, Portland, OR 97239 USA. OHSU Canc Inst, Portland, OR USA. Portland Vet Affairs Med Ctr, Div Hematol & Med Oncol, Portland, OR USA. Oregon Hlth Sci Univ, Dept Pathol, Portland, OR 97201 USA. RP Hayes-Lattin, B (reprint author), Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Adult Bone Marrow Transplanat Program, Mailcode L586,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM hayeslat@ohsu.edu NR 22 TC 17 Z9 17 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0361-8609 J9 AM J HEMATOL JI Am. J. Hematol. PD MAR PY 2004 VL 75 IS 3 BP 142 EP 145 DI 10.1002/ajh.10474 PG 4 WC Hematology SC Hematology GA 779TR UT WOS:000189317500005 PM 14978694 ER PT J AU Glassman, PA Good, CB Kelley, ME Bradley, M Valentino, M AF Glassman, PA Good, CB Kelley, ME Bradley, M Valentino, M TI Physician satisfaction with formulary policies: Is it access to formulary or nonformulary drugs that matters most? SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID COST-CONTAINMENT; BENEFIT PLANS AB Objective: To assess physician satisfaction with Department of Veterans Affairs (VA) formulary policies and to examine the correlation between physician satisfaction and perceived access to formulary and nonformulary medications. Study Design: Cross-sectional survey with specific questions on access to formulary and nonformulary medications. Statistical analyses. included assessment of associations between physician satisfaction and various measures of access. Participants and Methods: Initial sample of 4015 staff physicians working in VA healthcare facilities. Responses were received from 1812 (49%) of the 3682 physicians in the final eligible sample population. Results: Most clinicians (72%) reported that their local formulary covered more than 90% of the medications they wanted to prescribe. Most (71%) agreed that drug restrictions were important to contain costs, and 86% agreed that it was important for VA to choose "best-value" drugs. Respondents reported an 89% approval rate for nonformulary drugs, though 31% indicated that approvals routinely took 3 or more days. We found strong associations between physician satisfaction and self-reported approval rates for nonformulary drugs (P = .001), timely approval of nonformulary requests (P < .001), and percentage of nonformulary prescriptions as a proportion of overall prescriptions at a regional level (P < .01). There was no significant correlation between physician satisfaction and number of medications added to regional formularies or with drug costs per unique patient. Conclusions: VA physicians were generally supportive of VA formulary policies including choosing best-value drugs to control pharmaceutical expenditures. Nevertheless, access to nonformulary drugs and timely approval of requests for nonformulary medications were strong predictors of clinician satisfaction and Support for cost-containment measures. C1 VA Greater Los Angeles, W Los Angeles Vet Affairs Med Ctr, Div Gen Internal Med, Healthcare Syst,Dept Vet Affairs, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Vet Affairs Med Ctr, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. RAND Corp, Survey Res Ctr, Washington, DC USA. Vet Affairs Hosp, Pharm Benefits Management Strateg Healthcare Grp, Hines, IL USA. RP Glassman, PA (reprint author), VA Greater Los Angeles, W Los Angeles Vet Affairs Med Ctr, Div Gen Internal Med, Healthcare Syst,Dept Vet Affairs, 111G,11301 Wiltshire Blvd, Los Angeles, CA 90073 USA. EM peter.glassman@med.va.gov NR 27 TC 9 Z9 9 U1 0 U2 3 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD MAR PY 2004 VL 10 IS 3 BP 209 EP 216 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 803IM UT WOS:000220224800006 PM 15032258 ER PT J AU Andrikopoulos, S Hull, RL Verchere, CB Wang, F Wilbur, SM Wight, TN Marzban, L Kahn, SE AF Andrikopoulos, S Hull, RL Verchere, CB Wang, F Wilbur, SM Wight, TN Marzban, L Kahn, SE TI Extended life span is associated with insulin resistance in a transgenic mouse model of insulinoma secreting human islet amyloid polypeptide SO AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM LA English DT Article DE amylin; euglycemic hyperinsulinemic clamp; insulin sensitivity ID IN-VITRO; DIABETES-MELLITUS; FIBRIL FORMATION; CELL-LINE; MICE; AMYLIN; IAPP; LANGERHANS; PROINSULIN; PEPTIDES AB Pancreatic amyloid is found in patients with insulinomas and type 2 diabetes. To study mechanisms of islet amyloidogenesis, we produced transgenic mice expressing the unique component of human islet amyloid, human islet amyloid polypeptide (hIAPP). These mice develop islet amyloid after 12 mo of high-fat feeding. To determine whether we could accelerate the rate of islet amyloid formation, we crossbred our hIAPP transgenic animals with RIP-Tag mice that develop islet tumors and die at 12 wk of age from hypoglycenia. At 12 wk of age, this new line of hIAPPXRIP-Tag mice was heavier (29.7 +/- 1.0 vs. 25.0 +/- 1.3 g, P < 0.05) and had increased plasma glucose levels (4.6 +/- 0.4 vs. 2.9 +/- 0.6 mmol/l, P < 0.05) compared with littermate RIP-Tag mice. However, the hIAPPXRIP-Tag mice did not display islet amyloid or amyloid fibrils despite high circulating hIAPP levels (24.6 +/- 7.0 pmol/l). Interestingly, hIAPPXRIP-Tag mice had a longer life span than RIP-Tag mice (121 +/- 8 vs. 102 +/- 5 days, P < 0.05). This increase in life span in hIAPPXRIP-Tag was positively correlated with body weight (r = 0.48, P < 0.05) and was associated with decreased insulin sensitivity compared with RIP-Tag mice. hIAPPXRIP-Tag mice did not develop amyloid during their 4-mo life span, suggesting that increased hIAPP secretion is insufficient for islet amyloid formation within such a short time. However, hIAPPXRIP-Tag mice did have an increase in life span that was associated with insulin resistance, suggesting that hIAPP has extrapancreatic effects, possibly on peripheral glucose metabolism. C1 Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98109 USA. Univ Washington, Hope Heart Inst, Seattle, WA 98108 USA. Univ Washington, Dept Pathol, Seattle, WA 98108 USA. British Columbia Res Inst Childrens & Womens Hlth, Vancouver, BC V5Z 4H4, Canada. RP Kahn, SE (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 151,1660 S Columbian Way, Seattle, WA 98109 USA. EM skahn@u.washington.edu FU NIDDK NIH HHS [DK-17047, DK-50703] NR 48 TC 3 Z9 3 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1849 J9 AM J PHYSIOL-ENDOC M JI Am. J. Physiol.-Endocrinol. Metab. PD MAR PY 2004 VL 286 IS 3 BP E418 EP E424 DI 10.1152/ajpendo.00137.2003 PG 7 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 776XP UT WOS:000189144900013 PM 14613923 ER PT J AU Reeve, JR Wu, SV Keire, DA Faull, K Chew, P Solomon, TE Green, GM Coskun, T AF Reeve, JR Wu, SV Keire, DA Faull, K Chew, P Solomon, TE Green, GM Coskun, T TI Differential bile-pancreatic secretory effects of CCK-58 and CCK-8 SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE cholecystokinin ID CHOLECYSTOKININ CCK; HUMAN-PLASMA; RAT; RECEPTORS; BINDING; ACINI; FORM; RADIOIMMUNOASSAY; BIOACTIVITY; INTESTINE AB In this work, we 1) synthesized rat CCK-58, 2) determined the amounts and forms of rat CCK in whole blood after stimulation of its release by casein, 3) determined the potency of CCK-8 and CCK-58 peptides to displace labeled CCK-8 from CCKA and CCKB receptors transfected into Chinese hamster ovary (CHO) cells, and 4) examined the biological actions of CCK-8 and rat CCK-58 in an anesthetized rat model. CCK-58 was the only detected endocrine form of CCK in rat blood. Synthetic rat CCK-58 was less potent than CCK-8 for displacing the label from CCKA and CCKB receptors in transfected CHO cells. However, rat CCK-58 was more potent than CCK-8 for stimulation of pancreatic protein secretion in the anesthetized rat. In addition, CCK-58 but not CCK-8 stimulated fluid secretion in this anesthetized rat model. These data suggest that regions outside the COOH terminus of rat CCK-58 influence the expression of CCK biological activity. The presence of only CCK-58 in the circulation and the fact that its biological activity differs from CCK-8 suggests that CCK-58 deserves scrutiny in other physiological models of CCK activity. C1 Vet Affairs Greater Los Angeles Hlth Care Syst, CURE Digest Dis Res Ctr, Res Serv 151, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Pasarow Mass Spectrometry Lab, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Chem & Biochem, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90095 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. RP Reeve, JR (reprint author), Vet Affairs Greater Los Angeles Hlth Care Syst, CURE Digest Dis Res Ctr, Res Serv 151, Bldg 115,Rm 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jreeve@ucla.edu FU NIDDK NIH HHS [DK-41301, R01-DK-33850] NR 39 TC 23 Z9 23 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD MAR PY 2004 VL 286 IS 3 BP G395 EP G402 DI 10.1152/ajpgi.00020.2003 PG 8 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 771KD UT WOS:000188783400005 PM 14604858 ER PT J AU Tan, Y Hutchison, FN Jaffa, AA AF Tan, Y Hutchison, FN Jaffa, AA TI Mechanisms of angiotensin II-induced expression of B-2 kinin receptors SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE AT(1) receptors; mitogen-activated protein kinase; vascular smooth muscle cells ID VASCULAR SMOOTH-MUSCLE; ACTIVATED PROTEIN-KINASE; RENIN GENE-EXPRESSION; C-FOS INDUCTION; PROSTAGLANDIN E(2); CONVERTING-ENZYME; RENAL KALLIKREIN; TYPE-2 RECEPTOR; NITRIC-OXIDE; BRADYKININ AB Although the primary roles of the kallikrein-kinin system and the renin-angiotensin system are quite divergent, they are often intertwined under pathophysiological conditions. We examined the effect of ANG II on regulation of B-2 kinin receptors (B2KR) in vascular cells. Vascular smooth muscle cells (VSMC) were treated with ANG II in a concentration (10(-9)-10(-6) M)-and time (0-24 h)-dependent manner, and B2KR protein and mRNA levels were measured by Western blots and PCR, respectively. A threefold increase in B2KR protein levels was observed as early as 6 h, with a peak response at 10(-7) M. ANG II (10(-7) M) also increased B2KR mRNA levels twofold 4 h after stimulation. Actinomycin D suppressed the increase in B2KR mRNA and protein levels induced by ANG II. To elucidate the receptor subtype involved in mediating this regulation, VSMC were pretreated with losartan (AT(1) receptor antagonist) and/or PD-123319 (AT(2) receptor antagonist) at 10 muM for 30 min, followed by ANG II (10(-7) M) stimulation. Losartan completely blocked the ANG II-induced B2KR increase, whereas PD-123319 had no effect. In addition, expression of B2KR mRNA levels was decreased in AT(1A) receptor knockout mice. Finally, to determine whether ANG II stimulates B2KR expression via activation of the MAPK pathway, VSMC were pretreated with an inhibitor of p42/p44(mapk) (PD-98059) and/or an inhibitor of p38(mapk) (SB-202190), followed by ANG II (10(-7) M) for 24 h. Selective inhibition of the p42/p44(mapk) pathway significantly blocked the ANG II-induced increase in B2KR expression. These findings demonstrate that ANG II regulates expression of B2KR in VSMC and provide a rationale for studying the interaction between ANG II and bradykinin in the pathogenesis of vascular dysfunction. C1 Med Univ S Carolina, Dept Med, Div Endocrinol Diabet Med Genet, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Jaffa, AA (reprint author), Med Univ S Carolina, Dept Med, Div Endocrinol Diabet Med Genet, 114 Doughty St,POB 250776, Charleston, SC 29425 USA. EM jaffaa@musc.edu FU NHLBI NIH HHS [HL-55782, HL-71255]; NIDDK NIH HHS [DK-46543] NR 48 TC 28 Z9 29 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 EI 1522-1539 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD MAR PY 2004 VL 286 IS 3 BP H926 EP H932 DI 10.1152/ajpheart.00757.2003 PG 7 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 771KB UT WOS:000188783200016 PM 14766673 ER PT J AU O'Connell, JB Maggard, MA Livingston, EH Yo, CK AF O'Connell, JB Maggard, MA Livingston, EH Yo, CK TI Colorectal cancer in the young SO AMERICAN JOURNAL OF SURGERY LA English DT Review DE cancer; colorectal; review; risk factors; young ID 40 YEARS OLD; PATIENTS LESS; LARGE BOWEL; 3 DECADES; CARCINOMA; AGE; COLON; RECTUM; ADENOCARCINOMA; ADULTS AB Background: Colorectal cancer (CRC) is generally thought of as a disease of older persons; however a significant proportion of patients <40 years present with this disease. Many investigators have published single-institution series on CRC in the young, yet the data vary markedly. We performed a structured review of the current literature aiming to (1) characterize CRC in the young population and (2) determine how CRC in this population should be further addressed regarding detection and treatment. Data sources: A Medline literature search was completed. Articles were chosen to include those studies that examined patients <40 years old. A total of 55 articles were chosen from the search and review of the bibliographies. Conclusions: We found that CRC in the young population appears to be more aggressive, to present with later stage, and to have poorer pathologic findings. However, if detected early, young patients with Dukes' stage A or B lesions have better overall 5-year survival rates. These findings emphasize the need for health care providers to have a heightened awareness when caring for this young population, particularly because excellent modalities exist to diagnose and treat colorectal cancer. (C) 2004 Excerpta Medica, Inc. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Encino, CA 91436 USA. W Los Angeles Vet Affairs Hosp, Dept Surg, Los Angeles, CA USA. Univ Texas, SW Med Ctr, Dept Surg, Dallas, TX USA. RP O'Connell, JB (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, 5001 Gloria Ave, Encino, CA 91436 USA. EM jbocjboc@hotmail.com NR 60 TC 96 Z9 101 U1 2 U2 3 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD MAR PY 2004 VL 187 IS 3 BP 343 EP 348 DI 10.1016/j.amjsurg.2003.12.020 PG 6 WC Surgery SC Surgery GA 801PL UT WOS:000220107700006 PM 15006562 ER PT J AU Trail, M Nelson, ND Van, JN Appel, SH Lai, EC AF Trail, M Nelson, ND Van, JN Appel, SH Lai, EC TI Major stressors facing patients with amyotrophic lateral sclerosis (ALS): a survey to identify their concerns and to compare with those of their caregivers SO AMYOTROPHIC LATERAL SCLEROSIS AND OTHER MOTOR NEURON DISORDERS LA English DT Article DE amyotrophic lateral sclerosis; stressors; quality of life; caregivers; existential; physical; psychosocial ID QUALITY-OF-LIFE; DISEASE AB OBJECTIVE: To identify and compare the primary existential, physical, and psychosocial stressors affecting patients with ALS and their caregivers. Health care providers, together with patients and their caregivers, are challenged to identify both physical and psychosocial concerns that have the greatest impact on quality of life over the course of a serious illness. It is also helpful to understand the priorities of these concerns from the patients' and caregivers' perspectives so that we can render optimal care and help patients and their families with the myriad problems that accompany a progressive and fatal disease. METHODS: We analyzed responses from the first 66 patients with ALS and 61 ALS caregivers who attended the Baylor College of Medicine, Department of Neurology, Vicki Appel MDA ALS Clinic and who completed our internally generated 19-item survey. Subjects were asked to choose their three most important concerns. For analysis purposes we categorized the data into three domains: existential, physical, and psychosocial. Demographic data were collected. The Appel ALS Rating Scale (AALS) was used to measure disease symptom severity. RESULTS: Sixty-six patients (45 men, 21 women) with a mean age of 57.9 (range 30-82) years and 61 caregivers completed the checklist. At the time the patients completed the survey, their mean AALS total score was 77.0 (range 34-132), indicating mild to moderate disability. The most important stressors identified by patients and caregivers were existential concerns (86.4% of patients and 79.7% of caregivers) and physical stressors (80.3% of patients and 76.3% of caregivers). Less than 50% of both groups endorsed psychosocial stressors (38%). However, when we analyzed the domain specific items, there was a significant difference between patients and caregivers on worries about the patient's dependency (37.9% of patients and 6.8% of caregivers). DISCUSSION: Health care professionals should apply a holistic approach to treatment and care of patients with ALS. Families should be included in the process, and it should not be assumed that patients and caregivers will agree on all issues. Future research should focus on therapeutic interventions to help ALS patients and their families cope with the multiple stressors accompanying a catastrophic illness. C1 Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. RP Lai, EC (reprint author), Baylor Coll Med, Dept Neurol, 6550 Fannin,Suite 1801, Houston, TX 77030 USA. EM elai@bcm.tmc.edu NR 18 TC 22 Z9 22 U1 0 U2 2 PU TAYLOR & FRANCIS AS PI OSLO PA CORT ADELERSGT 17, PO BOX 2562, SOLLI, 0202 OSLO, NORWAY SN 1466-0822 J9 AMYOTROPH LATERAL SC JI Amyotroph. Lateral. Scler. Mot. Neuron Disord. PD MAR PY 2004 VL 5 IS 1 BP 40 EP 45 DI 10.1080/14660820310016075 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 807QS UT WOS:000220516600008 PM 15204023 ER PT J AU Raber, J Fan, Y Matsumori, Y Liu, ZY Weinstein, PR Fike, JR Liu, JL AF Raber, J Fan, Y Matsumori, Y Liu, ZY Weinstein, PR Fike, JR Liu, JL TI Irradiation attenuates neurogenesis and exacerbates ischemia-induced deficits SO ANNALS OF NEUROLOGY LA English DT Article ID TRANSIENT GLOBAL-ISCHEMIA; CENTRAL-NERVOUS-SYSTEM; CEREBRAL-ISCHEMIA; BRAIN IRRADIATION; MOTOR RECOVERY; DENTATE GYRUS; X-IRRADIATION; ADULT BRAIN; STROKE; RAT AB Increased neurogenesis after cerebral ischemia suggests that functional recovery after stroke may be attributed, in part, to neural regeneration. In this study, we investigated the role of neurogenesis in the behavioral performance of gerbils after cerebral global ischemia. We used ionizing radiation to decrease neural regeneration, and 2 weeks later cerebral global ischemia was induced by bilateral common carotid artery occlusion. One month after the occlusion, the animals were behaviorally tested. Irradiation alone reduced neurogenesis but did not change vascular or dendritic morphology at the time of behavioral testing. Neither did irradiation, ischemia, or combined treatment impair rotor-rod performance or alter open-field activity. Gerbils subjected to both irradiation and ischemia demonstrated impaired performance in the water-maze task, compared with those that received only ischemia, radiation, or no treatment. These impairments after cerebral global ischemia under conditions of reduced neurogenesis support a role for the production of new cells in mediating functional recovery. C1 Univ Calif San Francisco, Dept Neurol Surg 112C, San Francisco, CA 94121 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR USA. RP Liu, JL (reprint author), Univ Calif San Francisco, Dept Neurol Surg 112C, 4150 Clement St, San Francisco, CA 94121 USA. EM miro@itsa.ucsf.edu RI Liu, Jialing/A-8627-2012 OI Liu, Jialing/0000-0003-4420-4382 FU NCI NIH HHS [R01 CA 76141]; NIA NIH HHS [R01 AG 20079]; NINDS NIH HHS [R01 NS 40469, R21 NS 40088] NR 44 TC 160 Z9 166 U1 0 U2 3 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0364-5134 J9 ANN NEUROL JI Ann. Neurol. PD MAR PY 2004 VL 55 IS 3 BP 381 EP 389 DI 10.1002/ana.10853 PG 9 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 779BM UT WOS:000189275800010 PM 14991816 ER PT J AU Hodges, SH Anderson, AL Connor, NP AF Hodges, SH Anderson, AL Connor, NP TI Remodeling of neuromuscular junctions in aged rat genioglossus muscle SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 83rd Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 02-03, 2003 CL NASHVILLE, TN SP Amer Broncho Esophagol Assoc DE aging; confocal microscopy; genioglossus muscle; neuromuscular junction ID CONTRACTILE PROPERTIES; DIFFERENTIAL CHANGES; MOTOR UNITS; NERVE; TONGUE; REGENERATION; ASPIRATION; PHARYNGEAL; DYSPHAGIA; ANIMALS AB Speech and swallowing disorders represent a large clinical problem in elderly persons. Poor lingual control is associated with both speech and swallowing impairment. Studies of limb and laryngeal muscles suggest that age-related musculoskeletal changes may be characterized by remodeling of muscles, nerves, and their connections at neuromuscular junctions (NMJs). To evaluate dynamic remodeling of NMJ structure in the tongue as a function of aging, we studied tongues from 10 aged and 10 young rats. A fluorescent, triple-labeled, immunohistochemical technique was used with genioglossus (GG) muscle samples to allow confocal microscopic visualization of receptor clusters, nerve terminals, axons, and synaptic vesicles. Normal axon terminals and receptor clusters were easily identified in young rat GG muscles, whereas aging induced a significantly higher degree of receptor dispersal. These results suggest that NMJ remodeling is found in aged GG muscles and may underlie the progressive neuromuscular changes observed in the elderly. C1 Univ Wisconsin, Ctr Clin Sci, Div Otolaryngol Head & Neck Surg, Dept Surg, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Connor, NP (reprint author), Univ Wisconsin, Ctr Clin Sci, Div Otolaryngol Head & Neck Surg, Dept Surg, Room K4-711,600 Highland Ave, Madison, WI 53792 USA. NR 34 TC 12 Z9 13 U1 1 U2 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2004 VL 113 IS 3 BP 175 EP 179 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 803CQ UT WOS:000220209600001 PM 15053197 ER PT J AU Liu, JH Chen, PW Asch, SM Busuttil, RW Ko, CY AF Liu, JH Chen, PW Asch, SM Busuttil, RW Ko, CY TI Surgery for hepatocellular carcinoma: Does it improve survival? SO ANNALS OF SURGICAL ONCOLOGY LA English DT Article DE hepatocellular carcinoma; HCC; surgery; survival; outcomes; liver cancer ID UNITED-STATES; HEPATIC RESECTION; WESTERN CENTER; CIRRHOSIS; QUALITY; CANCER; PROGRAM; CARE AB Background: The incidence and mortality of hepatocellular carcinoma (HCC) are increasing in the United States. Whether surgery is associated with improved survival at the population level is relatively unknown. To address this question, we used a population-based cancer registry to compare survival outcomes between patients receiving and not receiving surgery with similar tumor sizes and health status. Methods: By using the Surveillance, Epidemiology, and End Results database, we identified HCC patients who had surgically resectable disease as defined by published expert guidelines. After excluding patients with contraindications to surgery, we performed both survival analysis and Cox regression to identify predictors of improved survival. Results: Of the 4008 patients diagnosed with HCC between 1988 and 1998, 417 were candidates for surgical resection. The mean age was 63.6 years; mean tumor size was 3.3 cm. The 5-year overall survival with surgery was 33% with a mean of 47.1 months; without surgery, the 5-year overall survival was 7% with a mean of 17.9 months (P <.001). In the multivariate Cox regression, surgery was significantly associated with improved survival (P <.001). Specifically, patients who received surgery had a 55% decreased rate of death compared with patients who did not have surgery, even after controlling for tumor size, age, sex, and race. Conclusions: This study shows that surgical therapy is associated with improved survival in patients with unifocal, nonmetastatic HCC tumors <5 cm. If this is confirmed in future studies, efforts should be made to ensure that appropriate patients with resectable HCC receive high-quality care, as well as the opportunity for potentially curative surgery. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. RP Liu, JH (reprint author), 11301 W Olymp Blvd,648, Los Angeles, CA 90064 USA. EM jerome8@ucla.edu NR 22 TC 52 Z9 54 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD MAR PY 2004 VL 11 IS 3 BP 298 EP 303 DI 10.1245/ASO.2004.03.042 PG 6 WC Oncology; Surgery SC Oncology; Surgery GA 780KX UT WOS:000189380800013 PM 14993025 ER PT J AU Guller, U Anstrom, KJ Holman, WL Allman, RM Sansom, M Peterson, ED AF Guller, U Anstrom, KJ Holman, WL Allman, RM Sansom, M Peterson, ED TI Outcomes of early extubation after bypass surgery in the elderly SO ANNALS OF THORACIC SURGERY LA English DT Article ID INTENSIVE-CARE UNIT; MECHANICALLY VENTILATED PATIENTS; RANDOMIZED CONTROLLED TRIAL; FAST-TRACK RECOVERY; CARDIAC-SURGERY; GRAFT-SURGERY; TRACHEAL EXTUBATION; MYOCARDIAL-ISCHEMIA; COST; STAY AB Background. While early extubation after coronary artery bypass grafting (CABG) has been associated with resource savings, its effect on patient outcomes remains unclear. The goal of the present investigation was to evaluate whether early extubation can be performed safely in elderly CABG patients in community practice. Methods. We studied 6,446 CABG patients, aged 65 years and older, treated at 35 hospitals between 1995 and 1998. Patients were categorized based on their post-CABG extubation duration (early, < 6 hours; intermediate, 6 to < 12 hours; and late, 12 to 24 hours). We compared unadjusted and risk-adjusted mortality, reintubation rates, and post-CABG length of stay (pLOS). We also examined the association between patients' intubation time and outcomes among patients with similar propensity for early extubation and among high-risk patient subgroups. Results. The overall mean post-CABG intubation time was 9.8 (SD 5.7) hours with 29% of patients extubated within 6 hours. After adjusting for preoperative risk factors patients extubated in less than 6 hours had significantly shorter postoperative hospital stays than those with later extubation times. Patients extubated early also tended to have equal or better risk-adjusted mortality than those with intermediate (odds ratio: 1.69, p = 0.08) or long intubation times (odds ratio: 1.97, p = 0.02). These results were consistent among patients with similar preoperative propensity for early extubation and among important high-risk patient subgroups. There was no evidence for higher reintubation rates among elderly patients selected for early extubation. Conclusions. In community practice, early extubation after CABG can be achieved safely in selected elderly patients. This practice was associated with shorter hospital stays without adverse impact on postoperative outcomes. (C) 2004 by The Society of Thoracic Surgeons. C1 Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Med, Div Cardiol, Durham, NC 27710 USA. Duke Univ, Med Ctr, Outcomes Res & Assessment Grp, Durham, NC 27710 USA. Univ Basel Hosp, Dept Surg, Div Gen Surg, CH-4031 Basel, Switzerland. Univ Alabama, Sch Med, Dept Surg,Birmingham Atlanta VA,GRECC, Birmingham VA Med Ctr,Alabama Qual Assurance Fdn, Birmingham, AL 35294 USA. Univ Alabama, Ctr Aging, Birmingham, AL USA. RP Peterson, ED (reprint author), Duke Univ, Med Ctr, Duke Clin Res Inst, Box 17969, Durham, NC 27715 USA. EM peter016@mc.duke.edu NR 37 TC 23 Z9 24 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD MAR PY 2004 VL 77 IS 3 BP 781 EP 788 DI 10.1016/athoracsur.2003.09.059 PG 8 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 779TL UT WOS:000189317000006 PM 14992871 ER PT J AU Sung, N Takayama, K Collins, MT AF Sung, N Takayama, K Collins, MT TI Possible association of GroES and antigen 85 proteins with heat resistance of Mycobacterium paratuberculosis SO APPLIED AND ENVIRONMENTAL MICROBIOLOGY LA English DT Article ID AVIUM SUBSP PARATUBERCULOSIS; T-CELL RECOGNITION; CROHNS-DISEASE; THERMAL-RESISTANCE; ESCHERICHIA-COLI; MYCOLIC ACIDS; LISTERIA-MONOCYTOGENES; BICINCHONINIC ACID; SHOCK PROTEINS; TUBERCULOSIS AB Conflicting reports on the heat resistance of Mycobacterium paratuberculosis prompted an examination of the effect of culture medium on this property of the organism. M. paratuberculosis was cultured in three types of media (fatty acid-containing medium 7H9-OADC (oleic acid-albumin-dextrose-catalase supplement) and glycerol-containing media WR-GD and 7H9-GD [glycerol-dextrose supplement]) at pH 6.0. M. paratuberculosis grown under these three culture conditions was then tested for heat resistance in distilled water at 65degreesC. Soluble proteins and mycolic acids of M. paratuberculosis were evaluated by two-dimensional ellectrophoresis (2-DE) and thin-layer chromatography (TLC), respectively. The type of culture medium used significantly affected the heat resistance of M. paratuberculosis. The decimal reduction times at 65degreesC (D61-C values; times required to reduce the concentration of bacteria by a factor of 10 at 65degreesC) for M. paratuberculosis strains grown in 7H9-OADC were significantly higher than those for the organisms grown in WR-GD medium (P < 0.01). When the glycerol-dextrose supplement of WR was substituted for the fatty acid supplement (OADC) in 7H9 medium (resulting in 7H9-GD), the D-65degreesC value was significantly lower than that for the organism grown in 7H9-OADC medium (P = 0.022) but higher than that when it was cultured in WR-GD medium (P = 0.005). Proteomic analysis by 2-DE of soluble proteins extracted from M. paratuberculosis grown without heat stress in the three media (7H9-OADC, 7H9-GD, and WR-GD) revealed that seven proteins were more highly expressed in 7H9-OADC medium than in the other two media. When the seven proteins were subjected to matrix-assisted laser desorption ionization-mass spectrometric analysis, four of the seven protein spots were unidentifiable. The other three proteins were identified as GroES heat shock protein, alpha antigen, and antigen 85 complex B (Ag85B; fibronectin-binding protein). These proteins may be associated with the heat resistance of M. paratuberculosis. Alpha antigen and Ag85B are both trehalose mycolyltransferases involved in mycobacterial cell wall assembly. TLC revealed that 7H9-OADC medium supported production of more trehalose dimycolates and cell wall-bound mycolic acids than did WR-CD medium. The present study shows that in vitro culture conditions significantly affect heat resistance, cell wall synthesis, and protein expression of M. paratuberculosis and emphasize the importance of culture conditions on in vitro and ex vivo studies to estimate heat resistance. C1 Univ Wisconsin, Sch Vet Med, Dept Pathobiol Sci, Madison, WI 53706 USA. Univ Wisconsin, Dept Bacteriol, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Mycobacteriol Res Lab, Madison, WI 53795 USA. Univ Wisconsin, Dept Microbiol & Immunol, Madison, WI 53705 USA. RP Collins, MT (reprint author), 2015 Linden Dr, Madison, WI 53706 USA. EM mcollin5@facstaff.wisc.edu NR 65 TC 19 Z9 20 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0099-2240 J9 APPL ENVIRON MICROB JI Appl. Environ. Microbiol. PD MAR PY 2004 VL 70 IS 3 BP 1688 EP 1697 DI 10.1128/AEM.70.3.1688-1697.2004 PG 10 WC Biotechnology & Applied Microbiology; Microbiology SC Biotechnology & Applied Microbiology; Microbiology GA 802HO UT WOS:000220154800054 PM 15006794 ER PT J AU Blutt, SE Conner, ME AF Blutt, SE Conner, ME TI Kinetics of rotavirus infection in mice are not altered in a ground-based model of spaceflight SO AVIATION SPACE AND ENVIRONMENTAL MEDICINE LA English DT Article DE virus; hindlimb unloading; immunity; mucosal; enteric; intestine; microgravity ID LISTERIA-MONOCYTOGENES INFECTION; SPACE-FLIGHT; ANTIORTHOSTATIC SUSPENSION; IMMUNE-SYSTEM; DURATION MISSIONS; MOUSE MODEL; WEIGHTLESSNESS; RESISTANCE; RESPONSES AB Introduction: The effect of simulated spaceflight conditions using the hindlimb unloading model on mucosal immune responses has not been examined. Therefore, we determined whether clearance, protection, and the antibody responses to an enteric pathogen, rotavirus, were altered under simulated spaceflight conditions. Methods: Groups of mice were either restrained and hindlimb unloaded, restrained without hindlimb unloading, or housed under standard conditions for either 4 or 14 d prior to and an additional 10 d following inoculation with ECwt murine rotavirus. An additional group of mice previously infected with rotavirus was housed under the three conditions for either 4 or 14 d prior to a rotavirus challenge. Results: Hindlimb unloading of mice did not alter clearance of a primary rotavirus infection compared with controls nor were there differences in protection from rotavirus challenge 42 d later between the three groups, all housed under standard conditions. There were no differences in protection from rotavirus challenge in mice that were hindlimb unloaded during the challenge infection compared with controls. The generation of rotavirus-specific fecal antibodies, as measured by enzyme-linked immunosorbent assay (ELISA), was not significantly different between any of the groups following either primary or challenge rotavirus infection. However, serum rotavirus-specific IgG1 antibody was not induced in mice housed under normal conditions and challenged under hindlimb unloading conditions compared with controls. Discussion: These data are the first examination of the mucosal immune response to an enteric viral pathogen under simulated spaceflight conditions and indicate that rotavirus immunity was not impacted in this model. C1 Baylor Coll Med, Dept Mol Virol & Microbiol, Houston, TX 77030 USA. Med Res Serv, Dept Vet Affairs Med Ctr, Houston, TX USA. RP Conner, ME (reprint author), Baylor Coll Med, Dept Mol Virol & Microbiol, 1 Baylor Plaza, Houston, TX 77030 USA. EM mconner@bcm.tmc.edu NR 24 TC 2 Z9 2 U1 0 U2 0 PU AEROSPACE MEDICAL ASSOC PI ALEXANDRIA PA 320 S HENRY ST, ALEXANDRIA, VA 22314-3579 USA SN 0095-6562 J9 AVIAT SPACE ENVIR MD JI Aviat. Space Environ. Med. PD MAR PY 2004 VL 75 IS 3 BP 215 EP 219 PG 5 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Sport Sciences SC Public, Environmental & Occupational Health; General & Internal Medicine; Sport Sciences GA 809OJ UT WOS:000220645700004 PM 15018288 ER PT J AU Wynn, JK Dawson, ME Schell, AM McGee, M Salveson, D Green, MF AF Wynn, JK Dawson, ME Schell, AM McGee, M Salveson, D Green, MF TI Prepulse facilitation and prepulse inhibition in schizophrenia patients and their unaffected siblings SO BIOLOGICAL PSYCHIATRY LA English DT Article DE startle; prepulse inhibition; prepulse facilitation; orienting; schizophrenia; endophenotypic marker ID SCHIZOTYPAL PERSONALITY-DISORDER; CONDUCTANCE ORIENTING RESPONSE; STARTLE EYEBLINK MODIFICATION; ATTENTIONAL PROCESSES; MISMATCH NEGATIVITY; REFLEX MODIFICATION; ACOUSTIC STARTLE; GATING DEFICITS; RELATIVES; ABNORMALITIES AB Background: Deficits in schizophrenia patients and their first-degree relatives have been reported in prepulse inhibition (PPI), a phenomenon that measures an early stage of information processing (sensorimotor gating). It is less clear whether these information processing deficits extend to prepulse facilitation (PPF), which measures a later stage of generalized alerting or orienting. Methods. This study examined three separate issues: first, whether schizophrenia patients have deficits in PPI and PPF; second, whether the siblings of patients show deficits in these processes; and third, whether prepulse duration influences the degree of the deficits. These issues were examined in 76 schizophrenia patients, 36 of their siblings, and 41 normal control subjects. Results: Patients and siblings did not differ from control subjects in PPI, perhaps due to the use of different procedural parameters compared with other laboratories that have consistently found PPI deficits in schizophrenia patients. Patients and their siblings produced significantly less PPF than control subjects. For both PPI and PPF, prepulse duration was not a significant factor. Conclusions: These results imply that PPF deficits reveal a generalized alerting or orienting deficit that is present in both schizophrenia patients and their siblings, suggesting that this deficit may be tapping an endophenotypic vulnerability factor. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA USA. Univ So Calif, Dept Psychol, Los Angeles, CA 90089 USA. Occidental Coll, Dept Psychol, Los Angeles, CA 90041 USA. RP Wynn, JK (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 210, Los Angeles, CA 90073 USA. RI Wynn, Jonathan/H-3749-2014 OI Wynn, Jonathan/0000-0002-1763-8540 FU NIMH NIH HHS [MH43292, MH-46433, MH14584] NR 44 TC 47 Z9 47 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD MAR 1 PY 2004 VL 55 IS 5 BP 518 EP 523 DI 10.1016/j.biopsych.2003.10.018 PG 6 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 779HV UT WOS:000189290000012 PM 15023580 ER PT J AU Forman, SD Dougherty, GG Casey, BJ Siegle, GJ Braver, TS Barch, DM Stenger, VA Wick-Hull, C Pisarov, LA Lorensen, E AF Forman, SD Dougherty, GG Casey, BJ Siegle, GJ Braver, TS Barch, DM Stenger, VA Wick-Hull, C Pisarov, LA Lorensen, E TI Opiate addicts lack error-dependent activation of rostral anterior cingulate SO BIOLOGICAL PSYCHIATRY LA English DT Article DE substance-related disorders; heroin dependence; decision making; choice behavior; impulsivity; personality ID EVENT-RELATED FMRI; PREFRONTAL CORTEX; FUTURE CONSEQUENCES; IMPULSE CONTROL; HEROIN-ADDICTS; PERSONALITY; SMOKERS; DISORDER; SMOKING; DAMAGE AB Background: Healthy individuals performing response suppression tasks activate anterior cingulate cortex with occurrence of false alarm error responses to nontargets. Fundamental questions include whether this error-related activation provides a signal contributing to behavioral control and given generally poorer performance on such tasks by addicts, whether this signal is disrupted in addiction. Methods: We used rapid, event-related functional magnetic resonance imaging to study 13 individuals with opiate dependence and 26 healthy control individuals performing a Go/NoGo task. Results: Compared with controls, opiate addicts exhibited an attenuated anterior cingulate cortex error signal and significantly poorer task performance. In controls, the individual level of event-related anterior cingulate cortex activation accompanying false alarm error positively predicted task performance, particularly sensitivity in discriminating targets from nontargets. Conclusions: The attenuation of this error signal in anterior cingulate cortex may play a role in loss of control in addiction and other forms of impulsive behavior. C1 Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Dept Vet Affairs, Pittsburgh, PA USA. Cornell Univ, Weill Med Coll, Sackler Inst Dev Psychobiol, New York, NY 10021 USA. Washington Univ, Dept Psychol, St Louis, MO 63130 USA. RP Forman, SD (reprint author), Vet Affairs Pittsburgh HCS, Highland Dr Div, 7180 Highland Dr, Pittsburgh, PA 15206 USA. RI Barch, Deanna/G-8638-2013 OI Braver, Todd/0000-0002-2631-3393 FU NIDA NIH HHS [R29 DA 11721]; NIMH NIH HHS [R01 MH066031] NR 54 TC 140 Z9 146 U1 8 U2 21 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD MAR 1 PY 2004 VL 55 IS 5 BP 531 EP 537 DI 10.1016/j.biopsych.2003.09.011 PG 7 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 779HV UT WOS:000189290000014 PM 15023582 ER PT J AU Krouse, RS Rosenfeld, KE Grant, M Aziz, N Byock, I Sloan, J Casarett, D AF Krouse, RS Rosenfeld, KE Grant, M Aziz, N Byock, I Sloan, J Casarett, D TI Palliative care research: Issues and opportunities SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Editorial Material ID MALIGNANT BOWEL OBSTRUCTION; QUALITY-OF-LIFE; CANCER CARE; GUIDELINES C1 So Arizona Vet Affairs Hlth Care Syst, Dept Surg, Tucson, AZ 85723 USA. Univ Arizona, Tucson, AZ 85721 USA. W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. City Hope Natl Med Ctr, Dept Nursing Res & Educ, Duarte, CA 91010 USA. NCI, Off Canc Survivorship, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. Dartmouth Hitchcock Med Ctr, Sect Palliat Med, Hanover, NH USA. Mayo Canc Ctr, Stat Unit, Rochester, MN USA. Univ Penn, Ctr Hlth Equ Res & Promot, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Div Geriatr, Philadelphia, PA 19104 USA. RP Krouse, RS (reprint author), So Arizona Vet Affairs Hlth Care Syst, Dept Surg, Surg Care Line 2-112, Tucson, AZ 85723 USA. EM robert.krouse@med.va.gov NR 17 TC 20 Z9 21 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD MAR PY 2004 VL 13 IS 3 BP 337 EP 339 PG 3 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 801FE UT WOS:000220081000001 PM 15006905 ER PT J AU Pold, M Zhu, LX Sharma, S Burdick, MD Lin, Y Lee, PPN Pold, A Luo, J Krysan, K Dohadwala, M Mao, JT Batra, RK Strieter, RM Dubinett, SM AF Pold, M Zhu, LX Sharma, S Burdick, MD Lin, Y Lee, PPN Pold, A Luo, J Krysan, K Dohadwala, M Mao, JT Batra, RK Strieter, RM Dubinett, SM TI Cyclooxygenase-2-dependent expression of angiogenic CXC chemokines ENA-78/CXC ligand (CXCL) 5 and interleukin-8/CXCL8 in human non-small cell lung cancer SO CANCER RESEARCH LA English DT Article ID FACTOR-KAPPA-B; ENDOTHELIAL GROWTH-FACTOR; PROSTATE-CANCER; TUMOR ANGIOGENESIS; PROSTAGLANDIN E-2; MOLECULAR-BIOLOGY; BCL-2 EXPRESSION; FACTOR BETA-1; IN-VIVO; APOPTOSIS AB Elevated tumor cyclooxygenase (COX)-2 activity plays a multifaceted role in non-small cell lung cancer (NSCLC). To elucidate the role of COX-2 in the in vitro and in vivo expression of two known NSCLC angiogenic peptides, CXC ligand (CXCL) 8 and CXCL5, we studied two COX-2 gene-modified NSCLC cell lines, A549 and H157. COX-2 overexpression enhanced the in vitro expression of both CXCL8 and CXCL5. In contrast, specific COX-2 inhibition decreased the production of both peptides as well as nuclear translocation of nuclear factor kappaB. In a severe combined immunodeficient mouse model of human NSCLC, the enhanced tumor growth of COX-2-overexpressing tumors was inhibited by neutralizing anti-CXCL5 and anti-CXCL8 antisera. We conclude that COX-2 contributes to the progression of NSCLC tumorigenesis by enhancing the expression of angiogenic chemokines CXCL8 and CXCL5. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Pulm & Crit Care Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Lung Canc Res Program, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Ctr, Los Angeles, CA USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Pulm & Crit Care Med, 37-131 CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu FU NCI NIH HHS [CA87879, P50 CA90388, R01 CA71818, R01 CA85686]; NHLBI NIH HHS [P01 HL67665] NR 76 TC 86 Z9 96 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD MAR 1 PY 2004 VL 64 IS 5 BP 1853 EP 1860 DI 10.1158/0008-5472.CAN-03-3262 PG 8 WC Oncology SC Oncology GA 780DY UT WOS:000189357800041 PM 14996749 ER PT J AU Matute-Bello, G Winn, RK Martin, TR Liles, WC AF Matute-Bello, G Winn, RK Martin, TR Liles, WC TI Sustained lipopolysaccharide-induced lung inflammation in mice is attenuated by functional deficiency of the Fas/Fas ligand system SO CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY LA English DT Article ID EPITHELIAL-CELL APOPTOSIS; SOLUBLE FAS LIGAND; CONFER IMMUNE PRIVILEGE; INJURY; EXPRESSION; ACTIVATION; DEATH AB To determine whether the Fas/Fas ligand (FasL) (CD95/CD178) system contributes to the development of an inflammatory response in vivo, 2.5 mug of bacterial lipopolysaccharide (LPS; endotoxin) per g was administered intranasally to healthy mice (C57BL/6) and mutant mice deficient in either Fas (lpr mice) or FasL (g/d mice). Sustained LPS-induced neutrophilic inflammation in the lungs was attenuated in both lpr and gld mice. These observations provide further evidence of a proinflammatory role for the Fas/FasL system in the lungs. C1 Univ Washington, Sch Med, Med Res Serv, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Sch Med, Div Pulm & Crit Care Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Div Allergy & Infect Dis, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Surg, Seattle, WA 98195 USA. RP Matute-Bello, G (reprint author), Vet Adm Med Ctr, Pulm Res Grp, 1660 S Columbian Way, Seattle, WA 98108 USA. EM matuteb@u.washington.edu FU NHLBI NIH HHS [R01 HL065892, HL62995, HL65892, HL70840-01, K08 HL070840, R01 HL062995] NR 15 TC 34 Z9 35 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 1071-412X J9 CLIN DIAGN LAB IMMUN JI Clin. Diagn. Lab. Immunol. PD MAR PY 2004 VL 11 IS 2 BP 358 EP 361 DI 10.1128/CDLI.11.2.358-361.2004 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 807DV UT WOS:000220483100021 PM 15013988 ER PT J AU Neuzil, KM AF Neuzil, KM TI Influenza vaccine for children SO CLINICAL INFECTIOUS DISEASES LA English DT Review ID CONTROLLED TRIAL; EFFICACY; DISEASE C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Neuzil, KM (reprint author), Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, 1660 S Columbian Wy, Seattle, WA 98108 USA. EM kneuzil@u.washington.edu NR 11 TC 4 Z9 5 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAR 1 PY 2004 VL 38 IS 5 BP 689 EP 691 DI 10.1086/382888 PG 3 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 777EY UT WOS:000189163900012 PM 14986253 ER PT J AU Clapp, L Martin, B Beresford, TP AF Clapp, L Martin, B Beresford, TP TI Sublingual cocaine - Novel recurrence of an ancient practice SO CLINICAL NEUROPHARMACOLOGY LA English DT Review DE cocaine; sublingual; routes of use ID VALIDITY AB Present knowledge suggests that cocaine is almost always used by snorting, injecting, or smoking. During a recent treatment study, we encountered 2 cases who reported active cocaine use by the sublingual route exclusively. We describe here 1) the method of sublingual use, 2) its attraction for cocaine dependent individuals, especially those who wish to conceal use, and 3) concerns regarding the medical consequences of sublingual cocaine use. Sublingual cocaine use may cause unique medical symptoms and may easily evade detection by medical personnel. C1 Dept Vet Affairs Med Ctr, Denver, CO USA. Univ Colorado, Ctr Hlth Sci, Denver, CO 80202 USA. RP Beresford, TP (reprint author), Denver VA Med Ctr, 1055 Clermont St, Denver, CO 80220 USA. EM Thomas.Beresford@uchsc.edu NR 7 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0362-5664 J9 CLIN NEUROPHARMACOL JI Clin. Neuropharmacol. PD MAR-APR PY 2004 VL 27 IS 2 BP 93 EP 94 DI 10.1097/00002826-200403000-00010 PG 2 WC Clinical Neurology; Pharmacology & Pharmacy SC Neurosciences & Neurology; Pharmacology & Pharmacy GA 817YU UT WOS:000221213600010 PM 15252272 ER PT J AU DeRubertis, FR Craven, PA Melhem, MF Salah, E AF DeRubertis, FR Craven, PA Melhem, MF Salah, E TI Attenuation of renal injury in db/db mice overexpressing superoxide dismutase - Evidence for reduced superoxide-nitric oxide interaction SO DIABETES LA English DT Article ID AORTIC ENDOTHELIAL-CELLS; GROWTH-FACTOR-BETA; ALPHA-LIPOIC ACID; PROTEIN-KINASE-C; OXIDATIVE STRESS; DIABETIC-RATS; GLOMERULAR INJURY; MESANGIAL CELLS; VITAMIN-C; NEPHROPATHY AB The effects of overexpression of Cu2+/Zn2+ superoxide dismutase-1 (SOD-1) on indexes of renal injury were compared in 5-month-old nontransgenic (NTg) db/db mice and db/db mice hemizygous for the human SOD-1 transgene (SOD-Tg). Both diabetic groups exhibited similar hyperglycemia and weight gain. However, in NTg-db/db mice, albaminuria, glomerular accumulation of immunoreactive transforming growth factor-beta, collagen alpha1(IV), nitrotyrosine, and mesangial matrix were all significantly increased compared with either nondiabetic mice or SOD-Tg-db/db. SOD-1 activity and reduced glutathione levels were higher, whereas malondialdehyde content was lower, in the renal cortex of SOD-Tg-db/db compared with NTg-db/db mice, consistent with a renal antioxidant effect in the transgenic mice. Inulin clearance (C-IN) and urinary excretion of guanosine 3',5'-cyclic monophosphate (U-cGMP) were increased in SOD-Tg-db/db mice compared with corresponding values in nondiabetic mice or NTg-db/db mice. C-IN and U-cGMP were suppressed by Nomega-nitro-L-arginine methyl ester in SOD-Tg-db/db but not in NTg-db/db mice, implying nitric oxide (NO) dependence of these increases and enhanced renal NO bioactivity in SOD-Tg-db/db. Studies of NO-responsive cGMP in isolated glomeruli supported greater quenching of NO in glomeruli from NTg-db/db compared with SOD-Tg-db/db mice. Evidence of increased NO responsiveness and the suppression of glomerular nitrotyrosine may both reflect reduced NO-superoxide interaction in SOD-Tg-db/db mice. The results implicate superoxide in the pathogenesis of diabetic nephropathy. C1 VA Pittsburgh Healthcare Syst, Dept Med, Pittsburgh, PA 15240 USA. VA Pittsburgh Healthcare Syst, Dept Pathol, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. RP DeRubertis, FR (reprint author), VA Pittsburgh Healthcare Syst, Dept Med, Univ Dr C, Pittsburgh, PA 15240 USA. EM frederick.derubertis@med.va.gov NR 49 TC 86 Z9 90 U1 0 U2 5 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD MAR PY 2004 VL 53 IS 3 BP 762 EP 768 DI 10.2337/diabetes.53.3.762 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 779NV UT WOS:000189307500031 PM 14988262 ER PT J AU Albrecht-Betancourt, M Hijazi, RA Cunningham, GR AF Albrecht-Betancourt, M Hijazi, RA Cunningham, GR TI Androgen replacement in men with hypogonadism and erectile dysfunction SO ENDOCRINE LA English DT Article DE testosterone; androgen; hypogonadism; libido; erectile dysfunction ID TRANSDERMAL TESTOSTERONE GEL; SLEEP-RELATED ERECTIONS; SEXUAL-BEHAVIOR; SERUM TESTOSTERONE; ELECTRICAL-STIMULATION; PENILE TUMESCENCE; LONG-TERM; THERAPY; HORMONES; BRAIN AB The prevalence of hypogonadism and erectile dysfunction (ED) increases with age. Hypogonadism also is frequently associated with decreased libido and ED. Testosterone replacement therapy for hypogonadal ED is effective in restoring sexual desire and erectile function, especially in younger and healthy men. It appears to be less effective in older men with comorbid diseases that may cause ED. Therapy should be individualized, considered carefully, and closely monitored because of potential risks, especially in older men. The FDA has approved several testosterone delivery systems. These include a buccal testosterone tablet, intramuscular injections, transdermal and subcutaneous forms. There also are several promising experimental androgens under investigation including non-steroidal selective androgen receptor modulators (SARMs). C1 Baylor Coll Med, Dept Med, Houston, TX USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX USA. VA Med Ctr, Houston, TX USA. RP Cunningham, GR (reprint author), VA Med Ctr 151, 2002 Holcombe Blvd, Houston, TX USA. EM glennc@bcm.tmc.edu NR 50 TC 8 Z9 8 U1 1 U2 1 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0969-711X J9 ENDOCRINE JI Endocrine PD MAR-APR PY 2004 VL 23 IS 2-3 BP 143 EP 148 DI 10.1385/ENDO:23:2-3:143 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 827IO UT WOS:000221893100011 PM 15146093 ER PT J AU Barbour, LA Shao, JH Qiao, LP Leitner, W Anderson, M Friedman, JE Draznin, B AF Barbour, LA Shao, JH Qiao, LP Leitner, W Anderson, M Friedman, JE Draznin, B TI Human placental growth hormone increases expression of the p85 regulatory unit of phosphatidylinositol 3-kinase and triggers severe insulin resistance in skeletal muscle SO ENDOCRINOLOGY LA English DT Article ID GESTATIONAL DIABETES-MELLITUS; PHOSPHOINOSITIDE 3-KINASE; TYROSINE PHOSPHORYLATION; SIGNALING PATHWAYS; 3T3-L1 ADIPOCYTES; P85-ALPHA SUBUNIT; TRANSGENIC MICE; GLUCOSE-UPTAKE; GH RECEPTOR; OBESE WOMEN AB The insulin resistance of normal pregnancy is necessary to divert fuels to the fetus to meet fetal growth demands and is mediated by placental hormones. We recently demonstrated that human placental GH (hPGH) can trigger severe insulin resistance in transgenic (TG) mice. In this study we sought to elucidate the cellular mechanisms by which hPGH interferes with insulin signaling in muscle in TG mice. Insulin-stimulated GLUT-4 translocation to the plasma membrane ( PM) was reduced in the TG compared with wild-type (WT) mice ( P = 0.05). Insulin receptor (IR) levels were modestly reduced by 19% ( P < 0.01) in TG mice, but there were no changes in phosphorylation of IR or IR substrate-1 (IRS-1) between WT and TG mice. A singular finding was a highly significant increase in the p85α regulatory subunit of phosphatidylinositol 3-kinase ( PI 3-kinase; P < 0.001), yet a reduced ability of insulin to stimulate IRS-1-associated PI 3-kinase activity ( P < 0.05). Although the levels of the p110 catalytic subunit protein of PI 3-kinase and IRS-1 were unchanged in the TG mice, insulin's ability to stimulate p110 association with IRS-1 was markedly reduced ( P < 0.0001). We demonstrate a unique mechanism of insulin resistance and suggest that hPGH may contribute to the insulin resistance of normal pregnancy by increasing the expression of the p85alpha monomer, which competes in a dominant negative fashion with the p85-p110 heterodimer for binding to IRS-1 protein. C1 Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Obstet & Gynecol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pediat, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Res Serv, Denver, CO 80262 USA. RP Barbour, LA (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Med, 4200 E 9th Ave,Box B-198, Denver, CO 80262 USA. EM lynn.barbour@uchsc.edu FU NCRR NIH HHS [1K23-RR-017496-01]; NIDDK NIH HHS [DK-62155] NR 25 TC 90 Z9 91 U1 0 U2 2 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD MAR 1 PY 2004 VL 145 IS 3 BP 1144 EP 1150 DI 10.1210/en.2003-1297 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 775HW UT WOS:000189035500020 PM 14633976 ER PT J AU Zhu, ZT Munhall, A Shen, KZ Johnson, SW AF Zhu, ZT Munhall, A Shen, KZ Johnson, SW TI Calcium-dependent subthreshold oscillations determine bursting activity induced by N-methyl-D-aspartate in rat subthalamic neurons in vitro SO EUROPEAN JOURNAL OF NEUROSCIENCE LA English DT Article DE brain slice; burst firing; firing pattern; subthalamic nucleus; whole-cell recording ID METABOTROPIC GLUTAMATE RECEPTORS; ACTIVATED POTASSIUM CHANNELS; ACTION-POTENTIAL GENERATION; SINGLE-SPIKE ACTIVITY; MOUSE CENTRAL NEURONS; NUCLEUS NEURONS; NEUROTRANSMITTER RELEASE; PLATEAU POTENTIALS; PARKINSONS-DISEASE; PYRAMIDAL NEURONS AB We used whole-cell patch recordings in current clamp to investigate the ionic dependence of burst firing induced by N-methyl-d-aspartate (NMDA) in neurons of the subthalamic nucleus (STN) in slices of rat brain. NMDA (20 mum) converted single-spike firing to burst firing in 87% of STN neurons tested. NMDA-induced bursting was blocked by AP5 (50 mum), and was not mimicked by the non-NMDA receptor agonist AMPA (0.6 mum). Tetrodotoxin (1 mum) converted bursts to oscillations of membrane potential, which were most robust when oscillations ranged between -50 and -70 mV. The NMDA bursts were blocked by an elevated extracellular concentration of Mg2+, but superfusate containing no added Mg2+ either reduced or increased burst firing, depending upon the amount of intracellular current injection. Block of K+ conductances by apamin and tetraethylammonium prolonged burst duration, but iberiotoxin had no effect. NMDA-induced burst firing and membrane oscillations were completely blocked by superfusate containing no added Ca2+, and they were significantly reduced when patch pipettes contained BAPTA. Selective antagonists for T-type (mibefradil, 10 mum), L-type (nifedipine, 3 mum), and N-type (omega-conotoxin GVIA, 1 mum) Ca2+ channels had no effect on NMDA burst firing. Superfusate containing a low concentration of Na+ (20 mm) completely abolished NMDA-induced burst firing. Flufenamic acid (10 mum), which blocks current mediated by Ca2+-activated nonselective cation channels (I-CAN), reversibly abolished NMDA-depended bursting. These results are consistent with the hypothesis that NMDA-induced burst firing in STN neurons requires activation of either an I-CAN or a Na+-Ca2+ exchanger. C1 Portland VA Med Ctr, Portland, OR 97207 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97239 USA. RP Johnson, SW (reprint author), Portland VA Med Ctr, R&D 61,3710 SW US Vet Hosp Rd,POB 1034, Portland, OR 97207 USA. EM johnsost@ohsu.edu FU NINDS NIH HHS [NS38715] NR 72 TC 43 Z9 43 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0953-816X J9 EUR J NEUROSCI JI Eur. J. Neurosci. PD MAR PY 2004 VL 19 IS 5 BP 1296 EP 1304 DI 10.1111/j.1460-9568.2004.03240.x PG 9 WC Neurosciences SC Neurosciences & Neurology GA 802QA UT WOS:000220176800017 PM 15016087 ER PT J AU El-Serag, HB Davila, JA AF El-Serag, HB Davila, JA TI Is fibrolamellar carcinoma different from hepatocellular carcinoma? A US population-based study SO HEPATOLOGY LA English DT Article ID NATURAL-HISTORY; CHILDHOOD; HEPATOMA; CHILDREN AB There have been no population-based studies of the epidemiology and prognosis of patients with fibrolamellar carcinoma (FLC). We conducted a retrospective cohort study using information collected by population-based registries of the Surveillance, Epidemiology, and End Results (SEER) program. The demographic features, stage at diagnosis, and type of therapy, as well as age-adjusted incidence rates and observed and relative survival rates were compared between persons with FLC and those with hepatocellular carcinoma (HCC) diagnosed between 1986 and 1999. A multivariate Cox proportional hazards model was constructed to examine the effect of histology (FLC vs. HCC) on the risk of mortality. There were 68 microscopically confirmed cases of FLC and 7,896 cases of HCC. FLC constituted 0.85% of all cases of primary liver cancer and 13.4% of all cases below the age of 40. Compared to HCC, patients with FLC were more likely to be younger (mean age 39 vs. 65), female (51.5% vs. 26.3%), and white (85.3% vs. 56.9%). A greater proportion of case with FLC had localized disease (41.2% vs. 30.9%), or received potentially curative therapy (resection, transplantation), compared to cases with HCC. The age-adjusted incidence rate for FLC was 0.02 per 100,000; No significant differences in age-adjusted incidence rates were observed by gender or race. The 1- and 5-year observed and relative survival rates were significantly longer in patients with FLC than HCC. The 5-year relative survival rate was 31.8% (95% CI, 20.5%-43.1%) for FLC, compared with 6.8% (95% CI, 6.3%-7.4%) for HCC. Adjusting for differences in age, gender, race, stage of disease, receipt of resection or transplantation, and time of diagnosis, FLC was independently associated with a 46% reduction in risk of mortality within 5years compared with HCC. In conclusion, in a population-based study, we observed remarkable differences in the epidemiology and prognosis of FLC compared to HCC. C1 Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu NR 14 TC 94 Z9 101 U1 0 U2 6 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD MAR PY 2004 VL 39 IS 3 BP 798 EP 803 DI 10.1002/hep.20096 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 806IP UT WOS:000220427900027 PM 14999699 ER PT J AU Jefferson, JA Simon, J Escudero, E Hurtado, ME Swenson, ER Wesson, DE Schreiner, GF Schoene, RB Fohnson, RJ Hurtado, A AF Jefferson, JA Simon, J Escudero, E Hurtado, ME Swenson, ER Wesson, DE Schreiner, GF Schoene, RB Fohnson, RJ Hurtado, A TI Increased oxidative stress following acute and chronic high altitude exposure SO HIGH ALTITUDE MEDICINE & BIOLOGY LA English DT Article DE reactive oxygen species; lipid peroxidation; F-2-isoprostane; chronic mountain sickness; acute mountain sickness ID CHRONIC MOUNTAIN-SICKNESS; MODERATE-ALTITUDE; LIPID-PEROXIDATION; ANTIOXIDANT ENZYMES; REACTIVE OXYGEN; GLUTATHIONE DISULFIDE; HYPOBARIC HYPOXIA; VITAMIN-E; IN-VIVO; HUMANS AB Jefferson, J. Ashley, Jan Simoni, Elizabeth Escudero, Maria-Elena Hurtado, Erik R. Swenson, Donald E. Wesson, George F. Schreiner, Robert B. Schoene, Richard J. Johnson, Abdias Hurtado. Increased oxidative stress following acute and chronic high altitude exposure. High Alt. Med. Biol. 5:61-69, 2004.-The generation of reactive oxygen species is typically associated with hyperoxia and ischemia reperfusion. Recent evidence has suggested that increased oxidative stress may occur with hypoxia. We hypothesized that oxidative stress would be increased in subjects exposed to high altitude hypoxia. We studied 28 control subjects living in Lima, Peru (sea level), at baseline and following 48 h exposure to high altitude (4300 m). To assess the effects of chronic altitude exposure, we studied 25 adult males resident in Cerro de Pasco, Peru (altitude 4300 m). We also studied 27 subjects living in Cerro de Pasco who develop excessive erythrocytosis (hematocrit > 65%) and chronic mountain sickness. Acute high altitude exposure led to increased urinary F-2-isoprostane, 8-iso PGF(2alpha) (1.31 +/- 0.8 mug/g creatinine versus 2.15 +/- 1.1, p = 0.001) and plasma total glutathione (1.29 +/- 0.10 mumol versus 1.37 +/- 0.09, p = 0.002), with a trend to increased plasma thiobarbituric acid reactive substance (TBARS) (59.7 +/- 36 pmol/mg protein versus 63.8 +/- 27, P = NS). High altitude residents had significantly elevated levels of urinary 8-iso PGF(2alpha) (1.3 +/- 0.8 mug/g creatinine versus 4.1 +/- 3.4, p = 0.007), plasma TBARS (59.7 +/- 36 pmol/mg protein versus 85 +/- 28, p = 0.008), and plasma total glutathione (1.29 +/- 0.10 mumol versus 1.55 +/- 0.19, p < 0.0001) compared to sea level. High altitude residents with excessive erythrocytosis had higher levels of oxidative stress compared to high altitude residents with normal hematological adaptation. In conclusion, oxidative stress is increased following both acute exposure to high attitude without exercise and with chronic residence at high altitude. C1 Univ Washington, Div Nephrol, Seattle, WA 98195 USA. Texas Tech Univ, Dept Surg, Lubbock, TX 79409 USA. Univ Peruana Cayetano Heredia, Hosp Loayza, Nephrol Ctr, Lima, Peru. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Texas Tech Univ, Dept Internal Med, Lubbock, TX 79409 USA. Scios Inc, Sunnyvale, CA USA. Univ Washington, Providence Med Ctr, Seattle, WA 98195 USA. Baylor Coll Med, Renal Sect, Houston, TX 77030 USA. RP Jefferson, JA (reprint author), Univ Washington, Div Nephrol, Box 356521,1959 Pacific Ave, Seattle, WA 98195 USA. EM jashleyj@u.washington.edu NR 42 TC 67 Z9 71 U1 1 U2 12 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1527-0297 J9 HIGH ALT MED BIOL JI High Alt. Med. Biol. PD SPR PY 2004 VL 5 IS 1 BP 61 EP 69 DI 10.1089/152702904322963690 PG 9 WC Biophysics; Public, Environmental & Occupational Health; Sport Sciences SC Biophysics; Public, Environmental & Occupational Health; Sport Sciences GA 812WL UT WOS:000220869500007 PM 15072717 ER PT J AU Couto, L Parker, A Gordon, JW AF Couto, L Parker, A Gordon, JW TI Direct exposure of mouse spermatozoa to very high concentrations of a serotype-2 adeno-associated virus gene therapy vector fails to lead to germ cell transduction SO HUMAN GENE THERAPY LA English DT Article ID RECOMBINANT AAV-2 VECTOR; THYMIDINE KINASE GENE; HEMOPHILIA-B DOGS; GANCICLOVIR THERAPY; FACTOR-IX; ADENOVIRUS; EXPRESSION; INJECTION; DNA; BIODISTRIBUTION AB In a clinical safety trial involving an adeno-associated virus (AAV) gene therapy vector encoding human factor IX, intrahepatic administration of the vector was associated with the finding of vector DNA in semen that persisted for several weeks. Uncertainty remains as to the route by which the vector reached semen, but the finding raised the prospect that mature sperm could be exposed to the vector and sustain integration of vector DNA. To provocatively test for the ability of AAV vectors to transduce mature sperm, we exposed mouse sperm to concentrations of the same vector used in clinical studies at concentrations ranging from 840 to 3400 particles per sperm cell, performed in vitro fertilization and embryo transfer, and evaluated newborn pups by Southern analysis for the presence of vector sequences. Of 102 pups analyzed, none showed evidence of vector DNA integration. We conclude from these studies that exposure of mature sperm to AAV gene therapy vectors is highly unlikely to lead to germline transduction. C1 Avigen Inc, Alameda, CA 94502 USA. CUNY Mt Sinai Sch Med, Dept Obstet Gynecol, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Human Genet, New York, NY 10029 USA. RP Gordon, JW (reprint author), Bronx Vet Adm Med Ctr, Res Bldg,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Jon.Gordon@mssm.edu NR 26 TC 20 Z9 21 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1043-0342 J9 HUM GENE THER JI Hum. Gene Ther. PD MAR PY 2004 VL 15 IS 3 BP 287 EP 291 DI 10.1089/104303404322886138 PG 5 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine GA 803DZ UT WOS:000220213100006 PM 15018737 ER PT J AU Goodfriend, TL Calhoun, DA AF Goodfriend, TL Calhoun, DA TI Resistant hypertension, obesity, sleep apnea, and aldosterone - Theory and therapy SO HYPERTENSION LA English DT Article DE obesity; aldosterone; sleep apnea; hypertension; fatty acids; renin ID CHRONIC EPISODIC HYPOXIA; BLOOD-PRESSURE; INSULIN-RESISTANCE; SYMPATHETIC ACTIVITY; RENIN-ACTIVITY; HEART-FAILURE; SPIRONOLACTONE; MORBIDITY; PLASMA; MECHANISMS AB Hypertension resistant to 2 antihypertensive drugs is more common among obese patients than among lean patients. The case we describe and the observations we report suggest that refractoriness among obese hypertensives is frequently caused by obstructive sleep apnea and/or inappropriately high plasma aldosterone levels. In other words, obese hypertensives may have sleep apnea, obese hypertensives without sleep apnea may have inappropriately elevated levels of plasma aldosterone, and a surprising number of obese patients with sleep apnea also have elevated levels of aldosterone. The mechanisms by which obesity and obstructive sleep apnea increase aldosterone levels and raise blood pressure are not understood, but sympathetic nervous system activation and production of nonclassical adrenal stimuli are two possibilities. Obstructive sleep apnea can be detected with a careful history and various sleep studies. Inappropriately elevated aldosterone levels can be detected by measuring the ratio of plasma aldosterone concentration to plasma renin activity. Successful treatment of these resistant hypertensives often can be achieved by devices that provide positive pressure to the upper airway to correct obstructive sleep apnea and by incorporating an aldosterone antagonist in the therapeutic regimen. C1 William S Middleton Mem Vet Adm Med Ctr, Res Serv, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI USA. Univ Wisconsin, Dept Pharmacol, Madison, WI 53706 USA. Univ Alabama, Vasc Biol & Hypertens Program, Birmingham, AL USA. RP Goodfriend, TL (reprint author), William S Middleton Mem Vet Adm Med Ctr, Res Serv, 2500 Overlook Terrace, Madison, WI 53705 USA. EM tgoodfri@facstaff.wisc.edu NR 59 TC 140 Z9 164 U1 0 U2 11 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD MAR PY 2004 VL 43 IS 3 BP 518 EP 524 DI 10.1161/01.HYP.0000116223.97436.e5 PG 7 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 778LR UT WOS:000189243500001 PM 14732721 ER PT J AU Koontz, AM Cooper, RA Boninger, ML Souza, AL Fay, BT AF Koontz, AM Cooper, RA Boninger, ML Souza, AL Fay, BT TI Scapular range of motion in a quasi-wheelchair push SO INTERNATIONAL JOURNAL OF INDUSTRIAL ERGONOMICS LA English DT Article; Proceedings Paper CT Workshop on Anthropometry and Disability CY 2001 CL Buffalo, NY SP NIDRR, Access Board DE shoulder; wheelchair propulsion; biomechanics; kinematics; scapular motion ID UPPER EXTREMITY; SHOULDER PAIN; KINEMATICS; POSITION; IMPINGEMENT; PROPULSION; BIOMECHANICS; ORIENTATION; ASSOCIATION; MECHANISM AB Descriptions of shoulder kinematics during wheelchair propulsion are limited to motions of the upper arm due to the difficulty of measuring scapular movement in vivo. Using a digitizing stylus, the three-dimensional positions of three anatomical landmark's on the scapula were recorded for 10 manual wheelchair users in six different statically held hand positions (-30degrees, -15degrees, 0degrees, 15degrees, 30degrees, 60degrees) on the pushrim. In each hand position, a motion analysis system recorded the coordinates of infrared markers on the arm and torso. Scapular, humeral, and torso angles were computed using an Euler angle decomposition method for each position relative to the torso. At the beginning of the push, the scapula was rotated slightly upward (1.5degrees), minimally protracted (15degrees), and maximally tipped forward (22degrees). In addition, the humerus was maximally extended, abducted and internally rotated. As subjects moved forward along the pushrim, the protraction angle increased while the forward tipping angle decreased. The humerus became increasingly more flexed as the push progressed with small changes observed in humeral abduction and internal rotation. A stepwise multiple regression analysis procedure (p<0.01) revealed that the torso, humeral flexion/extension and abduction angles are good predictors for estimating forward tipping and upward/downward rotation of the scapula. The regression equations enable researchers to estimate scapular orientation during propulsion which could provide further insight into specific biomechanical factors that lead to shoulder pathology. C1 Vet Affairs Pittsburgh Hlth Care Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Med Ctr, Dept Phys Med & Rehabil, Pittsburgh, PA 15261 USA. RP Koontz, AM (reprint author), Vet Affairs Pittsburgh Hlth Care Syst, Human Engn Res Labs, 7180 Highland Dr,151R-1, Pittsburgh, PA 15206 USA. EM akoontz@pitt.edu OI Boninger, Michael/0000-0001-6966-919X NR 36 TC 4 Z9 4 U1 1 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0169-8141 J9 INT J IND ERGONOM JI Int. J. Ind. Ergon. PD MAR PY 2004 VL 33 IS 3 BP 237 EP 248 DI 10.1016/j.ergon.2003.04.002 PG 12 WC Engineering, Industrial; Ergonomics SC Engineering GA 778NW UT WOS:000189248500007 ER PT J AU Siegle, GJ Steinhauer, SR Thase, ME AF Siegle, GJ Steinhauer, SR Thase, ME TI Pupillary assessment and computational modeling of the Stroop task in depression SO INTERNATIONAL JOURNAL OF PSYCHOPHYSIOLOGY LA English DT Article; Proceedings Paper CT 11th World Congress of Psychophysiology CY 2002 CL Montreal, CANADA DE depression; neural network; stroop; interference; pupil dilation; attention ID MAJOR DEPRESSION; EMOTIONAL INFORMATION; RESPONSES; ABNORMALITIES; DYSFUNCTION; PERFORMANCE; METABOLISM; ATTENTION; REDUCTION; DISORDER AB Depressed individuals frequently display disruptions in selective attention, but the time course and specificity of these difficulties are not well-understood. To better understand the nature of attentional disruptions in depression, 28 healthy adults and 23 unmedicated depressed adults completed a Stroop color-naming task using a long inter-stimulus interval and pupil dilation was recorded as a measure of cognitive load. Both groups took longer to name the color for incongruent than congruent trials. Pupil dilation was also larger for incongruent trials than for congruent trials across groups. which suggested that pupil dilation reflected cognitive load on the task. Though the groups did not differ in the magnitude of Stroop effect in pupil dilation, depressed individuals displayed decreased pupil dilation in the seconds following stimuli relative to controls. Computational neural network modeling further suggested that observed effects were consistent with decreased prefrontal cortex activity, associated with decreased cognitive control. (C) 2003 Elsevier B.V. All rights reserved. C1 Univ Pittsburgh, Western Psychiat Inst & Clin, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Siegle, GJ (reprint author), Univ Pittsburgh, Western Psychiat Inst & Clin, 3811 O Hara St, Pittsburgh, PA 15213 USA. EM gsiegle+@pitt.edu FU NIMH NIH HHS [MH55762, MH60473, MH64159] NR 37 TC 72 Z9 74 U1 3 U2 10 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-8760 J9 INT J PSYCHOPHYSIOL JI Int. J. Psychophysiol. PD MAR PY 2004 VL 52 IS 1 BP 63 EP 76 DI 10.1016/j.ijpsycho.2003.12.010 PG 14 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 806GW UT WOS:000220423400006 PM 15003373 ER PT J AU Steinhauer, SR Siegle, GJ Condray, R Pless, M AF Steinhauer, SR Siegle, GJ Condray, R Pless, M TI Sympathetic and parasympathetic innervation of pupillary dilation during sustained processing SO INTERNATIONAL JOURNAL OF PSYCHOPHYSIOLOGY LA English DT Article; Proceedings Paper CT 11th World Congress of Psychophysiology CY 2002 CL Montreal, CANADA DE pupillary dilation; sustained processing; sympathetic and parasympathetic pathways; pharmacology ID RESPONSES; REFLEX; PERFORMANCE; LOAD AB The contributions of separate sympathetic and parasympathetic pathways to pupillary dilation during a sustained processing task were studied through environmental and pharmacological manipulations. In Experiment 1, 22 healthy volunteers (11 female) performed a serial Subtract 7 task while pupil diameter was recorded both during moderate room light and in darkness. In a control for verbalization, subjects performed an easier Add I task. In all conditions, pupil diameter increased significantly during the response period as compared to a pre-verbalization baseline period. Pupillary dilation was increased for the difficult task, and further increase in dilation was associated with recording in light. This suggests a major differential contribution to task difficulty mediated through inhibition of the parasympathetic pathway. In Experiment 2, a subgroup of 12 volunteers (seven female) repeated all conditions at three additional sessions in which one eye was instilled with tropicamide (to block the parasympathetic sphincter muscle), dapiprazole (to block the sympathetic dilator muscle) or placebo. All pharmacological conditions resulted in overall dilation during task performance. Differential performance similar to the placebo condition was seen only in the dapiprazole condition, when parasympathetic activation was intact. The findings suggest that sustained performance during a difficult task is modulated by cortical inhibition of the parasympathetic pathway at the oculomotor nucleus. Moreover, modulation of both ambient light intensity and pharmacological blockade of the final pupillary musculature were observed to provide converging approaches for quantifying the activity of identifiable central autonomic pathways. (C) 2003 Elsevier B.V. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Biometr Res Program, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Ophthalmol, Pittsburgh, PA USA. RP Steinhauer, SR (reprint author), VA Pittsburgh Healthcare Syst, Biometr Res Program, 7180 Highland Dr,151R, Pittsburgh, PA 15206 USA. EM sthauer@pitt.edu FU NIMH NIH HHS [MH55762] NR 19 TC 117 Z9 121 U1 3 U2 19 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-8760 J9 INT J PSYCHOPHYSIOL JI Int. J. Psychophysiol. PD MAR PY 2004 VL 52 IS 1 BP 77 EP 86 DI 10.1016/j.ijpsycho.2003.12.005 PG 10 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 806GW UT WOS:000220423400007 PM 15003374 ER PT J AU Trueba, G Zapata, S Madrid, K Cullen, P Haake, D AF Trueba, G Zapata, S Madrid, K Cullen, P Haake, D TI Cell aggregation: a mechanism of pathogenic Leptospira to survive in fresh water SO INTERNATIONAL MICROBIOLOGY LA English DT Article DE Leptospira; starvation; fresh-water survival; cellular aggregation; aqueous habitats ID OUTER-MEMBRANE PROTEIN; VISCOUS ENVIRONMENTS; MOLECULAR-CLONING; SEQUENCE-ANALYSIS; LIPOPROTEIN; EPIDEMIC; GROWTH AB Transmission of leptospirosis is facilitated by the survival of pathogenic leptospires in moist environments outside their mammalian host. In the present study, the survival mechanisms of Leptospira interrogans serovar Canicola in aqueous conditions and lack of nutrients were investigated. In distilled water, leptospires were able to remain motile for 110 days (pH 7.2). However, when incubated in a semi-solid medium composed of distilled water and 0.5% purified agarose (pH 7.2), they survived 347 days. In this viscous environment, aggregates of live spirochetes were observed. Neither antibiotics (e.g. tetracycline and ampicillin) nor nutrients inhibited leptospiral aggregation. Immunoblot analysis suggested that cells incubated in water down-regulate the expression of LipL31, an inner-membrane protein, but retain expression of other membrane proteins. These studies provide insights into the mechanisms by which pathogenic Leptospira survives for prolonged periods of time in natural aqueous environments, a key stage in the leptospiral lifecycle. C1 Univ San Francisco Quito, Inst Microbiol, Quito, Ecuador. Monash Univ, Bacterial Pathogenesis Res Grp, Clayton, Vic 3800, Australia. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA USA. RP Trueba, G (reprint author), Univ San Francisco Quito, Inst Microbiol, Via Interocean, Quito, Ecuador. EM gabriel@mail.usfq.edu.cc OI Trueba, Gabriel/0000-0003-2617-9021 FU NIAID NIH HHS [AI-34431] NR 28 TC 62 Z9 66 U1 1 U2 10 PU SPRINGER-VERLAG HEIDELBERG PI HEIDELBERG PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY SN 1139-6709 J9 INT MICROBIOL JI Int. Microbiol. PD MAR PY 2004 VL 7 IS 1 BP 35 EP 40 PG 6 WC Biotechnology & Applied Microbiology; Microbiology SC Biotechnology & Applied Microbiology; Microbiology GA 823IP UT WOS:000221604600006 PM 15179605 ER PT J AU Lyons, TJ Jenkins, AJ Zheng, DY Lackland, DT McGee, D Garvey, WT Klein, RL AF Lyons, TJ Jenkins, AJ Zheng, DY Lackland, DT McGee, D Garvey, WT Klein, RL CA DCCT EDIC Res Grp TI Diabetic retinopathy and serum lipoprotein subclasses in the DCCT/EDIC cohort SO INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE LA English DT Article ID LOW-DENSITY-LIPOPROTEIN; PLASMINOGEN-ACTIVATOR INHIBITOR-1; ENDOTHELIAL-CELLS; PITTSBURGH EPIDEMIOLOGY; COMPLICATIONS TRIAL; RISK-FACTORS; IDDM; LDL; NEPHROPATHY; ASSOCIATION AB PURPOSE. To determine associations between retinopathy status and detailed serum lipoprotein subclass profiles in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) cohort. METHODS. Persons with type 1 diabetes (440 women, 548 men) from the DCCT/EDIC cohort were studied. Retinopathy was characterized by Early Treatment Diabetic Retinopathy Study (ETDRS) scores, hard exudate scores, and ETDRS scores minus the hard exudate component. Lipoproteins were characterized by conventional lipid profile, nuclear magnetic resonance lipoprotein subclass profile (NMR-LSP), apoA1, apoB, lipoprotein(a), and susceptibility of LDL to oxidation. Data were analyzed with and without the following covariates: age, gender, duration of diabetes, HbA(1C), albumin excretion rate (AER), creatinine clearance, hypertension, body mass index, waist-hip ratio, DCCT treatment group, smoking status. RESULTS. The severity of retinopathy was positively associated with triglycerides (combined cohort) and negatively associated with HDL cholesterol (men, combined cohort). NMR-LSP iden-tified retinopathy as being positively associated with small and medium VLDL and negatively with VLDL size. In men only, retinopathy was positively associated with small LDL, LDL particle concentration, apoB concentration, and small HDL and was negatively associated with large LDL, LDL size, large HDL, and HDL size. No associations were found with apoA1, Lp(a), or susceptibility of LDL to oxidation. All three measures of retinopathy revealed the same associations. CONCLUSIONS. NMR-LSP reveals new associations between serum lipoproteins and severity of retinopathy in type 1 diabetes. The data are consistent with a role for dyslipoproteinemia involving lipoprotein subclasses in the pathogenesis of diabetic retinopathy. C1 Univ Oklahoma, Hlth Sci Ctr, Endocrinol Sect, Oklahoma City, OK 73104 USA. Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biometry, Charleston, SC 29425 USA. Univ Alabama Birmingham, Dept Nutr Sci, Birmingham, AL USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Lyons, TJ (reprint author), Univ Oklahoma, Hlth Sci Ctr, Endocrinol Sect, 941 Stanton I Young Blvd,BSEB329A, Oklahoma City, OK 73104 USA. EM timothy-lyons@ouhsc.edu FU NHLBI NIH HHS [P01 HL55782] NR 42 TC 153 Z9 160 U1 1 U2 7 PU ASSOC RESEARCH VISION OPHTHALMOLOGY INC PI ROCKVILLE PA 12300 TWINBROOK PARKWAY, ROCKVILLE, MD 20852-1606 USA SN 0146-0404 EI 1552-5783 J9 INVEST OPHTH VIS SCI JI Invest. Ophthalmol. Vis. Sci. PD MAR PY 2004 VL 45 IS 3 BP 910 EP 918 DI 10.1167/iovs.02-0648 PG 9 WC Ophthalmology SC Ophthalmology GA 776QZ UT WOS:000189129200034 PM 14985310 ER PT J AU Korthuis, PT Asch, SM Anaya, HD Morgenstern, H Goetz, MB Yano, EM Rubenstein, LV Lee, ML Bozzette, SA AF Korthuis, PT Asch, SM Anaya, HD Morgenstern, H Goetz, MB Yano, EM Rubenstein, LV Lee, ML Bozzette, SA TI Lipid screening in HIV-infected veterans SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV; AIDS; hyperlipidemia; protease inhibitors; quality of health care ID HUMAN-IMMUNODEFICIENCY-VIRUS; PROTEASE INHIBITORS; ANTIRETROVIRAL THERAPY; UNITED-STATES; INSULIN-RESISTANCE; CARE; DISEASE; HYPERLIPIDEMIA; RISK; RECOMMENDATIONS AB Background: Lipid screening is recommended for patients taking protease inhibitors (PIs). Methods: We examined data from the Veterans Administration Immunology Case Registry to assess lipid screening among HIV-infected veterans who received Pis for at least 6 consecutive months during 1999 and 2001. We estimated crude and adjusted associations between lipid screening and patient characteristics (age, gender, HIV exposure, and race/ethnicity), comorbidities (AIDS, cardiovascular disease, diabetes, hypertension, smoking, and hyperlipidemia), and facility characteristics (urban location, case management, guidelines, and quality improvement programs) Results: Among 4065 patients on Pis, clinicians screened 2395 (59%) for lipids within 6 months of initiating treatment. Adjusting for patient characteristics, comorbidities, facility traits, and clustering, lipid screening was more common among patients who were cared for in urban areas (relative risk [RR] = 1.3, confidence limits: 1.0-1.5), diabetic (RR = 1,2, confidence limits: 1.1-1.3), or previously hyperlipidemic (RR = 1.4, confidence limits: 1.3-1.5) and less common among patients with a history of intravenous drug use (IVDU) (RR = 0.90, confidence limits: 0.79-1.0) or unknown HIV risk (RR = 0.85, confidence limits: 0.75-0.95). Conclusions: Six in 10 patients taking Pis receive lipid screening within 6 months of PI use. Systemic interventions to improve overall HIV quality of care should also address lipid screening, particularly among patients with unknown or IVDU HIV risk and those cared for in nonurban areas. C1 Oregon Hlth & Sci Univ, Portland, OR 97239 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. VA HSR&D, Ctr Excellence Study Healthcare Provider Behav, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Med, David Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Epidemiol, Los Angeles, CA USA. San Diego VA Med Ctr, San Diego, CA USA. Univ Calif San Diego, San Diego, CA 92103 USA. RP Korthuis, PT (reprint author), Oregon Hlth & Sci Univ, 3181 SW Sam Jackson Pk Rd,Mail Code L-475, Portland, OR 97239 USA. EM korthuis@ohsu.edu OI Goetz, Matthew/0000-0003-4542-992X NR 42 TC 10 Z9 10 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD MAR 1 PY 2004 VL 35 IS 3 BP 253 EP 260 DI 10.1097/00126334-200403010-00005 PG 8 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 804WA UT WOS:000220327600005 PM 15076239 ER PT J AU Callahan, HS Cummings, DE Pepe, MS Breen, PA Matthys, CC Weigle, DS AF Callahan, HS Cummings, DE Pepe, MS Breen, PA Matthys, CC Weigle, DS TI Postprandial suppression of plasma ghrelin level is proportional to ingested caloric load but does not predict intermeal interval in humans SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID GASTRIC BYPASS-SURGERY; PRADER-WILLI-SYNDROME; GROWTH-HORMONE SECRETAGOGUE; CIRCULATING GHRELIN; FOOD-INTAKE; WEIGHT-LOSS; ACYLATED PEPTIDE; BODY-WEIGHT; RATS; SECRETION AB Plasma ghrelin levels rise before meals and fall rapidly afterward. If ghrelin is a physiological meal-initiation signal, then a large oral caloric load should suppress ghrelin levels more than a small caloric load, and the request for a subsequent meal should be predicted by recovery of the plasma ghrelin level. To test this hypothesis, 10 volunteers were given, at three separate sessions, liquid meals ( preloads) with widely varied caloric content (7.5%, 16%, or 33% of total daily energy expenditure) but equivalent volume. Preloads were consumed at 0900 h, and blood was sampled every 20 min from 0800 h until 80 min after subjects spontaneously requested a meal. The mean ( +/- SE) intervals between ingestion of the 7.5%, 16%, and 33% preloads and the subsequent voluntary meal requests were 247 +/- 24, 286 +/- 20, and 321 +/- 27 min, respectively ( P = 0.015), and the nadir plasma ghrelin levels were 80.2 +/- 2.8%, 72.7 +/- 2.7%, and 60.8 +/- 2.7% of baseline ( the 0900 h value), respectively ( P < 0.001). A Cox regression analysis failed to show a relationship between ghrelin profile and the spontaneous meal request. We conclude that the depth of postprandial ghrelin suppression is proportional to ingested caloric load but that recovery of plasma ghrelin is not a critical determinant of intermeal interval. C1 Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Weigle, DS (reprint author), Univ Washington, Harborview Med Ctr, Box 359757,325 9th Ave, Seattle, WA 98104 USA. EM weigle@u.washington.edu FU NCRR NIH HHS [RR00037]; NIDDK NIH HHS [DK02860, DK17047, DK35816, DK55460, DK61516] NR 43 TC 167 Z9 172 U1 1 U2 7 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD MAR PY 2004 VL 89 IS 3 BP 1319 EP 1324 DI 10.1210/jc.2003-031267 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 800LV UT WOS:000220030700047 PM 15001628 ER PT J AU Fan, VS Au, DH McDonell, MB Fihn, SD AF Fan, VS Au, DH McDonell, MB Fihn, SD TI Intraindividual change in SF-36 in ambulatory clinic primary care patients predicted mortality and hospitalizations SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE quality of life; hospitalization; mortality; cohort study; regression analysis; risk adjustment ID QUALITY-OF-LIFE; HEALTH-STATUS; VETERANS-AFFAIRS; DISEASE; RISK; OUTCOMES AB Objective: We sought to determine whether change in SF-36 scores over time is associated with the risk of adverse outcomes. dStudy Design and Setting: 7,702 participants in the Ambulatory Care Quality Improvement Project who completed a baseline and 1-year SF-36. Using logistic regression methods we estimated the 1-year risk of hospitalization and death based on previous 1-year changes in the physical (PCS) and mental (MCS) component summary scores. Results: After adjusting for baseline PCS scores, age, VA hospital site, distance to VA, and comorbidity, a >10-point decrease in PCS score was associated with an increased risk of death (OR 2.3, 95% CI 1.6-3.4) and hospitalization (OR 1.8, 1.4-2.2). An increased risk was also seen with a >10-point decrease in the MCS (OR for death, 1.6, 1.1-2.3; OR for hospitalization 1.5, 1.2-1.8). Conclusion: Change in SF-36 PCS and MCS scores is associated with mortality and hospitalizations, and provides important prognostic information over baseline scores alone. (C) 2004 Elsevier Inc. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Ctr Excellence, Hlth Serv Res & Dev 152, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Fan, VS (reprint author), VA Puget Sound Hlth Care Syst, Ctr Excellence, Hlth Serv Res & Dev 152, 1600 S Columbian Way, Seattle, WA 98108 USA. EM vfan@u.washington.edu NR 31 TC 22 Z9 22 U1 2 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD MAR PY 2004 VL 57 IS 3 BP 277 EP 283 DI 10.1016/j.jclinepi.2003.08.004 PG 7 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 814OH UT WOS:000220983500008 PM 15066688 ER PT J AU Sloan, KL Straits-Troster, KA Dominitz, JA Kivlahan, DR AF Sloan, KL Straits-Troster, KA Dominitz, JA Kivlahan, DR TI Hepatitis C tested prevalence and comorbidities among veterans in the US Northwest SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Article DE hepatitis C; epidemiology; veterans; screening ID VIRUS-INFECTION; UNITED-STATES AB Goals: (1) Investigate the epidemiology of hepatitis C virus infection among patients seen in the Veterans Administration Northwest Network; (2) examine time trends in testing practices and results; and (3) estimate the prevalence of hepatitis C virus infection among active patients. Background: Hepatitis C virus infection causes chronic hepatitis and cirrhosis and is a leading cause of end-stage liver disease. Hepatitis C virus antibodies are estimated to be present in 1.8% of the US population, but reports of its prevalence among US veterans range from 1.7 to 35%. Study: Retrospective review of computerized medical records of veterans tested for hepatitis C from October 1994 through December 2000 (n = 37,938) at 8 Northwest Veterans Administration Medical Centers. Results: Among tested veterans, 8230 (21.7%) had evidence of hepatitis C virus infection. The number of patients tested increased annually from 2335 to 18,191, while the proportion with first-time positive hepatitis C test results decreased from 35 to 10%. This drop in tested prevalence was associated with a shift away from testing individuals at highest risk-those with positive hepatitis B serostatus, repeatedly elevated alanine transaminase levels, and drug use disorder diagnoses. We estimate that 11.4% of the Northwest Network veteran users are hepatitis C virus seropositive, with a lower bound of 4.0% and upper bound of 19.5%. Conclusions: Although estimates of hepatitis C virus infection rates among veteran users of the Veterans Administration system remain higher than those for the general population, changes in testing practice make generalizations from earlier studies hazardous. C1 Vet Affairs Puget Sound Hlth Care Syst, Mental Hlth Serv, Seattle, WA 98108 USA. NW Hepatitis C Resource Ctr, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. Vet Affairs Ctr Excellence Subst Abuse Treatment, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Gastroenterol Serv, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Seattle Epidemiol Res & Informat Ctr, Seattle, WA USA. RP Sloan, KL (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Mental Hlth Serv, 116-ATC,1660 S Columbian Way, Seattle, WA 98108 USA. EM Kevin.Sloan@med.va.gov OI Dominitz, Jason/0000-0002-8070-7086 NR 10 TC 17 Z9 17 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD MAR PY 2004 VL 38 IS 3 BP 279 EP 284 DI 10.1097/00004836-200403000-00016 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 776JR UT WOS:000189113300016 PM 15128077 ER PT J AU Quinones, MP Ahuja, SK Jimenez, F Schaefer, J Garavito, E Rao, A Chenaux, G Reddick, RL Kuziel, WA Ahuja, SS AF Quinones, MP Ahuja, SK Jimenez, F Schaefer, J Garavito, E Rao, A Chenaux, G Reddick, RL Kuziel, WA Ahuja, SS TI Experimental arthritis in CC chemokine receptor 2-null mice closely mimics severe human rheumatoid arthritis SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID COLLAGEN-INDUCED ARTHRITIS; II COLLAGEN; T-CELLS; DBA/1 MICE; INFLAMMATORY ARTHRITIS; MONOCLONAL-ANTIBODIES; INFLAMED JOINTS; SYNOVIAL-FLUID; LYMPHOCYTES-T; MOUSE MODEL AB The prevailing paradigm is that in human rheumatoid arthritis (RA), the accumulation of monocytes and T cells in the joint, mediated in part by such CC chemokine receptors (CCRs) as CCR2 and CCR5, respectively, plays a central role in disease pathogenesis. To further validate this paradigm, we conducted proof-of-principle studies and tested the hypothesis that gene inactivation of Ccr2 or CcrS will ameliorate experimental RA. Contrary to our expectations, we found that in two well-established murine models of experimental RA, CCR2 expression in the hematopoietic cell compartment served as a negative regulator of autoantibody production as well as arthritic disease onset, severity, and resolution. In contrast, the RA phenotype in Ccr5-null mice was similar to that of WT mice. Remarkably, the collagen-induced arthritis phenotype of Cer2(-/-) mice mimicked closely that of severe human RA, including production of rheumatoid factor, enhanced T cell production, and monocyte/macrophage accumulation in the joints. Our findings demonstrate an essential protective role of CCR2 expression in RA, indicate the existence of alternative receptors responsible for monocyte/macrophage accumulation to inflamed joints, and emphasize the need to clarify carefully the complex effects of the chemokine system in RA before they can be considered as therapeutic targets. C1 Univ Texas, Hlth Sci Ctr, Dept Med, MC 7870, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Vet Adm Ctr Res AIDS & HIV 1 Infect, San Antonio, TX USA. Fdn Univ San Martin, Bogota, Colombia. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Univ Texas, Dept Mol Genet & Microbiol, Austin, TX 78712 USA. Univ Texas, Inst Cellular & Mol Biol, Austin, TX 78712 USA. RP Ahuja, SK (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, MC 7870, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM ahuja@uthscsa.edu FU NIAID NIH HHS [R01 AI048644, AI-48644] NR 73 TC 98 Z9 107 U1 0 U2 1 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD MAR PY 2004 VL 113 IS 6 BP 856 EP 866 DI 10.1172/JCI200420126 PG 11 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 803ZO UT WOS:000220269200013 PM 15067318 ER PT J AU Cook, JM Riggs, DS Thompson, R Coyne, JC Sheikh, JI AF Cook, JM Riggs, DS Thompson, R Coyne, JC Sheikh, JI TI Posttraumatic stress disorder and current relationship functioning among World War II ex-prisoners of war SO JOURNAL OF FAMILY PSYCHOLOGY LA English DT Article ID VIETNAM COMBAT VETERANS; FORMER PRISONERS; FOLLOW-UP; MENTAL-HEALTH; PTSD; CONFLICT; MARRIAGE; QUALITY; ADJUSTMENT; EXPERIENCE AB This study examined the association of posttraumatic stress disorder (PTSD) with the quality of intimate relationships among present-day male World War II ex-prisoners of war (POWs). Ex-POWs had considerable marital stability; those with PTSD were no less likely to be in an intimate relationship. Ex-POWs in an intimate relationship who had PTSD (N = 125) were compared with ex-POWs in a relationship who did not have PTSD (N = 206). Marital functioning was within a range expected for persons without traumatic exposure. Yet, over 30% of those with PTSD reported relationship problems compared with only 11% of those without PTSD. Ex-POWs with PTSD reported poorer adjustment and communication with their partners and more difficulties with intimacy. Emotional numbing was significantly associated with relationship difficulties independent of other symptom complexes and severity of PTSD. Implications for clinical practice are discussed. C1 Univ Penn, Treatment Res Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. VA Palo Alto Med Ctr, Dept Psychiat & Behav Sci, Palo Alto, CA USA. Stanford Univ, Stanford, CA 94305 USA. RP Cook, JM (reprint author), Univ Penn, Treatment Res Ctr, Dept Psychiat, 3900 Chestnut St, Philadelphia, PA 19104 USA. EM cook_j@mail.trc.upenn.edu RI Thompson, Richard/G-5408-2011 OI Thompson, Richard/0000-0003-0127-513X NR 54 TC 107 Z9 107 U1 2 U2 7 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0893-3200 J9 J FAM PSYCHOL JI J. Fam. Psychol. PD MAR PY 2004 VL 18 IS 1 BP 36 EP 45 DI 10.1037/0893-3200.18.1.36 PG 10 WC Psychology, Clinical; Family Studies SC Psychology; Family Studies GA 800PA UT WOS:000220039000004 PM 14992608 ER PT J AU Stelzner, M AF Stelzner, M TI 2003 SSAT-AGA-ASGE Workshop on "Palliative Therapy of Rectal Cancer" - Summary statement SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Editorial Material C1 Univ Washington, Dept Surg, Seattle, WA 98195 USA. VA Puget Sound Healthcare Syst, Seattle, WA USA. RP Stelzner, M (reprint author), Univ Calif Los Angeles, Dept Surg, VA Greater Los Angeles, 10H2-MS,11301 Wilshire Blv, Los Angeles, CA 90073 USA. EM matthias.stelzner@med.va.gov NR 0 TC 3 Z9 3 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1091-255X J9 J GASTROINTEST SURG JI J. Gastrointest. Surg. PD MAR-APR PY 2004 VL 8 IS 3 BP 253 EP 258 DI 10.1016/j.gassur.2003.11.021 PG 6 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 806EI UT WOS:000220416800007 PM 15019917 ER PT J AU Marks, JP Reed, W Colby, K Ibrahim, SA AF Marks, JP Reed, W Colby, K Ibrahim, SA TI A culturally competent approach to cancer news and education in an inner city community: Focus group findings SO JOURNAL OF HEALTH COMMUNICATION LA English DT Article ID RACIAL-DIFFERENCES; HEALTH BELIEFS; BREAST-CANCER; ATTITUDES; KNOWLEDGE; WOMEN; MAMMOGRAPHY; RISK; CARE AB Ethnic minorities who live in socioeconomically disenfranchised communities suffer disproportionately from many health problems including cancer. In an effort to reduce these disparities, many health-care practitioners and scholars have promoted "culturally competent" health education efforts. One component of culturally competent eudcation is a grounded knowledge base. To obtain knowledge about the cancer-related ideas of members of one African American community, researchers conducted focus groups with public housing residents and used the findings to develop a five-part television news series about breast, prostate, and cervix cancers. We found that participants gathered information from the folk, popular, and professional health sectors and constructed their cancer-related ideas from this information. Furthermore, experiences of racism, sexism, and classism colored their beliefs and behaviors regarding the prevention, detection, and treatment of common cancers. For this community "cancer" represents a giant screen upon which individual fears and societal ethnic, political, and economic tensions are projected. C1 Publ Hlth Prod Inc, Cleveland, OH 44118 USA. Cleveland State Univ, Urban Child Res Ctr, Cleveland, OH 44115 USA. VA Pittsburgh Hlth Care Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. RP Marks, JP (reprint author), Publ Hlth Prod Inc, 2192 Briarwood Rd, Cleveland, OH 44118 USA. EM phpjpmarks@peoplepc.com NR 40 TC 13 Z9 13 U1 2 U2 7 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1081-0730 J9 J HEALTH COMMUN JI J. Health Commun. PD MAR-APR PY 2004 VL 9 IS 2 BP 143 EP 157 DI 10.1080/10810730490425303 PG 15 WC Communication; Information Science & Library Science SC Communication; Information Science & Library Science GA 810YK UT WOS:000220739400007 PM 15204825 ER PT J AU Chren, M Sahay, A Bertenthal, D AF Chren, M Sahay, A Bertenthal, D TI Quality-of-life outcomes of treatments for nonmelanoma skin cancer SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract CT 65th Annual Meeting of the Society-for-Investigative-Dermatology CY APR 28-MAY 01, 2004 CL Providence, RI SP Soc Investigat Dermatol C1 Univ Calif San Francisco, San Francisco, CA USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD MAR PY 2004 VL 122 IS 3 MA 380 BP A64 EP A64 PG 1 WC Dermatology SC Dermatology GA 809UB UT WOS:000220660500432 ER PT J AU Jin, JH Zhang, W Werth, VP AF Jin, JH Zhang, W Werth, VP TI Thalidomide inhibits the induction of tumor necrosis factor-alpha by ultraviolet B irradiation of human keratinocytes SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract CT 65th Annual Meeting of the Society-for-Investigative-Dermatology CY APR 28-MAY 01, 2004 CL Providence, RI SP Soc Investigat Dermatol C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD MAR PY 2004 VL 122 IS 3 MA 038 BP A7 EP A7 PG 1 WC Dermatology SC Dermatology GA 809UB UT WOS:000220660500093 ER PT J AU Nahm, WK Morhenn, VB Moy, RL Falanga, V AF Nahm, WK Morhenn, VB Moy, RL Falanga, V TI Characteristics of whole-cell patch clamping in cultured human keratinocytes SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract CT 65th Annual Meeting of the Society-for-Investigative-Dermatology CY APR 28-MAY 01, 2004 CL Providence, RI SP Soc Investigat Dermatol C1 Univ Calif San Diego, San Diego, CA 92103 USA. VA San Diego Healthcare Syst, San Diego, CA USA. Boston Univ, Sch Med, Roger Williams Med Ctr, Providence, RI USA. W Los Angeles VA Med Ctr, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD MAR PY 2004 VL 122 IS 3 MA 565 BP A95 EP A95 PG 1 WC Dermatology SC Dermatology GA 809UB UT WOS:000220660500615 ER PT J AU Nlhal, M Mukhtar, H Wood, GS AF Nlhal, M Mukhtar, H Wood, GS TI Epigallocatechin-3-gallate (EGCG) causes cell cycle arrest and apoptosis in human melanoma cells via modulation of the cyclin kinase inhibitor (cki)-cyclin dependent kinase (cdk) network and Bcl2 family proteins SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract CT 65th Annual Meeting of the Society-for-Investigative-Dermatology CY APR 28-MAY 01, 2004 CL Providence, RI SP Soc Investigat Dermatol C1 Univ Wisconsin, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD MAR PY 2004 VL 122 IS 3 MA 941 BP A157 EP A157 PG 1 WC Dermatology SC Dermatology GA 809UB UT WOS:000220660500987 ER PT J AU Rhim, E Reiber, GE Smith, DG Raugi, GJ Sullivan, K AF Rhim, E Reiber, GE Smith, DG Raugi, GJ Sullivan, K TI Foot ulcers in people with diabetes: signs of infection are the major determinant for use of cultures, antibiotics and x-rays and are associated with amputation SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract CT 65th Annual Meeting of the Society-for-Investigative-Dermatology CY APR 28-MAY 01, 2004 CL Providence, RI SP Soc Investigat Dermatol C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care, Hlth Serv & Epidemiol, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD MAR PY 2004 VL 122 IS 3 MA 309 BP A52 EP A52 PG 1 WC Dermatology SC Dermatology GA 809UB UT WOS:000220660500358 ER PT J AU Chalfant, CE Szulc, Z Roddy, P Bielawska, A Hannun, YA AF Chalfant, CE Szulc, Z Roddy, P Bielawska, A Hannun, YA TI The structural requirements for ceramide activation of serine-threonine protein phosphatases SO JOURNAL OF LIPID RESEARCH LA English DT Article DE protein phosphatase-2A; protein phosphatase-1; ceramide-activated protein phosphatase ID KINASE-C-ZETA; SPHINGOLIPID BREAKDOWN PRODUCTS; D-ERYTHRO-SPHINGOSINE; CELL-DIFFERENTIATION; SIGNAL-TRANSDUCTION; MEDIATED BIOLOGY; BINDING; DEPHOSPHORYLATION; INHIBITION; SUBSTRATE AB The protein phosphatases1 (PP1) and 2A (PP2A) serve as ceramide-activated protein phosphatases (CAPP). In this study, the structural requirements for interaction between ceramide and CAPP were determined. D-erythro-C-6 ceramide activated the catalytic subunit of PP2A (PP2Ac) approximately 3-fold in a stereospecific manner. In contrast, saturation of the 4-5 double bond, producing D-erythro-dihydro C-6 ceramide, inhibited PP2Ac (IC50 = 8.5 muM). Furthermore, phyto C6 ceramide, D-erythro-dehydro C6 ceramide, and D-erythro-cis-C-6 ceramide had no effect on PP2Ac activity. Modification of the sphingoid chain also abolished the ability of ceramide to activate PP2Ac. Further studies demonstrated the requirement for the amide group, the primary hydroxyl group, and the secondary hydroxyl group of the sphingoid backbone for activation of PP2Ac through the synthesis and evaluation of D-erythro-urea C6 ceramide, L-erythro-urea C-6 ceramide, D-erythro-N-methyl C-6 ceramide, D-erythro-1-O-methyl C-6 ceramide, D-erythro-3-O-methyl C-6 ceramide, and (2S) 3-keto C-6 ceramide. None of these compounds induced significant activation of PP2Ac. Liposome binding studies were also conducted using analogs of D-erythro-C C6 ceramide, and the results showed that the ability of ceramide analogs to influence CAPP (activation or inhibition) was associated with the ability of the analogs to bind to CAPP. This study demonstrates strict structural requirements for interaction of ceramide with CAPP, and disclose ceramide as a very specific regulator of CAPP. The studies also begin to define features that transform ceramide analogs into inhibitors of CAPP.-Chalfant, C. E., Z. Szulc, P. Roddy, A. Bielawska, and Y. A. Hannun. The structural requirements for ceramide activation of serine-threonine protein phosphatases. C1 Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Med Ctr, Charleston, SC 29401 USA. RP Chalfant, CE (reprint author), Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. EM hannun@musc.edu FU NCI NIH HHS [CA-87584]; NIGMS NIH HHS [GM-19953-02] NR 45 TC 87 Z9 89 U1 0 U2 2 PU LIPID RESEARCH INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0022-2275 J9 J LIPID RES JI J. Lipid Res. PD MAR PY 2004 VL 45 IS 3 BP 496 EP 506 DI 10.1194/jlrM300347-JLR200 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 802VB UT WOS:000220189900011 PM 14657198 ER PT J AU Wong, FCL Swartz, BE Gee, M Mandelkern, M AF Wong, FCL Swartz, BE Gee, M Mandelkern, M TI Occipital hypometabolism demonstrated by positron emission tomography after temporal lobectomy for refractory epilepsy SO JOURNAL OF NEURO-OPHTHALMOLOGY LA English DT Article ID CROSSED CEREBELLAR DIASCHISIS; VISUAL-FIELD DEFICITS; LOBE EPILEPSY; ISCHEMIC LESIONS; BLOOD-FLOW; MEMORY; BRAIN; METABOLISM; RECOVERY; CORTEX AB Background: Epilepsy surgery involves well-planned discrete injury to the brain and may create visual deficits. This study seeks to evaluate the indirect effects of temporal lobectomy on brain metabolism by correlating visual field defects and glucose metabolism in the visual cortex of patients before and after undergoing epilepsy surgery. Methods: A retrospective survey of 11 patients who had undergone temporal lobectomy for refractory epilepsy in a single institution from 1986 to 1989, and who had prelobectomy and post-lobectomy visual field examinations and F-18 2-fluorodeoxyglucose positron emission tomography (FDG-PET) as part of a standard comprehensive epilepsy surgery evaluation. The PET images were analyzed to provide a correlation with the visual field defects that developed after the temporal lobectomy. Results: Occipital hypometabolism in the absence of structural lesions of the occipital lobe was noted in seven patients with contralateral visual field defects and in one of four patients without a visual field defect. FDG-PET studies in three patients repeated for as long as 20 months after lobectomy showed no significant change in the occipital hypometabolism pattern. Conclusions: Although the occipital cortex was not directly injured during temporal lobectomy, the resulting hypometabolism correlates with the clinical findings of visual field defects. The hypometabolism may be due to deafferentation after interruption of the optic pathways and appears to be persistent. C1 Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA. W Los Angeles VAMC, Neurol Serv, Los Angeles, CA USA. W Los Angeles VAMC, PET Ctr, Los Angeles, CA USA. Case Western Reserve Univ, Univ Hosp Cleveland, Cleveland, OH 44106 USA. Univ Calif Irvine, Dept Phys, Irvine, CA 92717 USA. RP Wong, FCL (reprint author), Univ Texas, MD Anderson Canc Ctr, 1515 Holcombe Blvd,Box 59, Houston, TX 77030 USA. EM Fwong@di.mdacc.tmc.edu NR 28 TC 2 Z9 2 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1070-8022 J9 J NEURO-OPHTHALMOL JI J. Neuro-Ophthal. PD MAR PY 2004 VL 24 IS 1 BP 19 EP 23 DI 10.1097/00041327-200403000-00004 PG 5 WC Clinical Neurology; Ophthalmology SC Neurosciences & Neurology; Ophthalmology GA 805BJ UT WOS:000220341500004 PM 15206433 ER PT J AU Huang, GD Feuerstein, M AF Huang, GD Feuerstein, M TI Identifying work organization targets for a work-related musculoskeletal symptom prevention program SO JOURNAL OF OCCUPATIONAL REHABILITATION LA English DT Article DE job stress; work organization; ergonomics; low back pain; upper extremity; symptoms; intervention ID UPPER EXTREMITY DISORDERS; CARPAL-TUNNEL-SYNDROME; FORM HEALTH SURVEY; RISK-FACTORS; PSYCHOSOCIAL FACTORS; OCCUPATIONAL STRESS; LIMB DISORDERS; BACK DISORDERS; PAIN; ENVIRONMENT AB While research linking work organization factors to work-related musculoskeletal disorders has been increasing, there is still a need to delineate specific dimensions to be targeted by intervention programs. The present cross-sectional investigation identified work organization risk factors for low back (LB) and upper extremity (UE) symptoms and determined the magnitudes of such associations. Questionnaires containing items on ergonomic, individual psychosocial, and occupational psychosocial factors were administered to a sample of workers (n = 248 U. S. Marines) in previously identified high-risk job categories for musculoskeletal disorders. Study participants were categorized into groups of either having LB symptoms only, UE symptoms only, concurrent LB and UE symptoms, or being asymptomatic on the basis of self-report. Additionally, measures of pain intensity, physical function, and mental health were obtained. Linear regression analyses adjusting for demographics, ergonomic factors, and individual psychosocial factors indicated that decision authority and experienced responsibility for work were significant correlates for pain intensity during the week. Logistic regression analyses indicated that ergonomic stressors were a risk factor for all symptomatic groups (OR = 1.02 per point increase; 95% CI: 1.0-1.1). Time pressure (OR = 1.2 per point increase; 95% CI: 1.0-1.4) was also a significant risk factor for all symptomatic groups, while cognitive processing placed workers at higher risks for concurrent LB and UE symptoms (OR = 1.2; 95% CI: 1.0-1.4). Interpersonal demands placed individuals at a lower risk for LB symptoms (OR = 0.8; 95% CI: 0.5-1.0). Findings highlight the importance of intervention approaches that address time pressure, cognitive processing factors, and interpersonal demands at work. In light of past biobehavioral studies, these results also suggest that job redesign and interventions that address a worker's workstyle when faced with increased work demands may help reduce the likelihood of musculoskeletal symptoms and/or their intensity. C1 Uniformed Serv Univ Hlth Sci, Dept Med & Clin Psychol, Bethesda, MD 20814 USA. US Dept Vet Affairs, Off Res & Dev, Washington, DC USA. Uniformed Serv Univ Hlth Sci, Dept Prevent Med & Biometr, Bethesda, MD 20814 USA. Georgetown Univ, Sch Med, Dept Psychiat, Div Behav Med, Washington, DC USA. RP Feuerstein, M (reprint author), Uniformed Serv Univ Hlth Sci, Dept Med & Clin Psychol, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA. EM mfeuerstein@usuhs.mil NR 64 TC 16 Z9 17 U1 3 U2 9 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1053-0487 J9 J OCCUP REHABIL JI J. Occup. Rehabil. PD MAR PY 2004 VL 14 IS 1 BP 13 EP 30 DI 10.1023/B:JOOR.0000015008.25177.8b PG 18 WC Rehabilitation; Social Issues SC Rehabilitation; Social Issues GA 771DP UT WOS:000188770600002 PM 15055501 ER PT J AU Tan, G Jensen, MP Thornby, JI Shanti, BF AF Tan, G Jensen, MP Thornby, JI Shanti, BF TI Validation of the brief pain inventory for chronic nonmalignant pain SO JOURNAL OF PAIN LA English DT Article DE pain assessment instrument; chronic nonmalignant pain ID LOW-BACK-PAIN; CANCER PAIN; CEREBRAL-PALSY; VERSION; INTERFERENCE; ADJUSTMENT; SEVERITY; VALIDITY; UTILITY AB The Brief Pain Inventory (BPI; Cleeland and associates) has been used primarily to assess patients with cancer-related pain. Although it has been validated in many languages and is widely used, there has not yet been research published to validate its use for patients with chronic nonmalignant pain as the primary presenting problem. This study was designed to fill this gap by examining the psychometric properties of the BPI in 440 patients with chronic intractable pain referred to a chronic pain clinic at a metropolitan tertiary-care teaching hospital. Results indicated acceptable internal consistency (Cronbach alpha coefficients were .85 for the intensity items and .88 for the interference items). A factor analysis resulted in 2 distinct and independent factors, supporting the validity of the 2-factor structure of the BPI. Zero-order correlations indicated that the association with a measure of disability (the Roland-Morris Disability Questionnaire [RMDQ]) was significantly higher for BPI interference (r = 0.57) than for BPI intensity (r = 0.40, t = 5.71, P < .01) and that the correlation with BPI interference was not more than 0.80, supporting the conclusion that these scales assess related, but also distinct, dimensions. Finally, the finding that both BPI scales showed statistically significant improvement with treatment confirms the responsivity of BPI in detecting and reflecting improvement in pain over time. Perspective: This paper validated the psychometric properties of a pain Assessment instrument (The Brief Pain inventory) originally developed to assess cancer pain and extended its use for the chronic nonmalignant pain population. This provides an important and widely used diagnostic tool for the clinician treating chronic pain. (C) 2004 by the American Pain Society. C1 Anesthesiol & Mental Hlth Care Line Subst Depende, Pain Sect, Houston, TX USA. Houston VA Med Ctr, Pain Sect, Houston, TX USA. Baylor Coll Med, Vet Affairs Med Ctr, Dept Anesthesiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Family Med, Houston, TX 77030 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Tan, G (reprint author), Baylor Coll Med, Vet Affairs Med Ctr, Dept Anesthesiol, 2002 Holcombe Blvd,116 MH C-L, Houston, TX 77030 USA. EM tan.gabriel@med.va.gov NR 31 TC 415 Z9 422 U1 4 U2 24 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 1526-5900 J9 J PAIN JI J. Pain PD MAR PY 2004 VL 5 IS 2 BP 133 EP 137 DI 10.1016/j.jpain.2003.12.005 PG 5 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 811KP UT WOS:000220771100008 PM 15042521 ER PT J AU Weisbord, SD Fried, LF Arnold, RM Rotondi, AJ Fine, MJ Levenson, DJ Switzer, GE AF Weisbord, SD Fried, LF Arnold, RM Rotondi, AJ Fine, MJ Levenson, DJ Switzer, GE TI Development of a symptom assessment instrument for chronic hemodialysis patients: The dialysis symptom index SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article DE symptom burden; hemodialysis; scale development ID QUALITY-OF-LIFE; STAGE RENAL-DISEASE; CANCER PAIN MANAGEMENT; PHYSICAL SYMPTOMS; PALLIATIVE CARE; PSYCHOSOCIAL FACTORS; MEDICAL-CENTER; PREVALENCE; OUTCOMES; RATINGS AB Little is known about the prevalence, severity, or impact of symptoms in hemodialysis patients because of the lack of a validated symptom assessment instrument. We systematically developed an index to assess physical and emotional symptom burden in this patient population. We employed four steps in the generation of this index: a review of dialysis quality-of-life instruments, three focus groups, experts' content validity assessment, and test-retest reliability measurement. Seventy-five symptoms were identified. Of these, 46 appeared in greater than or equal to 4 of the instruments/focus groups and were considered for inclusion. Twelve were grouped into other symptom constructs and experts judged four of the remaining items not to be pertinent, leaving 30 items in the new index. Overall kappa statistic was 0.48 +/- 0.22. These steps allowed the systematic development of a 30-item symptom assessment index for hemodialysis patients. Additional reliability and validity testing is needed prior to its widespread use. (C) 2004 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved. C1 Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Crit Care Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Dept Med, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Inst Canc, Inst Performance Improvement, Pittsburgh, PA USA. Univ Pittsburgh, Inst Canc, Ctr Bioeth & Hlth Law, Pittsburgh, PA USA. Univ Pittsburgh, Dept Hlth Policy & Management, Pittsburgh, PA USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA USA. RP Weisbord, SD (reprint author), Univ Pittsburgh, Med Ctr, Renal Electrolyte Div, A919 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15261 USA. FU NHLBI NIH HHS [T32 HL 07820-05] NR 55 TC 69 Z9 75 U1 1 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD MAR PY 2004 VL 27 IS 3 BP 226 EP 240 DI 10.1016/j.jpainsymman.2003.07.004 PG 15 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 806OV UT WOS:000220444100006 PM 15010101 ER PT J AU Starkebaum, G Sasso, EH AF Starkebaum, G Sasso, EH TI Hepatitis C and B cells: Induction of autoimmunity and lymphoproliferation may reflect chronic stimulation through cell-surface receptors SO JOURNAL OF RHEUMATOLOGY LA English DT Editorial Material ID VIRUS-INFECTION; SJOGRENS-SYNDROME; LYMPHOMA; GENE; CRYOGLOBULINEMIA; PROTEIN; COMPLEX C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Rheumatol, Seattle, WA 98195 USA. RP Starkebaum, G (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, S-01 COS,1660 S Columbian Way, Seattle, WA 98108 USA. EM Gordon.Starkebaum@med.va.gov NR 24 TC 12 Z9 12 U1 0 U2 0 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD MAR PY 2004 VL 31 IS 3 BP 416 EP 418 PG 3 WC Rheumatology SC Rheumatology GA 802FF UT WOS:000220148700004 PM 14994381 ER PT J AU Sloan, SM Budoff, JE Hipp, JA Nguyen, L AF Sloan, SM Budoff, JE Hipp, JA Nguyen, L TI Coracoclavicular ligament reconstruction using the lateral half of the conjoined tendon SO JOURNAL OF SHOULDER AND ELBOW SURGERY LA English DT Article ID ROTATOR CUFF TEARS; ACROMIOCLAVICULAR DISLOCATIONS; CORACOACROMIAL LIGAMENT; ASYMPTOMATIC SHOULDERS; GLENOHUMERAL JOINT; REPAIR; DEBRIDEMENT; REPLACEMENT; INJURIES; COMPLEX AB To preserve the corocoacromial (CA) ligament, we have used the lateral half of the conjoined tendon as an outograft source to replace the coracoclavicular (CC) ligament. The purpose of this study is to compare the ultimate tensile strength of the lateral 12 mm of the conjoined tendon with that of the CA ligament and the CC ligament. Eight paired cadaveric male shoulders were tested to tensile failure with a custom pneumatic testing apparatus. Although the lateral 12 mm of the conjoined tendon was stronger than the CA ligament, this difference was not statistically significant (P = .37). However, the intact CC ligament (621 +/- 209 N) was approximately 250% stronger than either the lateral 12 mm of the conjoined tendon (265 +/- 79 N., P < .001) or the CA ligament (246 +/- 69 N, P < .001). We believe that the lateral half of the conjoined tendon is a viable alternative outograft source for reconstruction of the CC ligament in cases of symptomatic acromioclavicular joint dislocation. Though not as strong as the native CC ligaments, the conjoined tendon is slightly stronger than the commonly used CA ligament. C1 Baylor Coll Med, Dept Orthopaed Surg, Houston, TX 77030 USA. Houston VAMC, Houston, TX USA. RP Budoff, JE (reprint author), 6550 Fannin St,Suite 2525, Houston, TX 77030 USA. EM jbudoff@bcm.tmc.edu NR 36 TC 26 Z9 34 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 1058-2746 J9 J SHOULDER ELB SURG JI J. Shoulder Elbow Surg. PD MAR-APR PY 2004 VL 13 IS 2 BP 186 EP 190 DI 10.1016/j.jse.2003.12.002 PG 5 WC Orthopedics; Sport Sciences; Surgery SC Orthopedics; Sport Sciences; Surgery GA 804AX UT WOS:000220272700012 PM 14997097 ER PT J AU Royall, DR Palmer, R Chiodo, LK Polk, MJ AF Royall, DR Palmer, R Chiodo, LK Polk, MJ TI Declining executive control in normal aging predicts change in functional status: The freedom house study SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE aging; disability; assessment; longitudinal; executive function ID MINI-MENTAL-STATE; COGNITIVE IMPAIRMENT; STRUCTURAL MODELS; ELDERLY RETIREES; DISABILITY; LEVEL; OLDER; POPULATION; INTERVIEW; FEATURES AB OBJECTIVES: To assess the contribution of executive control function (ECF) to functional status. DESIGN: Three-year longitudinal cohort study. SETTING: A comprehensive-care retirement community. PARTICIPANTS: Five hundred forty-seven noninstitutionalized septuagenarians. MEASUREMENTS: The Mini-Mental State Examination (MMSE) and Executive Interview (EXIT25). Functional status was assessed using instrumental activities of daily living (IADLs). Latent growth curves of MMSE, EXIT25, and IADL were modeled. The rate of change in IADLs (DeltaIADL), adjusted for baseline IADLs and cognition, was regressed on the rate of change in each cognitive measure (adjusted for baseline cognition). Models were also adjusted for baseline age, level of care, and comorbid illnesses. RESULTS: Baseline test scores were within normal ranges, but mean EXIT25 scores reached the impaired range by the second follow-up. There was significant variability around the baseline means and slopes for all variables. The rate of change in EXIT25 was strongly correlated with DeltaIADL (r=-0.57, P<.001). This remained significant after adjusting for baseline EXIT25 scores, IADLs, age, comorbid disease, and level of care. The effect of the EXIT25 on DeltaIADL was stronger than those of age, baseline IADLs, comorbid disease, or level of care. The rate of change in MMSE scores was not significantly associated with DeltaIADL. CONCLUSION: ECF is a significant and independent correlate of functional status in normal aging. Traditional dementia case finding is likely to underestimate cognition-related disability. Neither a normal baseline MMSE score nor stable MMSE scores over time preclude functionally significant changes in ECF. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. S Texas Vet Hlth Syst Audie L Murphy Div GRECC, Dept Psychiat, San Antonio, TX USA. S Texas Vet Hlth Syst Audie L Murphy Div GRECC, Dept Med, San Antonio, TX USA. S Texas Vet Hlth Syst Audie L Murphy Div GRECC, Dept Pharmacol, San Antonio, TX USA. S Texas Vet Hlth Syst Audie L Murphy Div GRECC, Dept Family Practice, San Antonio, TX USA. RP Royall, DR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. EM royall@uthscsa.edu NR 44 TC 155 Z9 159 U1 1 U2 9 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD MAR PY 2004 VL 52 IS 3 BP 346 EP 352 DI 10.1111/j.1532-5415.2004.52104.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 774PA UT WOS:000188990600003 PM 14962147 ER PT J AU Wijelath, ES Rahman, S Murray, J Patel, Y Savidge, G Sobel, M AF Wijelath, ES Rahman, S Murray, J Patel, Y Savidge, G Sobel, M TI Fibronectin promotes VEGF-induced CD34(+) cell differentiation into endothelial cells SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID BLOOD-VESSEL FORMATION; PROGENITOR CELLS; PRECURSOR CELLS; HEMATOPOIETIC-CELLS; GROWTH; ADHESION; NEOVASCULARIZATION; INTEGRIN; ANGIOGENESIS; LETHALITY AB Background: Adult endothelial progenitor cells (EPC) may be a useful source for engineering the endothelialization of vascular grafts. However, the optimal factors that promote differentiation of EPCs into endothelium, remain to be elucidated. The goal of this current report was to determine which extracellular matrix (ECM) protein might modulate or enhance the effects of EPCs on differentiation into mature endothelium. Methods: Human EPCs (CD34(+) cells) were cultured in ECM-coated six-well plates in MCDB-131 medium containing vascular endothelial growth factor (VEGF), insulin-like growth factor-1, and basic fibroblast growth factor. After 21 days, differentiated endothelial colonies were confirmed by immunofluorescence for von Willebrand factor (vWF) and vascular-endothelial (VE)-cadherin and mRNA expression of the endothelial markers FIk-1, vWF, and VE-cadherin. Cell migration toward the VEGF-matrix protein combinations was also measured. Results: As judged by positive staining for endothelial markers vWF and VE-cadherin, the combination of VEGF with fibronectin (FN) produced significantly more endothelial colonies (P <.05) than did collagens I or IV or vitronectin. Defined fragments of IN did not enhance VEGF-mediated effects. Fibrinogen produced intermediate stimulation of differentiation. FN also enhanced VEGF-mediated CD34(+) cell migration. Blockade of alpha5beta1, but not alphavbeta3 or alphavbeta5, inhibited both VEGF-mediated CD34(+) cell differentiation and migration. Conclusions: VEGF and IN together significantly promote the migration and differentiation of CD34(+) cells. This synergism is specific to FN and the alpha5beta1 integrin. Combinations of VEGF and FN may be useful in promoting differentiation of circulating endothelial progenitors into endothelial cells for tissue engineering. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Surg, Div Vasc Surg, Seattle, WA 98195 USA. St Thomas Hosp, GKT Med Sch, Coagulat Res Lab, London, England. RP Wijelath, ES (reprint author), VA Puget Sound Hlth Care Syst, 151,1660 S Columbian Way, Seattle, WA 98108 USA. EM errolw@washington.edu NR 30 TC 101 Z9 118 U1 0 U2 6 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD MAR PY 2004 VL 39 IS 3 BP 655 EP 660 DI 10.1016/j.jvs.2003.10.042 PG 6 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 902WJ UT WOS:000227387100024 PM 14981463 ER PT J AU Roman, GC Royall, DR AF Roman, GC Royall, DR TI A diagnostic dilemma: is "Alzheimer's dementia" Alzheimer's disease, vascular dementia, or both? SO LANCET NEUROLOGY LA English DT Editorial Material ID POPULATION; EVOLUTION C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX USA. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. EM ROMANG@uthscsa.edu NR 10 TC 26 Z9 26 U1 0 U2 1 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1474-4422 J9 LANCET NEUROL JI Lancet Neurol. PD MAR PY 2004 VL 3 IS 3 BP 141 EP 141 DI 10.1016/S1474-4422(04)00674-X PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 802MK UT WOS:000220167400012 PM 14980525 ER PT J AU Kezirian, EJ Weaver, EM Yueh, B Deyo, RA Khuri, SF Daley, J Henderson, W AF Kezirian, EJ Weaver, EM Yueh, B Deyo, RA Khuri, SF Daley, J Henderson, W TI Incidence of serious complications after uvulopalatopharyngoplasty SO LARYNGOSCOPE LA English DT Article; Proceedings Paper CT 106th Annual Meeting of the Triological-Society CY MAY 04-06, 2003 CL NASHVILLE, TN SP Triolog Soc DE obstructive sleep apnea; complications; mortality; palate surgery; uvulopalatopharyngoplasty; veterans; VA ID OBSTRUCTIVE SLEEP-APNEA; SURGICAL-TREATMENT; CARE; MANAGEMENT; SURGERY AB Objectives: Uvulopalatopharyngoplasty (UPPP) is the most common surgical treatment for obstructive sleep apnea (OSA). Anatomic and physiologic abnormalities associated with OSA can make perioperative management difficult. Only single-site case series provide current estimates of the incidence of perioperative complications, with a pooled crude serious complication rate of 3.5% and a crude mortality rate of 0.4%. The primary objective of this study was to calculate the incidence of perioperative morbidity and mortality in a large, multisite cohort of UPPP patients. Study Design. Prospective cohort study of adults undergoing inpatient LTPPP with or without other concurrent procedures Methods: The serious complication and 30-day mortality rates were calculated from the Department of Veterans Affairs (VA) National Surgical Quality Improvement Program database of prospectively collected outcomes of all VA inpatient surgeries nationally 1991 to 2001. Serious complications were defined by 15 specific life-threatening complications. Deaths were captured whether the patient was in the hospital or discharged. Results: Veteran patients (n = 3130) had a mean age of 50 years and were predominantly male (97%). The serious nonfatal complication rate was 1.5% (47/3,130) (95% confidence interval [CI] 1.1%, 1.9%). The 30-day mortality rate was 0.2% (7/3130) (95% Cl 0.1%, 0.4%). There was no significant effect of year of surgery or patient age on the risk of serious complication or death. Conclusion. The incidence of serious nonfatal complications and 30-day mortality after UPPP are 1.5% and 0.2%, respectively, in a large cohort of LTPPP patients at veteran hospitals. C1 Univ Washington, Sch Med, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Hlth Sci, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Brockton W Roxbury Vet Affairs Med Ctr, W Roxbury, MA USA. Harvard Med Sch, Boston, MA USA. Tenet Hlth Care, Dallas, TX USA. Stanford Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Stanford, CA 94305 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. RP Weaver, EM (reprint author), 112-OTO,1660 S Columbian Way, Seattle, WA 98108 USA. EM eweaver@u.washington.edu FU NHLBI NIH HHS [K23 HL068849-01A2, K23 HL068849]; NIDCD NIH HHS [T32 DC000018] NR 11 TC 52 Z9 72 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0023-852X J9 LARYNGOSCOPE JI Laryngoscope PD MAR PY 2004 VL 114 IS 3 BP 450 EP 453 DI 10.1097/00005537-200403000-00012 PG 4 WC Medicine, Research & Experimental; Otorhinolaryngology SC Research & Experimental Medicine; Otorhinolaryngology GA 811YA UT WOS:000220806000010 PM 15091217 ER PT J AU Damschroder, LJ Baron, J Hershey, JC Asch, DA Jepson, C Ubel, PA AF Damschroder, LJ Baron, J Hershey, JC Asch, DA Jepson, C Ubel, PA TI The validity of person tradeoff measurements: Randomized trial of computer elicitation versus face-to-face interview SO MEDICAL DECISION MAKING LA English DT Article; Proceedings Paper CT 24th Annual Meeting of the Society-for-Medical-Decision-Making CY OCT 19-23, 2002 CL BALTIMORE, MARYLAND SP Soc Med Decis Making DE person tradeoff; utility assessment; computer elicitation; cost-effectiveness; randomized trial; Internet survey ID LONGITUDINAL DATA-ANALYSIS; WEB-BASED SURVEYS; HEALTH-CARE; UTILITY ELICITATIONS; OFF ELICITATIONS; SOCIETAL VALUE; INTERNET; VALUES; BIASES; SCALE AB Can person tradeoff (PTO) value judgments be elicited by a computer, or is a face-to-face interview needed? The authors randomly assigned 95 subjects to interview or computer methods for the PTO, a valuation measure that is often difficult for subjects. They measured relative values of foot numbness, leg paralysis, and quadriplegia (all 3 pairs) at 2 reference group sizes (10 or 100). Relative values did not differ between computer and interview. Overall, 21% of responses were equality responses, 13% were high extreme values, and 5% violated ordinal criteria. The groups did not differ in these measures. The authors also assessed consistency across reference group size (10 v. 100). Although relative values were significantly lower for 100 than for 10, mode did not influence the size of this effect. Subjects made, on average, equally consistent judgments for the 3 comparisons. A computerized PTO elicitation protocol produced results of similar quality to that of a face-to-face interview. C1 Univ Michigan, Div Gen Internal Med, Ann Arbor, MI 48109 USA. VA Ann Arbor Healthcare Syst, VA Hlth Serv Res & Ctr Practice Management & Outc, Ann Arbor, MI USA. Univ Michigan, Program Improving Hlth Care Decis, Ann Arbor, MI 48109 USA. Univ Penn, Dept Psychol, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Div Gen Internal Med, Philadelphia, PA 19104 USA. RP Damschroder, LJ (reprint author), Univ Michigan, Div Gen Internal Med, 300 N Ingalls,Room 7C27, Ann Arbor, MI 48109 USA. OI Asch, David/0000-0002-7970-286X; Damschroder, Laura/0000-0002-3657-8459 FU NICHD NIH HHS [R01 HD38963] NR 48 TC 17 Z9 17 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0272-989X J9 MED DECIS MAKING JI Med. Decis. Mak. PD MAR-APR PY 2004 VL 24 IS 2 BP 170 EP 180 DI 10.1177/0272989X04263160 PG 11 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 805VA UT WOS:000220392600006 PM 15090103 ER PT J AU Daniron-Rodriguez, J White-Kazemipour, W Washington, D Villa, VM Dhanani, S Harada, ND AF Daniron-Rodriguez, J White-Kazemipour, W Washington, D Villa, VM Dhanani, S Harada, ND TI Accessibility and acceptability of the Department of Veteran Affairs health care: Diverse veterans' perspectives SO MILITARY MEDICINE LA English DT Article ID PATIENT SATISFACTION; MINORITY VETERANS; VA; SERVICES; SYSTEM; DETERMINANTS; COVERAGE; ACCESS AB Objectives: Diverse veteran's perspectives on the accessibility and acceptability of the Department of Veteran Affairs (VA) health services are presented. Methods: The qualitative methodology uses 16 focus groups (N = 178) stratified by war cohort (World War II and Korean Conflict versus Vietnam War and Persian Gulf War) and four ethnic/racial categories (African American, Asian American, European American, Hispanic American). Results: Five themes emerged regarding veterans' health care expectations: (1) better information regarding available services, (2) sense of deserved benefits, (3) concern about welfare stigma, (4) importance of physician attentiveness, and (5) staff respect for patients as veterans. Although veterans' ethnic/racial backgrounds differentiated their military experiences, it was the informants' veteran identity that framed what they expected of VA health services. Conclusions: Accessibility and acceptability of VA health care is related to veterans' perspectives of the nature of their entitlement to service. Provider education and customer service strategies should consider the identified factors to increase access to VA as well as improve veterans' acceptance of the care. C1 Vet Adm Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Policy & Social Res, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Anthropol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90095 USA. RP Daniron-Rodriguez, J (reprint author), Vet Adm Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90095 USA. NR 25 TC 0 Z9 0 U1 2 U2 4 PU ASSOC MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 EI 1930-613X J9 MIL MED JI Milit. Med. PD MAR PY 2004 VL 169 IS 3 BP 243 EP 250 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 019IR UT WOS:000235829300017 ER PT J AU Heinrich, MC AF Heinrich, MC TI Targeting FLT3 kinase in acute myelogenous leukemia: Progress, perils, and prospects SO MINI-REVIEWS IN MEDICINAL CHEMISTRY LA English DT Review DE FLT3; tyrosine kinase; kinase inhibitor; AML; KIT; PDGFR ID ACUTE MYELOID-LEUKEMIA; INTERNAL TANDEM DUPLICATION; RECEPTOR TYROSINE KINASE; ACUTE PROMYELOCYTIC LEUKEMIA; CELLS IN-VITRO; HEMATOPOIETIC PROGENITOR CELLS; ACUTE LYMPHOBLASTIC-LEUKEMIA; TRANS-RETINOIC ACID; GASTROINTESTINAL STROMAL TUMORS; HISTONE DEACETYLASE INHIBITORS AB Activating mutations of the FLT3 receptor tyrosine kinase are the most common recurring genetic abnormality in acute myelogenous leukemia (AM). Inhibition of FLT3 kinase activity by small molecule inhibitors has been proposed as a novel therapeutic approach AML. The pre-clinical and clinical development of candidate FLT3 inhibitors will be reviewed. C1 Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR 97201 USA. RP Heinrich, MC (reprint author), R&D-19,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. EM heinrich@ohsu.edu NR 149 TC 8 Z9 8 U1 0 U2 0 PU BENTHAM SCIENCE PUBL LTD PI SHARJAH PA EXECUTIVE STE Y26, PO BOX 7917, SAIF ZONE, 1200 BR SHARJAH, U ARAB EMIRATES SN 1389-5575 J9 MINI-REV MED CHEM JI Mini-Rev. Med. Chem. PD MAR PY 2004 VL 4 IS 3 BP 255 EP 271 DI 10.2174/1389557043487394 PG 17 WC Chemistry, Medicinal SC Pharmacology & Pharmacy GA 890BM UT WOS:000226486700003 PM 15032673 ER PT J AU Echchgadda, I Song, CS Roy, AK Chatterjee, B AF Echchgadda, I Song, CS Roy, AK Chatterjee, B TI Dehydroepiandrosterone sulfotransferase is a target for transcriptional induction by the vitamin D receptor SO MOLECULAR PHARMACOLOGY LA English DT Article ID HUMAN CYTOSOLIC SULFOTRANSFERASES; FARNESOID X-RECEPTOR; HYDROXYSTEROID SULFOTRANSFERASE; MOLECULAR-CLONING; GENE PROMOTER; EXPRESSION; SULFATION; METABOLISM; LIVER; PXR AB Dehydroepiandrosterone sulfotransferase (SULT2A1) is a cytosolic enzyme that mediates sulfo-conjugation of endogenous hydroxysteroids (dehydroepiandrosterone, testosterone, bile acids), and diverse xenobiotic compounds. Upon sulfonation, SULT2A1 substrates become polar and water-soluble and thus suitable for rapid excretion. SULT2A1 is abundantly expressed in the liver and intestine. Recent evidence has shown that the ligand-activated vitamin D receptor (VDR) can transcriptionally induce the xenobiotic-metabolizing cytochrome P450 enzymes. Herein, we report that VDR also targets SULT2A1 for transcriptional activation. Vitamin D stimulated endogenous SULT2A1 expression and induced transfected human, mouse, and rat SULT2A1 promoters in liver and intestinal cells upon cotransfection with VDR. An inverted repeat DNA element (IR0), located within -191 to -168 positions of mouse and rat Sult2A1, mediates VDR induction of Sult2A1. DNase1 footprinting, competition EMSA, and antibody supershift assay showed that the IR0 is a binding site for the RXR-alpha/VDR heterodimer. Point mutations within the IR0 prevented RXR/VDR binding and abolished VDR-mediated Sult2A1 induction. The IR0 element conferred VDR responsiveness on a thymidine kinase promoter. Thus, VDR-mediated nuclear signaling may be important in the phase II metabolism involving Sult2A1. The rodent Sult2A1 gene is also induced by the farnesoid X receptor (FXR) and pregnane X receptor (PXR) through the same IR0. In competition transfections, FXR or PXR inhibited VDR induction of the IR0. Competitive functional interactions among VDR, PXR, and FXR suggest that the intracellular hormonal and metabolic milieu may determine the extent to which a specific nuclear receptor pathway would influence steroid/xenobiotic metabolism using dehydroepiandrosterone sulfotransferase. C1 Univ Texas, Hlth Sci Ctr, Dept Mol Med, Inst Biotechnol, San Antonio, TX 78245 USA. Univ Texas, Hlth Sci Ctr, Dept Struct & Cellular Biol, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Chatterjee, B (reprint author), Univ Texas, Hlth Sci Ctr, Dept Mol Med, Inst Biotechnol, 15355 Lambda Dr, San Antonio, TX 78245 USA. EM chatterjee@uthscsa.edu FU NIA NIH HHS [T32-AG00165] NR 40 TC 101 Z9 104 U1 1 U2 5 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0026-895X J9 MOL PHARMACOL JI Mol. Pharmacol. PD MAR 1 PY 2004 VL 65 IS 3 BP 720 EP 729 DI 10.1124/mol.65.3.720 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 775TX UT WOS:000189077700028 PM 14978251 ER PT J AU Bennekov, T Spector, D Langhoff, E AF Bennekov, T Spector, D Langhoff, E TI Induction of immunity against human cytomegalovirus SO MOUNT SINAI JOURNAL OF MEDICINE LA English DT Article DE cytomegalovirus; vaccine; immunity; gene transduction; dendritic cells ID BONE-MARROW TRANSPLANT; T-LYMPHOCYTE RESPONSES; DENDRITIC CELLS; IN-VIVO; GENE-THERAPY; RECOMBINANT ADENOVIRUSES; GANCICLOVIR PROPHYLAXIS; SURFACE EXPRESSION; CELLULAR-IMMUNITY; VIRUS PNEUMONIA AB Most healthy individuals have been exposed to human cytomegalovirus (HCMV) and harbor the virus in a dormant form. However, in situations of immune compromise, HCMV infection is associated with high mortality rates in recipients of bone marrow transplants and with significant morbidity in recipients of solid organ transplants. Conventional vaccination with attenuated HCMV or HCMV proteins fails to prime protective immune responses, presumably because the antigens fail to be presented effectively in vivo. Dendritic cells (DC) are professional antigen-presenting cells that can be genetically engineered to direct their ability to induce immune responses toward immunodominant HCMV antigens. DC are a distinct lineage of leukocytes whose function is most notable for their ability to form clusters with T cells and stimulate vigorous cytotoxic T lymphocyte responses. We hypothesize that in this capacity, DC engineered to express HCMV antigens are uniquely positioned to control immunity against HCMV. C1 Bronx Vet Adm Med Ctr, Nephrol Sect, Bronx, NY 10468 USA. Penn State Univ, Dept Microbiol & Immunol, Hershey, PA USA. State Serum Inst, Vaccine Sect, Copenhagen, Denmark. Mt Sinai Med Ctr, Div Nephrol, New York, NY 10029 USA. RP Langhoff, E (reprint author), Bronx Vet Adm Med Ctr, Nephrol Sect, Room 9C-11F,120 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Erik.Langhoff@med.va.gov FU NIAID NIH HHS [AI28734] NR 73 TC 11 Z9 13 U1 0 U2 0 PU MOUNT SINAI HOSPITAL PI NEW YORK PA BOX 1094 ONE GUSTAVE L LEVY PLACE ATTN: CIRCULATION ASST, NEW YORK, NY 10029-6574 USA SN 0027-2507 J9 MT SINAI J MED JI Mt. Sinai J. Med. PD MAR PY 2004 VL 71 IS 2 BP 86 EP 93 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 802IM UT WOS:000220157200002 PM 15029400 ER PT J AU Reger, MA Henderson, ST Hale, C Cholerton, B Baker, LD Watson, GS Hyde, K Chapman, D Craft, S AF Reger, MA Henderson, ST Hale, C Cholerton, B Baker, LD Watson, GS Hyde, K Chapman, D Craft, S TI Effects of beta-hydroxybutyrate on cognition in memory-impaired adults SO NEUROBIOLOGY OF AGING LA English DT Article DE beta-hydroxybutyrate; ketone bodies; Alzheimer's disease; mild cognitive impairment; APOE; cognition; neuropsychology ID ALZHEIMERS-DISEASE; GLUCOSE-METABOLISM; SENILE DEMENTIA; BRAIN; HYPOGLYCEMIA; RESPONSES AB Glucose is the brain's principal energy substrate. In Alzheimer's disease (AD), there appears to be a pathological decrease in the brain's ability to use glucose. Neurobiological evidence suggests that ketone bodies are, an effective alternative energy substrate for the brain. Elevation of plasma ketone body levels. through an oral dose of medium chain triglycerides (MCTs) may improve cognitive functioning in older adults with memory disorders. On separate days, 20 subjects with AD or niild cognitive impairment consumed a drink containing emulsified MCTs or placebo: Significant increases in levels of the ketone body beta-hydroxybutyrate (beta-OHB) were observed 90 min after treatment (P = 0.007) when cognitive tests were administered. beta-OHB elevations were moderated by apolipoprotein E (APOE) genotype (P = 0.036). For epsilon4+ subjects, beta-OHB levels continued to rise between the 90 and 120 min blood draws in the treatment condition, while the p-OHB levels of epsilon4- subjects held constant (P < 0.009). On cognitive testing, MCT treatment facilitated performance on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog) for epsilon4- subjects, but not for epsilon4+ subjects (P = 0.04). Higher ketone values were associated with greater improvement in paragraph recall with MCT treatment relative to placebo across all subjects (P = 0.02). Additional research is warranted to determine the therapeutic benefits of MCTs for patients with AD and how APOE-epsilon4 status may mediate p-OHB efficacy. (C) 2003 Elsevier Science Inc. All rights reserved. C1 Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Accera Inc, Aurora, CO 80010 USA. Univ Puget Sound, Dept Psychol, Tacoma, WA 98416 USA. RP Craft, S (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, 1660 S Columbian Way,S-182-GRECC, Seattle, WA 98108 USA. EM scraft@u.washington.edu NR 19 TC 136 Z9 137 U1 2 U2 32 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD MAR PY 2004 VL 25 IS 3 BP 311 EP 314 DI 10.1016/S0197-4580(03)00087-3 PG 4 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 778FV UT WOS:000189229600006 PM 15123336 ER PT J AU Mesches, MH Gemma, C Veng, LM Allgeier, C Young, DA Browning, MD Bickford, PC AF Mesches, MH Gemma, C Veng, LM Allgeier, C Young, DA Browning, MD Bickford, PC TI Sulindac improves memory and increases NMDA receptor subunits in aged Fischer 344 rats SO NEUROBIOLOGY OF AGING LA English DT Article DE aging; memory; nonsteroidal anti-inflammatory drug; NSAID; N-methyl-D-aspartate receptor; NMDA-R; cytokine; neurodegeneration; water maze; fear conditioning; hippocampus; interleukin 1 beta ID LONG-TERM POTENTIATION; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; NEURONAL SIGNAL-TRANSDUCTION; PPAR-GAMMA AGONISTS; ALZHEIMERS-DISEASE; DIETARY SUPPLEMENTATION; BEHAVIORAL DEFICITS; CHRONIC NEUROINFLAMMATION; INFLAMMATORY MECHANISMS; SPATIAL MEMORY AB Inflammatory processes in the central nervous system are thought to contribute to Alzheimer's disease (AD). Chronic administration of nonsteroidal anti-inflammatory drugs (NSAIDs) decreases the incidence of Alzheimer's disease. There are very few studies, however, on the cognitive impact of chronic NSAID administration. The N-methyl-D-aspartate (NMDA) receptor is implicated in learning and memory, and age-related decreases in the NMDA NR2B subunit correlate with memory deficits. Sulindac, an NSAID that is a nonselective cyclooxygenase (COX) inhibitor was chronically administered to aged Fischer 344 rats for 2 months. Sulindac, but not its non-COX active metabolite, attenuated age-related deficits in learning and memory as assessed in the radial arm water maze and contextual fear conditioning tasks. Sulindac treatment also attenuated an age-related decrease in the NR1 and NR2B NMDA receptor subunits and prevented an age-related increase in the pro-inflammatory cytokine, interleukin 1beta (IL-1beta), in the hippocampus. These findings support the inflammation hypothesis of aging and have important implications for potential cognitive enhancing effects of NSAIDs in the elderly. (C) 2003 Elsevier Inc. All rights reserved. C1 Denver VA Med Ctr, Med Res Serv 151, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Neurosci Program, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. James A Haley Vet Adm Med Ctr, Res Serv, Tampa, FL 33620 USA. USFCOM, Dept Neurosurg, Ctr Aging & Brain Repair, Tampa, FL USA. RP Mesches, MH (reprint author), Denver VA Med Ctr, Med Res Serv 151, 1055 Clermont St, Denver, CO 80220 USA. EM michael.mesches@uchsc.edu RI Bickford, Paula/J-5970-2012 OI Bickford, Paula/0000-0001-9657-7725; Gemma, Carmelina/0000-0002-4480-0056 FU NIA NIH HHS [AG00961, AG04418] NR 68 TC 58 Z9 62 U1 2 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD MAR PY 2004 VL 25 IS 3 BP 315 EP 324 DI 10.1016/S0197-4580(03)00116-7 PG 10 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 778FV UT WOS:000189229600007 PM 15123337 ER PT J AU Brown, AM Gordon, D Lee, H Caudy, M Haroutunian, V Blass, JP AF Brown, AM Gordon, D Lee, H Caudy, M Haroutunian, V Blass, JP TI Substantial linkage disequilibrium across the dihydrolipoyl succinyltransferase gene region without Alzheimer's disease association SO NEUROCHEMICAL RESEARCH LA English DT Article DE energy metabolism; mitochondria; gene; Alzheimer's disease; polymorphism ID KETOGLUTARATE DEHYDROGENASE COMPLEX; HARDY-WEINBERG PROPORTIONS; APOLIPOPROTEIN-E; DLST GENE; TYPE-4 ALLELE; FREQUENCY; MUTATIONS; GENOTYPE; TESTS; RISK AB Association of the candidate gene DLST with late-onset Alzheimer's disease (LOAD) risk has been suggested on the basis of case-control studies. This gene, located on chromosome 24q24.3, encodes a subunit of a mitochondrial component known to be defective in AD, the alpha-ketoglutarate dehydrogenase complex. Positive reports have correlated different DLST alleles with LOAD, whereas other groups have failed to find any significant association. We therefore reexamined the association of DLST and LOAD in a more ethnically homogeneous series using three additional single nucleotide polymorphisms (SNP) located within or closely flanking either end of the DLST gene. Pairwise analysis of these SNPs indicated there was strong linkage disequilibrium across the DLST locus. Analysis of complex genotypes or haplotypes based upon all five SNP loci failed to identify a LOAD risk allele, suggesting that further studies of DLST in relation to AD are not warranted. C1 Burke Med Res Inst, Dementia Res Serv, White Plains, NY 10605 USA. Cornell Univ, Weill Med Coll, Dept Biochem, New York, NY USA. Cornell Univ, Weill Med Coll, Dept Neurol & Neurosci, New York, NY USA. Cornell Univ, Weill Med Coll, Dept Med, New York, NY USA. Rockefeller Univ, Lab Stat Genet, New York, NY 10021 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. RP Brown, AM (reprint author), Burke Med Res Inst, Dementia Res Serv, 785 Mamaroneck Ave, White Plains, NY 10605 USA. EM ambrown@med.cornell.edu FU NHGRI NIH HHS [K01-HG00055]; NIA NIH HHS [AG14930, P01-AG02219]; NIMH NIH HHS [MH44292] NR 40 TC 4 Z9 5 U1 0 U2 1 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0364-3190 J9 NEUROCHEM RES JI Neurochem. Res. PD MAR PY 2004 VL 29 IS 3 BP 629 EP 635 DI 10.1023/B:NERE.0000014833.54481.1d PG 7 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 770ZB UT WOS:000188760300016 PM 15038610 ER PT J AU Katz, MM Tekell, JL Bowden, CL Brannan, S Houston, JP Berman, N Frazer, A AF Katz, MM Tekell, JL Bowden, CL Brannan, S Houston, JP Berman, N Frazer, A TI Onset and early behavioral effects of pharmacologically different antidepressants and placebo in depression SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE onset of antidepressant effects; antidepressants; desipramine; paroxetine; unipolar depression; norepinephrine; serotonin ID GENERALIZED ANXIETY DISORDER; LOCUS-COERULEUS NEURONS; TRUE DRUG RESPONSE; 5-HYDROXYINDOLEACETIC ACID; VIDEO METHODOLOGY; EARLY IMPROVEMENT; MAJOR DEPRESSION; PATTERN-ANALYSIS; PAROXETINE; SEROTONIN AB This study was aimed at resolving the time course of clinical action of antidepressants (ADs) and the type of early behavioral changes that precede recovery in treatment-responsive depressed patients. The first goal was to identify, during the first 2 weeks of treatment, the onset of clinical actions of the selective serotonin reuptake inhibitor (SSRI), paroxetine, and the selective noradrenergic reuptake inhibitor, desipramine (DMI). The second aim was to test the hypothesis that the two pharmacologic subtypes would induce different early behavioral changes in treatment-responsive patients. The design was a randomized, parallel group, placebo-controlled, double-blind study for 6 weeks of treatment following a 1-week washout period. The study utilized measures of the major behavioral components of the depressive disorder as well as overall severity. The results indicated that the onset of clinical actions of DMI ranged from 3 to 13 days, averaged 13 days for paroxetine, and was 16-42 days for placebo. Furthermore, as hypothesized, the different types of ADs initially impacted different behavioral aspects of the disorder. After I week of treatment, DMI produced greater reductions in motor retardation and depressed mood than did paroxetine and placebo, and this difference persisted at the second week of treatment. Early improvement in depressed mood-motor retardation differentiated patients who responded to DMI after 6 weeks of treatment from those that did not. Paroxetine initially reduced anxiety more in responders than in nonresponders, and by the second week, significantly improved depressed mood and distressed expression in responders to a greater extent. Depressed patients who responded to placebo showed no consistent early pattern of behavior improvement. Early drug-specific behavioral changes were highly predictive of ultimate clinical response to the different ADs, results that could eventually be applied directly to clinical practice. C1 Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. Univ Texas, SW Med Ctr, Dallas VA Med CTr, Dept Psychiat, Dallas, TX USA. Cyberonics, Houston, TX USA. Eli Lilly & Co, Indianapolis, IN 46285 USA. Harbor UCLA Med Ctr, Torrance, CA 90509 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Frazer, A (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pharmacol, 7703 Floyd Curl Dr,MSC 7764, San Antonio, TX 78284 USA. EM frazer@uthscsa.edu NR 68 TC 145 Z9 149 U1 0 U2 5 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD MAR PY 2004 VL 29 IS 3 BP 566 EP 579 DI 10.1038/sj.npp.1300341 PG 14 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 800FE UT WOS:000220013500015 PM 14627997 ER PT J AU Sung, EC Friedlander, AH Kobashigawa, JA AF Sung, EC Friedlander, AH Kobashigawa, JA TI The prevalence of calcified carotid atheromas on the panoramic radiographs of patients with dilated cardiomyopathy SO ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTICS LA English DT Article ID CARDIAC TRANSPLANTATION; HEART-FAILURE; STROKE; ATHEROSCLEROSIS; ONSET; RISK AB Objective. Individuals with dilated cardiomyopathy (DCM) often die from heart failure without a transplant. Of those who do receive a transplant, a significant number suffer a perioperative stroke, although the cause is often in doubt. Our study attempts to determine whether the prevalence of calcified carotid artery atheromas, a known cause of stroke, is greater on the panoramic radiographs of individuals with DCM than it is among controls. Study design. Twenty-seven persons [mean age 62.3 years] enrolled in the UCLA Cardiac Transplantation Program were provided a panoramic radiograph. An age-matched, atherogenic risk-matched cohort of 54 patients free of DCM served as controls. The radiographs of patients in each group were examined for the presence of calcified carotid atheromas. Results. Nine of the 27 patients with DCM had calcified atheromas, whereas only 2 of the 54 patients in the control group had such lesions. This difference was statistically significant (P < .001). Conclusions. Panoramic radiographs may be helpful in identifying some DCM patients with occult carotid artery atherosclerosis who may be at risk for a subsequent stroke. C1 Univ Calif Los Angeles, Med Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Hosp Dent Serv, Ctr Med, Los Angeles, CA USA. Univ Calif Los Angeles, Med Ctr, Cardiac Transplant Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Friedlander, AH (reprint author), Univ Calif Los Angeles, Med Ctr, Los Angeles, CA 90024 USA. EM arthur.friedlander@med.va.gov NR 30 TC 23 Z9 23 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 1079-2104 J9 ORAL SURG ORAL MED O JI Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. PD MAR PY 2004 VL 97 IS 3 BP 404 EP 407 DI 10.1016/j.tripleo.2003.08.025 PG 4 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 803NO UT WOS:000220238000023 PM 15024368 ER PT J AU Stewart, MG Smith, TL Weaver, EM Witsell, DL Yueh, B Hannley, MT Johnson, JT AF Stewart, MG Smith, TL Weaver, EM Witsell, DL Yueh, B Hannley, MT Johnson, JT CA Nose Study Invest TI Outcomes after nasal septoplasty: Results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study SO OTOLARYNGOLOGY-HEAD AND NECK SURGERY LA English DT Article ID QUALITY-OF-LIFE; FUNCTIONAL SEPTOPLASTY; SEPTAL SURGERY; HEALTH-STATUS; RHINOMANOMETRY; RHINOSINUSITIS; HYPERTROPHY; TURBINATE; SYMPTOMS AB OBJECTIVE. Our goal was to assess disease-specific quality of life outcomes after nasal septoplasty in adults with nasal obstruction. DESIGN, SETTINGS, AND PATIENTS: We conducted a prospective observational outcomes multicenter study with 14 sites and 16 investigators, including private practice and academic settings. Patients had had septal deviation and symptomatic nasal obstruction for at least 3 months, and medical management had failed. METHODS: Patients with septal deviation completed a validated outcomes instrument (the Nasal Obstruction Septoplasty Effectiveness (NOSE) scale) before and 3 and 6 months after septoplasty, with or without partial turbinectomy. RESULTS: Fifty-nine patients underwent surgery; there was a significant improvement in mean NOSE score at 3 months after septoplasty (67.5 versus 23.1, P < 0.0001), and this improvement was unchanged at 6 months. Patient satisfaction was very high, and patients used significantly fewer nasal medications. CONCLUSIONS: In patients with septal deformity, nasal septoplasty results in significant improvement in disease-specific quality of life, high patient satisfaction, and decreased medication use. C1 Baylor Coll Med, Bobby R Alford Dept Otorinolaryngol & Communicat, Houston, TX 77030 USA. Med Coll Wisconsin, Dept Otolaryngol Head & Neck Surg, Milwaukee, WI 53226 USA. VA Puget Sound Healthcare Syst, Hlth Serv Res & Dev Serv, Seattle, WA USA. Univ Washington, Sch Med, Dept Otolaryngol Head & Neck Surg, Seattle, WA USA. Duke Univ, Sch Med, Dept Surg, Div Otolaryngol Head & Neck Surg, Durham, NC 27706 USA. Amer Acad Otolaryngol, Head & Neck Surg Fdn, Alexandria, VA USA. Univ Pittsburgh, Sch Med, Dept Otolaryngol Head & Neck Surg, Pittsburgh, PA 15261 USA. RP Stewart, MG (reprint author), Baylor Coll Med, Bobby R Alford Dept Otorinolaryngol & Communicat, 1 Baylor Plaza,NA-102, Houston, TX 77030 USA. EM mgstew@bcm.tmc.edu OI Yueh, Bevan/0000-0003-1380-1053 FU NHLBI NIH HHS [K23 HL068849, K23 HL068849-01A2, HL068849] NR 22 TC 157 Z9 163 U1 1 U2 4 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0194-5998 J9 OTOLARYNG HEAD NECK JI Otolaryngol. Head Neck Surg. PD MAR PY 2004 VL 130 IS 3 BP 283 EP 290 DI 10.1016/j.otohns.2003.12.004 PG 8 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 808NE UT WOS:000220575000001 PM 15054368 ER PT J AU Lee, JCR Shannon, L Boyle, NG Klitzner, TS Bersohn, MM AF Lee, JCR Shannon, L Boyle, NG Klitzner, TS Bersohn, MM TI Evaluation of safety and efficacy of pacemaker and defibrillator implantation by axillary incision in pediatric patients SO PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY LA English DT Article ID TRANSVENOUS PACING LEADS; SYSTEMS AB We successfully implanted 11 pacemakers, 6 defibrillators, and 1 biventricular pacemaker in 18 Pediatric patients (15 female; 4 to 15 years, average age: 9) using the retropectoral transvenous approach with a hidden axillary incision. The average follow-up period was 24 months (range 49 months). Eight patients had congenital structural heart conditions (d-transposition of great arteries SIP Mustard operation, d-transposition of great arteries SIP arterial switch operation, truncus arteriosus, right ventricular diverticula, ventricular septal defect, hypertrophic cardiomyopathy). Four patients had acquired heart conditions (dilated cardiomyopathy, myocarditis). Excellent sensing and pacing thresholds were achieved in all attempted implantations. There was no pneumothorax. There was one lead dislodgement. One lead fracture distant from the subclavian vein occurred 4 months after implantation. Implantation of pacemakers and defibrillators via axillary incisions can be safe and effective in pediatric patients. This approach avoids skin erosion when implanting large devices such as defibrillotors or biventricular devices in small patients with limited muscle mass while achieving superior aesthetic results. The axillary or extrathoracic venous entry site avoids subclavian crush syndrome. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Div Pediat Cardiol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Div Cardiol, Los Angeles, CA 90024 USA. RP Lee, JCR (reprint author), Heart Inst Children, Med Corp, POB 24854, Los Angeles, CA 90024 USA. EM lee@stanfordalumni.org NR 8 TC 8 Z9 8 U1 0 U2 0 PU BLACKWELL FUTURA PUBLISHING, INC PI MALDEN PA 350 MAIN STREET, MALDEN, MA 01248-5018 USA SN 0147-8389 J9 PACE JI PACE-Pacing Clin. Electrophysiol. PD MAR PY 2004 VL 27 IS 3 BP 304 EP 307 DI 10.1111/j.1540-8159.2004.00432.x PG 4 WC Cardiac & Cardiovascular Systems; Engineering, Biomedical SC Cardiovascular System & Cardiology; Engineering GA 805JD UT WOS:000220361700005 PM 15009854 ER PT J AU Mohit, AA Samii, A Slimp, JC Grady, MS Goodkin, R AF Mohit, AA Samii, A Slimp, JC Grady, MS Goodkin, R TI Mechanical failure of the electrode wire in deep brain stimulation SO PARKINSONISM & RELATED DISORDERS LA English DT Article DE deep brain stimulation.; mechanical failure; wire breakage; tremor; Parkinson's disease AB The feasibility and efficacy of deep brain stimulation (DBS) has offered new possibilities for treatment of movement disorders. Mechanical failure of the DBS system is a potential complication. Here we report five patients who presented with mechanical failure of the DBS system. Radiographs of the skull and cervical spine were analyzed for disruptions. Seven instances of lead breakage near the connection of the DBS electrode with the extension wire were identified. In one patient this was in the paramastoid area over the skull, while in all others were in the supraclavicular location. The patients consisted of three men and two women ranging in age from 24 to 78 (at the time of first operation), one person suffering three breakages. The length of spanned time from implantation to presentation ranged from 8 to 32 months. Palpation of the electrode lead wire in the neck for breakage proved unreliable. Radiography localized the site of breakage in all but one patient who required intraoperative exploration, which revealed that although the lead wire was disrupted, the two ends remained in contact. The fact that all breakages occurred near the connection wire suggests that to-and-fro motion of the DBS electrode with repeated head turning leads to fatigue and eventual disruption. (C) 2003 Elsevier Ltd. All rights reserved. C1 Univ Washington, Sch Med, Dept Neurol, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Neurol Surg, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98108 USA. Univ Penn, Dept Neurol Surg, Philadelphia, PA 19104 USA. RP Samii, A (reprint author), Univ Washington, Sch Med, Dept Neurol, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,Mailstop 127, Seattle, WA 98108 USA. EM asamii@u.washington.edu NR 5 TC 7 Z9 7 U1 1 U2 2 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1353-8020 EI 1873-5126 J9 PARKINSONISM RELAT D JI Parkinsonism Relat. Disord. PD MAR PY 2004 VL 10 IS 3 BP 153 EP 156 DI 10.1016/j.parkreldis.2003.11.001 PG 4 WC Clinical Neurology SC Neurosciences & Neurology GA 802KX UT WOS:000220163500007 ER PT J AU Murray, MD Harris, LE Overhage, JM Zhou, XH Eckert, GJ Smith, FE Buchanan, NN Wolinsky, FD McDonald, CJ Tierney, WM AF Murray, MD Harris, LE Overhage, JM Zhou, XH Eckert, GJ Smith, FE Buchanan, NN Wolinsky, FD McDonald, CJ Tierney, WM TI Failure of computerized treatment suggestions to improve health outcomes of outpatients with uncomplicated hypertension: Results of a randomized controlled trial SO PHARMACOTHERAPY LA English DT Article DE computers; practice guidelines; hypertension; randomized controlled trials ID CLINICAL-PRACTICE GUIDELINES; PREVENTIVE CARE GUIDELINES; JOINT NATIONAL COMMITTEE; HIGH BLOOD-PRESSURE; MEDICAL OUTCOMES; WORK PATTERNS; JNC-V; PHYSICIANS; REMINDERS; QUALITY AB Study Objective. To assess the effects of evidence-based treatment suggestions for hypertension made to physicians and pharmacists using a comprehensive electronic medical record system. Design. Randomized controlled trial with a 2 x 2 factorial design of physician and pharmacist interventions, which resulted in four groups of patients: physician intervention only, pharmacist intervention only, intervention by physician and pharmacist, and intervention by neither physician nor pharmacist (control). Setting. Academic primary care internal medicine practice. Subjects. Seven hundred twelve patients with uncomplicated hypertension. Measurements and Main Results. Suggestions were displayed to physicians on computer workstations used to write outpatient orders and to pharmacists when filling prescriptions. The primary end point was generic health-related quality of life. Secondary end points were symptom profile and side effects from antihypertensive drugs, number of emergency department visits and hospitalizations, blood pressure measurements, patient satisfaction with physicians and pharmacists, drug therapy compliance, and health care charges. In the control group, implementation of care changes in accordance with treatment suggestions was observed in 26% of patients. In the intervention groups, compliance with suggestions was poor, with treatment suggestions implemented in 25% of patients for whom suggestions were displayed only to pharmacists, 29% of those for whom suggestions were displayed only to physicians, and 35% of the group for whom both physicians and pharmacists received suggestions (p=0.13). Intergroup differences were neither statistically significant nor clinically relevant for generic health-related quality of life, symptom and side-effect profiles, number of emergency department visits and hospitalizations, blood pressure measurements, charges, or drug therapy compliance. Conclusion. Computer-based intervention using a sophisticated electronic physician order-entry system failed to improve compliance with treatment suggestions or outcomes of patients with uncomplicated hypertension. C1 St Louis Univ, Sch Publ Hlth, St Louis, MO 63103 USA. Univ Washington, VA Puget Sound Hlth Care Syst, HSR&D Ctr Excellence, Dept Biostat, Tacoma, WA USA. Richard L Roudebush Vet Adm Med Ctr, Indianapolis, IN 46202 USA. Purdue Univ, Sch Pharm, Dept Pharm Practice, W Lafayette, IN 47907 USA. Purdue Univ, Sch Pharm, Regenstrief Inst, W Lafayette, IN 47907 USA. Indiana Univ, Sch Med, Dept Med, Bloomington, IN USA. RP Murray, MD (reprint author), Regenstrief Inst Hlth Care, Regenstrief Inst, 6th Floor,1050 Wishard Blvd, Indianapolis, IN 46202 USA. EM mmurray@regenstrief.org RI Wolinsky, Fredric/F-9231-2011 OI Wolinsky, Fredric/0000-0002-0916-4955; Overhage, Joseph/0000-0003-0223-0195 FU AHRQ HHS [R01 HS07763] NR 59 TC 72 Z9 73 U1 0 U2 3 PU PHARMACOTHERAPY PUBLICATIONS INC PI BOSTON PA NEW ENGLAND MEDICAL CENTER, 806, 750 WASHINGTON ST, BOSTON, MA 02111 USA SN 0277-0008 J9 PHARMACOTHERAPY JI Pharmacotherapy PD MAR PY 2004 VL 24 IS 3 BP 324 EP 337 DI 10.1592/phco.24.4.324.33173 PG 14 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 779QY UT WOS:000189312800003 PM 15040645 ER PT J AU Netscher, DT AF Netscher, DT TI Aesthetic outcome of breast implant removal in 85 consecutive patients SO PLASTIC AND RECONSTRUCTIVE SURGERY LA English DT Article ID EXPLANTATION C1 Baylor Coll Med, Div Plast Surg, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Plast Surg Serv, Houston, TX USA. RP Netscher, DT (reprint author), 6624 Fannin,Suite 2730, Houston, TX 77030 USA. EM netscher@bcm.tmc.edu NR 7 TC 5 Z9 5 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0032-1052 J9 PLAST RECONSTR SURG JI Plast. Reconstr. Surg. PD MAR PY 2004 VL 113 IS 3 BP 1057 EP 1059 DI 10.1097/01.PRS.0000105686.02437.74 PG 3 WC Surgery SC Surgery GA 800YL UT WOS:000220063500046 PM 15108906 ER PT J AU Flashman, LA Green, MF AF Flashman, LA Green, MF TI Review of cognition and brain structure in schizophrenia: profiles, longitudinal course, and effects of treatment SO PSYCHIATRIC CLINICS OF NORTH AMERICA LA English DT Review ID FIRST-EPISODE SCHIZOPHRENIA; TREATMENT-RESISTANT SCHIZOPHRENIA; NEUROLEPTIC-NAIVE PATIENTS; PLACEBO-CONTROLLED TRIAL; CAUDATE NUCLEI VOLUMES; MAGNETIC-RESONANCE; FOLLOW-UP; 1ST-EPISODE SCHIZOPHRENIA; ANTIPSYCHOTIC-DRUGS; PSYCHOTIC-PATIENTS AB Schizophrenia is a serious, chronic mental illness that presents with neurocognitive and neuroanatomic abnormalities. This article briefly reviews the literature on the neurocognitive and neuroanatomic profiles of individuals with schizophrenia and addresses the issue of whether these performance deficits and structural abnormalities are stable across the course of the illness. Finally, the article discusses the effects of psychopharmacology on the neurocognitive deficits seen in patients with schizophrenia, examining the effects of conventional and atypical antipsychotics. C1 Dartmouth Coll Sch Med, Dept Psychiat, Dartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA. New Hampshire Hosp, Concord, NH 03301 USA. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Flashman, LA (reprint author), Dartmouth Coll Sch Med, Dept Psychiat, Dartmouth Hitchcock Med Ctr, 1 Med Ctr Dr, Lebanon, NH 03756 USA. EM flashman@dartmouth.edu NR 128 TC 60 Z9 63 U1 4 U2 12 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0193-953X J9 PSYCHIAT CLIN N AM JI Psychiatr. Clin. North Amer. PD MAR PY 2004 VL 27 IS 1 BP 1 EP + DI 10.1016/S0193-983X(03)00105-9 PG 28 WC Psychiatry SC Psychiatry GA 810OC UT WOS:000220712600002 PM 15062627 ER PT J AU Wynn, JK Dawson, ME Schell, AM AF Wynn, JK Dawson, ME Schell, AM TI The functional relationship between visual backward masking and prepulse inhibition SO PSYCHOPHYSIOLOGY LA English DT Article DE visual backward masking; visual prepulse inhibition; auditory prepulse inhibition; information processing ID WEAK PRE-STIMULATION; STARTLE REFLEX; P50 SUPPRESSION; SCHIZOPHRENIA; DISCRETE; EYEBLINK; ATTENTION; CHANNELS; ONSET; BLINK AB This, experiment demonstrated a relationship between prepulse inhibition (PPI) of the startle eyeblink and visual backward masking in college students. It was hypothesized that recovery from backward masking effects is due in part to sensory gating, as assessed by auditory and visual PPI. Visual presentations of letters served as targets or visual prepulses in an intermixed session of backward masking and PPI. Backward masking and PPI (both auditory and visual) were assessed at stimulus onset asynchronies of 30, 45, 60, 120, and 150 ms. A repeated-measures regression revealed that there was a relationship between backward masking and PPI for both visual and auditory PPI, with higher levels of PPI being associated with greater recovery from backward masking. The data are consistent with the hypothesis that recovery from backward masking effects is affected by sensory gating acting in part to gate out the interruptive effects of the mask. C1 Univ So Calif, Dept Psychol, Los Angeles, CA 90089 USA. Occidental Coll, Dept Psychol, Los Angeles, CA 90041 USA. RP Wynn, JK (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,MIRECC 210A, Los Angeles, CA 90073 USA. EM jkwynn@ucla.edu RI Wynn, Jonathan/H-3749-2014 OI Wynn, Jonathan/0000-0002-1763-8540 FU NIMH NIH HHS [MH 14584, MH01086, MH46433] NR 28 TC 8 Z9 11 U1 0 U2 2 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD MAR PY 2004 VL 41 IS 2 BP 306 EP 312 DI 10.1111/j.1469-8986.2004.00153.x PG 7 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 804QI UT WOS:000220312800015 PM 15032996 ER PT J AU Wright, EF Thompson, RL Paunovich, ED AF Wright, EF Thompson, RL Paunovich, ED TI Post-traumatic stress disorder: Considerations for dentistry SO QUINTESSENCE INTERNATIONAL LA English DT Article DE bruxism; occlusal appliance; periodontal ligament inflammation; post-traumatic stress disorder; pulpitis; temporomandibular disorder; temporomandibular joint ID MOTOR-VEHICLE ACCIDENTS; VIETNAM VETERANS; TRAUMATIC EVENTS; PAIN; COMORBIDITY; IMPAIRMENT; PREVALENCE; MANAGEMENT; COMMUNITY; PATTERNS AB A dental patient with post-traumatic stress disorder (PTSD) may present with greater dental and behavioral challenges than most dental patients. The background review of PTSD's initiating factors, diagnostic criteria, and medical management should help practitioners better understand and manage these challenges. Many of the challenges the clinician may encounter and managing recommendations are described. A case report of a PTSD patient complaining of constant bilateral tooth pain of the maxillary and mandibular bicuspids and molars is presented. Recommended techniques for identifying the tooth pain source and contributing factors are provided. The primary contributing factor for the patient's tooth pain was determined to be his severe tooth clenching activity. A maxillary acrylic appliance provided some pain reduction and a subsequent mandibular soft occlusal appliance worn opposing the maxillary appliance provided additional relief. C1 S Texas Vet Hlth Care Syst, Dept Restorat Dent, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Clin Oral Hlth Program Geriatr & Extended Care, San Antonio, TX 78229 USA. RP Wright, EF (reprint author), S Texas Vet Hlth Care Syst, Dept Restorat Dent, Mail Code 7890,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM wrighte@uthscsa.edu NR 47 TC 8 Z9 8 U1 1 U2 4 PU QUINTESSENCE PUBL CO INC PI CAROL STREAM PA 551 NORTH KIMBERLY DR, CAROL STREAM, IL 60188-1881 USA SN 0033-6572 J9 QUINTESSENCE INT JI Quintessence Int. PD MAR PY 2004 VL 35 IS 3 BP 206 EP 210 PG 5 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 813CM UT WOS:000220885200007 PM 15119679 ER PT J AU Kee, KS Horan, WP Mintz, J Green, MF AF Kee, KS Horan, WP Mintz, J Green, MF TI Do the siblings of schizophrenia patients demonstrate affect perception deficits? SO SCHIZOPHRENIA RESEARCH LA English DT Article; Proceedings Paper CT 8th International Congress on Schizophrenia Research CY APR 28-MAY 02, 2001 CL WHISTLER, CANADA DE siblings; schizophrenia patients; affect perception deficits ID GENERALIZED POOR PERFORMANCE; FACIAL-AFFECT RECOGNITION; EMOTION RECOGNITION; SOCIAL COGNITION; BEHAVIOR; EXPRESSIONS; COMPETENCE; RISK AB Affect perception deficits have been extensively documented in schizophrenia and are associated with the social dysfunction that is characteristic of this disorder. The two previous studies examined facial affect perception in genetically at-risk samples and yielded mixed results. The current study was designed to provide a rigorous test of affect perception abilities among schizophrenia patients (n=58), their biological siblings without psychosis (n=51), and nonpsychiatric controls (n=49). Participants completed three measures of affect perception, including facial, vocal, and combined modality. Schizophrenia patients performed significantly worse than controls on two of the three affect perception tests as well as a composite index based on all three tests. The performance of the sibling group fell between the patient and control groups on each of the affect perception tests. However, group differences achieved statistical significance only for the composite index with the siblings performing significantly worse than controls and significantly better than the schizophrenia group. These findings demonstrate that subtle deficits in affect perception are detectable in the unaffected siblings of schizophrenia patients when multiple measures of different types of affect perception abilities are used in combination. (C) 2003 Elsevier B.V. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Kee, KS (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,MIRECC 210A,Bldg 210,VISN22, Los Angeles, CA 90073 USA. EM kee@ucla.edu FU NIMH NIH HHS [MH43292] NR 44 TC 84 Z9 86 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD MAR PY 2004 VL 67 IS 1 BP 87 EP 94 DI 10.1016/S0920-9964(03)00217-2 PG 8 WC Psychiatry SC Psychiatry GA 770PH UT WOS:000188738800010 PM 14741328 ER PT J AU Bruno, A McConnell, JP Cohen, SN Tietjen, GE Wallis, RA Gorelick, PB Bang, NU AF Bruno, A McConnell, JP Cohen, SN Tietjen, GE Wallis, RA Gorelick, PB Bang, NU TI Serial urinary 11-dehydrothromboxane B2, aspirin dose, and vascular events in blacks after recent cerebral infarction SO STROKE LA English DT Article DE aspirin; cerebral infarction; platelets ID ACUTE ISCHEMIC STROKE; DISEASE; B-2; RESISTANCE; TRIAL AB Background and Purpose-Incomplete platelet inhibition by aspirin ( aspirin resistance) may be a reason for stroke recurrence in some patients. 11-Dehydrothromboxane B2 (11-DTB2) is a stable thromboxane A2 metabolite that reflects in vivo platelet activation. This pilot study was intended to evaluate the reproducibility of urinary 11-DTB2 over time and to look for evidence of aspirin resistance. Methods-All subjects were screened for the African American Antiplatelet Stroke Prevention Study (AAASPS) 7 to 90 days after noncardioembolic cerebral infarction. Of 83 subjects with at least 1 urine sample, 52 were enrolled in AAASPS (randomized to blinded treatment with aspirin 650 mg/d or ticlopidine 500 mg/d), and 31 were enrolled in an open-label antiplatelet therapy cohort. Subjects were followed up for 2 years, with 11-DTB2 measurements scheduled at baseline and 6, 12, and 24 months. Vascular events were cerebral infarction, myocardial infarction, or vascular death. Results-Despite considerable individual up or down fluctuations, the median 11-DTB2 change did not significantly differ from zero in any of the subgroups. However, in 6 subjects with a 4-fold decrease in aspirin dose from 1300 to 325 or 81 mg/d, the 11-DTB2 level increased from 611 to 1881 pg/mg creatinine (P=0.06). Vascular events occurred in 7 of 61 aspirin-treated subjects, and 11-DTB2 levels did not correlate with the events. Conclusions-Fluctuations in urinary 11-DTB2 after cerebral infarction in blacks do not correlate with changes in aspirin doses, except perhaps when the dose changes by a factor of 4 or more. A larger study is needed to look further for aspirin resistance. C1 Indiana Univ, Sch Med, Dept Neurol, Indianapolis, IN 46202 USA. Mayo Clin, Rochester, MN USA. Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. Med Coll Ohio, Toledo, OH 43699 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Rush Presbyterian St Lukes Med Ctr, Chicago, IL 60612 USA. RP Bruno, A (reprint author), Indiana Univ, Sch Med, Dept Neurol, 541 Clin Dr,Room 290C, Indianapolis, IN 46202 USA. EM abruno@iupui.edu NR 12 TC 20 Z9 23 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD MAR PY 2004 VL 35 IS 3 BP 727 EP 730 DI 10.1161/01.STR.0000117097.76953.A6 PG 4 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 778LQ UT WOS:000189243400022 PM 14963281 ER PT J AU Livingston, EH Ko, CY AF Livingston, EH Ko, CY TI Socioeconomic characteristics of the population eligible for obesity surgery SO SURGERY LA English DT Article ID BODY-MASS INDEX; CORONARY HEART-DISEASE; SELF-REPORTED HEIGHT; HEALTH-CARE COSTS; UNITED-STATES; ECONOMIC CONSEQUENCES; LIFETIME HEALTH; RELATIVE WEIGHT; US ADULTS; MORTALITY AB Background. Obesity is increasing in the American population in epidemic proportions. Weight reduction surgery results in sustained weight loss for morbidly obese individuals-a group of patients refractory to nonsurgical obesity treatment. Surgical indications were outlined in a National Institutes Of Health (NIH) consensus, conference published in 1991. Using the NIH criteria, we compared the socioeconomic characteristics of the population eligible for these operations to those receiving them. Methods. The 2000 National Health Interview Survey database was examined to identify how many individuals in the American population were eligible for obesity operations. Socioeconomic characteristics for those individuals were then assessed. The Healthcare Cost and Utility Project and National Hospital Discharge Survey databases were queried to determine how many gastric bypass operations were performed and what the patient's socioeconomic characteristics were. Results. There are 5,324,123 people, or 2.8% of the American population, who are eligible for obesity surgery. Of these, a disproportionate number were black, poorly educated, or impoverished, and 38% rely on Medicare or Medicaid for their health insurance. Of the 28,590 gastric bypass operations performed in 2000, only 13% of patients used Medicare or Medicaid to pay for the operation. Fewer than expected operations were performed on blacks. Regional differences were observed with disproportionately more operations performed in the Northeast and fewer in the Midwest than would be predicted from the surgery-eligible population living in these regions. Conclusions. A significant fraction of the American population could potentially benefit from obesity surgery. However, many of those individuals are black, poorly educated, and impoverished. Public assistance programs need to account for these patients. Centers performing bariatric operations need to accommodate the educational and financial constraints these patients have when planning long-term postoperative care. C1 Univ Texas, SW Med Ctr, Div Gastrointestinal & Endocrine Surg, Dallas, TX USA. VA N Texas Hlth Care Syst, Dallas, TX USA. VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Livingston, EH (reprint author), Univ Texas, SW Med Ctr, Div Gastrointestinal & Endocrine Surg, 5323 Harry Hines Blvd,Room E7-126, Dallas, TX USA. NR 45 TC 69 Z9 69 U1 0 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0039-6060 J9 SURGERY JI Surgery PD MAR PY 2004 VL 135 IS 3 BP 288 EP 296 DI 10.1016/j.surg.2003.07.008 PG 9 WC Surgery SC Surgery GA 779QE UT WOS:000189310900008 PM 14976479 ER PT J AU Freedland, SJ Presti, JC Kane, CJ Aronson, WJ Terris, MK Dorey, F Amling, CL AF Freedland, SJ Presti, JC Kane, CJ Aronson, WJ Terris, MK Dorey, F Amling, CL CA Search Database Study Grp TI Do younger men have better biochemical outcomes after radical prostatectomy? SO UROLOGY LA English DT Article ID EXTERNAL-BEAM RADIATION; OF-DEFENSE CENTER; SEXTANT BIOPSIES; CANCER INCIDENCE; DISEASE RESEARCH; SEARCH DATABASE; FREE SURVIVAL; ANTIGEN; RECURRENCE; TRENDS AB Objectives. To examine the relationship between age and biochemical failure after radical prostatectomy (RP), controlling for the year of surgery. Prior studies have suggested that younger men have lower prostate-specific antigen recurrence rates after RP, although none of the prior studies had controlled for the year of surgery. Methods. We examined the data from 1753 men treated with RP between 1988 and 2002 at five equal access medical centers. We compared age, as a categorical variable according to decade of life (50 years old or younger, 51 to 60, 61 to 70, and older than 70 years), with the clinical and pathologic variables at RP, as well as the time to biochemical recurrence, using a multivariate Cox proportional hazards model. Results. Age was significantly related to the year of surgery, with the more recently treated patients being younger than less recently treated patients (P <0.001). After controlling for the year of surgery, the younger men had smaller prostates, fewer high-grade tumors on biopsy, and less lymph node metastasis, but a greater percentage of cores with cancer. On multivariate analysis, men 50 years old or younger had significantly lower recurrence rates than did the older men. Moreover, men older than 70 years had significantly greater prostate-specific antigen failure rates than men aged 51 to 70 years or men aged 50 years or younger. Conclusions. The average age of men undergoing RP has decreased with time. Independent of this, young men have more favorable outcomes after RP than older men. Continued screening to detect prostate cancer among younger men when it is most curable appears warranted. C1 Johns Hopkins Univ, Sch Med, Dept Urol, Baltimore, MD 21287 USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. Vet Affairs Med Ctr, Dept Surg, Urol Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA USA. Med Coll Georgia, Div Urol, Augusta, GA 30912 USA. San Diego Naval Hosp, Dept Urol, San Diego, CA USA. RP Freedland, SJ (reprint author), Johns Hopkins Univ, Sch Med, Dept Urol, 600 N Wolfe St, Baltimore, MD 21287 USA. OI Terris, Martha/0000-0002-3843-7270 NR 26 TC 39 Z9 45 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0090-4295 J9 UROLOGY JI Urology PD MAR PY 2004 VL 63 IS 3 BP 518 EP 522 DI 10.1016/j.urology.2003.10.045 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 803HZ UT WOS:000220223500020 PM 15028449 ER PT J AU Lui, KJ Zhou, XH AF Lui, KJ Zhou, XH TI Testing non-inferiority (and equivalence) between two diagnostic procedures in paired-sample ordinal data SO STATISTICS IN MEDICINE LA English DT Article DE non-inferiority; equivalence; ordinal scale; sensitivity; specificity; paired-sample data ID SIZE DETERMINATION; MATCHED-PAIRS; NONINFERIORITY; BIOEQUIVALENCE AB Before adopting a new diagnostic procedure, which is more convenient and less expensive than the standard existing procedure, it is essentially important to assess whether the diagnostic accuracy of the new procedure is non-inferior (or equivalent) to that of the standard procedure. In this paper, we consider the situation where test responses are on an ordinal scale with more than two categories. We give two definitions of non-inferiority, one in terms of the probability of correctly identifying the case for a randomly selected pair of a case and a non-case over all possible cut-off points, and the other in terms of both the sensitivity and specificity directly. On the basis of large sample theory, we develop two simple test procedures for detecting non-inferiority. We further conduct Monte Carlo simulation to evaluate the finite sample performance of these test procedures. We note that the two asymptotic test procedures proposed here can actually perform reasonably well in a variety of situations even when the numbers of studied subjects from the diseased and non-diseased populations are not large. To illustrate the use of the proposed test procedures, we include an example of determining whether the diagnostic accuracy of using a digitized film is non-inferior to that of using a plain film for screening breast cancer. Finally, we note that the extension of these results to accommodate the case of detecting (two-sided) equivalence is simply straightforward. Copyright (C) 2004 John Wiley Sons, Ltd. C1 San Diego State Univ, Coll Sci, Dept Math & Stat, San Diego, CA 92182 USA. Univ Washington, Hlth Serv Res & Dev Ctr Excellence, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Biostat, Seattle, WA 98108 USA. RP Lui, KJ (reprint author), San Diego State Univ, Coll Sci, Dept Math & Stat, San Diego, CA 92182 USA. EM kjl@rohan.sdsu.edu NR 23 TC 7 Z9 7 U1 1 U2 3 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0277-6715 J9 STAT MED JI Stat. Med. PD FEB 28 PY 2004 VL 23 IS 4 BP 545 EP 559 DI 10.1002/dim.1607 PG 15 WC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Medicine, Research & Experimental; Statistics & Probability SC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Research & Experimental Medicine; Mathematics GA 770NY UT WOS:000188737900002 PM 14755388 ER PT J AU Holroyd-Leduc, JM Straus, SE AF Holroyd-Leduc, JM Straus, SE TI Management of urinary incontinence in women - Scientific review SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID RANDOMIZED CONTROLLED-TRIAL; MIDDLE-AGED WOMEN; DOUBLE-BLIND; RISK-FACTORS; OVERACTIVE BLADDER; STRESS-INCONTINENCE; ELECTRICAL-STIMULATION; DETRUSOR INSTABILITY; URGE INCONTINENCE; POSTMENOPAUSAL WOMEN AB Context Urinary incontinence is a common health problem among women that negatively impacts quality of life. Therefore, it is important that primary care physicians have an understanding of how to manage urinary incontinence effectively. Objective To review the most recent, high-quality evidence regarding the etiology and management of urinary incontinence in women. Data Sources and Study Selection Searches of MEDLINE, EMBASE, The Cochrane Library, and the ACP Journal Club were performed to identify English-language articles published between 1998-2003 that focused on the etiology or treatment of urinary incontinence in adult women. The references of each retrieved article were reviewed and an expert in the field was contacted to identify additional relevant articles. Data Extraction Using a combination of more than 80 search terms, we included articles of etiology that were cohort studies, case-control studies, cross-sectional studies, or systematic reviews of cohort, case-control, and/or cross-sectional studies. Studies of treatment had to be randomized controlled trials or systematic reviews of randomized controlled trials. The quality of each article was assessed independently by each author and inclusion (n = 66) was determined by consensus. Data Synthesis Multiple factors have been found to be associated with urinary incontinence, some of which are amenable to modification. Factors associated with incontinence include age, white race, higher educational attainment, pregnancy-related factors, gynecological factors, urological and gastrointestinal tract factors, comorbid diseases, higher body mass index, medications, smoking, caffeine, and functional impairment. There are several effective non pharmacological treatments including pelvic floor muscle training, electrical stimulation, bladder training, and prompted voiding. Anticholinergic drugs are effective in the treatment of urge urinary incontinence. Several surgical interventions are effective in the management of stress incontinence, including open retropubic colposuspension and suburethral sling procedure. Conclusion Urinary incontinence in women is an important public health concern, and effective treatment options exist. C1 San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, Div Geriatr, San Francisco, CA USA. Univ Toronto, Univ Hlth Network, Div Gen Internal Med, Toronto, ON, Canada. RP Holroyd-Leduc, JM (reprint author), SFVAMC 181G, 4150 Clement St,Bldg 1, San Francisco, CA 94121 USA. EM Jayna.Holroyd-Leduc@med.va.gov; sstraus@mtsinai.on.ca NR 76 TC 106 Z9 110 U1 0 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 25 PY 2004 VL 291 IS 8 BP 986 EP 995 DI 10.1001/jama.291.8.986 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 777MK UT WOS:000189182000027 PM 14982915 ER PT J AU Holroyd-Leduc, JM Straus, SE AF Holroyd-Leduc, JM Straus, SE TI Management of urinary incontinence in women - Clinical applications SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID RANDOMIZED CONTROLLED TRIAL; HEALTH-CARE-SEEKING; OVERACTIVE BLADDER; HELP-SEEKING; TOLTERODINE; OXYBUTYNIN; SYMPTOMS; EFFICACY; OLDER; TOLERABILITY AB Urinary incontinence, defined as involuntary loss of urine, is a common health problem among women. The prevalence rate is between 12% and 55% for having ever experienced urinary incontinence. It is associated with poor self-rated health, impaired quality of life, social isolation, and depressive symptoms. However, physicians are usually not the ones to initiate discussion about incontinence with their patients. We present clinical cases to illustrate common scenarios in which a physician may be able to help a female patient manage her urinary incontinence by specifically addressing associated factors and offering treatments to improve or possibly even cure her symptoms. Several evidence-based effective nonpharmacological, pharmacological, and surgical treatment options are outlined. C1 San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. Univ Toronto, Univ Hlth Network, Div Gen Internal Med, Toronto, ON, Canada. RP Holroyd-Leduc, JM (reprint author), SFVAMC 181G, 4150 Clement St,Bldg 1, San Francisco, CA 94121 USA. EM Jayna.Holroyd-Leduc@med.va.gov; sstraus@mtsinai.on.ca NR 19 TC 26 Z9 27 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 25 PY 2004 VL 291 IS 8 BP 996 EP 999 DI 10.1001/jama.291.8.996 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 777MK UT WOS:000189182000028 PM 14982916 ER PT J AU Grande, LA Kinney, GA Miracle, GL Spain, WJ AF Grande, LA Kinney, GA Miracle, GL Spain, WJ TI Dynamic influences on coincidence detection in neocortical pyramidal neurons SO JOURNAL OF NEUROSCIENCE LA English DT Article DE coincidence detection; synchrony; phase delay; neocortex; pyramidal neuron; synaptic inhibition; jitter; dynamic clamp ID NUCLEUS LAMINARIS; VISUAL-CORTEX; SYNAPTIC DEPRESSION; BRAIN-STEM; INTEGRATIVE PROPERTIES; SENSORIMOTOR CORTEX; CORTICAL-NEURONS; SPIKING NEURONS; MOTOR CORTEX; FIRING RATE AB The firing rate of neocortical pyramidal neurons is believed to represent primarily the average arrival rate of synaptic inputs; however, it has also been found to vary somewhat depending on the degree of synchrony among synaptic inputs. We investigated the ability of pyramidal neurons to perform coincidence detection, that is, to represent input timing in their firing rate, and explored some factors that influence that representation. We injected computer-generated simulated synaptic inputs into pyramidal neurons during whole-cell recordings, systematically altering the phase delay between two groups of periodic simulated input events. We explored how input intensity, the synaptic time course, inhibitory synaptic conductance, and input jitter influenced the firing rate representation of input timing. In agreement with computer modeling studies, we found that input synchronization increases firing rate when intensity is low but reduces firing rate when intensity is high. At high intensity, the effect of synchrony on firing rate could be switched from reducing to increasing firing rate by shortening the simulated excitatory synaptic time course, adding inhibition ( using the dynamic clamp technique), or introducing a small input jitter. These opposite effects of synchrony may serve different computational functions: as a means of increasing firing rate it may be useful for efficient recruitment or for computing a continuous parameter, whereas as a means of decreasing firing rate it may provide gain control, which would allow redundant or excessive input to be ignored. Modulation of dynamic input properties may allow neurons to perform different operations depending on the task at hand. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Physiol & Biophys, Seattle, WA 98105 USA. Univ Washington, Dept Neurol, Seattle, WA 98105 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98105 USA. RP Spain, WJ (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM spain@u.washington.edu FU BLRD VA [I01 BX000386] NR 66 TC 26 Z9 26 U1 1 U2 1 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD FEB 25 PY 2004 VL 24 IS 8 BP 1839 EP 1851 DI 10.1523/JNEUROSCI.3500-03.2004 PG 13 WC Neurosciences SC Neurosciences & Neurology GA 777XZ UT WOS:000189210300006 PM 14985424 ER PT J AU Yun, JJ Whiting, D Fischbein, MP Banerji, A Irie, Y Stein, D Fishbein, MC Proudfoot, AEI Laks, H Berliner, JA Ardehali, A AF Yun, JJ Whiting, D Fischbein, MP Banerji, A Irie, Y Stein, D Fishbein, MC Proudfoot, AEI Laks, H Berliner, JA Ardehali, A TI Combined blockade of the chemokine receptors CCR1 and CCR5 attenuates chronic rejection SO CIRCULATION LA English DT Article DE transplantation; lymphocytes; rejection; chemokine ID CARDIAC ALLOGRAFT VASCULOPATHY; SMOOTH-MUSCLE-CELLS; RANTES PRODUCTION; MONOCYTE ARREST; IN-VITRO; ACTIVATION; ATHEROSCLEROSIS; RECRUITMENT; LYMPHOCYTES; HEARTS AB Background - Chemokine-chemokine receptor interaction and the subsequent recruitment of T-lymphocytes to the graft are early events in the development of chronic rejection of transplanted hearts or cardiac allograft vasculopathy (CAV). In this study, we sought to determine whether blockade of chemokine receptors CCR1 and CCR5 with Met-RANTES affects the development of CAV in a murine model. Methods and Results - B6.CH-2(bm12) strain donor hearts were transplanted heterotopically into wild-type C57BL/6 mice ( myosin heavy chain II mismatch). Recipients were treated daily with either Met-RANTES or vehicle starting on postoperative day 4 and were euthanized on postoperative days 24 and 56. We found that Met-RANTES significantly reduced intimal thickening in this model of chronic rejection and that Met-RANTES markedly decreased the infiltration of CD4 and CD8 T lymphocytes and MOMA-2(+) monocytes/ macrophages into transplanted hearts. Met-RANTES also suppressed the ex vivo and in vitro proliferative responses of recipient splenocytes to donor antigens. Finally, Met-RANTES treatment was associated with a marked reduction in RANTES/CCL5 and monocyte chemoattractant protein-1 gene transcript levels in the donor hearts. Conclusions - Antagonism of the chemokine receptors CCR1 and CCR5 with Met-RANTES attenuates CAV development in vivo by reducing mononuclear cell recruitment to the transplanted heart, proliferative responses to donor antigens, and intragraft RANTES/CCL5 and monocyte chemoattractant protein-1 gene transcript levels. These findings suggest that chemokine receptors CCR1 and CCR5 play significant roles in the development of chronic rejection and may serve as potential therapeutic targets. C1 Univ Calif Los Angeles, Med Ctr, Div Cardiothorac Surg, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Pathol & Lab Med, Los Angeles, CA USA. Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA USA. Serono Pharmaceut Res Inst, Geneva, Switzerland. RP Ardehali, A (reprint author), Univ Calif Los Angeles, Med Ctr, Div Cardiothorac Surg, Dept Surg, CHS 62-182,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM aardehali@mednet.ucla.edu FU NHLBI NIH HHS [P01 HL30568]; NIAID NIH HHS [AI07126-23] NR 27 TC 66 Z9 74 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 24 PY 2004 VL 109 IS 7 BP 932 EP 937 DI 10.1161/01.CIR.0000112595.65972.8A PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 777FR UT WOS:000189165800023 PM 14757698 ER PT J AU Ruo, B Rumsfeld, JS Pipkin, S Browner, WS Whooley, MA AF Ruo, B Rumsfeld, JS Pipkin, S Browner, WS Whooley, MA TI Depressive symptoms and treadmill exercise capacity: Findings from the heart and soul study. SO CIRCULATION LA English DT Meeting Abstract CT 44th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 03-06, 2004 CL San Francisco, CA SP Amer Heart Assoc C1 UCSF VA, San Francisco, CA USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Calif Pacific Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 24 PY 2004 VL 109 IS 7 MA P107 BP E102 EP E102 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 777FR UT WOS:000189165800162 ER PT J AU Gennuso, F Fernetti, C Tirolo, C Testa, N L'Episcopo, F Caniglia, S Morale, MC Ostrow, JD Pascolo, L Tiribelli, C Marchetti, B AF Gennuso, F Fernetti, C Tirolo, C Testa, N L'Episcopo, F Caniglia, S Morale, MC Ostrow, JD Pascolo, L Tiribelli, C Marchetti, B TI Bilirubin protects astrocytes from its own toxicity by inducing up-regulation and translocation of multidrug resistance-associated protein 1 (Mrp1) SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID FIBROBLAST-GROWTH-FACTOR; BLOOD-BRAIN-BARRIER; P-GLYCOPROTEIN EXPRESSION; UNCONJUGATED BILIRUBIN; OXIDATIVE STRESS; CHOROID-PLEXUS; ENDOTHELIAL-CELLS; MICROGLIAL CELLS; GOLGI-APPARATUS; RAT ASTROCYTES AB Unconjugated bilirubin (UCB) causes encephalopathy in severely jaundiced neonates by damaging astrocytes and neurons. Astrocytes, which help defend the brain against cytotoxic insults, express the ATP-dependent transporter, multidrug resistance-associated protein 1 (Mrp1), which mediates export of organic anions, probably including UCB. We therefore studied whether exposure to UCB affects the expression and intracellular localization of Mrp1 in cultured mouse astroglial cells (>95% astrocytes). Mrp1 was localized and quantitated by confocal laser scanning microscopy and double immunofluorescence labeling by using specific antibodies against Mrp1 and the astrocyte marker glial fibrillary acidic protein, plus the Golgi marker wheat germ agglutinin (WGA). In unexposed astrocytes, Mrp1 colocalized with WGA in the Golgi apparatus. Exposure to UCB at a low unbound concentration (B-f) of 40 nM caused rapid redistribution of Mrp1 from the Golgi throughout the cytoplasm to the plasma membrane, with a peak 5-fold increase in Mrp1 immunofluorescence intensity from 30 to 120 min. Bf above aqueous saturation produced a similar but aborted response. Exposure to this higher Bf for 16 h markedly decreased Trypan blue exclusion and methylthiazoletetrazoilum activity and increased apoptosis 5-fold by terminal deoxynucleotidyltrans-ferase-mediated dUTP nick end labeling assay. These toxic effects were modestly increased by inhibition of Mrp1 activity with 3-([3-(2-[7-chloro-2-quinolinyl]ethenyl)phenyl-(3-dimethylamino-3-oxopropyl)-thio-methyl]thio)propanoic acid (MK571). By contrast, B-f = 40 nM caused injury only if Mrp1 activity was inhibited by MK571, which also blocked translocation of Mrp1. Our conclusion is that in astrocytes, UCB up-regulates expression of Mrp1 and promotes its trafficking from the Golgi to the plasma membrane, thus moderating cytotoxicity from UCB, presumably by limiting its intracellular accumulation. C1 OASI Inst Res & Care Mental Retardat & Brain Agin, Neuropharmacol Sect, I-94010 Troina, Italy. Univ Trieste, Dept Biochem, I-34127 Trieste, Italy. Univ Trieste, Liver Res Ctr, I-34127 Trieste, Italy. Univ Washington, Sch Med, Dept Med, Div Gastroenterol Hepatol, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Res Serv 151L, Seattle, WA 98108 USA. Univ Sassari, Fac Med, Dept Pharmacol, I-07100 Sassari, Italy. RP Marchetti, B (reprint author), OASI Inst Res & Care Mental Retardat & Brain Agin, Neuropharmacol Sect, I-94010 Troina, Italy. EM bianca.marchetti@oasi.en.it RI Tirolo, Cataldo/C-9929-2017; Caniglia, Salvatore/D-1001-2017; Morale, Maria Concetta/D-5847-2017; Nunzio, Testa/D-8023-2017 OI Tirolo, Cataldo/0000-0003-1747-8134; Caniglia, Salvatore/0000-0003-1238-6193; Morale, Maria Concetta/0000-0003-0624-7234; Nunzio, Testa/0000-0002-4024-2325; Marchetti, Bianca/0000-0002-9287-8448; L'Episcopo, Francesca/0000-0003-3292-9677 NR 47 TC 94 Z9 96 U1 0 U2 7 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD FEB 24 PY 2004 VL 101 IS 8 BP 2470 EP 2475 DI 10.1073/pnas.0308452100 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 802CA UT WOS:000220140400044 PM 14983033 ER PT J AU Dobie, DJ Kivlahan, DR Maynard, C Bush, KR Davis, TM Bradley, KA AF Dobie, DJ Kivlahan, DR Maynard, C Bush, KR Davis, TM Bradley, KA TI Posttraumatic stress disorder in female veterans - Association with self-reported health problems and functional impairment SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID QUALITY-OF-LIFE; MALE VIETNAM VETERANS; PTSD CHECKLIST; PRIMARY-CARE; SCREENING INSTRUMENT; SEXUAL VICTIMIZATION; TRAUMATIC EVENTS; AFFAIRS PATIENTS; BREAST-CANCER; DESERT-STORM AB Background: The purpose of this report is to identify self-reported health problems and functional impairment associated with screening positive for posttraumatic stress disorder (PTSD) in women seen for care at a Department of Veterans Affairs (VA) medical center. Methods: A survey was mailed to all women (N = 1935) who received care at the VA Puget Sound Health Care System between October 1996 and January 1998. The survey inquired about health history and habits. It included the PTSD Checklist-Civilian Version (PCL-C) and validated screening measures for other psychiatric disorders. The veteran's version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36-V) was included to assess health-related quality of life. Results: Of the 1259 eligible women who completed the survey, 266 women (21%) screened positive for current PTSD (PCL-C score greater than or equal to50). In age-adjusted bivariate analyses, women who screened positive for PTSD reported more psychiatric problems, substance abuse, and lifetime exposure to domestic violence. They were significantly more likely to endorse physical health problems including obesity, smoking, irritable bowel syndrome, fibromyalgia, chronic pelvic pain, polycystic ovary disease, asthma, cervical cancer, and stroke. In fully adjusted multivariate models, a PCL-C score of 50 or greater was independently associated with scoring in the lowest quartile on SF-36-V subscales and composite scales. Conclusions: Symptoms of PTSD are common in women treated at VA facilities. In addition, PTSD is associated with self-reported mental and physical health problems and poor health-related quality of life in these patients. These findings have implications for the design of VA primary care services for the growing population of female veterans. C1 Univ Washington, Sch Med, Dept Psychiat, Seattle, WA USA. Univ Washington, Sch Med, Dept Behav Sci, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA USA. Hlth Serv Res & Dev, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Dobie, DJ (reprint author), S-116 VA PSHCS,1660 S Columbian Way, Seattle, WA 98108 USA. EM djdobie@u.washington.edu RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 NR 60 TC 183 Z9 188 U1 5 U2 17 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD FEB 23 PY 2004 VL 164 IS 4 BP 394 EP 400 DI 10.1001/archinte.164.4.394 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 776ZE UT WOS:000189148600006 PM 14980990 ER PT J AU Niquet, J Allen, SG Baldwin, RA Wasterlain, CG AF Niquet, J Allen, SG Baldwin, RA Wasterlain, CG TI Evidence of caspase-3 activation in hyposmotic stress-induced necrosis SO NEUROSCIENCE LETTERS LA English DT Article DE dentate gyrus culture; electron microscopy; immunocytochemistry ID TRANSIENT CEREBRAL-ISCHEMIA; CELL-DEATH; APOPTOTIC NEURODEGENERATION; BRAIN; HIPPOCAMPUS; NEURONS AB Primary culture of dentate gyrus was submitted to a hyposmotic stress that induces a rapid cell death that is necrosis morphologically. Surprisingly, we observed a rapid and dramatic upregulation of the active form of caspase-3 (caspase-3(a)) in both neurons and glial cells. Caspase-3(a) immunoreactivity appears as early as 1 min after hyposmotic treatment, when some neurons are still alive, suggesting that caspase-3a may contribute to further necrotic cell death. (C) 2003 Elsevier Ireland Ltd. All rights reserved. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. RP Niquet, J (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jniquet@ucla.edu FU NINDS NIH HHS [NS13515] NR 12 TC 11 Z9 12 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0304-3940 J9 NEUROSCI LETT JI Neurosci. Lett. PD FEB 19 PY 2004 VL 356 IS 3 BP 225 EP 227 DI 10.1016/j.neulet.2003.11.063 PG 3 WC Neurosciences SC Neurosciences & Neurology GA 774DX UT WOS:000188965400018 PM 15036635 ER PT J AU Luoh, SW Venkatesan, N Tripathi, R AF Luoh, SW Venkatesan, N Tripathi, R TI Overexpression of the amplified Pip4k2 beta gene from 17q11-12 in breast cancer cells confers proliferation advantage SO ONCOGENE LA English DT Article DE tumor biology; breast cancer; gene amplification; gene expression; HER-2/Neu ID IN-SITU HYBRIDIZATION; PHOSPHATIDYLINOSITOL PHOSPHATE KINASES; GROWTH-FACTOR RECEPTOR; HER-2/NEU GENE; N-MYC; INOSITIDE PHOSPHORYLATION; AMPLIFICATION STATUS; 11Q13 AMPLIFICATION; PUTATIVE ONCOGENE; PROGNOSTIC-FACTOR AB Gene amplification is common in solid tumors and is associated with adverse prognosis, disease progression, and development of drug resistance. A small segment from chromosome 17q11-12 containing the HER-2/Neu gene is amplified in about 25% of breast cancer. HER-2/Neu amplification is associated with adverse prognosis and may predict response to chemotherapy and hormonal manipulation. Moreover, HER-2/Neu amplification may select patients for anti-HER-2/Neu-based therapy with Herceptin. We and others recently described a common sequence element from the HER-2/Neu region that was amplified in breast cancer cells. In addition, most, if not all, of the amplified genes from this region display overexpression. This raises the intriguing possibility that genes immediately adjacent to HER-2/Neu may influence the biological behavior of breast cancer carrying HER-2/ Neu amplification and serve as rational targets for therapy. By extracting sequence information from public databases, we have constructed a contig in bacterial artificial chromosomes (BACs) that extends from HER-2/ Neu to a phosphotidylinositol phosphate kinase (PIPK), Pip4k2beta from 17q11 - 12. Although a role of PI-3-kinase and AKT in cancer biology has been previously described, PIPK has not been previously implicated. We show that Pip4k2b, initially known as Pip5k2beta, is amplified in a subset of breast cancer cell lines and primary breast cancer samples that carry HER-2/ Neu amplification. Out of eight breast cancer cell lines with HER-2/ Neu amplification, three have concomitant amplification of the Pip4k2beta gene - UACC-812, BT-474 and ZR-75-30. Similarly, two out of four primary breast tumors with HER-2/ Neu amplification carry Pip4k2b gene amplification. Intriguingly, one tumor displays an increase in the gene copy number of Pip4k2b that is significantly more than that of HER-2/ Neu. Moreover, dual color FISH reveals that amplified Pip4k2b gene may exist in a distinct structure from that of HER-2/ Neu in ZR-75-30 cell line. These studies suggest that Pip4k2b may reside on an amplification maximum distinct from that of HER-2/Neu and serve as an independent target for amplification and selective retention. Pip4k2beta amplification is associated with overexpression at the RNA and protein level in breast cancer cell lines. Stable expression of Pip4k2b in breast cancer cell lines with and without HER-2/Neu amplification increases cell proliferation and anchorage-independent growth. The above observations implicate Pip4k2b in the development and/or progression of breast cancer. Our study suggests that Pip4k2b may be a distinct target for gene amplification and selective retention from 17q11-12. C1 Univ Calif Los Angeles, Med Ctr, Dept Med, Div Hematol & Oncol, Los Angeles, CA 90095 USA. Cincinnati Vet Affairs Med Ctr, Cincinnati, OH 45220 USA. Univ Cincinnati, Coll Med, Dept Med, Div Hematol & Oncol, Cincinnati, OH 45267 USA. RP Luoh, SW (reprint author), Oregon Hlth Sci Univ, Portland VA Med Ctr, RAD 47,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. NR 67 TC 29 Z9 29 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0950-9232 J9 ONCOGENE JI Oncogene PD FEB 19 PY 2004 VL 23 IS 7 BP 1354 EP 1363 DI 10.1038/sj.onc.1207251 PG 10 WC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity GA 775HZ UT WOS:000189035800003 PM 14691457 ER PT J AU Fihn, SD McDonell, MB Diehr, P Anderson, SM Bradley, KA Au, DH Spertus, JA Burman, M Reiber, GE Kiefe, CI Cody, M Sanders, KM Whooley, MA Rosenfeld, K Baczek, LA Sauvigne, A AF Fihn, SD McDonell, MB Diehr, P Anderson, SM Bradley, KA Au, DH Spertus, JA Burman, M Reiber, GE Kiefe, CI Cody, M Sanders, KM Whooley, MA Rosenfeld, K Baczek, LA Sauvigne, A TI Effects of sustained audit/feedback on self-reported health status of primary care patients SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; CONTINUING MEDICAL-EDUCATION; CORONARY-ARTERY DISEASE; QUALITY-OF-LIFE; PHYSICIAN PERFORMANCE; PRACTICE GUIDELINES; PROBLEM DRINKING; QUESTIONNAIRE; DATABASES; FEEDBACK AB PURPOSE: Because limited audit/feedback of health status information has yielded mixed results, we evaluated the effects of a sustained program of audit/feedback on patient health and satisfaction. METHODS: We conducted a group-randomized effectiveness trial in which firms within Veterans Administration general internal medicine clinics served as units of randomization, intervention, and analysis. Respondents to a baseline health inventory were regularly mailed the 36-Item Short Form (SF-36) and, as relevant, questionnaires about six chronic conditions (ischemic heart disease, diabetes, chronic obstructive pulmonary disease, depression, alcohol use, and hypertension) and satisfaction with care. Data were reported to primary providers at individual patient visits and in aggregate during a 2-year period. RESULTS: Baseline forms were mailed to 34,050 patients; of the 22,413 respondents, 15,346 completed and returned follow-up surveys. Over the 2-year study, the difference between intervention and control groups (as measured by difference in average slope) was -0.26 (95% confidence interval [CI]: -0.79 to 0.27; P = 0.28) for the SF-36 Physical Component Summary score and -0.53 (95% CI: -1.09 to 0.03; P = 0.06) for the SF-36 Mental Component Summary score. No significant differences emerged after adjusting for deaths. There were no significant differences in condition -specific measures or satisfaction between groups after adjustment for provider type, panel size, and number of intervention visits, or after analysis of patients who completed all forms. CONCLUSION: An elaborate, sustained audit/feedback program of general and condition-specific measures of health/satisfaction did not improve outcomes. To be effective, such data probably should be incorporated into a comprehensive chronic disease management program. (C) 2004 by Excerpta Medica Inc. C1 NW Hlth Serv Res & Dev Ctr Excellence, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Missouri, Sch Med, Kansas City, MO 64110 USA. Dept Vet Affairs Med Ctr, Birmingham, AL USA. Dept Vet Affairs Med Ctr, Little Rock, AR USA. Dept Vet Affairs Med Ctr, Richmond, VA USA. Dept Vet Affairs Med Ctr, San Francisco, CA USA. Dept Vet Affairs Med Ctr, Los Angeles, CA USA. Dept Vet Affairs Med Ctr, White River Jct, VT USA. RP Fihn, SD (reprint author), NW Hlth Serv Res & Dev Ctr Excellence, VA Puget Sound Hlth Care Syst, 152,1660 S Columbian Way, Seattle, WA 98108 USA. EM sfihn@u.washington.edu NR 44 TC 56 Z9 57 U1 5 U2 6 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD FEB 15 PY 2004 VL 116 IS 4 BP 241 EP 248 DI 10.1016/j.amjmed.2003.10.026 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 774UH UT WOS:000189003300005 PM 14969652 ER PT J AU Chen, XL Liang, HY Van Remmen, H Vijg, J Richardson, A AF Chen, XL Liang, HY Van Remmen, H Vijg, J Richardson, A TI Catalase transgenic mice: characterization and sensitivity to oxidative stress SO ARCHIVES OF BIOCHEMISTRY AND BIOPHYSICS LA English DT Article DE catalase; transgenic mice; oxidative stress; antioxidant enzymes ID ZINC-SUPEROXIDE-DISMUTASE; NF-KAPPA-B; NECROSIS-FACTOR-ALPHA; HYDROGEN-PEROXIDE; GLUTATHIONE-PEROXIDASE; ACATALASEMIC MICE; INDUCED APOPTOSIS; SMALL-INTESTINE; MOUSE-LIVER; CELLS AB The role of catalase in the antioxidant defense system was studied using transgenic mice [Tg(CAT)] harboring a human genomic clone containing the entire human CAT gene. Catalase activity was 2-fold higher in the tissues of hemizygous [Tg(CAT)(+/o)] mice and 3- to 4-fold higher in the tissues of homozygous [Tg(CAT)(+/+)] mice compared to wild type mice. The human CAT transgene was expressed in a tissue-specific pattern that was similar to the endogenous catalase gene. The levels of other major antioxidant enzymes were not altered in the tissues of the transgenic mice. Hepatocytes and fibroblasts from the Tg(CA T)(+/+) mice were more resistant to hydrogen peroxide-induced cell death but were more sensitive to paraquat and TNFalpha toxicity. Fibroblasts from the Tg(CA T)(+/+) mice showed reduced growth rate in culture without treatment and reduced colony-forming capability after gamma-irradiation compared to fibroblasts from wild type mice. In addition, the Tg(CAT)(+/+) animals were more sensitive to gamma-irradiation. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev & Aging Studies, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Res Serv, San Antonio, TX 78284 USA. RP Richardson, A (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM richardsona@uthscsa.edu RI Liang, Hanyu/A-1066-2010 FU NIA NIH HHS [P01 AG14674, P03 AG13319, P01 AG020591] NR 73 TC 47 Z9 52 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-9861 J9 ARCH BIOCHEM BIOPHYS JI Arch. Biochem. Biophys. PD FEB 15 PY 2004 VL 422 IS 2 BP 197 EP 210 DI 10.1016/j.abb.2003.12.023 PG 14 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 771NE UT WOS:000188791600011 PM 14759608 ER PT J AU Tuxworth, WJ Saghir, AN Spruill, LS Menick, DR McDermott, PJ AF Tuxworth, WJ Saghir, AN Spruill, LS Menick, DR McDermott, PJ TI Regulation of protein synthesis by eIF4E phosphorylation in adult cardiocytes: the consequence of secondary structure in the 5 '-untranslated region of mRNA SO BIOCHEMICAL JOURNAL LA English DT Article DE cardiocyte; eIF4E (eukaryotic initiation factor 4E); hypertrophy; Mnk1 (MAP kinase signal-integrating kinase 1); protein synthesis; translation ID INITIATION-FACTOR 4E; CAP-BINDING PROTEIN; NA+-CA2+ EXCHANGER GENE; TRANSLATION INITIATION; CARDIAC-HYPERTROPHY; FELINE CARDIOCYTES; SYNTHESIS RATES; FACTOR EIF-4E; KINASE MNK1; FACTOR 4G AB In adult cardiocytes. eIF4E (eukaryotic initiation factor 4E) activity and protein synthesis are increased concomitantly in response to stimuli that induce hypertrophic growth. We tested the hypothesis that increases in eIF4E activity selectively improve the translational efficiency of mRNAs that have an excessive amount of secondary structure in the 5'-UTR (5'-untranslated region). The activity of eIF4E was modified in primary cultures of adult cardiocytes using adenoviral gene transfer to increase either the amount of eIF4E or the extent of endogenous eIF4E phosphorylation. Subsequently, the effects of eIF4E on translational efficiency were assayed following adenoviral-mediated expression of luciferase reporter mRNAs that were either 'stronger' (less structure in the 5'-UTR) or 'weaker' (more structure in the 5'-UTR) with respect to translational efficiency. The insertion of G + C-rich repeats into the 5'-UTR doubled the predicted amount of secondary structure and was sufficient to reduce translational efficiency of the reporter mRNA by 48 +/- 13 %. Translational efficiency of the weaker reporter mRNA was not significantly improved by overexpression of wild-type eIF4E when compared with the stronger reporter mRNA. In contrast, overexpression of the eIF4E kinase Mnk1 [MAP (mitogen-activated protein) kinase signal-integrating kinase 1] was sufficient to increase the translational efficiency of either reporter mRNA, independent of the amount of secondary structure in their respective 5'-UTRs. The increases in translational efficiency produced by Mnk1 occurred in association with corresponding decreases in mRNA levels. These findings indicate that the positive effect of eIF4E phosphorylation on translational efficiency in adult cardiocytes is coupled with the stability of mRNA. C1 Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Charleston, SC 29403 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29403 USA. RP McDermott, PJ (reprint author), Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Strom Thurmond Biomed Res Bldg,Room 303,114 Dough, Charleston, SC 29403 USA. EM mcdermp@musc.edu FU NHLBI NIH HHS [P01 HL-48788] NR 50 TC 25 Z9 26 U1 0 U2 0 PU PORTLAND PRESS PI LONDON PA 59 PORTLAND PLACE, LONDON W1N 3AJ, ENGLAND SN 0264-6021 J9 BIOCHEM J JI Biochem. J. PD FEB 15 PY 2004 VL 378 BP 73 EP 82 DI 10.1042/BJ20031027 PN 1 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 779JB UT WOS:000189290600009 PM 14629199 ER PT J AU Lacerda, ALT Keshavan, MS Hardan, AY Yorbik, O Brambilla, P Sassi, RB Nicoletti, M Mallinger, AG Frank, E Kupfer, DJ Soares, JC AF Lacerda, ALT Keshavan, MS Hardan, AY Yorbik, O Brambilla, P Sassi, RB Nicoletti, M Mallinger, AG Frank, E Kupfer, DJ Soares, JC TI Anatomic evaluation of the orbitofrontal cortex in major depressive disorder SO BIOLOGICAL PSYCHIATRY LA English DT Article DE neuroimaging; magnetic resonance imaging; unipolar depression; prefrontal cortex; orbital frontal cortex; OFC ID SUBGENUAL PREFRONTAL CORTEX; POSITRON-EMISSION-TOMOGRAPHY; CEREBRAL-BLOOD-FLOW; MOOD DISORDERS; GENDER DIFFERENCES; FRONTAL-LOBE; FUNCTIONAL NEUROANATOMY; UNIPOLAR DEPRESSION; PARKINSONS-DISEASE; ONSET DEPRESSION AB Background: The orbitofrontal cortex (OFC) plays a major role in neuropsychologic functioning including exteroceptive and interoceptive information coding, reward-guided behavior, impulse control, and mood regulation, This study examined the OFC and its subdivisions in patients with MDD and matched healthy control subjects. Methods. Magnetic resonance imaging (MRI) was performed on 31 unmedicated MDD and 34 control subjects matched for age, gender, and race. Gray matter volumes of the OFC and its lateral and medial subdivisions were measured blindly. Results: The MDD patients had smaller gray matter volumes in tight medial [two-way analysis of covariance F(1, 60) = 4.285; p = .043] and left lateral OFC [F (1, 60) = 4.252; p = .044]. Left lateral OFC volume correlated negatively with age in patients but not in control subjects. Male, but not female patients exhibited smaller left and right medial OFC volumes compared with healthy control subjects of the same gender. Conclusions: These findings suggest that patients with MDD have reduced OFC gray matter volumes. Although this reduction might be important in understanding the pathophysiology of MDD, its functional and psychopathologic consequences are as yet unclear. Future studies examining the relationship between specific symptomatic dimensions of MDD and OFC volumes could be especially informative. C1 Univ Texas, Hlth Sci Ctr, Div Mood & Anxiety Disorders, Dept Psychiat, San Antonio, TX 78229 USA. Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Sch Med, Pittsburgh, PA 15260 USA. State Univ Campinas, Sch Med Sci, Dept Med Psychol & Psychiat, Campinas, Brazil. GATA, Child & Adolescent Psychiat Dept, Ankara, Turkey. Univ Pavia, Sch Med, Dept Psychiat, I-27100 Pavia, Italy. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, BR-05508 Sao Paulo, Brazil. Univ Pittsburgh, Dept Pharmacol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Neurosci, Pittsburgh, PA 15260 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Div Mood & Anxiety Disorders, Dept Psychiat, MC 7792,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. RI Lacerda, Acioly/A-7052-2010; brambilla, paolo/B-4184-2010 OI Lacerda, Acioly/0000-0002-9370-0449; brambilla, paolo/0000-0002-4021-8456 FU NCRR NIH HHS [M01 RRR 00056]; NIMH NIH HHS [MH 30915, MH 01180, MH 01736, MH 45156, MH 45203, MH 64027] NR 73 TC 120 Z9 127 U1 8 U2 15 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD FEB 15 PY 2004 VL 55 IS 4 BP 353 EP 358 DI 10.1016/j.biopsych.2003.08.021 PG 6 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 774DP UT WOS:000188964700004 PM 14960287 ER PT J AU Beer, TM Garzotto, M Lowe, BA Ellis, WJ Montalto, MA Lange, PH Higano, CS AF Beer, TM Garzotto, M Lowe, BA Ellis, WJ Montalto, MA Lange, PH Higano, CS TI Phase I study of weekly mitoxantrone and docetaxel before prostatectomy in patients with high-risk localized prostate cancer SO CLINICAL CANCER RESEARCH LA English DT Article ID NEOADJUVANT HORMONAL-THERAPY; RADICAL PROSTATECTOMY; PELVIC LYMPHADENECTOMY; CONSECUTIVE PATIENTS; BREAST-CANCER; CHEMOTHERAPY; TRIAL; ESTRAMUSTINE; RECURRENCE; ANTIGEN AB Purpose: The purpose is to determine the dose-limiting toxicity (DLT) and maximum-tolerated dose (MTD) of mitoxantrone and docetaxel administered weekly before prostatectomy in men with localized prostate cancer at high risk for recurrence. Experimental Design: Twenty-two patients were treated with four cycles of docetaxel 35 mg/m(2) and increasing doses of mitoxantrone starting at 2 mg/m(2) repeated weekly for 3 weeks of a 4-week cycle before prostatectomy. The MTD was defined as that dose at which fewer than one-third of patients experienced a DLT (greater than or equal tograde 4 hematological or greater than or equal tograde 3 nonhematological toxicity). Changes in serum prostate-specific antigen and serum testosterone, and pathological outcome with surgery were secondary endpoints. Results: The MTD for mitoxantrone in combination with this dose of docetaxel was 4 mg/m(2). Neutropenia was the DLT for the combination. Ten of 12 patients treated at the MTD completed the planned 16 weeks of chemotherapy, whereas 2 discontinued therapy early because of toxicity. The median reduction in PSA was 41% (range, 4-88%). Serum testosterone levels remained constant postchemotherapy. Conclusions: In this patient population, the planned Phase II regimen is 4 mg/m(2) mitoxantrone and 35 mg/m(2) docetaxel weekly for 3 of every 4 weeks. Delivery of this regimen before prostatectomy is feasible with acceptable toxicity. Additional studies are needed to determine whether this combined modality approach will reduce cancer recurrence rates in this high-risk population. Because extent of disease and exposure to prior therapy may impact treatment tolerance these safety data may not be applicable to patients with advanced prostate cancer. C1 Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Urol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Univ Washington, Div Urol, Seattle, WA 98195 USA. Univ Washington, Div Oncol, Seattle, WA 98195 USA. RP Beer, TM (reprint author), Oregon Hlth & Sci Univ, Dept Med, Mail Code L586,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM beert@ohsu.edu FU NCRR NIH HHS [3M01RR00334-33S2] NR 26 TC 28 Z9 28 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD FEB 15 PY 2004 VL 10 IS 4 BP 1306 EP 1311 DI 10.1158/1078-0432.CCR-1021-03 PG 6 WC Oncology SC Oncology GA 776JE UT WOS:000189112200015 PM 14977829 ER PT J AU Torbeyns, A Marder, SR Carson, W Jody, D Kaplita, S Saba, A Stock, E AF Torbeyns, A Marder, SR Carson, W Jody, D Kaplita, S Saba, A Stock, E TI Glycemic control and plasma lipids in long-term treatment with aripiprazole SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 12th Biennial Winter Workshop on Schizophrenia CY FEB 07-13, 2004 CL DAVOS, SWITZERLAND C1 Bristol Myers Squibb Co, Waterloo, Belgium. Bristol Myers Squibb Co, Princeton, NJ 08543 USA. Bristol Myers Squibb Co, Wallingford, CT 06492 USA. W Los Angeles VA, Dept Psychiat, Los Angeles, CA USA. Otsuka Amer Pharmaceut Inc, Princeton, NJ USA. Otsuka Maryland Res Inst, Rockville, MD USA. EM anne.torbeyns@bms.com NR 0 TC 4 Z9 4 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD FEB 15 PY 2004 VL 67 IS 1 SU S BP 192 EP 193 PG 2 WC Psychiatry SC Psychiatry GA 771LW UT WOS:000188788100461 ER PT J AU Sundararaj, KP Wood, RE Ponnusamy, S Salas, AM Szulc, Z Bielawska, A Obeid, LM Hannun, YA Ogretmen, B AF Sundararaj, KP Wood, RE Ponnusamy, S Salas, AM Szulc, Z Bielawska, A Obeid, LM Hannun, YA Ogretmen, B TI Rapid shortening of telomere length in response to ceramide involves the inhibition of telomere binding activity of nuclear glyceraldehyde-3-phosphate dehydrogenase SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID HUNTINGTONS-DISEASE FIBROBLASTS; LUNG ADENOCARCINOMA CELLS; CANCER CELLS; PROTEIN; END; RNA; SEQUENCE; POT1; GENE; EXPRESSION AB Ceramide has been demonstrated as one of the upstream regulators of telomerase activity. However, the role for ceramide in the control of telomere length remains unknown. It is shown here that treatment of the A549 human lung adenocarcinoma cells with C-6-ceramide results in rapid shortening of telomere length. During the examination of ceramide-regulated telomere-binding proteins, nuclear glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was identified to associate with both single- and double-stranded telomeric DNA with high specificity in vitro. The association of nuclear GAPDH with telomeres in interphase nuclei was also demonstrated by co-fluorescence in situ hybridization and chromatin immunoprecipitation analysis. Further data demonstrated that the nuclear localization of GAPDH is regulated by ceramide in a cell cycle-dependent manner parallel with the inhibition of its telomere binding activity in response to ceramide. In addition, the results revealed that nuclear GAPDH is distinct from its cytoplasmic isoform and that telomere binding function of nuclear GAPDH is strikingly higher than the cytoplasmic isoform. More importantly, the functional role for nuclear GAPDH in the maintenance and/or protection of telomeric DNA was identified by partial inhibition of the expression of GAPDH using small interfering RNA, which resulted in rapid shortening of telomeres. In contrast, overexpression of nuclear GAPDH resulted in the protection of telomeric DNA in response to exogenous ceramide as well as in response to anticancer drugs, which have been shown to induce endogenous ceramide levels. Therefore, these results demonstrate a novel function for nuclear GAPDH in the maintenance and/or protection of telomeres and also show that mechanisms of the rapid degradation of telomeres in response to ceramide involve the inhibition of the telomere binding activity of nuclear GAPDH. C1 Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Ogretmen, B (reprint author), Med Univ S Carolina, Dept Biochem & Mol Biol, 173 Ashley Ave,BSB-518E, Charleston, SC 29425 USA. EM ogretmen@musc.edu OI obeid, lina/0000-0002-0734-0847 FU NCI NIH HHS [CA88932, P01 CA097132]; NIA NIH HHS [AG16583] NR 49 TC 78 Z9 86 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD FEB 13 PY 2004 VL 279 IS 7 BP 6152 EP 6162 DI 10.1074/jbc.M310549200 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 771GD UT WOS:000188776500131 PM 14630908 ER PT J AU Ben-Zeev, O Doolittle, MH AF Ben-Zeev, O Doolittle, MH TI Maturation of hepatic lipase - Formation of functional enzyme in the endoplasmic reticulum is the rate-limiting step in its secretion SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID PANCREATIC TRIGLYCERIDE LIPASE; LIPOPROTEIN-LIPASE; QUALITY-CONTROL; GENE FAMILY; MISFOLDED GLYCOPROTEINS; LINKED GLYCOSYLATION; CHAPERONE CALNEXIN; CATALYTIC-ACTIVITY; GOLGI COMPARTMENT; INSECT CELLS AB Among three lipases in the lipase gene family, hepatic lipase (HL), lipoprotein lipase, and pancreatic lipase, HL exhibits the lowest intracellular specific activity (i.e. minimal amounts of catalytic activity accompanied by massive amounts of inactive lipase mass in the endoplasmic reticulum ( ER)). In addition, HL has a distinctive sedimentation profile, where the inactive mass overlaps the region containing active dimeric HL and trails into progressively larger molecular forms. Eventually, at least half of the HL inactive mass in the ER reaches an active, dimeric conformation (t(1/2) = 2 h) and is rapidly secreted. The remaining inactive mass is degraded. HL maturation occurs in the ER and is strongly dependent on binding to calnexin in the early co-/post-translational stages. Later stages of HL maturation occur without calnexin assistance, although inactive HL at all stages appears to be associated in distinct complexes with other ER proteins. Thus, unlike other lipases in the gene family, HL maturation is the rate-limiting step in its secretion as a functional enzyme. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. RP Doolittle, MH (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 113,Rm 312, Los Angeles, CA 90073 USA. EM markdool@ucla.edu FU NHLBI NIH HHS [HL28481] NR 57 TC 16 Z9 16 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD FEB 13 PY 2004 VL 279 IS 7 BP 6171 EP 6181 DI 10.1074/jbc.M310051200 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 771GD UT WOS:000188776500133 PM 14630921 ER PT J AU Yan, LL Liu, K Daviglus, ML Matthews, KA Kiefe, CI AF Yan, LL Liu, K Daviglus, ML Matthews, KA Kiefe, CI TI Hostility and impatience as risk factors for hypertension - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID BLOOD-PRESSURE; CARDIA C1 Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. Univ Alabama, Div Prevent Med, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Yan, LL (reprint author), Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA. EM lijing@northwestern.edu NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 11 PY 2004 VL 291 IS 6 BP 692 EP 692 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 772AY UT WOS:000188819200014 ER PT J AU Fabian, TJ Amico, JA Kroboth, PD Mulsant, BH Corey, SE Begley, AE Bensasi, SG Weber, E Dew, MA Reynolds, CF Pollock, BG AF Fabian, TJ Amico, JA Kroboth, PD Mulsant, BH Corey, SE Begley, AE Bensasi, SG Weber, E Dew, MA Reynolds, CF Pollock, BG TI Paroxetine-induced hyponatremia in older adults - A 12-week prospective study SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 42nd Annual Meeting of the New-Clinical-Drug-Evaluation-Unit CY JUN 10-13, 2002 CL BOCA RATON, FLORIDA SP NIMH ID SEROTONIN-REUPTAKE INHIBITORS; ANTIDIURETIC-HORMONE SECRETION; ARGININE VASOPRESSIN; IDIOPATHIC HYPONATREMIA; ELDERLY-PEOPLE; RATING-SCALE; RISK-FACTORS; DEPRESSION; PLASMA; FLUOXETINE AB Background: Older depressed patients are at high risk for development of hyponatremia after initiation of the selective serotonin reuptake inhibitor paroxetine, despite clinical monitoring and preventive management. The purposes of this study were to determine the incidence and etiology of paroxetine-induced hyponatremia in older patients and to identify patient characteristics that may account for variability in susceptibility to this adverse event. Methods: This prospective, longitudinal study was conducted in a university-based ambulatory psychiatric research clinic from August 1999 through September 2001. Patients included 75 men and women aged 63 through 90 years (mean +/- SD age, 75.3 +/- 6.0 years) who received a diagnosis of a current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, major depressive episode and were prescribed paroxetine. We monitored plasma sodium levels before initiating paroxetine therapy and after 1, 2, 4, 6, and 12 weeks of treatment. In a subset of individuals, we measured levels of antidiuretic hormone, glucose, serum urea nitrogen, and creatinine. Hyponatremia was defined as a plasma sodium level of less than 135 mEq/L after initiation of paroxetine therapy. Results: Hyponatremia developed in 9 (12%) of the 75 patients after initiation of paroxetine treatment. Mean SD time to development of hyponatremia was 9.3 +/- 4.7 days (median, 9 days; range, 1-14 days; n=8). In the multivariate regression, lower body mass index and lower baseline plasma sodium level (<138 mEq/L) were significant risk factors for the development of hyponatremia in these patients. Conclusions: Hyponatremia is an underrecognized and potentially serious complication of paroxetine treatment in older patients. Our results provide a foundation for understanding the etiology and risk factors associated with paroxetine-induced hyponatremia. C1 Univ Pittsburgh, Dept Pharmaceut Sci, Sch Pharm, Intervent Res Ctr Late Life Mood Disorders, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA 15261 USA. Vet Affairs Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Fabian, TJ (reprint author), Univ Pittsburgh, Dept Pharmaceut Sci, Sch Pharm, Intervent Res Ctr Late Life Mood Disorders, 806 Salk Hall, Pittsburgh, PA 15261 USA. EM fabiant@msx.upmc.edu RI chen, xuanlan/H-4158-2011 FU NIA NIH HHS [AG05133]; NIMH NIH HHS [MH01613, MH0295, MH19986, MH37869, MH43832, MH52247, MH55756, MH65416] NR 38 TC 61 Z9 63 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD FEB 9 PY 2004 VL 164 IS 3 BP 327 EP 332 DI 10.1001/archinte.164.3.327 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 771JQ UT WOS:000188782200016 PM 14769630 ER PT J AU Cao, Q Mak, KM Ren, CL Lieber, CS AF Cao, Q Mak, KM Ren, CL Lieber, CS TI Leptin stimulates tissue inhibitor of metalloproteinase-1 in human hepatic stellate cells - Respective roles of the JAK/STAT and JAK-mediated H2O2-dependent MAPK pathways SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID ACTIVATED PROTEIN-KINASE; TRANSFORMING GROWTH-FACTOR-BETA-1; EXTRACELLULAR-MATRIX; SIGNAL-TRANSDUCTION; ALCOHOLIC CIRRHOSIS; ENDOTHELIAL-CELLS; GENE-EXPRESSION; LIVER FIBROSIS; MESSENGER-RNA; SERUM LEPTIN AB Leptin is recognized as a profibrogenic hormone in the liver, but the mechanisms involved have not been clarified. The tissue inhibitor of metalloproteinase (TIMP)-1, which acts through inhibition of collagen degradation, is synthesized by activated hepatic stellate cells (HSC) in response to fibrogenic substances. The capacity of leptin to induce TIMP-1 and its signaling molecules were investigated in a human HSC cell line, LX-2. Leptin stimulated TIMP-1 protein, mRNA, and promoter activity. JAK1 and -2, as well as STAT3 and -5, were activated. After leptin, there was increased expression of tyrosine 1141-phosphorylated leptin receptor, which may contribute to STAT3 activation. AG 490, a JAK inhibitor, blocked JAK phosphorylation with concomitant inhibition of STAT activation, TIMP-1 mRNA expression, and promoter activity. Leptin also induced an oxidative stress, which was inhibited by AG 490, indicating a JAK mediation process. ERK1/2 MAPK and p38 were activated, which was prevented by catalase, indicating an H2O2-dependent mechanism. Catalase treatment resulted in total suppression of TIMP-1 mRNA expression and promoter activity. SB203580, a p38 inhibitor, prevented p38 activation and reduced TIMP-1 message half-life with down-regulation of TIMP-1 mRNA. These changes were reproduced by overexpression of the dominant negative p38alpha and p38beta mutants. PD098059, an ERK1/2 inhibitor, opposed ERK1/2 activation and TIMP-1 promoter activity, leading to TIMP-1 mRNA down-regulation. Thus, leptin has a direct action on liver fibrogenesis by stimulating TIMP-1 production in activated HSC. This process appears to be mediated by the JAK/STAT pathway via the leptin receptor long form and the H2O2-dependent p38 and ERK1/2 pathways via activated JAK. C1 Bronx Vet Affairs Med Ctr, Alcohol & Nutr Res Ctr, Bronx, NY 10468 USA. Mt Sinai Sch Med, Bronx, NY 10468 USA. RP Lieber, CS (reprint author), Bronx Vet Affairs Med Ctr, Alcohol & Nutr Res Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM liebercs@aol.com FU NIAAA NIH HHS [AA11115, R01 AA012867] NR 64 TC 112 Z9 128 U1 0 U2 6 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD FEB 6 PY 2004 VL 279 IS 6 BP 4292 EP 4304 DI 10.1074/jbc.M308351200 PG 13 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 768UW UT WOS:000188554300047 PM 14625304 ER PT J AU Hilliard, AA Weinberger, SE Tierney, LM Midthun, DE Saint, S AF Hilliard, AA Weinberger, SE Tierney, LM Midthun, DE Saint, S TI Occam's razor versus Saint's Triad SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material C1 Mayo Clin & Mayo Fdn, Dept Med, Rochester, MN 55905 USA. Mayo Clin & Mayo Fdn, Div Pulm & Crit Care Med, Rochester, MN 55905 USA. Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA. Harvard Univ, Sch Med, Boston, MA USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, Sch Med, San Francisco, CA USA. Ann Arbor Vet Affairs Hlth Serv Res & Dev Ctr Exc, Ann Arbor, MI USA. Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA. RP Saint, S (reprint author), Box 0429,300 NIB,Room 7E08, Ann Arbor, MI 48109 USA. EM saint@umich.edu FU AHRQ HHS [P20-HS11540] NR 5 TC 38 Z9 41 U1 0 U2 3 PU MASSACHUSETTS MEDICAL SOC/NEJM PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD FEB 5 PY 2004 VL 350 IS 6 BP 599 EP 603 DI 10.1056/NEJMcps031794 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 770FP UT WOS:000188712800013 PM 14762188 ER PT J AU Haas, JS Kaplan, CP Gerstenberger, EP Kerlikowske, K AF Haas, JS Kaplan, CP Gerstenberger, EP Kerlikowske, K TI Changes in the use of postmenopausal hormone therapy after the publication of clinical trial results SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID ESTROGEN REPLACEMENT THERAPY; CORONARY HEART-DISEASE; MYOCARDIAL-INFARCTION; PLUS PROGESTIN; UNITED-STATES; BREAST-CANCER; WOMEN; PREVENTION AB Background: The recent publication of clinical trial results has led to a dramatic shift in the evidence about postmenopausal hormone therapy. Objective: To examine whether the publication of clinical trial results, specifically the Heart and Estrogen/progestin Replacement Study (HERS) in 1998 and the Women's Health Initiative (WHI) in 2002, has influenced the use of hormone therapy among postmenopausal women. Design: Observational cohort (1997 to 2003). Setting: San Francisco Mammography Registry, San Francisco, California. Participants: Postmenopausal women between the ages of 50 and 74 years without a personal history of breast cancer who underwent mammography (151862 mammograms). Measurements: Self-reported current use of hormone therapy. Results: Among menopausal women who had mammography, it was estimated that 41% were currently using hormone therapy in 1997. Before the publication of HERS, the use of hormone therapy was increasing at a rate of 1% (95% Cl, 0% to 2%) per quarter. After the publication of HERS, use decreased by 1% (Cl, -3% to 0%) per quarter. In contrast, the publication of the WHI in 2002 was associated with a more substantial decline in the use of hormone therapy of 18% (Cl, -21% to -16%) per quarter. Similar associations were observed for most subgroups of women, including women older than 65 years of age; women with a previous hysterectomy; and women who described their race or ethnicity as white, African American, Latina, Chinese, or Filipina. Conclusions: The release of the HERS data was temporally associated with a modest decline in the use of hormone therapy. In contrast, the release of the principal findings from the WHI was associated with a more substantial decline in use by postmenopausal women. The reason for the differences in decline may relate to the fact that the WHI results were widely publicized or were more applicable to most postmenopausal women because the WHI study was performed in healthy women. C1 Brigham & Womens Hosp, Div Gen Med & Primary Care, Boston, MA 02120 USA. Harvard Univ, Sch Med, Boston, MA 02115 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. RP Haas, JS (reprint author), Brigham & Womens Hosp, Div Gen Med & Primary Care, 1620 Tremont St, Boston, MA 02120 USA. EM jhaas@partners.org FU NCI NIH HHS [U01CA63740] NR 16 TC 211 Z9 211 U1 1 U2 3 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD FEB 3 PY 2004 VL 140 IS 3 BP 184 EP 188 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 770BZ UT WOS:000188704500004 PM 14757616 ER PT J AU Doherty, MJ Bird, TD Leverenz, JB AF Doherty, MJ Bird, TD Leverenz, JB TI alpha-Synuclein in motor neuron disease: an immunohistologic study SO ACTA NEUROPATHOLOGICA LA English DT Article DE amyotrophic lateral sclerosis; alpha-Synuclein; Lewy body; immunohistochemistry ID AMYOTROPHIC-LATERAL-SCLEROSIS; SUPEROXIDE-DISMUTASE GENE; BRAIN IRON ACCUMULATION; MULTIPLE SYSTEM ATROPHY; BODY-LIKE INCLUSIONS; PARKINSONS-DISEASE; LEWY BODIES; DEMENTIA; NEURODEGENERATION; IMMUNOREACTIVITY AB alpha-Synuclein (ASN) has been implicated in neurodegenerative disorders characterized by Lewy body inclusions such as Parkinson's disease and dementia with Lewy bodies. Lewy body-like inclusions have also been observed in spinal neurons of patients with amyotrophic lateral sclerosis (ALS) and reports suggest possible ASN abnormalities in ALS patients. We assessed ASN immunoreactivity in spinal and brain tissues of subjects who had died of progressive motor neuron disorders (MND). Clinical records of subjects with MND and a comparison group were reviewed to determine the diagnosis according to El-Escariol Criteria of ALS. Cervical, thoracic and lumbar cord sections were stained with an antibody to ASN. A blinded, semiquantitative review of sections from both groups included examination for evidence of spheroids, neuronal staining, cytoplasmic inclusions, anterior horn granules, white and gray matter glial staining, corticospinal tract axonal fiber and myelin changes. MND cases, including ALS and progressive muscular atrophy, displayed significantly increased ASN staining of spheroids (Pless than or equal to0.001), and glial staining in gray and white matter (Pless than or equal to0.05). Significant abnormal staining of corticospinal axon tract fibers and myelin was also observed (Pless than or equal to0.05 and 0.01). Detection of possible ASN-positive neuronal inclusions did not differ between groups. Significant ASN abnormalities were observed in MND. These findings suggest a possible role for ASN in MND; however, the precise nature of this association is unclear. C1 VA Puget Sound Healthcare Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. VA Puget Sound Healthcare Syst, Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA 98108 USA. VA Puget Sound Healthcare Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med Genet & Med, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. RP Leverenz, JB (reprint author), VA Puget Sound Healthcare Syst, Mental Illness Res Educ & Clin Ctr, 116MIRECC,1660 S Columbian Way, Seattle, WA 98108 USA. EM leverenz@u.washington.edu NR 28 TC 21 Z9 21 U1 0 U2 0 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0001-6322 J9 ACTA NEUROPATHOL JI Acta Neuropathol. PD FEB PY 2004 VL 107 IS 2 BP 169 EP 175 DI 10.1007/s00401-003-0790-2 PG 7 WC Clinical Neurology; Neurosciences; Pathology SC Neurosciences & Neurology; Pathology GA 765UH UT WOS:000188301800011 PM 14648076 ER PT J AU Sureka, A Parada, JP Deloria-Knoll, M Chmiel, JS Phan, L Lyons, TM Ali, S Yarnold, PR Weinstein, RA DeHovitz, JA Jacobson, JM Goetz, MB Campo, RE Berland, D Bennett, CL Uphold, CR AF Sureka, A Parada, JP Deloria-Knoll, M Chmiel, JS Phan, L Lyons, TM Ali, S Yarnold, PR Weinstein, RA DeHovitz, JA Jacobson, JM Goetz, MB Campo, RE Berland, D Bennett, CL Uphold, CR TI HIV-related pneumonia care in older patients hospitalized in the early HAART era SO AIDS PATIENT CARE AND STDS LA English DT Article ID PNEUMOCYSTIS-CARINII-PNEUMONIA; ACTIVE ANTIRETROVIRAL THERAPY; ACQUIRED-IMMUNODEFICIENCY-SYNDROME; STAGE BREAST-CANCER; PULMONARY COMPLICATIONS; BACTERIAL PNEUMONIA; PROGNOSTIC-FACTORS; COLORECTAL-CANCER; INFECTION; AGE AB Age-related variations in care have been identified for HIV-associated Pneumocystis carinii pneumonia (PCP) in both the 1980s and 1990s. We evaluated if age-related variations affected all aspects of HIV-specific and non-HIV-specific care for HIV-infected individuals with PCP or community-acquired pneumonia (CAP), or whether age-related variations were primarily limited to HIV-specific aspects of care. Subjects were HIV-infected persons with PCP (n = 1855) or CAP (n = 1415) hospitalized in 8 cities from 1995 to 1997. Nine percent of our study patients had received protease inhibitors and 39% had received any type of antiretroviral therapy prior to hospitalization. Data were abstracted from medical records and included severity of illness, HIV-specific aspects of care ( initiation of PCP medications), general measures of care [ initiation of CAP medications, intubation, and intensive care units (ICU)], and inpatient mortality. Compared to younger patients, pneumonia patients 50 years of age or older were significantly more likely to: be severely ill (PCP, 20.4% vs. 10.4%; CAP, 27.5% vs. 14.9%; each p = 0.001), receive ICU care (PCP, 22.0% vs. 12.8%, p = 0.002; CAP: 15.1% vs. 9.4%; p = 0.02), and be intubated (PCP, 14.6% vs. 8.4%, p = 0.01; CAP, 9.9% vs. 5.6%, p = 0.03). Compared to younger patients, older patients (greater than or equal to50 years) had similar rates of timely medications for CAP (48.5% vs. 50.8%) but had lower rates of receiving anti-PCP medications (85.8% vs. 92.9%, p = 0.002). Differences by age in timely initiation of PCP medications, ICU use, and intubation were limited to the nonseverely ill patients. Older hospitalized patients were more likely to die (PCP, 18.3% vs. 10.4%; CAP, 13.4% vs. 8.5%; each p< 0.05). After adjustment for disease severity and timeliness of antibiotic use, mortality rates were similar for both age groups. Physicians should develop strategies that increase awareness of the possibility of HIV infection in older individuals. C1 VA Chicago Hlth Care Syst, Lakeside Div, Chicago, IL 60611 USA. Northwestern Univ, Sch Med, Buehler Ctr Aging, Chicago, IL USA. Loyola Univ, Stritch Sch Med, Maywood, IL 60153 USA. Edward Hines Jr Vet Adm Hosp, Midw Ctr Hlth Serv Res & Policy, Hines, IL 60141 USA. Northwestern Univ, Sch Med, Dept Prevent Med, Chicago, IL USA. Cook Cty Hosp, Dept Med, Chicago, IL 60612 USA. Rush Med Coll, Chicago, IL 60612 USA. SUNY Hlth Sci Ctr, Dept Med, Brooklyn, NY 11203 USA. Mt Sinai Med Ctr, AIDS Ctr, New York, NY 10029 USA. VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Miami, Sch Med, Div Infect Dis, Miami, FL USA. Sinai Hlth Syst, Dept Med, Chicago, IL USA. Malcolm Randall VA Med Ctr, Rehabil Outcomes Res Ctr, Gainesville, FL USA. RP Bennett, CL (reprint author), VA Chicago Hlth Care Syst, Lakeside Div, 400 E Ontario St,Suite 205, Chicago, IL 60611 USA. EM cbenne@nwu.edu RI Bennett, Charles/C-2050-2008; Andrade, Hugo/M-6631-2013 OI Andrade, Hugo/0000-0001-6781-6125; Goetz, Matthew/0000-0003-4542-992X FU NIDA NIH HHS [5R01DA10628-02] NR 29 TC 8 Z9 9 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1087-2914 J9 AIDS PATIENT CARE ST JI Aids Patient Care STDS PD FEB PY 2004 VL 18 IS 2 BP 99 EP 107 DI 10.1089/108729104322802524 PG 9 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 777RY UT WOS:000189192400005 PM 15006184 ER PT J AU Duka, T Gentry, J Malcolm, R Ripley, TL Borlikova, G Stephens, DN Veatch, LM Becker, HC Crews, FT AF Duka, T Gentry, J Malcolm, R Ripley, TL Borlikova, G Stephens, DN Veatch, LM Becker, HC Crews, FT TI Consequences of multiple withdrawals from alcohol SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Review DE binge drinking; executive function; EEG; appetitive conditioning ID NUCLEUS-ACCUMBENS CORE; CORTICOTROPIN-RELEASING-FACTOR; ANTERIOR CINGULATE CORTEX; CHRONIC ETHANOL EXPOSURE; EVENT-RELATED POTENTIALS; BRAIN-DAMAGE; BASOLATERAL AMYGDALA; FACIAL EXPRESSIONS; ANIMAL-MODEL; REPEATED DEPRIVATIONS AB This article represents the proceedings of a symposium at the 2003 annual meeting of the Research Society on Alcoholism in Fort Lauderdale, FL, organized by Theodora Duka and chaired by Dai Stephens. The purpose of the symposium was to examine the effects of multiple experiences of withdrawal from alcohol in animals made dependent on alcohol and in humans who are alcohol dependent. Parallels were drawn to the effects of repeated short-lived high-content alcohol exposures in animals and in humans who are social drinkers but indulge in binge drinking. The presentations were (1) Multiple detoxifications and risk of relapse in abstinent alcoholics, by John Gentry and Robert Malcolm; (2) Emotional and cognitive impairments after long-term use of alcohol: relationship to multiple detoxifications and binge drinking, by Theodora Duka; (3) The effect of repeated withdrawal from ethanol on conditioning to appetitive stimuli, by Tamzin Ripley, Gilyanna Borlikova, and Dai Stephens; (4) Alcohol withdrawal kindling: electrographic measures in a murine model of behavioral seizure sensitization, by Lynn Veatch and Howard Becker; and (5) Binge drinking induced changes in CNS, by Fulton Crews. C1 Univ Sussex, Lab Expt Psychol, Brighton BN1 9QG, E Sussex, England. Univ Sussex, Sch Life Sci, Psychol Dept, Brighton BN1 9QG, E Sussex, England. Med Univ S Carolina, Charleston Alcohol Res Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Dept Vet Affairs, Charleston, SC USA. Univ N Carolina, Sch Med, Ctr Alcohol Studies, Chapel Hill, NC USA. RP Duka, T (reprint author), Univ Sussex, Lab Expt Psychol, Brighton BN1 9QG, E Sussex, England. EM dorad@biols.susx.ac.uk RI Borlikova, Gilyana/E-8245-2012; Stephens, David/G-2384-2012 NR 127 TC 66 Z9 66 U1 4 U2 14 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD FEB PY 2004 VL 28 IS 2 BP 233 EP 246 DI 10.1097/01.ALC.000113780.41701.81 PG 14 WC Substance Abuse SC Substance Abuse GA 776YR UT WOS:000189147400005 PM 15112931 ER PT J AU Butler, J Forman, DE Abraham, WT Gottlieb, SS Loh, E Massie, BM O'Connor, CM Rich, MW Stevenson, LW Wang, YF Young, JB Krumholz, HM AF Butler, J Forman, DE Abraham, WT Gottlieb, SS Loh, E Massie, BM O'Connor, CM Rich, MW Stevenson, LW Wang, YF Young, JB Krumholz, HM TI Relationship between heart failure treatment and development of worsening renal function among hospitalized patients SO AMERICAN HEART JOURNAL LA English DT Article ID SUBCUTANEOUS ERYTHROPOIETIN; INTRAVENOUS IRON; FUROSEMIDE; ANEMIA; PHARMACOKINETICS; INSUFFICIENCY; DYSFUNCTION; PROGRESSION; OUTCOMES; THERAPY AB Background Among patients who are hospitalized with heart failure (HF), worsening renal function (WRF) is associated with worse outcomes. Whether treatment for HF contributes to WRF is unknown. In this study, we sought to assess whether acute treatment for patients who were hospitalized with HF contributes to WRF. Methods Data were collected in a nested case-control study on 382 subjects who were hospitalized with HF (191 patients with WRF, defined as a rise in serum creatinine level >26.5 mumol/L (0.3 mg/dl), and 191 control subjects). The association of medications, fluid intake/output, and weight with WRF was assessed. Results. Calcium channel blocker (CCB) use and loop diuretic doses were higher in patients on the day before WRF (25% vs 10% for CCB; 199 +/- 195 mg vs 143 +/- 119 mg for loop diuretics; both P < .05). There were no significant differences in the fluid intake/output or weight changes in the 2 groups. Angiotensin-converting enzyme (ACE) inhibitor use was not associated with WRF. Other predictors of WRF included elevated creatinine level at admission, uncontrolled hypertension, and history of HF or diabetes mellitus. Higher hematocrit levels were associated with a lower risk. Vasodilator use was higher among patients on the day before WRF (46% vs 35%, P < .05), but was not an independent predictor in the multivariable analysis. Conclusions Several medical strategies, including the use of CCBs and a higher dose of loop diuretics, but not ACE inhibitors, were associated with a higher risk of WRF. Although assessment of inhospital diuresis was limited, WRF could not be explained by greater fluid loss in these patients. Determining whether these interventions are responsible for WRF or are markers of higher risk requires further investigation. C1 Vanderbilt Univ, Med Ctr, Div Cardiol, Nashville, TN 37232 USA. Boston Med Ctr, Boston, MA USA. Univ Kentucky, Lexington, KY USA. Univ Maryland, Baltimore, MD 21201 USA. Univ Penn, Philadelphia, PA 19104 USA. San Francisco VAMC, San Francisco, CA USA. Duke Univ, Durham, NC USA. Barnes Jewish Hosp, St Louis, MO 63110 USA. Brigham & Womens Hosp, Boston, MA 02115 USA. Yale Univ, New Haven, CT USA. Cleveland Clin Fdn, Cleveland, OH 44195 USA. RP Butler, J (reprint author), Vanderbilt Univ, Med Ctr, Div Cardiol, 383 PRB, Nashville, TN 37232 USA. EM javed.butler@vanderbilt.edu NR 21 TC 264 Z9 285 U1 0 U2 3 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD FEB PY 2004 VL 147 IS 2 BP 331 EP 338 DI 10.1016/j.ahj.2003.08.012 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 803TR UT WOS:000220253900029 PM 14760333 ER PT J AU Corvera-Tindel, T Doering, LV Woo, MA Khan, S Dracup, K AF Corvera-Tindel, T Doering, LV Woo, MA Khan, S Dracup, K TI Effects of a home walking exercise program on functional status and symptoms in heart failure SO AMERICAN HEART JOURNAL LA English DT Article ID QUALITY-OF-LIFE; LEFT-VENTRICULAR DYSFUNCTION; CONTROLLED-TRIAL; ACTIVITY RESTRICTION; TEST-PERFORMANCE; CAPACITY; RESISTANCE AB Background Hospital-based exercise programs using a bicycle ergometer or a combination of exercise modalities have shown positive benefits in heart failure, but may not be readily accessible to many patients. Thus, we sought to evaluate the effects of a 12-week home walking exercise program on functional status and symptoms in patients with heart failure. Methods A randomized controlled trial comparing a 12-week progressive home walking exercise program (n = 42) to a "usual activity" control group (n = 37) was conducted in patients with heart failure (78 [99%] male; mean age 62.6 +/- 10.6 years; ejection fraction 27% +/- 8.8%; 63 [80%] New York Heart Association class II; 15[20%] New York Heart Association class III-IV) from a Veterans Affairs medical center and a university-affiliated medical center. Functional status (peak oxygen consumption via cardiopulmonary exercise testing, 6-minute walk test, the Heart Failure Functional Status. Inventory), and symptoms (Dyspnea-Fatigue Index score with a postglobal rating of symptoms) were measured at baseline and 12 weeks. Results No adverse events related to exercise training occurred. Overall mean compliance to training was 74 +/- 37%. Peak oxygen consumption and the Heart Failure Functional Status Inventory were unchanged with training. Compared to the usual activity group, the training group had significantly longer walking distances measured by the 6-minute walk test (1264 +/- 255 vs 1337 +/- 272 feet, P = .00.1), and improved postglobal rating of symptoms (P = .03). Conclusion In patients with heart failure, a progressive home walking exercise program is acceptable, increases walking distance, and decreases global rating of symptoms. C1 Greater Los Angeles Vet Affairs Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Cedars Sinai Med Ctr, Sch Med, Los Angeles, CA 90048 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Corvera-Tindel, T (reprint author), VAGLAHS, Room 6207,Mail Code 118R,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Teresita.Corvera@med.va.gov NR 32 TC 59 Z9 59 U1 0 U2 6 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD FEB PY 2004 VL 147 IS 2 BP 339 EP 346 DI 10.1016/j.ahj.2003.09.007 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 803TR UT WOS:000220253900030 PM 14760334 ER PT J AU Takahashi, T Koehler, J Swenson, P Duchin, J AF Takahashi, T Koehler, J Swenson, P Duchin, J TI Evaluation of a public health Salmonella surveillance system in King County, Washington SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Article AB Objectives: Salmonella infection is the most common cause of foodborne bacterial outbreaks and deaths in the United States. The effectiveness of Salmonella surveillance for detecting outbreaks depends on timeliness of reporting. We evaluated the public health Salmonella surveillance system in King County, Washington, during an outbreak and at baseline. Methods: We assessed the timeliness of the Salmonella surveillance system in King County using the Public Health-Seattle & King County Laboratory (County PHL) database from 1998 to 1999. We determined median days for key steps involved in the Salmonella identification and reporting process and the percentage of suspected Salmonella isolates confirmed. Time intervals for key steps during a Salmonella outbreak were compared to baseline surveillance. Results: Of the 652 suspected Salmonella isolates sent to the County PHL from 22 clinical laboratories, 617 (94.6%) were confirmed as Salmonella. Salmonella confirmation rates improved from 1998 to 1999, and 41% of the submitting laboratories, contributing 32.4% of the isolates, had 100% confirmation rates for both years. The median total identification time during the outbreak did not differ significantly from baseline (13 days vs 17 days). The time interval for serotyping contributed most to the total identification time. Conclusions: King County's Salmonella surveillance system requires more than 2 weeks to confirm and report serotype results for Salmonella isolates. Variation in total identification time depends on serotyping time. A more detailed study of other surveillance systems may identify approaches to decrease total identification time. C1 Publ Hlth Seattle & King Cty, Seattle, WA USA. Univ Washington, Div Allergy & Infect Dis, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA USA. RP Takahashi, T (reprint author), Vet Adm Med Ctr, 1660 S Columbian Way,S-111-GIMC, Seattle, WA 98108 USA. NR 8 TC 11 Z9 11 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-6553 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD FEB PY 2004 VL 32 IS 1 BP 7 EP 11 DI 10.1016/j.ajic.2003.06.003 PG 5 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 777AD UT WOS:000189151000003 PM 14755228 ER PT J AU Pogach, L Charns, MP Wrobel, JS Robbins, JM Bonacker, KM Haas, L Reiber, GE AF Pogach, L Charns, MP Wrobel, JS Robbins, JM Bonacker, KM Haas, L Reiber, GE TI Impact of policies and performance measurement on development of organizational coordinating strategies for chronic care delivery SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID SURGICAL SERVICES; DIABETIC-PATIENTS; QUALITY CHASM; MANAGEMENT; OUTCOMES; FOOT; COST AB Objective: To examine the impact of policy directives and performance feedback on the organization (specifically the coordination) of foot care programs for veterans, as mandated by public law within the Department of Veterans Affairs Health Care System (VA). Study Design: Case study of 10 VA medical centers performing diabetes-related amputations. Patients and Methods: Based on expert consensus, we identified 16 recommended foot care delivery coordination strategies. Structured interview protocols developed for primary care, foot care, and surgical providers, as well as administrators, were adapted from a prior study of surgical departments. Results: Although performance measurement results for foot risk screening and referral were high at all study sites over 2 calendar years (average 85%, range 69% to 92%), the number of coordination strategies implemented by any site was relatively low, averaging only 5.4 or 34% (range 1-12 strategies). No facility had systematically collected data to evaluate whether preventive foot care was provided to patients with high-risk foot conditions, or whether these patients had unmet foot care needs. Conclusions: Although foot care policies and data feedback resulted in extremely high rates of adherence to foot-related performance measurement, there remained opportunities for improvement in the development of coordinated, technology-supported, data-driven, patient-centered foot care programs. C1 Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Dept Vet Affairs, VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA USA. Vet Adm Med Ctr, Dept Vet Affairs, Cleveland, OH 44106 USA. Dartmouth Coll, Hitchcock Med Ctr, Dartmouth Med Sch, Dept Community & Family Med, Hanover, NH 03756 USA. Dept Vet Affairs, VA Med & Reg Off Ctr, White River Jct, VT USA. Boston Univ, Sch Publ Hlth, Program Hlth Policy & Management, Boston, MA USA. Boston Univ, Sch Publ Hlth, VA Management Decis & Res Ctr, Boston, MA USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Newark, NJ 07103 USA. Dept Vet Affairs, Ctr Healthcare Knowledge Management, New Jersey Hlth Care Syst, E Orange, NJ USA. RP Pogach, L (reprint author), E Orange VAMC, VA New Jersey Hlth Care Syst, Hlth Serv Res Ctr Healthcare Knowledge Management, Room 9-160 111,385 Tremont Ave, E Orange, NJ 07018 USA. EM leonard.pogach@med.va.gov NR 34 TC 9 Z9 9 U1 4 U2 7 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD FEB PY 2004 VL 10 IS 2 BP 171 EP 180 PN 2 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 775PD UT WOS:000189049200009 PM 15005510 ER PT J AU Walter, LC de Garmo, P Covinsky, KE AF Walter, LC de Garmo, P Covinsky, KE TI Association of older age and female sex with inadequate reach of screening flexible sigmoidoscopy SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID COLORECTAL-CANCER; ASYMPTOMATIC ADULTS; COLONOSCOPY; DIFFICULT; GENDER; PREDICTORS; RATIONALE; INSERTION; DESIGN; POLYPS AB PURPOSE: Estimates of the sensitivity of screening sigmoidoscopy assume an adequate depth of insertion is reached. However, in clinical practice, the frequency that sigmoidoscopy reaches various lengths of the colon is not known. We assessed the frequency of inadequate reach (depth of <50 cm of the colon) in a large U.S. cohort, according to age and sex. METHODS: We performed a cross-sectional study of 15,406 asymptomatic persons aged 50 years or older who underwent screening flexible sigmoidoscopy between April 1997 and October 2001 at sites participating in the Clinical Outcomes Research Initiative, which examines outcomes of endoscopy in "real life" settings. The maximum depth of insertion of the sigmoidoscope was measured in centimeters from the anus and classified as adequate (greater than or equal to50cm) or inadequate (<50cm). Patient characteristics as well as procedure-related variables were also recorded. RESULTS: Eighteen percent (n=2801) of subjects had an inadequate examination. In men, the percentage of inadequate examinations increased progressively with age, from 10% (343/3338) in those aged 50 to 59 years to 22% (53/248) in those aged 80 years or older (P<0.001). Inadequate examinations were more common in women at all ages, ranging from 19% (733/3798) in those aged 50 to 59 years to 32% (86/267) in those aged 80 years or older (P<0.001). These associations were confirmed in a multivariable analysis. CONCLUSION: Our finding that advancing age and female sex were independently associated with the risk of inadequate reach of screening sigmoidoscopy suggests that the sensitivity of sigmoidoscopy may be lower in these populations. Estimates of the benefits of sigmoidoscopy may need to be tailored to the age and sex of the patient. (C) 2004 by Excerpta Medica Inc. C1 San Francisco Vet Affairs Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Walter, LC (reprint author), San Francisco Vet Affairs Med Ctr, Div Geriatr, 181G,4150 Clement St, San Francisco, CA 94121 USA. EM louisew@itsa.ucsf.edu FU AHRQ HHS [K02HS00006]; NIDDK NIH HHS [DK 57132] NR 41 TC 18 Z9 18 U1 1 U2 2 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD FEB 1 PY 2004 VL 116 IS 3 BP 174 EP 178 DI 10.1016/j.amjmed.2003.09.030 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 770AX UT WOS:000188701900005 PM 14749161 ER PT J AU Adelson, DW Million, M Kanamoto, K Palanca, T Tache, Y AF Adelson, DW Million, M Kanamoto, K Palanca, T Tache, Y TI Coordinated gastric and sphincter motility evoked by intravenous CCK-8 as monitored by ultrasonomicrometry in rats SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE lower esophageal sphincter; pylorus; gastric intraluminal pressure; antrum; devazepide ID LOWER ESOPHAGEAL SPHINCTER; CHOLECYSTOKININ-OCTAPEPTIDE; PROXIMAL STOMACH; RELAXATION; PYLORUS; HUMANS; ANTAGONIST; RECEPTORS; PRESSURE; PATHWAY AB Gastric and sphincter motility evoked by intravenous injection of CCK-8 were investigated in urethane-anesthetized rats. Digital ultrasonomicrometry was used to monitor pyloric (PYL), antral ( ANT), corpus ( COR), and lower esophageal sphincter (LES) movements while simultaneously measuring intragastric pressure (IGP) and, in some experiments, subdiaphragmatic intraesophageal pressure (sIEP). Intracrystal distances (ICD) were measured continuously between pairs of piezoelectric crystals affixed to the serosa of PYL, ANT, COR ( circular and longitudinal), and LES. Consecutive intravenous injections of CCK-8 (0.3, 1, and 3 mug/kg) at 30-min intervals caused dose-dependent simultaneous tonic contractions of PYL and ANT, LES opening, and drops in IGP with peak changes at 3 mug/kg of - 17.9 +/- 2.1, - 7.7 +/- 2.5, 6.5 +/- 1.4, and - 29.2 +/- 3.8%, respectively, whereas intravenous saline had no effect. Rhythmic contractile activity was inhibited by CCK-8. COR responses were not significantly different from vehicle controls for most metrics, and the direction of response for circular COR varied between preparations, although not for repeated trials in a single preparation. During the LES response to CCK-8, sIEP rose in parallel with drops in IGP, indicating formation of a common cavity. Recovery of LES ICD after intravenous CCK occurred more rapidly than recovery of PYL ICD, suggesting the importance of preventing simultaneous patency of gastroesophageal and gastroduodenal passages. The CCKA receptor antagonist devazepide ( 500 mug/kg intravenous) inhibited motion responses evoked by intravenous CCK-8. These data revealed CCK-8-induced gastric and sphincter activity consistent with retropulsion of gastric content. C1 Univ Calif Los Angeles, Ctr Ulcer Res & Educ, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Div Digest Dis, David Geffen Sch Med, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Adelson, DW (reprint author), VAGLAHS W LA VAMC, CURE Digest Dis Res Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM dadelson@ucla.edu FU NIDDK NIH HHS [DK-41301, DK-57238-01A1S1] NR 28 TC 19 Z9 19 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD FEB PY 2004 VL 286 IS 2 BP G321 EP G332 DI 10.1152/ajpgi.00057.2003 PG 12 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 762VH UT WOS:000188002500017 PM 14715522 ER PT J AU Gukovskaya, AS Hosseini, S Satoh, A Cheng, JH Nam, KJ Gukovsky, I Pandol, SJ AF Gukovskaya, AS Hosseini, S Satoh, A Cheng, JH Nam, KJ Gukovsky, I Pandol, SJ TI Ethanol differentially regulates NF-kappa B activation in pancreatic acinar cells through calcium and protein kinase C pathways SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE alcoholic pancreatitis; inflammatory response; cholecystokinin; calcineurin ID INFLAMMATORY RESPONSE; INTRACELLULAR CA2+; GENE-EXPRESSION; CHOLECYSTOKININ; ALCOHOL; RATS; INJURY; SECRETION; ISOFORMS; CCK AB Mechanisms of alcoholic pancreatitis remain unknown. Previously, we showed that ethanol feeding sensitizes rats to pancreatitis caused by CCK-8, at least in part, by augmenting activation of the proinflammatory transcription factor NF-kappaB. To elucidate the mechanism of sensitization, here we investigate the effect of ethanol on Ca2+- and PKC-mediated pathways of CCK-induced NF-kappaB activation using an in vitro system of rat pancreatic acini incubated with ethanol. Ethanol augmented CCK-8-induced activation of NF-kappaB, similar to our in vivo findings with ethanol-fed rats. In contrast, ethanol prevented NF-kappaB activation caused by thapsigargin, an agent that mobilizes intracellular Ca2+ bypassing the receptor. Pharmacological analysis showed that NF-kappaB activation by thapsigargin but not by CCK-8 is mediated through the calcineurin pathway and that the inhibitory effect of ethanol on the thapsigargin-induced NF-kappaB activation could be through inhibiting this pathway. Ethanol augmented NF-kappaB activation induced by the phorbol ester PMA, a direct activator of PKC. Inhibitory analysis demonstrated that Ca2+-independent ( novel and/or atypical) PKC isoforms are involved in NF-kappaB activation induced by both CCK-8 and PMA in cells treated and not treated with ethanol. The results indicate that ethanol differentially affects the Ca2+/calcineurin- and PKC-mediated pathways of NF-kappaB activation in pancreatic acinar cells. These effects may play a role in the ability of ethanol to sensitize pancreas to the inflammatory response and pancreatitis. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, W Los Angeles Ctr, Res Ctr Alcohol Liver & Pancreat Injury, Los Angeles, CA 90073 USA. RP Gukovskaya, AS (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, W Los Angeles Ctr, Res Ctr Alcohol Liver & Pancreat Injury, 11301 Wilshire Blvd,Bldg 258,Rm 340, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu FU NIAAA NIH HHS [P50-AA11999, T32-AA07578]; NIDDK NIH HHS [DK-59508] NR 53 TC 57 Z9 59 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD FEB PY 2004 VL 286 IS 2 BP G204 EP G213 DI 10.1152/ajpgi.00088.2003 PG 10 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 762VH UT WOS:000188002500004 PM 12958018 ER PT J AU Asghar-Ali, AA Taber, KH Hurley, RA Hayman, LA AF Asghar-Ali, AA Taber, KH Hurley, RA Hayman, LA TI Pure neuropsychiatric presentation of multiple sclerosis SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Editorial Material ID LATE-LIFE DEPRESSION; EXECUTIVE DYSFUNCTION SYNDROME; MATTER; WHITE; HYPERINTENSITIES; DISORDER; CIRCUITS; MS C1 Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Herbert J Frensley Ctr Imaging Res, Dept Radiol, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Mental Hlth Care Line, Houston, TX USA. RP Asghar-Ali, AA (reprint author), Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, 1 Baylor Plaza, Houston, TX 77030 USA. EM aasghara@hotmail.com NR 30 TC 30 Z9 31 U1 1 U2 2 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD FEB PY 2004 VL 161 IS 2 BP 226 EP 231 DI 10.1176/appi.ajp.161.2.226 PG 6 WC Psychiatry SC Psychiatry GA 818WT UT WOS:000221275900006 PM 14754769 ER PT J AU Littooy, FN Gagovic, V Sandu, C Mansour, A Kang, S Greisler, HP AF Littooy, FN Gagovic, V Sandu, C Mansour, A Kang, S Greisler, HP TI Comparison of standard carotid endarterectomy with Dacron patch angioplasty versus eversion carotid endarterectomy during a 4-year period SO AMERICAN SURGEON LA English DT Article; Proceedings Paper CT 46th Annual Meeting of the Midwest-Surgical-Association CY AUG 10-13, 2003 CL Galena, IL SP Midwest Surgical Assoc AB Currently, the two primary approaches to carotid endarterectomy for extracranial carotid stenosis are carotid endarterectomy with patch angioplasty and eversion carotid endarterectomy. In a retrospective study over a 4-year period from 1998 to 2002, we had an opportunity to compare the two approaches as two surgeons utilized carotid endarterectomy with Dacron patch angioplasty and two other surgeons utilized eversion carotid endarterectomy. During the 4-year period, 189 carotid endarterectomies were performed, 125 with Dacron patch angioplasty (CE-P) and 64 with eversion (EE) endarterectomy. There were no significant differences in age of the patients, operative indication, or associated risk factors between the two groups. Perioperative outcome measurement in the CE-P versus EE included stroke or transient ischemic attack, 1.6 per cent versus 1.56 per cent, cranial nerve injury, 2.4 per cent versus 3.13 per cent; death, 0.8 per cent versus 0 per cent; need for operative conversion or revision, 2.4 per cent versus 7.81 per cent, respectively. Only the need for operative conversion or revision reached significant difference (P < 0.05), although the need decreased to 4 per cent for the last 50 EE cases. Recurrent stenosis of 50 per cent to 79 per cent was 4.88 per cent versus 3.13 per cent and >80 per cent was 0.81 per cent versus 0 per cent in the CE-P versus EE group over a follow up of 16.3 months and 17.0 months, respectively. We conclude that both CE-P and EE are equally efficacious operative approaches to extracranial carotid occlusive disease. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. RP Littooy, FN (reprint author), Edward Hines Vet Adm Med Ctr, Dept Surg, 112, Hines, IL 60141 USA. NR 10 TC 15 Z9 19 U1 1 U2 1 PU SOUTHEASTERN SURGICAL CONGRESS PI ATLANTA PA 141 WEST WIEUCA RD, STE B100, ATLANTA, GA 30342 USA SN 0003-1348 J9 AM SURGEON JI Am. Surg. PD FEB PY 2004 VL 70 IS 2 BP 181 EP 185 PG 5 WC Surgery SC Surgery GA 779AZ UT WOS:000189274600030 PM 15011924 ER PT J AU Maggard, MA Lane, KE O'Connell, JB Ko, CY AF Maggard, MA Lane, KE O'Connell, JB Ko, CY TI Beyond the clinical trials: How prevalent are sentinel lymph node biopsies performed for breast cancer SO ANNALS OF SURGICAL ONCOLOGY LA English DT Meeting Abstract CT 57th Annual Cancer Symposium of the Society-of-Surgical-Oncology CY MAR 18-21, 2004 CL NEW YORK, NEW YORK SP Soc Surg Oncol C1 Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. Univ Calif San Francisco, Div Surg Oncol, San Francisco, CA 94143 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD FEB PY 2004 VL 11 IS 2 SU S BP S57 EP S57 DI 10.1007/BF02523989 PG 1 WC Oncology; Surgery SC Oncology; Surgery GA 771LD UT WOS:000188786100026 ER PT J AU O'Connell, JB Maggard, MA Ko, CY AF O'Connell, JB Maggard, MA Ko, CY TI Variations in the use of curative surgery: How do regions in the US compare SO ANNALS OF SURGICAL ONCOLOGY LA English DT Meeting Abstract CT 57th Annual Cancer Symposium of the Society-of-Surgical-Oncology CY MAR 18-21, 2004 CL NEW YORK, NEW YORK SP Soc Surg Oncol C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Greater Los Angeles VA Hlth Care Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD FEB PY 2004 VL 11 IS 2 SU S BP S124 EP S124 DI 10.1007/BF02524207 PG 1 WC Oncology; Surgery SC Oncology; Surgery GA 771LD UT WOS:000188786100244 ER PT J AU O'Connell, JB Maggard, MA Ko, CY AF O'Connell, JB Maggard, MA Ko, CY TI Cancer-directed surgery for localized disease: Underuse in the elderly SO ANNALS OF SURGICAL ONCOLOGY LA English DT Meeting Abstract CT 57th Annual Cancer Symposium of the Society-of-Surgical-Oncology CY MAR 18-21, 2004 CL NEW YORK, NEW YORK SP Soc Surg Oncol C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Greater Los Angeles VA Hlth Care Syst, Los Angeles, CA USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD FEB PY 2004 VL 11 IS 2 SU S BP S67 EP S68 DI 10.1007/BF02524023 PG 2 WC Oncology; Surgery SC Oncology; Surgery GA 771LD UT WOS:000188786100060 ER PT J AU O'Connell, JB Maggard, MA Ko, CY AF O'Connell, JB Maggard, MA Ko, CY TI The new AJCC 6 staging system for colon cancer - Does it prognosticate correctly SO ANNALS OF SURGICAL ONCOLOGY LA English DT Meeting Abstract CT 57th Annual Cancer Symposium of the Society-of-Surgical-Oncology CY MAR 18-21, 2004 CL NEW YORK, NEW YORK SP Soc Surg Oncol C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Greater Los Angeles VA Med Ctr, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD FEB PY 2004 VL 11 IS 2 SU S BP S68 EP S68 DI 10.1007/BF02524024 PG 1 WC Oncology; Surgery SC Oncology; Surgery GA 771LD UT WOS:000188786100061 ER PT J AU Ho, PM Arciniegas, DB Grigsby, J McCarthy, M McDonald, GO Moritz, TE Shroyer, AL Sethi, GK Henderson, WG London, MJ VillaNueva, CB Grover, FL Hammermeister, KE AF Ho, PM Arciniegas, DB Grigsby, J McCarthy, M McDonald, GO Moritz, TE Shroyer, AL Sethi, GK Henderson, WG London, MJ VillaNueva, CB Grover, FL Hammermeister, KE TI Predictors of cognitive decline following coronary artery bypass graft surgery SO ANNALS OF THORACIC SURGERY LA English DT Article ID NEUROPSYCHOLOGICAL DYSFUNCTION; CARDIOPULMONARY BYPASS; LONGITUDINAL ASSESSMENT; CARDIAC OPERATIONS; OUTCOMES; DEMENTIA AB Background. A significant number of patients develop cognitive impairment that persists for months following coronary artery bypass grafting (CABG) surgery. Our objectives were to identify patient-related risk factors, processes of care, and the occurrence of any perioperative complications associated with cognitive decline. Methods. Nine hundred thirty-nine patients enrolled in the Processes, Structures, and Outcomes of Care in Cardiac Surgery study undergoing CABG-only surgery at 14 Veterans Administration medical centers between 1992 and 1996 completed a short battery of cognitive tests at baseline and 6-months post-CABG. The composite cognitive score was based on the sum of errors for each individual item in the battery. Multiple linear regression analyses were used to identify independent predictors of the 6-month composite cognitive score. Results. In multivariable analyses, patient characteristics associated with cognitive decline included cerebrovascular disease (p = 0.009), peripheral vascular disease (p = 0.007), history of chronic disabling neurologic illness (p = 0.016), and living alone (p = 0.049), while the number of years of education (p = 0.001) was inversely related to cognitive decline. After adjustment for baseline patient risk factors, the presence of any postoperative complication(s) (p = 0.001) was also associated with cognitive decline while cardiopulmonary bypass time (p = 0.008) was inversely related to cognitive decline. Conclusions. Patients with noncoronary manifestations of atherosclerosis, chronic disabling neurologic illness, or limited social support are at risk for cognitive decline after CABG surgery. In contrast, more years of education were associated with less cognitive decline. Preoperative assessment of risk factors identified in this study may be useful when counseling patients about the risk for cognitive decline following CABG surgery. (C) 2004 by The Society of Thoracic Surgeons. C1 Denver Vet Affairs Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Dept Surg, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Dept Neuropsychiat, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Dept Biometr, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Colorado Hlth Outcomes Program, Denver, CO 80202 USA. Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. Dept Vet Affairs, Cent Off, Washington, DC USA. Hines VAMC, Vet Affairs Cooperat Studies Program, Coordinating Ctr, Hines, IL USA. Univ Arizona, Dept Surg, Tucson VAMC, Tucson, AZ 85721 USA. Univ Calif San Francisco, Anesthesia Serv, San Francisco VAMC, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA. RP Ho, PM (reprint author), 1055 Clermont St,111B, Denver, CO 80220 USA. EM michael.ho@uchsc.edu RI Arciniegas, David/A-3792-2009; Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 FU NHLBI NIH HHS [1 F32 HL69596-01] NR 28 TC 70 Z9 71 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD FEB PY 2004 VL 77 IS 2 BP 597 EP 603 DI 10.1016/S0003-4975(03)01358-4 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 769LQ UT WOS:000188651900050 PM 14759444 ER PT J AU Shores, MM Sloan, KL Matsumoto, AM Moceri, VM Felker, B Kivlahan, DR AF Shores, MM Sloan, KL Matsumoto, AM Moceri, VM Felker, B Kivlahan, DR TI Increased incidence of diagnosed depressive illness in hypogonadal older men SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID TESTOSTERONE REPLACEMENT THERAPY; PLACEBO-CONTROLLED TRIAL; REFRACTORY DEPRESSION; AFRICAN-AMERICAN; MAJOR DEPRESSION; MOOD; AGE; DISORDER; SYMPTOMS; ESTROGEN AB Context: Age-associated hypogonadism (testosterone deficit) occurs in 30% of men after the age of 55; it is associated with decreased muscle mass, bone mineral density, and libido, and with anorexia, fatigue, and irritability. Although some of these symptoms overlap with those of depression, the association between the 2 disorders is unclear. Objective: To determine if hypogonadal men have an increased incidence of depressive illness compared with eugonadal men. Design: Historical cohort study using computerized medical records, followed by a manual medical record review. Setting: Veterans Affairs Puget Sound Health Care System. Results: The 2-year incidence of diagnosed depressive illness was 21.7% in hypogonadal men vs 7.1% in others (x (2)(1) = 6.0, P = .01). A Kaplan-Meier survival analysis showed a significant difference between hypogonadal and eugonadal men in time to diagnosed depression (log-rank test 2 x (1)(2) = 6.9, P = .008). We used Cox proportional hazards regression models to examine the association of hypogonadism and time to depression diagnosis, adjusting for age, race, number of clinic visits, alcohol use disorders, prostate cancer, and overall medical comorbidity. The unadjusted hazard ratio for depression with hypogonadism was 3.5 (95% confidence interval, 1.3-9.4) (P = .01). Controlling for all covariates, hypogonadism remained significantly associated with depression (adjusted hazard ratio, 4.2; 95% confidence interval, 1.5-12.0) (P = .008). Participants: Two hundred seventy-eight men 45 years and older, without prior diagnosed depressive illness and with consistently normal or low testosterone levels (total testosterone level less than or equal to200 ng/dL [less than or equal to6.94 nmol/L]; or free testosterone level less than or equal to0.9 ng/dL [less than or equal to0.03 nmol/L]) at baseline and during a 2-year follow-up period. Main Outcome Measures: incidence of, and time to, a depression diagnosis. Conclusions: Hypogonadal men showed an increased incidence of depressive illness and a shorter time to diagnosis of depression. Further prospective studies are needed to confirm these preliminary findings and to clarify the role of testosterone in the treatment of depressive illness in older men. C1 Vet Affairs Puget Sound Hlth Care Syst, GRECC, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Shores, MM (reprint author), Vet Affairs Puget Sound Hlth Care Syst, GRECC, 1660 S Columbian Way,S-182, Seattle, WA 98108 USA. EM molly.shores@med.va.gov NR 45 TC 119 Z9 120 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD FEB PY 2004 VL 61 IS 2 BP 162 EP 167 DI 10.1001/archpsyc.61.2.162 PG 6 WC Psychiatry SC Psychiatry GA 769MA UT WOS:000188652800006 PM 14757592 ER PT J AU Siboo, IR Sieder, F Kumar, K Howe, MM DuBow, MS AF Siboo, IR Sieder, F Kumar, K Howe, MM DuBow, MS TI Characterization of P-lys-proximal morphogenetic genes of transposable bacteriophage Mu SO ARCHIVES OF VIROLOGY LA English DT Article ID COMPLETE GENOME SEQUENCE; LAMBDA TERMINASE ENZYME; DNA PACKAGING ENZYME; FUNCTIONAL DOMAINS; SMALL-SUBUNIT; PHAGE-LAMBDA; INVITRO MATURATION; POSITIVE REGULATOR; PROHEAD BINDING; PORTAL PROTEIN AB Late during the bacteriophage Mu lytic cycle, Mu DNA must be matured and packaged from its dispersed integration sites in the host DNA in order to produce progeny virions. Whereas control of late gene transcription in Mu is becoming well understood, less is known about the phage morphogenetic process. To investigate the latter, we cloned and sequenced a similar to4.3-kb region of the phage DNA beginning just upstream of the leftmost late promoter P-lys. Previous mapping of amber mutations had located the lysis (lys) and proposed DNA maturation genes D and E in this region. When the DNA sequence was analyzed, seven potential open reading frames were found. DNA sequence analysis of amber mutations in genes D and E identified the sixth and seventh open reading frames as D and E, respectively. Cloning and expression of this region enabled production of cell-free protein extracts that specifically recognize the phage-encoded packaging sequence (pac), a characteristic exhibited by phage maturation enzymes. In addition, the E protein was found to share homology with the large subunit of many phage DNA maturation enzymes. These results support the hypothesis that D and E encode subunits of the Mu DNA maturation enzyme. C1 McGill Univ, Dept Microbiol & Immunol, Montreal, PQ, Canada. Univ Tennessee, Ctr Hlth Sci, Dept Mol Sci, Memphis, TN 38163 USA. RP Siboo, IR (reprint author), San Francisco VAMC, 4150 Clemet St 111W2, San Francisco, CA 94121 USA. EM irsiboo@itsa.ucsf.edu OI Siboo, Ian/0000-0002-0055-7058 NR 62 TC 1 Z9 3 U1 0 U2 1 PU SPRINGER-VERLAG WIEN PI VIENNA PA SACHSENPLATZ 4-6, PO BOX 89, A-1201 VIENNA, AUSTRIA SN 0304-8608 J9 ARCH VIROL JI Arch. Virol. PD FEB PY 2004 VL 149 IS 2 BP 241 EP 259 DI 10.1007/s00705-003-0216-4 PG 19 WC Virology SC Virology GA 767EW UT WOS:000188428100003 PM 14745593 ER PT J AU Sims, KJ Spassieva, SD Voit, EO Obeid, LM AF Sims, KJ Spassieva, SD Voit, EO Obeid, LM TI Yeast sphingolipid metabolism: clues and connections SO BIOCHEMISTRY AND CELL BIOLOGY-BIOCHIMIE ET BIOLOGIE CELLULAIRE LA English DT Review DE yeast; sphingolipid metabolism; subcellular localization; protein-protein interactions; stress response; aging ID LONG-CHAIN BASES; INOSITOL PHOSPHORYLCERAMIDE SYNTHASE; PHOSPHOSPHINGOLIPID PHOSPHOLIPASE-C; SACCHAROMYCES-CEREVISIAE CELLS; PROTEIN-PROTEIN INTERACTIONS; BIOCHEMICAL SYSTEMS ANALYSIS; FATTY-ACID ELONGATION; SERINE PALMITOYLTRANSFERASE; CERAMIDE SYNTHESIS; MULTIDRUG-RESISTANCE AB This review of sphingolipid metabolism in the budding yeast Saccharomyces cerevisiae contains information on the enzymes and the genes that encode them, as well as connections to other metabolic pathways. Particular attention is given to yeast homologs, domains, and motifs in the sequence, cellular localization of enzymes, and possible protein-protein interactions. Also included are genetic interactions of special interest that provide clues to the cellular biological roles of particular sphingolipid metabolic pathways and specific sphingolipids. C1 Med Univ S Carolina, Dept Med, Ralph H Johnson Vet Adm, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. RP Obeid, LM (reprint author), Med Univ S Carolina, Dept Med, Ralph H Johnson Vet Adm, Charleston, SC 29425 USA. EM obeidl@musc.edu OI obeid, lina/0000-0002-0734-0847 FU NIA NIH HHS [AG16583]; NIGMS NIH HHS [GM062887]; NLM NIH HHS [T15LM07438] NR 109 TC 44 Z9 45 U1 1 U2 6 PU NATL RESEARCH COUNCIL CANADA PI OTTAWA PA RESEARCH JOURNALS, MONTREAL RD, OTTAWA, ONTARIO K1A 0R6, CANADA SN 0829-8211 J9 BIOCHEM CELL BIOL JI Biochem. Cell Biol. PD FEB PY 2004 VL 82 IS 1 BP 45 EP 61 DI 10.1139/003-086 PG 17 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 809VS UT WOS:000220664800005 PM 15052327 ER PT J AU Benmansour, S Altamirano, AV Jones, DJ Sanchez, TA Gould, GG Pardon, MC Morilak, DA Frazer, A AF Benmansour, S Altamirano, AV Jones, DJ Sanchez, TA Gould, GG Pardon, MC Morilak, DA Frazer, A TI Regulation of the norepinephrine transporter by chronic administration, of antidepressants SO BIOLOGICAL PSYCHIATRY LA English DT Article DE antidepressant; norepinephrine transporter; desipramine; paroxetine; norepinephrine uptake; nisoxetine binding ID SEROTONIN TRANSPORTER; DOWN-REGULATION; H-3 NISOXETINE; MESSENGER-RNA; UPTAKE SITES; RAT-BRAIN; IN-VIVO; DESIPRAMINE; EXPRESSION; OLIGOMERIZATION AB Background. Downregulation of serotonin transporter was observed previously after chronic treatment with selective serotonin reuptake inhibitors (SSRIs) but not selective norepinephrine reuptake inhibitors (NRIs). This study investigated if chronic treatment of rats with selective NRIs or SSRIs also affected the norepinephrine transporter (NET). Methods: Rats were treated for 3 to 6 weeks by osmotic minipumps with either the selective NRIs, desipramine, or the SSRI paroxetine. Results. [H-3]nisoxetine binding sites as well as [H-3]norepinephrine uptake were decreased in hippocampus and cortex after treatment with desipramine. By contrast, paroxetine-treated rats showed no alteration in either [H-3]nisoxetine binding or [H-3]norepinephrine uptake. NET messenger RNA levels in the locus coeruleus were unchanged by desipramine treatment. Conclusions. These results demonstrate that the marked decrease in NET density 1) is not a consequence of a decrease in gene expression; 2) was caused only by a selective NRI; and 3) was associated with a parallel decrease in norepinephrine uptake. C1 Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Anesthesiol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Benmansour, S (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pharmacol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. OI Pardon, Marie-Christine/0000-0003-4737-9479; Gould, Georgianna/0000-0002-5470-8763 FU NIMH NIH HHS [MH 53851, MH 57001] NR 23 TC 47 Z9 49 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD FEB 1 PY 2004 VL 55 IS 3 BP 313 EP 316 DI 10.1016/S0006-3223(03)00676-0 PG 4 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 767HK UT WOS:000188434000016 PM 14744474 ER PT J AU Rowe, PSN Kumagai, Y Gutierrez, G Garrett, IR Blacher, R Rosen, D Cundy, J Navvab, S Chen, D Drezner, MK Quarles, LD Mundy, GR AF Rowe, PSN Kumagai, Y Gutierrez, G Garrett, IR Blacher, R Rosen, D Cundy, J Navvab, S Chen, D Drezner, MK Quarles, LD Mundy, GR TI MEPE has the properties of an osteoblastic phosphatonin and minhibin SO BONE LA English DT Review DE MEPE; renal phosphate excretion; mineralization ID LINKED HYPOPHOSPHATEMIC MICE; MOUSE BONE-CELLS; TUMOR-INDUCED OSTEOMALACIA; OPOSSUM KIDNEY-CELLS; HYP MOUSE; ONCOGENIC OSTEOMALACIA; PARATHYROID-HORMONE; PHEX GENE; PHOSPHONOFORMIC ACID; TRANSPLANTED CELLS AB Matrix extracellular phosphoglycoprotein (MEPE) is expressed exclusively in osteoblasts, osteocytes and odontoblasts with markedly elevated expression found in X-linked hypophosphatemic rickets (Hyp) osteoblasts and in oncogenic hypophosphatemic osteomalacia (OHO) tumors. Because these syndromes are associated with abnormalities in mineralization and renal phosphate excretion, we examined the effects of insect-expressed full-length human-MEPE (Hu-MEPE) on serum and urinary phosphate in vivo, (PO4)-P-33 uptake in renal proximal tubule cultures and mineralization of osteoblast cultures. Dose-dependent hypophosphatemia and hyperphosphaturia occurred in mice following intraperitoneal (IP) administration of Hu-MEPE (up to 400 mug kg(-1) 31 h(-1)), similar to mice given the phosphaturic hormone PTH (80 mug kg(-1) 31 h(-1)). Also the fractional excretion of phosphate (FEP) was stimulated by MEPE [65.0% (P < 0.001)] and PTH groups [53.3% (P < 0.001)] relative to the vehicle group [28.7% (SEM 3.97)]. In addition, Hu-MEPE significantly inhibited (PO4)-P-33 uptake in primary human proximal tubule renal cells (RPTEC) and a human renal cell line (Hu-CL8) in vitro (V-max 53.4% inhibition; K-m 27.4 ng/ml, and V-max 9.1% inhibition; K-m 23.8 ng/ml, respectively). Moreover, Hu-MEPE dose dependently (50-800 ng/ml) inhibited BMP2-mediated mineralization of a murine osteoblast cell line (2T3) in vitro. Inhibition of mineralization was localized to a small (2 kDa) cathepsin B released carboxy-terminal MEPE peptide (protease-resistant) containing the acidic serine-aspartate-rich motif (ASARM peptide). We conclude that MEPE promotes renal phosphate excretion and modulates mineralization. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Periodont, UTHSCSA, San Antonio, TX 78229 USA. Acologix Inc, Emeryville, CA 94608 USA. Osteoscreen, San Antonio, TX 78229 USA. Univ Wisconsin, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, GRECC, Madison, WI 53792 USA. Duke Univ, Dept Med, Ctr Bone Mineral Disorders, Durham, NC 27710 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. RP Rowe, PSN (reprint author), Univ Texas, Hlth Sci Ctr, Dept Periodont, UTHSCSA, 7703 Floyd Curl Dr,Room 3-579U, San Antonio, TX 78229 USA. EM rowep@uthscsa.edu FU NCI NIH HHS [P01 CA040035, P01 CA40035]; NIAMS NIH HHS [R01 AR051598]; NIDCR NIH HHS [R03 DE015900] NR 106 TC 164 Z9 171 U1 0 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 8756-3282 J9 BONE JI Bone PD FEB PY 2004 VL 34 IS 2 BP 303 EP 319 DI 10.1016/j.bone.2003.10.005 PG 17 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 800FJ UT WOS:000220014000008 PM 14962809 ER PT J AU Ren, CZ Li, LK Yang, GA Timme, TL Goltsov, A Ren, CH Ji, XR Addai, J Luo, HB Ittmann, MM Thompson, TC AF Ren, CZ Li, LK Yang, GA Timme, TL Goltsov, A Ren, CH Ji, XR Addai, J Luo, HB Ittmann, MM Thompson, TC TI RTVP-1, a tumor suppressor inactivated by methylation in prostate cancer SO CANCER RESEARCH LA English DT Article ID PATHOGENESIS-RELATED PROTEIN; CPG ISLAND; GENE; EXPRESSION; CELLS; P53; HYPERMETHYLATION; CAVEOLIN; MRTVP-1; ORIGIN AB We previously identified and characterized a novel p53-regulated gene in mouse prostate cancer cells that was homologous to a human gene that had been identified in brain cancers and termed RTVP-1 or GLIPR. In this report, we document that the human RTVP-1 gene is also regulated by p53 and induces apoptosis in human prostate cancer cell lines. We show that the expression of the human RTVP-1 gene is down-regulated in human prostate cancer specimens compared with normal human prostate tissue at the mRNA and protein levels. We further document epigenetic changes consistent with RTVP-1 being a tumor suppressor in human prostate cancer. C1 Baylor Coll Med, Scott Dept Urol, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA. Baylor Coll Med, Dept Radiol, Houston, TX 77030 USA. RP Thompson, TC (reprint author), 6560 Fannin,Suite 2100, Houston, TX 77030 USA. EM timothyt@www.urol.bcm.tmc.edu FU PHS HHS [P50-58204, R01-50588] NR 24 TC 40 Z9 43 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD FEB 1 PY 2004 VL 64 IS 3 BP 969 EP 976 DI 10.1158/0008-5472.CAN-03-2592 PG 8 WC Oncology SC Oncology GA 771VF UT WOS:000188806200029 PM 14871827 ER PT J AU Goldberg, SL Makkar, R Duckwiler, G AF Goldberg, SL Makkar, R Duckwiler, G TI New strategies in the percutaneous management of coronary artery fistulae: A case report SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE coronary artery fistula; embolization; congenital heart disease; case report ID INTERNAL CAROTID-ARTERY; TRANSCATHETER EMBOLIZATION; ARTERIOVENOUS-FISTULAS; MYOCARDIAL-INFARCTION; ENDOVASCULAR APPROACH; SACCULAR ANEURYSMS; ELECTROTHROMBOSIS; CHILDREN; CLOSURE; ADULTS AB Coronary artery fistulae are rare anomalies often treated percutaneously. New techniques aiding in the percutaneous closure of a giant coronary artery, not previously described, are presented in a case report. These techniques include the use of intravascular ultrasound imaging and the use of electrolytically detachable platinum coils. (C) 2004 Wiley-Liss, Inc. C1 W Los Angeles Vet Adm, Ctr Med, Div Cardiol, Los Angeles, CA USA. Univ Calif Los Angeles, Ctr Med, Dept Radiol, Los Angeles, CA USA. RP Goldberg, SL (reprint author), Univ Washington, Sch Med, Div Cardiol, Box 356115,1959 NE Pacific St, Seattle, WA 98195 USA. EM stevgold@u.washington.edu NR 28 TC 6 Z9 6 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 1522-1946 J9 CATHETER CARDIO INTE JI Catheter. Cardiovasc. Interv. PD FEB PY 2004 VL 61 IS 2 BP 227 EP 232 DI 10.1002/ccd.10758 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 771VU UT WOS:000188807400015 PM 14755818 ER PT J AU Offner, H Zamora, A Subramanian, S Polanczyk, M Krogstad, A Auci, DL Morgan, EE Reading, CL AF Offner, H Zamora, A Subramanian, S Polanczyk, M Krogstad, A Auci, DL Morgan, EE Reading, CL TI A synthetic androstene analogue inhibits collagen-induced arthritis in the mouse SO CLINICAL IMMUNOLOGY LA English DT Article DE CIA; arthritis; androstene; DHEA; cytokines ID PROLIFERATOR-ACTIVATED RECEPTORS; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; RHEUMATOID-ARTHRITIS; MULTIPLE-SCLEROSIS; IN-VITRO; T-CELLS; DEHYDROEPIANDROSTERONE; MICE; INFLAMMATION; ALPHA AB Dehydroepiandrosterone (DHEA), a precursor of immune-regulating hormones (IRH) including the androstenes, has attracted much interest over the last several decades because of its many antiaging, metabolic, and immune modulating effects. 5-Androstene-16alpha fluoro-17-one (fluasterone, also known as HE2500) is a synthetic androstene analogue that retains anti-inflammatory, antiproliferative, and immuneregulating activities of the parent molecule, but is nontoxic and practically devoid of androgenic or estrogenic side effects. In the present studies, we tested the ability of fluasterone to limit disease in the DBA mouse model of collagen-induced arthritis (CIA). We found that mice receiving injections of fluasterone displayed significant delay in onset, decrease in CIA peak score, and significant decrease of the daily mean clinical score. Benefit was associated with significant decreases in (1) bovine type II collagen (bCII)-specific IgG(1) and IgG(2). antibody levels in serum; (2) production of TNF-alpha, IL-6, IFN-gamma, but not IL-10; (3) lymphocyte proliferative response to bCII protein; and (4) joint inflammation, erosion, and synovial proliferation as judged by histological analysis. This is the first study to report that an IRH can ameliorate ongoing disease in a CIA mouse model with relevance to RA and to correlate that finding with decreases in pro-inflammatory cytokines. (C) 2004 Elsevier Inc. All rights reserved. C1 Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97239 USA. Vet Affairs Med Ctr, Portland, OR 97239 USA. Univ Missouri, Dept Vet Pathobiol, Columbia, MO 65211 USA. Hollis Eden Pharmaceut Inc, San Diego, CA 92121 USA. RP Offner, H (reprint author), Portland VA Med Ctr, R&D 31, 3710 SW US,Vet Hosp Rd, Portland, OR 97239 USA. EM offnerva@ohsu.edu FU NIAID NIH HHS [AI42376]; NINDS NIH HHS [NS23444] NR 59 TC 9 Z9 10 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PD FEB PY 2004 VL 110 IS 2 BP 181 EP 190 DI 10.1016/j.clim.2003.11.003 PG 10 WC Immunology SC Immunology GA 803KF UT WOS:000220229300009 PM 15003815 ER PT J AU Swarztrauber, K AF Swarztrauber, K TI Barriers to the management of patients with surgically remediable intractable epilepsy SO CNS SPECTRUMS LA English DT Review ID HEALTH-CARE; TEMPORAL-LOBE; UNITED-STATES; ADOLESCENTS; PHYSICIANS; CHILDREN; ACCESS; COMMUNICATION; PREFERENCES; PERCEPTIONS AB It is estimated that only a small proportion of patients with surgically remediable intractable epilepsy receive surgical treatment. There are multiple reasons why this is the case. Patients with intractable epilepsy are sometimes severely disabled and disability can create barriers to getting recommended care. Patients with epilepsy are not well informed about their condition and the available treatments. The incidence of epilepsy is similar in minority populations, and surgically remediable epilepsy frequently presents in adolescence. Nevertheless, these vulnerable populations have specific barriers to receiving epilepsy care, which are often not addressed. In addition, despite scientific evidence for the benefits of the surgical treatment of epilepsy, many healthcare providers do not recommend or adequately discuss surgery with patients. Solutions to these barriers will require interventions that result in informed and capable patients who actively participate in their care and healthcare providers who practice culturally sensitive, recommended care. C1 Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Hlth Serv Res, Parkinsons Dis Res Educ & Clin Ctr, Portland, OR USA. RP Swarztrauber, K (reprint author), Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. EM swarztra@ohsu.edu FU NINDS NIH HHS [U01-NS42372] NR 54 TC 9 Z9 9 U1 7 U2 8 PU M B L COMMUNICATIONS, INC PI NEW YORK PA 333 HUDSON ST, 7TH FLOOR, NEW YORK, NY 10013 USA SN 1092-8529 J9 CNS SPECTRUMS JI CNS Spectr. PD FEB PY 2004 VL 9 IS 2 BP 146 EP 152 PG 7 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 895VA UT WOS:000226890700017 PM 14999170 ER PT J AU Drezner, MK AF Drezner, MK TI Treatment of anticonvulsant drug-induced bone disease SO EPILEPSY & BEHAVIOR LA English DT Article DE anticonvulsant drugs; bone remodeling; osteopenia; osteoporosis; osteomalacia; vitamin D; bisphosphonates ID CONTROLLED THERAPEUTIC TRIAL; VITAMIN-D; CALCIUM-METABOLISM; INDUCED OSTEOMALACIA; ANTIEPILEPTIC DRUGS; PARATHYROID-HORMONE; EPILEPTIC PATIENTS; MINERAL DENSITY; PLASMA 25-HYDROXYVITAMIN-D; CHILDREN AB Although the pathophysiology of bone disease in patients treated with anticonvulsant drugs may vary, most affected patients have increased bone remodeling rather than decreased mineralization. Milder cases may show high bone turnover without significant loss of cortical or trabecular bone. Cases of intermediate severity may exhibit the characteristic features of a high-turnover osteopenia/osteoporosis, but some patients with severe bone disease may manifest the features of an osteomalacic disorder. Prophylactic vitamin D supplementation at doses tip to 2000 IU/day can be recommended for all patients on initiation of anticonvulsant therapy. A calcium intake of 600-1000 mg/day should also be ensured. If an osteopenic/osteoporotic disorder exists, treatment with 2000-4000 IU/day vitamin D is appropriate. Vitamin D doses of 5000-15,000 IU/day may be needed to treat osteomalacia. Conventional treatment with bisphosphonates may be needed when the response to vitamin D is inadequate. However, routine use of bisphosphonates in patients receiving long-term anticonvulsant therapy cannot at present be recommended. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Hosp, Ctr Geriatr Res Educ & Clin, Madison, WI 53792 USA. RP Drezner, MK (reprint author), Univ Wisconsin, Sch Med, Dept Med, 600 Highland Ave, Madison, WI 53792 USA. EM mkd@medicine.wisc.edu NR 49 TC 53 Z9 56 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1525-5050 J9 EPILEPSY BEHAV JI Epilepsy Behav. PD FEB PY 2004 VL 5 SU 2 BP S41 EP S47 DI 10.1016/j.yebeh.2003.11.028 PG 7 WC Behavioral Sciences; Clinical Neurology; Psychiatry SC Behavioral Sciences; Neurosciences & Neurology; Psychiatry GA 805ES UT WOS:000220350200007 PM 15123011 ER PT J AU Mazarati, AM Baldwin, R Klitgaard, H Matagne, A Wasterlain, CG AF Mazarati, AM Baldwin, R Klitgaard, H Matagne, A Wasterlain, CG TI Anticonvulsant effects of levetiracetam and levetiracetam-diazepam combinations in experimental status epilepticus SO EPILEPSY RESEARCH LA English DT Article DE status epilepticus; levetiracetam; diazepam; experimental model ID SUSTAINING STATUS EPILEPTICUS; TEMPORAL-LOBE EPILEPSY; ANTIEPILEPTIC DRUG LEVETIRACETAM; RAT PILOCARPINE MODEL; PARTIAL SEIZURES; DOUBLE-BLIND; EFFICACY; PROFILE; TRIAL; SAFETY AB Status epilepticus (SE) is a neurological emergency, with high mortality and high morbidity among survivors, and novel therapeutic agents are needed to improve this picture. We examined the effects of the antiepileptic drug levetiracetam (LEV) in an experimental model Of Self-sustaining status epilepticus (SSSE), induced in rats by electrical stimulation of the perforant path. LEV's unique spectrum of anticonvulsant activity, very high therapeutic index, and neuroprotective properties, make it a potentially interesting agent in the treatment of SE. Pretreatment with LEV intravenously reduced (30 mg/kg) or prevented (50-1000 mg/kg) the development of self-sustaining seizures. Treatment during the maintenance phase of SSSE diminished (at 200 mg/kg) or aborted seizures (in doses of 500 or 1000 mg/kg). Addition of LEV significantly enhanced the anticonvulsant effects of diazepam (DZP), even when both drugs where given in doses far below their therapeutic level. We conclude that LEV deserves further evaluation in the treatment of status epilepticus. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, Geffen Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. UCB Bioprod SA, Pharma Sector, Preclin CNS Res, Braine LAlleud, Belgium. Univ Calif Los Angeles, Geffen Sch Med, Brain Res Inst, Los Angeles, CA USA. RP Mazarati, AM (reprint author), Univ Calif Los Angeles, Geffen Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. EM mazarati@ucla.edu FU NINDS NIH HHS [NS 43409, NS 13515] NR 30 TC 65 Z9 67 U1 2 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-1211 J9 EPILEPSY RES JI Epilepsy Res. PD FEB PY 2004 VL 58 IS 2-3 BP 167 EP 174 DI 10.1016/j.eplepsyres.2004.02.002 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 821ZC UT WOS:000221501000008 PM 15120747 ER PT J AU El-Serag, HB Tran, T Everhart, JE AF El-Serag, HB Tran, T Everhart, JE TI Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma SO GASTROENTEROLOGY LA English DT Article ID NONALCOHOLIC FATTY LIVER; OF-VETERANS-AFFAIRS; UNITED-STATES; NATURAL-HISTORY; CANCER RISK; INSULIN-RESISTANCE; MELLITUS; STEATOHEPATITIS; CIRRHOSIS; HEPATITIS AB Background & Aims: An association between diabetes and chronic liver disease has been reported. However, the temporal relationship between these conditions remains unknown. Methods: We identified all patients with a hospital discharge diagnosis of diabetes between 1985 and 1990 using the computerized records of the Department of Veterans Affairs. We randomly assigned 3 patients without diabetes for every patient with diabetes. We excluded patients with concomitant liver disease. The remaining cohort was followed through 2000 for the occurrence of chronic nonalcoholic liver disease (CNLD) and hepatocellular carcinoma (HCC). Hazard rate ratios (HRR) were determined in Cox proportional hazard survival analysis. Results: The study cohort comprised 173,643 patients with diabetes and 650,620 patients without diabetes. Most were men (98%). Patients with diabetes were older (62 vs. 54 years) than patients without diabetes. The incidence of chronic nonalcoholic liver disease was significantly higher among patients with diabetes (incidence rate: 18.13 vs. 9.55 per 10,000 person-years, respectively, P < 0.0001). Similar results were obtained for HCC (incidence rate: 2.39 vs. 0.87 per 10,000 person-years, respectively, P < 0.0001). Diabetes was associated with an HRR of 1.98 (95% Cl: 1.88 to 2.09, P < 0.0001) of CNLD and an HRR of 2.16 (1.86 to 2.52, P < 0.0001) of hepatocellular carcinoma. Diabetes carried the highest risk among patients with longer than 10 years of follow-up. Conclusions: Among men with diabetes, the risk of CNLD and HCC is doubled. This increase in risk is independent of alcoholic liver disease, viral hepatitis, or demographic features. C1 Houston Dept Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX USA. Houston Dept Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. NIDDK, Bethesda, MD 20892 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu NR 51 TC 553 Z9 571 U1 2 U2 19 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD FEB PY 2004 VL 126 IS 2 BP 460 EP 468 DI 10.1053/j.gastro.2003.10.065 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 771XJ UT WOS:000188811100013 PM 14762783 ER PT J AU Gukovsky, I Cheng, JH Nam, KJ Lee, OT Lugea, A Fischer, L Penninger, JM Pandol, SJ Gukovskaya, AS AF Gukovsky, I Cheng, JH Nam, KJ Lee, OT Lugea, A Fischer, L Penninger, JM Pandol, SJ Gukovskaya, AS TI Phosphatidylinositide 3-kinase gamma regulates key pathologic responses to cholecystokinin in pancreatic acinar cells SO GASTROENTEROLOGY LA English DT Article ID NF-KAPPA-B; PHOSPHOINOSITIDE 3-KINASE; TRYPSINOGEN ACTIVATION; INTRACELLULAR TRYPSINOGEN; INFLAMMATORY RESPONSE; CA2+ INFLUX; MAST-CELLS; MAP KINASE; CALCIUM; ENTRY AB Background & Aims: Early events in the pancreatic acinar cell critical for development of pancreatitis include activation of the transcription factor nuclear factor kappaB (NF-kappaB), abnormal Ca2+ responses, and trypsinogen activation. Mechanisms underlying these responses, which can be studied in isolated pancreatic acini stimulated with supraphysiologic doses of cholecystokinin (CCK-8), remain poorly understood. We here report that these responses are regulated by phosphatidylinositide 3-kinase (PI3K) gamma. Methods: To inactivate PI3K, we used mice deficient in the catalytic PI3Kgamma subunit p110gamma as well as the PI3K inhibitors LY294002 and wortmannin. We measured Ca2+ responses by using Fura-2, NF-kappaB-binding activity by electromobility shift assay, IkappaB degradation by Western blotting, and trypsinogen activation by fluorogenic assay. Results: CCK-induced intracellular Ca2+ mobilization, Ca2+ influx, trypsinogen, and NF-kappaB activation were all diminished in pancreatic acini isolated from p110gamma(-/-) mice. Both in mouse and rat acini, these responses were inhibited by the PI3K inhibitors. The Ca2+ signal and trypsinogen activation were similarly reduced in acini isolated from p110gamma(-/-) and p110gamma(+/-) mice compared with wild-type mice. By contrast, NF-kappaB activation was inhibited in p110gamma(-/-) acini but not in p110gamma(+/-) acini. These differences indicate that the mechanism of NF-kappaB regulation by PI3Kgamma differs from those for the Ca2+ and trypsinogen responses. CCK-induced responses in p110gamma(-/-) acini were all further inhibited by LY294002, indicating the involvement of other PI3K isoform(s), in addition to PI3Ky. Conclusions: The results show that key pathologic responses of the pancreatic acinar cell are regulated by PI3Kgamma and suggest an important role for this PI3K isoform in pancreatitis. C1 Univ Calif Los Angeles, W Los Angeles VA Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Austrian Acad Sci, Inst Mol Biotechnol, Dept Med, A-1010 Vienna, Austria. RP Gukovsky, I (reprint author), Univ Calif Los Angeles, W Los Angeles VA Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Dept Med, Bldg 258,Room 340,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM igukovsk@ucla.edu RI Penninger, Josef/I-6860-2013 OI Penninger, Josef/0000-0002-8194-3777 FU NIAAA NIH HHS [P50-AA11999]; NIDDK NIH HHS [DK59508] NR 62 TC 52 Z9 57 U1 0 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD FEB PY 2004 VL 126 IS 2 BP 554 EP 566 DI 10.1053/j.gastro.2003.11.017 PG 13 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 771XJ UT WOS:000188811100022 PM 14762792 ER PT J AU Leung, FW AF Leung, FW TI The venerable nasogastric tube SO GASTROINTESTINAL ENDOSCOPY LA English DT Editorial Material ID UPPER-GASTROINTESTINAL-TRACT; RANDOMIZED CONTROLLED-TRIAL; RIGHT SUBCLAVIAN ARTERY; BLEEDING PEPTIC-ULCER; NATIONAL ASGE SURVEY; COLORECTAL SURGERY; ABDOMINAL-SURGERY; ROUTINE USE; HEMORRHAGE; ENDOSCOPY C1 Vet Affairs Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr & Nursing Home, Med Serv, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, Sepulveda Ambulatory Care Ctr & Nursing Home, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. RP Leung, FW (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr & Nursing Home, Med Serv, Los Angeles, CA USA. NR 64 TC 6 Z9 6 U1 0 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD FEB PY 2004 VL 59 IS 2 BP 255 EP 260 AR PII S0016-5107(03)02961-9 DI 10.1016/S0016-5107(03)02691-9 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 772ZA UT WOS:000188872100014 PM 14745400 ER PT J AU Schnelle, JF AF Schnelle, JF TI Determining the relationship between staffing and quality SO GERONTOLOGIST LA English DT Editorial Material C1 Univ Calif Los Angeles, Borun Ctr Gerontol Res, JHA, Reseda, CA 91335 USA. Univ Calif Los Angeles, Dept Med, Reseda, CA 91335 USA. VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA USA. Jewish Home Aging, Reseda, CA USA. RP Schnelle, JF (reprint author), Univ Calif Los Angeles, Borun Ctr Gerontol Res, JHA, 7150 Tampa Ave, Reseda, CA 91335 USA. EM jschnell@ucla.edu NR 11 TC 16 Z9 16 U1 0 U2 0 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD FEB PY 2004 VL 44 IS 1 BP 10 EP 12 PG 3 WC Gerontology SC Geriatrics & Gerontology GA 777EZ UT WOS:000189164000002 PM 14978316 ER PT J AU Goodfriend, TL Ball, DL Egan, BM Campbell, WB Nithipatikom, K AF Goodfriend, TL Ball, DL Egan, BM Campbell, WB Nithipatikom, K TI Epoxy-keto derivative of linoleic acid stimulates aldosterone secretion SO HYPERTENSION LA English DT Article; Proceedings Paper CT 57th Annual Fall Conference and Scientific Sessions of the American-Heart-Association-Council-for-Blood-Pressure-Research CY SEP 23-26, 2003 CL WASHINGTON, D.C. SP Amer Heart Assoc Council High Blood Pressure Res DE fatty acids; oxidative stress; hypertension; aldosterone; obesity; adrenal gland ID RAT ADRENAL-CELLS; FREE FATTY-ACID; OXIDATIVE STRESS; BLOOD-PRESSURE; ESSENTIAL-HYPERTENSION; GLOMERULOSA CELLS; OBESITY; ANGIOTENSIN; STEROIDOGENESIS AB Plasma levels of aldosterone are not always predictable from the activity of renin and the concentration of potassium. Among the unexplained are elevated levels of aldosterone in some obese humans. Obesity is characterized by increased plasma fatty acids and oxidative stress. We postulated that oxidized fatty acids stimulate aldosteronogenesis. The most readily oxidized fatty acids are the polyunsaturated, and the most abundant of those is linoleic acid. We tested oxidized derivatives of linoleic acid for effects on rat adrenal cells. One derivative, 12,13-epoxy-9-keto-10(trans)-octadecenoic acid (EKODE), was particularly potent. EKODE stimulated aldosteronogenesis at concentrations from 0.5 to 5 mumol/L, and inhibited aldosteronogenesis at higher doses. EKODE's stimulatory effect was most prominent when angiotensin and potassium effects were submaximal. The lipid's mechanism of action was on the early pathway leading to pregnenolone; its action was inhibited by atrial natriuretic peptide. Plasma EKODE was measured by liquid chromatography/mass spectrometry. All human plasmas tested contained EKODE in concentrations ranging from 10(-9) to 5x10(-7) mol/L. In samples from 24 adults, levels of EKODE correlated directly with aldosterone (r=0.53, P=0.007). In the 12 blacks in that cohort, EKODE also correlated with body mass index and systolic pressure. Those other correlations were not seen in white subjects. The results suggest that oxidized derivatives of polyunsaturated fatty acids other than arachidonic are biologically active. Compounds like EKODE, derived from linoleic acid, may affect adrenal steroid production in humans and mediate some of the deleterious effects of obesity and oxidative stress, especially in blacks. C1 William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI USA. Univ Wisconsin, Dept Pharmacol, Madison, WI 53706 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Coll Wisconsin, Dept Pharmacol, Milwaukee, WI 53226 USA. RP Goodfriend, TL (reprint author), William S Middleton Mem Vet Adm Med Ctr, 2500 Overlook Terrace, Madison, WI 53705 USA. EM theodore.goodfriend@med.va.gov NR 31 TC 120 Z9 120 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD FEB PY 2004 VL 43 IS 2 BP 358 EP 363 DI 10.1161/01.HYP.0000113294.06704.64 PN 2 PG 6 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 769VD UT WOS:000188669700012 PM 14718355 ER PT J AU Henning, KJ Brennan, PJ Hoegg, C O'Rourke, E Dyer, BD Grace, TL AF Henning, KJ Brennan, PJ Hoegg, C O'Rourke, E Dyer, BD Grace, TL TI Health system preparedness for bioterrorism: Bringing the tabletop to the hospital SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID BIOLOGICAL TERRORISM; MASS DESTRUCTION; PUBLIC-HEALTH; WEAPONS AB OBJECTIVE: To evaluate the acceptance and usefulness of a hospital-based tabletop bioterrorism exercise. DESIGN: A descriptive study of responses to a smallpox scenario delivered as a tabletop exercise in three modules. SETTING: A large, multi-institutional urban health system. PARTICIPANTS: Healthcare workers representing 16 hospital departments. RESULTS: Thirty-nine (78%) of 50 invited employees from 4 hospitals participated. Key responses highlighted the importance of pre-event planning in intra-departmental communication, identification of resources for the dependents of healthcare workers, clarification of the chain of command within the hospital, establishment of a link to key governmental agencies, and advanced identification of negative pressure rooms for cohorting large numbers of patients. Almost one-fourth of the participants described their hospital department as poorly prepared for a bioterrorism event of moderate size. At the conclusion of the tabletop, 79% of the participants stated that the exercise had increased their knowledge of preplanning activities. Seventy-nine percent of all participants, 94% of physicians and nurses, and 95% of participants from non-university hospitals ranked the exercise as extremely or very useful. The exercise was completed in 31/2 hours and its total direct cost (excluding lost time from work) was $225 (U.S.). CONCLUSIONS: Tabletop exercises are a feasible, well-accepted modality for hospital bioterrorism preparedness training. Hospital employees, including physicians and nurses, rank this method as highly useful for guiding preplanning activities. Infection control staff and hospital epidemiologists should play a lead role in hospital preparedness activities. Further assessment of the optimal duration, type, and frequency of tabletop exercises is needed. C1 Univ Penn, Sch Med, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Infect Control & Hosp Epidemiol, Philadelphia, PA USA. Univ Penn Hlth Syst, Safety Management Program, Philadelphia, PA USA. Hosp Univ Penn, Infect Control Dept, Philadelphia, PA 19104 USA. Penn Hosp, Infect Control Dept, Philadelphia, PA 19107 USA. RP Henning, KJ (reprint author), Div Epidemiol, 125 Worth St,Box 315-CN6, New York, NY 10013 USA. NR 31 TC 15 Z9 15 U1 2 U2 3 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD FEB PY 2004 VL 25 IS 2 BP 146 EP 155 DI 10.1086/502366 PG 10 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 775CC UT WOS:000189022300013 PM 14994941 ER PT J AU Asch, SM Fremont, AM Turner, BJ Gifford, A McCutchan, JA Mathews, WMC Bozzette, SA Shapiro, MF AF Asch, SM Fremont, AM Turner, BJ Gifford, A McCutchan, JA Mathews, WMC Bozzette, SA Shapiro, MF TI Symptom-based framework for assessing quality of HIV care SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE HIV; patient-centered care; quality indicators; quality of care; symptoms ID HUMAN-IMMUNODEFICIENCY-VIRUS; OF-LIFE; SERVICES UTILIZATION; UNITED-STATES; UNMET EXPECTATIONS; INFECTED PATIENTS; COST; PREVALENCE; DISEASE; RELIABILITY AB Objective. To evaluate HIV quality of care using a symptom-based, patient-centered framework. Methods. An expert panel developed 13 quality indicators for three common symptoms: cough with fever and/or shortness of breath; severe or persistent diarrhea; and significant weight loss. A nationally representative probability sample of HIV-infected adults was interviewed between 1996 and 1997. Participants were asked about the presence and severity of HIV symptoms during the preceding 6 months, and care received. Variation in adherence to the indicators was assessed by symptom type and patient characteristics. Results. In all, 2864 (71%) patients completed interviews and 920 reported being at least moderately bothered with one of the three symptoms. Of these, 41, 74, and 65% of patients with a symptom of cough, weight loss, or diarrhea, respectively, reported receiving all indicated care. Performance was better for patients with more severe HIV, measured as a CD4 cell count <50 cells/microliter, compared with those with less severe HIV, measured as CD4 cell count >500 cells/microliter (43% versus 60%; P = 0.02). Uninsured patients had worse performance than Medicare patients (45% versus 62%; P = 0.04), but care did not differ by patient's age, gender, ethnicity, HIV risk factor, providers' HIV patient load, or region. Only CD4 count remained significantly associated with performance in the multivariate analyses. Conclusions. Symptom-based quality indicators may provide a useful supplement to conventional measures. Patients with HIV reported substantial underuse of services for common, burdensome symptoms. Although adherence to quality indicators was better for patients with more advanced HIV disease, many still received suboptimal care. Vulnerable patient groups generally did not receive worse quality of care, suggesting that symptom-based measures of quality may measure domains that are distinct from those captured by conventional indicators. C1 VA Greater Los Angeles Hlth Syst, Dept Gen Internal Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. RAND Corp, Hlth, Santa Monica, CA USA. Univ Penn, Div Gen Med, Philadelphia, PA 19104 USA. VA San Diego Healthcare Syst, Hlth Serv Res & Dev Program, San Diego, CA USA. Univ Calif San Diego, Sch Med, Dept Med, Div Infect Dis, La Jolla, CA 92093 USA. Univ Calif Los Angeles, Sch Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA. RP Asch, SM (reprint author), VA Greater Los Angeles Hlth Syst, Dept Gen Internal Med, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM sasch@rand.org FU AHRQ HHS [U01 HS 08578] NR 35 TC 7 Z9 8 U1 3 U2 4 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1353-4505 J9 INT J QUAL HEALTH C JI Int. J. Qual. Health Care PD FEB PY 2004 VL 16 IS 1 BP 41 EP 50 DI 10.1093/intqhc/mzh004 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 771PX UT WOS:000188796200006 PM 15020559 ER PT J AU Shores, MM Ryan-Dykes, P Williams, RM Mamerto, B Sadak, T Pascualy, M Felker, BL Zweigle, M Nichol, P Peskind, ER AF Shores, MM Ryan-Dykes, P Williams, RM Mamerto, B Sadak, T Pascualy, M Felker, BL Zweigle, M Nichol, P Peskind, ER TI Identifying undiagnosed dementia in residential care veterans: comparing telemedicine to in-person clinical examination SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE telemedicine; telepsychiatry; dementia; screening; 7-Minute Screen; veterans ID CLOCK DRAWING TEST; MINI-MENTAL-STATE; ALZHEIMERS-DISEASE; CONTROLLED TRIAL; PROGRAM; EXTENSION; SYSTEM AB Background Dementia is a common but frequently undiagnosed problem in aging. Barriers to early diagnosis include a lack of routine screening for dementia and a lack of access to specialty consultative services. We conducted a pilot study to see if telemedicine could provide reliable, accurate geriatric consultative services to evaluate patients for dementia who were residing at remote sites. Methods This was a prospective cohort study that compared the diagnostic reliability of telemedicine to an in-person examination for dementia. Eligible subjects were residents of a Washington State Veterans' Home, age 60 years or older, with no prior diagnosis of dementia. Eligible subjects were screened for dementia using the 7-Minute Screen. Veterans who screened positive and consented to participate in the study received an in-person neuropsychiatric evaluation at baseline, and then both telemedicine and in-person examinations for dementia conducted by experienced geriatric psychiatrists. The accuracy of the telemedicine diagnosis was estimated by comparing it to the diagnosis from the clinical examination. Three geriatric psychiatrists who were blinded to the results of the clinical examination conducted the telemedicine and in-person examinations. We also assessed attitudes of the subjects and geriatric psychiatrists towards the telemedicine sessions. Results Eighteen of 85 subjects screened were 'positive' for dementia on the 7 Minute Screen. Of these, 16 consented to participate in the telemedicine study. Twelve of the 16 subjects were subsequently diagnosed with dementia by the telemedicine examination. The telemedicine diagnoses were in 100% agreement with the diagnoses from the in-person clinical examinations. Moreover, the subjects reported a high degree of satisfaction with the telemedicine experience and that they would like to have further care through telemedicine in the future. The geriatric psychiatrists reported technical difficulties with the audio-visual quality of telemedicine in the initial phases of the project that resolved as familiarity with the telemedicine equipment increased. None of these problems had an adverse impact on the diagnostic accuracy of telemedicine. Conclusions We found that telemedicine was as accurate as an in-person clinical examination in establishing the diagnosis of dementia. In addition, subjects reported a high degree of satisfaction with telemedicine and a willingness to participate in telemedicine clinical care in the future. Given the large increase in the aging population and the shortage of geriatric psychiatrists nationally, it appears that telemedicine may be a promising means to expand the availability of geriatric psychiatric consultation to remote areas. Published in 2004 by John Wiley Sons, Ltd. C1 GRECC, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. MIRECC, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Washington Vet Homes, Orting, WA USA. RP Shores, MM (reprint author), GRECC, VA Puget Sound Hlth Care Syst, 1660 S Columbia Way,S-182B, Seattle, WA 98108 USA. EM molly.shores@med.va.gov NR 38 TC 32 Z9 32 U1 2 U2 7 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD FEB PY 2004 VL 19 IS 2 BP 101 EP 108 DI 10.1002/gps.1029 PG 8 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 776CE UT WOS:000189096800001 PM 14758575 ER PT J AU Zhao, JL Pergola, PE Roman, LJ Kellogg, DL AF Zhao, JL Pergola, PE Roman, LJ Kellogg, DL TI Bioactive nitric oxide concentration does not increase during reactive hyperemia in human skin SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE skin blood flow; vasodilation; amperometric electrode; laser-Doppler flowmetry ID HUMAN FOREARM; HEAT-STRESS; SUBSTANCE-P; VASODILATATION; SYNTHASE; VESSELS AB This study examined whether nitric oxide ( NO) is involved in the cutaneous response to reactive hyperemia ( RH) in the human forearm. We enrolled seven healthy volunteers. NO concentrations were monitored using a NO selective amperometric electrode (ISO-NOP200, World Precision Instruments) inserted into the skin of the forearm. Laser-Doppler flowmetry ( Moor Instruments) was used for monitoring skin blood flow (SkBF) at the same site. SkBF and NO levels were monitored and recorded continuously throughout the experiment. An intradermal microdialysis probe was inserted adjacent to the NO electrode for drug delivery. Data collection began 140 min after the NO electrodes and microdialysis probes were inserted. RH was achieved by the inflation of a blood pressure cuff to 25 mmHg above systolic pressure for 7 min after which the pressure in the cuff was abruptly released. Acetylcholine (ACh) was given by microdialysis probe at the end of RH study to verify the ability of the electrode system to detect changes in the NO concentration. SkBF and NO data before RH and immediately, 2, 5, 7, and 10 min after cuff deflation were used for analysis. SkBF increased immediately after release of the occlusion ( P < 0.0001) and remained elevated for 2 min. No significant NO changes occurred with the increases in LDF. ACh induced increases in both SkBF and NO ( P < 0.000 and P < 0.037, respectively). We conclude that RH increases SkBF by mechanisms that do not require a measurable increase in NO concentrations. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Geriatr & Gerontol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Biochem, San Antonio, TX 78229 USA. Dept Vet Affairs, S Texas Vet Hlth Care Syst, Audie L Murphy Mem Vet Hosp Div, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Kellogg, DL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Geriatr & Gerontol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NHLBI NIH HHS [HL-65599] NR 29 TC 40 Z9 40 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD FEB 1 PY 2004 VL 96 IS 2 BP 628 EP 632 DI 10.1152/japplphysiol.00639.2003 PG 5 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 761EU UT WOS:000187888400029 PM 14715681 ER PT J AU Shen, BJ McCreary, CP Myers, HF AF Shen, BJ McCreary, CP Myers, HF TI Independent and mediated contributions of personality, coping, social support, and depressive symptoms to physical functioning outcome among patients in cardiac rehabilitation SO JOURNAL OF BEHAVIORAL MEDICINE LA English DT Article DE coronary heart disease (CHD); depression; hostility; optimism; social support ID CORONARY-ARTERY-DISEASE; MYOCARDIAL-INFARCTION; HEART-DISEASE; BYPASS-SURGERY; HOSTILITY; HEALTH; METAANALYSIS; PROGNOSIS; RESOURCES; OPTIMISM AB This study examined the direct and mediated contributions of psychosocial variables to posttreatment physical functioning among 142 patients receiving cardiac rehabilitation. Two models were proposed and tested. In the first model, psychosocial factors were correlated and made to predict baseline and 6-week physical functioning. The results showed that after controlling for age, illness severity, baseline physical functioning, and other psychosocial correlates, optimism and social support still significantly predicted better posttreatment physical functioning. In the second model, we explored both the direct and mediational relationships between psychosocial factors and physical health outcomes. Optimism and social support were found to contribute to health outcomes not only directly but also indirectly through the mediation of less engagement in detrimental coping and lower depressive symptoms, whereas hostility and negative coping only predicted outcomes indirectly through mediators. These findings highlighted the importance of addressing psychosocial issues and their interrelationships in cardiac rehabilitation. C1 Univ Miami, Dept Psychol, Coral Gables, FL 33124 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. VA Greater Los Angeles Hlth Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. RP Shen, BJ (reprint author), Univ Miami, Dept Psychol, POB 248185, Coral Gables, FL 33124 USA. EM bshen@miami.edu NR 49 TC 55 Z9 58 U1 2 U2 9 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0160-7715 J9 J BEHAV MED JI J. Behav. Med. PD FEB PY 2004 VL 27 IS 1 BP 39 EP 62 DI 10.1023/B:JOBM.0000013643.36767.22 PG 24 WC Psychology, Clinical SC Psychology GA 768FC UT WOS:000188532100004 PM 15065475 ER PT J AU London, MJ Itani, KMF Perrino, AC Guarino, PD Schwartz, GG Cunningham, F Gottlieb, SS Henderson, WG AF London, MJ Itani, KMF Perrino, AC Guarino, PD Schwartz, GG Cunningham, F Gottlieb, SS Henderson, WG TI Perioperative beta-blockade: A survey of physician attitudes in the department of veterans affairs SO JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA LA English DT Article DE postoperative complications; perioperative period; beta-adrenergic receptor antagonists; vascular surgery; noncardiac surgery; clinical surveys ID SILENT-MYOCARDIAL-ISCHEMIA; MAJOR VASCULAR-SURGERY; HIGH-RISK PATIENTS; NONCARDIAC SURGERY; CARDIAC EVENTS; CARDIOVASCULAR MORBIDITY; MORTALITY; GUIDELINE; BLOCKERS; ASSOCIATION AB Objective: To delineate clinician opinion on the efficacy, safety, and logistics of perioperative beta-adrenergic blockade for patients undergoing noncardiac surgery. Design: Survey of opinions and clinical practices. Setting: Internet-based survey form. Participants: Members of the Associations of Veterans Affairs Anesthesiologists and Surgeons and chiefs of cardiology in centers with surgical programs. Interventions: None. Measurements and Main Results: One hundred twenty-seven responses from 62 Veterans Affairs Medical Centers in 35 states (57 anesthesiologists, 45 surgeons, 25 cardiologists) were analyzed. Ninety-two percent agreed that it is effective in reducing short-term adverse outcomes, declining to 60% for long-term outcome. There was greater enthusiasm for its use in patients with known coronary artery disease (87%) than in patients with risk factors only (72%). Although 66% considered it efficacious in vascular surgery, only 30% were convinced it was for nonvascular surgery (with a similar distribution for safety in these settings). Preoperative use was favored (94%), with most physicians favoring use within 1 week of surgery (52%). Most favored 1 to 2 weeks of postoperative therapy (43%), with the remainder favoring shorter (19%) or longer (35%) durations. Although 71% of clinicians reported frequent use in their practice, most believed its use was largely informal by their colleagues (83%) and rarely based on a formal clinical pathway (13%). Conclusion: A wide range of opinions by clinicians regarding the efficacy, safety, and logistics of perioperative beta-adrenergic blockade was encountered, suggesting need for additional clinical research and centralized efforts at increasing compliance with existing guidelines. (C) 2004 Elsevier Inc. All rights reserved. C1 Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. Baylor Coll Med, Dept Surg, Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Yale Univ, Sch Med, Dept Anesthesia, Vet Affairs Connecticut Healthcare Syst, West Haven, CT 06516 USA. W Haven Cooperat Studies Coordinating Ctr, Dept Vet Affairs, West Haven, CT USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver Vet Affairs Med Ctr, Denver, CO USA. Hines VAMC, Pharm Benefits Management Grp, Hines, IL USA. Univ Maryland, Sch Med, Dept Med, Baltimore Vet Affairs Med Ctr, Baltimore, MD 21201 USA. Univ Colorado, Hlth Outcomes Program, Hlth Sci Ctr, Denver, CO 80202 USA. RP London, MJ (reprint author), Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. NR 27 TC 15 Z9 16 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1053-0770 J9 J CARDIOTHOR VASC AN JI J. Cardiothorac. Vasc. Anesth. PD FEB PY 2004 VL 18 IS 1 BP 14 EP 24 DI 10.1053/j.jvca.2003.10.004 PG 11 WC Anesthesiology; Cardiac & Cardiovascular Systems; Respiratory System; Peripheral Vascular Disease SC Anesthesiology; Cardiovascular System & Cardiology; Respiratory System GA 777CZ UT WOS:000189158300003 PM 14973793 ER PT J AU Amory, JK Watts, NB Easley, KA Sutton, PR Anawalt, BD Matsumoto, AM Bremner, WJ Tenover, JL AF Amory, JK Watts, NB Easley, KA Sutton, PR Anawalt, BD Matsumoto, AM Bremner, WJ Tenover, JL TI Exogenous testosterone or testosterone with finasteride increases bone mineral density in older men with low serum testosterone SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID BENIGN PROSTATIC HYPERPLASIA; SEX STEROID-LEVELS; TRANSDERMAL TESTOSTERONE; LONGITUDINAL CHANGES; TURNOVER MARKERS; HYPOGONADAL MEN; HIP FRACTURE; ELDERLY MEN; ESTROGEN; AGE AB Older men, particularly those with low serum testosterone (T) levels, might benefit from T therapy to improve bone mineral density (BMD) and reduce fracture risk. Concerns exist, however, about the impact of T therapy on the prostate in older men. We hypothesized that the combination of T and finasteride (F), a 5alpha-reductase inhibitor, might increase BMD in older men without adverse effects on the prostate. Seventy men aged 65 yr or older, with a serum T less than 12.1 nmol/liter on two occasions, were randomly assigned to receive one of three regimens for 36 months: T enanthate, 200 mg im every 2 wk with placebo pills daily (T-only); T enanthate, 200 mg every 2 wk with 5 mg F daily (T+F); or placebo injections and pills (placebo). Low BMD was not an inclusion criterion. We obtained serial measurements of BMD of the lumbar spine and hip by dual x-ray absorptiometry. Prostate-specific antigen (PSA) and prostate size were measured at baseline and during treatment to assess the impact of therapy on the prostate. Fifty men completed the 36-month protocol. By an intent-to-treat analysis including all men for as long as they contributed data, T therapy for 36 months increased BMD in these men at the lumbar spine [10.2+/-1.4% (mean percentage increase from baseline+/-SEM; T-only) and 9.3+/-1.4% (T+F) vs. 1.3+/-1.4% for placebo (P<0.001)] and in the hip [2.7 +/- 0.7% (T-only) and 2.2 +/- 0.7% (T+F) vs. -0.2 +/- 0.7% for placebo, (P <= 0.02)]. Significant increases in BMD were seen also in the intertrochanteric and trochanteric regions of the hip. After 6 months of therapy, urinary deoxypyridinoline (a bone-resorption marker) decreased significantly compared with baseline in both the T-only and T+F groups (P<0.001) but was not significantly reduced compared with the placebo group. Over 36 months, PSA increased significantly from baseline in the T-only group (P<0.001). Prostate volume increased in all groups during the 36-month treatment period, but this increase was significantly less in the T+F group compared with both the T-only and placebo groups (P=0.02). These results demonstrate that T therapy in older men with low serum T increases vertebral and hip BMD over 36 months, both when administered alone and when combined with F. This finding suggests that dihydrotestosterone is not essential for the beneficial effects of T on BMD in men. In addition, the concomitant administration of F with T appears to attenuate the impact of T therapy on prostate size and PSA and might reduce the chance of benign prostatic hypertrophy or other prostate-related complications in older men on T therapy. These findings have important implications for the prevention and treatment of osteoporosis in older men with low T levels. C1 Emory Univ, Sch Med, Rollins Sch Publ Hlth, Dept Med, Atlanta, GA 30329 USA. Emory Univ, Sch Med, Rollins Sch Publ Hlth, Dept Biostat, Atlanta, GA 30329 USA. Univ Cincinnati, Coll Med, Dept Med, Cincinnati, OH 45267 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Sch Med, Ctr Geriatr Res Educ & Clin, Seattle, WA 98195 USA. RP Tenover, JL (reprint author), Wesley Woods Hlth Ctr, 1841 Clifton Rd NE, Atlanta, GA 30329 USA. RI Easley, Kirk/K-6910-2015 OI Easley, Kirk/0000-0003-4419-2617 FU NIA NIH HHS [AG10975] NR 34 TC 257 Z9 275 U1 0 U2 5 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD FEB 1 PY 2004 VL 89 IS 2 BP 503 EP 510 DI 10.1210/jc.2003-031110 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 771AT UT WOS:000188763900008 PM 14764753 ER PT J AU Matsumoto, AM Bremner, WJ AF Matsumoto, AM Bremner, WJ TI Editorial: Serum testosterone assays - Accuracy matters SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Editorial Material ID BINDING GLOBULIN; MEN; TRANSPORT; PLASMA; WOMEN C1 Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. RP Bremner, WJ (reprint author), Univ Washington, Sch Med, Dept Med, 1959 NE Pacific St,Box 356420, Seattle, WA 98195 USA. EM wbremner@u.washington.edu NR 19 TC 124 Z9 129 U1 1 U2 3 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD FEB 1 PY 2004 VL 89 IS 2 BP 520 EP 524 DI 10.1210/jc.2003-032175 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 771AT UT WOS:000188763900011 PM 14764756 ER PT J AU Nanavati, SA Opekun, AR Hacken-Bitar, JB Cole, RA Anand, BS Graham, DY AF Nanavati, SA Opekun, AR Hacken-Bitar, JB Cole, RA Anand, BS Graham, DY TI Migrating shell fragment as a cause of recurrent obscure gastrointestinal bleeding SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Letter ID WIRELESS CAPSULE ENDOSCOPY C1 VA Med Ctr, Dept Med, Houston, TX USA. VA Med Ctr, Dept Diagnost Radiol, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. RP Nanavati, SA (reprint author), VA Med Ctr, Dept Med, Houston, TX USA. NR 7 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD FEB PY 2004 VL 38 IS 2 BP 137 EP 138 DI 10.1097/00004836-200402000-00014 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 768MR UT WOS:000188547200014 PM 14745292 ER PT J AU Freedland, SJ Aronson, WJ Kane, CJ Presti, JC Amling, CL Elashoff, D Terris, MK AF Freedland, SJ Aronson, WJ Kane, CJ Presti, JC Amling, CL Elashoff, D Terris, MK TI Impact of obesity on biochemical control after radical prostatectomy for clinically localized prostate cancer: A report by the shared equal access regional cancer hospital database study group SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID BODY-MASS INDEX; SEXTANT BIOPSIES; SEARCH DATABASE; UNITED-STATES; RISK FACTOR; FOLLOW-UP; RACE; DIET; PREVALENCE; RECURRENCE AB Purpose Given the limited information regarding the impact of obesity on treatment outcomes for prostate cancer, we sought to examine the relationship between body mass index (BMI) and cancer control after radical prostatectomy (RP). Patients and Methods We compared clinicopathologic and biochemical outcome information across BMI groups from 1,106 men treated with BP between 1988 and 2002. Multivariate analysis was used to determine if BMI significantly predicted adverse pathology or biochemical recurrence. Results Obesity was related to year of surgery (P < .001) and race (P < .001), with black men having the highest obesity rates. Obese patients had higher biopsy and pathologic grade tumors (P < .001). On multivariate analysis, BMI greater than or equal to 35 kg/m(2) was associated with a trend for higher rates of positive surgical margins (P = .008). Overweight patients (BMI, 25 to 30 kg/m(2)) had a significantly decreased risk of seminal vesicle invasion (P = .039). After controlling for all preoperative clinical variables including year of surgery, BMI greater than or equal to 35 kg/m(2) significantly predicted biochemical failure after BP (P = .002). After controlling for surgical margin status, BMI greater than or equal to 35 kg/m(2) remained a significant predictor of biochemical failure (P = .012). There was a trend for BMI greater than or equal to 35 kg/m(2) to be associated with higher failure rates than BMI between 30 and 35 kg/m(2) (P = .053). Conclusion The percentage of obese men undergoing RP in our data set doubled in the last 10 years. Obesity was associated with higher-grade tumors, a trend toward increased risk of positive surgical margins, and higher biochemical failure rates among men treated with RP. A BMI greater than or equal to 35 kg/m(2) was associated with a higher risk of failure than a BMI between 30 and 35 kg/m(2). (C) 2004 by American Society of Clinical Cincology. C1 Johns Hopkins Sch Med, Dept Urol, Baltimore, MD 21287 USA. Univ Calif Los Angeles, Dept Urol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. Vet Adm Med Ctr, Urol Sect, Dept Surg, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA USA. San Diego Naval Hosp, Dept Urol, San Diego, CA USA. Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA. RP Freedland, SJ (reprint author), Johns Hopkins Sch Med, Dept Urol, 600 N Wolfe St, Baltimore, MD 21287 USA. EM sfreedl1@jhmi.edu NR 41 TC 257 Z9 261 U1 0 U2 1 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 330 JOHN CARLYLE ST, STE 300, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD FEB 1 PY 2004 VL 22 IS 3 BP 446 EP 453 PG 8 WC Oncology SC Oncology GA 770PJ UT WOS:000188738900011 PM 14691122 ER PT J AU Feuerstein, M Shaw, WS Nicholas, RA Huang, GD AF Feuerstein, M Shaw, WS Nicholas, RA Huang, GD TI From confounders to suspected risk factors: psychosocial factors and work-related upper extremity disorders SO JOURNAL OF ELECTROMYOGRAPHY AND KINESIOLOGY LA English DT Article; Proceedings Paper CT Symposium on perspectives on Musculoskeletal Disorder Causation and Control CY MAY 21-22, 2003 CL COLUMUS, OHIO DE work-related upper extremity disorders; psychosocial factors; workstyle ID MUSCULOSKELETAL DISORDERS; COMPUTER USERS; JOB STRESS; SYMPTOMS; DISEASE; FORCES; NECK AB Psychosocial variables have recently been more prominent among epidemiologic risk factors for work-related upper extremity disorders (WRUEDs),. but bio-behavioral mechanisms underlying these associations have been elusive. One reason is that the psychosocial domain has included many broad and disparate variables (e.g. mood, coping skills, job control, job satisfaction, job stress. social support), and this lack of specificity in the conceptualization of psychosocial factors has produced limited hypothesis testing opportunities. Therefore, recent research efforts have focused on identifying and conceptualizing specific psychosocial factors that might more clearly delineate plausible bio-behavioral mechanisms linking psychosocial factors to WRUEDs. One such factor is workstyle, a strategy that workers may employ for completing, responding to, or coping with job demands that might affect musculoskeletal health. Preliminary studies have provided support for measurable differences in workstyle among individual workers and an association with upper extremity pain and discomfort. An initial self-report measure of workstyle has been pilot tested among office workers and shown acceptable reliability and validity. Future studies are needed to study this construct among other working populations and to determine its relationship with other clinical endpoints. Nevertheless, early findings suggest workstyle may be a potential focus of WRUED prevention efforts. Published by Elsevier Ltd. C1 Uniformed Serv Univ Hlth Sci, Dept Med & Clin Psychol, Bethesda, MD 20814 USA. Georgetown Univ, Med Ctr, Bethesda, MD 20814 USA. Univ Massachusetts, Sch Med, Hopkinton, MA 01748 USA. Liberty Mutual Ctr Disabil Res, Hopkinton, MA 01748 USA. US Dept Vet Affairs, Off Res & Dev, Bethesda, MD 20814 USA. RP Feuerstein, M (reprint author), Uniformed Serv Univ Hlth Sci, Dept Med & Clin Psychol, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA. EM mfeuerstein@usuhs.mil NR 27 TC 38 Z9 41 U1 0 U2 9 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1050-6411 J9 J ELECTROMYOGR KINES JI J. Electromyogr. Kinesiol. PD FEB PY 2004 VL 14 IS 1 BP 171 EP 178 DI 10.1016/j.jelekin.2003.09.016 PG 8 WC Neurosciences; Physiology; Rehabilitation; Sport Sciences SC Neurosciences & Neurology; Physiology; Rehabilitation; Sport Sciences GA 775ZC UT WOS:000189089700019 PM 14759762 ER PT J AU Johnson, RL Saha, S Arbelaez, JJ Beach, MC Cooper, LA AF Johnson, RL Saha, S Arbelaez, JJ Beach, MC Cooper, LA TI Racial and ethnic differences in patient perceptions of bias and cultural competence in health care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE bias; cultural competence; disparities; racial and ethnic minorities ID RACIAL/ETHNIC DISPARITIES; DIVERSE POPULATIONS; TEACHING RESIDENTS; PHYSICIAN; RACE; FRAMEWORK; EDUCATION; PROVIDERS; MODEL AB OBJECTIVES: To determine: 1) whether racial and ethnic differences exist in patients' perceptions of primary care provider (PCP) and general health care system-related bias and cultural competence; and 2) whether these differences are explained by patient demographics, source of care, or patient-provider communication variables. DESIGN: Cross-sectional telephone survey. SETTING: The Commonwealth Fund 2001 Health Care Quality Survey. SUBJECTS: A total of 6,299 white, African-American, Hispanic, and Asian adults. MEASUREMENTS AND MAIN RESULTS: Interviews were conducted using random-digit dialing; oversampling respondents from communities with high racial/ethnic minority concentrations; and yielding a 54.3% response rate. Main outcomes address respondents' perceptions of their PCPs' and health care system-related bias and cultural competence; adjusted probabilities (Pr) are reported for each ethnic group. Most racial/ethnic differences in perceptions of PCP bias and cultural competence were explained by demographics, source of care, and patient-physician communication variables. In contrast, racial/ethnic differences in patient perceptions of health care system-wide bias and cultural competence persisted even after controlling for confounders: African Americans, Hispanics, and Asians remained more likely than whites (P < .001) to perceive that: 1) they would have received better medical care if they belonged to a different race/ethnic group (Pr 0.13, Pr 0.08, Pr 0.08, and Pr 0.01, respectively); and 2) medical staff judged them unfairly or treated them with disrespect based on race/ethnicity (Pr 0.06, Pr 0.04, Pr 0.06, and Pr 0.01, respectively) and how well they speak English (Pr 0.09, Pr 0.06, Pr 0.06, and Pr 0.03, respectively). CONCLUSION: While demographics, source of care, and patient-physician communication explain most racial and ethnic differences in patient perceptions of PCP cultural competence, differences in perceptions of health care system-wide bias and cultural competence are not fully explained by such factors. Future research should include closer examination of the sources of cultural bias in the US medical system. C1 Johns Hopkins Univ, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD 21205 USA. Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA. Portland VA Med Ctr, Gen Internal Med Sect, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Med, Portland, OR USA. Johns Hopkins Univ, Sch Med, Dept Med, Div Gen Internal Med, Baltimore, MD 21205 USA. RP Cooper, LA (reprint author), Johns Hopkins Univ, Welch Ctr Prevent Epidemiol & Clin Res, 2024 E Monument St,Suite 2-500, Baltimore, MD 21205 USA. EM lisa.cooper@jhmi.edu NR 37 TC 210 Z9 210 U1 5 U2 26 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD FEB PY 2004 VL 19 IS 2 BP 101 EP 110 DI 10.1111/j.1525-1497.2004.30262.x PG 10 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 779KD UT WOS:000189293100001 PM 15009789 ER PT J AU Wiren, KM Toombs, AR Zhang, XW AF Wiren, KM Toombs, AR Zhang, XW TI Androgen inhibition of MAP kinase pathway and Elk-1 activation in proliferating osteloblasts SO JOURNAL OF MOLECULAR ENDOCRINOLOGY LA English DT Article ID SIGNAL-TRANSDUCTION PATHWAYS; OSTEOBLASTIC CELL-LINE; BONE-CELLS; EXTRACELLULAR-MATRIX; OSTEOSARCOMA CELLS; ADRENAL ANDROGENS; RAT OSTEOBLASTS; UP-REGULATION; IN-VITRO; RECEPTOR AB Non-aromatizable androgens have significant beneficial effects on skeletal homeostasis independently of conversion to estradiol, but the effects of androgens on bone cell metabolism and cell proliferation are still poorly understood. Using an osteoblastic model with enhanced androgen responsiveness, MC3T3-E1 cells stably transfected with androgen receptor (AR) under the control of the type I collagen promoter (coIAR-MC3T3), the effects of androgens on mitogenic signaling were characterized. Cultures were treated with the non-aromatizable androgen 5alpha-dihydrotestosterone (DHT) and the effects on osteoblast viability were determined as measured by an MTT assay. A complex response was observed in that continuous short-term DHT treatment enhanced osteoblast viability, but with longer-term DHT treatment inhibition was observed. The inhibition by DHT was prevented by the specific AR antagonist hydroxyflutamide, and was also observed in primary cultures of normal rat calvarial osteoblasts. In order to identify potential mediators of this effect, mitogenic pathway-specific cDNA microarrays were interrogated. Reduced hybridization of several genes important in MAP kinase-mediated signaling was observed, with the most dramatic effect on Elk-1 expression. Analysis of phosphorylation cascades demonstrated that DHT treatment inhibited phosphoERK1/2 levels, MAP kinase activation of Elk-1, Elk-1 protein and phosphoElk-1 levels, and downstream AP-1/luciferase reporter activity. Together, these data provide the first evidence that androgen inhibition of the MAP kinase signaling pathway is a potential mediator of osteoblast growth, and are consistent with the hypothesis that the MAP cascade may be a specific downstream target of DHT. C1 Portland Vet Affairs Med Ctr, Bone & Mineral Res Unit, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Med, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Behav Neurosci, Portland, OR USA. RP Wiren, KM (reprint author), Portland VA Med Ctr P3 RD39, 3710 SW Vet Hosp Rd, Portland, OR 97239 USA. EM wirenk@ohsu.edu NR 42 TC 20 Z9 20 U1 0 U2 1 PU SOC ENDOCRINOLOGY PI BRISTOL PA 22 APEX COURT, WOODLANDS, BRADLEY STOKE, BRISTOL BS32 4JT, ENGLAND SN 0952-5041 J9 J MOL ENDOCRINOL JI J. Mol. Endocrinol. PD FEB PY 2004 VL 32 IS 1 BP 209 EP 226 DI 10.1677/jme.0.0320209 PG 18 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 804NM UT WOS:000220305400016 PM 14766003 ER PT J AU Yao, JK Cheng, P Wengenack, TM Poduslo, JF AF Yao, JK Cheng, P Wengenack, TM Poduslo, JF TI Multiplicity effects of oxidative stress in the cortex of a transgenic mouse model of Alzheimer's disease SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 6th Biennial Meeting of the Asian-Pacific-Society-for-Neurochemistry CY FEB 04-07, 2004 CL Hong Kong, PEOPLES R CHINA SP Asian-Pacific Soc Neurochem DE Alzheimer's disease; cortex; glutathione; oxidative stress; transgenic mouse C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA. Mayo Clin, Rochester, MN USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD FEB PY 2004 VL 88 SU 1 BP 49 EP 49 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 775UH UT WOS:000189078700145 ER PT J AU Liu, TB Perry, G Chan, HW Verdile, G Martins, RN Smith, MA Atwood, CS AF Liu, TB Perry, G Chan, HW Verdile, G Martins, RN Smith, MA Atwood, CS TI Amyloid-beta-induced toxicity of primary neurons is dependent upon differentiation-associated increases in tau and cyclin-dependent kinase 5 expression SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE amyloid-beta; antisense oligonucleotides; cyclin-dependent kinase 5; differentiation; tau; viability ID MICROTUBULE-ASSOCIATED PROTEIN; PERIPHERAL NERVOUS-SYSTEM; ALZHEIMERS-DISEASE; HIPPOCAMPAL-NEURONS; PRECURSOR PROTEIN; OXIDATIVE STRESS; LIVING CELLS; IN-VITRO; A-BETA; NEUROFIBRILLARY TANGLES AB It has previously been reported that amyloid-beta (Abeta) peptide is neurotrophic to undifferentiated but neurotoxic to differentiated primary neurons. The underlying reasons for this differential effect is not understood. Recently, the toxicity of Abeta to neurons was shown to be dependent upon the activation of cyclin-dependent kinase 5 (Cdk5), thought to promote tau phosphorylation that leads to cytoskeletal disruption, morphological degeneration and apoptosis. Here we report that Cdk5, tau, and phosphorylated-tau (P-tau) are expressed at very low levels in undifferentiated primary neurons, but that the expression of Cdk5 and tau and the phosphorylation of tau increase markedly between 4 and 8 days of differentiation in vitro. Tau expression decreased after this time, as did the level of P-tau, to low levels by 17 days. Abeta induced tau phosphorylation of neurons only after greater than or equal to 4 days of differentiation, a time that coincides with the onset of Abeta toxicity. Blocking tau expression (and therefore tau phosphorylation) with an antisense oligonucleotide completely blocked Abeta toxicity of differentiated primary neurons, thereby confirming that tau was essential for mediating Abeta toxicity. Our results demonstrate that differentiation-associated changes in tau and Cdk-5 modulate the toxicity of Abeta and explain the opposite responses of differentiated and undifferentiated neurons to Abeta. Our results predict that only cells containing appreciable levels of tau are susceptible to Abeta-induced toxicity and may explain why Abeta is more toxic to neurons compared with other cell types. C1 Univ Wisconsin, Sch Med, Dept Med, Wm S Middleton Mem VA,GRECC 11G, Madison, WI 53705 USA. Univ Wisconsin, Dept Pathol & Lab Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI USA. Case Western Reserve Univ, Inst Pathol, Cleveland, OH 44106 USA. Univ Western Australia, Dept Psychiat & Clin Neurosci, Perth, WA 6009, Australia. Hollywood Private Hosp, Sir James McCusker Alzheimers Dis Res Unit, Perth, WA, Australia. RP Atwood, CS (reprint author), Univ Wisconsin, Sch Med, Dept Med, Wm S Middleton Mem VA,GRECC 11G, 2500 Overlook Terrace, Madison, WI 53705 USA. EM csa@medicine.wisc.edu RI Smith, Mark/A-9053-2009; Perry, George/A-8611-2009 OI Perry, George/0000-0002-6547-0172 FU NIA NIH HHS [R01 AG19356] NR 97 TC 64 Z9 69 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD FEB PY 2004 VL 88 IS 3 BP 554 EP 563 DI 10.1046/j.1471-4159.2003.02196.x PG 10 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 763YQ UT WOS:000188128400005 PM 14720205 ER PT J AU Won, JS Im, YB Khan, M Singh, AK Singh, I AF Won, JS Im, YB Khan, M Singh, AK Singh, I TI The role of neutral sphingomyelinase produced ceramide in lipopolysaccharide-mediated expression of inducible nitric oxide synthase SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE ceramide; inducible nitric oxide synthase; neutral sphingomyelinase; NF-kappa B; ras ID TUMOR-NECROSIS-FACTOR; FACTOR-KAPPA-B; ACTIVATED PROTEIN-KINASE; SMOOTH-MUSCLE-CELLS; FACTOR-ALPHA; TYROSINE KINASE; PHOSPHATIDYLINOSITOL 3-KINASE; PRIMARY ASTROCYTES; INTERFERON-GAMMA; GENE-EXPRESSION AB Lipopolysaccharide (LPS) and interferon-gamma (IFN) treatment of C6 rat glioma cells increased the intracellular ceramide level and the expression of the inducible nitric oxide synthase (iNOS) gene. To delineate the possible role of ceramide in the induction of iNOS, we examined the source of intracellular ceramide and associated signal transduction pathway(s) with the use of inhibitors of intracellular ceramide generation. The inhibitor of neutral sphingomyelinase (3-O-methylsphingomyelin, MSM) inhibited the induction of iNOS, whereas inhibitor of acidic sphingomyelinase (SR33557) or that of ceramide de novo synthesis (fumonisin B1) had no effect on the induction of iNOS. MSM-mediated inhibition of iNOS induction was reversed by the supplementation of exogenous C-8-ceramide, suggesting that ceramide production by neutral sphingomyelinase (nSMase) is a key mediator in the induction of iNOS. The MSM-mediated inhibition of iNOS gene expression correlated with the decrease in the activity of ras. Inhibition of co-transfected iNOS promoter activity by dominant negative ras supported the role of ras in the nSMase-dependent regulation of iNOS gene. NF-kappaB DNA binding activity and its transactivity were also reduced by MSM pretreatment, and were completely reversed by the supplementation of C-8-ceramide. As the dominant negative ras also reduced NF-kappaB transactivity, NF-kappaB activation may be downstream of ras. Our results suggest that ceramide generated by nSMase may be a critical mediator in the regulation of iNOS gene expression via ras-mediated NF-kappaB activation under inflammatory conditions. C1 Med Univ S Carolina, Dept Pediat, Div Dev Neurogenet, CSB 316, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, Div Dev Neurogenet, CSB 316, 171 Ashley Ave, Charleston, SC 29425 USA. EM singhi@musc.edu FU NINDS NIH HHS [NS-22576, NS-34741, NS-37766, NS-40810] NR 68 TC 37 Z9 41 U1 0 U2 1 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD FEB PY 2004 VL 88 IS 3 BP 583 EP 593 DI 10.1046/j.1471-4159.2003.02165.x PG 11 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 763YQ UT WOS:000188128400008 PM 14720208 ER PT J AU Gardner, B Zhu, LX Roth, MD Tashkin, DP Dubinett, SM Sharma, S AF Gardner, B Zhu, LX Roth, MD Tashkin, DP Dubinett, SM Sharma, S TI Cocaine modulates cytokine and enhances tumor growth through sigma receptors SO JOURNAL OF NEUROIMMUNOLOGY LA English DT Article; Proceedings Paper CT 9th Conference of the Society-of-NeuroImmune-Pharmacology CY OCT 02-06, 2002 CL CLEARWATER BEACH, FLORIDA SP SNIP, Univ So Florida DE cocaine; sigma receptor; tumor; cytokine; interleukin-10; immunity ID T-CELL; TGF-BETA; HABITUAL SMOKERS; AND/OR TOBACCO; NITRIC-OXIDE; DRUG-USERS; IFN-GAMMA; IN-VIVO; IL-10; MICE AB Sigma receptors are intracellular receptors that interact with a variety of psychotropic ligands, including cocaine. Administration of cocaine to mice promoted the in vivo growth of a syngeneic lung cancer cell line and identical effects were observed with PRE 084, a selective sigma, receptor agonist. Increased tumor growth was accompanied by an increase in IL-10 and a decrease in IFN-gamma production in splenocytes and at the tumor site. The tumor-promoting effects produced by both cocaine and PRE 084 were abrogated by administration of specific antibodies to IL-10, or by administration of a sigma, receptor antagonist. We conclude that sigma, receptor ligands, including cocaine, augment tumor growth via a cytokine-dependent, receptor-mediated mechanism that involves regulation of T helper l/T helper 2 cytokine balance. (C) 2003 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Div Pulm & Crit Care Med, Los Angeles, CA 90095 USA. Vet Adm Greater Los Angeles Healthcare Syst, Div Pulm & Crit Care Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Lung Canc Res Program, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. RP Gardner, B (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Div Pulm & Crit Care Med, 37-131 Ctr Hlth Sci,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM bgardner@mednet.ucla.edu; sharmasp@ucla.edu FU NCI NIH HHS [R01 CA71818]; NIDA NIH HHS [R01 DA08254]; PHS HHS [P50 90388] NR 35 TC 21 Z9 21 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-5728 J9 J NEUROIMMUNOL JI J. Neuroimmunol. PD FEB PY 2004 VL 147 IS 1-2 BP 95 EP 98 DI 10.1016/j.neuroim.2003.10.020 PG 4 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 772GQ UT WOS:000188834000023 PM 14741436 ER PT J AU Stelzner, M AF Stelzner, M TI Achieving balance in academic surgery SO JOURNAL OF SURGICAL RESEARCH LA English DT Article; Proceedings Paper CT 36th Annual Meeting of the Association-for-Academic-Surgery CY NOV 07-09, 2002 CL BOSTON, MASSACHUSETTS SP Assoc Acad Surg DE balance; surgeon-scientist; family life; research ID INTESTINE; FALLS C1 Univ Washington, Dept Surg, VAPSHCS Surg Serv 112, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Stelzner, M (reprint author), Univ Washington, Dept Surg, VAPSHCS Surg Serv 112, 1660 S Columbian Way, Seattle, WA 98108 USA. EM stelzner@u.washington.edu NR 10 TC 0 Z9 0 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0022-4804 J9 J SURG RES JI J. Surg. Res. PD FEB PY 2004 VL 116 IS 2 BP 350 EP 354 DI 10.1016/j.jss.2003.09.013 PG 5 WC Surgery SC Surgery GA 774WC UT WOS:000189008300021 PM 15013375 ER PT J AU Harbrecht, BG Zenati, MS Ochoa, JB Townsend, RN Puyana, JC Wilson, MA Peitzman, AB AF Harbrecht, BG Zenati, MS Ochoa, JB Townsend, RN Puyana, JC Wilson, MA Peitzman, AB TI Management of adult blunt splenic injuries: Comparison between level I and level II trauma centers SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Article ID NONOPERATIVE MANAGEMENT; EASTERN-ASSOCIATION; SURGERY; GENDER AB BACKGROUND: The factors important in determining outcome when managing adult blunt splenic injuries continue to be debated. Whether trauma center level designation (Level I versus Level II) affects patient management has not been evaluated. STUDY DESIGN: We conducted a retrospective analysis of prospectively gathered data from the Pennsylvania Trauma Outcome Study database that collected information from 27 statewide trauma centers (Level I [15], Level II [17]). Adult patients (ages 16 years) with blunt splenic injuries (ICD-9-CM 865) were evaluated. Demographic data, injury data, and trauma center level designation were collected, and patient management, length of stay, and mortality were analyzed. RESULTS: There were 2,138 adult patients who suffered blunt splenic injuries during the study period (1998-2000). Patients treated at Level II trauma centers (n = 772) had a higher rate of operative treatment (38.2% versus 30.7%) (p < 0.001), but a shorter mean length of stay (10.1 +/- 0.4 versus 12.0 +/- 0.4 days) (p < 0.01) compared with patients in Level I trauma centers (n = 1,366). The rate of failure of nonoperative treatment was lower at Level II trauma centers (13.0% versus 17.6%) (p < 0.05), but the mortality for patients managed nonoperatively was higher (8.4% versus 4.5%) (p < 0.05). Splenorrhaphy was performed more frequently in Level I trauma centers. CONCLUSIONS: Management differences exist in the treatment of adult blunt splenic injuries between institutions of different trauma center level designation. Multicenter studies should account for this finding in design and implementation. (C) 2004 by the American College of Surgeons. C1 Univ Pittsburgh, Med Ctr, Dept Surg, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Surg Serv, Pittsburgh, PA USA. RP Harbrecht, BG (reprint author), Univ Pittsburgh, Med Ctr, Dept Surg, F1264-200 Lothrop St, Pittsburgh, PA 15213 USA. RI Zenati, Mazen/C-2020-2012 NR 15 TC 24 Z9 25 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD FEB PY 2004 VL 198 IS 2 BP 232 EP 239 DI 10.1016/j.jamcollsurg.2003.10.007 PG 8 WC Surgery SC Surgery GA 771NZ UT WOS:000188793900009 PM 14759780 ER PT J AU Fitzpatrick, AL Kuller, LH Ives, DG Lopez, OL Jagust, W Breitner, JCS Jones, B Lyketsos, C Dulberg, C AF Fitzpatrick, AL Kuller, LH Ives, DG Lopez, OL Jagust, W Breitner, JCS Jones, B Lyketsos, C Dulberg, C TI Incidence and prevalence of dementia in the cardiovascular health study SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE Alzheimer's disease; dementia; education; incidence; prevalence; race; vascular dementia ID ALZHEIMERS-DISEASE; VASCULAR DEMENTIA; UNITED-STATES; POPULATION; DIAGNOSIS; RISK; AD; CRITERIA; PROJECT; DECLINE AB OBJECTIVES: To estimate the incidence and prevalence of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) in the Cardiovascular Health Study (CHS) cohort. DESIGN: Longitudinal cohort study using prospectively and retrospectively collected data to evaluate dementia. SETTING: Four U.S. communities. PARTICIPANTS: There were 3,602 CHS participants, including 2,865 white and 492 African-American participants free of dementia, who completed a cranial magnetic resonance image between 1992 and 1994 and were followed for an average of 5.4 years. MEASUREMENTS: Dementia was classified by neurologist/psychiatrist committee review using neuropsychological tests, neurological examinations, medical records, physician questionnaires, and proxy/informant interviews. Demographics and apolipoprotein E (APOE) genotype were collected at baseline. Incidence by type of dementia was determined using National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for AD and Alzheimer's Disease Diagnostic and Treatment Center's State of California criteria for VaD. RESULTS: Classification resulted in 227 persons with prevalent dementia at entry into the study and 480 incident cases during follow-up. Incidence rates of dementia scaled to age 80 were 34.7 per 1,000 person-years for white women, 35.3 for white men, 58.8 for African-American women, and 53.0 for African-American men. Sex differences were not significant within race. Adjusted for age and education, racial differences were only of borderline significance and may have been influenced by ascertainment methodology. Rates differed substantially by educational attainment but were only significant for whites. Those with the APOE epsilon4 allele had an incidence rate at age 80 of 56.4, compared with 29.6 for those without this allele (P<.001). In whites, type-specific incidence at age 80 was 19.2 for AD versus 14.6 for VaD. These rates were 34.7 and 27.2 for African Americans. At termination of observation, women had only a slightly higher prevalence of dementia (16.0%) than men (14.7%). CONCLUSION: Sex and racial differences were not found, and VaD was higher than reported in other studies. These data provide new estimates of dementia incidence in a community sample for projection of future burden. C1 Univ Washington, Dept Epidemiol, Seattle, WA 98115 USA. Univ Washington, Dept Biostat, Seattle, WA 98115 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA. Univ Calif Davis, Dept Neurol, Davis, CA 95616 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Div Geriatr Psychait, Seattle, WA 98195 USA. Wake Forest Univ, Bowman Gray Sch Med, Dept Psychiat, Winston Salem, NC USA. Johns Hopkins Univ, Sch Publ Hlth, Dept Mental Hyg, Baltimore, MD USA. Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA. RP Fitzpatrick, AL (reprint author), Univ Washington, Dept Epidemiol, Bldg 29,Suite 310,6200 NE 74th St, Seattle, WA 98115 USA. EM fitzpal@u.washington.edu FU NHLBI NIH HHS [N01-HC-85079, N01-HC-85086]; NIA NIH HHS [5 R01 AG15928-02] NR 46 TC 186 Z9 189 U1 1 U2 15 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD FEB PY 2004 VL 52 IS 2 BP 195 EP 204 DI 10.1111/j.1532-5415.2004.52058.x PG 10 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 765JR UT WOS:000188263900004 PM 14728627 ER PT J AU Asthana, S Middleton, WS AF Asthana, S Middleton, WS TI Estrogen and cognition: A true relationship? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Editorial Material ID RANDOMIZED CONTROLLED-TRIAL; HEALTH INITIATIVE MEMORY; CENTRAL-NERVOUS-SYSTEM; POSTMENOPAUSAL WOMEN; REPLACEMENT THERAPY; PLUS PROGESTIN; TRANSDERMAL ESTROGEN; HORMONE REPLACEMENT; ALZHEIMERS-DISEASE; OLDER WOMEN C1 Univ Wisconsin, Sch Med,Sect Geriatr & Gerontol, Ctr Geriatr Res Educ & Clin, William S Middleton Mem Vet Hosp, Madison, WI 53705 USA. Wisconsin Alzheimers Inst, Madison, WI USA. RP Asthana, S (reprint author), Univ Wisconsin, Sch Med,Sect Geriatr & Gerontol, Ctr Geriatr Res Educ & Clin, William S Middleton Mem Vet Hosp, Madison, WI 53705 USA. NR 23 TC 9 Z9 10 U1 1 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD FEB PY 2004 VL 52 IS 2 BP 316 EP 318 DI 10.1111/j.1532-5415.2004.52078.x PG 3 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 765JR UT WOS:000188263900024 PM 14728648 ER PT J AU McPherson, EA Luo, ZM Brown, RA Lebard, LS Corless, CC Speth, RC Bagby, SP AF McPherson, EA Luo, ZM Brown, RA Lebard, LS Corless, CC Speth, RC Bagby, SP TI Chymase-like angiotensin II-generating activity in end-stage human autosomal dominant polycystic kidney disease SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID BLOOD-PRESSURE CONTROL; MAST-CELLS; CONVERTING-ENZYME; MYOCARDIAL-INFARCTION; FORMING PATHWAYS; RENAL-DISEASE; EXPRESSION; GENE; SYSTEM; TISSUE AB Autosomal dominant polycystic kidney disease (ADPKD) is characterized by exuberant inflammation and fibrosis, a process believed to contribute to progressive loss of normal renal function. Despite early-onset hypertension and intrarenal renin/angiotensin II (AngII) activation, angiotensin-converting enzyme (ACE) inhibition does not consistently confer renal protection in ADPKD. The hypothesis was that mast cells within the inflammatory interstitium release chymase, an enzyme capable of efficient conversion of AngI to AngII, providing an ACE-independent route of AngII generation. End-stage ADPKD renal tissue extracts and cyst fluids were assayed for time-dependent, chymostatin-inhibitable conversion of I-125-AngT to I-125-AngII under conditions of ACE and aminopeptidase inhibition by means of HPLC. Thirteen of 14 ADPKD kidney extracts exhibited chymase-like AngII-generating capacity; calculated initial reaction rates averaged 3.9 +/- 2.9 fmol AngII/min/mug protein with a mean maximal conversion of 55% +/- 30% of added substrate. AngII-generating activity was both protein and substrate dependent. All five cyst fluid samples were negative. Chymase-like activity was detectable in only three of six non-ADPKD kidney extracts. Immunoreactive chymase protein was present in/around mast cells within the fibrotic renal interstitium in all samples. Findings demonstrate for the first time the presence of mast cells, mast cell-associated immunoreactive chymase protein, and chymase-like AngII generating capacity in ADPKD cystic kidneys. Results support the potential for ACE-independent AngII generation and for mast cell-initiated inflammatory processes in ADPKD, each with therapeutic implications for ADPKD renal progression. C1 Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Pathol, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. Washington State Univ, Dept Vet & Comparat Anat Pharmacol & Physiol, Pullman, WA 99164 USA. RP Bagby, SP (reprint author), Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, 3314 SW US Vet Hosp Rd,Suite 262, Portland, OR 97239 USA. EM bagbys@ohsu.edu NR 41 TC 34 Z9 36 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD FEB PY 2004 VL 15 IS 2 BP 493 EP 500 DI 10.1097/01.ASN.0000109782.28991.26 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 769AQ UT WOS:000188604600029 PM 14747398 ER PT J AU Dunn, NJ Yanasak, E Schillaci, J Simotas, S Rehm, LP Souchek, J Menke, T Ashton, C Hamilton, JD AF Dunn, NJ Yanasak, E Schillaci, J Simotas, S Rehm, LP Souchek, J Menke, T Ashton, C Hamilton, JD TI Personality disorders in veterans with posttraumatic stress disorder and depression SO JOURNAL OF TRAUMATIC STRESS LA English DT Article DE trauma; PTSD; personality disorders; depression; assessment ID ADMINISTERED PTSD SCALE; VIETNAM VETERANS; PSYCHIATRIC-DISORDERS; COMBAT VETERANS; SYMPTOMS; CLINICIAN; COMORBIDITY; PREDICTORS; PREVALENCE; EXPOSURE AB Little is known about the frequency of the full-range of personality disorders in outpatients with concurrent posttraumatic stress disorder (PTSD) and depression, a common and oftentimes treatment-resistant combination in clinical practice. In a group therapy outcome study, Axis I and II diagnoses were assessed with the Structured Clinical Interview for DSM-IV and the Clinician-Administered PTSD Scale to select 115 male combat veterans with PTSD and depressive disorder. Within this sample, 52 (45.2%) had one or more personality disorders - most commonly paranoid (17.4%), obsessive-compulsive (16.5%), avoidant (12.2%), and borderline (8.7%) - and 19 (16.5%) had two or more. Documenting a substantial frequency of personality disorders is a first step in devising appropriate interventions for this treatment-resistant combination of disorders. C1 Vet Affairs Med Ctr, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Hlth Serv Res & Dev Serv, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ Houston, Houston, TX USA. RP Dunn, NJ (reprint author), Vet Affairs Med Ctr, Mental Hlth Care Line 116MHCL,2002 Holcombe Blvd, Houston, TX 77030 USA. EM ndunn@bcm.tmc.edu NR 35 TC 27 Z9 27 U1 3 U2 6 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD FEB PY 2004 VL 17 IS 1 BP 75 EP 82 DI 10.1023/B:JOTS.0000014680.54051.50 PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 770TA UT WOS:000188745900011 PM 15027797 ER PT J AU Wang, VS Saab, S AF Wang, VS Saab, S TI Liver transplantation in the era of model for end-stage liver disease SO LIVER INTERNATIONAL LA English DT Review DE liver transplantation; MELD ID HEPATOCELLULAR-CARCINOMA; WAITING-LIST; MELD SCORE; ALLOCATION POLICY; SURVIVAL; MORTALITY; PREDICTORS; SEVERITY; PATIENT; DROPOUT AB Liver transplantation is challenged by organ shortage and prolonged waiting list time. The goal of the ideal organ allocation system is to transplant individuals least likely to survive without a liver transplantation, and maintain appropriate rates of postoperative survival. Currently, liver allocation in the United States is based on the model for end-stage liver disease (MELD). Studies have shown MELD to be objective and accurate in predicting short-term survival in patients with cirrhosis. C1 Univ Calif Los Angeles, Med Ctr, Div Digest Dis, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dumont UCLA Liver Transplant Ctr, Los Angeles, CA 90095 USA. RP Saab, S (reprint author), Univ Calif Los Angeles, Med Ctr, Div Digest Dis, 44-138 CHS MC 168417,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM Ssaab@mednet.ucla.edu NR 29 TC 63 Z9 70 U1 0 U2 0 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 1478-3231 J9 LIVER INT JI Liver Int. PD FEB PY 2004 VL 24 IS 1 BP 1 EP 8 DI 10.1111/j.1478-3231.2004.00888.x PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 803CZ UT WOS:000220210500001 PM 15101994 ER PT J AU Fung, CH Woo, HE Asch, SM AF Fung, CH Woo, HE Asch, SM TI Controversies and legal issues of prescribing and dispensing medications using the Internet SO MAYO CLINIC PROCEEDINGS LA English DT Review ID PRESCRIPTION DRUGS; SILDENAFIL VIAGRA; DIRECT SALE; PHARMACIES; CONSUMERS; BOARDS AB Online pharmacies fall into 3 major categories: independent Internet-only sites, online branches of "brick-and-mortar" pharmacies, and sites representing partnership among neighborhood pharmacies. Potential benefits of online pharmacies include increased access, lower transaction and product costs, and greater anonymity. However, online pharmacies have generated controversies, including the use of "cyberdoctors" on some sites, the dispensing of drugs without prescriptions from other sites, and the importation of prescription medications. Although some online pharmacies are legitimate and likely provide benefits to patients, other online pharmacies engage in questionable practices. Numerous state and federal regulations and laws have tried to address controversies surrounding rogue Internet pharmacies. Because online pharmacies are increasingly common, clinicians may encounter patients asking for advice and information about online pharmacies. We review the regulatory framework governing online pharmacies and the potential risks and benefits of using online pharmacies. C1 VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. RP Fung, CH (reprint author), 11301 Wilshire Bldg 111G, Los Angeles, CA 90073 USA. NR 102 TC 24 Z9 25 U1 0 U2 6 PU MAYO CLINIC PROCEEDINGS PI ROCHESTER PA 660 SIEBENS BLDG MAYO CLINIC, ROCHESTER, MN 55905 USA SN 0025-6196 J9 MAYO CLIN PROC JI Mayo Clin. Proc. PD FEB PY 2004 VL 79 IS 2 BP 188 EP 194 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 770HX UT WOS:000188718100008 PM 14959914 ER PT J AU Weiner, M Long, J AF Weiner, M Long, J TI Cross-sectional versus longitudinal performance assessments in the management of diabetes SO MEDICAL CARE LA English DT Article; Proceedings Paper CT Conference on Measuring and Improving Healthcare Quality CY APR 18-20, 2002 CL UNIV PENN, PHILADELPHIA, PENNSYLVANIA HO UNIV PENN DE diabetes; quality indicators; health care; quality of health care ID CARDIOVASCULAR EVENTS; PRIMARY PREVENTION; GLYCEMIC CONTROL; CANCER; COSTS; CARE AB Background: Performance assessments help to quantify the level of adherence with practice standards and are often used to measure and compare the quality of care. However, most performance assessments are based on a cross-sectional analysis of patient information, whereas patient care is inherently longitudinal. This discordance could confound the relationship between the performance measure and the true quality of care. Objective: The objective of this study was to illustrate differences in performance assessment as measured by a traditional cross-sectional analysis compared with a longitudinal analysis. Methods: We conducted a cross-sectional and longitudinal analysis of a cohort of diabetic patients in an integrated delivery system having primary care visits and hemoglobin A1c (HBA1c) testing in both 1999 and 2000. Results: In the cross-sectional analysis of 4661 patients, we found a modestly increasing proportion achieved an HBA1c level of <8.0%: 73.1% in 1999 and 75.6% in 2000. Longitudinal analysis, however, suggested that certain subsets of patients were more likely to switch from good to poor control or retain their level of poor control over the 2 years studied. In particular, compared with whites, blacks were 1.76 (95% confidence interval [CI], 1.31-2.37) times as likely to switch from good to poor control and only 0.56 (95% CI, 0.41-0.76) times as likely to switch from poor to good control. Patients aged 35 to 49 were 2.54 (95% CI, 1.79-3.45) times as likely to switch from good to poor and only 0.66 (95% CI, 0.47-0.94) times as likely to switch from poor to good control than patients over age 64 years. Conclusions: Cross-sectional performance assessments could mask changes in diabetes control among individuals belonging to a cohort and, conceptually, are poorer indicators of care process than longitudinal measures. In addition, longitudinal analyses suggest the influence of patient sociodemographic factors on the performance assessment that should be accounted for when comparing quality of care for diabetes. C1 Philadelphia VA Med Ctr, Ctr Hlth Equity & Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Weiner, M (reprint author), 423 Guardian Dr,Rm 1116, Philadelphia, PA 19104 USA. EM mweiner@mail.med.upenn.edu NR 16 TC 6 Z9 6 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 2004 VL 42 IS 2 SU S BP 34 EP 39 DI 10.1097/01.mlr.0000109167.86509.24 PG 6 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 768FN UT WOS:000188533100005 ER PT J AU O'Malley, KJ Roddey, TS Gartsman, GM Cook, KF AF O'Malley, KJ Roddey, TS Gartsman, GM Cook, KF TI Outcome expectancies, functional outcomes, and expectancy fulfillment for patients with shoulder problems SO MEDICAL CARE LA English DT Article DE outcome expectancies; shoulder function; outcomes; expectancy fulfillment ID TOTAL HIP-ARTHROPLASTY; FULL-THICKNESS TEARS; PATIENTS EXPECTATIONS; ROTATOR CUFF; LOW-BACK; PREOPERATIVE EXPECTATIONS; ARTHROSCOPIC TREATMENT; PAIN EXPECTANCIES; SELF-EFFICACY; PRIMARY-CARE AB Objectives: This study was conducted to evaluate the relationship among patient outcome expectancies, perceived shoulder function changes, and perceptions of expectancy fulfillment. Methods: Patients (n = 199) treated for shoulder problems at one orthopedic surgeon's office completed a baseline survey comprised of measures of outcome expectancies, shoulder function, health status, and demographics. At I month, 2 months, and 3 months, patients completed a mailed follow-up survey comprised of all baseline measures except demographic variables. At 3 months, a measure of expectancy fulfillment was added. A general linear modeling approach was used to assess the significance and effect size of 1) outcome expectancies on changes in shoulder function; and (2) outcome expectancies, shoulder function changes, and their interaction on perceptions of expectancy fulfillment. Results: Outcome expectancies significantly predicted changes in shoulder function and accounted for 10% of the variance in functional improvement. The improvement difference between patients with high expectancies compared with those with low expectancies was clinically relevant (4.57 points), as it was greater than the minimal clinically important difference (3.02 points). Outcome expectancies and shoulder function changes significantly predicted patients' perceptions of fulfilled expectancies, but their interaction was not statistically significant. Conclusions: Results highlight the importance of patient expectancy in medical encounters. The findings suggest the need for interventions targeting patient expectancies such as including discussions about expectancy in patient-physician negotiations of therapeutic plans. Results also underscore the need for the development of better measures of outcome expectancies and expectancy fulfillment. C1 Baylor Coll Med, Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Dept Med,Sect Hlth Serv Res, Houston, TX 77030 USA. Texas Womans Univ, Dept Phys Therapy, Houston, TX USA. Univ Texas, Hlth Sci Ctr, Fondren Orthoped Grp, Houston, TX USA. VA Med Ctr, Parkinsons Dis Res, Educ & Clin Ctr, Houston, TX USA. RP O'Malley, KJ (reprint author), 905 W Howard Lane, Austin, TX 78753 USA. EM kimberly.omalley@pearson.com NR 47 TC 16 Z9 16 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 2004 VL 42 IS 2 BP 139 EP 146 DI 10.1097/01.mlr.0000108766.00294.92 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 767GP UT WOS:000188432100007 PM 14734951 ER PT J AU Ozen, M Medreano, EE Ittmann, M AF Ozen, M Medreano, EE Ittmann, M TI Inhibition of proliferation and survival of melanoma cells by adenoviral-mediated expression of dominant negative fibroblast growth factor receptor SO MELANOMA RESEARCH LA English DT Article DE melanoma; fibroblast growth factors; receptors; G(2); cytokinesis; adenovirus ID NORMAL HUMAN MELANOCYTES; DNA-DAMAGE; TRANSFORMED PHENOTYPE; MALIGNANT-MELANOMA; PROSTATE-CANCER; KINASE; PROGRESSION; INVOLVEMENT; SUPPRESSION; INDUCTION AB Melanoma is the most deadly cutaneous malignancy; its incidence has risen significantly over the last 30 years and there is no effective treatment for advanced melanoma. Autocrine expression of fibroblast growth factors (FGFs) is a common event in malignant melanoma. We therefore sought to inhibit the proliferation and survival of melanoma cells as an approach to melanoma therapy by disrupting FGF signalling via adenoviral-mediated expression of a dominant negative FGF receptor. We tested three melanoma cell lines (A375, IIB and UCD) that express FGF2 and respond to exogenous FGF2 with increased proliferation. In all three cell lines, there was a significant decrease in net proliferation, and in two (A375 and UCD) an increase in cell death, associated with expression of the dominant negative FGF receptor. In these two cell lines, expression of the dominant negative FGF receptor resulted in the accumulation of p21 (WAF1/cip1), decreased cell division cycle-2 (cdc2) kinase activity, an increase in the percentage of cells in the G(2) phase of the cell cycle, and inhibition of cytokinesis, with accumulation of binucleated cells. These studies reveal that inhibition of FGF signalling can markedly decrease the net proliferation of melanoma cells by a novel mechanism involving a decrease in cdc2 kinase activity, an increase in p21 expression, inhibition of G(2) progression, inhibition of cytokinesis and increased cell death. In contrast, disruption of FGF signalling had only slight effects on normal melanocytes. Disruption of FGF signalling via the expression of the dominant negative FGF receptor is, therefore, a potential therapeutic approach in human melanoma. C1 Baylor Coll Med, Texas Med Ctr, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Texas Med Ctr, Dept Mol & Cell Biol, Houston, TX 77030 USA. Dept Vet Affairs, VA Med Ctr, Houston, TX USA. RP Ittmann, M (reprint author), Houston VAMC, Res Serv, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM mittmann@bcm.tmc.edu FU NCI NIH HHS [R0-1 CA-84282] NR 31 TC 19 Z9 20 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0960-8931 J9 MELANOMA RES JI Melanoma Res. PD FEB PY 2004 VL 14 IS 1 BP 13 EP 21 DI 10.1097/01.cmr.0000114316.54394.3c PG 9 WC Oncology; Dermatology; Medicine, Research & Experimental SC Oncology; Dermatology; Research & Experimental Medicine GA 809WY UT WOS:000220668000002 PM 15091189 ER PT J AU Schechter, NM Plotnick, MI AF Schechter, NM Plotnick, MI TI Measurement of the kinetic parameters mediating protease-serpin inhibition SO METHODS LA English DT Article DE serpins; inhibition; serine protease; kinetics; pseudo-first order; second order; progress curve; complex breakdown; stoichiometry of inhibition ID PLASMINOGEN-ACTIVATOR INHIBITOR-1; REACTIVE-CENTER LOOP; PLASMA PROTEINASE-INHIBITORS; ANTITHROMBIN-III; CONFORMATIONAL DISEASE; SUBSTRATE-SPECIFICITY; MICHAELIS COMPLEX; HUMAN CHYMASE; MECHANISM; ALPHA(1)-ANTICHYMOTRYPSIN AB Serine protease inhibition by proteins of the serpin family is a unique and complex process involving physical, chemical, and conformational changes. After encounter with the reactive site of inhibitor, the protease is conformationally trapped as a covalent complex resembling the acyl-protease intermediate of catalysis. The stability of the trap is not permanent and may vary for different proteases. In addition, the trapping mechanism is not 100% efficient and a fraction of the serpin may be consumed like a substrate before inactivation is complete. Characterization of protease-serpin inhibition therefore requires the measurement of three parameters: the apparent second order rate constant of inhibition (k(inh)), the stoichiometry of inhibition (SI), and the rate of complex breakdown (k(brkdn)). The basic kinetic methods to establish these parameters are described. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA. Univ Penn, Dept Biochem & Biophys, Philadelphia, PA 19104 USA. Univ Penn, Pulm Allergy & Crit Care Div, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Schechter, NM (reprint author), Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA. EM schechte@mail.med.upenn.edu; mplotnic@mail.med.upenn.edu FU NHLBI NIH HHS [HL50523]; NIAMS NIH HHS [AR39674] NR 56 TC 33 Z9 33 U1 0 U2 6 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1046-2023 J9 METHODS JI Methods PD FEB PY 2004 VL 32 IS 2 BP 159 EP 168 DI 10.1016/S1046-2023(03)00207-X PG 10 WC Biochemical Research Methods; Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 762ZV UT WOS:000188043600009 PM 14698628 ER PT J AU Cheng, EM Siderowf, A Swarztrauber, K Eisa, M Lee, M Vickrey, BG AF Cheng, EM Siderowf, A Swarztrauber, K Eisa, M Lee, M Vickrey, BG TI Development of quality of care indicators for Parkinson's disease SO MOVEMENT DISORDERS LA English DT Review DE quality indicators; Parkinson's disease; quality of health care; health services research ID VULNERABLE ELDERS; HEALTH-CARE; DEPRESSION; CRITERIA; APPROPRIATENESS; SPECIALTY; EXPLICIT; RATINGS AB Parkinson's disease (PD) is a major cause of disability. To date, there have been no large-scale efforts to measure the quality of PD care because of a lack of quality indicators for conducting an explicit review of PD care processes. We present a set of quality indicators for PD care. Based on a structured review of the medical literature, 79 potential indicators were drafted. Through a two-round modified Delphi process, an expert panel of seven movement disorders specialists rated each indicator on criteria of validity, feasibility, impact on outcomes, room for improvement, and overall utility. Seventy-one quality indicators met validity and feasibility thresholds. Applying thresholds for impact on out-comes, room for improvement, and overall utility, a subset of 29 indicators was identified, spanning dopaminergic therapy, assessment of functional status, assessment and treatment of depression, coordination of care, and medication use. Multivariable analysis showed that overall utility ratings were driven by validity and impact on outcomes (P < 0.01). An expert panel can reach consensus on a set of highly rated quality indicators for PD care, which can be used to assess quality of PD care and guide the design of quality improvement projects. (C) 2003 Movement Disorder Society C1 VA Greater Los Angeles Healthcare Syst, Parkinsons Dis Res Educ & Clin Ctr, Dept Neurol, Los Angeles, CA 90073 USA. Philadelphia Vet Affairs Med Ctr, PADRECC, Philadelphia, PA USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Oregon Hlth Sci Univ, Vet Affairs Med Ctr, PADRECC, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Yale Univ, Dept Neurol, New Haven, CT USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. RP Cheng, EM (reprint author), VA Greater Los Angeles Healthcare Syst, Parkinsons Dis Res Educ & Clin Ctr, Dept Neurol, 11301 Wilshire Blvd,B500,ML 127, Los Angeles, CA 90073 USA. EM eric.cheng@med.va.gov FU AHRQ HHS [K-08 HS000004] NR 39 TC 28 Z9 28 U1 1 U2 3 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD FEB PY 2004 VL 19 IS 2 BP 136 EP 150 DI 10.1002/mds.10664 PG 15 WC Clinical Neurology SC Neurosciences & Neurology GA 777DR UT WOS:000189160700002 PM 14978668 ER PT J AU Danda, RS Kirk, LJ Pergola, PE AF Danda, RS Kirk, LJ Pergola, PE TI High-dose iron gluconate in chronic kidney disease patients SO NEPHROLOGY LA English DT Letter ID RENAL-INSUFFICIENCY C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Danda, RS (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78284 USA. NR 6 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING ASIA PI CARLTON PA 54 UNIVERSITY ST, P O BOX 378, CARLTON, VICTORIA 3053, AUSTRALIA SN 1320-5358 J9 NEPHROLOGY JI Nephrology PD FEB PY 2004 VL 9 IS 1 BP 47 EP 48 DI 10.1111/j.1440-1797.2003.00220.x PG 2 WC Urology & Nephrology SC Urology & Nephrology GA 768KN UT WOS:000188542300011 PM 14996310 ER PT J AU Lipsky, BA Hirschmann, JV AF Lipsky, BA Hirschmann, JV TI Pneumococcal polysaccharide vaccines do not protect the elderly from pneumococcal infections SO NETHERLANDS JOURNAL OF MEDICINE LA English DT Editorial Material ID COST-EFFECTIVENESS; CLINICAL EFFECTIVENESS; EFFICACY; VACCINATION; ADULTS; PEOPLE; METAANALYSIS; PNEUMONIA; OLDER; COUNTRIES C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98108 USA. RP Lipsky, BA (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM Benjamin.Lipsky@med.va.gov OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 28 TC 10 Z9 10 U1 0 U2 0 PU VAN ZUIDEN COMMUNICATIONS PI ALPHEN AAN DE RIJN PA HENRY DUNANTWEG 40A, 2402 NR ALPHEN AAN DE RIJN, NETHERLANDS SN 0300-2977 J9 NETH J MED JI Neth. J. Med. PD FEB PY 2004 VL 62 IS 2 BP 33 EP 35 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 803NP UT WOS:000220238100001 PM 15127828 ER PT J AU Myrick, H Anton, RF Li, XB Henderson, S Drobes, D Voronin, K George, MS AF Myrick, H Anton, RF Li, XB Henderson, S Drobes, D Voronin, K George, MS TI Differential brain activity in alcoholics and social drinkers to alcohol cues: Relationship to craving SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE neuroimaging; alcoholism; craving ID COMPULSIVE DRINKING SCALE; HUMAN PREFRONTAL CORTEX; NUCLEUS-ACCUMBENS; ORBITOFRONTAL CORTEX; GUSTATORY NEOCORTEX; ANTERIOR CINGULATE; VENTRAL STRIATUM; DRUG-ABUSE; COCAINE; REWARD AB Using fMRI, our group previously found that after a sip of alcohol and exposure to alcohol beverage pictures, alcoholics compared to social drinkers had increased differential brain activity in the prefrontal cortex and anterior thalamus. This study extends this earlier work with several improvements including imaging the entire brain (rather than the anterior half previously) and recording craving, while the subjects viewed images within the scanner. In a Philips 1.5T MRI scanner, 10 nontreatment-seeking alcoholics and 10 age-matched healthy social drinkers were given a sip of alcohol before viewing a 12 min randomized presentation of pictures of alcoholic beverages, nonalcoholic beverages, and two different visual control tasks, During picture presentation, changes in regional brain activity were measured in 15 transverse T2*-weighted blood oxygen level dependent slices. Subjects rated their urge to drink after each picture sequence. After a sip of alcohol, while viewing alcohol cues compared to viewing other beverage cues, the alcoholics, but not social drinkers, reported higher craving ratings and had increased activity in the prefrontal cortex and anterior limbic regions. Brain activity in the left nucleus accumbens, anterior cingulate, and left orbitofrontal cortex significantly correlated with subjective craving ratings in alcohol subjects but not in control subjects. This study suggests, as did our earlier study, that alcoholics and not social drinkers, when exposed to alcohol cues. have increased brain activity in areas that reportedly subserve craving for other addictive substances. C1 Med Univ S Carolina, Inst Psychiat 4N, Dept Psychiat & Behav Sci, Alcohol Res Ctr, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Res & Dev Serv, Charleston, SC 29401 USA. MUSC, CAIR, Charleston, SC 29425 USA. RP Myrick, H (reprint author), Med Univ S Carolina, Inst Psychiat 4N, Dept Psychiat & Behav Sci, Alcohol Res Ctr, 67 President St, Charleston, SC 29425 USA. EM myrickh@musc.edu FU NIAAA NIH HHS [2 P50 AA10761-03, K23 AA00314] NR 52 TC 221 Z9 227 U1 6 U2 24 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD FEB PY 2004 VL 29 IS 2 BP 393 EP 402 DI 10.1038/sj.npp.1300295 PG 10 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 771DD UT WOS:000188769600018 PM 14679386 ER PT J AU Yehuda, R Yang, RK Golier, JA Tischler, L Liong, B Decker, K AF Yehuda, R Yang, RK Golier, JA Tischler, L Liong, B Decker, K TI Effect of topiramate on glucocorticoid receptor mediated action SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE topiramate; glucocorticoid receptors; lysozyme activity; post-traumatic stress disorder; depression; mononuclear leukocytes ID POSTTRAUMATIC-STRESS-DISORDER; CULTURED HIPPOCAMPAL-NEURONS; MDR1A P-GLYCOPROTEIN; COMBAT VETERANS; DEXAMETHASONE; CORTISOL; RELEVANCE; EFFICACY; ABSENCE; ATROPHY AB This study examined the effects of topiramate (TPM) on glucocorticoid receptors (GRs) in mononuclear leukocytes of nine men and four women with chronic and recurring post-traumatic stress disorder (PTSD) and a group of comparison subjects (nine men, four women). A measure of 60 ml of blood was withdrawn by venipuncture at 0800 and mononuclear leukocytes were isolated. The cells were incubated with a series of concentrations of dexamethasone (DEX) without or with 50 mumol/l of TPM to evaluate the effects of DEX to inhibit lysozyme activity and the effect of TPM on it. ANCOVA compared the IC50 for lysozyme inhibition under conditions of DEX only and TPM + DFX. TPM affected lysozyme IC50 in the direction of increasing the sensitivity of the receptor in the sample as a whole. This effect was more pronounced in the mononuclear leukocytes from participants in the PTSD group, particularly in cells from subjects whose pretreatment lysozyme IC50 was relatively higher (eg, reflecting decreased glucococorticoid receptor responsiveness), compared to the rest of the sample. In conclusion, further investigation of the actions of TPM on GR and other neuroendocrine systems may prove useful in understanding some of the other established clinical effects of this agent. C1 Bronx Vet Affairs Med Ctr, Bronx, NY USA. Mt Sinai Sch Med, Dept Psychiat, Traumat Stress Studies Program, Bronx, NY USA. RP Yehuda, R (reprint author), Bronx Vet Affairs, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM rachel.yehuda@med.va.gov NR 30 TC 14 Z9 14 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD FEB PY 2004 VL 29 IS 2 BP 433 EP 439 DI 10.1038/sj.npp.1300331 PG 7 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 771DD UT WOS:000188769600023 PM 14666121 ER PT J AU Adelson, DW Million, M AF Adelson, DW Million, M TI Tracking the moveable feast: Sonomicrometry and gastrointestinal motility SO NEWS IN PHYSIOLOGICAL SCIENCES LA English DT Article ID LOWER ESOPHAGEAL SPHINCTER; CHOLECYSTOKININ-OCTAPEPTIDE; SMALL-INTESTINE; RATS AB Ultrasonomicrometry measures distance between piezoelectric crystals based on transmission time of ultrasound bursts. It allows monitoring of coordinated motion of small and delicate tissues, including gastrointestinal sphincters. Its suitability for motility studies in small animals such as mice suggests that its use in gastrointestinal studies will increase in coming years. C1 W Los Angeles Vet Affairs Med Ctr, Vet Affairs Greater Los Angeles Area Hlth Syst, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. W Los Angeles Vet Affairs Med Ctr, Vet Affairs Greater Los Angeles Area Hlth Syst, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. RP Adelson, DW (reprint author), W Los Angeles Vet Affairs Med Ctr, Vet Affairs Greater Los Angeles Area Hlth Syst, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. OI Adelson, David/0000-0002-4623-6030 FU NIDDK NIH HHS [DK-57328-01A1S1, DK-41301] NR 20 TC 10 Z9 11 U1 0 U2 0 PU NEWS IN PHYSIOLOGICAL SCIENCES PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0886-1714 J9 NEWS PHYSIOL SCI JI News Physiol. Sci. PD FEB PY 2004 VL 19 BP 27 EP 32 DI 10.1152/nips.01439.2003 PG 6 WC Physiology SC Physiology GA 774EB UT WOS:000188965800006 PM 14739400 ER PT J AU Farahani, P Fisler, JS Wong, H Diament, AL Yi, NJ Warden, CH AF Farahani, P Fisler, JS Wong, H Diament, AL Yi, NJ Warden, CH TI Reciprocal hemizygosity analysis of mouse hepatic lipase reveals influence on obesity SO OBESITY RESEARCH LA English DT Article DE genetics; percentage body fat; cholesterol; hepatic lipase activity; food intake ID INTRAABDOMINAL FAT; GENETIC-LOCI; LIPOPROTEIN METABOLISM; LIPID-METABOLISM; BODY-COMPOSITION; OLDER MEN; MODEL; MICE; LDL; CHOLESTEROL AB Objectives: We previously demonstrated coincident quantitative trait loci (QTLs) for percentage body fat, plasma hepatic lipase (HL) activity, and plasma cholesterol on mouse chromosome 7. In the present study, we investigated whether hepatic lipase (Lipc) is an obesity gene, whether Lipc interacts with an unknown gene on chromosome 7, and how HL activity is linked to the chromosome 7 locus. Research Methods and Procedures: BSB mice are a model of complex obesity due to interactions among genes from C57BL/6J and Mus spretus (SPRET) in (C57BL/6J X SPRET) X C57BL/6J backcross mice. Five crosses tested the impact on obesity of combinations of inactive (knockout) and wild-type Lipc alleles from C57BL/6J or SPRET in a reciprocal hemizygosity analysis. Results: The combined data from this allelic series suggest that Lipc alleles, and not alleles from a gene linked to Lipc, influence obesity. No interaction between Lipc and chromosome 7 was demonstrated. We confirmed the chromosome 7 QTLs for obesity, HL activity, and cholesterol. Because obesity and HL activity are not consistently associated in the BSB model, linkage of HL activity to chromosome 7 is not secondary to obesity per se. We also report, for the first time to our knowledge, a QTL in mammals for food intake. Discussion: This use of reciprocal hemizygosity analysis in mammals, which, to our knowledge, is the first reported, reveals its power to detect previously unknown effects of Lipc on obesity. C1 Univ Calif Davis, Rowe Program Genet, Davis, CA 95616 USA. Univ Calif Davis, Dept Nutr, Davis, CA 95616 USA. Univ Calif Davis, Dept Pediat, Davis, CA 95616 USA. Univ Calif Davis, Sect Neurobiol Physiol & Behav, Davis, CA 95616 USA. W Los Angeles VA Med Ctr, Lipid Res Lab, Los Angeles, CA USA. Univ Alabama, Dept Biostat, Birmingham, AL USA. RP Warden, CH (reprint author), Univ Calif Davis, Rowe Program Genet, Davis, CA 95616 USA. EM chwarden@ucdavis.edu FU NIDDK NIH HHS [R01 DK53993, DK35747, DK07355] NR 34 TC 19 Z9 19 U1 0 U2 0 PU NORTH AMER ASSOC STUDY OBESITY PI SILVER SPRING PA 8630 FENTON ST, SUITE 918, SILVER SPRING, MD 20910 USA SN 1071-7323 J9 OBES RES JI Obes. Res. PD FEB PY 2004 VL 12 IS 2 BP 292 EP 305 DI 10.1038/oby.2004.37 PG 14 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 779TX UT WOS:000189318000015 PM 14981222 ER PT J AU Stewart, MG Witsell, DL Smith, TL Weaver, EM Yueh, B Hannley, MT AF Stewart, MG Witsell, DL Smith, TL Weaver, EM Yueh, B Hannley, MT TI Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale SO OTOLARYNGOLOGY-HEAD AND NECK SURGERY LA English DT Article ID CHRONIC SINUSITIS; SEPTAL SURGERY; HEALTH-STATUS; OUTCOMES; SEPTOPLASTY AB OBJECTIVE: The study goal was to validate a disease-specific health status instrument for use in patients with nasal obstruction. DESIGN, SETTINGS, AND PATIENTS: The study consisted of a prospective instrument validation conducted at 4 academic medical centers with 32 adults with nasal septal deformity. METHODS: Prospective instrument validation occurred in 2 stages. Stage 1 was the development of a preliminary (alpha-version) instrument of potential items. Stage 2 was a test of the alpha-version for item performance, internal consistency, and test-retest reliability; construct, discriminant, criterion validity, and responsiveness; and creation of the final instrument. RESULTS: Items with poor performance were eliminated from the alpha-version instrument. In testing the final instrument, test-retest reliability was adequate at 0.702; internal consistency reliability was also adequate at 0.785. Validity was confirmed using correlation and comparison analysis, and response sensitivity was excellent. CONCLUSIONS: The Nasal Obstruction Symptom Evaluation Scale is a valid, reliable, and responsive instrument that is brief and easy to complete and has potential use for outcomes studies in adults with nasal obstruction. C1 Baylor Coll Med, Bobby R Alford Dept Otolarynogol & Communicat Sci, Houston, TX 77030 USA. Duke Univ, Dept Surg, Div Otolaryngol Head & Neck Surg, Durham, NC 27706 USA. Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Milwaukee, WI 53226 USA. Univ Washington, Sch Med, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Surg & Perioperat Care Serv, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA USA. Amer Acad Otolaryngol Head & Neck Surg Fdn, Alexandria, VA 22314 USA. RP Stewart, MG (reprint author), Baylor Coll Med, Bobby R Alford Dept Otolarynogol & Communicat Sci, 6550 Fannin St,Suite 1727, Houston, TX 77030 USA. EM mgstew@bcm.tmc.edu OI Yueh, Bevan/0000-0003-1380-1053 FU NHLBI NIH HHS [K23 HL068849, K23 HL068849-01A2]; ODCDC CDC HHS [CD-98318] NR 22 TC 225 Z9 233 U1 0 U2 7 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0194-5998 J9 OTOLARYNG HEAD NECK JI Otolaryngol. Head Neck Surg. PD FEB PY 2004 VL 130 IS 2 BP 157 EP 163 DI 10.1016/j.otohns.2003.09.016 PG 7 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 779TP UT WOS:000189317300001 PM 14990910 ER PT J AU Schumacher, HR Habre, W Meador, R Hsia, EC AF Schumacher, HR Habre, W Meador, R Hsia, EC TI Predictive factors in early arthritis: Long-Term follow-up SO SEMINARS IN ARTHRITIS AND RHEUMATISM LA English DT Review DE unclassified arthritis; transient arthritis; rheumatoid arthritis; spondyloarthropathy; hands; polyarthritis ID EARLY RHEUMATOID-ARTHRITIS; SYNOVIAL MEMBRANE; RECENT-ONSET; INFLAMMATORY POLYARTHRITIS; CLASSIFICATION CRITERIA; CLINICAL-FEATURES; DISEASE; DISABILITY; SPONDYLOARTHROPATHIES; OLIGOARTHRITIS AB Background. Because recent-onset inflammatory arthritis exhibits considerable clinical and prognostic variability, it is important to attempt to predict which patients are likely to have a poor prognosis as early as possible. Most prognostic studies have looked at patients who fulfilled proposed criteria for a definite diagnosis of rheumatoid arthritis (RA) or other well-defined conditions; less information exists concerning predictive factors for other types of early arthritis. Objectives: To examine prognosis in early arthritis, the authors assessed the long-term outcome in a cohort of patients who presented with inflammatory arthritis of short duration. Associations between outcome and patient clinical characteristics were analyzed to determine possible prognostic factors. Methods: Since 1968, patients were selected to be followed up in 2 early-arthritis clinics if they had evidence of inflammatory joint disease and symptom duration was < 1 year. Length of follow-up was variable, but was at least 1 year. At last follow-up, patients were classified as being in remission or as having persistent disease. Factors associated with a poor outcome were identified by using formal statistical methods. Results: A total of 121 patients were included in this analysis. Mean disease duration to the first evaluation was 3 months, and median follow-up was 5 years (range, 1 to 30 months). Twenty-one patients (17%) had transient disease defined as total duration of < 6 weeks. Sixty-three patients (52%) were in remission at final follow-up, with unclassified patients doing the best. Patients meeting criteria for RA or spondylarthropathies had more persistent disease. Polyarticular disease predicted more persistent disease (P < .05). In multivariable analyses, patients with initial hand involvement were much less likely to achieve remission of their disease (odds ratio, 0.18; 95% confidence interval, 0.05 to 0.66). Only 4 patients had either class 4 function or joint replacement. Conclusions: Our findings indicate that prognosis in early inflammatory arthritis is generally good, with more than half of all patients achieving remission in our cohort. Patients with unclassified arthritis fared better than those meeting criteria for RA or spondylarthropathy. Of the many clinical variables examined as possible prognostic factors, hand involvement was the strongest predictor of a poor outcome. Relevance: The long follow-up of these patients with early arthritis provides clues for the clinician to the likely course and shows that many patients will do well. (C) 2004 Elsevier Inc. All rights reserved. C1 Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Div Rheumatol, Philadelphia, PA 19104 USA. RP Schumacher, HR (reprint author), Vet Affairs Med Ctr, 151K,Univ & Woodland Ave, Philadelphia, PA 19104 USA. EM schumacr@mail.med.upenn.edu NR 55 TC 25 Z9 28 U1 1 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0049-0172 J9 SEMIN ARTHRITIS RHEU JI Semin. Arthritis Rheum. PD FEB PY 2004 VL 33 IS 4 BP 264 EP 272 DI 10.1053/S0049-0172(03)00130-6 PG 9 WC Rheumatology SC Rheumatology GA 777GD UT WOS:000189166900005 PM 14978664 ER PT J AU Ostrow, JD Pascolo, L Brites, D Tiribelli, C AF Ostrow, JD Pascolo, L Brites, D Tiribelli, C TI Molecular basis of bilirubin-induced neurotoxicity SO TRENDS IN MOLECULAR MEDICINE LA English DT Article ID RESISTANCE-ASSOCIATED PROTEIN; ANION-TRANSPORTING POLYPEPTIDES; DEVELOPING RAT-BRAIN; MICROVESSEL ENDOTHELIAL-CELLS; FIBROBLAST-GROWTH-FACTOR; CENTRAL-NERVOUS-SYSTEM; MULTIDRUG-RESISTANCE; P-GLYCOPROTEIN; UNCONJUGATED BILIRUBIN; CHOROID-PLEXUS AB Unconjugated bilirubin (UCB), at slightly elevated unbound concentrations, is toxic to astrocytes and neurons, damaging mitochondria (causing impaired energy metabolism and apoptosis) and plasma membranes (causing oxidative damage and disrupting transport of neurotransmitters). Accumulation of UCB in the CSF and CNS is limited by its active export, probably mediated by MRP1/Mrp1 present in choroid plexus epithelia, capillary endothelia, astrocytes and neurons. Upregulation of MRP1/Mrp1 protein levels by UCB might represent an important adaptive mechanism that protects the CNS from UCB toxicity. These concepts could explain the varied susceptibility of newborns to bilirubin neurotoxicity and the occurrence of neurological damage at plasma UCB concentrations well below therapeutic guidelines, and are relevant to the increasing prevalence of bilirubin encephalopathy in newborns. C1 Univ Trieste, Liver Res Ctr, I-34012 Trieste, Italy. VA Puget Sound Hlth Care Syst, Seattle Div, Res Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, GI Hepatol Div, Seattle, WA 98108 USA. Univ Trieste, Dept BBCM, I-34012 Trieste, Italy. Univ Lisbon, Fac Pharm, Ctr Mol Pathogenesis, P-1649019 Lisbon, Portugal. RP Tiribelli, C (reprint author), Univ Trieste, Liver Res Ctr, AREA Sci Pk, I-34012 Trieste, Italy. EM ctliver@csfunits.it RI Brites, Dora/M-8293-2013; iMed.ULisboa, iMed.ULisboa/C-6292-2014; iMed.ULisboa, NeuronGliaBiol /B-5403-2014 OI Brites, Dora/0000-0002-3024-9777; NR 70 TC 100 Z9 107 U1 1 U2 9 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1471-4914 J9 TRENDS MOL MED JI Trends Mol. Med PD FEB PY 2004 VL 10 IS 2 BP 65 EP 70 DI 10.1016/j.molmed.2003.12.003 PG 6 WC Biochemistry & Molecular Biology; Cell Biology; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Cell Biology; Research & Experimental Medicine GA 780BE UT WOS:000189350600005 PM 15102359 ER PT J AU Zhou, XH Castelluccio, P AF Zhou, XH Castelluccio, P TI Adjusting for non-ignorable verification bias in clinical studies for Alzheimer's disease SO STATISTICS IN MEDICINE LA English DT Article; Proceedings Paper CT 2nd International Conference on Statistical Methodology on Alzheimers Disease Research CY MAY 10-12, 2002 CL LEXINGTON, KENTUCKY DE Alzheimer's disease; ROC curves; verification bias; profile likelihood; non-ignorability ID DIAGNOSTIC-TESTS AB A common problem for comparing the relative accuracy of two screening tests for Alzheimer's disease (AD) in a two-stage design study is verification bias. If the verification bias can be assumed to be ignorable, Zhou and Higgs have proposed a maximum likelihood approach to compare the relative accuracy of screening tests in a two-stage design study. However, if the verification mechanism also depends on the unobserved disease status, the ignorable assumption does not hold. In this paper, we discuss how to use a profile likelihood approach to compare the relative accuracy of two screening tests for AD without assuming the ignorable verification bias mechanism. Copyright (C) 2004 John Wiley Sons, Ltd. C1 Univ Washington, Dept Biostat, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, NW HSR&d Ctr Excellence, Seattle, WA 98108 USA. Purdue Univ, Dept Stat, W Lafayette, IN 47907 USA. RP Zhou, XH (reprint author), Univ Washington, Dept Biostat, F600 HSB Box 357232, Seattle, WA 98195 USA. EM azhou@u.washington.edu FU AHRQ HHS [R29HS08559] NR 7 TC 9 Z9 9 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0277-6715 J9 STAT MED JI Stat. Med. PD JAN 30 PY 2004 VL 23 IS 2 BP 221 EP 230 DI 10.1002/sim.1711 PG 10 WC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Medicine, Research & Experimental; Statistics & Probability SC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Research & Experimental Medicine; Mathematics GA 763TW UT WOS:000188117400007 PM 14716724 ER PT J AU Fischer, ME Vitek, ME Hedeker, D Henderson, WG Jacobsen, SJ Goldberg, J AF Fischer, ME Vitek, ME Hedeker, D Henderson, WG Jacobsen, SJ Goldberg, J TI A twin study of erectile dysfunction SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID INTERNATIONAL INDEX; CORPUS CAVERNOSUM; EJACULATORY DYSFUNCTION; PENILE ERECTION; UNITED-STATES; NITRIC-OXIDE; RISK-FACTORS; PREVALENCE; EXPRESSION; IMPOTENCE AB Background: The extent of genetic influence on erectile dysfunction (ED) is unknown. This study determines the contribution of heredity to ED in a sample of middle-aged men. Methods: A classical twin study was conducted in the Vietnam Era Twin Registry, a national sample of male-male pairs (mean birth year, 1949) who served on active duty during the Vietnam era (1965-1975). A 1999 male health survey was completed by 890 monozygotic (MZ) and 619 dizygotic (DZ) pairs. The prevalence and heritability of 2 self-report indicators of ED, difficulty in having an erection and in maintaining an erection, are estimated. Results: The prevalence of difficulty in having an erection is 23.3% and in maintaining an erection is 26.7%. Twin correlations for dysfunction in having an erection are 0.35 (95% confidence interval [CI], 0.28-0.41) in MZ and 0.17 (95% Cl, 0.09-0.27) in DZ pairs. For dysfunction in maintaining an erection, the twin correlations in MZ and DZ pairs are 0.39 (95% Cl, 0.32-0.45) and 0.18 (95% Cl, 0.09-0.27), respectively. The estimated heritability of liability for dysfunction in having an erection is 35% and in maintaining an erection is 42%. The heritable influence on ED remained significant after adjustment for ED risk factors. Conclusions: The present study demonstrates an ED-specific genetic component that is independent of genetic influences from numerous ED risk factors. The results suggest that future molecular genetic studies to identify ED-related polymorphisms are warranted. C1 VA Puget Sound Hlth Care Syst, VET Registry Seattle ERIC, Seattle, WA 98108 USA. Vet Affairs Edward Hines Jr Hosp, Coordinating Ctr, Cooperat Studies Program, Hines, IL USA. Univ Illinois, Epidemiol Biostat Div, Chicago, IL USA. Mayo Clin & Mayo Fdn, Div Epidemiol, Rochester, MN 55905 USA. RP Goldberg, J (reprint author), VA Puget Sound Hlth Care Syst, VET Registry Seattle ERIC, MS 152E,1660 S Columbian Way, Seattle, WA 98108 USA. EM goldie1@u.washington.edu NR 38 TC 12 Z9 12 U1 1 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JAN 26 PY 2004 VL 164 IS 2 BP 165 EP 168 DI 10.1001/archinte.164.2.165 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 769LY UT WOS:000188652600006 PM 14744839 ER PT J AU Ganesh, S Tsurutani, N Suzuki, T Hoshii, Y Ishihara, T Delgado-Escueta, AV Yamakawa, K AF Ganesh, S Tsurutani, N Suzuki, T Hoshii, Y Ishihara, T Delgado-Escueta, AV Yamakawa, K TI The carbohydrate-binding domain of Lafora disease protein targets Lafora polyglucosan bodies SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE epilepsy; polyglucosan inclusion; carpora amylacea; neurodegeneration; phosphatase; carbohydrate binding ID PROGRESSIVE MYOCLONUS EPILEPSY; GLYCATION END-PRODUCTS; EPM2A GENE; CORPORA-AMYLACEA; PHOSPHATASE; MUTATIONS; IDENTIFICATION; MYOCARDIUM; SPECTRUM; GLYCOGEN AB Lafora's disease (LD) is an amosomal recessive and fatal form of epilepsy with onset in late childhood or adolescence. One of the characteristic features of LD pathology is the presence of periodic acid-Schiff (PAS) positive Lafora inclusion bodies. Lafora bodies are present primarily in neurons, but they have also been found in other organs. Histochemical and biochemical studies have indicated that Lafora bodies are composed mainly of polysaccharides. The LD gene, EPM2A, encodes a 331 amino acid long protein named laforin that contains an N-terminal carbohydrate-binding domain (CBD) and a C-terminal dual-specificity phosphatase domain (DSPD). Here we demonstrate that the CBD of laforin targets the protein to Lafora inclusion bodies and this property could be evolutionarily conserved. We also tested in vitro the effects of five LD missense mutations on laforin's affinity to Lafora body. While the missense mutant W32G failed to bind to purified Lafora body, four other mutants (S25P, E28L, F88L, and R108C) did not show any effect on the binding affinity. Based on these observations we propose the existence of a laforin-mediated glycogen metabolic pathway regulating the disposal of pathogenic polyglucosan inclusions. This is the first report demonstrating a direct association between the LD gene product and the disease-defining storage product, the Lafora bodies. (C) 2003 Elsevier Inc. All rights reserved. C1 Indian Inst Technol, Dept Biol Sci & Bioengn, Kanpur 208016, Uttar Pradesh, India. RIKEN, Brain Sci Inst, Neurogenet Lab, Wako, Saitama 35101, Japan. Yamaguchi Univ, Sch Med, Dept Pathol 1, Yamaguchi, Japan. Univ Calif Los Angeles, Sch Med, Comprehens Epilepsy Program, Epilepsy Genet Genom Labs, Los Angeles, CA USA. VA GLAHS W Los Angeles Med Ctr, Los Angeles, CA USA. RP Ganesh, S (reprint author), Indian Inst Technol, Dept Biol Sci & Bioengn, Kanpur 208016, Uttar Pradesh, India. EM sganesh@iitk.ac.in; yamakawa@brain.riken.go.jp RI Ganesh, Subramniam/B-4131-2009; Yamakawa, Kazuhiro/N-5050-2015 OI Delgado-Escueta, Antonio V./0000-0002-1581-6999 NR 29 TC 53 Z9 54 U1 0 U2 5 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD JAN 23 PY 2004 VL 313 IS 4 BP 1101 EP 1109 DI 10.1016/j.bbrc.2003.12.043 PG 9 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 762TF UT WOS:000187997700041 PM 14706656 ER PT J AU Gera, JF Mellinghoff, IK Shi, YJ Rettig, MB Tran, C Hsu, JH Sawyers, CL Lichtenstein, AK AF Gera, JF Mellinghoff, IK Shi, YJ Rettig, MB Tran, C Hsu, JH Sawyers, CL Lichtenstein, AK TI AKT activity determines sensitivity to mammalian target of rapamycin (mTOR) inhibitors by regulating cyclin D1 and c-myc expression SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID EIF2-ALPHA KINASE GCN2; TRANSLATION INITIATION; MESSENGER-RNA; SIGNALING PATHWAY; CELL-SURVIVAL; CANCER-CELLS; TOR; IRES; GROWTH; HYPOTHESIS AB Prior work demonstrates that AKT activity regulates sensitivity of cells to G(1) arrest induced by mammalian target of rapamycin (mTOR) inhibitors such as rapamycin and CCI-779. To investigate this, a novel high-throughput microarray polysome analysis was performed to identify genes whose mRNA translational efficiency was differentially affected following mTOR inhibition. The analysis also allowed the assessment of steady-state transcript levels. We identified two transcripts, cyclin D1 and c-myc, which exhibited differential expression in an AKT-dependent manner: High levels of activated AKT resulted in rapamycin-induced down-regulation of expression, whereas low levels resulted in up-regulation of expression. To ectopically express these proteins we exploited the finding that the p27(kip1) mRNA was efficiently translated in the face of mTOR inhibition irrespective of AKT activity. Thus, the p27(kip1) 5'-untranslated region was fused to the cyclin D1 and c-myc coding regions and these constructs were expressed in cells. In transfected cells, expression of cyclin D1 or c-myc was not decreased by rapamycin. Most importantly, this completely converted sensitive cells to a phenotype resistant to G(1) arrest. Furthermore, the AKT-dependent differential expression patterns of these two genes was also observed in a mouse xenograft model following in vivo treatment with CCI-779. These results identify two critical downstream molecular targets whose expression is regulated by AKT activity and whose down-regulation is required for rapamycin/CCI-779 sensitivity. C1 Univ Calif Los Angeles, Med Ctr, W Los Angeles Vet Adm, Dept Med,Div Hematol & Oncol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Jonsson Comprehens Canc Ctr, Howard Hughes Med Inst,Mol Biol Inst, Los Angeles, CA 90073 USA. RP Gera, JF (reprint author), Univ Calif Los Angeles, Med Ctr, W Los Angeles Vet Adm, Dept Med,Div Hematol & Oncol, Los Angeles, CA 90073 USA. EM gera@ucla.edu RI Sawyers, Charles/G-5327-2016 FU NCI NIH HHS [CA096920] NR 36 TC 233 Z9 243 U1 0 U2 7 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JAN 23 PY 2004 VL 279 IS 4 BP 2737 EP 2746 DI 10.1074/jbc.M309999200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 764MU UT WOS:000188211300051 PM 14576155 ER PT J AU Matejuk, A Dwyer, J Hopke, C Vandenbark, AA Offner, H AF Matejuk, A Dwyer, J Hopke, C Vandenbark, AA Offner, H TI Opposing roles for TGF-beta 1 and TGF-beta 3 isoforms in experimental autoimmune encephalomyelitis SO CYTOKINE LA English DT Article DE EAE; estrogen; TGF-beta 1; TGF-beta 3 ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; GROWTH-FACTOR-BETA; MYELIN BASIC-PROTEIN; MESSENGER-RNA EXPRESSION; T-CELLS; TRANSFORMING GROWTH-FACTOR-BETA-1; TGF-BETA; DIFFERENTIAL EXPRESSION; CYTOKINE RESPONSE; NERVOUS-SYSTEM AB Hormones can exert significant protective effects on autoimmune diseases by activating immunoregulatory mechanisms. One of the possible mechanisms of hormonal protection might be through the anti-inflammatory effects of the TGF-beta molecule. The present study investigated the changes in expression of two TGF-beta isoforms, TGF-beta1 and TGF-beta3, in C57BL/6 and TCR transgenic (T/R+) B10.PL mice that manifested or were protected against clinical signs of experimental autoimmune encephalomyelitis (EAE) with 17beta-estradiol (E2) treatment. We here demonstrate an inverse relationship between expression of TGF-beta1 that is enhanced in mice with EAE, and TGF-beta3 that is enhanced in E2-protected mice. The differential expression of TGF-beta isoforms was observed in spinal cord tissue but not spleen. Additionally TGF-beta1 expression was evident both in whole spinal cord tissue and mononuclear cells isolated from inflamed tissue, in contrast to TGF-beta3 that was only detected in spinal cord tissue but not in mononuclear cells. Further studies revealed that CD3 and especially MAC-1 positive cells were the main source of TGF-beta1 in the mononuclear CNS population. Of crucial importance, the TGF-beta3 isoform displayed anti-proliferative properties towards encephalitogenic cells in vitro. We propose that the TGF-beta1 and TGF-beta3 isoforms play opposing roles in the expression of EAE. (C) 2003 Elsevier Ltd. All rights reserved. C1 Portland VA Med Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97201 USA. RP Offner, H (reprint author), Portland VA Med Ctr, R&D 31,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. EM offnerva@ohsu.edu FU NIAID NIH HHS [AI42376]; NINDS NIH HHS [NS23221, NS23444] NR 39 TC 12 Z9 13 U1 1 U2 2 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1043-4666 J9 CYTOKINE JI Cytokine PD JAN 21 PY 2004 VL 25 IS 2 BP 45 EP 51 DI 10.1016/j.cyto.2003.09.007 PG 7 WC Biochemistry & Molecular Biology; Cell Biology; Immunology SC Biochemistry & Molecular Biology; Cell Biology; Immunology GA 765NW UT WOS:000188290900001 PM 14693159 ER PT J AU Diwan, A Dibbs, Z Nemoto, S DeFreitas, G Carabello, BA Sivasubramanian, N Wilson, EM Spinale, FG Mann, DL AF Diwan, A Dibbs, Z Nemoto, S DeFreitas, G Carabello, BA Sivasubramanian, N Wilson, EM Spinale, FG Mann, DL TI Targeted overexpression of noncleavable and secreted forms of tumor necrosis factor provokes disparate cardiac phenotypes SO CIRCULATION LA English DT Article DE hypertrophy; remodeling; metalloproteinases ID MATRIX-METALLOPROTEINASE INHIBITION; FACTOR-ALPHA; HEART-FAILURE; CONVERTING ENZYME; TRANSGENIC MICE; DYSFUNCTION; GEOMETRY AB Background - Recent studies suggest that posttranslation processing or "shedding" (ie, secretion) of tumor necrosis factor (TNF) by tumor necrosis factor-alpha converting enzyme ( TACE) may contribute to the left ventricular (LV) remodeling that occurs in the failing human heart. Methods and Results - To address the functional significance of TNF shedding, we generated lines of transgenic mice with targeted overexpression of secreted wild-type (MHCsTNF2) TNF and overexpression of a mutated noncleavable transmembrane form of TNF (MHCmTNF). Both lines of mice had overlapping levels of myocardial TNF protein; however, the phenotypes of the MHCsTNF2 and MHCmTNF mice were strikingly disparate. Whereas the MHCmTNF mice developed a concentric LV hypertrophy phenotype, the MHCsTNF2 mice developed a dilated LV phenotype. The fibrillar collagen weave in MHCmTNF mice with concentric hypertrophy was characterized by thick collagen fibrils and increased collagen content, whereas the fibrillar collagen weave in the MHCsTNF2 mice with LV dilation was characterized by a diminished collagen content. Inhibition of matrix metalloproteinases with a broad-based matrix metalloproteinase inhibitor prevented LV dilation in the MHCsTNF2 mice. Conclusions - These findings suggest that posttranslational processing of TNF, as opposed to TNF expression per se, is responsible for the adverse cardiac remodeling that occurs after sustained TNF overexpression. C1 Baylor Coll Med, Winters Ctr Heart Failure Res, Houston, TX 77030 USA. Baylor Coll Med, Med Serv Care Line, Houston, TX 77030 USA. Baylor Coll Med, Houston VAMC, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. Med Univ S Carolina, Dept Surg, Charleston, SC 29425 USA. RP Mann, DL (reprint author), Baylor Coll Med, Winters Ctr Heart Failure Res, MS 524,6565 Fannin, Houston, TX 77030 USA. EM dmann@bcm.tmc.edu OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [R01 HL58081-01, P50 HL-O6H, HL-42250-10/10, R01 HL61543-01] NR 15 TC 48 Z9 48 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JAN 20 PY 2004 VL 109 IS 2 BP 262 EP 268 DI 10.1161/01.CIR.0000109642.27985.FA PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 765CX UT WOS:000188250500021 PM 14699008 ER PT J AU Amici, R Sanford, LD Kearney, K McInerney, B Ross, RJ Horner, RL Morrison, AR AF Amici, R Sanford, LD Kearney, K McInerney, B Ross, RJ Horner, RL Morrison, AR TI A serotonergic (5-HT2) receptor mechanism in the laterodorsal tegmental nucleus participates in regulating the pattern of rapid-eye-movement sleep occurrence in the rat SO BRAIN RESEARCH LA English DT Article DE REM sleep; serotonin; 5-HT2 receptor; laterodorsal tegmental nucleus; single REM sleep episode; sequential REM sleep episode; REM sleep cluster ID DORSAL RAPHE NUCLEUS; FREELY MOVING CATS; MESOPONTINE CHOLINERGIC NUCLEI; REM-SLEEP; AMBIENT-TEMPERATURE; BEHAVIORAL AROUSAL; WAKING CYCLE; NEURONS; WAKEFULNESS; AGONIST AB Serotonin [5-hydroxytryptamine (5-HT)] plays an inhibitory role in rapid-eye-movement (REM) sleep although the exact mechanism(s) and site(s) of action are not known. It is commonly assumed that 5-HT exerts its influence on REM sleep via input from the dorsal raphe nucleus (DRN) directly onto cholinergic neurons involved in the generation of REM sleep. 5-HT2 receptor sites have been found on cholinergic neurons in the laterodorsal tegmental nucleus (LDT) and pedunculopontine tegmental nucleus (PPT). We locally microinjected the 5-HT2 agonist DOI ((+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane HCl) and the 5-HT2 antagonist, ketanserin, in LDT in rats to determine whether these receptor sites are involved in the regulation of behavioral states. DOI and ketanserin primarily affected REM sleep, by significantly decreasing or increasing, respectively, the number, but not the duration, of REM sleep episodes. DOI specifically decreased the occurrence of clusters of REM sleep episodes appearing at intervals less than or equal to 3 min (sequential episodes) without affecting single episodes separated by more than 3 min. An opposite effect of ketanserin on REM sleep clusters, although not statistically significant, was observed. (C) 2003 Elsevier B.V. All rights reserved. C1 Univ Penn, Sch Vet Med, Dept Biol Anim, Lab Study Brain Sleep, Philadelphia, PA 19104 USA. Univ Bologna, Dept Human & Gen Physiol, Bologna, Italy. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Morrison, AR (reprint author), Univ Penn, Sch Vet Med, Dept Biol Anim, Lab Study Brain Sleep, 3800 Spruce St, Philadelphia, PA 19104 USA. EM armsleep@vet.upenn.edu FU NHLBI NIH HHS [HLB42236]; NIMH NIH HHS [MH42903] NR 47 TC 24 Z9 28 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD JAN 16 PY 2004 VL 996 IS 1 BP 9 EP 18 DI 10.1016/j.brainres.2003.09.026 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 760XX UT WOS:000187861500002 PM 14670626 ER PT J AU Mukhin, YV Garnovskaya, MN Ullian, ME Raymond, JR AF Mukhin, YV Garnovskaya, MN Ullian, ME Raymond, JR TI ERK is regulated by sodium-proton exchanger in rat aortic vascular smooth muscle cells SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID ACTIVATED PROTEIN-KINASE; NA+-H+ EXCHANGER; GROWTH-FACTOR RECEPTOR; RENAL MESANGIAL CELLS; ASCITES TUMOR-CELLS; ANGIOTENSIN-II; INTRACELLULAR PH; COUPLED RECEPTORS; HEART-FAILURE; VENTRICULAR MYOCYTES AB The purposes of this study were to test 1) the relationship between two widely studied mitogenic effector pathways, and 2) the hypothesis that sodium-proton exchanger type 1 (NHE-1) is a regulator of extracellular signal-regulated protein kinase (ERK) activation in rat aortic smooth muscle (RASM) cells. Angiotensin II (Ang II) and 5-hydroxytryptamine (5-HT) stimulated both ERK and NHE-1 activities, with activation of NHE-1 preceding that of ERK. The concentration-response curves for 5-HT and Ang II were superimposable for both processes. Inhibition of NHE-1 with pharmacological agents or by isotonic replacement of sodium in the perfusate with choline or tetramethylammonium greatly attenuated ERK activation by 5-HT or Ang II. Similar maneuvers significantly attenuated 5-HT- or Ang II-mediated activation of MEK and Ras but not transphosphorylation of the epidermal growth factor (EGF) receptor. EGF receptor blockade attenuated ERK activation, but not NHE-1 activation by 5-HT and Ang II, suggesting that the EGF receptor and NHE-1 work in parallel to stimulate ERK activity in RASM cells, converging distal to the EGF receptor but at or above the level of Ras in the Ras-MEK-ERK pathway. Receptor- independent activation of NHE-1 by acute acid loading of RASM cells resulted in the rapid phosphorylation of ERK, which could be blocked by pharmacological inhibitors of NHE-1 or by isotonic replacement of sodium, closely linking the proton transport function of NHE-1 to ERK activation. These studies identify NHE as a new regulator of ERK activity in RASM cells. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Med Serv, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC 29425 USA. RP Mukhin, YV (reprint author), Med Univ S Carolina, Dept Med, Div Nephrol, 96 Jonathan Lucas St,Rm 829 CSB,POB 250623, Charleston, SC 29425 USA. EM mukhinyv@musc.edu FU NCRR NIH HHS [S10 RR 013005]; NIDDK NIH HHS [DK 02694, DK 52448] NR 67 TC 36 Z9 37 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JAN 16 PY 2004 VL 279 IS 3 BP 1845 EP 1852 DI 10.1074/jbc.M304907200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 762WT UT WOS:000188005700035 PM 14600156 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI Personal view: going around in circles - circuitous medical management plans SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID ANNOTATED ALGORITHMIC APPROACH; BARRETTS-ESOPHAGUS; SURVEILLANCE AB Physicians occasionally embark on a work-up that, after a lengthy path, leads them to a clinical situation similar to that from which they started their original pursuit. This article aims to describe the characteristics of circular medical management and means for its avoidance. The underlying medical problem often presents itself initially as a bewildering array of consecutive outcomes similar to a complex decision tree. On closer inspection, however, few of the outcomes are associated with a high probability, and only one path stands out as the most likely one to take. This path usually ends in such options as expectant management, supportive measures or doing nothing, which are already available at the onset of work-up. If medical management is drawn out and takes a long time to complete, sight of its circular nature is easily lost. If many different specialists care for a patient, little appreciation for circular paths occurs. A prospective outline of the management plan and the elimination of paths with low a priori probability can help to prevent unnecessary medical interventions. The physician may then come to realize that standing still and waiting become as effective and less costly than a lengthy circular work-up. C1 Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 7 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD JAN 15 PY 2004 VL 19 IS 2 BP 191 EP 195 DI 10.1111/j.0269-2813.2004.01849.x PG 5 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 763YJ UT WOS:000188127800005 PM 14723610 ER PT J AU Tobin, MJ AF Tobin, MJ TI Sleep-disordered breathing, control of breathing, respiratory muscles, pulmonary function testing in AJRCCM 2003 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review ID POSITIVE AIRWAY PRESSURE; INTERMITTENT HYPOXIA; LUNG-CANCER; QUADRICEPS FATIGABILITY; MECHANICAL VENTILATION; ANATOMIC DISORDER; OXIDATIVE STRESS; CYSTIC-FIBROSIS; APNEA SYNDROME; HEART-FAILURE C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Div Pulm & Crit Care Med, Hines, IL USA. RP Tobin, MJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Route 111N, Hines, IL 60141 USA. EM mtobin2@lumc.edu NR 85 TC 2 Z9 3 U1 1 U2 3 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD JAN 15 PY 2004 VL 169 IS 2 BP 254 EP 264 DI 10.1164/rccm.2312010 PG 11 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 763RQ UT WOS:000188114600026 PM 14718239 ER PT J AU Tobin, MJ AF Tobin, MJ TI Asthma, airway biology, and nasal disorders in AJRCCM 2003 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review ID EXERCISE-INDUCED BRONCHOCONSTRICTION; NITRIC-OXIDE; ALLERGEN CHALLENGE; SIGNALING PATHWAY; EPITHELIAL-CELLS; CHILDHOOD ASTHMA; MOUSE MODEL; IN-VIVO; INFLAMMATION; HYPERRESPONSIVENESS C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Div Pulm & Crit Care Med, Hines, IL USA. RP Tobin, MJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Route 111N, Hines, IL 60141 USA. EM mtobin2@lumc.edu NR 86 TC 4 Z9 4 U1 0 U2 0 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD JAN 15 PY 2004 VL 169 IS 2 BP 265 EP 276 DI 10.1164/rccm.2312011 PG 12 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 763RQ UT WOS:000188114600027 PM 14718240 ER PT J AU Tobin, MJ AF Tobin, MJ TI Pediatrics, surfactant, and cystic fibrosis in AJRCCM 2003 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review ID RESPIRATORY-DISTRESS-SYNDROME; MECONIUM ASPIRATION SYNDROME; EXHALED BREATH CONDENSATE; OBSTRUCTIVE SLEEP-APNEA; LUNG-FUNCTION; NONTUBERCULOUS-MYCOBACTERIA; BRONCHOPULMONARY-DYSPLASIA; INTERMITTENT HYPOXIA; CHILDHOOD ASTHMA; PROTEIN-A C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Div Pulm & Crit Care Med, Hines, IL USA. RP Tobin, MJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Route 111N, Hines, IL 60141 USA. EM mtobin2@lumc.edu NR 79 TC 1 Z9 1 U1 1 U2 1 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD JAN 15 PY 2004 VL 169 IS 2 BP 277 EP 287 DI 10.1164/rccm.2312009 PG 11 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 763RQ UT WOS:000188114600028 PM 14718241 ER PT J AU Tobin, MJ AF Tobin, MJ TI Tuberculosis, lung infections, interstitial lung disease, social issues and journalology in AJRCCM 2003 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review ID IDIOPATHIC PULMONARY-FIBROSIS; ACUTE RESPIRATORY SYNDROME; NECROSIS-FACTOR-ALPHA; DOUBLE-EDGED-SWORD; CYSTIC-FIBROSIS; LATENT TUBERCULOSIS; INTERFERON-GAMMA; GROWTH-FACTOR; HYPERSENSITIVITY PNEUMONITIS; NONTUBERCULOUS-MYCOBACTERIA C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Div Pulm & Crit Care Med, Hines, IL USA. RP Tobin, MJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Route 111N, Hines, IL 60141 USA. EM mtobin2@lumc.edu NR 116 TC 2 Z9 2 U1 1 U2 1 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD JAN 15 PY 2004 VL 169 IS 2 BP 288 EP 300 DI 10.1164/rccm.2312006 PG 13 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 763RQ UT WOS:000188114600029 PM 14718242 ER PT J AU Tobin, MJ AF Tobin, MJ TI Chronic obstructive pulmonary disease, pollution, pulmonary vascular disease, transplantation, pleural disease, and lung cancer in AJRCCM 2003 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Div Pulm & Crit Care Med, Hines, IL USA. RP Tobin, MJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Route 11IN, Hines, IL 60141 USA. EM mtobin2@lumc.edu NR 0 TC 3 Z9 6 U1 0 U2 2 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD JAN 15 PY 2004 VL 169 IS 2 BP 301 EP 313 DI 10.1164/rccm.2312007 PG 13 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 763RQ UT WOS:000188114600030 PM 14718243 ER PT J AU Nath, N Giri, S Prasad, R Singh, AK Singh, I AF Nath, N Giri, S Prasad, R Singh, AK Singh, I TI Potential targets of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor for multiple sclerosis therapy SO JOURNAL OF IMMUNOLOGY LA English DT Article ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; CENTRAL-NERVOUS-SYSTEM; TUMOR-NECROSIS-FACTOR; NF-KAPPA-B; NITRIC-OXIDE SYNTHASE; HMG-COA REDUCTASE; T-CELLS; TRANSCRIPTION FACTOR; DENDRITIC CELLS AB The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors or statins are newly identified immunomodulators. In vivo treatment of SJL/J mice with lovastatin reduced the duration and clinical severity of active and passive experimental autoimmune encephalomyelitis (EAE), an animal model for multiple sclerosis. Lovastatin induced the expression of GATA3 and the phosphorylation of STAT6, whereas it inhibited tyrosine phosphorylation of Janus kinase 2, tyrosine kinase 2, and STAT4. Inhibition of the Janus kinase-STAT4 pathway by lovastatin modulated TO to Th1 differentiation and reduced cytokine (IFN-gamma and TNF-alpha) production, thus inducing Th2 cytokines (IL-4, IL-5, and IL-10). It inhibited T-bet (T box transcription factor) and NF-kappaB in activated T cells and significantly reduced infiltration of CD4- and MHC class II-positive cells to CNS. Further, it stabilized IL-4 production and GATA-3 expression in differentiated Th2 cells, whereas in differentiated Th1 cells it inhibited the expression of T-bet and reduced the production of IFN-gamma. Moreover, lovastatin-exposed macrophage and BV2 (microglia) in allogeneic MLRs induced the production of the anti-inflammatory cytokine IL-10. These observations indicate that the antiinflammatory effects of lovastatin are mediated via T cells as well as APCs, because it modulates the polarization patterns of naive T cell activation in an APC-independent system. Together, these findings reveal that lovastatin may have possible therapeutic value involving new targets (in both APCs and T cells) for the treatment of multiple sclerosis and other inflammatory diseases. The Journal of Immunology, 2004, 172: 1273-1286. C1 Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Dept Pathol, Charleston, SC 29425 USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, 96 Jonathan Lucas St,Clin Sci Bldg,Suite 316, Charleston, SC 29425 USA. EM singhi@musc.edu FU NINDS NIH HHS [NS 41044, NS 22576, NS 37766, NS 34741] NR 65 TC 106 Z9 118 U1 0 U2 1 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD JAN 15 PY 2004 VL 172 IS 2 BP 1273 EP 1286 PG 14 WC Immunology SC Immunology GA 762WM UT WOS:000188005200065 PM 14707106 ER PT J AU Giri, S Nath, N Smith, B Viollet, B Singh, AK Singh, I AF Giri, S Nath, N Smith, B Viollet, B Singh, AK Singh, I TI 5-aminoimidazole-4-carboxamide-1-beta-4-ribofuranoside inhibits proinflammatory response in glial cells: A possible role of AMP-activated protein kinase SO JOURNAL OF NEUROSCIENCE LA English DT Article DE glia; AICAR; NF-kappa B; inflammation; C/EBP; AMPK ID CENTRAL-NERVOUS-SYSTEM; NITRIC-OXIDE SYNTHASE; RAT-LIVER; PERMEABLE ACTIVATOR; AICA-RIBOSIDE; FATTY-ACID; C/EBP; PHOSPHORYLATION; EXPRESSION; INDUCTION AB AMP-activated protein kinase (AMPK) is tightly regulated by the cellular AMP:ATP ratio and plays a central role in the regulation of energy homeostasis and metabolic stress. A pharmacological activator of AMPK, 5-amino-4-imidazole carboxamide riboside (AICAR) inhibited lipopolysaccharide (LPS)-induced expression of proinflammatory cytokines (tumor necrosis factor alpha, interleukin-1beta, and interleukin-6) and inducible nitric oxide synthase in primary rat astrocytes, microglia, and peritoneal macrophages. AICAR attenuates the LPS-induced activation of nuclear factor kappaB via downregulation of IkappaB kinase alpha/beta activity. It also inhibits nuclear translocation of CCAAT/enhancer-binding protein (C/EBP) transcription factor by inhibiting the expression of C/EBP-delta in brain glial cells. The dominant negative form of AMPKalpha(2) (D157A) and its antisense documents a possible role of AMPK in the regulation of the cellular proinflammatory process. AICAR also inhibited the production of inflammatory mediators in serum and their expression in CNS of rats injected with a sublethal dose of LPS by intraperitoneal injection. These observations in cultured cells as well as in the animal model suggest that AICAR may be of therapeutic value in treating inflammatory diseases. C1 Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Univ Paris 05, CNRS, INSERM, Dept Genet Dev & Mol Pathol,Inst Cochin, F-75014 Paris, France. Ralph Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, 316 Clin Sci Bldg, Charleston, SC 29425 USA. EM singhi@musc.edu FU NINDS NIH HHS [NS-22576, NS 37766, NS-34741, NS-40144, NS-40810] NR 45 TC 174 Z9 184 U1 3 U2 8 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD JAN 14 PY 2004 VL 24 IS 2 BP 479 EP 487 DI 10.1523/JNEUROSCI.4288-03.2004 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 763QE UT WOS:000188098000019 PM 14724246 ER PT J AU Birbeck, GL Gifford, DR Song, J Belin, TR Mittman, BS Vickrey, BG AF Birbeck, GL Gifford, DR Song, J Belin, TR Mittman, BS Vickrey, BG TI Do malpractice concerns, payment mechanisms, and attitudes influence test-ordering decisions? SO NEUROLOGY LA English DT Article ID PHYSICIAN ATTITUDES; UNCERTAINTY AB Greater understanding is needed of nonclinical factors that determine neurologists' decisions to order tests. The authors surveyed 595 US neurologists and utilized demographic information, attitude scales, and clinical scenarios to evaluate the influence of nonclinical factors on test-ordering decisions. Greater test reliance, higher malpractice concerns, and receiving reimbursement for testing were all associated with a higher likelihood of test ordering. These findings have implications for training needs and suggest malpractice worries may inflate health care costs. C1 Michigan State Univ, Dept Neurol, E Lansing, MI 48824 USA. Michigan State Univ, Dept Epidemiol, E Lansing, MI 48824 USA. Brown Univ, Dept Med, Providence, RI 02912 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Biostat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Alzheimers Dis Res Ctr, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA 90406 USA. RP Birbeck, GL (reprint author), 138 Serv Rd,A-217, E Lansing, MI 48824 USA. EM Gretchen.Birbeck@ht.msu.edu NR 10 TC 28 Z9 28 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD JAN 13 PY 2004 VL 62 IS 1 BP 119 EP 121 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 762XR UT WOS:000188010100031 PM 14718712 ER PT J AU Baer, JS Rosengren, DB Dunn, CW Wells, EA Ogle, RL Hartzler, B AF Baer, JS Rosengren, DB Dunn, CW Wells, EA Ogle, RL Hartzler, B TI An evaluation of workshop training in motivational interviewing for addiction and mental health clinicians SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE motivational interviewing; training evaluation; skill acquisition ID STANDARDIZED PATIENTS; SIMULATED PATIENTS; INTERVENTIONS; SKILLS AB We evaluated a 2-day training workshop on motivational interviewing (MI) for addiction and mental health clinicians (n = 22). Clinicians completed the helpful responses questionnaire (HRQ) and taped interactions with a standardized patient (SP). Independent, blinded coders rated the tapes using the motivational interviewing skills code (MISC). Post-training assessment showed significant increase on the HRQ and two of four MISC summary scores for SP interviews. At 2-month follow-up, means of the HRQ and two MISC summary scores remained higher than baseline, but declined from post-training. Some MI skills improved to a greater degree than others, and a subset of clinicians (>40%) showed continued improvement at follow-up. Results were consistent across interviews with different SPs, supporting the use of this assessment method. Findings highlight the need for additional research on the use of standardized patients, alternative assessment techniques, and effective methods of technology transfer for MI skill acquisition and retention. (C) 2003 Elsevier Ireland Ltd. All rights reserved. C1 Univ Washington, Dept Psychol, Seattle, WA 98108 USA. VA Med Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Inst Alcohol & Drug Abuse, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Social Work, Seattle, WA 98195 USA. Univ N Carolina, Dept Psychol, Wilmington, NC 28403 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Baer, JS (reprint author), Univ Washington, Dept Psychol, S-116-ATC,1660 S Colombian Way, Seattle, WA 98108 USA. EM jsbaer@u.washington.edu NR 22 TC 107 Z9 107 U1 0 U2 10 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD JAN 7 PY 2004 VL 73 IS 1 BP 99 EP 106 DI 10.1016/j.drugalcdep.2003.10.001 PG 8 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 763VV UT WOS:000188121900011 PM 14687964 ER PT J AU Lutz, EP Kako, Y Yagyu, H Heeren, J Marks, S Wright, T Melford, K Ben-Zeev, O Radner, H Merkel, M Bensadoun, A Wong, H Goldberg, IJ AF Lutz, EP Kako, Y Yagyu, H Heeren, J Marks, S Wright, T Melford, K Ben-Zeev, O Radner, H Merkel, M Bensadoun, A Wong, H Goldberg, IJ TI Mice expressing only covalent dimeric heparin binding-deficient lipoprotein lipase - Muscles inefficiently secrete dimeric enzyme SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID MONOCLONAL-ANTIBODY; TRANSGENIC MICE; SULFATE; TISSUES; INVOLVEMENT; SITE AB Lipoprotein lipase (LpL) hydrolyzes triglycerides of circulating lipoproteins while bound as homodimers to endothelial cell surface heparan sulfate proteoglycans. This primarily occurs in the capillary beds of muscle and adipose tissue. By creating a mouse line that expresses covalent dimers of heparin-binding deficient LpL (hLpL(HBM-Dimer)) in muscle, we confirmed in vivo that linking two LpL monomers in a head to tail configuration creates a functional LpL. The hLpL(HBM-Dimer) transgene produced abundant activity and protein in muscle, and the LpL was the expected size of a dimer (similar to110 kDa). Unlike the heparin-binding mutant monomer, hLpL(HBM-Dimer) had the same stability as nonmutated LpL. The hLpL(HBM-Dimer) transgene prevented the neonatal demise of LpL knockout mice; however, these mice were hypertriglyceridemic. Postheparin plasma LpL activity was lower than expected with the robust expression in muscle and was no longer covalently linked. Studies in transfected cells showed that Chinese hamster lung cells, but not COS cells, also degraded tandem repeated LpL into monomers. Thus, although muscle can synthesize tethered, dimeric LpL, efficient production of this enzyme leading to secretion, and physiological function appears to favor secretion of a noncovalent dimer composed of monomeric subunits. C1 Columbia Univ, Dept Med, New York, NY 10032 USA. Univ Hamburg, Hosp Eppendorf, Dept Med, D-20246 Hamburg, Germany. Univ Hamburg, Hosp Eppendorf, Dept Med Biochem & Mol Biol, D-20246 Hamburg, Germany. Cornell Univ, Div Nutr Sci, Ithaca, NY 14853 USA. Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Dept Med, Lipid Res Lab, Los Angeles, CA 90073 USA. Univ Mainz, Inst Pathol, D-55101 Mainz, Germany. RP Goldberg, IJ (reprint author), Columbia Univ, Dept Med, 630 W 168th St, New York, NY 10032 USA. OI Merkel, Martin/0000-0002-2850-5110 FU NHLBI NIH HHS [HL028481, HL014990, HL45095] NR 21 TC 3 Z9 3 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JAN 2 PY 2004 VL 279 IS 1 BP 238 EP 244 DI 10.1074/jbc.M310559200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 757GU UT WOS:000187555300029 PM 14570890 ER PT J AU Holschneider, DP Maarek, JMI Yang, J Harimoto, J Scremin, OU AF Holschneider, DP Maarek, JMI Yang, J Harimoto, J Scremin, OU TI Activation of cerebral cortex during acoustic challenge or acute foot-shock in freely moving, nontethered rats SO NEUROSCIENCE LETTERS LA English DT Article DE brain mapping; cerebral blood flow; infusion pump; autoradiography; auditory cortex; electroshock; stress ID BLOOD-FLOW; INDICATOR FRACTIONATION; CONSCIOUS RAT; STRESS AB Most brain mapping techniques require immobilization of the subject, which extinguishes all but the simplest behaviors. We applied in freely moving rats an implantable microbolus infusion pump (MIP) which can be triggered by remote activation for the injection of the cerebral blood flow tracer [C-14]iodoantipyrine during behavioral activation. Consistent with previous electrophysiological, metabolic and brain anatomic studies, CBF-related tissue radioactivity (CBF-TR) increased in acoustic cortex during a 1000 Hz/8000 Hz alternating tone. In response to an acute foot-shock, CBF-TR increased in visual cortex, parietal association cortex, and extended into primary motor cortex, and primary somatosensory cortex mapping the trunk. These results support the utility of implantable pumps as adjunct tools for studying cerebral activation during behavioral challenges in nontethered, nonrestrained animals. (C) 2003 Elsevier Ireland Ltd. All rights reserved. C1 Univ So Calif, Dept Psychiat & Behav Sci, Los Angeles, CA 90089 USA. Univ So Calif, Dept Neurol, Los Angeles, CA 90089 USA. Univ So Calif, Keck Sch Med, Dept Cell & Neurobiol, Los Angeles, CA 90089 USA. Univ So Calif, Dept Biomed Engn, Los Angeles, CA 90089 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Physiol, Los Angeles, CA 90024 USA. RP Holschneider, DP (reprint author), Univ So Calif, Dept Psychiat & Behav Sci, Los Angeles, CA 90089 USA. EM holschne@usc.edu FU NIA NIH HHS [K12 AG000521]; NIBIB NIH HHS [R01 EB-00300-03, R01 EB000300] NR 15 TC 6 Z9 6 U1 0 U2 3 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0304-3940 J9 NEUROSCI LETT JI Neurosci. Lett. PD JAN 2 PY 2004 VL 354 IS 1 BP 74 EP 78 DI 10.1016/j.neulet.2003.09.078 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 765TA UT WOS:000188298500019 PM 14698485 ER PT J AU Hinkin, CH Hardy, DJ Mason, KI Castellon, SA Durvasula, RS Lam, MN Stefaniak, M AF Hinkin, CH Hardy, DJ Mason, KI Castellon, SA Durvasula, RS Lam, MN Stefaniak, M TI Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse SO AIDS LA English DT Article; Proceedings Paper CT Workshop on Mental Health Research Issues in HIV Infection and Aging CY APR, 2002 CL WASHINGTON, DC SP Natl Inst Mental Hlth DE aging; alcohol abuse; drug abuse; electronic monitoring; medication adherence; neuropsychology ID SELF-REPORTED ADHERENCE; ANTIRETROVIRAL THERAPY; DRUG-RESISTANCE; PROTEASE INHIBITORS; AIDS; OLDER; PERFORMANCE; DYSFUNCTION; PREDICTORS; OUTCOMES AB Objective: To examine the predictors of antiretroviral adherence among HIV-infected adults, with a particular focus on advancing age, neuropsychological dysfunction, and substance abuse. Design: Prospective observational design. Methods: Participants were 148 HIV-infected adults between the ages of 25 and 69 years, all on a self-administered antiretroviral regimen. Medication adherence was tracked over a one-month period using an electronic monitoring device (medication event monitoring system caps). All participants completed a comprehensive battery of neuropsychological tests as well as a structured psychiatric interview. Results: The mean adherence rate for the entire cohort was 80.7%, with older patients (greater than or equal to50 years) demonstrating significantly better medication adherence than younger patients (87.5 versus 78.3%). Logistic regression analyses found that older patients were three times more likely to be classified as good adherers (defined as greater than or equal to95% adherent). Neurocognitive impairment conferred a 2.5 times greater risk of poor adherence. Among the older patients, those who were classified as poor adherers performed significantly worse on neuropsychological testing, particularly on measures of executive function and psychomotor speed. Current drug abuse/dependence, but not current alcohol abuse/dependence, was also associated with sub-optimal medication adherence. Conclusion: Although older age is associated with higher rates of antiretroviral adherence, older participants who were cognitively impaired showed disproportionate difficulty in adequately adhering to their medication regimen. As such, efforts to detect neuropsychological dysfunction, particularly among older patients, and a thorough assessment of substance abuse, appear to be essential for the effective treatment of HIV-infected adults. (C) 2004 Lippincott Williams Wilkins. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst, Psychol Serv, Los Angeles, CA USA. Calif State Univ Los Angeles, Dept Psychol, Los Angeles, CA 90032 USA. RP Hinkin, CH (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, 760 Westwood Plaza,Room C8-747, Los Angeles, CA 90024 USA. EM chinkin@ucla.edu FU NIMH NIH HHS [R01 MH058552, R01 MH058552-02, R01 MH58552, T32 MH019535] NR 37 TC 265 Z9 272 U1 0 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD JAN PY 2004 VL 18 SU 1 BP S19 EP S25 PG 7 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 805OL UT WOS:000220375500004 PM 15075494 ER PT J AU Justice, AC McGinnis, KA Atkinson, JH Heaton, RK Young, C Sadek, J Madenwald, T Becker, JT Conigliaro, J Brown, ST Rimland, D Crystal, S Simberkoff, M AF Justice, AC McGinnis, KA Atkinson, JH Heaton, RK Young, C Sadek, J Madenwald, T Becker, JT Conigliaro, J Brown, ST Rimland, D Crystal, S Simberkoff, M CA VACS 5 Project Team TI Psychiatric and neurocognitive disorders among HIV-positive and negative veterans in care: Veterans Aging Cohort Five-Site Study SO AIDS LA English DT Article; Proceedings Paper CT Workshop on Mental Health Research Issues in HIV Infection and Aging CY APR, 2002 CL WASHINGTON, DC SP Natl Inst Mental Hlth DE HIV; cognitive function; depression; substance abuse; symptoms ID DEMOGRAPHICALLY CORRECTED NORMS; VERBAL-LEARNING-TEST; DIAGNOSTIC INTERVIEW; AIDS; AGE; EPIDEMIOLOGY; DEPRESSION; INFECTION; VALIDITY; DEMENTIA AB Background: The risk for psychiatric and neurocognitive disorders among middle-aged and older individuals with HIV infection has not been well characterized. Methods: The Veterans Aging Cohort 5-Site Study enrolled 1803 patients (1047 HIV-positive) from VA infectious disease and general medicine clinics from September 2001 to June 2002. A convenience subset of 10 patients from each site (n=50) was consented for formal neurocognitive and psychiatric (NCP) testing. Data from this subset were linked to the larger sample. Results: Kappa scores for agreement beyond chance were fair for available measures when compared with formal NCP testing. Using available measures, depressive symptoms (PHQ-9 and provider reported), alcohol abuse or dependence (ICD-9 codes), and drug abuse or dependence (DAST-10) decreased with age in HIV-negative subjects (P trend <0.05) but did not among HIV-positive subjects (P>0.05). HIV-positive subjects demonstrated higher prevalence of these conditions with increasing age when compared to HIV-negative subjects. Patient report of memory problems increased with age among both groups after excluding those reporting symptoms of depression (PHQ-9egreater than or equal to10). Conclusion: Available measures were no substitute for formal NCP testing. Older HIV-positive veterans demonstrate greater prevalence of depressive symptoms, alcohol abuse or dependence, and drug abuse or dependence than age-matched, HIV-negative veterans. Both groups reported increased memory problems with advancing age. This preliminary work suggests a substantial prevalence of psychiatric and neurocognitive problems among middle-aged and older HIV-infected individuals. (C) 2004 Lippincott Williams Wilkins. C1 VA Pittsburgh Healthcare Syst, Vet Aging Cohort Ctr, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, PA USA. VA San Diego Healthcare Syst, San Diego, CA USA. Univ Calif San Diego, HIB Neurobehav Res Ctr, San Diego, CA 92103 USA. Univ Pittsburgh, Western Psychiat Inst, Pittsburgh, PA USA. CUNY Mt Sinai Sch Med, Bromx VA Med Ctr, New York, NY 10029 USA. VA Med Program, HIV Program, Atlanta, GA USA. Rutgers State Univ, Div Aging, New Brunswick, NJ 08903 USA. VA New Harbor Helathcare Syst, New York, NY USA. RP Justice, AC (reprint author), W Haven VA Healthcare Syst, 950 Campbell Ave,11-ACSLG, W Haven, CT 06516 USA. EM amy.justice2@med.va.gov FU NIA NIH HHS [K23 AG00826]; NIAAA NIH HHS [3U01 AA 13566]; NIMH NIH HHS [MH01011, 5P30 MH062512] NR 35 TC 73 Z9 74 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD JAN PY 2004 VL 18 SU 1 BP S49 EP S59 PG 11 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 805OL UT WOS:000220375500008 PM 15075498 ER PT J AU Schneider, A Barmada, MM Slivka, A Martin, JA Whitcomb, DC AF Schneider, A Barmada, MM Slivka, A Martin, JA Whitcomb, DC TI Analysis of tumor necrosis factor-alpha, transforming growth factor-beta(1), interleukin-10, and interferon-gamma polymorphisms in patients with alcoholic chronic pancreatitis SO ALCOHOL LA English DT Article DE alcohol; chronic pancreatitis; cytokines; polymorphisms ID IDIOPATHIC CHRONIC-PANCREATITIS; GROWTH-FACTOR-BETA-1 GENE; STELLATE CELLS; TNF-ALPHA; PROMOTER REGION; FIBROSIS; IDENTIFICATION; ASSOCIATION; EXPRESSION; MUTATIONS AB The pathophysiologic mechanisms underlying alcoholic chronic pancreatitis are poorly understood. Cytokines participate in the immunologic progression of acute and chronic pancreatitis and may play an important role in the development of pancreatic fibrosis. Functional polymorphisms in cytokine genes have been identified that alter cytokine production. The aims of the current investigation were to determine whether functional polymorphisms in the tumor necrosis factor-alpha (TNF-alpha) gene at positions -308 and -238; in the transforming growth factor-beta 1 (TGF-beta1) gene at positions -509, +869 (codon 10), and +915 (codon 25); in the interleukin-10 (IL-10) gene at position -1082; and in the intron 1 of the interferon-gamma (IFN-gamma) gene at position +874 are associated with alcoholic chronic pancreatitis. We investigated 42 patients with alcoholic chronic pancreatitis. We studied 94 control subjects for the TNF-alpha polymorphisms and 73 control subjects for the remaining polymorphisms. Mutation analysis was performed by direct DNA sequencing or by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). The genotype frequencies were similar between patients and control subjects for all investigated cytokine polymorphisms (P > .05). We did not find an association between the different genotypes and the clinical course of the disease. Therefore, we assume that these genetic variants do not play a dominant role in alcoholic chronic pancreatitis. (C) 2004 Elsevier Inc. All rights reserved. C1 Univ Pittsburgh, Dept Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Human Genet, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Ctr Genom Sci, Pittsburgh, PA 15213 USA. RP Whitcomb, DC (reprint author), Univ Pittsburgh, Dept Med, 571 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15213 USA. EM whitcomb@pitt.edu OI Barmada, M Michael/0000-0002-3604-6460 FU NIDDK NIH HHS [DK54709] NR 45 TC 30 Z9 32 U1 1 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0741-8329 J9 ALCOHOL JI Alcohol PD JAN PY 2004 VL 32 IS 1 BP 19 EP 24 DI 10.1016/j.alcohol.2003.09.006 PG 6 WC Substance Abuse; Pharmacology & Pharmacy; Toxicology SC Substance Abuse; Pharmacology & Pharmacy; Toxicology GA 814DO UT WOS:000220955600002 PM 15066699 ER PT J AU Snow, AL Norris, MP Doody, R Molinari, VA Orengo, CA Kunik, ME AF Snow, AL Norris, MP Doody, R Molinari, VA Orengo, CA Kunik, ME TI Dementia deficits scale rating self-awareness of deficits SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Article DE dementia; deficit awareness; insight ID GERIATRIC DEPRESSION SCALE; ALZHEIMERS-DISEASE; COGNITIVE DEFICITS; CAREGIVER BURDEN; IMPAIRED INSIGHT; MEMORY DEFICIT; ANOSOGNOSIA; UNAWARENESS; PERFORMANCE; BEHAVIOR AB Impaired deficit awareness is important to detect because of its clinical implications; for example, patients with impaired awareness are more likely to engage in potentially dangerous activities, such as operating the stove. This study evaluated the reliability and validity of the Dementia Deficits Scale (DDS), a new multidimensional instrument for the assessment of self-awareness of cognitive, emotional, and functional deficits associated with dementia. Three parallel forms of the DDS were independently completed by the patient, clinician, and informant. The DDS yields two measures of deficit awareness: the discrepancy between clinician and patient assessments of the patient's deficits, and the discrepancy between informant and patient assessments. The DDS demonstrated adequate reliability and good divergent and convergent validity. Clinician and informant reports each added unique information, highlighting the importance of including both perspectives in the awareness assessment process. The DDS is recommended as a reliable and valid tool for the clinical and empirical assessment of deficit awareness in patients with dementia. C1 Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, Houston, TX 77030 USA. Houston VA Med Ctr, Mental Hlth Serv Line, Houston, TX 77030 USA. Houston VA Med Ctr, Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Baylor Coll Med, Baylor Alzheimers Dis Ctr, Houston, TX 77030 USA. Univ S Florida, Dept Aging & Mental Hlth, Tampa, FL 33620 USA. RP Snow, AL (reprint author), Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, 2002 Holcombe Blvd,152, Houston, TX 77030 USA. EM asnow@bcm.tme.edu FU NIA NIH HHS [P50-AG00149, AGO 8664] NR 39 TC 20 Z9 21 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0893-0341 J9 ALZ DIS ASSOC DIS JI Alzheimer Dis. Assoc. Dis. PD JAN-MAR PY 2004 VL 18 IS 1 BP 22 EP 31 DI 10.1097/00002093-200401000-00005 PG 10 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 801PK UT WOS:000220107600005 PM 15198084 ER PT J AU Raitt, MH Kusumoto, W Giraud, GD McAnulty, JH AF Raitt, MH Kusumoto, W Giraud, GD McAnulty, JH TI Electrophysiologic predictors of the recurrence of persistent atrial fibrillation within 30 days of cardioversion SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID AVERAGED P-WAVE; DURATION; RISK AB Patients with recurrence of persistent atrial fibrillation within 30 days. of cardioversion had slower atrial conduction, a slower sinus rate, no difference in the absolute value of the effective refractory period, greater early reverse remodeling of the effective refractory period, and more premature atrial contractions than those who did not. These findings highlight the role of slow conduction and premature atrial contractions in the pathophysiology of atrial fibrillation and suggest a possible proarrhythmic effect of reverse remodeling. (C) 2003 by Excerpta Medica, Inc. C1 Portland Vet Affairs Med Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Kaiser Permanente, Denver, CO USA. RP Raitt, MH (reprint author), P-3 CARD,3710 SW US Vet Rd, Portland, OR 97239 USA. OI Raitt, Merritt/0000-0001-5638-7732 NR 15 TC 27 Z9 27 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JAN 1 PY 2004 VL 93 IS 1 BP 107 EP 110 DI 10.1016/j.amjcard.2003.08.079 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 760GT UT WOS:000187803800026 PM 14697481 ER PT J AU Harris, DS Batki, SL Berger, SP AF Harris, DS Batki, SL Berger, SP TI Fluoxetine attenuates adrenocortical but not subjective responses to cocaine cues SO AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE LA English DT Article DE cocaine; cues; craving; fluoxetine; cortisol; adrenocortical ID CORTICOTROPIN-RELEASING-FACTOR; INDUCED REINSTATEMENT; SEEKING BEHAVIOR; RATS; SEROTONIN; CORTICOSTERONE; RELAPSE; STRESS; DRUG; ANTIDEPRESSANT AB Preclinical data suggest a link between stress reactivity and cocaine self-administration by rodents. Serotonin appears to modulate the hypothalamic-pituitary -adrenal (HPA) axis. We studied the effects of chronic treatment with the scrotonin reuptake inhibitor fluoxetine 40 mg/day on subjective and hormonal responses to cocaine cues in 22 subjects participating in a controlled clinical trial for cocaine dependence. Fluoxetine antagonized the cue-induced increase in cortisol but increased subjects' ratings of the likelihood of cocaine use in response to cocaine cues. Cortisol response to cocaine cues was not related to subjective craving. Activation of the HPA axis by cocaine cues does not appear to be a necessary mediator of cue-induced craving. C1 Univ Cincinnati, Dept Psychiat, Cincinnati, OH 45220 USA. Vet Adm Med Ctr, Cincinnati, OH 45220 USA. SUNY Upstate Med Univ, Dept Psychiat, Syracuse, NY USA. Syracuse VA Med Ctr, Syracuse, NY USA. Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Dept Psychiat, Portland, OR 97201 USA. RP Harris, DS (reprint author), Univ Cincinnati, Dept Psychiat, 3200 Vine St, Cincinnati, OH 45220 USA. EM debra.harris4@med.va.gov FU NCRR NIH HHS [5-M01-RR00083]; NIDA NIH HHS [P50-DA09253] NR 42 TC 7 Z9 7 U1 0 U2 1 PU MARCEL DEKKER INC PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 USA SN 0095-2990 J9 AM J DRUG ALCOHOL AB JI Am. J. Drug Alcohol Abuse PY 2004 VL 30 IS 4 BP 765 EP 782 DI 10.1081/ADA-200037542 PG 18 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 877LQ UT WOS:000225572500004 PM 15624548 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI Decision analysis in clinical gastroenterology SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Review ID COST-EFFECTIVENESS; MANAGEMENT; DISEASE; STRATEGY; DILATION; THERAPY AB OBJECTIVES: Although the tools of medical decision analysis have been mostly used to address complex issues of healthcare and management policies, an important role remains for decision analysis to play in solving mundane medical problems of daily practice. The present article alms to restate the origins of decision analysis and to demonstrate the utility of decision models in clinical gastroenterology. METHODS: Three clinical scenarios are presented to illustrate the applicability of decision analysis in clinical gastroenterology. The examples are modeled as simple decision trees and phrased in terms of threshold analysis. RESULTS: In spite of its striking simplicity, the framework of threshold analysis is able to capture a large variety of heterogeneous and often perplexing medical problems. Rather than calculate a cost-effectiveness or cost-benefit ratio, the result of the analysis is expressed as a probability value, which forms the threshold between the two choices against or in favor of a particular medical action. For most analyses little if any calculation is needed to solve the decision tree, and the final outcome of the analysis can be derived based on comparative estimates and considerations of magnitude only. CONCLUSIONS: The study demonstrates that threshold analysis can serve as a simple and convenient instrument to solve a large variety of problems in clinical gastroenterology. C1 Portland VA Med Ctr P3 G1, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Gastroenterol Hepatol, Portland, OR 97201 USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr P3 G1, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. NR 18 TC 12 Z9 14 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD JAN PY 2004 VL 99 IS 1 BP 163 EP 169 DI 10.1046/j.1572-0241.2003.04011.x PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 763AV UT WOS:000188047200030 PM 14687159 ER PT J AU Johnson, RA Teran, FJ Durante, W Peyton, KJ Johnson, FK AF Johnson, RA Teran, FJ Durante, W Peyton, KJ Johnson, FK TI Enhanced heme oxygenase-mediated coronary vasodilation in Dahl salt-sensitive hypertension SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Article DE heme oxygenase; heart; coronary vessels; hypertension; Dahl rats ID CARBON-MONOXIDE; NITRIC-OXIDE; RAT-HEART; ANGIOTENSIN-II; EXPRESSION; INHIBITOR; REPERFUSION; RELAXATION; INDUCTION; MECHANISM AB Background: Cardiovascular tissues express heme oxygenase (HO), which metabolizes heme to form carbon monoxide (CO). Carbon monoxide promotes relaxation of coronary vascular smooth muscle. Increased HO-I expression provides cardioprotection during certain pathologic conditions. On a high salt (HS) diet Dahl salt-sensitive (DS) rats develop hypertension that is accompanied by left ventricular hypertrophy, whereas Dahl salt-resistant rats (DR) do not. This study tests the hypothesis that cardiac HO-1 expression is increased in DS rats with salt-induced hypertension and provides cardioprotection by promoting coronary vasodilation. Methods: Male DS and DR rats were placed on a HS (8% NaCl) or low salt (LS, 0.3% NaCl) diet for 4 weeks. Cardiac HO isoform expression were determined by immunohistochemistry. Experiments used isolated paced Langendorff-hearts perfused at a constant flow. Changes in coronary perfusion pressure and left ventricular contractility (dP/dt(max)) were measured in response to an inhibitor of HO, chromium mesoporphyrin (CrMP). Results: With respect to the LS group, DS rats on HS diet showed elevated mean arterial pressure and increased heart weight. Coronary arterial HO-1 immunostaining was enhanced in HS rats, but HO-2 staining was similar in both groups. In isolated Langendorff-hearts the HO inhibitor CrMP increased coronary perfusion pressure and calculated coronary resistance, and decreased left ventricular contractility (dP/dt(max)) in both groups, but the response was exaggerated in HS rat hearts. In the DR strain, HS diet did not augment CrMP responses and had no effect on any of the parameters measured with respect to the LS diet. Conclusions: These findings suggest that coronary HO-1 expression is increased to promote enhanced coronary vasodilation in DS rats with salt-induced hypertension. (C) 2004 American Journal of Hypertension, Ltd. C1 Tulane Univ, Hlth Sci Ctr, Dept Physiol, New Orleans, LA 70112 USA. Houston VA Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pharmacol, Houston, TX 77030 USA. RP Johnson, RA (reprint author), Tulane Univ, Hlth Sci Ctr, Dept Physiol, 1430 Tulane Ave,SL39, New Orleans, LA 70112 USA. FU NCRR NIH HHS [P20 RR017659]; NHLBI NIH HHS [R01 HL59976, R01 HL64577] NR 25 TC 11 Z9 11 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD JAN PY 2004 VL 17 IS 1 BP 25 EP 30 DI 10.1016/j.amjhyper.2003.08.009 PG 6 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 760GQ UT WOS:000187803600005 PM 14700508 ER PT J AU Singh, H Kalavar, J AF Singh, H Kalavar, J TI Quality of care for hypertension and diabetes in federal- versus commercial-managed care organizations SO AMERICAN JOURNAL OF MEDICAL QUALITY LA English DT Article DE health care quality; HEDIS measures; primary care; veterans affairs ID ACUTE MYOCARDIAL-INFARCTION; BLOOD-PRESSURE; UNITED-STATES; VETERANS; MEDICARE; DISEASE; SYSTEM; TRIAL; MEN; VA AB Initiatives to improve quality in primary care include use of performance measures to benchmark health care organizations. We looked for an objective way to compare primary care quality in the Veterans Affairs (VA) with that of private sector. We analyzed performance measures of the Health Plan and Employer Data Information Set (HEDIS) used in ambulatory care for hypertension and diabetes and compared a sample data from a network of VA hospitals with those from National Committee for Quality Assurance's The State of Health Care Quality 2002 Report. The VA data were comparable to the national data. Performance on the hypertension control measure was slightly below the HEDIS national average but better than the regional commercial average. VA's performance on all diabetes measures was higher. Although the VA network had a large influx in patient base recently, the quality of outpatient care in hypertension and diabetes as measured by standardized performance indicators in the network compared favorably with commercial Health Maintenance Organizations in the private sector. C1 VA Med Ctr, Sect Primary Care, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP Singh, H (reprint author), VA Med Ctr, Sect Primary Care, 111PC,2002 Holcombe Blvd, Houston, TX 77030 USA. EM hardeeps@bcm.tmc.edu NR 22 TC 9 Z9 9 U1 0 U2 0 PU AMER COLLEGE MEDICAL QUALITY PI BETHESDA PA 4334 MONTGOMERY AVE, 2ND FL, BETHESDA, MD 20814-4402 USA SN 1062-8606 J9 AM J MED QUAL JI Am. J. Med. Qual. PD JAN-FEB PY 2004 VL 19 IS 1 BP 19 EP 24 DI 10.1177/106286060401900104 PG 6 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 767JW UT WOS:000188437300003 PM 14977021 ER PT J AU Diamond, LH Kliger, AS Goldman, RS Palevsky, PM AF Diamond, LH Kliger, AS Goldman, RS Palevsky, PM TI Commentary: Quality improvement projects: How do we protect patients' rights? SO AMERICAN JOURNAL OF MEDICAL QUALITY LA English DT Editorial Material DE accountability; clinical practice; clinical research; informed consent; quality improvement AB A recent ruling by the Office of Human Research Protection (OHRP) has renewed an ongoing debate over whether Institutional Review Boards (IRBs) should have oversight not only over clinical research but also over quality improvement projects (QIPs). The authors discussed the similarities and differences among clinical practice, QIPs, and clinical research, pointing out issues to consider when identifying the most appropriate method for QIP oversight and accountability. They note that potential solutions must address ethical issues (eg, patient safety, privacy, and self-determination) and weigh the effect of the underlying QIP goal (administrative versus clinical improvement) on an individual patient and patient populations. They conclude that because QIPs are an extension of clinical practice and have elements of clinical research, it too should have an oversight system. Institutional or regional quality improvement boards, operating parallel to current IRBs, are suggested as 1 means of ensuring that QIP participants are offered the same protections as those who take part in clinical research. C1 Medstat, Washington, DC 20008 USA. Yale Univ, Sch Med, New Haven, CT 06520 USA. Hosp St Raphael, Dept Med, New Haven, CT USA. Univ New Mexico, Hlth Sci Ctr, Albuquerque, NM 87131 USA. VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. RP Diamond, LH (reprint author), Medstat, 4301 Connecticut Ave,NW,Suite 330, Washington, DC 20008 USA. EM louis.diamond@medstat.com OI Palevsky, Paul/0000-0002-7334-5400 NR 2 TC 7 Z9 7 U1 0 U2 0 PU AMER COLLEGE MEDICAL QUALITY PI BETHESDA PA 4334 MONTGOMERY AVE, 2ND FL, BETHESDA, MD 20814-4402 USA SN 1062-8606 J9 AM J MED QUAL JI Am. J. Med. Qual. PD JAN-FEB PY 2004 VL 19 IS 1 BP 25 EP 27 DI 10.1177/106286060401900105 PG 3 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 767JW UT WOS:000188437300004 PM 14977022 ER PT J AU Nowbar, S Burkart, KM Gonzales, R Gozansky, WS Gaudio, JC Taylor, MRG Zwillich, CW AF Nowbar, S Burkart, KM Gonzales, R Gozansky, WS Gaudio, JC Taylor, MRG Zwillich, CW TI Obesity-associated hypoventilation in hospitalized patients: Prevalence, effects, and outcome SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID OBSTRUCTIVE SLEEP-APNEA; POSITIVE AIRWAY PRESSURE; PICKWICKIAN-SYNDROME; MORTALITY; COMPLICATIONS; HYPERCAPNIA; ALTITUDE; FAILURE; DISEASE; LEVEL AB BACKGROUND: Severe obesity is associated with hypoventilation, a disorder that may adversely affect morbidity and mortality. We sought to determine the prevalence and effects of obesity-associated hypoventilation in hospitalized patients. METHODS: Consecutive admissions to internal medicine services were screened over a 6-month period. In all eligible subjects with severe obesity (body mass index greater than or equal to35 kg/m(2)), we administered a sleep questionnaire, and performed neuropsychological, arterial blood gas, and pulmonary function testing. Hospital course and mortality at 18 months was also determined. RESULTS: Of 4332 admissions, 6% (n = 277) of patients were severely obese, of whom 150 were enrolled, 75 refused to participate, and 52 met the exclusion criteria. Hypoventilation (mean [+/- SD] arterial partial pressure of carbon dioxide [PaCO2], 52 +/- 7 mm Hg) was present in 31% (n = 47) of subjects who did not have, other reasons for hypercapnia. Decreased objective attention/concentration and increased subjective sleepiness were present in patients with obesity-associated hypoventilation compared with in severely obese hospitalized patients without hypoventilation (simple obesity group; mean PaCO2, 37 +/- 6 mm Hg). There were higher rates of intensive care (P = 0.08), long-term care at discharge (P = 0.01), and mechanical ventilation (P = 0.01) among subjects with obesity-associated hypoventilation. Therapy for hypoventilation at discharge was initiated in only 6 (13%) of the patients with obesity-associated hypoventilation. At 18 months following. hospital discharge, mortality was 23% in the obesity-associated hypoventilation group as compared with 9% in the simple obesity group (hazard ratio = 4.0; 95% confidence interval: 1.5 to 10.4]. CONCLUSION: Hypoventilation frequently complicates severe obesity among hospitalized adults and is associated with excess morbidity and mortality. (C) 2004 by Excerpta Medica Inc. C1 Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80220 USA. Denver Hlth Med Ctr, Denver, CO 80220 USA. Univ Calif San Francisco, Sch Med, Div Gen Internal Med, Dept Med, San Francisco, CA 94143 USA. Rose Med Ctr, Denver, CO USA. Brown Univ, Providence, RI 02912 USA. RP Zwillich, CW (reprint author), Denver Vet Affairs Med Ctr, 1055 Clermont St,111, Denver, CO 80220 USA. EM clifford.zwillich@med.va.gov NR 24 TC 168 Z9 178 U1 0 U2 3 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JAN 1 PY 2004 VL 116 IS 1 BP 1 EP 7 DI 10.1016/j.amjmed.2003.08.022 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 763AY UT WOS:000188047900001 PM 14706658 ER PT J AU Kemmer, K Corless, CL Fletcher, JA McGreevey, L Haley, A Griffith, D Cummings, OW Wait, C Town, A Heinrich, MC AF Kemmer, K Corless, CL Fletcher, JA McGreevey, L Haley, A Griffith, D Cummings, OW Wait, C Town, A Heinrich, MC TI KIT mutations are common in testicular seminomas SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID GERM-CELL TUMORS; GASTROINTESTINAL STROMAL TUMORS; PROTOONCOGENE C-KIT; TYROSINE KINASE-ACTIVITY; ACUTE MYELOID-LEUKEMIA; FACTOR RECEPTOR; URTICARIA PIGMENTOSA; ACTIVATING MUTATIONS; HUMAN MASTOCYTOSIS; CATALYTIC DOMAIN AB Expression of KIT tyrosine kinase is critical for normal germ cell development and is observed in the majority of seminomas. Activating mutations in KIT are common in gastrointestinal stromal tumors and mastocytosis. In this study we examined the frequency and spectrum of KIT mutations in 54 testicular seminomas, 1 ovarian dysgerminoma and 37 non-seminomatous germ cell tumors (NSGCT). Fourteen seminomas (25.9%) contained exon 17 point mutations including D816V (6 cases), D816H (3 cases), Y823D (2 cases), and single examples of Y823C, N822K, and T801I. No KIT mutations were found in the ovarian dysgerminoma or the NSGCTs. In transient transfection assays, mutant isoforms D816V, DK16H, Y823D, and N822K were constitutively phosphorylated in the absence of the natural ligand for KIT, stem cell factor (SCF). In contrast, activation of T801I and wild-type KIT required SCF. Mutants N822K and Y823D were inhibited by imatinib mesylate (Gleevec, previously STI571) whereas D816V and D816H were both resistant to imatinib mesylate. Biochemical evidence of KIT activation, as assessed by KIT phosphorylation and KIT association with phosphatidylinositol (PI) 3-kinase in tumor cell lysates, was largely confined to seminomas with a genomic KIT mutation. These findings suggest that activating KIT mutations may contribute to tumorigenesis in a subset of seminomas, but are not involved in NSGCT. C1 Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Inst Canc, Div Hematol & Oncol, Dept Pathol, Portland, OR 97201 USA. Brigham & Womens Hosp, Dept Pathol, Boston, MA 02115 USA. Indiana Univ, Dept Pathol, Indianapolis, IN 46204 USA. RP Heinrich, MC (reprint author), Portland VA Med Ctr, R&D19,3710 US Vet Hosp Rd, Portland, OR 97239 USA. FU NCI NIH HHS [N01-CO-12400, N01CO12400] NR 49 TC 208 Z9 216 U1 1 U2 1 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 0002-9440 J9 AM J PATHOL JI Am. J. Pathol. PD JAN PY 2004 VL 164 IS 1 BP 305 EP 313 DI 10.1016/S0002-9440(10)63120-3 PG 9 WC Pathology SC Pathology GA 757KB UT WOS:000187560600032 PM 14695343 ER PT J AU Bertocci, GE Munin, MC Frost, KL Burdett, R Wassinger, CA Fitzgerald, SG AF Bertocci, GE Munin, MC Frost, KL Burdett, R Wassinger, CA Fitzgerald, SG TI Isokinetic performance after total hip replacement SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE total hip replacement; isokinetic performance; endurance; rehabilitation; biomechanical performance; muscle strength ID ARTHROPLASTY; RECOVERY; KNEE AB Objective: To evaluate differences in isokinetic hip flexion, extension, and abduction muscle performance of operated vs. nonoperated hips in older adults who have undergone elective, unilateral, total hip replacement (THR) surgery and completed rehabilitation. Design: Quasi-experimental study using a nonequivalent posttestonly control group design, comprising 20 unilateral THR patients and a convenience sample of 22 healthy older adults. THR patients participated between 4 and 5 mos after surgery. THR subjects received an average of 13 outpatient or home-based physical therapy sessions, Isokinetic muscle strength and fatigue was assessed through measurement of hip peak torque per body weight, total work, and average power using a robotic dynamometer. Results: Comparisons of THR subjects' operated vs. nonoperated hips showed no significant differences in isokinetic performance for any of the examined variables. THR subjects' operated hips generated significantly less peak torque per body weight, total work, and average power across all exercises as compared with a population of healthy subjects. Conclusions: THR subjects' operated and nonoperated hips showed similar blomechanical performance. THR patients are not being restored to the same level of strength and muscular endurance as compared with a population of healthy adults. These findings may be useful in providing a preliminary rationale for revising current approaches in THR rehabilitation protocols. C1 Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Univ Pittsburgh, 5044 Forbes Tower, Pittsburgh, PA 15260 USA. NR 22 TC 35 Z9 42 U1 0 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0894-9115 EI 1537-7385 J9 AM J PHYS MED REHAB JI Am. J. Phys. Med. Rehabil. PD JAN PY 2004 VL 83 IS 1 BP 1 EP 9 DI 10.1097/01.PHM.0000098047.26314.93 PG 9 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 758FM UT WOS:000187623100001 PM 14709968 ER PT J AU Furukawa, O Bi, LC Guth, PH Engel, E Hirokawa, M Kaunitz, JD AF Furukawa, O Bi, LC Guth, PH Engel, E Hirokawa, M Kaunitz, JD TI NHE3 inhibition activates duodenal bicarbonate secretion in the rat SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE epithelial cells; cystic fibrosis transmembrane conductance regulator; back titration; S3226 ID TRANSMEMBRANE CONDUCTANCE REGULATOR; BORDER NA+/H+ EXCHANGER; EPITHELIAL-CELLS; MEDIATED INHIBITION; CARBONIC-ANHYDRASE; CL-/HCO3-EXCHANGE; INTRACELLULAR PH; APICAL SURFACE; ADENOMA DRA; IN-VIVO AB We examined the effect of inhibition of Na+/H+ exchange (NHE) on duodenal bicarbonate secretion (DBS) in rats to further understand DBS regulation. DBS was measured by using the pH-stat method and by using CO2-sensitive electrodes. 5-(N,N-dimethyl)-amiloride (50 muM; DMA), a concentration that selectively inhibits the NHE isoforms NHE1 and NHE2, but not NHE3, did not affect DBS. Nevertheless, 3 mM DMA, a higher concentration that inhibits NHE1, NHE2, and NHE3, significantly increased DBS. Moreover, S1611 and S3226, both specific inhibitors of NHE3 only, or perfusion with Na+-free solutions, dose dependently increased DBS, as measured by pH-stat and CO2-sensitive electrode, without affecting intracellular pH. Coperfusion with 0.1 muM indomethacin, 0.5 mM DIDS, or 1 mM methazolamide did not affect S3226-induced DBS. Nevertheless, coperfusion with 0.1 and 0.3 mM 5-nitro-2-(3-phenylpropylamino) benzoic acid, which inhibits the cystic fibrosis transmembrane conductor regulator (CFTR), dose dependently inhibited S3226-induced DBS. In conclusion, only specific apical NHE3 inhibition increased DBS, whereas prostaglandin synthesis, Na+-HCO3- cotransporter activation, or intracellular HCO3- formation by carbonic anhydrase was not involved. Because NHE3 inhibition-increased DBS was inhibited by an anion channel inhibitor and because reciprocal CFTR regulation has been previously shown between NHE3 and apical membrane anion transporters, we speculate that NHE3 inhibition increased DBS by altering anion transporter function. C1 Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Biomath, Los Angeles, CA 90024 USA. CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 114,Rm 217,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [2-R01-DK-54221] NR 45 TC 30 Z9 31 U1 1 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD JAN 1 PY 2004 VL 286 IS 1 BP G102 EP G109 DI 10.1152/ajpgi.00092.2003 PG 8 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 751YQ UT WOS:000187118600014 PM 12881227 ER PT J AU Evans, SB Wilkinson, CW Gronbeck, P Bennett, JL Zavosh, A Taborsky, GJ Figlewicz, DP AF Evans, SB Wilkinson, CW Gronbeck, P Bennett, JL Zavosh, A Taborsky, GJ Figlewicz, DP TI Inactivation of the DMH selectively inhibits the ACTH and corticosterone responses to hypoglycemia SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE dorsomedial hypothalamus; stress; rat; lidocaine; hypothalamic-pituitary-adrenal axis ID DORSOMEDIAL HYPOTHALAMIC NUCLEUS; PARAVENTRICULAR NUCLEUS; COUNTERREGULATORY RESPONSES; CHEMICAL-STIMULATION; LOCAL-ANESTHETICS; AUTONOMIC FAILURE; EFFECTIVE SPREAD; FOS EXPRESSION; NERVE ACTIVITY; RAT AB We have previously reported that repeated bouts of insulin-induced hypoglycemia (IIH) in the rat result in blunted activation of the paraventricular, arcuate, and dorsomedial hypothalamic (DMH) nuclei. Because DMH activation has been implicated in the sympathoadrenal and hypothalamic-pituitary-adrenal (HPA) responses to stressors, we hypothesized that its blunted activation may play a role in the impaired counterregulatory response that is also observed with repeated bouts of IIH. In the present study, we evaluated the role of normal DMH activation in the counterregulatory response to a single bout of IIH. Local infusion of lidocaine (n = 8) to inactivate the DMH during a 2-h bout of IIH resulted in a significant overall decrease of the ACTH response and a delay of onset of the corticosterone response compared with vehicle-infused controls (n = 9). We observed suppression of the ACTH response at time (t) = 90 and 120 min (50 +/- 12 and 63 +/- 6%, respectively, of control levels) and early suppression of the corticosterone response at t = 30 min (59 +/- 13% of the control level). The epinephrine, norepinephrine, and glucagon responses were not altered by DMH inactivation. Our finding suggests that DMH inactivation may play a specific role in decreasing the HPA axis response after repeated bouts of IIH. C1 Vet Affairs Puget Sound Hlth Care Syst, Div Endocrinol Metab, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. RP Figlewicz, DP (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Div Endocrinol Metab, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [R01 DK-50154, DK-62446, DK-40963] NR 44 TC 16 Z9 16 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD JAN 1 PY 2004 VL 286 IS 1 BP R123 EP R128 DI 10.1152/ajpregu.00328.2003 PG 6 WC Physiology SC Physiology GA 751BX UT WOS:000187033900022 PM 14660476 ER PT J AU Lee, JC Chantra, PK Chen, L Larsen, LH Bassett, LW AF Lee, JC Chantra, PK Chen, L Larsen, LH Bassett, LW TI The role of sonography in male breast imaging SO AMERICAN JOURNAL OF ROENTGENOLOGY LA English DT Meeting Abstract CT 104th Annual Meeting of the American-Roentgen-Ray-Society CY MAY 02-07, 2004 CL Miami Beach, FL SP Amer Roentgen Ray Soc C1 Univ Calif Los Angeles, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ So Calif, Keck Sch Med, Los Angeles, CA 90089 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ROENTGEN RAY SOC PI RESTON PA 1891 PRESTON WHITE DR, SUBSCRIPTION FULFILLMENT, RESTON, VA 22091 USA SN 0361-803X J9 AM J ROENTGENOL JI Am. J. Roentgenol. PY 2004 VL 182 IS 4 SU S BP 83 EP 83 PG 1 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 808UD UT WOS:000220593100314 ER PT J AU Leaf, DA Kleinman, MT Deitrick, RW AF Leaf, DA Kleinman, MT Deitrick, RW TI The effects of exercise on markers of lipid peroxidation in renal dialysis patients compared with control subjects SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Article DE renal dialysis; exercise; oxidative stress; lipids ID CORONARY-ARTERY DISEASE; HEMODIALYSIS-PATIENTS; OXIDATIVE STRESS; VITAMIN-E; ACCELERATED ATHEROSCLEROSIS; MAINTENANCE HEMODIALYSIS; UREMIC PATIENTS; OXIDANT STRESS; FREE-RADICALS; FATTY-ACIDS AB Purpose: The purpose of this study was to compare the susceptibility to exercise-induced lipid peroxidation of patients on chronic maintenance dialysis (CMD) and non-CMD control subjects. Design: Cross-sectional comparison of exercise-induced changes in breath ethane and pentane flux between patients on CMD (group A) and an age-, gender-, medical diagnosis-, smoking-, and ethanol consumption-matched comparison group (group B). Breath ethane and pentane were measured at rest before exercise, during cardiopulmonary exercise stress testing (CPX) at lactic acidosis threshold (Vo(2)LAT), and 5 minutes after CPX. Results: Group comparisons of clinical characteristics reveal that the groups were similar in terms of age, ethnicity, comorbid diagnoses, prevalence of medication use, BMI, measurements of aerobic exercise capacity, cigarette smoking and ethanol consumption behaviors. All subjects successfully completed the CPX protocol achieving Vo(2)LAT. There were significant differences in breath ethane flux between group A and B subjects, with greater pre-exercise, Vo(2)LAT, and postexercise ethane levels in group A compared with group B subjects, and significant group differences, with lower breath ethane/pentane flux ratios at rest, Vo(2)LAT, and recovery with lower ratios in group B than group A subjects. Discussion/Conclusions: This study shows that patients on CMD have greater lipid peroxidation compared with control subjects at rest and during and after physical exercise. In addition, compared with control subjects, patients on CMD preferentially peroxidize n-3 polyunsaturated fatty acids at rest and during physical exercise and recovery. The lipid peroxidation profile may result in an unfavorable endoperoxide shift and should be evaluated further, along with modalities to reduce oxidative stress among patients on CMD. C1 Greater Los Angeles VA Healthcare Syst, Div Gen Internal Med, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Irvine, Dept Community & Environm Med, Irvine, CA 92717 USA. Univ Scranton, Dept Exercise Sci & Sport, Scranton, PA 18510 USA. RP Leaf, DA (reprint author), Greater Los Angeles VA Healthcare Syst, Div Gen Internal Med, Dept Med, 111G,Wiltshire & Sawtelle Blvds, Los Angeles, CA 90073 USA. EM david.leaf@med.va.gov NR 48 TC 9 Z9 10 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-9629 J9 AM J MED SCI JI Am. J. Med. Sci. PD JAN PY 2004 VL 327 IS 1 BP 9 EP 14 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 764FQ UT WOS:000188197100004 PM 14722390 ER PT J AU Soule, JL Olyaei, AJ Busch, AMH Schwartz, JM Rosen, HR Ham, JM Orloff, SL AF Soule, JL Olyaei, AJ Busch, AMH Schwartz, JM Rosen, HR Ham, JM Orloff, SL TI Vancomycin-resistant Enterococcus in liver transplant recipients: A dramatic improvement in outcomes with new anti-VRE antibiotics. SO AMERICAN JOURNAL OF TRANSPLANTATION LA English DT Meeting Abstract CT American Transplant Congress CY MAY 14-19, 2004 CL Boston, MA SP Amer Soc Transplant Surg, Amer Soc Transplantat C1 Oregon Hlth Sci Univ, Dept Surg, Div Transplantat, Portland, OR 97201 USA. Portland VA Med Ctr, Dept Surg, Div Transplantat, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med, Div Hepatol, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 1600-6135 J9 AM J TRANSPLANT JI Am. J. Transplant. PY 2004 VL 4 SU 8 MA 737 BP 358 EP 359 PG 2 WC Surgery; Transplantation SC Surgery; Transplantation GA 819NT UT WOS:000221322500736 ER PT J AU Mandal, AK Drew, N Tableman, M Lapidus, JA AF Mandal, AK Drew, N Tableman, M Lapidus, JA TI Transplantation of renal allografts from hepatitis C seropositive deceased donors into elderly hepatitis C seronegative recipients SO AMERICAN JOURNAL OF TRANSPLANTATION LA English DT Meeting Abstract CT American Transplant Congress CY MAY 14-19, 2004 CL Boston, MA SP Amer Soc Transplant Surg, Amer Soc Transplantat C1 Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. Portland State Univ, Dept Math & Stat, Portland, OR 97207 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 1600-6135 J9 AM J TRANSPLANT JI Am. J. Transplant. PY 2004 VL 4 SU 8 MA 874 BP 396 EP 396 PG 1 WC Surgery; Transplantation SC Surgery; Transplantation GA 819NT UT WOS:000221322500873 ER PT J AU Bartzokis, G Beckson, M Lu, PH Edwards, N Rapoport, R Bridge, P Mintz, J AF Bartzokis, G Beckson, M Lu, PH Edwards, N Rapoport, R Bridge, P Mintz, J TI Cortical gray matter volumes are associated with subjective responses to cocaine infusion SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID MAGNETIC-RESONANCE; BRAIN MORPHOLOGY; IN-VIVO; AGE; ABUSERS; LOBE; ADDICTS; MRI; ABNORMALITIES; HIPPOCAMPUS AB We analyzed the relationship between cocaine-induced euphoria and measures of frontal and temporal gray matter volumes in eleven cocaine-dependent (CD) patients who underwent magnetic resonance imaging (MRI). Self-reported ratings of the intensity of euphoric response to cocaine infusion were obtained from the CD subjects at 3, 10, and 30 minutes after cocaine infusion. Significant positive correlation between frontal and temporal cortical gray matter volume and the intensity of euphoria was observed at 10 minutes after IV cocaine. The data suggest that frontal and temporal lobe gray matter volume is associated with some of the reinforcing effects of cocaine. Given the well-established negative linear relationship between cortical gray matter volume and age, cortical gray matter volume may be a marker for the neurobiological substrate of the age-related reduction in addiction rates. C1 Univ Calif Los Angeles, Sch Med, Dept Neurol, Div Brain Mapping,Lab Neuroimaging, Los Angeles, CA 90024 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA USA. NIDA, Medicat Dev Div, Rockville, MD USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Alzheimers Dis Ctr, 710 Westwood Plaza,Room 2-238, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013 NR 30 TC 13 Z9 16 U1 1 U2 3 PU BRUNNER-ROUTLEDGE PI PHILADELPHIA PA 325 CHESTNUT ST, 8TH FL, PHILADELPHIA, PA 19106 USA SN 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD JAN-FEB PY 2004 VL 13 IS 1 BP 64 EP 73 DI 10.1080/10550490490265352 PG 10 WC Substance Abuse SC Substance Abuse GA 771EH UT WOS:000188772300006 PM 14766439 ER PT J AU Kampman, KM Pettinati, HM Volpicelli, JR Oslin, DM Lipkin, C Sparkman, T O'Brien, CP AF Kampman, KM Pettinati, HM Volpicelli, JR Oslin, DM Lipkin, C Sparkman, T O'Brien, CP TI Cocaine dependence severity predicts outcome in outpatient detoxification from cocaine and alcohol SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID TREATMENT ATTRITION; WITHDRAWAL; DISORDERS; ABUSE AB This study compared the effects of alcohol and cocaine dependence severity on the outcome of outpatient detoxification from alcohol and cocaine. Subjects included 84 subjects with both alcohol and cocaine dependence admitted for outpatient detoxification. Fifty-three of the 84 subjects (63%) completed detoxification. Baseline cocaine use, cocaine craving, and cocaine withdrawal symptoms predicted detoxification outcome, whereas alcohol use, alcohol craving, and alcohol withdrawal symptoms did not. Among cocaine- and alcohol-dependent subjects, cocaine dependence severity appears to be a more important predictor of detoxification success than alcohol dependence severity. C1 Univ Penn, Sch Med, Treatment Res Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Kampman, KM (reprint author), Univ Penn, Sch Med, Treatment Res Ctr, Dept Psychiat, 3900 Chestnut St, Philadelphia, PA 19104 USA. EM kampman_k@mail.trc.upenn.edu FU NIDA NIH HHS [P60 DA 051186] NR 20 TC 28 Z9 28 U1 2 U2 2 PU BRUNNER-ROUTLEDGE PI PHILADELPHIA PA 325 CHESTNUT ST, 8TH FL, PHILADELPHIA, PA 19106 USA SN 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD JAN-FEB PY 2004 VL 13 IS 1 BP 74 EP 82 DI 10.1080/10550490490265389 PG 9 WC Substance Abuse SC Substance Abuse GA 771EH UT WOS:000188772300007 PM 14766440 ER PT J AU Kier, FJ Davenport, DS AF Kier, FJ Davenport, DS TI Unaddressed problems in the study of spirituality and health SO AMERICAN PSYCHOLOGIST LA English DT Editorial Material ID RELIGION C1 VA Pittsburgh Healthcare Syst, Highland Dr Div, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. Texas A&M Univ, College Stn, TX 77843 USA. RP Kier, FJ (reprint author), VA Pittsburgh Healthcare Syst, Highland Dr Div, Behav Hlth 116 A-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM frederick.kier@med.va.gov NR 8 TC 10 Z9 10 U1 0 U2 0 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0003-066X J9 AM PSYCHOL JI Am. Psychol. PD JAN PY 2004 VL 59 IS 1 BP 53 EP 54 DI 10.1037/0003.066X.59.1.53 PG 2 WC Psychology, Multidisciplinary SC Psychology GA 765LP UT WOS:000188285300016 PM 14736330 ER PT J AU Bishop, MJ AF Bishop, MJ TI Mivacurium and bronchospasm - In response SO ANESTHESIA AND ANALGESIA LA English DT Letter C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Bishop, MJ (reprint author), Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-2999 J9 ANESTH ANALG JI Anesth. Analg. PD JAN PY 2004 VL 98 IS 1 BP 272 EP 272 PG 1 WC Anesthesiology SC Anesthesiology GA 757KK UT WOS:000187561400078 ER PT J AU Schumacher, SD Brockwell, RC Andrews, J Ogles, D AF Schumacher, SD Brockwell, RC Andrews, J Ogles, D TI Bulk liquid oxygen supply failure SO ANESTHESIOLOGY LA English DT Article C1 Univ Alabama, Sch Med, Dept Anesthesiol, Birmingham, AL 35249 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Alabama Hosp & Clin, Dept Bldg & Engn Serv, Birmingham, AL USA. RP Brockwell, RC (reprint author), Univ Alabama, Sch Med, Dept Anesthesiol, 619 S 19th St,Jefferson Tower 964, Birmingham, AL 35249 USA. NR 9 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-3022 J9 ANESTHESIOLOGY JI Anesthesiology PD JAN PY 2004 VL 100 IS 1 BP 186 EP 189 DI 10.1097/00000542-200401000-00032 PG 4 WC Anesthesiology SC Anesthesiology GA 758FN UT WOS:000187623200030 PM 14695744 ER PT J AU Holman, WL Sansom, M Kiefe, CI Peterson, ED Hubbard, SG Delong, DF Allman, RM AF Holman, WL Sansom, M Kiefe, CI Peterson, ED Hubbard, SG Delong, DF Allman, RM TI Alabama coronary artery bypass grafting project - Results from Phase II of a Statewide quality improvement initiative SO ANNALS OF SURGERY LA English DT Article ID RANDOMIZED CONTROLLED TRIAL; INTERNAL MAMMARY ARTERY; ACHIEVABLE BENCHMARKS; HOSPITAL MORTALITY; EARLY EXTUBATION; EARLY DISCHARGE; CABG SURGERY; MORBIDITY; OUTCOMES; LENGTH AB Objective/Background: This report describes the first round of results for Phase II of the Alabama CABG Project, a regional quality improvement initiative. Methods: Charts submitted by all hospitals in Alabama performing CABG (ICD-9 codes 36.10-36.20) were reviewed by a Clinical Data Abstraction Center (CDAC) (preintervention 1999-2000; postintervention 2000-2001). Variables that described quality in Phase I were abstracted for Phase II and data describing the new variables of beta-blocker use and lipid management were collected. Data samples collected onsite by participating hospitals were used for rapid cycle improvement in Phase II. Results: CDAC data (n = 1927 cases in 1999; n = 2001 cases in 2000) showed that improvements from Phase I in aspirin prescription, internal mammary artery use, and duration of intubation persisted in Phase II. During Phase II, use of beta-blockers before, during, or after CABG increased from 65% to 76% of patients (P < 0.05). Appropriate lipid management, an aggregate variable, occurred in 91% of patients before and 91% after the educational intervention. However. there were improvements in 3 of 5 subcategories for lipid management (documenting a lipid disorder [52%-57%], initiating drug therapy [45%-53%], and dietary counseling [74%-91%]; P < 0.05). Conclusions: In Phase II, this statewide process-oriented quality improvement program added two new measures of quality. Achievements of quality improvement from Phase I persisted in Phase II, and improvements were seen in the new variables of lipid management and perioperative use of beta-blockers. C1 Birmingham VA Med Ctr, Birmingham, AL USA. Univ Alabama, Birmingham, AL USA. Alabama Qual Assurance Fdn, Birmingham, AL USA. UAB, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL USA. Birmingham Atlanta VA Geriatr Res Educ & Clin Ctr, Birmingham, AL USA. Duke Univ, Med Ctr, Durham, NC 27706 USA. E Alabama Med Ctr, Opelika, AL USA. RP Holman, WL (reprint author), Dept Surg, ZRB 719,703 S 19th St, Birmingham, AL 35294 USA. EM wholman@its.uab.edu NR 25 TC 14 Z9 15 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD JAN PY 2004 VL 239 IS 1 BP 99 EP 109 DI 10.1097/01.sla.0000103065.17661.8f PG 11 WC Surgery SC Surgery GA 774FK UT WOS:000188968900016 PM 14685107 ER PT J AU Rathore, SS Epstein, AJ Vopp, KGM Krumholz, HM AF Rathore, SS Epstein, AJ Vopp, KGM Krumholz, HM TI Hospital coronary artery bypass graft surgery volume and patient mortality, 1998-2000 SO ANNALS OF SURGERY LA English DT Article ID NEW-YORK-STATE; SURGICAL VOLUME; OUTCOME RELATIONSHIPS; INHOSPITAL MORTALITY; POTENTIAL BENEFITS; CARDIAC-SURGERY; UNITED-STATES; RISK-FACTORS; OPERATIONS; QUALITY AB Objective: To evaluate the association between annual hospital coronary artery bypass graft (CABG) surgery volume and in-hospital mortality. Summary Background Data: The Leapfrog Group recommends health care purchasers contract for CABG services only with hospitals that perform greater than or equal to500 CABGs annually to reduce mortality; it is unclear whether this standard applies to current practice. Methods: We conducted a retrospective analysis of the National Inpatient Sample database for patients who underwent CABG in 1998-2000 (n = 228,738) at low (12-249 cases/year), medium (250-499 cases/year), and high (greater than or equal to500 cases/year) CABG volume hospitals. Crude in-hospital mortality rates were 4.21% in low-volume hospitals, 3.74% in medium-volume hospitals, and 3.54% in high-volume hospitals (trend P < 0.001). Compared with patients at high-volume hospitals (odds ratio 1.00, referent), patients at low-volume hospitals remained at increased risk of mortality after multivariable adjustment (odds ratio 1.26, 95% confidence interval = 1.15-1.39). The mortality risk for patients at medium-volume hospitals was of borderline significance (odds ratio 1.11, 95% confidence interval = 1.01-1.21). However, 207 of 243 (85%) of low-volume and 151 of 169 (89%) of medium-volume hospital-years had risk-standardized mortality rates that were statistically lower or comparable to those expected. In contrast, only 11 of 169 (6%) of high-volume hospital-years had outcomes that were statistically better than expected. Conclusions: Patients at high-volume CABG hospitals were, on average, at a lower mortality risk than patients at lower-volume hospitals. However, the small size of the volume-associated mortality difference and the heterogeneity in outcomes within all CABG volume groups suggest individual hospital CABG volume is not a reliable marker of hospital CABG quality. C1 Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med,MD PhD Program, New Haven, CT 06520 USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT 06520 USA. Univ Penn, Wharton Sch Buiness, Dept Hlth Care Syst, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Gen Internal Med Sect, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Hosp, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. RP Rathore, SS (reprint author), Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med,MD PhD Program, New Haven, CT 06520 USA. FU AHRQ HHS [T32 HS000009, T32-HS00009] NR 46 TC 67 Z9 67 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD JAN PY 2004 VL 239 IS 1 BP 110 EP 117 DI 10.1097/01.sla.0000103066.22732.b8 PG 8 WC Surgery SC Surgery GA 774FK UT WOS:000188968900017 PM 14685108 ER PT J AU Gaasch, WH Zile, MR AF Gaasch, WH Zile, MR TI Left ventricular diastolic dysfunction and diastolic heart failure SO ANNUAL REVIEW OF MEDICINE LA English DT Review DE cardiac function; congestive heart failure; diastole; ejection fraction ID NORMAL EJECTION FRACTION; NORMAL SYSTOLIC FUNCTION; PRESSURE-VOLUME CURVE; HYPERTROPHIC CARDIOMYOPATHY; PULMONARY-EDEMA; DOPPLER-ECHOCARDIOGRAPHY; NATRIURETIC PEPTIDE; ELDERLY-PATIENTS; CORONARY REVASCULARIZATION; ESSENTIAL-HYPERTENSION AB Thirty to fifty percent of patients presenting with signs and symptoms of heart failure have a normal left ventricular (LV) systolic ejection fraction. The clinical examination cannot distinguish these patients (diastolic heart failure) from those with a depressed ejection fraction (systolic heart failure), but echocardiography can. The management of diastolic heart failure has two major objectives. The first is to reverse the consequences of diastolic dysfunction (e.g., venous congestion), and the second is to eliminate or reduce the factors responsible for diastolic dysfunction (e.g., myocardial hypertrophy, fibrosis, and ischemia). C1 Lahey Clin Fdn, Dept Cardiovasc Med, Burlington, MA 01805 USA. Univ Massachusetts, Sch Med, Worcester, MA 01655 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29401 USA. Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Div Cardiol, Charleston, SC 29425 USA. RP Gaasch, WH (reprint author), Lahey Clin Fdn, Dept Cardiovasc Med, Burlington, MA 01805 USA. EM William.H.Gaasch@Lahey.org NR 84 TC 138 Z9 147 U1 0 U2 3 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0066-4219 J9 ANNU REV MED JI Annu. Rev. Med. PY 2004 VL 55 BP 373 EP 394 DI 10.1146/annurev.55.091902.104417 PG 22 WC Medicine, General & Internal SC General & Internal Medicine GA 827RL UT WOS:000221918000022 PM 14746527 ER PT J AU Siegel, JM AF Siegel, JM TI Hypocretin (orexin): Role in normal behavior and neuropathology SO ANNUAL REVIEW OF PSYCHOLOGY LA English DT Review DE REM sleep; hypothalamus; narcolepsy; cataplexy; feeding; motor; alertness ID LOCUS-COERULEUS NEURONS; IN-VIVO MICRODIALYSIS; DORSAL RAPHE NUCLEUS; AMINO-ACID RELEASE; HUMAN NARCOLEPSY; RETICULAR-FORMATION; GABA RELEASE; MUSCLE TONE; RAT-BRAIN; HISTAMINERGIC NEURONS AB The hypocretins (Hcrts, also known as orexins) are two peptides, both synthesized by a small group of neurons, most of which are in the lateral hypothalamic and perifornical regions of the hypothalamus. The hypothalamic Hcrt system directly and strongly innervates and potently excites noradrenergic, dopaminergic, serotonergic, histaminergic, and cholinergic neurons. Hcrt also has a major role in modulating the release of glutamate and other amino acid transmitters. Behavioral investigations have revealed that Hcrt is released at high levels in active waking and rapid eye movement (REM) sleep and at minimal levels in non-REM sleep. Hcrt release in waking is increased markedly during periods of increased motor activity relative to levels in quiet, alert waking. Evidence for a role for Hcrt in food intake regulation is inconsistent. I hypothesize that Hcrt's major role is to facilitate motor activity tonically and phasically in association with motivated behaviors and to coordinate this facilitation with the activation of attentional and sensory systems. Degeneration of Hcrt neurons or genetic mutations that prevent the normal synthesis of Hcrt or of its receptors causes human and animal narcolepsy. Narcolepsy is characterized by an impaired ability to maintain alertness for long periods and by sudden losses of muscle tone (cataplexy). Administration of Hcrt can reverse symptoms of narcolepsy in animals, may be effective in treating human narcolepsy, and may affect a broad range of motivated behaviors. C1 Univ Calif Los Angeles, Ctr Sleep Res, Vet Affairs Greater Los Angeles Healthcare Syst S, North Hills, CA 91343 USA. Univ Calif Los Angeles, Ctr Sleep Res, Dept Psychiat & Biobehav Sci, North Hills, CA 91343 USA. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Ctr Sleep Res, Vet Affairs Greater Los Angeles Healthcare Syst S, North Hills, CA 91343 USA. EM jsiegel@ucla.edu FU NHLBI NIH HHS [HL060246]; NIMH NIH HHS [MH64109]; NINDS NIH HHS [NS64109, NS14610] NR 100 TC 153 Z9 159 U1 1 U2 10 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0066-4308 J9 ANNU REV PSYCHOL JI Annu. Rev. Psychol. PY 2004 VL 55 BP 125 EP 148 DI 10.1146/annurev.psych.55.090902.141545 PG 28 WC Psychology; Psychology, Multidisciplinary SC Psychology GA 780BK UT WOS:000189351100005 PM 14744212 ER PT J AU Andes, D Marchillo, K Conklin, R Krishna, G Ezzet, F Cacciapuoti, A Loebenberg, D AF Andes, D Marchillo, K Conklin, R Krishna, G Ezzet, F Cacciapuoti, A Loebenberg, D TI Pharmacodynamics of a new triazole, posaconazole, in a murine model of disseminated candidiasis SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID IN-VIVO ACTIVITIES; OROPHARYNGEAL CANDIDIASIS; STREPTOCOCCUS-PNEUMONIAE; AMPHOTERICIN-B; OTITIS-MEDIA; FLUCONAZOLE; ALBICANS; INFECTIONS; RESISTANCE; VITRO AB Previous in vivo studies have characterized the pharmacodynamic characteristics of two triazole compounds, fluconazole and ravuconazole. These investigations demonstrated that the 24-h area under the concentration-time curve (AUC)/MIC ratio is the critical pharmacokinetic-pharmacodynamic (PK-PD) parameter associated with treatment efficacy. Further analysis demonstrated that a free-drug triazole 24-h AUC/MIC ratio of 20 to 25 was predictive of treatment success in both experimental models and clinical trials. We used a neutropenic murine model of disseminated Candida albicans infection to similarly characterize the time course activity of the new triazole, posaconazole. The PK-PD parameters (percent time above MIC, AUC/MIC ratio, and peak serum drug level/MIC ratio) were correlated with in vivo efficacy, as measured by organism number in kidney cultures after 48 h of therapy. Kinetics and protein binding following oral posaconazole dosing were performed in neutropenic infected mice. Peak levels and AUC from 0 h to infinity values were nonlinear over the 16-fold dose range studied. Serum drug elimination half-life ranged from 12.0 to 17.7 h. Protein binding was 99%. Single dose postantifungal effect studies demonstrated prolonged suppression of organism regrowth after serum posaconazole levels had fallen below the MIC. Treatment efficacy with the four dosing intervals studied was similar, supporting the AUC/MIC ratio as the PK-PD parameter predictive of efficacy. Nonlinear regression analysis also suggested that the AUC/MIC ratio was strongly predictive of treatment outcomes (AUC/MIC ratio R-2 = 83%; peak serum drug/MIC ratio R-2 = 85%; time that serum levels of posaconazole remained above the MIC R-2 = 65%). Similar studies were conducted with 11 additional C albicans isolates with various posaconazole susceptibilities (MIC, 0.015 to 0.12 mug/ml) to determine if a similar 24-h AUC/MIC ratio was associated with efficacy. The posaconazole free-drug AUC/MIC ratios were similar for all of the organisms studied (6.12 to 26.7, mean +/- SD = 16.9 +/- 7.8, P value, 0.42). These free-drug AUC/MIC ratios are similar to those observed for other triazoles in this model. C1 Univ Wisconsin, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53792 USA. Schering Plough Res Inst, Kenilworth, NJ USA. RP Andes, D (reprint author), Univ Wisconsin, 600 Highland Ave,Room H4-572, Madison, WI 53792 USA. NR 27 TC 107 Z9 112 U1 1 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD JAN PY 2004 VL 48 IS 1 BP 137 EP 142 DI 10.1128/AAC.48.1.137-142.2004 PG 6 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 759FW UT WOS:000187728500020 PM 14693531 ER PT J AU Zandi, PP Anthony, JC Khachaturian, AS Stone, SV Gustafson, D Tschanz, JT Norton, MC Welsh-Bohmer, KA Breitner, JCS AF Zandi, PP Anthony, JC Khachaturian, AS Stone, SV Gustafson, D Tschanz, JT Norton, MC Welsh-Bohmer, KA Breitner, JCS CA Cache Cty Study Grp TI Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements - The Cache County Study SO ARCHIVES OF NEUROLOGY LA English DT Article ID COGNITIVE FUNCTION; NUTRITIONAL-STATUS; OXIDATIVE STRESS; DIETARY-INTAKE; ASSOCIATION; POPULATION; SAMPLE; PERFORMANCE; DEMENTIA; HEALTH AB Background: Antioxidants may protect the aging brain against oxidative damage associated with pathological changes of Alzheimer disease (AD). Objective: To examine the relationship between antioxidant supplement use and risk of AD. Design: Cross-sectional and prospective study of dementia. Elderly (65 years or older) county residents were assessed in 1995 to 1997 for prevalent dementia and AD, and again in 1998 to 2000 for incident illness. Supplement use was ascertained at the first contact. Setting: Cache County, Utah. Participants: Among 4740 respondents (93%) with data sufficient to determine cognitive status at the initial assessment, we identified 200 prevalent cases of AD. Among 3227 survivors at risk, we identified 104 incident AD cases at follow-up. Main Outcome Measure: Diagnosis of AD by means of multistage assessment procedures. Results: Analyses of prevalent and incident AD yielded similar results. Use of vitamin E and C (ascorbic acid) supplements in combination was associated with reduced AD prevalence (adjusted odds ratio, 0.22; 95% confidence interval, 0.05-0.60) and incidence (adjusted hazard ratio, 0.36; 95% confidence interval, 0.09-0.99). A trend toward lower AD risk was also evident in users of vitamin E and multivitamins containing vitamin C, but we saw no evidence of a protective effect with use of vitamin E or vitamin C supplements alone, with multivitamins alone, or with vitamin B-complex supplements. Conclusions: Use of vitamin E and vitamin C supplements in combination is associated with reduced prevalence and incidence of AD. Antioxidant supplements merit further study as agents for the primary prevention of AD. C1 Johns Hopkins Univ, Dept Mental Hlth, Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA. Johns Hopkins Univ, Adv Acad Programs, Baltimore, MD USA. Utah State Univ, Dept Food Sci & Nutr, Logan, UT USA. Utah State Univ, Dept Psychol, Logan, UT 84322 USA. Utah State Univ, Dept Family Consumer & Human Dev, Logan, UT 84322 USA. Utah State Univ, Ctr Epidemiol Stat, Logan, UT 84322 USA. Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC 27710 USA. Duke Univ, Med Ctr, Joseph & Kathleen Bryan Alzheimers Dis Res Ctr, Durham, NC 27710 USA. Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA USA. RP Zandi, PP (reprint author), Johns Hopkins Univ, Dept Mental Hlth, Bloomberg Sch Publ Hlth, Hampton House,Room 857,624 N Broadway, Baltimore, MD 21205 USA. EM pzandi@jhsph.edu RI Tschanz, JoAnn/E-5986-2010; Norton, Maria/E-6994-2013 FU NIA NIH HHS [R01 AG 11380]; NIDA NIH HHS [K05 DA015799]; NIMH NIH HHS [T32 MH 14592] NR 35 TC 372 Z9 403 U1 3 U2 24 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD JAN PY 2004 VL 61 IS 1 BP 82 EP 88 DI 10.1001/archneur.61.1.82 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 763BV UT WOS:000188050900013 PM 14732624 ER PT J AU Boninger, ML Cooper, RA Koontz, AM Souza, AL Towers, JD DiCianno, BE AF Boninger, ML Cooper, RA Koontz, AM Souza, AL Towers, JD DiCianno, BE TI Shoulder magnetic resonance imaging abnormalities, wheelchair propulsion, and gender (vol 84, pg 1615, 2003) SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Correction C1 Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Boninger, ML (reprint author), Univ Pittsburgh, Pittsburgh, PA 15260 USA. OI Boninger, Michael/0000-0001-6966-919X NR 1 TC 1 Z9 1 U1 0 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD JAN PY 2004 VL 85 IS 1 BP 172 EP 172 DI 10.1016/j.apmr.2003.11.006 PG 1 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 761GH UT WOS:000187892800029 ER PT J AU Williams, TN Zhang, CX Game, BA He, L Huang, Y AF Williams, TN Zhang, CX Game, BA He, L Huang, Y TI C-reactive protein stimulates MMP-1 expression in U937 histiocytes through Fc gamma RII and extracellular signal-regulated kinase pathway: An implication of CRP involvement in plaque destabilization SO ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY LA English DT Article DE C-reactive protein; matrix metalloproteinase; arteriosclerosis; gene expression ID MATRIX METALLOPROTEINASE-1 EXPRESSION; CORONARY-ARTERY-DISEASE; HUMAN ENDOTHELIAL-CELLS; ATHEROSCLEROTIC PLAQUE; CROSS-LINKING; RECEPTOR; COMPLEMENT; INFLAMMATION; SYNTHESIZE; MONOCYTES AB Objective-It has been shown that plasma level of C-reactive protein (CRP) is an independent predictor for acute coronary syndromes and is associated with plaque weakening. However, the underlying mechanisms are not well understood. In this study, we investigated the effect of CRP on the expression of matrix metalloproteinase-1 (MMP-1) that has been implicated in plaque vulnerability by human U937 histiocytes and monocyte-derived macrophages. Methods and Results-Enzyme-linked immunosorbent assay of MMP-1 in conditioned medium showed that treatment of U937 cells with 100 mug/mL of CRP for 24 hour led to a 3- to 5-fold increase in MMP-1 secretion. CRP also markedly stimulated MMP-1 release from human monocyte-derived macrophages. In contrast, CRP had no effect on tissue inhibitor of metalloproteinase-1 (TIMP-1) secretion. Northern blot showed that CRP upregulated MMP-1 mRNA expression. Collagenase activity assay showed that CRP increased collagen-degrading activity in cell-conditioned medium. Furthermore, results showed that the stimulation of MMP-1 secretion by CRP was inhibited by anti-CD32, but not by anti-CD64 antibody, and by mitogen-activated protein kinase/extracellular signal-regulated kinase (MEK) inhibitor PD98059. Finally, Western blot showed that CRP stimulated phosphorylation of extracellular signal-regulated kinase. Conclusions-This study demonstrates that CRP stimulates MMP-1 expression by U937 cells through FcgammaRII and extracellular signal-regulated kinase pathway. These findings suggest that CRP may promote matrix degradation and thus contribute to plaque vulnerability. C1 Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. RP Huang, Y (reprint author), Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, 114 Doughty St, Charleston, SC 29403 USA. NR 37 TC 86 Z9 104 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1079-5642 J9 ARTERIOSCL THROM VAS JI Arterioscler. Thromb. Vasc. Biol. PD JAN PY 2004 VL 24 IS 1 BP 61 EP 66 DI 10.1161/01.ATV.0000104014.24367.16 PG 6 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 760BV UT WOS:000187791600010 PM 14592848 ER PT J AU Studer, RK Bergman, R Stubbs, T Decker, K AF Studer, RK Bergman, R Stubbs, T Decker, K TI Chondrocyte response to growth factors is modulated by p38 mitogen-activated protein kinase inhibition SO ARTHRITIS RESEARCH & THERAPY LA English DT Article DE chondrocytes; interleukin-1; nitric oxide; p38 mitogen-activated protein kinase; transforming growth factor beta ID N-TERMINAL KINASE; NITRIC-OXIDE; ARTICULAR CHONDROCYTES; GENE-EXPRESSION; CULTURED CHONDROCYTES; RHEUMATOID-ARTHRITIS; SELECTIVE INHIBITOR; CELL-PROLIFERATION; ATDC5 CELLS; MAP KINASE AB Inhibitors of p38 mitogen-activated protein kinase ( MAPK) diminish inflammatory arthritis in experimental animals. This may be effected by diminishing the production of inflammatory mediators, but this kinase is also part of the IL-1 signal pathway in articular chondrocytes. We determined the effect of p38 MAPK inhibition on proliferative and synthetic responses of lapine chondrocytes, cartilage, and synovial fibroblasts under basal and IL-1-activated conditions. Basal and growth factor-stimulated proliferation and proteoglycan synthesis were determined in primary cultures of rabbit articular chondrocytes, first-passage synovial fibroblasts, and cartilage organ cultures. Studies were performed with or without p38 MAPK inhibitors, in IL-1-activated and control cultures. Media nitric oxide and prostaglandin E(2) were assayed. p38 MAPK inhibitors blunt chondrocyte and cartilage proteoglycan synthesis in response to transforming growth factor beta; responses to insulin-like growth factor 1 (IGF-1) and fetal calf serum (FCS) are unaffected. p38 MAPK inhibitors significantly reverse inhibition of cartilage organ culture proteoglycan synthesis by IL-1. p38 MAPK inhibition potentiated basal, IGF-1-stimulated and FCS-stimulated chondrocyte proliferation, and reversed IL-1 inhibition of IGF-1-stimulated and FCS-stimulated DNA synthesis. Decreases in nitric oxide but not prostaglandin E(2) synthesis in IL-1-activated chondrocytes treated with p38 MAPK inhibitors are partly responsible for this restoration of response. Synovial fibroblast proliferation is minimally affected by p38 MAPK inhibition. p38 MAPK activity modulates chondrocyte proliferation under basal and IL-1-activated conditions. Inhibition of p38 MAPK enhances the ability of growth factors to overcome the inhibitory actions of IL-1 on proliferation, and thus could facilitate restoration and repair of diseased and damaged cartilage. C1 Univ Pittsburgh, Sch Med, Dept Orthopaed Surg, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15261 USA. RP Studer, RK (reprint author), VA Med Ctr, Res & Dev, Univ Dr C, Pittsburgh, PA 15240 USA. EM rstuder@pitt.edu NR 34 TC 21 Z9 22 U1 0 U2 0 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1478-6354 J9 ARTHRITIS RES THER JI Arthritis Res. Ther. PY 2004 VL 6 IS 1 BP R56 EP R64 DI 10.1186/ar1022 PG 9 WC Rheumatology SC Rheumatology GA 750WM UT WOS:000187021500010 ER PT S AU Goodman, M New, A Siever, L AF Goodman, M New, A Siever, L BE Yehuda, R McEwen, B TI Trauma, genes, and the neurobiology of personality disorders SO BIOBEHAVIORAL STRESS RESPONSE: PROTECTIVE AND DAMAGING EFFECTS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Protective and Damaging Effects of the Biobehavioral Stress Response CY SEP 07-09, 2003 CL New York, NY SP Glaxosmithkline, Janssen Pharmaceut, Pfizer Inc, Solvay, Bristol Myers Squibb, Novartis Pharmaceut, Astrazeneca, Eli Lilly & Co, Johnson & Johnson, Merck, Ortho McNeil Pharmaceut Inc DE trauma; genes; personality disorder; impulsive aggression; neurobiology ID SEROTONIN TRANSPORTER GENE; POSITRON-EMISSION-TOMOGRAPHY; CHILDHOOD SEXUAL-ABUSE; TRYPTOPHAN-HYDROXYLASE GENE; BORDERLINE PERSONALITY; MONOAMINE-OXIDASE; PROMOTER REGION; ANTISOCIAL PERSONALITY; IMPULSIVE-AGGRESSION; SUICIDAL-BEHAVIOR AB A model for personality dysfunction posits an interaction between inherited susceptibility and environmental factors such as childhood trauma. Core biological vulnerabilities in personality include dimensions of affective instability, impulsive aggression, and cognition/perceptual domains. For the dimension of impulsive aggression, often seen in borderline personality disorder (BPD), the underlying neurobiology involves deficits in central serotonin function and alterations in specific brain regions in the cingulate and the medial and orbital prefrontal cortex. The role of trauma in the development of personality disorder and especially for BPD remains unclear. Although recent studies suggest that BPD is not a trauma-spectrum disorder and that it is biologically distinct from posttraumatic stress disorder, high rates of childhood abuse and neglect do exist for individuals with personality dysfunction. Personality symptom clusters seem to be unrelated to specific abuses, but they may relate to more enduring aspects of interpersonal and family environments in childhood. Whereas twin and family studies indicate a partially heritable basis for impulsive aggression, studies of serotonin-related genes to date suggest only modest contributions to behavior. Gene-environment interactions involving childhood maltreatment are demonstrated in recent studies on antisocial behaviors and aggressive rhesus monkeys and highlight the need for further research in this important area. C1 Bronx Vet Adm Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. RP Goodman, M (reprint author), Bronx Vet Adm Med Ctr, Dept Psychiat, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM marianne.goodman@med.va.gov NR 86 TC 71 Z9 73 U1 4 U2 25 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-518-4 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2004 VL 1032 BP 104 EP 116 DI 10.1196/annals.1314.008 PG 13 WC Behavioral Sciences; Endocrinology & Metabolism; Multidisciplinary Sciences; Physiology; Psychology SC Behavioral Sciences; Endocrinology & Metabolism; Science & Technology - Other Topics; Physiology; Psychology GA BBW44 UT WOS:000228129700009 PM 15677398 ER PT J AU Brody, AL Mandelkern, MA Jarvik, ME Lee, GS Smith, EC Huang, JC Bota, RG Bartzokis, G London, ED AF Brody, AL Mandelkern, MA Jarvik, ME Lee, GS Smith, EC Huang, JC Bota, RG Bartzokis, G London, ED TI Differences between smokers and nonsmokers in regional gray matter volumes and densities SO BIOLOGICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Annual Meeting of the European-Society-for-Research-on-Nicotine-and-Tobacco CY OCT 05, 2002 CL SANTANDER, SPAIN SP European Soc Res Nicotine Tobacco DE magnetic resonance imaging; nicotine dependence; voxel-based morphometry; prefrontal cortex; anterior cingulate cortex; ventral striatum ID VOXEL-BASED MORPHOMETRY; NICOTINIC ACETYLCHOLINE-RECEPTORS; QUANTITATIVE CEREBRAL ANATOMY; SILENT BRAIN INFARCTION; AGE-RELATED-CHANGES; CIGARETTE-SMOKING; SEX-DIFFERENCES; IN-VIVO; COGNITIVE PERFORMANCE; CARDIOVASCULAR HEALTH AB Background: Magnetic resonance imaging (MRI) studies have demonstrated large-scale brain abnormalities in cigarette smokers, such as ventricular enlargement and atrophy. Converging lines of evidence point to functional differences between smokers and nonsmokers in specific brain regions, namely the lateral prefrontal cortex (PFC), anterior cingulate cortex (ACC), ventral striatum, and thalamus. Using MRI, we examined these regions for differences in gray matter between smokers and nonsmokers. Metbods: Thirty-six otherwise bealthy adults (19 smokers and 17 nonsmoking control subjects) underwent three-dimensional Fourier-transform spoiled-gradient-recalled acquisition MRI of the brain. Both band-drawn regions of interest and the computer program voxel-based morphometry were used to assess group differences in regional gray matter volumes and densities, respectively. Results: Smokets hadsmallergray mattervolumes andlowergray matter densities than nonsmokers in the PFC bilaterally, along with smaller volumes in the left dorsal ACC and lower gray matter densities in the right cerebellum. Smokers also bad negative associations between pack-year smoking history and PFC gray matter densities. Conclusions: Smokers and nonsmokers differed in regional gray matter in brain areas previously linked with nicotine dependence. These findings might reflect effects of chronic smoking, predisposing traits that lead to smoking, or some combination of these factors. (C) 2004 Society of Biological Psychiatry. C1 Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Lab Neuroimaging, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Mol & Med Pharmacol, Los Angeles, CA 90024 USA. Univ Calif Irvine, Dept Phys, Irvine, CA 92717 USA. RP Brody, AL (reprint author), 300 UCLA Med Plaza,Suite 2200, Los Angeles, CA 90095 USA. RI Bartzokis, George/K-2409-2013 FU NIDA NIH HHS [R01 DA14093, R01 DA15059] NR 116 TC 209 Z9 216 U1 4 U2 19 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD JAN 1 PY 2004 VL 55 IS 1 BP 77 EP 84 DI 10.1016/S0006-3223(03)00610-3 PG 8 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 759NH UT WOS:000187743400010 PM 14706428 ER PT J AU Salli, U Mitalipov, S Meshul, CK Pau, FKY Thomson, JA Wolf, DP AF Salli, U Mitalipov, S Meshul, CK Pau, FKY Thomson, JA Wolf, DP TI Neuronal differentiation of GFP-expressing rhesus monkey embryonic stem cells SO BIOLOGY OF REPRODUCTION LA English DT Meeting Abstract CT 37th Annual Meeting of the Society-for-the-Study-of-Reproduction CY AUG 01-04, 2004 CL Univ British Columbia, Vancouver, CANADA SP Soc Study Reprod HO Univ British Columbia C1 Oregon Hlth Sci Univ, Oregon Natl Primate Res Ctr, Div Reprod Sci, Beaverton, OR USA. Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Dept Behav Neurobiol, Portland, OR 97201 USA. Univ Wisconsin, Wisconsin Natl Primate Res Ctr, Dept Anat, Madison, WI 53706 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SOC STUDY REPRODUCTION PI MADISON PA 1603 MONROE ST, MADISON, WI 53711-2021 USA SN 0006-3363 J9 BIOL REPROD JI Biol. Reprod. PY 2004 SI SI MA 545 BP 217 EP 218 PG 2 WC Reproductive Biology SC Reproductive Biology GA 840HJ UT WOS:000222848400604 ER PT J AU Zhang, BX Ma, XY Shu, ZJ Yeh, CK Swerdlow, RH Katz, MS AF Zhang, BX Ma, XY Shu, ZJ Yeh, CK Swerdlow, RH Katz, MS TI Differential regulation of intracellular calcium oscillations by mitochondria and gap junctions SO BIOPHYSICAL JOURNAL LA English DT Meeting Abstract CT 48th Annual Meeting of the Biophysical Society CY FEB 14-18, 2004 CL Baltimore, MD SP Biophys Soc C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Univ Virginia, Hlth Sci Ctr, Dept Neurol, Charlottesville, VA 22908 USA. S Texas Vet Hlth Care Syst, Grecc, Almd, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Res Serv 151, ALMD, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BIOPHYSICAL SOCIETY PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0006-3495 J9 BIOPHYS J JI Biophys. J. PD JAN PY 2004 VL 86 IS 1 SU S BP 27A EP 27A PN 2 PG 1 WC Biophysics SC Biophysics GA 762KQ UT WOS:000187971200132 ER PT J AU Hashimoto, JG Beadles-Bohling, AS Wiren, KM AF Hashimoto, JG Beadles-Bohling, AS Wiren, KM TI Comparison of RiboGreen (R) and 18S rRNA quantitation for normalizing real-time RT-PCR expression analysis SO BIOTECHNIQUES LA English DT Article ID POLYMERASE CHAIN-REACTION; QUANTIFICATION; VALIDATION C1 Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Wiren, KM (reprint author), Portland VA Med Ctr, P3-R&D39,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM wirenk@ohsu.edu OI Wiren, Kristine/0000-0002-6159-4450 NR 9 TC 71 Z9 73 U1 0 U2 2 PU EATON PUBLISHING CO PI NATICK PA 154 E. CENTRAL ST, NATICK, MA 01760 USA SN 0736-6205 J9 BIOTECHNIQUES JI Biotechniques PD JAN PY 2004 VL 36 IS 1 BP 54 EP + PG 5 WC Biochemical Research Methods; Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 763KF UT WOS:000188083600007 PM 14740484 ER PT J AU Soares, JC Kochunov, P Monkul, ES Nicoletti, MA Brambilla, P Sassi, RB Mallinger, AG Frank, E Kupfer, DJ Lancaster, J Fox, PT AF Soares, JC Kochunov, P Monkul, ES Nicoletti, MA Brambilla, P Sassi, RB Mallinger, AG Frank, E Kupfer, DJ Lancaster, J Fox, PT TI Deformation field morphometry findings in bipolar disorder SO BIPOLAR DISORDERS LA English DT Meeting Abstract CT Conference of the International-Society-for-Bipolar-Disorders CY FEB 05-07, 2004 CL Sydney, AUSTRALIA SP Int Soc Bipolar Disorders C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Mood & Anxiety Disorders Div, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Res Imaging Ctr, San Antonio, TX USA. Dokuz Eylul Univ, Sch Med, Dept Psychiat, Izmir, Turkey. Univ Verona, Sch Med, Dept Med & Publ Hlth, I-37100 Verona, Italy. Univ Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo, Brazil. Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Pharmacol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Neurosci, Pittsburgh, PA USA. RI Kochunov, Peter/E-4711-2010; brambilla, paolo/B-4184-2010 OI brambilla, paolo/0000-0002-4021-8456 NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 1398-5647 J9 BIPOLAR DISORD JI Bipolar Disord. PY 2004 VL 6 SU 1 MA 124 BP 16 EP 17 PG 2 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 778RR UT WOS:000189255000024 ER PT J AU Campling, B AF Campling, B TI Topotecan in small cell lung cancer SO CANCER BIOLOGY & THERAPY LA English DT Editorial Material DE small cell lung cancer; chemotherapy; topotecan ID COOPERATIVE-ONCOLOGY-GROUP; PHASE-II; CYCLOPHOSPHAMIDE; CAMPTOTHECIN; TRIAL C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Campling, B (reprint author), Univ Penn, Univ & Woodland Ave, Philadelphia, PA 19104 USA. EM complinb@mail.med.upenn.edu NR 11 TC 2 Z9 2 U1 0 U2 0 PU LANDES BIOSCIENCE PI GEORGETOWN PA 810 SOUTH CHURCH STREET, GEORGETOWN, TX 78626 USA SN 1538-4047 J9 CANCER BIOL THER JI Cancer Biol. Ther. PD JAN PY 2004 VL 3 IS 1 BP 94 EP 95 DI 10.4161/cbt.3.1.713 PG 2 WC Oncology SC Oncology GA 805QF UT WOS:000220380100019 PM 14739785 ER PT J AU Kane, MA AF Kane, MA TI The role of folates in squamous cell carcinoma of the head and neck SO CANCER DETECTION AND PREVENTION LA English DT Article DE folate; head and neck cancer; squamous cell carcinoma; chemoprevention ID METHYLENETETRAHYDROFOLATE REDUCTASE POLYMORPHISMS; LUNG-CANCER PATIENTS; NEURAL-TUBE DEFECTS; DNA EXCISION-REPAIR; ESOPHAGEAL CANCER; STRAND BREAKS; RISK-FACTORS; PROMOTER METHYLATION; CHINESE POPULATION; EPITHELIAL-CELLS AB The primary objective of this review is to explore the hypothesis that folate insufficiency may be important in the pathogenesis of squamous cell carcinomas of the head and neck (SCCHN) and that folate repletion may be an effective component of chemoprevention. The main results are that folate insufficiency disrupts DNA global and specific gene methylation patterns such that the activity of certain tumor suppressor genes such as p16 and possibly p53 may be lost. Folate pool imbalance and impaired repair mechanisms may contribute to DNA instability and strand breaks. Sensitive methods exist for identification of individuals with folate insufficiency in contrast to the relatively insensitive conventional serum or red cell folate assays with broad "normal" ranges. The impact of folate supplementation can thus be quantified. Folate imbalance may result from alterations in folate cellular uptake by the reduced folate carrier (RFC) and/or the folate receptor (FR) and polymorphisms in enzymes important in folate retention such as folylpolyglutamate synthetase and in folate modification such as methylene tetrahydrofolate reductase (MTHFR). Known predisposing factors for SCCHN such as alcohol and tobacco carcinogens may influence folate balance. Folate supplementation may reduce primary or secondary risk of cancer. Formal studies of folate sufficiency in persons at risk for or diagnosed and treated for SCCHN are needed to define the role of folate supplementation in the prevention of these cancers. (c) 2004 lnternational Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved. C1 Univ Colorado, Hlth Sci Ctr, Div Med Oncol, Denver, CO 80220 USA. Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Kane, MA (reprint author), Univ Colorado, Hlth Sci Ctr, Div Med Oncol, 1055 Clermont St, Denver, CO 80220 USA. EM madeleine.kane@uchsc.edu NR 75 TC 1 Z9 1 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0361-090X J9 CANCER DETECT PREV JI Cancer Detect. Prev. PY 2004 VL 29 IS 1 BP 46 EP 53 DI 10.1016/j.cdp.2004.08.002 PG 8 WC Oncology SC Oncology GA 906SS UT WOS:000227664000007 ER PT J AU Chen, TT Brown, EJ Huang, EJ Seaman, WE AF Chen, TT Brown, EJ Huang, EJ Seaman, WE TI Expression and activation of signal regulatory protein alpha on astrocytomas SO CANCER RESEARCH LA English DT Article ID TYROSINE-PHOSPHATASE SHP-2; T-CELL; SIRP-ALPHA; NEGATIVE REGULATION; ADHESION MOLECULE; NEURITE OUTGROWTH; NERVOUS-SYSTEM; MYELOID CELLS; SHPS-1; CD47 AB High-grade astrocytomas and glioblastomas are usually unresectable because they extensively invade surrounding brain tissue. Here, we report the expression and function of a receptor on many astrocytomas that may alter both the proliferative and invasive potential of these tumors. Signal regulatory protein (SIRP) alpha1 is an immunoglobulin superfamily transmembrane glycoprotein that is normally expressed in subsets of myeloid and neuronal cells. Transfection of many cell types with SIRPalpha1, including glioblastomas, has been shown to inhibit their proliferation in response to a range of growth factors. Furthermore, the expression of a murine SIRPalpha1 mutant has been shown to enhance cell adhesion and initial cell spreading but to inhibit cell extension and movement. The extracellular portion of SIRPalpha1 binds CD47 (integrin-associated protein), although this interaction is not required for integrin-mediated activation of SIRPalpha1. On phosphorylation, SIRPalpha1 recruits the tyrosine phosphatases SHP-1 and SHP-2, which are important in its functions. Although SHP-1 is uniquely expressed on hematopoietic cells, SHP-2 is ubiquitously expressed, so that SIRPalpha1 has the potential to function in many cell types, including astrocytomas. Because SIRPalpha1 regulates cell functions that may contribute to the malignancy of these tumors, we examined the expression of SIRPs in astrocytoma cell lines by flow cytometry using a monoclonal antibody against all SIRPs. Screening of nine cell lines revealed clear cell surface expression of SIRPs on five cell lines, whereas Northern blotting for SIRPalpha transcripts showed mRNA present in eight of nine cell lines. All nine cell lines expressed the ligand for SIRPalpha1, CD47. To further examine the expression and function of SIRPs, we studied the SF126 and U373MG astrocytoma cell lines, both of which express SIRPs, in greater detail. SHIP transcripts in these cells are identical in sequence to SIRPalpha1. The expressed deglycosylated protein is the same size as SIRPalpha1, but in the astrocytoma cells, it is underglycosylated compared with SIRPalpha1 produced in transfected Chinese hamster ovary cells. It is nonetheless still capable of binding soluble CD47. Moreover, SIRPalpha1 in each of the two cell lines recruited SHP-2 on phosphorylation, and SIRPalpha1 phosphorylation in cultured cells is CD47 dependent. Finally, examination of frozen sections from 10 primary brain tumor biopsies by immunohistochemistry revealed expression of SIRPs on seven of the specimens, some of which expressed high levels of SIRPs. Most of the tumors also expressed CD47. This is the first demonstration that astrocytomas can express SIRPa. Given the known role of SIRPa in regulating cell adhesion and responses to mitogenic growth factors, the expression of SIRPalpha1 on astrocytomas may, be of considerable importance in brain tumor biology, and it offers the potential of a new avenue for therapeutic intervention. C1 San Francisco VA Med Ctr, Dept Immunol, San Francisco, CA USA. San Francisco VA Med Ctr, Dept Pathol, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, Div Hematol Oncol, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, Div Rheumatol, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, Div Infect Dis, San Francisco, CA USA. RP Chen, TT (reprint author), San Francisco VA Hosp, Dept Arthritis Immunol, 4150 Clement St,111R, San Francisco, CA 94121 USA. EM thochen@itsa.ucsf.edu FU NIDDK NIH HHS [5T32 DK-7636-19] NR 65 TC 9 Z9 11 U1 0 U2 2 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JAN 1 PY 2004 VL 64 IS 1 BP 117 EP 127 DI 10.1158/0008-5472.CAN-3455-2 PG 11 WC Oncology SC Oncology GA 765QA UT WOS:000188293900018 PM 14729615 ER PT J AU Kogai, T Kanamoto, Y Che, LH Taki, K Moatamed, F Schultz, JJ Brent, GA AF Kogai, T Kanamoto, Y Che, LH Taki, K Moatamed, F Schultz, JJ Brent, GA TI Systemic retinoic acid treatment induces sodium/iodide symporter expression and radioiodide uptake in mouse breast cancer models SO CANCER RESEARCH LA English DT Article ID SODIUM-IODIDE SYMPORTER; THYROID NA+/I-SYMPORTER; PROSTATE-CANCER; GENE-EXPRESSION; MAMMARY-GLAND; UPSTREAM ENHANCER; RECEPTOR-ALPHA; CELL-LINE; HORMONE; THERAPY AB Lactating breast tissue and some breast cancers express the sodium/iodide symporter (NIS) and concentrate iodide. We recently demonstrated that all-trans retinoic acid (tRA) induces both NIS gene expression and iodide accumulation in vitro in well-differentiated human breast cancer cells (MCF-7). In the present study, we investigated the in vivo efficacy and specificity of tRA-stimulated iodide accumulation in mouse breast cancer models. Immunodeficient mice with MCF-7 xenograft tumors were treated with systemic tRA for 5 days. Iodide accumulation in the xenograft tumors was markedly increased, similar to15-fold greater than levels without treatment, and the effects were tRA dose dependent. Iodide accumulation in other organs was not significantly influenced by tRA treatment. Significant induction of NIS mRNA and protein in the xenograft tumors was observed after tRA treatment. Iodide accumulation and NIS mRNA expression were also selectively induced in breast cancer tissues in transgenic mice expressing the oncogene, polyoma virus middle T antigen. These data demonstrate selective induction of functional NIS in breast cancer by tRA. Treatment with short-term systemic retinoic acid, followed by radioiodide administration, is a potential tool in the diagnosis and treatment of some differentiated breast cancer. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Mol Endocrinol Lab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Dept Med & Physiol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90073 USA. RP Brent, GA (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Mol Endocrinol Lab, Bldg 114,Room 230,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM gbrent@ucla.edu FU NCI NIH HHS [CA8936401] NR 50 TC 46 Z9 46 U1 0 U2 4 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JAN 1 PY 2004 VL 64 IS 1 BP 415 EP 422 DI 10.1158/0008-5472.CAN-03-2285 PG 8 WC Oncology SC Oncology GA 765QA UT WOS:000188293900056 PM 14729653 ER PT J AU Choudhury, GG Abboud, HE AF Choudhury, GG Abboud, HE TI Tyrosine phosphorylation-dependent PI 3 kinase/Akt signal transduction regulates TGF beta-induced fibronectin expression in mesangial cells SO CELLULAR SIGNALLING LA English DT Article DE mesangial cell; TGF beta; tyrosine phosphorylation; Akt; fibronectin ID GROWTH-FACTOR-BETA; NF-KAPPA-B; ACTIVATED PROTEIN-KINASE; SERINE-THREONINE KINASE; CAMP RESPONSE ELEMENT; PHOSPHATIDYLINOSITOL 3-KINASE; GENE-EXPRESSION; DNA-SYNTHESIS; TRANSFORMING GROWTH-FACTOR-BETA-1; TRANSCRIPTION FACTOR AB TGFbeta stimulates expression of fibronectin in various cells, including mesangial cells. The mechanism by which TGFbeta exerts this effect is not fully understood. We investigated the involvement of tyrosine phosphorylation and the phosphatidylinositol (PI) 3 kinase/Akt signalling pathway in this process. TGFbeta increased tyrosine phosphorylation, resulting in activation of PI 3 kinase in mesangial cells. Inhibition of tyrosine phosphorylation blocked TGFbeta-induced fibronectin expression. Inhibition of PI 3 kinase activity also prevented fibronectin expression induced by TGFbeta. Furthermore, expression of constitutively active PI 3 kinase by adenovirus-mediated gene transfer increased fibronectin expression similar to TGFbeta. TGFbeta stimulated Akt serine threonine kinase in a tyrosine kinase- and PI 3 kinase-dependent manner. Inhibition of TGFbeta-induced Akt activity by adenovirus-mediated expression of a dominant-negative mutant of Akt abolished expression of fibronectin. Dominant-negative PI 3 kinase or dominant-negative Akt inhibited TGFbeta-induced fibronectin transcription. In contrast, and similarly to TGFbeta, expression of constitutively active PI 3 kinase or constitutively active Akt increased transcription of fibronectin, confirming a prominent role of these kinases in expression of fibronectin. These data provide the evidence that activation of TGFbeta receptor serine threonine kinase stimulates the PI 3 kinase/Akt pathway in a tyrosine phosphorylation-dependent manner and define a role for the same signal transduction pathway in TGFbeta-induced fibronectin expression. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Choudhury, GG (reprint author), Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med, 7703 Floyd Curl Dr,Mail Code 7882, San Antonio, TX 78229 USA. NR 67 TC 26 Z9 26 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0898-6568 J9 CELL SIGNAL JI Cell. Signal. PD JAN PY 2004 VL 16 IS 1 BP 31 EP 41 DI 10.1016/S0898-6568(03)00094-9 PG 11 WC Cell Biology SC Cell Biology GA 748KU UT WOS:000186861700004 ER PT J AU Feikin, DR Elie, CM Goetz, MB Lennox, JL Carlone, GM Romero-Steiner, S Holder, PF O'Brien, WA Whitney, CG Butler, JC Breiman, RF AF Feikin, DR Elie, CM Goetz, MB Lennox, JL Carlone, GM Romero-Steiner, S Holder, PF O'Brien, WA Whitney, CG Butler, JC Breiman, RF TI Specificity of the antibody response to the pneumococcal polysaccharide and conjugate vaccines in human immunodeficiency virus-infected adults SO CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY LA English DT Article ID LINKED-IMMUNOSORBENT-ASSAY; CAPSULAR POLYSACCHARIDES; STREPTOCOCCUS-PNEUMONIAE; RANDOMIZED TRIAL; CHILDREN; DISEASE; HIV; VACCINATION; ACTIVATION; EFFICACY AB Nonspecific antibodies, which are thought to be nonprotective, have been shown to contribute a substantial proportion of the measured concentration in the standardized immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) for pneumococcal polysaccharide capsular antibodies. The presence of such antibodies in human immunodeficiency virus (HIV)-infected persons has not been evaluated. The amount of nonspecific antibodies is proportional to the reduction in IgG antibody concentration that occurs with serum absorption with the heterologous polysaccharide 22F. We measured the amount of nonspecific antibodies before and after vaccination with the pneumococcal conjugate vaccine (PCV; n = 33) or the pneumococcal polysaccharide vaccine (PPV; n = 34) in HIV-infected adults with CD4 counts of greater than or equal to200 cells/mm(3). Blood was drawn before and 2 months after vaccination. For prevaccination sera, we found a substantial amount of nonspecific antibodies for serotypes 4, 6B, 9V, and 23F (23 to 47% of measured IgG concentration), but not for serotype 14. There tended to be proportionately less nonspecific antibodies in postvaccine sera than prevaccine sera for PCV, but not for PPV. Subjects with a low HIV viral load (less than or equal to400 copies/ml) had proportionately more nonspecific antibodies than those with higher viral load before and after both vaccines. After 22F absorption, the geometric mean concentrations of antibodies were significantly higher post-PCV than post-PPV for the high viral load group for all five serotypes, but for no serotypes in the low viral load group. These findings confirm that absorption with a heterologous pneumococcal polysaccharide (e.g., 22F) is necessary to remove nonspecific antibodies in a standardized IgG ELISA for pneumococcal capsular antibodies in HIV-infected adults. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Resp Dis Branch, Div Bacterial & Mycot Dis, Atlanta, GA USA. Emory Univ, Atlanta, GA 30322 USA. Grady Infect Dis Program, Atlanta, GA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Univ Texas, Med Branch, Galveston, TX 77550 USA. RP Feikin, DR (reprint author), 1600 Clifton Rd,Mailstop C23, Atlanta, GA 30333 USA. EM dfeikin@cdc.gov RI Lennox, Jeffrey/D-1654-2014 OI Lennox, Jeffrey/0000-0002-2064-5565; Romero-Steiner, Sandra/0000-0003-4128-7768; Goetz, Matthew/0000-0003-4542-992X NR 27 TC 29 Z9 30 U1 0 U2 2 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 1071-412X J9 CLIN DIAGN LAB IMMUN JI Clin. Diagn. Lab. Immunol. PD JAN PY 2004 VL 11 IS 1 BP 137 EP 141 DI 10.1128/CDLI.11.1.137-141.2004 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 764HL UT WOS:000188201400024 PM 14715560 ER PT J AU Romashko, AA Young, MRI AF Romashko, AA Young, MRI TI Protein phosphatase-2A maintains focal adhesion complexes in keratinocytes and the loss of this regulation in squamous cell carcinomas SO CLINICAL & EXPERIMENTAL METASTASIS LA English DT Article DE cytoskeleton; focal adhesions; HNSCC; keratinocytes; paxillin; PP-2A; squamous cell carcinoma ID CYTOSKELETAL ORGANIZATION; TYROSINE PHOSPHORYLATION; HUMAN HEAD; PAXILLIN; MOTILITY; KINASE; ASSOCIATION; MICROTUBULES; METASTASIS; MIGRATION AB Studies assessed if the serine/threonine protein phosphatase-2A (PP-2A) maintains cytoskeletal integrity of normal keratinocytes and if this differs in malignant cells. Murine and human keratinocyte cell lines contained more PP-2A activity than did the murine SCC VII/SF squamous cell carcinoma cells or primary cultures of human head and neck squamous cell carcinoma (HNSCC) cells. Since tyrosine phosphorylation of the focal adhesion proteins paxillin and FAK is indicative of more stable focal adhesions, cells were immunostained for phosphotyrosine plus either paxillin or FAK, and then examined by confocal microscopy. In non-malignant keratinocytes, phosphotyrosine staining co-localized with paxillin and FAK. This co-localization occurred at the cell periphery in a pattern resembling focal adhesions. In contrast, the co-localization of phosphotyrosine with either paxillin or FAK along the cell periphery was almost absent in the SCC cells or in keratinocytes that were treated with okadaic acid to inhibit PP-2A activity. Consistent with this was a rounded cellular morphology with less extended processes as compared to control keratinocytes. These studies indicate PP-2A maintains the organization and tyro si ne-phosphorylated state of the focal adhesion proteins FAK and paxillin, and that the loss of PP-2A activity results in a loss of cytoskeletal organization, as is seen in SCC. C1 Loyola Univ, Stritch Sch Med, Dept Otolaryngol, Maywood, IL 60153 USA. Ralph H Johnson VA Med Ctr, Res Serv, Dept Otolaryngol, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Otolaryngol, Charleston, SC 29425 USA. RP Young, MRI (reprint author), Ralph H Johnson VA Med Ctr, Res Serv 151, 109 Bee St, Charleston, SC 29401 USA. EM rita.young@med.va.gov FU NCI NIH HHS [CA45080, CA85266, CA79768] NR 25 TC 13 Z9 13 U1 0 U2 2 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0262-0898 J9 CLIN EXP METASTAS JI Clin. Exp. Metastasis PY 2004 VL 21 IS 4 BP 371 EP 379 DI 10.1023/B:CLIN.0000046178.08043.f8 PG 9 WC Oncology SC Oncology GA 869ND UT WOS:000224990400011 PM 15554394 ER PT J AU Suarez-Cuervo, C Merrell, MA Watson, L Harris, KW Rosenthal, EL Vaananen, HK Selander, K AF Suarez-Cuervo, C Merrell, MA Watson, L Harris, KW Rosenthal, EL Vaananen, HK Selander, K TI Breast cancer cells with inhibition of p38 alpha have decreased MMP-9 activity and exhibit decreased bone metastasis in mice SO CLINICAL & EXPERIMENTAL METASTASIS LA English DT Article DE bone metastasis; breast cancer; MMP-9; motility; p38 alpha; urokinase plasminogen activator ID ACTIVATED PROTEIN-KINASE; UROKINASE PLASMINOGEN-ACTIVATOR; ENDOTHELIAL GROWTH-FACTOR; MESSENGER-RNA STABILITY; P38 MAPK PATHWAY; TRANSFORMING GROWTH-FACTOR-BETA-1; MATRIX METALLOPROTEINASES; SUPPRESSOR GENE; UP-REGULATION; EXPRESSION AB p38 belongs to a family of mitogen-activated protein kinases, which transfer extracellular signals into intracellular responses. p38 is also frequently detected in clinical breast cancer specimens, but its role as a prognostic factor is not known. Of the various p38 isoforms, p38alpha has been shown to mediate the in vitro invasiveness of breast cancer cells through up-regulation of urokinase plasminogen activator (uPA). We studied the role of p38alpha in breast cancer bone metastases, using dominant negative blockade approach. Human MDA-MB-231 breast cancer clones stably expressing dominant negative p38alpha (p38/AF) exhibited decreased basal MMP-9 activity. TGF-beta(1)-induced MMP-9 activity was also blunted in these clones, as compared with controls in which TGF-beta(1) up-regulated MMP-9 activity. Consistent with these findings, SB202190, a specific p38 inhibitor, also inhibited TGF-beta(1)-induced MMP-9 activity in parental cells. The p38/AF clones exhibited also reduced uPA production after growth on vitronectin and decreased cell motility, as compared with controls. VEGF production levels in all the studied clones were similar. The p38/AF clone, which had similar in vitro growth rate as the control pcDNA3 clone, formed significantly less bone metastases in a mouse model, as compared with the control clone. In conclusion, inhibition of the p38alpha pathway results in decreased MMP-9 activity, impaired uPA expression and decreased motility, all of which may contribute to the decreased formation of bone metastasis. C1 Univ Alabama, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA. Univ Alabama, Div Otolaryngol, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Turku, Dept Anat, Inst Biomed, SF-20500 Turku, Finland. RP Selander, K (reprint author), Univ Alabama, Dept Med, Div Hematol Oncol, WTI T558,1824 6th Ave S, Birmingham, AL 35294 USA. EM katri.selander@ccc.uab.edu FU NCI NIH HHS [P50 CA 89019] NR 49 TC 38 Z9 44 U1 0 U2 3 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0262-0898 J9 CLIN EXP METASTAS JI Clin. Exp. Metastasis PY 2004 VL 21 IS 6 BP 525 EP 533 DI 10.1007/s10585-004-3503-x PG 9 WC Oncology SC Oncology GA 884TC UT WOS:000226108100006 PM 15679050 ER PT J AU Giordano, TP Soini, H Teeter, LD Adams, GJ Musser, JM Graviss, EA AF Giordano, TP Soini, H Teeter, LD Adams, GJ Musser, JM Graviss, EA TI Relating the size of molecularly defined clusters of tuberculosis to the duration of symptoms SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 38th Annual Meeting of the Infectious-Diseases-Society-of-America CY SEP 06-11, 2000 CL NEW ORLEANS, LOUISIANA SP Infect Dis Soc Amer ID NEW-YORK-CITY; DRUG-RESISTANT TUBERCULOSIS; MYCOBACTERIUM-TUBERCULOSIS; NOSOCOMIAL TRANSMISSION; SAN-FRANCISCO; OUTBREAK; EPIDEMIOLOGY; STRAIN; POPULATION; VIRULENT AB Molecular profiling of Mycobacterium tuberculosis isolates has improved recognition of tuberculosis case clusters, but the determinants of cluster size are unknown. We hypothesized that longer duration of symptoms prior to initiation of tuberculosis therapy would be associated with increased cluster size. All patients with tuberculosis in Harris County, Texas, identified between 10/1/95 and 12/31/97 through a prospective population-based project were interviewed, had their medical records reviewed, and had M. tuberculosis isolates molecularly characterized. There were 506 symptomatic, evaluable patients in 74 clusters, ranging in size from 2 patients (32 clusters) to 61 patients (1 cluster). The median duration of symptoms was 46 days (range, 1-471 days). There was no association between the log-transformed duration of symptoms and cluster size in univariate or multivariate analysis. In multivariate analysis, age and HIV coinfection were inversely related to cluster size, but only weakly. The size of molecularly defined clusters of tuberculosis was not related to the duration of symptoms of most patients who belonged to clusters. C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Dept Psychiat, Houston, TX 77030 USA. NIAID, Rocky Mt Labs, NIH, Hamilton, MT 59840 USA. RP Giordano, TP (reprint author), Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. FU NIAID NIH HHS [N01-AO-02738, 5T32AI07456-10]; NIMH NIH HHS [1K23MH67505-01] NR 35 TC 7 Z9 7 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JAN 1 PY 2004 VL 38 IS 1 BP 10 EP 16 DI 10.1086/380454 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 754PF UT WOS:000187325000002 PM 14679442 ER PT J AU Lipsky, BA Itani, K Norden, C AF Lipsky, BA Itani, K Norden, C CA Linezolid Diabet Foot Infect Study TI Treating foot infections in diabetic patients: A randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/amoxicillin-clavulanate SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 40th Annual Meeting of the Infectious-Diseases-Society-of-America CY OCT 24-27, 2002 CL CHICAGO, ILLINOIS SP Infectious Dis Soc Amer ID RESISTANT STAPHYLOCOCCUS-AUREUS; PERIPHERAL VASCULAR-DISEASE; LOWER-EXTREMITY INFECTIONS; THERAPY; EPIDEMIOLOGY; MELLITUS; CIPROFLOXACIN; PENETRATION; PNU-100766; VANCOMYCIN AB Foot infections in diabetic patients are predominantly caused by gram-positive cocci, many of which are now antibiotic resistant. Because linezolid is active against these pathogens, we compared the efficacy and safety of intravenous and oral formulations with that of intravenous ampicillin-sulbactam and intravenous and oral amoxicillin-clavulanate given for 7-28 days in a randomized, open-label, multicenter study of all types of foot infection in diabetic patients ( ratio of linezolid to comparator drug recipients, 2: 1). Among 371 patients, the clinical cure rates associated with linezolid and the comparators were statistically equivalent overall (81% vs. 71%, respectively) but were significantly higher for linezolid-treated patients with infected foot ulcers (81% vs. 68%;) and for patients without osteomyelitis (87% vs. 72%; P = .03). Cure rates were comparable for inpatients and outpatients and for both oral and intravenous formulations. Drug-related adverse events were significantly more common in the linezolid group, but they were generally mild and reversible. Linezolid was at least as effective as aminopenicillin/beta-lactamase inhibitors for treating foot infections in diabetic patients. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Antibiot Res Clin, Seattle, WA 98108 USA. Vet Affairs Med Ctr, Dept Gen Surg, Houston, TX 77030 USA. Pfizer Inc, Peapack, NJ USA. RP Lipsky, BA (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Antibiot Res Clin, S-111-GIMC,1660 S Columbian Wy, Seattle, WA 98108 USA. OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 30 TC 159 Z9 165 U1 1 U2 12 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JAN 1 PY 2004 VL 38 IS 1 BP 17 EP 24 DI 10.1086/380449 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 754PF UT WOS:000187325000003 PM 14679443 ER PT J AU Uribarri, J Prabhakar, S Kahn, T AF Uribarri, J Prabhakar, S Kahn, T TI Hyponatremia in peritoneal dialysis patients SO CLINICAL NEPHROLOGY LA English DT Article DE hyponatremia; peritoneal dialysis; sodium dialysate loss; salt intake ID REMOVAL; SODIUM; FLUID; CAPD AB Background: Low serum sodium is uncommon. m peritoneal dialysis (PD), which is surprising in view of the important role of normal kidney function to regulate water and sodium balance. Methods: We report 2 cases of persistent hyponatremia with balance studies in Case 1. We performed measurements of dialysate sodium and volume output over 24 hours in a group of chronic PD patients. Results: The low serum sodium concentration did not vary too much with overall fluid removal via dialysis in patient 1, mainly because large quantities of sodium were removed in the dialysate. In the 24-hour studies, a significant relationship was found between net daily PD sodium removal and net daily dialysate volume removed (r=0.65). There was no relationship between net daily PD sodium removal and serum sodium concentration. There was a linear direct correlation between serum and dialysate sodium concentration (r=0.8) as shown by others previously. Conclusions: These results suggest that the main determinant of PD sodium loss is net dialysate ultrafiltration volume. Water loss via dialysis is necessarily associated with sodium loss. In order to maintain a normal serum sodium concentration salt intake must be proportional to the water loss induced by dialysis. The stimuli that allow dialysis patients to maintain this delicate balance between water and salt intake are of considerable interest but remain undetermined. C1 Mt Sinai Sch Med, Div Renal, New York, NY USA. Texas Tech Univ, Hlth Sci Ctr, Div Renal, Lubbock, TX 79430 USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. RP Uribarri, J (reprint author), Mt Sinai Med Ctr, 1 Gustave Levy Pl, New York, NY 10029 USA. EM jaime.uribarri@mssm.edu NR 10 TC 2 Z9 2 U1 0 U2 1 PU DUSTRI-VERLAG DR KARL FEISTLE PI OBERHACHING PA BAJUWARENRING 4, D-82041 OBERHACHING, GERMANY SN 0301-0430 J9 CLIN NEPHROL JI Clin. Nephrol. PD JAN PY 2004 VL 61 IS 1 BP 54 EP 58 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 762YD UT WOS:000188030700008 PM 14964458 ER PT J AU Montoya, ID Gorelick, DA Preston, KL Schroeder, JR Umbricht, A Cheskin, LJ Lange, R Contoreggi, C Johnson, RE Fudala, PJ AF Montoya, ID Gorelick, DA Preston, KL Schroeder, JR Umbricht, A Cheskin, LJ Lange, R Contoreggi, C Johnson, RE Fudala, PJ TI Randomized trial of buprenorphine for treatment of concurrent opiate and cocaine dependence SO CLINICAL PHARMACOLOGY & THERAPEUTICS LA English DT Article ID METHADONE-MAINTENANCE TREATMENT; OPIOID DEPENDENCE; RHESUS-MONKEYS; CLINICAL-TRIAL; INTRAVENOUS COCAINE; MAINTAINED PATIENTS; ABUSE; USERS; IMPACT; HUMANS AB Background: Buprenorphine is a partial mu-opiate agonist and kappa-opiate antagonist with established efficacy in the treatment of opiate dependence. Its efficacy for cocaine dependence is uncertain. This study evaluated buprenorphine for the treatment of concomitant cocaine and opiate dependence. Methods: Two hundred outpatients currently dependent on both cocaine and opiates were randomly assigned to double-blind groups receiving a sublingual solution of buprenorphine (2, 8, or 16 mg daily, or 16 mg on alternate days, or placebo), plus weekly individual drug abuse counseling, for 13 weeks. The chief outcome measures were urine concentrations of opiate and cocaine metabolites (quantitative) and proportion of urine samples positive for opiates or cocaine (qualitative). Group differences were assessed by use of mixed regression modeling. Results: The target dose of buprenorphine was achieved in 179 subjects. Subjects receiving 8 or 16 mg buprenorphine daily showed statistically significant decreases in urine morphine levels (P = .0135 for 8 mg and P < .001 for 16 mg) or benzoylecgonine concentrations (P = .0277 for 8 mg and P = .006 for 16 mg) during the maintenance phase of the study. For the 16-mg group, mean benzoylecgonine concentrations fell from 3715 ng/mL during baseline to 186 ng/mL during the withdrawal phase; mean morphine concentrations fell from 3311 ng/mL during baseline to 263 ng/mL during withdrawal. For the 8-mg group, mean benzoylecgonine concentrations fell from 6761 ng/mL during baseline to 676 ng/mL during withdrawal; mean morphine concentrations fell from 3890 ng/mL during baseline to 661 ng/mL during withdrawal. Qualitative urinalysis showed a similar pattern of results. Subjects receiving the highest dose showed concomitant decreases in both urine morphine and benzoylecgonine concentrations. There were no significant group differences in treatment retention or adverse events. Conclusions: A sublingual buprenorphine solution at 16 mg daily is well tolerated and effective in reducing concomitant opiate and cocaine use. The therapeutic effect on cocaine use appears independent of that on opiate use. C1 NIDA, Intramural Res Program, NIH, Dept Hlth & Human Serv, Baltimore, MD 21224 USA. NIDA, Div Treatment Res & Dev, NIH, Dept Hlth & Human Serv, Baltimore, MD 21224 USA. Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA. Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA USA. RP Gorelick, DA (reprint author), NIDA, Intramural Res Program, NIH, Dept Hlth & Human Serv, 5500 Nathan Shock Dr, Baltimore, MD 21224 USA. EM dgorelic@intra.nida.nih.gov RI Preston, Kenzie/J-5830-2013 OI Preston, Kenzie/0000-0003-0603-2479 FU Intramural NIH HHS [Z99 DA999999] NR 51 TC 80 Z9 81 U1 1 U2 4 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0009-9236 J9 CLIN PHARMACOL THER JI Clin. Pharmacol. Ther. PD JAN PY 2004 VL 75 IS 1 BP 34 EP 48 DI 10.1016/j.clpt.2003.09.004 PG 15 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 765YJ UT WOS:000188318400003 PM 14749690 ER PT J AU Behnam, K Brochmann, EJ Murray, SS AF Behnam, K Brochmann, EJ Murray, SS TI Alkali-urea extraction of demineralized bone matrix removes noggin, an inhibitor of bone morphogenetic proteins SO CONNECTIVE TISSUE RESEARCH LA English DT Article DE bone; bone morphogenetic proteins; noggin; osteogenesis ID VENTRALIZING FACTOR; SPEMANN ORGANIZER; XENOPUS MESODERM; INDUCTION; OSSIFICATION; MUTATIONS; CHORDIN; GENE AB Demineralized bone matrix (DBM) and native bone morphogenetic protein (nBMP) are complex mixtures of non-collagenous bone proteins. These mixtures contain many of the BMPs that are available as recombinant molecules. Information regarding the presence in these materials of molecules that may affect the availability and activity of the BMPs is very limited. We have devised a simple chemical extraction of DBM using alkali-urea that produces a water soluble extractate that inhibits the osteogenic activity of DBM. We have demonstrated the presence of noggin, an extracellular BMP ligand antagonist, in this material. We conclude that differential chemical extraction may be a useful means of removing inhibitory molecules from DBM and nBMP. C1 Univ Calif Los Angeles, Dept Physiol Sci, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst, Sepulveda Ambulatory Care Ctr & Nursing Home, Geriatr Res Educ & Clin Ctr, Sepulveda, CA USA. RP Murray, SS (reprint author), Vet Adm Med Ctr, GRECC 11E, 16111 Plummer St, Sepulveda, CA 91343 USA. EM murrayes@ucla.edu NR 21 TC 5 Z9 5 U1 0 U2 1 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 0300-8207 J9 CONNECT TISSUE RES JI Connect. Tissue Res. PY 2004 VL 45 IS 4-5 BP 257 EP 260 DI 10.1080/03008200490903048 PG 4 WC Cell Biology; Orthopedics SC Cell Biology; Orthopedics GA 897XX UT WOS:000227041300008 PM 15763935 ER PT J AU Watson, D Grover, R Anzueto, A Lorente, J Smithies, M Bellomo, R Guntupalli, K Grossman, S Donaldson, J Le Gall, JR AF Watson, D Grover, R Anzueto, A Lorente, J Smithies, M Bellomo, R Guntupalli, K Grossman, S Donaldson, J Le Gall, JR CA Glaxo Wellcome Int Septic Shock St TI Cardiovascular effects of the nitric oxide synthase inhibitor N-G-methyl-L-arginine hydrochloride (546C88) in patients with septic shock: Results of a randomized, double-blind, placebo-controlled multicenter study (study no. 144-002) SO CRITICAL CARE MEDICINE LA English DT Article DE human; severe sepsis; septic shock; nitric oxide; nitric oxide synthase inhibitor; N-G-methyl-L-arginine hydrochloride; randomized; placebo-controlled trial; norepinephrine; dopamine; dobutamine; arginine; nitrate; hemodynamics ID IMPROVES SURVIVAL; SEPSIS SYNDROME; CLINICAL-TRIAL; DYSFUNCTION; PRESSURE; HUMANS; INVIVO; MODEL AB Objective: To assess the hemodynamic effects of the nitric oxide synthase inhibitor 546C88 in patients with septic shock, although this was not a stated aim of the protocol. The predefined primary efficacy objective of the protocol was resolution of shock determined at the end of a 72-hr treatment period. Design: Multicentered, randomized, placebo-controlled, safety and efficacy study. Setting. Forty-eight intensive care units in Europe, North America, and Australia. Patients: A total of 312 patients with septic shock diagnosed within 24 hr before randomization. Interventions: Patients were randomly allocated to receive either 546C88 or placebo (5% dextrose) by intravenous infusion for up to 72 hrs. Conventional vasoactive therapy was restricted to norepinephrine, dopamine, and dobutamine. Study drug was initiated at 0.1 mL/kg/hr (5 mg/kg/hr 546C88) and titrated according to response up to a maximum rate of 0.4 mL/kg/hr with the objective to maintain mean arterial pressure at 70 mm Hg while attempting to withdraw any concurrent vasopressor(s). Measurements and Main Results: Requirement for vasopressors, systemic and pulmonary hemodynamics, indices of oxygen transport, and plasma concentrations of arginine and nitrate were assessed over time. The median mean arterial pressure for both groups was maintained greater than or equal to70 mm Hg. There was an early increase in systemic and pulmonary vascular tone and oxygen extraction, whereas both cardiac index and oxygen delivery decreased for patients in the 546C88 cohort. Although these parameters subsequently returned toward baseline values, the observed differences between the treatment groups, except for pulmonary vascular resistance and oxygen extraction, persisted throughout the treatment period, despite a reduced requirement for vasopressors in the 546C88 cohort. These changes were associaled with a reduction in plasma nitrate concentrations, which were elevated in both groups before the start of therapy. Conclusions. The nitric oxide synthase inhibitor 546C88 can reduce the elevated plasma nitrate concentrations observed in patients with septic shock. In this study, treatment with 546C88 for up to 72 hrs was associated with an increase in vascular tone and a reduction in both cardiac index and oxygen delivery. The successful maintenance of a target mean arterial blood pressure :70 mm Hg was achieved with a reduction in the requirement for, or withdrawal of, conventional inotropic vasoconstrictor agents (i.e., dopamine and norepinephrine). There were no substantive untoward consequences accompanying these hemodynamic effects. An international, randomized, double-blind, placebo-controlled phase III study has since been conducted in patients with septic shock. Recruitment into the study was discontinued due to the emergence of increased mortality in the 546C88-treated group. C1 Hop St Louis, Dept Intens Care, Paris, France. Homerton Hosp, Dept Intens Care, London, England. Glaxo Wellcome Res & Dev Ltd, Int Dept Cardiovasc Crit Care & Anesthesia Clin D, Greenford, Middx, England. Audie L Murphy Mem Vet Adm Med Ctr, Dept Med Intens Care, San Antonio, TX 78284 USA. Hop Getafe, Dept Intens Care, Madrid, Spain. Univ Wales Hosp, Intens Care Unit, Cardiff CF4 4XW, S Glam, Wales. Austin Med Ctr, Dept Intens Care, Melbourne, Vic, Australia. Ben Taub Gen Hosp, Dept Med Intens Care, Houston, TX 77030 USA. RP Le Gall, JR (reprint author), Hop St Louis, Dept Intens Care, Paris, France. NR 25 TC 70 Z9 73 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD JAN PY 2004 VL 32 IS 1 BP 13 EP 20 DI 10.1097/01.CCM.0000104209.07273.FC PG 8 WC Critical Care Medicine SC General & Internal Medicine GA 765YN UT WOS:000188318800002 PM 14707555 ER PT J AU Lopez, A Lorente, JA Steingrub, J Bakker, J McLuckie, A Willatts, S Brockway, M Anzueto, A Holzapfel, L Breen, D Silverman, MS Takala, J Donaldson, J Arneson, C Grove, G Grossman, S Grover, R AF Lopez, A Lorente, JA Steingrub, J Bakker, J McLuckie, A Willatts, S Brockway, M Anzueto, A Holzapfel, L Breen, D Silverman, MS Takala, J Donaldson, J Arneson, C Grove, G Grossman, S Grover, R TI Multiple-center, randomized, placebo-controlled, double-blind study of the nitric oxide synthase inhibitor 546C88: Effect on survival in patients with septic shock SO CRITICAL CARE MEDICINE LA English DT Article DE human; severe sepsis; septic shock; nitric oxide; nitric oxide synthase inhibitor; N-G-methyl-L-arginine hydrochloride; placebo-controlled study; norepinephrine; dopamine; dobutamine; nitrate; resolution of shock ID SMOOTH-MUSCLE CELLS; L-ARGININE PATHWAY; METHYL-L-ARGININE; SEPSIS SYNDROME; ENDOTOXIN; PATHOGENESIS; MECHANISMS; DISEASE; DOGS AB Objective: To assess the safety and efficacy of the nitric oxide synthase inhibitor 546C88 in patients with septic shock. The predefined primary efficacy objective was survival at day 28. Design: Multiple-center, randomized, two-stage, double-blind, placebo-controlled, safety and efficacy study. Setting: A total of 124 intensive care units in Europe, North America, South America, South Africa, and Australasia. Patients: A total of 797 patients with septic shock diagnosed for <24 hrs. Interventions: Patients with septic shock were allocated to receive 546C88 or placebo (5% dextrose) for up to 7 days (stage 1) or 14 days (stage 2) in addition to conventional therapy. Study drug was initiated at 0.05 mL(.)kg(-1.)hr(-1) (2.5 mg(.)kg(-1.)hr(-1) 546C88) and titrated up to a maximum rate of 0.4 mL(.)kg(-1.)hr(-1) to maintain mean arterial pressure between 70 and 90 mm Hg while attempting to withdraw concurrent vasopressors. Measurements and Main Results: Hemodynamic variables, organ function data, microbiological data, concomitant therapy, and adverse event data were recorded at baseline, throughout treatment, and at follow-up. The primary end point was day-28 survival. The trial was stopped early after review by the independent data safety monitoring board. Day-28 mortality was 59% (259/439) in the 546C88 group and 49% (174/358) in the placebo group (p < .001). The overall incidence of adverse events was similar in both groups, although a higher proportion of the events was considered possibly attributable to study drug in the 546C88 group. Most of the events accounting for the disparity between the groups were associated with the cardiovascular system (e.g., decreased cardiac output, pulmonary hypertension, systemic arterial hypertension, heart failure). The causes of death in the study were consistent with those expected in patients with septic shock, although there was a higher proportion of cardiovascular deaths and a lower incidence of deaths caused by multiple organ failure in the 546C88 group. Conclusions: In this study, the nonselective nitric oxide synthase inhibitor 546C88 increased mortality in patients with septic shock. C1 Hosp Infanta Cristinam, Badajoz, Spain. Hosp Getafe, Madrid, Spain. Baystate Med Ctr, Crit Care Sect, Springfield, MA USA. Tufts Univ, Sch Med, Boston, MA 02111 USA. Ziekenhuisctr Apeldoorn, Afdeling Intens Care, Apeldoorn, Netherlands. Guys Hosp, Intens Care Unit, London SE1 9RT, England. Bristol Royal Infirm & Gen Hosp, Bristol BS2 8HW, Avon, England. St Johns Hosp, Livingston EH54 6PP, W Lothian, Scotland. Audie L Murphy Mem Vet Adm Med Ctr, Pulm Dis Sect, San Antonio, TX 78284 USA. SAMU, Serv Reanimat Urgences, Hop Fleyriat, Bourg en Bresse, France. Royal Hallamshire Hosp, Sheffield S10 2JF, S Yorkshire, England. Oshawa Gen Hosp, Oshawa, ON, Canada. Kuopio Univ Hosp, Intens Care Unit, SF-70210 Kuopio, Finland. Glaxo Wellcome Inc, Greenford, Middx, England. Glaxo Wellcome Inc, Res Triangle Pk, NC 27709 USA. RP Lopez, A (reprint author), Hosp Infanta Cristinam, Badajoz, Spain. RI Bakker, Jan/A-4011-2009; Silverman, Michael/J-3776-2014 OI Bakker, Jan/0000-0003-2236-7391; Silverman, Michael/0000-0002-0389-7656 NR 30 TC 437 Z9 455 U1 0 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD JAN PY 2004 VL 32 IS 1 BP 21 EP 30 DI 10.1097/01.CCM.0000105581.01815.C6 PG 10 WC Critical Care Medicine SC General & Internal Medicine GA 765YN UT WOS:000188318800003 PM 14707556 ER PT J AU Duda, JE AF Duda, JE TI Pathology and neurotransmitter abnormalities of dementia with Lewy bodies SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Review DE dementia with Lewy bodies; neuropathology; alpha-synuclein; neurotransmitters ID SLEEP BEHAVIOR DISORDER; ANTI-UBIQUITIN IMMUNOCYTOCHEMISTRY; NICOTINIC ACETYLCHOLINE-RECEPTORS; ALPHA-SYNUCLEIN IMMUNOREACTIVITY; SPORADIC ALZHEIMERS-DISEASE; PURE AUTONOMIC FAILURE; PARKINSONS-DISEASE; BODY DISEASE; CHOLINERGIC DYSFUNCTION; PROGRESSIVE DEMENTIA AB The neuropathology of dementia with Lewy bodies (DLB) is characterized by the presence of Lewy bodies (LBs) and Lewy neurites (LNs) in specific systems throughout the brainstem, diencephalon, basal ganglia and neocortex. DLB shares many features with Parkinson's disease (PD) with respect to LB distribution in the brainstem, and there is recent evidence that Lewy pathology (LP), which consists of LBs and LNs, may progress in a systematic fashion through the brain regardless of clinical phenotype. Increasing evidence supports a central role for LNs in Lewy neurodegeneration and engenders a 'neuritic dystrophy hypothesis' described herein. LP formation also occurs in Alzheimer's disease (AD) and other dementias, and it is unclear whether there is a common underlying pathophysiology in these diseases or if the LP merely represents a common final pathway. Cholinergic deficits are evident in both DLB and AD, with reductions in acetylcholine and abnormalities in nicotinic and muscarinic receptor expression in both diseases. Cholinergic deficits are greater in DLB than in AD, although generally there is less brain atrophy in DLB. The lower neurodegeneration and preservation of cholinergic receptors in DLB has important therapeutic implications because patients with DLB (vs. AD) may receive greater benefits from cholinergic pharmacologic therapy. Patients with DLB who display parkinsonian signs have severe dopamine neurotransmitter deficiencies similar to those in patients with PD, although the manifestation of these deficiencies is different. Both groups have striatal dopamine transporter deficiencies, but the striatal dopamine D2 receptors are reduced in DLB patients compared with PD and control subjects. D2 receptor deficiencies in DLB may be the cause of the relative lack of response to levodopa treatment and the severe adverse reaction to neuroleptics in these patients. Copyright (C) 2004 S. Karger AG, Basel. C1 Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. RP Duda, JE (reprint author), Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, 3900 Woodland Ave, Philadelphia, PA 19104 USA. NR 102 TC 37 Z9 40 U1 2 U2 9 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2004 VL 17 SU 1 BP 3 EP 14 DI 10.1159/000074677 PG 12 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 754DD UT WOS:000187286700002 PM 14676464 ER PT J AU Sultzer, DL AF Sultzer, DL TI Psychosis and antipsychotic medications in Alzheimer's disease: Clinical management and research perspectives SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE Alzheimer's disease; psychosis; treatment; antipsychotic medications ID PLACEBO-CONTROLLED-TRIAL; SEROTONIN REUPTAKE INHIBITORS; NURSING-HOME PATIENTS; BEHAVIORAL DISTURBANCES; PARKINSONS-DISEASE; DOUBLE-BLIND; LEWY BODIES; NEUROPSYCHIATRIC SYMPTOMS; GENETIC-VARIATION; RANDOMIZED TRIAL AB Psychosis is common in patients with Alzheimer's disease (AD) and contributes substantially to patient morbidity and caregiver distress. Antipsychotic medications are used to treat psychosis and other psychiatric or behavioral symptoms in AD, although optimal treatment guidelines have been elusive. Choosing the most advantageous medication for an individual patient is challenging. This article provides an overview of clinical management principles and medication treatment strategies for patients with AD and psychosis. Effects of individual medications are also described. Medications in the conventional neuroleptic, atypical antipsychotic, cholinesterase inhibitor, and serotonergic classes have been shown to ameliorate psychosis and behavioral symptoms in patients with AD, although the evidence is not conclusive for many medications. Side effects vary substantially across medication classes and modestly among individual patients. Improvement in agitation, aggression, or other behaviors with antipsychotic medication treatment may not depend on distinct antipsychotic effects. In contrast, there is preliminary evidence that delusions and hallucinations may respond to treatment with medications outside the antipsychotic class. Many important clinical questions warrant further research study. In particular, studies to compare how individual symptoms respond to different medications, and to examine how to best manage overlapping symptoms or incomplete treatment response are needed. Copyright (C) 2004 S. Karger AG, Basel. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Gero Neuropsychiat Div, Los Angeles, CA 90073 USA. RP Sultzer, DL (reprint author), Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, 3 South,116AF,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIMH NIH HHS [MH56031] NR 88 TC 15 Z9 15 U1 1 U2 3 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2004 VL 17 IS 1-2 BP 78 EP 90 DI 10.1159/000074279 PG 13 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 747XY UT WOS:000186832600012 PM 14566100 ER PT J AU Li, XB Nahas, Z Anderson, B Kozel, EA George, MS AF Li, XB Nahas, Z Anderson, B Kozel, EA George, MS TI Can left prefrontal rTMS be used as a maintenance treatment for bipolar depression? SO DEPRESSION AND ANXIETY LA English DT Article ID TRANSCRANIAL MAGNETIC STIMULATION; RATING-SCALE; TMS AB Numerous studies have examined the acute antidepressant effects of prefrontal transcranial magnetic stimulation (TMS). However, there is little information on whether TMS can be used as a maintenance treatment to maintain normal mood once subjects have responded. We describe seven adults with bipolar depression who responded acutely to TMS and were then treated with TMS weekly for up to 1 year. TMS was carried out over the left prefrontal cortex at 110% motor threshold, 5 Hz for 8 s for 40 trains. Three subjects completed 1 full year of weekly TMS with an average Hamilton Rating Scale for Depression of 13 (sd = 5.9) over the year. These data suggest but do not prove that TMS might eventually be used as an adjunctive maintenance treatment for at least some patients with bipolar depression. Much work remains. (C) 2004 Wiley-Liss, Inc. C1 Med Univ S Carolina, Inst Psychiat, Brain Stimulat Lab, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Li, XB (reprint author), Med Univ S Carolina, Inst Psychiat, Brain Stimulat Lab, 67 President St,Room 502 N,POB 250861, Charleston, SC 29425 USA. EM lixi@musc.edu NR 6 TC 52 Z9 53 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1091-4269 J9 DEPRESS ANXIETY JI Depress. Anxiety PY 2004 VL 20 IS 2 BP 98 EP 100 DI 10.1002/da.20027 PG 3 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 865ZF UT WOS:000224742000007 PM 15390210 ER PT J AU Chen, HH Nicoletti, M Sanches, M Hatch, JP Sassi, RB Axelson, D Brambilla, P Keshavan, MS Ryan, N Birmaher, B Soares, JC AF Chen, HH Nicoletti, M Sanches, M Hatch, JP Sassi, RB Axelson, D Brambilla, P Keshavan, MS Ryan, N Birmaher, B Soares, JC TI Normal pituitary volumes in children and adolescents with bipolar disorder: A magnetic resonance imaging study SO DEPRESSION AND ANXIETY LA English DT Article DE magnetic resonance imaging; bipolar disorder; pituitary; adolescents ID MAJOR DEPRESSION; GLAND; AGE; CORTISOL AB The volume of the pituitary gland in adults with bipolar disorder has previously been reported to be smaller than that of healthy controls. Such abnormalities would be consistent with the HPA dysfunction reported in this illness. We conducted a study of children and adolescents with bipolar disorder to determine whether size abnormalities in the pituitary gland are already present early in illness course. Magnetic resonance imaging (MRI) morphometric analysis of the pituitary gland was carried out in 16 DSM-IV children and adolescents with bipolar disorder (mean age +/- sd = 15.5 +/- 3.4 years) and 21 healthy controls (mean age +/- sd = 16.9 +/- 3. 8 years). Subjects underwent a 1.5 T MRI, with 3-D Spoiled Gradient Recalled (SPGR) acquisition. There was no statistically significant difference between pituitary gland volumes of bipolar patients compared to healthy controls (ANCOVA, age, gender, and ICV as covariates; F = 1.77, df = 1,32, P = .19). There was a statistically significant direct relationship between age and pituitary gland volume in both groups (r =. 59, df = 17, P = .007 for healthy controls; r = .61, df = 12, P = .008 for bipolar patients). No evidence of size abnormalities in the pituitary gland was found in child and adolescent bipolar patients, contrary to reports involving adult bipolar patients. This suggests that anatomical abnormalities in this structure may develop later in illness course as a result of continued HPA dysfunction. Depression and Anxiety 20:182-186, 2004. (C) 2005 Wiley-Liss, Inc. C1 Univ Texas, Hlth Sci Ctr, Div Mood & Anxiety Disorders, Dept Psychait, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX USA. Audie L Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo, Brazil. Univ Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo, Brazil. Univ Pittsburgh, Ctr Med, Dept Psychiat, Pittsburgh, PA USA. Univ Udine, Sect Psychiat, Dept Pathol & Expt & Clin Med, Udine, Italy. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Div Mood & Anxiety Disorders, Dept Psychait, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI brambilla, paolo/B-4184-2010 OI brambilla, paolo/0000-0002-4021-8456 FU NIMH NIH HHS [MH 01736, MH 30915, MH 55123, MH 59929] NR 21 TC 27 Z9 27 U1 2 U2 3 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1091-4269 J9 DEPRESS ANXIETY JI Depress. Anxiety PY 2004 VL 20 IS 4 BP 182 EP 186 DI 10.1002/da.20044 PG 5 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 891XI UT WOS:000226613900004 PM 15643632 ER PT J AU McNeely, MJ Boyko, EJ AF McNeely, MJ Boyko, EJ TI Type 2 diabetes prevalence in Asian Americans SO DIABETES CARE LA English DT Article ID IMPAIRED GLUCOSE-TOLERANCE; FASTING GLUCOSE; RISK; MELLITUS; COHORTS; HEALTH AB OBJECTIVE - Asians are thought to be at high risk for diabetes, yet there is little population-based information about diabetes in Asian Americans. The purpose of this study was to directly compare the prevalence of type 2 diabetes in Asian Americans with other racial and ethnic groups in the U.S. using data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS). RESEARCH DESIGN AND METHODS - The BRFSS is a population-based telephone survey of the health status and health behaviors of Americans in all 50 states, Guam, Puerto Rico, and the U.S. Virgin Islands. Subjects included 3,071 Asians, 12,561 blacks, 12,153 Hispanics, 2,299 Native Americans, 626 Pacific Islanders, and 129,116 non-Hispanic whites aged greater than or equal to30 years. Subjects who reported a physician-diagnosis of diabetes were considered to have type 2 diabetes unless they were diagnosed before age 30. RESULTS - Compared with whites, odds ratios (95% CIS) for diabetes, adjusted for age and sex, were 1.0 (0.7-1.4) for Asians, 2.3 (2.1-2.6) for blacks, 2.0 (1.8-2.3) for Hispanics, 2.2 (1.6-2.9) for Native Americans, and 3.1 (1.4-6.8) for Pacific Islanders. Results adjusted for BMI, age, and sex were 1.6 (1.2-2.3) for Asians, 1.9 (1.7-2.2) for blacks, 1.9 (1.6-2.1) for Hispanics, 1.8 (1.3-2.5) for Native Americans, and 3.0 (1.4-6.7) for Pacific Islanders. CONCLUSIONS - Similar proportions of Asian and non-Hispanic white Americans report having diabetes, but after accounting for the lower BMI of Asians, the adjusted prevalence of diabetes is 60% higher in Asian Americans. C1 Univ Washington, Div Internal Med, Dept Med, Seattle, WA 98105 USA. Vet Affairs Puget Sound Hlth Care Syst, Vet Affairs Epidemiol Res & Informat Ctr, Seattle, WA USA. RP McNeely, MJ (reprint author), Univ Washington, Div Internal Med, Dept Med, 4311 11th Ave NE,Suite 230, Seattle, WA 98105 USA. NR 19 TC 155 Z9 158 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JAN PY 2004 VL 27 IS 1 BP 66 EP 69 DI 10.2337/diacare.27.1.66 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 758JX UT WOS:000187632200013 PM 14693968 ER PT J AU Gopal, DV Reichelderfer, M Gaumnitz, EA Harter, J Jobe, BA AF Gopal, DV Reichelderfer, M Gaumnitz, EA Harter, J Jobe, BA TI Barrett's Esophagus - Is screening and surveillance justified? SO DISEASE MANAGEMENT & HEALTH OUTCOMES LA English DT Article ID GASTROESOPHAGEAL-REFLUX DISEASE; ENDOSCOPIC SURVEILLANCE; OBSERVER VARIATION; PRACTICE PATTERNS; CANCER-RISK; ADENOCARCINOMA; DYSPLASIA; DIAGNOSIS; CHEMOPREVENTION; PREVALENCE AB Barrett's esophagus is a condition that develops in approximately 10-15% of patients with chronic gastroesophageal reflux disease and is the only known major risk factor for esophageal adenocarcinoma. The incidence of esophageal adenocarcinoma has increased by 350% over the last 3 decades and the reasons for this dramatic increase are unclear. At the time of cancer diagnosis up to 50% of patients will have advanced regional or distant metastatic disease, with little or no chance of cure. The overall 5-year survival rate with advanced disease remains poor at <10%. Several studies have demonstrated an early stage of diagnosis and a marked improvement in the survival of patients with esophageal cancer detected by routine endoscopic surveillance in patients known to have pre-existing Barrett's esophagus. The aim of endoscopic surveillance in patients with Barrett's esophagus is the early diagnosis of esophageal cancer, when it is still potentially curable. The desired outcome is to further decrease the mortality rate associated with esophageal adenocarcinoma and identify and screen populations at risk for the development of dysplasia arising from Barrett's esophagus. This is the principle of the current screening and surveillance guidelines set out by several societies, including the American College of Gastroenterology, the American Society of Gastrointestinal Endoscopy, and the European Society of Gastrointestinal Endoscopy. However, as most patients with Barrett's esophagus do not develop adenocarcinoma, the cost effectiveness of endoscopic screening and surveillance strategies is questionable. To date, no prospective, randomized trials have been performed to evaluate the effectiveness of surveillance, the survival benefit in patients undergoing surveillance or the subsequent impact on healthcare costs. In this article, we focus on the basic principles and reasoning underlying the surveillance guidelines for Barrett's esophagus. In particular, that the disease is clinically important and has a high prevalence; the transition to adenocarcinoma could have a high death and/or disability rate; early diagnosis of adenocarcinoma should reduce mortality; and the screening method should be easily applied, safe, relatively inexpensive, and applicable to a large number of patients. We then review arguments for and against screening and surveillance as they apply to these principles and discuss the current literature that reviews the effectiveness of such surveillance strategies, including an outline of cost analysis. C1 Univ Wisconsin Hosp & Clin, Sect Gastroenterol & Hepatol, Madison, WI 53792 USA. Univ Wisconsin Hosp & Clin, Dept Pathol & Lab Med, Madison, WI 53792 USA. Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. RP Gopal, DV (reprint author), Univ Wisconsin Hosp & Clin, Sect Gastroenterol & Hepatol, H6-516,600 Highland Ave, Madison, WI 53792 USA. EM dvg@medicine.wisc.edu NR 41 TC 2 Z9 2 U1 0 U2 1 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 1173-8790 J9 DIS MANAG HEALTH OUT JI Dis. Manag. Health Outcomes PY 2004 VL 12 IS 6 BP 353 EP 361 DI 10.2165/00115677-200412060-00002 PG 9 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 882SV UT WOS:000225959500001 ER PT S AU Yao, JK van Kammen, DP AF Yao, JK van Kammen, DP BE Smythies, J TI Membrane phospholipids and cytokine interaction in schizophrenia SO DISORDERS OF SYNAPTIC PLASTICITY AND SCHIZOPHRENIA SE International Review of Neurobiology LA English DT Review ID POLYUNSATURATED FATTY-ACIDS; MAGNETIC-RESONANCE-SPECTROSCOPY; SOLUBLE INTERLEUKIN-2 RECEPTORS; NITRIC-OXIDE SYNTHASE; PROTEIN-KINASE-C; INFLAMMATORY RESPONSE SYSTEM; MESSENGER-RNA EXPRESSION; EXCITOTOXIC CELL-DEATH; POSTMORTEM HUMAN BRAIN; ACUTE-PHASE PROTEINS C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Med Ctr, Dept Psychiat, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA 15213 USA. Aventis Inc, Bridgewater, NJ 08807 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Columbia Univ, Dept Psychiat, New York, NY 10032 USA. RP Yao, JK (reprint author), VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. FU NIMH NIH HHS [MH43742, MH44841, MH58141] NR 230 TC 39 Z9 41 U1 1 U2 3 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA SN 0074-7742 BN 0-12-366860-3 J9 INT REV NEUROBIOL JI Int. Rev. Neurobiol. PY 2004 VL 59 BP 297 EP 326 PG 30 WC Neurosciences SC Neurosciences & Neurology GA BY85B UT WOS:000189478200013 PM 15006493 ER PT J AU Rogers, SJ Willliams, CS Roman, GC AF Rogers, SJ Willliams, CS Roman, GC TI Myelopathy in Sjogren's syndrome - Role of nonsteroidal immunosuppressants SO DRUGS LA English DT Article ID NERVOUS-SYSTEM DISEASE; SYNDROME CNS-SS; ANTI-RO(SS-A) AUTOANTIBODIES; CLASSIFICATION CRITERIA; PREDNISONE; IMMUNOPATHOGENESIS; PATHOGENESIS; INVOLVEMENT; MANIFESTATIONS; AZATHIOPRINE AB The incidence, aetiology and optimal treatment of CNS Sjogren's syndrome, including myelopathy associated with Sjogren's syndrome, are unknown at the present time. CNS Sjogren's syndrome is thought to be the result of an autoimmune vasculitis, but other mechanisms may be important. Spinal cord involvement in CNS Sjogren's syndrome may present as acute transverse myelitis, progressive myelitis, Brown-Sequard syndrome, neurogenic bladder or lower motor neurone disease. Optic nerve pathology frequently accompanies spinal cord involvement. Acute transverse myelitis has a high mortality and appears to be the most frequent form of spinal cord involvement in CNS Sjogren's syndrome, occurring in about 1% of all patients with Sjogren's syndrome. The patient's symptomatology and clinical course dictate current treatment of myelopathy. First-line treatment appears to be corticosteroid therapy. However, when the patient's condition fails to improve or deteriorates a nonsteroidal immunosuppressant agent should be considered. Agents used to treat myelopathy include cyclophosphamide, chlorambucil, azathioprine, ciclosporin (cyclosporin) and methotrexate in conjunction with corticosteroids. Most data exist as anecdotal reports. The agent of first choice, based on adverse effect profile and efficacy, appears to be cyclophosphamide given intravenously in pulse doses. Other nonsteroidal immunosuppressant agents should be considered, especially when lack of efficacy of, or intolerance to, cyclophosphamide exists in the patient's history. Glandular and other extraglandular symptoms may benefit concomitantly from the immunosuppressant treatment. In addition, when acute relief of symptomatology is needed, the patient may benefit from a trial of plasmapheresis or intravenous immunoglobulin. Infliximab (anti-tumour necrosis factor-alpha antibodies) has not been used as a treatment modality for myelopathy, but has shown some usefulness in the treatment of extraglandular symptoms, as well as peripheral nervous system manifestations of Sjogren's syndrome. This agent might be considered when all other treatment modalities have failed given the presumed importance of tumour necrosis factor in the pathogenesis of Sjogren's syndrome. C1 Univ Texas, Hlth Sci Ctr, Coll Pharm, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. Wilford Hall USAF Med Ctr, San Antonio, TX USA. RP Univ Texas, Hlth Sci Ctr, Coll Pharm, 7703 Floyd Curl Dr,MSC 6220, San Antonio, TX 78229 USA. EM rogerss@uthscsa.edu NR 44 TC 25 Z9 29 U1 0 U2 3 PU ADIS INT LTD PI NORTHCOTE PA 5 THE WAREHOUSE WAY, NORTHCOTE 0627, AUCKLAND, NEW ZEALAND SN 0012-6667 EI 1179-1950 J9 DRUGS JI Drugs PY 2004 VL 64 IS 2 BP 123 EP 132 DI 10.2165/00003495-200464020-00001 PG 10 WC Pharmacology & Pharmacy; Toxicology SC Pharmacology & Pharmacy; Toxicology GA 771WQ UT WOS:000188809400001 PM 14717615 ER PT J AU Chan, SE Schwartz, JM Rosen, HR AF Chan, SE Schwartz, JM Rosen, HR TI Treatment of hepatitis C in solid organ transplantation SO DRUGS LA English DT Article ID CHRONIC VIRAL-HEPATITIS; STAGE RENAL-DISEASE; ORTHOTOPIC LIVER-TRANSPLANTATION; INTERFERON-ALPHA THERAPY; VIRUS-INFECTION; HEMODIALYSIS-PATIENTS; PLUS RIBAVIRIN; HCV INFECTION; HEART-TRANSPLANTATION; ANTIVIRAL THERAPY AB Hepatitis C virus (HCV) infection is highly prevalent worldwide, and results in significant morbidity and mortality. HCV frequently infects haemodialysis patients and appears to impact on long-term survival of kidney transplant recipients. Therefore, treatment is recommended for kidney transplant candidates before transplantation and should be avoided following transplantation because of a high risk of allograft rejection. HCV infection does not appear to influence survival in cardiac transplant recipients and cardiac transplant recipients should also not be treated. In general, HCV-infected patients with cirrhosis are not considered as candidates for either kidney or cardiac transplantation given their risk of decompensation. HCV is the most common indication for liver transplantation and re-infection with varying degrees of liver injury is universal. Survival after liver transplantation is reduced among HCV-infected patients when compared with uninfected controls. Therefore, treatment using interferon and ribavirin is advocated; however, such therapy is frequently limited by adverse effects. Thus, improved antiviral treatment modalities are eagerly awaited in the transplant setting. C1 Oregon Hlth Sci Univ, Div Gastroenterol & Hepatol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Rosen, HR (reprint author), Oregon Hlth Sci Univ, Div Gastroenterol & Hepatol, 3710 SW US Vet Hosp Rd,POB 1034,P3-GI, Portland, OR 97201 USA. EM hugo.rosen@med.va.gov NR 75 TC 6 Z9 6 U1 0 U2 1 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 0012-6667 J9 DRUGS JI Drugs PY 2004 VL 64 IS 5 BP 489 EP 498 DI 10.2165/00003495-200464050-00003 PG 10 WC Pharmacology & Pharmacy; Toxicology SC Pharmacology & Pharmacy; Toxicology GA 802XU UT WOS:000220197000003 PM 14977386 ER PT J AU Dulai, GS Jensen, DM Kovacs, TOG Gralnek, IM Jutabha, R AF Dulai, GS Jensen, DM Kovacs, TOG Gralnek, IM Jutabha, R TI Endoscopic treatment outcomes in watermelon stomach patients with and without portal hypertension SO ENDOSCOPY LA English DT Article; Proceedings Paper CT Annual Scientific Meeting of the American-Society-for-Gastrointestinal-Endoscopy CY MAY 23, 2000 CL SAN DIEGO, CALIFORNIA SP Amer Soc Gastrointestinal Endoscopy ID ANTRAL VASCULAR ECTASIA; ND-YAG LASER; CIRRHOSIS; GASTROPATHY; FEATURES AB Background and Study Aims: Watermelon stomach is a source of recurrent gastrointestinal hemorrhage and anemia. The aims of this study were to describe the endoscopic appearance and treatment outcomes in watermelon stomach patients with and without portal hypertension. Patients and Methods: All patients with watermelon stomach enrolled in a hemostasis research group's prospective studies from 1991 to 1999 were identified. Investigators collected data using standardized forms. Comparisons were made using the chi-squared test, Wilcoxon rank-sum test, and Wilcoxon signed-rank test. Results: Twenty-six of 744 (4%) consecutively enrolled patients with nonvariceal upper gastrointestinal hemorrhage had watermelon stomach as the cause. Eight of these 26 patients (31%) also had portal hypertension. These patients had diffuse antral angiomas, as opposed to the classic linear arrays seen in those without portal hypertension. The demographic data and clinical presentations of the two groups were otherwise similar. Palliative endoscopic treatment was associated with a significant rise in hematocrit and a decrease in the need for blood transfusion or hospitalization in watermelon stomach patients with and without portal hypertension. Conclusions: Watermelon stomach patients with and without portal hypertension had similar clinical presentations. The endoscopic findings differed in that those with portal hypertension had more diffuse gastric angiomas. Bleeding was effectively palliated by endoscopic treatment, regardless of the presence of portal hypertension. C1 CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Ctr Ulcer Res & Educ, Digest Dis Res Ctr,Ctr Study Digest Healthcare Qu, Los Angeles, CA 90024 USA. RP Dulai, GS (reprint author), CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, Bldg 115,Room 215C,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM gdulai@mednet.ucla.edu FU NCRR NIH HHS [K23 RR 1618801]; NIDDK NIH HHS [K24 DK 02650, DK 41301] NR 26 TC 39 Z9 45 U1 0 U2 0 PU GEORG THIEME VERLAG KG PI STUTTGART PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY SN 0013-726X J9 ENDOSCOPY JI Endoscopy PD JAN PY 2004 VL 36 IS 1 BP 68 EP 72 PG 5 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 762LP UT WOS:000187973700010 PM 14722858 ER PT J AU Thompson, KW Suchomelova, LM AF Thompson, KW Suchomelova, LM TI Transplants of cells engineered to produce GABA suppress spontaneous seizures SO EPILEPSIA LA English DT Article DE transplantation; epilepsy; seizures; genetic engineering; GAD; GABA; tetracycline ID SPONTANEOUS RECURRENT SEIZURES; INDUCED STATUS EPILEPTICUS; SUBSTANTIA-NIGRA; KINDLING EPILEPSY; NEURAL TRANSPLANTATION; PARKINSONS-DISEASE; PIRIFORM CORTEX; PILOCARPINE; RATS; HIPPOCAMPUS AB Purpose: Cell transplantation into the brain is an aggressive clinical alternative. The hopes of treating diseases like intractable temporal lobe epilepsy have been subdued because the preclinical successes thus far have shown only slowing of epileptogenesis, or suppression of electrically induced seizures. Because the hallmark of epilepsy is spontaneous seizures, the clinical relevance of these studies has been questioned. The purpose of this study was to establish that cells genetically engineered to produce gamma-aminobutyric acid (GABA) could suppress spontaneous seizures in an accepted model of temporal lobe epilepsy. Methods: Conditionally immortalized neurons were engineered to produce GABA under the control of tetracycline. These cells were transplanted into the substantia nigra of spontaneously seizing animals. After transplantation, the animals were monitored for 3 days immediately after surgery and again for 3 days beginning 7-8 days after surgery. Seizures and epileptiform spikes were recorded and later analyzed with detection software combined with video monitoring. Results: Animals that received genetically engineered GABA-producing cells had significantly fewer spontaneous seizures than did animals that received control cells, or animals that received GABA-producing cells plus doxycycline at the observation period starting 1 week after transplantation. A significant suppression of epileptiform spikes also was noted between the group that received GABA-producing cells and the group that received the same cells but were given doxycycline. The engineered cells show evidence of integration with the host but limited survival. Conclusions: These data demonstrate that genetically engineered cells have the ability to suppress spontaneous seizures when transplanted into seizure-modulating nuclei. This is an important step toward defining a clinical potential for this approach in epilepsy. The fact that the gene of interest can be regulated suggests that individualizing transplant therapy may be possible. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Acad Sci Czech Republ, Inst Physiol, Prague, Czech Republic. RP Thompson, KW (reprint author), VA Greater Los Angeles Healthcare Syst, Bldg 114,Rm 137,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM kthompso@ucla.edu NR 38 TC 53 Z9 57 U1 0 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD JAN PY 2004 VL 45 IS 1 BP 4 EP 12 DI 10.1111/j.0013-9580.2004.29503.x PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 762GQ UT WOS:000187964000002 PM 14692901 ER PT J AU Houser, CR Huang, C Peng, ZC AF Houser, CR Huang, C Peng, ZC TI Increased expression of the delta subunit of the GABA(A) receptor in hippocampal interneurons during postnatal development SO EPILEPSIA LA English DT Meeting Abstract CT Annual Meeting of the American-Epilepsy-Society CY DEC 03-07, 2004 CL New Orlands, LA SP Amer Epilepsy Soc C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2004 VL 45 SU 7 BP 19 EP 19 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 861MG UT WOS:000224420100060 ER PT J AU Wallis, RA Panizzon, KL AF Wallis, RA Panizzon, KL TI Neuroprotective efficacy of the mitochondrial ATP-sensitive potassium channel opener, diazoxide, against depolarization injury to CA1 pyramidal neurons in rat hippocampal slices SO EPILEPSIA LA English DT Meeting Abstract CT Annual Meeting of the American-Epilepsy-Society CY DEC 03-07, 2004 CL New Orlands, LA SP Amer Epilepsy Soc C1 VA Greater Los Angeles Healthcare, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2004 VL 45 SU 7 BP 28 EP 28 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 861MG UT WOS:000224420100085 ER PT J AU Licht, EA Shewmon, DA Azen, SP Fujikawa, DG AF Licht, EA Shewmon, DA Azen, SP Fujikawa, DG TI Identifying risk factors for nonconvulsive status epilepticus: Tracking severity of subclinical epileptiform discharges suggests athreshold effect SO EPILEPSIA LA English DT Meeting Abstract CT Annual Meeting of the American-Epilepsy-Society CY DEC 03-07, 2004 CL New Orlands, LA SP Amer Epilepsy Soc C1 VA Greater Los Angeles Healthcare Syst, Dept Neurol, Sepulveda, CA USA. Univ Calif Los Angeles, Dept Neurol, David Geffen Sch Med, Los Angeles, CA 90024 USA. Olive View UCLA, Med Ctr, Dept Neurol, Los Angeles, CA USA. USC, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2004 VL 45 SU 7 BP 82 EP 82 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 861MG UT WOS:000224420100243 ER PT J AU Fujikawa, DG Trinidad, LB Ke, XG AF Fujikawa, DG Trinidad, LB Ke, XG TI Both mild and more severe insults produce caspase-independent necrotic neurons: In vivo evidence from 60-minute lithium-pilocarpine-induced seizures SO EPILEPSIA LA English DT Meeting Abstract CT Annual Meeting of the American-Epilepsy-Society CY DEC 03-07, 2004 CL New Orlands, LA SP Amer Epilepsy Soc C1 VA Greater Los Angeles Hlthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. Univ Utah, Sch Med, Div Neonatol, Salt Lake City, UT USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2004 VL 45 SU 7 BP 196 EP 197 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 861MG UT WOS:000224420100576 ER PT J AU Kim, DY van Brederode, H Sullivan, PG Spain, NJ Rho, JM AF Kim, DY van Brederode, H Sullivan, PG Spain, NJ Rho, JM TI Ketone bodies protect neocortical neurons against acute oxidative stress SO EPILEPSIA LA English DT Meeting Abstract CT Annual Meeting of the American-Epilepsy-Society CY DEC 03-07, 2004 CL New Orlands, LA SP Amer Epilepsy Soc C1 St Josephs Hosp, Barrow Neurol Inst, Phoenix, AZ 85013 USA. Med Ctr, Phoenix, AZ USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Kentucky, Med Ctr, SCoBIRC, Lexington, KY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2004 VL 45 SU 7 BP 199 EP 199 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 861MG UT WOS:000224420100584 ER PT J AU Rowan, AJ Ramsay, RE Collins, JF Pryor, F AF Rowan, AJ Ramsay, RE Collins, JF Pryor, F CA VACS 428 Study Grp TI Influence of initial seizure frequency on prognosis for seizure control in the elderly SO EPILEPSIA LA English DT Meeting Abstract CT Annual Meeting of the American-Epilepsy-Society CY DEC 03-07, 2004 CL New Orlands, LA SP Amer Epilepsy Soc C1 Bronx Vet Adm Med Ctr, Bronx, NY USA. Miami VA Med Ctr, Miami, FL USA. VA Med Ctr, VA Cooperat Studies Coordinating Ctr, Perry Point, MD USA. RI Ramsay, R. Eugene/D-4491-2011 NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2004 VL 45 SU 7 BP 312 EP 312 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 861MG UT WOS:000224420100918 ER PT J AU Rumsfeld, JS Masoudi, FA AF Rumsfeld, JS Masoudi, FA TI Sex differences: implications for heart failure care SO EUROPEAN HEART JOURNAL LA English DT Editorial Material ID CLINICAL-TRIALS; GENDER C1 Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Denver Hlth Med Ctr, Denver, CO 80220 USA. RP Rumsfeld, JS (reprint author), Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Denver Hlth Med Ctr, Cardiol 111B,1055 Clermont St, Denver, CO 80220 USA. EM John.Rumsfeld@med.va.gov NR 13 TC 6 Z9 6 U1 0 U2 0 PU W B SAUNDERS CO LTD PI LONDON PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND SN 0195-668X J9 EUR HEART J JI Eur. Heart J. PD JAN PY 2004 VL 25 IS 2 BP 101 EP 103 DI 10.1016/j.ehj.2003.11.006 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 768NG UT WOS:000188548600002 PM 14720524 ER PT J AU Roman, GC Rogers, SJ AF Roman, GC Rogers, SJ TI Donepezil: a clinical review of current and emerging indications SO EXPERT OPINION ON PHARMACOTHERAPY LA English DT Review DE aphasia; Alzheimer's disease; autism; cholinesterase inhibitors; cholinergic transmission; dementia; donepezil; drowsiness; Down's syndrome; head injury; Lewy body; memory; migraine; opioid drowsiness; Parkinson's disease; schizophrenia; seizures; stroke; tardive dyskinesia; vascular dementia ID MILD COGNITIVE IMPAIRMENT; PLACEBO-CONTROLLED TRIAL; CEREBRAL BLOOD-FLOW; PROGRESSIVE SUPRANUCLEAR PALSY; SEVERE ALZHEIMERS-DISEASE; TRAUMATIC BRAIN INJURY; HUMAN BASAL FOREBRAIN; LEWY BODY DEMENTIA; VASCULAR DEMENTIA; DOUBLE-BLIND AB This article reviews the piperidine derivative, donepezil hydrochloride (E2020, Aricept(R)), a reversible central acetylcholinesterase inhibitor currently approved for treatment of mild-to-moderate Alzheimer's disease. Donepezil is well absorbed orally, unaffected by food or by time of administration; it reaches therapeutic levels in doses of 5-10 mg/day and peak plasma concentrations are obtained 3-4 h after oral administration. A single bedtime dose is recommended due to the long elimination half-life of the drug (70 h). Donepezil does not cause liver toxicity or significant drug interactions and is relatively well-tolerated. Initial side effects include nausea, vomiting, diarrhoea, insomnia, muscle cramps, fatigue, anorexia and syncope. Caution is advised in patients with bradycardia. Long-term use of donepezil in AD has been found to delay nursing-home placement and to result in caregiver respite. Donepezil also slows deterioration of cognition and global function in patients with moderate-to-severe AD, with improvement of abnormal behaviours. in addition to AD, donepezil demonstrates significant improvement in cognition, global function and activities of daily living in comparison with placebo-treated patients with vascular dementia and has potential therapeutic benefit for other neurological conditions. C1 Univ Texas, Hlth Sci Ctr, Coll Pharm, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, Coll Pharm, 7703 Floyd Curl Dr,Mail Code 7883, San Antonio, TX 78229 USA. NR 216 TC 25 Z9 26 U1 1 U2 16 PU ASHLEY PUBLICATIONS LTD PI LONDON PA UNITEC HOUSE, 3RD FL, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON N3 1QB, ENGLAND SN 1465-6566 J9 EXPERT OPIN PHARMACO JI Expert Opin. Pharmacother. PD JAN PY 2004 VL 5 IS 1 BP 161 EP 180 DI 10.1517/14656566.5.1.161 PG 20 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 759YG UT WOS:000187782000017 PM 14680445 ER PT J AU Krysan, K Merchant, FH Zhu, L Dohadwala, M Luo, J Lin, Y Heuze-Vourc'h, N Pold, M Seligson, D Chia, D Goodglick, L Wang, HJ Strieter, R Sharma, S Dubinett, S AF Krysan, K Merchant, FH Zhu, L Dohadwala, M Luo, J Lin, Y Heuze-Vourc'h, N Pold, M Seligson, D Chia, D Goodglick, L Wang, HJ Strieter, R Sharma, S Dubinett, S TI COX-2-dependent stabilization of survivin in non-small cell lung cancer SO FASEB JOURNAL LA English DT Article DE cyclooxygenase 2; prostaglandin; NSCLC cells ID CASPASE ACTIVATION; PROSTAGLANDIN E-2; PROSTATE-CANCER; CYTOCHROME-C; APOPTOSIS; CYCLOOXYGENASE-2; EXPRESSION; PROTEIN; INHIBITOR; INVOLVEMENT AB Elevated tumor cyclooxygenase 2 (COX-2) expression is associated with increased angiogenesis, tumor invasion and promotion of tumor cell resistance to apoptosis. The mechanism(s) by which COX-2 exerts its cytoprotective effects are not completely understood but may be due to an imbalance of pro- and anti-apoptotic gene expression. To analyze COX-2-dependent gene expression and apoptosis, we created cell lines constitutively expressing COX-2 cDNA in sense and antisense orientations. Whereas COX-2 sense cells have significantly heightened resistance to radiation and drug-induced apoptosis, COX-2 antisense cells are highly sensitive to apoptosis induction. We found that the expression of the anti-apoptotic protein survivin correlated positively with COX-2 expression. A COX-2-dependent modulation of survivin ubiquitination led to its stabilization in COX-2 overexpressing cells, and this effect was replicated by exogenous PGE2 treatment of parental tumor cells. In contrast to previous studies in other cell types, in nonsmall cell lung cancer cells survivin was expressed in a cell cycle-independent manner. When established in SCID mice in vivo, COX-2 antisense-derived tumors had significantly decreased survivin levels while COX-2 sense-derived tumors demonstrated elevated levels compared with controls. In accord with these findings, survivin and COX-2 were frequently upregulated and co-expressed in human lung cancers in situ. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm & Crit Care Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Lung Canc Res Program, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Defined Tumor Marker Evaluat Ctr, Los Angeles, CA 90024 USA. RP Dubinett, S (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm & Crit Care Med, 37-131 CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu FU UCLA SPORE In Lung Cancer NIH [P50 CA90388]; TRDRP grant [12FT-0061]; Early Detection Research Network [NCI CA-99-008] FX This study was supported by the UCLA SPORE In Lung Cancer NIH P50 CA90388, TRDRP grant #12FT-0061 (K. Krysan) and the Early Detection Research Network (NCI CA-99-008; L. Goodglick, D. Chia, D. Seligson, and F. Merchant). NR 45 TC 103 Z9 129 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 EI 1530-6860 J9 FASEB J JI Faseb J. PD JAN PY 2004 VL 18 IS 1 BP 205 EP 206 DI 10.1096/fj.03-0369fje PG 2 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 772EX UT WOS:000188829300075 PM 14597555 ER PT J AU Brambilla, P Hardan, AY di Nemi, SU Caverzasi, E Soares, JC Perez, J Barale, F AF Brambilla, P Hardan, AY di Nemi, SU Caverzasi, E Soares, JC Perez, J Barale, F TI The functional neuroanatomy of autism SO FUNCTIONAL NEUROLOGY LA English DT Article DE brain imaging; fMRI; MRS; neuroimaging; PET; SPECT ID CEREBRAL-BLOOD-FLOW; MAGNETIC-RESONANCE; ASPERGER-SYNDROME; CHILDHOOD AUTISM; FACIAL EXPRESSIONS; NEURAL MECHANISMS; CORTICAL ACTIVITY; FACE RECOGNITION; HUMAN BRAIN; MIND AB Autism is a neurodevelopmental syndrome characterized by impaired social and executive functions. Functional magnetic resonance imaging (fMRI) is a non-invasive technique that allows investigation of the neural networks underlying cognitive impairments in autism. In this article, brain imaging studies investigating the functional brain anatomy of autism are reviewed. Face recognition, theory of mind and executive functions have all been explored in functional neuroimaging studies involving autistic patients. The available literature suggests an involvement of abnormal functional mechanisms in face recognition, mentalization and executive functions in adults with high-functioning autism or Asperger's syndrome, possibly due to brain maturation abnormalities, and resulting in dysfunctional reciprocal cortico-subcortical connections. Future functional neuroimaging research should investigate subgroups of autistic children and adolescents longitudinally and attempt to integrate genetic, cognitive and empirical approaches. Such studies will be instrumental in furthering understanding of the pathophysiology of autism and in exploring the importance of dimensional measures of the broader phenotype currently defined as autism. C1 IRCCS S Giovanni Dio Fatebenefratelli, Biol Psychiat Unit, Brescia, Italy. Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA USA. Univ Pavia, S Matteo Hosp, IRCCS, Dept Psychiat, I-27100 Pavia, Italy. Cascina Rossago Rehabil Ctr Autism, Pavia, Italy. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Brambilla, P (reprint author), Univ Udine, Policlin Univ, Sez Psichiatria, Dipartimento Patol & Med Sperimentale & Clin, Via Colugna 50, I-33100 Udine, Italy. EM brambillapf@tiscali.it RI brambilla, paolo/B-4184-2010 OI brambilla, paolo/0000-0002-4021-8456; BARALE, FRANCESCO/0000-0001-7820-6736 FU NIMH NIH HHS [MH 01736]; PHS HHS [M64027] NR 75 TC 22 Z9 23 U1 7 U2 26 PU C I C-EDIZIONI INTERNAZIONALI SRL PI ROME PA CORSO TRIESTE, 42, 00198 ROME, ITALY SN 0393-5264 J9 FUNCT NEUROL JI Funct. Neurol. PD JAN-MAR PY 2004 VL 19 IS 1 BP 9 EP 17 PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 828WK UT WOS:000222004200002 PM 15212111 ER PT J AU Burgio, KL AF Burgio, KL TI Behavioral treatment options for urinary incontinence SO GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT Conference on Advancing the Treatment of Fecal and Urinary Incontinence Through Rresearch: Trial Design Outcome Measures and Research Priorities CY NOV 03-05, 2002 CL MILWAUKEE, WISCONSIN ID RANDOMIZED CONTROLLED-TRIAL; PELVIC MUSCLE EXERCISE; GENUINE STRESS-INCONTINENCE; OLDER WOMEN; DETRUSOR INSTABILITY; URGE INCONTINENCE; BLADDER DRILL; ELECTRICAL-STIMULATION; DRUG-TREATMENT; ELDERLY WOMEN AB Behavioral treatments improve bladder control by changing the incontinent patient's behavior, especially his or her voiding habits, and by teaching skills for preventing urine loss. These treatments are effective for most outpatient men and women with stress, urge, or mixed incontinence. The average reduction in the frequency of incontinence ranges from 57% to 86%. In long-term care settings, treatment is generally more challenging and yields more modest results. The advantages of behavioral interventions include the absence of side-effects, patient comfort, and high levels of patient satisfaction. Although most patients who receive behavioral treatment achieve significant improvement, most are not completely dry. Thus, there is a need for research to explore ways to enhance the effectiveness of these conservative therapies. Combining behavioral treatment with other treatments may have additive effects. Research is also needed to understand better the mechanisms of therapeutic change, the best methods for teaching pelvic floor muscle control, the optimal exercise regimens, the predictors of outcome, and the efficacy of behavioral treatments in men. Although behavioral interventions aria more accepted today than 20 years ago, they are still not widely available or integrated into most clinical practices, and we know little of how effective they will be in these settings. Thus, it will be important to develop and evaluate creative modes of delivery, such as group intervention (especially by non-physician providers), in a variety of clinical settings. C1 Birmingham VA Med Ctr, Ctr Geriatr Res Educ & Clin, Birmingham, AL 35233 USA. Univ Alabama, Birmingham, AL USA. RP Burgio, KL (reprint author), Birmingham VA Med Ctr, Ctr Geriatr Res Educ & Clin, 700 19th St S, Birmingham, AL 35233 USA. EM kburgio@aging.uab.edu NR 52 TC 18 Z9 19 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JAN PY 2004 VL 126 IS 1 SU 1 BP S82 EP S89 DI 10.1053/j.gastro.2003.10.042 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 761CJ UT WOS:000187881900013 PM 14978643 ER PT J AU Naliboff, BD AF Naliboff, BD TI Choosing outcome variables: Global assessment and diaries SO GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT Conference on Advancing the Treatment of Fecal and Urinary Incontinence Through Rresearch: Trial Design Outcome Measures and Research Priorities CY NOV 03-05, 2002 CL MILWAUKEE, WISCONSIN ID CHRONIC PAIN; CLINICAL-TRIALS AB This report reviews the advantages and disadvantages of 2 types of outcome assessment regularly used in the literature on incontinence: (1) global assessments of symptoms or relief and (2) ratings of specific symptoms of incontinence. Global assessments are usually used when the target condition involves multiple and variable symptoms, They are easy for patients to understand and yield data that seem to correspond closely to the target of the treatment (e.g., symptom severity). The 2 major scaling approaches used in clinical symptom assessment, categorical scaling and cross-modality matching of symptom intensity to line length (visual analogue scales), are reviewed for their reliability and validity. Numerical scales provide the advantage of a large number of possible ratings (usually 9-100) and are intuitively easy to use. All methods of symptom assessment using patient recall are subject to potential reporting bias. Measures of current symptoms, although less biased, may not reflect ongoing symptom levels, and current symptom levels tend to influence patients' recall of both symptom severity and medication counts. However, patient-initiated ratings are relevant to assessing real-time" symptoms in incontinence trials, and even single retrospective ratings of "usual" symptom intensity may actually be an adequate reflection of the average symptom severity (at least for chronic pain). Applying subjective, predetermined criteria for success, such as the provision of "adequate relief," allows researchers to closely mimic clinical situations and use a cutoff point ("threshold") specifically associated with the condition and treatment being investigated. Devices such as personal digital assistants that can cue subjects for information at set or random intervals, record multiple types of responses, and accurately assess compliance with data recording should help facilitate future research. C1 Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. Vet Adm Greater Los Angeles Hlth Syst, Los Angeles, CA USA. RP Naliboff, BD (reprint author), Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, CURE Bldg 115,Rm 223,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM naliboff@ucla.edu NR 13 TC 12 Z9 13 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JAN PY 2004 VL 126 IS 1 SU 1 BP S129 EP S134 DI 10.1053/j.gastro.2003.10.011 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 761CJ UT WOS:000187881900019 PM 14978649 ER PT J AU Schnelle, JF Leung, FW AF Schnelle, JF Leung, FW TI Urinary and fecal incontinence in nursing homes SO GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT Conference on Advancing the Treatment of Fecal and Urinary Incontinence Through Rresearch: Trial Design Outcome Measures and Research Priorities CY NOV 03-05, 2002 CL MILWAUKEE, WISCONSIN ID LONG-TERM-CARE; ELDERLY-PATIENTS; RISK-FACTORS; CONTROLLED TRIAL; RESIDENTS; INTERVENTION; QUALITY; CONSTIPATION; MANAGEMENT; CONTINENCE AB Urinary and fecal incontinence affect 50% or more of nursing home residents and frequently occur together because immobility and dementia are primary risk factors for both conditions. Many residents (40%-60%) show immediate improvement when provided with consistent toileting assistance, which compensates for the immobility and dementia risk factors that prevent them from toileting independently. Residents who are responsive to assistance can be identified with a 2-day run-in trial during which prompts are provided every 2 hours to encourage toileting. This run-in trial also provides an opportunity to use protocols to identify and treat other reversible causes of incontinence (e.g., urinary tract infection, fecal impaction) and to diagnose problems with bladder or anorectal functioning. The effects of toileting assistance on the frequency of fecal incontinence, while significant, are less dramatic than those reported for urinary incontinence, primarily because of constipation. Fortunately, noninvasive interventions have been identified that address most of the risk factors common to both constipation and fecal incontinence. Trials are needed to evaluate treatments that integrate noninvasive interventions directed toward the use of laxatives or constipating agents, low toileting frequency, low food and fluid intake, and physical activity to improve constipation and fecal incontinence in nursing home residents. The scientific documentation of the efficacy of such a noninvasive intervention and the labor costs of implementing these measures can lead to major changes in how nursing home care is funded and provided. C1 Univ Calif Los Angeles, David Geffen Sch Med, Borun Ctr Gerontol Res, Div Geriatr, Reseda, CA 91335 USA. VA Greater Los Angeles Healthcare Syst, Jewish Home Aging, Reseda, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Sepulveda Ambulatory Care Ctr, VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. RP Schnelle, JF (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Borun Ctr Gerontol Res, Div Geriatr, 7150 Tampa Ave, Reseda, CA 91335 USA. EM jschnell@ucla.edu NR 44 TC 23 Z9 23 U1 0 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JAN PY 2004 VL 126 IS 1 SU 1 BP S41 EP S47 DI 10.1053/j.gastro.2003.10.017 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 761CJ UT WOS:000187881900007 PM 14978637 ER PT J AU Peden-Adams, MM Dudley, AC EuDaly, JG Allen, CT Gilkeson, GS Keil, DE AF Peden-Adams, MM Dudley, AC EuDaly, JG Allen, CT Gilkeson, GS Keil, DE TI Pyridostigmine bromide (PYR) alters immune function in B6C3F1 mice SO IMMUNOPHARMACOLOGY AND IMMUNOTOXICOLOGY LA English DT Article DE pyridostigmine bromide; IgM antibody responses; Gulf War illness; immunotoxicity ID CELL-MEDIATED-IMMUNITY; GULF-WAR VETERANS; CONCURRENT EXPOSURE; HOST-RESISTANCE; ETHYL CARBAMATE; PERSIAN-GULF; INHIBITION; TOXICITY; EXERCISE; DEET AB Pyridostigmine bromide (PYR) is an anti cholinesterase drug indicated for the treatment of myasthenia gravis and neuromuscular blockade reversal. It acts as a reversible cholinesterase inhibitor and was used as a pretreatment for soldiers during Operation Desert Storm to protect against possible nerve gas attacks. Since that time, PYR has been implicated as a possible causative agent contributing to Gulf War Illness. PYR's mechanism of action has been well-delineated with regards to its effects on the nervous system, yet little is known regarding potential effects on immunological function. To evaluate the effects of PYR on immunological function, adult female B6C3F1 mice were gavaged daily for 14 days with PYR (0, 1, 5, 10, or 20 mg/kg/day). Immune parameters assessed were lymphoproliferation, natural killer cell activity, the SRBC-specific antibody plaque-forming cell (PFC) response, thymus and spleen weight and cellularity, and thymic and splenic CD4/CD8 lymphocyte subpopulations. Exposure to PYR did not alter splenic and thymus weight or splenic cellularity. However, 20 mg PYR/kg/day decreased thymic cellularity with decreases in both CD4+/CD8+ (20 mg/kg/day) and CD4-/CD8- (10 and 20 mg/kg/day) cell types. Functional immune assays indicated that lymphocyte proliferative responses and natural killer cell activity were normal; whereas exposure to PYR significantly decreased primary IgM antibody responses to a T-cell dependent antigen at the 1, 5, 10 and 20 mg/kg treatment levels for 14 days. This is the first study to examine the immunotoxicological effects of PYR and demonstrate that this compound selectively suppresses humoral antibody responses. C1 Med Univ S Carolina, Dept Rheumatol & Immunol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Hlth Profess, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Marine Biomed & Environm Sci Ctr, Charleston, SC 29425 USA. Ralph Johnson VAMC, Med Res Serv, Charleston, SC USA. NIOSH, Morgantown, WV 26505 USA. RP Peden-Adams, MM (reprint author), MUSC MBES, 221 Fort Johnson Rd, Charleston, SC 29412 USA. EM pedenada@muse.edu NR 56 TC 11 Z9 11 U1 0 U2 3 PU MARCEL DEKKER INC PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 USA SN 0892-3973 J9 IMMUNOPHARM IMMUNOT JI Immunopharmacol. Immunotoxicol. PY 2004 VL 26 IS 1 BP 1 EP 15 DI 10.1081/IPH-120029939 PG 15 WC Immunology; Pharmacology & Pharmacy; Toxicology SC Immunology; Pharmacology & Pharmacy; Toxicology GA 811SK UT WOS:000220791400001 PM 15106728 ER PT J AU Steinberg, M Tschanz, JT Corcoran, C Steffens, DC Norton, MC Lyketsos, CG Breitner, JCS AF Steinberg, M Tschanz, JT Corcoran, C Steffens, DC Norton, MC Lyketsos, CG Breitner, JCS TI The persistence of neuropsychiatric symptoms in dementia: the Cache County Study SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE dementia; neuropsychiatric; persistence ID MINI-MENTAL-STATE; ALZHEIMERS-DISEASE; BEHAVIORAL DISTURBANCES; PREVALENCE; HEALTH; AD AB Objective To estimate the 18-month persistence of neuropsychiatric symptoms in dementia in a population-based sample, and to compare the severity of neuropsychiatric symptoms at baseline to the severity at 18-month follow-up. Methods A population-based sample of 329 residents of Cache County, Utah, diagnosed with dementia was rated on the Neuropsychiatric Inventory (NPI). Of the 204 participants with neuropsychiatric symptoms at baseline (defined as total NPI score >0), NPI data were obtained approximately 18 months later on 117 who were alive and available for follow-up. Results Eighty-one percent of those with neuropsychiatric symptoms at baseline (defined as total NPI score >0) continued to have at least one symptom at follow-up. Sixty-seven percent of participants with a clinically significant total NPI score (defined as greater than or equal to4) at baseline continued to have a clinically significant total NPI score at follow-up. Among the ten neuropsychiatric domains assessed at baseline, delusions persisted in 65.5% of individuals, followed by depression (58.3%), and aberrant motor behavior (55.6%), while hallucinations and disinhibition persisted in only 25.0% and 11.1% respectively. In participants who were symptomatic at both baseline and follow-up, the mean severity scores at the two observation points were comparable in all ten neuropsychiatric domains. Conclusions Neuropsychiatric symptoms in dementia overall were highly persistent. Among those in whom symptoms did persist, symptom severity a year and a half later appeared to be comparable. Copyright (C) 2004 John Wiley Sons, Ltd. C1 Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21218 USA. Utah State Univ, Dept Psychol, Logan, UT 84322 USA. Utah State Univ, Ctr Epidemiol Studies, Logan, UT 84322 USA. Utah State Univ, Dept Math & Stat, Logan, UT 84322 USA. Duke Univ, Sch Med, Dept Psychiat, Durham, NC 27706 USA. Utah State Univ, Dept Family & Human Dev, Logan, UT 84322 USA. Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Steinberg, M (reprint author), Johns Hopkins Univ Hosp, Osler 320,600 N Wolfe St, Baltimore, MD 21287 USA. EM martins@jhmi.edu RI Corcoran, Chris/F-2155-2010; Tschanz, JoAnn/E-5986-2010; Norton, Maria/E-6994-2013 FU NIA NIH HHS [AG-11380, AG-21136] NR 19 TC 73 Z9 75 U1 2 U2 3 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD JAN PY 2004 VL 19 IS 1 BP 19 EP 26 DI 10.1002/gps.1025 PG 8 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 768KF UT WOS:000188541600003 PM 14716695 ER PT J AU Berka, C Levendowski, DJ Cvetinovic, MM Petrovic, MM Davis, G Lumicao, MN Zivkovic, VT Popovic, MV Olmstead, R AF Berka, C Levendowski, DJ Cvetinovic, MM Petrovic, MM Davis, G Lumicao, MN Zivkovic, VT Popovic, MV Olmstead, R TI Real-time analysis of EEG indexes of alertness, cognition, and memory acquired with a wireless EEG headset SO INTERNATIONAL JOURNAL OF HUMAN-COMPUTER INTERACTION LA English DT Article ID ADAPTIVE TASK ALLOCATION; WORKING-MEMORY; SLEEP-DEPRIVATION; PERFORMANCE; ATTENTION; PSYCHOPHYSIOLOGY; QUANTIFICATION; SPECTRUM; DRIVERS; SYSTEM AB The integration of brain monitoring into the man-machine interface holds great promise for real-time assessment of operator status and intelligent allocation of tasks between machines and humans. This article presents an integrated hardware and software solution for acquisition and real-time analysis of the electroencephalogram (EEG) to monitor indexes of alertness, cognition, and memory. Three experimental paradigms were evaluated in a total of 45 participants to identify EEG indexes associated with changes in cognitive workload: the Warship Commander Task (WCT), a simulated navy command and control environment that allowed workload levels to be systematically manipulated; a cognitive task with three levels of difficulty and consistent sensory inputs and motor outputs; and a multisession. image learning and reccognition memory test. Across tasks and participants, specific changes in the EEG were identified that were reliably associated with levels of cognitive workload. The EEG indexes were also shown to change as a function of training on the WCT and the learning and memory task. Future applications of the system to augment cognition in military and industrial environments are discussed. C1 Adv Brain Monitoring Inc, Carlsbad, CA 92008 USA. Univ Belgrade, Fac Elect Engn, YU-11001 Belgrade, Serbia and Mont, Yugoslavia. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Berka, C (reprint author), Adv Brain Monitoring Inc, 2850 Pio Pico Dr,Suite A, Carlsbad, CA 92008 USA. EM chris@b-alert.com NR 55 TC 127 Z9 127 U1 9 U2 32 PU LAWRENCE ERLBAUM ASSOC INC PI MAHWAH PA 10 INDUSTRIAL AVE, MAHWAH, NJ 07430-2262 USA SN 1044-7318 J9 INT J HUM-COMPUT INT JI Int. J. Hum.-Comput. Interact. PY 2004 VL 17 IS 2 BP 151 EP 170 DI 10.1207/s15327590ijhc1702_3 PG 20 WC Computer Science, Cybernetics; Ergonomics SC Computer Science; Engineering GA 840UH UT WOS:000222884900003 ER PT J AU Williams, JW Stellato, CP Cornell, J Barrett, JE AF Williams, JW Stellato, CP Cornell, J Barrett, JE TI The 13-and 20-item Hopkins Symptom checklist depression scale: Psychometric properties in primary care patients with minor depression or dysthymia SO INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE LA English DT Article DE depressive disorder; psychological tests; Outcome and Process Assessment (Health Care) ID RANDOMIZED CONTROLLED-TRIAL; RATING-SCALE; HEALTH-STATUS; RESPONSIVENESS; INSTRUMENTS; MANAGEMENT; DISABILITY; VALIDITY; SEVERITY; IMPROVE AB Objective: Depression scales that are responsive to changes in clinical symptoms are important for clinical monitoring and outcomes assessment in longitudinal studies. We evaluated the psychometric properties and responsiveness to clinical change of the 13- and 20-item versions of the Hopkins Symptom Checklist Depression Scale (HSCL-D). Methods: A secondary data analysis from a large 11-week, multicenter clinical trial, comparing three treatments was performed. Adult patients with minor depression or dysthymia and a score of greater than or equal to 10 on the Hamilton Depression Rating Scale (HDRS) were recruited from primary care clinics. Item-total correlations and Cronbach alphas were computed for HSCL-D-13 and HSCL-D-20. Clinical response at 11 weeks was defined by a Hamilton Depression Rating Scale (HDRS) < 10, clinical remission by a HDRS < 7, and criterion symptom remission by less than or equal to 1 DSM-III-R criterion symptoms. Standardized effect sizes and Guyatt's responsiveness statistic were determined for the 13- and 20-item HSCL-D. Results: Of the 656 subjects enrolled, 511 (77.9%) had complete data and were included in the analysis. Patients were 61.1 +/- 15.0 years old; minor depression was diagnosed in 238, dysthymia in 273. Both scales had good internal consistency; Cronbach's alpha = 0.835 and 0.859 for the 13- and 20-items questionnaires respectively. Standardized effect sizes for clinical response (0.62 for the HSCL-D-13; 0.66 for the HSCL-D-20), clinical remission (0.69 and 0.70), and criterion symptom remission (0.65 and 0.67) showed moderate to large effects and did not differ significantly for the two versions. Responsiveness was virtually identical for patients with minor depression and dysthymia but responsiveness was substantially lower for ethnic minorities. Conclusion: The HSCL-D-13 and 20-item versions have similar responsiveness to change. For use in European Americans, we recommend the HSCL-D-13 if response burden is the preeminent consideration. To more fully capture DSM criterion symptoms, we recommend the HSCL-D-20. C1 Duke Univ, DVAMC, Med Ctr, HSR&D,Ctr Hlth Serv Res Primary Care, Durham, NC 27705 USA. Univ Texas, Hlth Sci Ctr, Dept Vet Affairs Med Ctr, San Antonio VA Hlth Serv Res Ctr Excellence, San Antonio, TX USA. Dartmouth Coll Sch Med, Hanover, NH USA. RP Williams, JW (reprint author), Duke Univ, DVAMC, Med Ctr, HSR&D,Ctr Hlth Serv Res Primary Care, Bldg 6,508 Fulton St, Durham, NC 27705 USA. EM jw.williams@duke.edu RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 NR 34 TC 19 Z9 20 U1 2 U2 8 PU BAYWOOD PUBL CO INC PI AMITYVILLE PA 26 AUSTIN AVE, AMITYVILLE, NY 11701 USA SN 0091-2174 J9 INT J PSYCHIAT MED JI Int. J. Psychiatr. Med. PY 2004 VL 34 IS 1 BP 37 EP 50 PG 14 WC Psychiatry SC Psychiatry GA 832SQ UT WOS:000222287800003 PM 15242140 ER PT J AU Mendez, MF AF Mendez, MF TI The accuracy of clinical criteria for the diagnosis of frontotemporal dementia SO INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE LA English DT Article DE frontotemporal dementia; dementia; organic personality changes; neuropsychiatry ID ALZHEIMERS-DISEASE; LOBAR DEGENERATION; CONSENSUS; CHROMOSOME-17; FEATURES; AD AB The clinical diagnosis of frontotemporal dementia (FTD) can be challenging even to experienced clinicians. In the absence of a definitive clinical test, this diagnosis relies on behavioral criteria. Difficulty applying these criteria arise for four main reasons. First, FTD patients present with social and personality changes that defy the neuropsychological model of dementia. Second, FTD is not a single disorder but a spectrum of clinical syndromes with asymmetric and motor variants. Third, there may be qualitatively different symptoms during stages of FTD. Finally, pathologic and genetic variability contributes to the clinical variability. Future research should refine the clinical criteria for FTD using clinicopathological correlation in addition to working on the development of neurobiological markers. C1 Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu NR 20 TC 6 Z9 6 U1 0 U2 0 PU BAYWOOD PUBL CO INC PI AMITYVILLE PA 26 AUSTIN AVE, AMITYVILLE, NY 11701 USA SN 0091-2174 J9 INT J PSYCHIAT MED JI Int. J. Psychiatr. Med. PY 2004 VL 34 IS 2 BP 125 EP 130 DI 10.2190/8V1X-11UN-YDXR-A9KF PG 6 WC Psychiatry SC Psychiatry GA 850QB UT WOS:000223626400002 PM 15387396 ER PT J AU Reed, DR Mueller, A Wallner, K Ford, E Merrick, G AF Reed, DR Mueller, A Wallner, K Ford, E Merrick, G TI RAPID Strand(TM) vs. loose (Iodine-125 seeds): A prospective randomized trial SO INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS LA English DT Meeting Abstract CT 46th Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology CY OCT 03-07, 2004 CL Atlanta, GA SP Amer Soc Therapeut Radiol & Oncol C1 VA Puget Sound, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. Schiffler Canc Ctr, Wheeling, WV USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0360-3016 J9 INT J RADIAT ONCOL JI Int. J. Radiat. Oncol. Biol. Phys. PY 2004 VL 60 IS 1 SU S MA 2208 BP S461 EP S461 PG 1 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 853UP UT WOS:000223854700551 ER PT J AU Olvera, RL Glahn, DC Caetano, SC Pliszka, SR Soares, JC AF Olvera, RL Glahn, DC Caetano, SC Pliszka, SR Soares, JC TI Neuroimaging studies in bipolar children and adolescents SO INTERNATIONAL REVIEW OF NEUROBIOLOGY, VOL 62 SE INTERNATIONAL REVIEW OF NEUROBIOLOGY LA English DT Review ID MAGNETIC-RESONANCE SPECTROSCOPY; WHITE-MATTER HYPERINTENSITIES; SUBGENUAL PREFRONTAL CORTEX; DEFICIT HYPERACTIVITY DISORDER; PROSPECTIVE FOLLOW-UP; REGIONAL CEREBRAL METABOLISM; CLINICALLY REFERRED CHILDREN; MAJOR DEPRESSIVE DISORDER; SUBCORTICAL BRAIN-REGIONS; TEMPORAL-LOBE STRUCTURES C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Dept Psychiat, Audie L Murphy Div, San Antonio, TX 78229 USA. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, Sao Paulo, Brazil. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78229 USA. RP Olvera, RL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. RI Caetano, Sheila/H-5010-2012 OI Caetano, Sheila/0000-0001-8403-7078 NR 154 TC 3 Z9 3 U1 5 U2 7 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA SN 0074-7742 J9 INT REV NEUROBIOL PY 2004 VL 62 BP 121 EP 146 DI 10.1016/S0074-7742(04)62004-6 PG 26 WC Neurosciences SC Neurosciences & Neurology GA BBI36 UT WOS:000225608200004 PM 15530570 ER PT J AU O'Toole, TP Freyder, PJ Gibbon, JL Hanusa, BJ Seltzer, D Fine, MJ AF O'Toole, TP Freyder, PJ Gibbon, JL Hanusa, BJ Seltzer, D Fine, MJ TI ASAM patient placement criteria treatment levels: Do they correspond to care actually received by homeless substance abusing adults? SO JOURNAL OF ADDICTIVE DISEASES LA English DT Article DE homelessness; substance abuse; substance abuse treatment ID MATCHING CLIENTS; ALCOHOLISM; INPATIENT; SERVICES AB We report findings from a community-based two-city survey of homeless adults comparing the level of substance abuse treatment assigned to them using the ASAM Patient Placement Criteria with care actually received during the previous 12 months. Overall 531 adults were surveyed with 382 meeting DSM-IIIR criteria of being in need of treatment or having a demand for treatment. Of those with a treatment need, 1.5% met criteria for outpatient care, 40.3% intensive outpatient/partial hospitalization care, 29.8% medically monitored care and 28.8% managed care levels. In contrast, of those receiving treatment (50.5%, 162 persons), almost all care received by this cohort was either inpatient or residential based (83.6%). Unsheltered homeless persons and those without insurance were significantly more likely to report not receiving needed treatment. Lack of treatment availability or capacity, expense, and changing one's mind while on a wait Est were the most commonly cited reasons for no treatment. C1 Johns Hopkins Univ, Welch Ctr Epidemiol Prevent & Clin Res, Baltimore, MD 21205 USA. Maricopa Cty Dept Publ Hlth, Phoenix, AZ USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP O'Toole, TP (reprint author), Johns Hopkins Univ, Welch Ctr Epidemiol Prevent & Clin Res, 2024 E Monument St, Baltimore, MD 21205 USA. EM totoole@jhmi.edu NR 19 TC 12 Z9 12 U1 1 U2 7 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 1055-0887 J9 J ADDICT DIS JI J. Addict. Dis. PY 2004 VL 23 IS 1 BP 1 EP 15 DI 10.1300/J069v23n01_01 PG 15 WC Substance Abuse SC Substance Abuse GA 808BX UT WOS:000220545700001 PM 15077836 ER PT J AU Jaffe, C Saxon, AJ Meredith, C Bush, KR Straits-Troster, KA Romwall, L AF Jaffe, C Saxon, AJ Meredith, C Bush, KR Straits-Troster, KA Romwall, L TI A pilot comparison of methamphetamine users with and without ADHD SO JOURNAL OF ADDICTIVE DISEASES LA English DT Meeting Abstract C1 UWSOM, Dept Psychiat, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 1 U2 2 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 1055-0887 J9 J ADDICT DIS JI J. Addict. Dis. PY 2004 VL 23 IS 2 MA 15A BP 139 EP 139 PG 1 WC Substance Abuse SC Substance Abuse GA 820NL UT WOS:000221396400024 ER PT J AU Danaher, PJ Cao, MK Anstead, GM Dolan, MJ DeWitt, CC AF Danaher, PJ Cao, MK Anstead, GM Dolan, MJ DeWitt, CC TI Reversible dilated cardiomyopathy related to amphotericin B therapy SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article DE posaconazole; coccidioidomycosis; Coccidioides immitis ID COCCIDIOIDOMYCOSIS; PERICARDITIS; MICE AB We describe a patient who developed dilated cardiomyopathy and clinical congestive heart failure after 2 months of therapy with amphotericin B (AmB) for disseminated coccidioidomycosis. His echocardiographic abnormalities and heart failure resolved after posaconazole was substituted for AmB. It is important to recognize the rare and potentially reversible toxicity of AmB. C1 David Grant USAF Med Ctr, Dept Infect Dis, Travis AFB, CA 94535 USA. David Grant USAF Med Ctr, Dept Cardiol, Travis AFB, CA 94535 USA. Dept Vet Affairs Med Ctr, Med Serv, S Texas Hlth Care Syst, San Antonio, TX 78229 USA. Wilford Hall USAF Med Ctr, Dept Infect Dis, Lackland AFB, TX 78236 USA. RP Danaher, PJ (reprint author), Infect Dis Serv, 60MDG-60MDOS-SGOMB,101 Bodin Circle, Travis AFB, CA 94535 USA. NR 19 TC 19 Z9 19 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD JAN PY 2004 VL 53 IS 1 BP 115 EP 117 DI 10.1093/jac/dkg472 PG 3 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 756JW UT WOS:000187462800020 PM 14657095 ER PT J AU Conhaim, RL Watson, KE Heisey, DM Leverson, GE Harms, BA AF Conhaim, RL Watson, KE Heisey, DM Leverson, GE Harms, BA TI Thromboxane receptor analog, U-46619, redistributes pulmonary microvascular perfusion in isolated rat lungs SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE alveolar perfusion; fluorescent microspheres; vasoconstriction; dispersion index analysis; perfusion heterogeneity ID VASCULAR-RESISTANCE; CIRCULATION; HYPOXIA; VOLUME AB Effects of vasoconstriction on the distribution of perfusion among alveoli are not well understood. To address this, we used a new method we developed to determine how microvascular perfusion distribution was affected by a potent vasoconstrictor, the thromboxane receptor analog U- 46619. Our method was to infuse 4-mum- diameter fluorescent latex microspheres into the circulation of isolated rat lungs vasoconstricted with U- 46619. We used a confocal microscope to image trapping patterns of the particles in dried sections of the lungs and then used dispersion index analysis to quantify the particle patterns in the images, which encompassed similar to 2,000 alveoli. Dispersion indexes revealed significantly more particle clustering ( inhomogeneous distribution) in vasoconstricted lungs than in normal flow controls or in controls in which flow was reduced by either lowering pulmonary arterial pressure or raising left atrial pressure. These results suggest that vasoconstriction occurred in the microvessels themselves, which are much smaller vessels than those previously thought to be capable of vasoconstriction. C1 Univ Wisconsin, Sch Med, Dept Surg, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Conhaim, RL (reprint author), Univ Wisconsin, Sch Med, Dept Surg, H5-301-BX3236 Clin Sci Ctr,600 Highland Ave, Madison, WI 53792 USA. NR 17 TC 8 Z9 8 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD JAN PY 2004 VL 96 IS 1 BP 245 EP 252 DI 10.1152/japplphysiol.00271.2003 PG 8 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 750HC UT WOS:000186984400034 PM 12959963 ER PT J AU Ansari, M Araoz, PA Gerard, SK Watzinger, N Lund, GK Massie, BM Higgins, CB Saloner, DA AF Ansari, M Araoz, PA Gerard, SK Watzinger, N Lund, GK Massie, BM Higgins, CB Saloner, DA TI Comparison of late enhancement cardiovascular magnetic resonance and thallium SPECT in patients with coronary disease and left ventricular dysfunction SO JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE LA English DT Article DE heart failure; magnetic resonance imaging; SPECT; myocardial infarction ID POSITRON-EMISSION-TOMOGRAPHY; MYOCARDIAL VIABILITY; ARTERY-DISEASE; HIBERNATING MYOCARDIUM; MOTION ARTIFACTS; TL-201; REST; RECOVERY; ATTENUATION; IMPROVEMENT AB Purpose: Late enhancement magnetic resonance imaging (MRI) was compared with thallium-201 rest-redistribution single photon emission computed tomography (SPECT) in patients with reduced left ventricular (LV) function and prior myocardial infarction (MI). Background: Hyperenhancement on contrast cardiac MRI using gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) has been reported to identify nonviable myocardium. Comparisons of MRI and thallium-201 SPECT have recently been reported. This study focuses on the comparison of these modalities specifically in patients with ischemic heart failure, where viability determination is most clinically relevant. Methods: Fifteen patients with LV dysfunction and prior MI [mean ejection fraction (EF) 35 +/- 11%] underwent thallium-201 rest-redistribution scintigraphy and contrast MRI on separate days. Each short axis slice was divided into six 60-degree segments, and correlations between MRI and scintigraphy were made on viability detection for each segment. For SPECT, the mean uptake score was calculated from the average of all percent relative activity values throughout each segment. Areas with <50% of maximal thallium uptake were considered nonviable. On MRI, regions with increased signal intensity after an injection of 0.1 mmol/kg Gd-DPTA were considered nonviable. Results: A total of 558 segments were analyzed. Overall, there was a strong inverse relationship between the area of hyperenhancement on MRI and diminished thallium-201 uptake on SPECT (r=-0.51, P<0.001). There was a significant correlation between the imaging methods for each individual segment, except for the inferior-septal segment (r=-0.38, P<0.08). Conclusions: In patients with LV dysfunction and prior MI, our data suggest MRI hyperenhancement significantly correlates with myocardial nonviability by thallium-201 SPECT. Correlations were weaker in the inferior-septal region, which may be due to SPECT attenuation artifact. C1 Univ Calif San Francisco, Dept Radiol 114D, San Francisco, CA 94121 USA. Univ Calif San Francisco, Div Cardiol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94121 USA. Univ Calif San Francisco, Inst Cardiovasc Res, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, Serv Radiol, San Francisco, CA USA. EM saloner@itsa.ucsf.edu NR 23 TC 17 Z9 17 U1 0 U2 0 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1097-6647 EI 1532-429X J9 J CARDIOVASC MAGN R JI J. Cardiov. Magn. Reson. PY 2004 VL 6 IS 2 BP 549 EP 556 DI 10.1081/JCMR-120030582 PG 8 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA 819KE UT WOS:000221313000010 PM 15137339 ER PT J AU Alexopoulos, GS Streim, J Carpenter, D Docherty, JP AF Alexopoulos, GS Streim, J Carpenter, D Docherty, JP TI Introduction: Methods, commentary, and summary SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID PLACEBO-CONTROLLED-TRIAL; NURSING-HOME RESIDENTS; ELDERLY-PATIENTS; DOUBLE-BLIND; LONG-TERM; ATYPICAL ANTIPSYCHOTICS; PARKINSONS-DISEASE; BEHAVIORAL DISTURBANCES; PSYCHOTIC DISORDERS; TARDIVE-DYSKINESIA AB Antipsychotics are widely used in geriatric psychiatric disorders. A growing number of atypical antipsychotics are available, expanding clinical options but complicating decision-making. Many questions about use of antipsychotics in older patients remain unanswered by available clinical literature. We therefore surveyed expert opinion on antipsychotic use in older patients (65 years of age or older) for recommendations concerning indications for antipsychotics, choice of antipsychotics for different conditions (e.g., delirium, dementia, schizophrenia, delusional disorder, psychotic mood disorders) and for patients with comorbid conditions or history of side effects, dosing strategies, duration of treatment, and medication combinations. Method. Based on a literature review, a 47-question survey with 1,411 options was developed. Approximately three quarters of the options were scored using a modified version of the RAND 9-point scale for rating appropriateness of medical decisions. For other options, experts were asked to write in answers. The survey was sent to 52 American experts on treatment of older adults (38 geriatric psychiatrists, 14 geriatric internists/family physicians), 48 (92%) of whom completed it. In analyzing responses to items rated on the 9-point scale, consensus was defined as a nonrandom distribution of scores by chi-square "goodness-of-fit" test. We assigned a categorical rank (first line/preferred, second line/alternate, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean. Guidelines indicating preferred treatment strategies were then developed for key clinical situations. Results. The expert panel reached consensus on 78% of options rated on the 9-point scale. The experts did not recommend using antipsychotics in panic disorder, generalized anxiety disorder, nonpsychotic major depression, hypochondriasis, neuropathic pain, severe nausea, motion sickness, or irritability, hostility, and sleep disturbance in the absence of a major psychiatric syndrome. However, antipsychotics were favored in several other disorders. For agitated dementia with delusions, the experts' first-line recommendation is an antipsychotic drug alone; they would also consider adding a mood stabilizer. Risperidone (0.5-2.0 mg/day) was first line followed by quetiapine (50-150 mg/day) and olanzapine (5.0-7.5 mg/day) as high second-line options. There was no first-line recommendation for agitated dementia without delusions; an antipsychotic alone was high second line (rated first line by 60% of the experts). The experts' first-line recommendation for late-life schizophrenia was risperidone (1.25-3.5 mg/day). Quetiapine (100-300 mg/day), olanzapine (7.5-15 mg/day), and aripiprazole (15-30 mg/day) were high second line. For older patients with delusional disorder, an antipsychotic was the only treatment recommended. For agitated nonpsychotic major depression in an older patient, the experts' first-line recommendation was an antidepressant alone (77% first line); second-line options were an antidepressant plus an antipsychotic, electroconvulsive therapy (ECT), an antidepressant plus a benzodiazepine, and an antidepressant plus a mood stabilizer. For nonpsychotic major depression with severe anxiety, the experts recommended an antidepressant alone (79% first line) and would also consider adding a benzodiazepine or mood stabilizer to the antidepressant. If an older patient with nonpsychotic major depression fails to respond to antidepressants at adequate dosages for adequate duration, there was limited support for adding an atypical antipsychotic to the antidepressant (36% first line after two failed antidepressant trials). Treatment of choice for geriatric psychotic major depression was an antipsychotic plus an antidepressant (98% first line), with ECT another first-line option (71% first line). For mild geriatric nonpsychotic mania, the first-line recommendation is a mood stabilizer alone; the experts would also consider discontinuing an antidepressant if the patient is receiving one. For severe nonpsychotic mania, the experts recommend a mood stabilizer plus an antipsychotic (57% first line) or a mood stabilizer alone (48% first line) and would discontinue any antidepressant the patient is receiving. For psychotic mania, treatment of choice is a mood stabilizer plus an antipsychotic (98% first line). Risperidone (1.25-3.0 mg/day) and olanzapine (5-15 mg/day) were first-line options in combination with a mood stabilizer for mania with psychosis, with quetiapine (50-250 mg/day) high second line. If a patient has responded well, the experts recommended the following duration of treatment before attempting to taper and discontinue the antipsychotic: delirium, 1 week; agitated dementia, taper within 3-6 months to determine the lowest effective maintenance dose; schizophrenia, indefinite treatment at the lowest effective dose; delusional disorder, 6 months-indefinitely at the lowest effective dose; psychotic major depression, 6 months; and mania with psychosis, 3 months. For patients with diabetes, dyslipidemia, or obesity, the experts would avoid clozapine, olanzapine, and conventional antipsychotics (especially low- and mid-potency). Quetiapine is first line for a patient with Parkinson's disease. Clozapine, ziprasidone, and conventional antipsychotics (especially low- and mid-potency) should be avoided in patients with QTc prolongation or congestive heart failure. For patients with cognitive impairment, constipation, diabetes, diabetic neuropathy, dyslipidemia, xerophthalmia, and xerostomia, the experts prefer risperidone, with quetiapine high second line. More than a quarter of the experts considered these combinations contraindicated: clozapine + carbamazepine, ziprasidone + tricyclic antidepressant (TCA), and a low-potency conventional antipsychotic + fluoxetine. In combining antidepressants and antipsychotics, the experts would be much more cautious with selective serotonin reuptake inhibitors that are more potent inhibitors of the CYP 450 enzymes (i.e., fluoxetine, fluvoxamine, paroxetine) and with nefazodone, TCAs, and monoamine oxidase inhibitors. The experts recommended extra monitoring when combining any antipsychotic with lithium, carbamazepine, lamotrigine, or valproate (except aripiprazole, risperidone, or a high-potency conventional plus valproate) or with codeine, phenytoin, or tramadol. Conclusions. The experts reached a high level of consensus on many of the key treatment questions. Within the limits of expert opinion and with the expectation that future research data will take precedence, these guidelines provide direction for common clinical dilemmas in the use of antipsychotics in elderly patients. Clinicians should keep in mind that no guidelines can address the complexities of an individual patient and that sound clinical judgment based on clinical experience should be used in applying these recommendations. C1 Cornell Univ, Cornell Inst Geriatr Psychiat, Ithaca, NY 14853 USA. Cornell Univ, Weill Med Coll, Ithaca, NY 14853 USA. Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Alexopoulos, GS (reprint author), Cornell Univ, Cornell Inst Geriatr Psychiat, Ithaca, NY 14853 USA. NR 76 TC 201 Z9 209 U1 3 U2 31 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PY 2004 VL 65 SU 2 BP 5 EP 99 PG 95 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 833BR UT WOS:000222311900001 PM 14994733 ER PT J AU Wirshing, DA AF Wirshing, DA TI Schizophrenia and obesity: Impact of antipsychotic medications SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Review ID INDUCED WEIGHT-GAIN; PLACEBO-CONTROLLED TRIAL; BODY-MASS INDEX; RANDOMIZED CONTROLLED-TRIALS; DOUBLE-BLIND; SCHIZOAFFECTIVE DISORDER; ACUTE EXACERBATION; INSULIN-RESISTANCE; UNITED-STATES; OPEN-LABEL AB Obesity is an epidemic in this country and much of the rest of the developed world. It is a major contributor to a range of metabolic disorders responsible for much of the medical morbidity and mortality that burden our society. The combination of the costs to society of the chronic illness of schizophrenia with the costs of obesity and the chronic illnesses associated with it, e.g., metabolic disorders, diabetes, dyslipidemias, and cardiovascular disease, represents a major public health problem. Obesity in schizophrenia is accentuated even further largely through illness-related factors, like poor dietary conditions and more sedentary lifestyles, and particularly because many of the psychiatric medications (antipsychotics, mood stabilizers, and antidepressants) used to combat this devastating illness themselves result in weight gain that, if untreated, may result in the usual obesity-associated morbidity and mortality. This article is intended to review some of the physiology of obesity and obesity-related metabolic disorders, the risks to schizophrenia patients engendered by obesity, the evidence for weight gain associated with the antipsychotic drugs, and the possible mechanisms involved in antipsychotic medication-associated weight gain. C1 W Los Angeles Vet Affairs Med Ctr, Schizophrenia Treatment Unit, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat, Los Angeles, CA 90024 USA. RP Wirshing, DA (reprint author), W Los Angeles Vet Affairs Med Ctr, Schizophrenia Treatment Unit, 11301 Wilshire Blvd,B151-H Mail Code 166747 Code, Los Angeles, CA 90073 USA. EM Donna.Wirshing@bmed.va.gov NR 163 TC 98 Z9 110 U1 5 U2 11 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PY 2004 VL 65 SU 18 BP 13 EP 26 PG 14 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 884QW UT WOS:000226101900002 PM 15600381 ER PT J AU Alexopoulos, GS Streim, JE Carpenter, D AF Alexopoulos, GS Streim, JE Carpenter, D TI Expert consensus guidelines for using antipsychotic agents in older patients SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article C1 Cornell Univ, Cornell Inst Geriatr Psychiat, White Plains, NY USA. Cornell Univ, Weill Med Coll, White Plains, NY USA. Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. Comprenhens NeuroSci, White Plains, NY 10605 USA. RP Carpenter, D (reprint author), Comprenhens NeuroSci, 21 Bloomingdale Rd, White Plains, NY 10605 USA. EM dcarpenter@cnsmail.com NR 0 TC 60 Z9 62 U1 0 U2 2 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PY 2004 VL 65 SU 2 BP 100 EP 105 PG 6 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 833BR UT WOS:000222311900002 ER PT J AU Rose, A Peters, N Shea, JA Armstrong, K AF Rose, A Peters, N Shea, JA Armstrong, K TI Development and testing of the health care system distrust scale SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE distrust; health care ID PATIENTS TRUST; AFRICAN-AMERICANS; MEDICAL-RESEARCH; PHYSICIAN SCALE; PATIENT TRUST; MANAGED CARE; PERFORMANCE; SATISFACTION; ATTITUDES; TUSKEGEE AB BACKGROUND: Distrust of the health care system may be a significant barrier to seeking medical care, adhering to preventive health care and treatment regimens, and participating in medical research. OBJECTIVE: To describe the development and psychometric testing of an instrument (the Health Care System Distrust Scale) to measure distrust of the health care system. METHODS: Scale development involved 2 phases. In Phase 1, a pilot instrument was developed based on a conceptual model of health care-related distrust. Draft items were created using focus group sessions with members of the general public, literature review, and expert opinion. Draft items were pilot tested with 55 individuals waiting to be assigned to jury duty at the Municipal Court of Philadelphia. A priori, candidate items for elimination or revision included those with >5% missing data, extremely low or high interitem or item-total correlations, or those having a negative effect on the scale's internal consistency. In Phase 2, we conducted a survey of 400 prospective jurors to assess the reliability and validity of the final scale scores. RESULTS: In Phase 1, a 10-item scale was constructed that included 4 items measuring honesty, 2 items measuring confidentiality, 2 items measuring competence, and 2 items measuring fidelity. The participants in Phase 2 had a mean age of 41 years. Forty-three percent were African-American, 45% white, and 4% Hispanic. Scores on the Health Care System Distrust scale ranged from 12 to 46 with a possible range from 10 to 50. The mean score was 29.4 with a standard deviation of 6.33. No item had over 5% missing data. Internal consistency (Cronbach's alpha) was 0.75. Item-total correlations ranged from 0.27 to 0.57. Principal components analysis revealed 1 general component accounting for 32% of the variance. Nine of the variables had loadings higher than 0.40. As predicted, distrust of the health care system was higher among African Americans than whites and was inversely correlated with trust in personal physicians. CONCLUSIONS: Initial testing suggests that we developed an instrument with valid and reliable scores in order to measure distrust of the health care system. Future research is needed to evaluate the validity and reliability of the Health Care System Distrust scale among diverse populations. This instrument can facilitate the investigation of the prevalence, causes, and effects of health care system distrust in the United States. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Abramson Canc Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. RP Armstrong, K (reprint author), 1233 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM karmstro@mail.med.upenn.edu NR 44 TC 77 Z9 79 U1 0 U2 10 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JAN PY 2004 VL 19 IS 1 BP 57 EP 63 DI 10.1111/j.1525-1497.2004.21146.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 766EP UT WOS:000188354000008 PM 14748861 ER PT J AU Kamide, K Rakugi, H Nagai, M Takiuchi, S Matsukawa, N Higaki, J Kawano, Y Ogihara, T Tuck, ML AF Kamide, K Rakugi, H Nagai, M Takiuchi, S Matsukawa, N Higaki, J Kawano, Y Ogihara, T Tuck, ML TI Insulin-mediated regulation of the endothelial renin-angiotensin system and vascular cell growth SO JOURNAL OF HYPERTENSION LA English DT Article DE angiotensin-coverting enzyme; angiotensinogen; insulin; renin; vascular endothelial cells ID SMOOTH-MUSCLE-CELLS; ISCHEMIC-HEART-DISEASE; ESSENTIAL-HYPERTENSION; CONVERTING-ENZYME; IN-VIVO; RESISTANCE; EXPRESSION AB Objective Insulin has a growth-stimulating effect for vascular tissue. At the tissue level, the vascular renin-angiotensin system (RAS) may be involved in the progression of atherosclerosis or vascular hypertrophy. We previously reported that the vascular RAS activity is activated in vascular smooth muscle cells (SMC) by insulin stimulation. However, the effect of insulin on the RAS in endothelial cells (EC) is not fully understood. Methods Cultured human EC were incubated with or without insulin. After incubation for 48 h, cellular angiotensinogen and renin mRNA expression and levels in the cells were quantified by slot-blot hybridization and radioimmunoassay. Angiotensin I converting enzyme (ACE) activity in EC homogenates was measured by modified Cushman and Cheung method. EC growth and SMC with or without EC using co-culture were assessed by H-3-thymidine uptake for evaluation of their growth. Results All doses of insulin (110, 100, 1000 muU/ml) decreased angiotensinogen and renin mRNA expression (angiotensinogen: 19.3%, P < 0.05; 25.4%, P < 0.01; 26.2%, P < 0.01, renin: 12.9%, P < 0.05; 21.3%, P < 0.01; 14.3%, P < 0.05, respectively). Both cellular angiotensinogen and renin level were also reduced by high levels of insulin. Neither 10 nor 100 muU/ml insulin increased cellular angiotensin converting enzyme (ACE) activity (2.17 to 3.48-folds, P = 0.077, 0.125, respectively) significantly, but 1000 muU/ml insulin strongly up-regulated ACE activity by 16.67-folds (P = 0.001) in cultured EC. For the co-culture with EC and SMC, 100 muU/ml insulin was not able to induce SMC but 1000 muU/ml insulin accelerated SMC growth in the co-culture. In contrast insulin that was over 100 muU/mI induced SMC growth in the sole culture of SMC. Conclusion Either low or high levels of insulin suppressed angiotensinogen and renin expression, however, high doses of insulin stimulated ACE activity in cultured human aortic EC. This may indicate that insulin regulates vascular cell growth and endothelial function via bifunctional modification of the vascular angiotensin generation. (C) 2004 Lippincott Williams Wilkins. C1 Natl Cardiovasc Ctr, Div Nephrol & Hypertens, Suita, Osaka 5658565, Japan. Osaka Univ, Dept Geriatr Med, Grad Sch Med, Suita, Osaka, Japan. Ehime Univ, Sch Med, Shigenobu, Ehime, Japan. Univ Calif Los Angeles, Sch Med, Div Endocrinol, Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Kamide, K (reprint author), Natl Cardiovasc Ctr, Div Nephrol & Hypertens, 5-7-1 Fujishirodai, Suita, Osaka 5658565, Japan. EM kamide@hsp.ncvc.go.jp NR 21 TC 14 Z9 18 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0263-6352 J9 J HYPERTENS JI J. Hypertens. PD JAN PY 2004 VL 22 IS 1 BP 121 EP 127 DI 10.1097/01.hjh.0000098157.70956.61 PG 7 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 837WQ UT WOS:000222672400020 PM 15106803 ER PT J AU Nath, SK Namjou, B Kilpatrick, J Garriott, CP Bruner, GR Scofield, RH Harley, JB AF Nath, SK Namjou, B Kilpatrick, J Garriott, CP Bruner, GR Scofield, RH Harley, JB TI A candidate region on 11p13 for systemic lupus erythematosus: A linkage identified in African-American families SO JOURNAL OF INVESTIGATIVE DERMATOLOGY SYMPOSIUM PROCEEDINGS LA English DT Article; Proceedings Paper CT 51st Annual Montagna Symposium on the Biology of Skin CY AUG 16-20, 2002 CL SNOWMASS, COLORADO ID GENOME-WIDE SEARCH; SIB-PAIR FAMILIES; SUSCEPTIBILITY GENES; SLE FAMILIES; GENETICS; LOCUS; SCAN AB Systemic Lupus Erythematosus (SLE), a chronic, complex disease, is the prototype for systemic human autoimmune diseases. Although environmental factors are crucial in triggering the condition, twin and family studies, as well as genetic linkage and association studies, have established its strong genetic predisposition. During the past few years, there has been considerable interest in identifying genomic segments linked to SLE through either a whole genome scan or a candidate gene approach. The discoid lupus erythematosus (DLE) skin lesion is one of the major, and discriminating, manifestations in SLE, especially in African American patients. In this study we have identified 58 multiplex families-27 African American, 26 European American, and 5 others-where at least one SLE patient is also reported to be afflicted with DLE. These families were chosen from the collection of families that are part of our ongoing linkage study for SLE. A genome-wide parametric and nonparametric linkage analysis was conducted with 320 markers. Significant evidence of linkage was identified in only one chromosomal location, 11p13, in the African American families. The maximum 2-point linkage was 5.6 in these pedigrees, obtained at a marker located 47 cm away from the p-terminal end of chromosome 11. The peak multipoint LOD score of 4.6 was obtained very nearby. The segregation of this gene suggests dominant inheritance. These results reveal an important genetic effect related to discoid rash at 11p13 in African Americans with SLE, and demonstrate, through increasing genetic homogeneity, the power of pedigree stratification to detect linkage in complex diseases. C1 Oklahoma Med Res Fdn, Arthrit & Immunol Res Program, Oklahoma City, OK 73104 USA. Oklahoma Med Res Fdn, Genet Epidemiol Unit, Oklahoma City, OK 73104 USA. Univ Oklahoma, Dept Med, Oklahoma City, OK USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. RP Nath, SK (reprint author), Oklahoma Med Res Fdn, Arthrit & Immunol Res Program, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM swapan-nath@omrf.ouhsc.edu FU NCRR NIH HHS [RR15577]; NIAID NIH HHS [AI24717, AI31584]; NIAMS NIH HHS [AR048928, AR-12253, AR45231, AR048940, AR049084, AR42460] NR 28 TC 16 Z9 16 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 1087-0024 J9 J INVEST DERM SYMP P JI J. Invest. Dermatol. Symp. Proc. PD JAN PY 2004 VL 9 IS 1 BP 64 EP 67 DI 10.1111/j.1087-0024.2004.00830.x PG 4 WC Dermatology SC Dermatology GA 764FB UT WOS:000188195800012 PM 14870988 ER PT J AU Oates, JC Gilkeson, GS AF Oates, JC Gilkeson, GS TI Nitric oxide induces apoptosis in spleen lymphocytes from MRL/lpr mice SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Article DE apoptosis; lupus; nitric oxide ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; PROGRAMMED CELL-DEATH; IN-VITRO APOPTOSIS; MRL-LPR/LPR MICE; FLOW-CYTOMETRIC DETECTION; PROTEIN-KINASE; DEPENDENT APOPTOSIS; AUTOIMMUNE-DISEASE; MURINE LUPUS; PHOSPHATIDYLSERINE EXPRESSION AB Background: MRL/MpJ-Tnfrsf6(lpr)(MRL/lpr) mice, a murine model of systemic lupus erythematosus (SLE), have defective expression of Fas, substantially reducing signaling for apoptosis via this mechanism. However, it is known that MRL/lpr mice have increased spontaneous apoptosis of leukocytes. These conflicting observations have stimulated interest in apoptosis in this SLE model. MRL/lpr mice overproduce nitric oxide (NO) as autoimmune disease progresses. In vitro administration of NO may induce or decrease apoptosis depending on the cell type. Therefore, we hypothesized that NO induces MRL/lpr spleen lymphocyte apoptosis independent of Fas receptor engagement. Methods: Percentages of apoptotic spleen lymphocytes from MRL/lpr and BALB/cJ mice were determined ex vivo after in vivo treatment with N-G-monomethyl-L-arginine (NMMA), a nitric oxide synthase (NOS) inhibitor. After culture in varying concentrations of a slow-acting NO donor, the following were determined in spleen lymphocytes: (1) levels of apoptosis, (2) the effect of phorbol myristate acid (PMA) on levels of NO-induced apoptosis, and (3) protein kinase C (PKC) activity. Results: Spleen. lymphocytes from MRL/lpr mice with active disease had increased levels of ex vivo apoptosis when compared with BALB/cJ controls. This increase was reduced by pharmacologic inhibition of NOS in MRL/lpr but not in BALB/cJ mice. Exogenous administration of NO in vitro reduced PKC activity and induced apoptosis in MRL/lpr spleen lymphocytes, an effect that could be reduced via coadministration of PMA in vitro. Conclusion: These results suggest that NO plays a role in spleen lymphocyte apoptosis in MRL/lpr mice, possibly via inhibition of PKC, despite a Fas defect. C1 Med Univ S Carolina, Dept Med, Div Rheumatol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Med Res Serv, Charleston, SC USA. RP Oates, JC (reprint author), Med Univ S Carolina, Dept Med, Div Rheumatol, 96 Jonathan Lucas St,Suite 912,POB 250637, Charleston, SC 29425 USA. EM oatesjc@musc.edu FU NIAMS NIH HHS [AR002193, AR45476] NR 65 TC 11 Z9 13 U1 1 U2 1 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP 62 EP 71 DI 10.2310/6650.2004.12395 PG 10 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600019 PM 14989372 ER PT J AU Chen, X Akis, N Choudhury, GG Madaio, M Kasinath, BS AF Chen, X Akis, N Choudhury, GG Madaio, M Kasinath, BS TI Dual signaling pathways regulate vascular endothelial growth factor (VEGF) induction of eNOS in glomerular endothelial (G Endo) cells. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2004 CL NEW ORLEANS, LOUISIANA SP Amer Federat Med Res C1 Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S320 EP S320 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600927 ER PT J AU Chi, R Jackson, LA Neuzil, KM AF Chi, R Jackson, LA Neuzil, KM TI Characteristics and outcomes of older adults with community-acquired pneumococcal bacteremia. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Grp Hlth Cooperat Puget Sound, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S95 EP S95 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600115 ER PT J AU Feliers, D Choudhury, GG Barnes, J Kasinath, BS AF Feliers, D Choudhury, GG Barnes, J Kasinath, BS TI Angiotensin II (AII) regulation of vascular endothelial growth factor (VEGF) synthesis in proximal tubular cells (MCT) by protein translation. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2004 CL NEW ORLEANS, LOUISIANA SP Amer Federat Med Res C1 Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S301 EP S301 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600825 ER PT J AU Gorin, Y Ricono, JM Wagner, B Kim, NH Bhandari, B Choudhury, GG Abboud, HE AF Gorin, Y Ricono, JM Wagner, B Kim, NH Bhandari, B Choudhury, GG Abboud, HE TI Nox4 mediates angiotensin II-induced mesangial cell hypertrophy via activation of Akt/protein kinase B. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2004 CL NEW ORLEANS, LOUISIANA SP Amer Federat Med Res C1 S Texas Vet Hlth Care Syst, Audie L Murphy Mem Hosp Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. GRECC, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S321 EP S321 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600932 ER PT J AU Grippa, J Watson, PA Reusch, JEB AF Grippa, J Watson, PA Reusch, JEB TI Insulin resistance accelerates age related loss of vascular CREB content. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Denver VAMC, Denver, CO USA. Univ Colorado, Denver, CO 80202 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S153 EP S153 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600443 ER PT J AU Huang, JV Casebeer, AW Plomondon, ME Shroyer, AL McDonald, GO Bell, MR Fullerton, D Grover, F Cunningham, F AF Huang, JV Casebeer, AW Plomondon, ME Shroyer, AL McDonald, GO Bell, MR Fullerton, D Grover, F Cunningham, F TI Department of Veterans Affairs post-coronary artery bypass graft patient six-month filling rates for key ischemic heart disease medication compared with non-Veterans Affairs facilities. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Denver VA Med Ctr, Denver, CO USA. RI Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S124 EP S124 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600277 ER PT J AU Mahimainathan, L Choudhury, GG AF Mahimainathan, L Choudhury, GG TI Tumor suppressor PTEN regulates TGF beta and high glucose-induced mesangial hypertrophy: Involvement of AKR kinase via PI 3 kinase signaling. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2004 CL NEW ORLEANS, LOUISIANA SP Amer Federat Med Res C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S301 EP S301 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600822 ER PT J AU Mariappan, MM Choudhury, GG Kasinath, BS AF Mariappan, MM Choudhury, GG Kasinath, BS TI Novel role for PLC in regulation of VEGF-induced Erk activation in proximal tubular epithelial cells and its role in protein synthesis. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2004 CL NEW ORLEANS, LOUISIANA SP Amer Federat Med Res C1 Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S320 EP S321 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600928 ER PT J AU Page, ST Herbst, KL Amory, JK Coviello, AD Anawalt, BD Matsumoto, AM Bremner, WJ AF Page, ST Herbst, KL Amory, JK Coviello, AD Anawalt, BD Matsumoto, AM Bremner, WJ TI Short term effects of androgen manipulation on adiponectin in normal men SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Univ Washington, Dept Med, Sch Med, Seattle, WA USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Sch Med, Seattle, WA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Charles Drew Univ, Dept Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S97 EP S98 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600129 ER PT J AU Phan, J Reue, K AF Phan, J Reue, K TI The role of lipin in diabetes and insulin resistance. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Univ Calif Los Angeles, Dept Human Genet, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S152 EP S152 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600437 ER PT J AU Phan, J Peterfy, M Reue, K AF Phan, J Peterfy, M Reue, K TI Lipin: A novel modulator of adiposity. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Univ Calif Los Angeles, Dept Human Genet, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S137 EP S137 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600348 ER PT J AU Tong, J Fujimoto, WY Kahn, SE Weigle, DS McNeely, MJ Leonetti, DL Shofer, JB Boyko, EJ AF Tong, J Fujimoto, WY Kahn, SE Weigle, DS McNeely, MJ Leonetti, DL Shofer, JB Boyko, EJ TI Predictors for increased visceral adiposity at 10-year follow-up in non-diabetic Japanese-Americans. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S130 EP S130 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600311 ER PT J AU Tylee, T Overduin, J Frayo, RS Cummings, DE AF Tylee, T Overduin, J Frayo, RS Cummings, DE TI Intestinal infusions of lactulose suppress ghrelin in a dose-dependent manner: Role of intestinal osmolarity in prandial ghrelin regulation. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S131 EP S131 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600315 ER PT J AU Tylee, T Overduin, J Frayo, RS Cummings, DE AF Tylee, T Overduin, J Frayo, RS Cummings, DE TI Intestinal infusions of lactulose suppress ghrelin in a dose-dependent manner: Role of intestinal osmolarity in prandial ghrelin regulation. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 28-31, 2004 CL CARMEL, CALIFORNIA SP Amer Federat Med Res C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 1 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S92 EP S92 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600096 ER PT J AU Wagner, B Gorin, Y Ghosh-Choudhury, G Ricono, JM Simon, M Chen, Y Abboud, HE AF Wagner, B Gorin, Y Ghosh-Choudhury, G Ricono, JM Simon, M Chen, Y Abboud, HE TI NADPH oxidase signaling in platelet-derived growth factor-BB stimulated metanephric mesenchymal cells. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2004 CL NEW ORLEANS, LOUISIANA SP Amer Federat Med Res C1 Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX USA. UTHSCSA, Div Nephrol, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2004 VL 52 IS 1 BP S320 EP S320 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 765ER UT WOS:000188254600926 ER PT J AU Epperson, TK Valente, AJ Gamez, MD Sumimoto, H Banfi, B Krause, KH Clark, RA AF Epperson, TK Valente, AJ Gamez, MD Sumimoto, H Banfi, B Krause, KH Clark, RA TI Specific requirement of the NADPH binding domain of NOX1 for superoxide generation with the NOXA1 and NOXO1 co-factors SO JOURNAL OF LEUKOCYTE BIOLOGY LA English DT Meeting Abstract CT 37th Annual Meeting of the Society-for-Leukocyte-Biology CY OCT 21-23, 2004 CL Toronto, CANADA SP Soc Leukocyte Biol C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Dept Med, San Antonio, TX USA. Univ Hosp Geneva, Dept Geriatr, Geneva, Switzerland. Kyushu Univ, Med Inst Bioregulat, Fukuoka 812, Japan. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0741-5400 J9 J LEUKOCYTE BIOL JI J. Leukoc. Biol. PY 2004 SU S BP 35 EP 35 PG 1 WC Cell Biology; Hematology; Immunology SC Cell Biology; Hematology; Immunology GA 851KD UT WOS:000223683100064 ER PT J AU Valente, AJ El Jamali, A Epperson, TK Gamez, M Clark, RA AF Valente, AJ El Jamali, A Epperson, TK Gamez, M Clark, RA TI Regulation of NOX1 NADPH oxidase activity by the SH3 domain of NOXA1 SO JOURNAL OF LEUKOCYTE BIOLOGY LA English DT Meeting Abstract CT 37th Annual Meeting of the Society-for-Leukocyte-Biology CY OCT 21-23, 2004 CL Toronto, CANADA SP Soc Leukocyte Biol C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0741-5400 J9 J LEUKOCYTE BIOL JI J. Leukoc. Biol. PY 2004 SU S BP 35 EP 36 PG 2 WC Cell Biology; Hematology; Immunology SC Cell Biology; Hematology; Immunology GA 851KD UT WOS:000223683100065 ER PT J AU Mundhekar, AN Bullard, DC Kucik, DF AF Mundhekar, AN Bullard, DC Kucik, DF TI Intra-cellular variability in adhesive properties of endothelial cells affects early steps in leukocyte recruitment SO JOURNAL OF LEUKOCYTE BIOLOGY LA English DT Meeting Abstract CT 37th Annual Meeting of the Society-for-Leukocyte-Biology CY OCT 21-23, 2004 CL Toronto, CANADA SP Soc Leukocyte Biol C1 Univ Alabama, Dept Biomed Engn, Birmingham, AL 35294 USA. Univ Alabama, Dept Pathol, Birmingham, AL 35294 USA. Univ Alabama, Dept Genom & Pathobiol, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Res Serv, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0741-5400 J9 J LEUKOCYTE BIOL JI J. Leukoc. Biol. PY 2004 SU S BP 37 EP 37 PG 1 WC Cell Biology; Hematology; Immunology SC Cell Biology; Hematology; Immunology GA 851KD UT WOS:000223683100070 ER PT J AU Li, SL He, WJ Qiang, M Wang, W Xiao, QF Valente, AJ Quinones, M Ahuja, S Clark, RA Freeman, GL AF Li, SL He, WJ Qiang, M Wang, W Xiao, QF Valente, AJ Quinones, M Ahuja, S Clark, RA Freeman, GL TI A synthetic promoter drives macrophage expression of ApoE and ameliorates atherosclerosis SO JOURNAL OF LEUKOCYTE BIOLOGY LA English DT Meeting Abstract CT 37th Annual Meeting of the Society-for-Leukocyte-Biology CY OCT 21-23, 2004 CL Toronto, CANADA SP Soc Leukocyte Biol C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0741-5400 J9 J LEUKOCYTE BIOL JI J. Leukoc. Biol. PY 2004 SU S BP 55 EP 56 PG 2 WC Cell Biology; Hematology; Immunology SC Cell Biology; Hematology; Immunology GA 851KD UT WOS:000223683100138 ER PT J AU Bubber, P Tang, JC Haroutunian, V Xu, H Davis, KL Blass, JP Gibson, GE AF Bubber, P Tang, JC Haroutunian, V Xu, H Davis, KL Blass, JP Gibson, GE TI Mitochondrial enzymes in schizophrenia SO JOURNAL OF MOLECULAR NEUROSCIENCE LA English DT Article DE schizophrenia; mitochondria; tricarboxylic acid cycle; neurodegenerative diseases; energy metabolism ID CEREBRAL GLUCOSE-METABOLISM; DEHYDROGENASE COMPLEX; BRAIN; POSTMORTEM; DISEASE; GENES AB The responses of brain metabolism and blood flow to stimulation are diminished in the dorsolateral prefrontal cortexes (DLPFCs) of schizophrenic patients. Reductions in mitochondrial enzymes underlie diminished metabolism in several neurodegenerative diseases. Thus, we tested whether reductions in selected mitochondrial enzymes could underlie the changes in schizophrenia. The activities of the pyruvate dehydrogenase complex (PDHC), aconitase, isocitrate dehydrogenase (ICDH), and the alpha-ketoglutarate dehydrogenase complex (KGDHC) were determined on DLPFCs from patients with schizophrenia (n = 26) and normal nonpsychiatric disease controls (n = 13). The enzyme activities (mU/mg protein; mean +/- SEM) were similar (values for controls and schizophrenic patients, respectively) for PDHC (11.36 +/- 1.5, 10.33 +/- 0.8), aconitase (1.06 +/- 0.1, 1.35 +/- 0.2), ICDH (31.70 +/- 2.7, 32.00 +/- 2.6), and KGDHC (2.62 +/- 0.4, 3.09 +/- 0.3). Separate analyses of the patients matched for age or postmortem interval gave similar conclusions. Cognitive dementia rating scores correlated poorly with activities of PDHC, aconitase, ICDH, and KGDHC. In one schizophrenic patient, activity of aconitase was undetectable, and in two others KGDHC activity was very low. Both had low activities of ICDH. A reduced activity of these enzymes in a subgroup is consistent with other data, suggesting that some patients with schizophrenia have abnormalities in brain mitochondria. However, in schizophrenia, unlike a number of neurodegenerative diseases, reductions in the activities of the key mitochondrial enzymes KGDHC and PDHC are not frequent. C1 Cornell Univ, Weill Med Coll, Burke Med Res Inst, Dept Neurol & Neurosci, White Plains, NY 10605 USA. Cornell Univ, Dept Psychiat, New York Presbyterian Hosp, Weill Med Coll, White Plains, NY USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY 10021 USA. Bronx Vet Affairs Med Ctr, MIRECC, Bronx, NY 10468 USA. RP Gibson, GE (reprint author), Cornell Univ, Weill Med Coll, Burke Med Res Inst, Dept Neurol & Neurosci, White Plains, NY 10605 USA. EM ggibson@med.cornell.edu FU NIA NIH HHS [AG19589, AG14930]; NIMH NIH HHS [MH45212] NR 31 TC 24 Z9 25 U1 1 U2 1 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0895-8696 J9 J MOL NEUROSCI JI J. Mol. Neurosci. PY 2004 VL 24 IS 2 BP 315 EP 321 DI 10.1385/JMN:24:2:315 PG 7 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 864IX UT WOS:000224628300018 PM 15456945 ER PT J AU Germano, PM Le, SV Oh, DS Fan, R Lieu, S Siu, A Pisegna, JR AF Germano, PM Le, SV Oh, DS Fan, R Lieu, S Siu, A Pisegna, JR TI Differential coupling of the PAC1 SV1 splice variant on human colonic tumors to the activation of intracellular cAMP but not intracellular Ca2+ does not activate tumor proliferation SO JOURNAL OF MOLECULAR NEUROSCIENCE LA English DT Article; Proceedings Paper CT 13th Annual Summer Neuropeptides Conference CY 2003 CL MONTAUK, NY DE pituitary adenylate cyclase-activating polypeptide; pituitary adenylate cyclase-activating polypeptide type 1 receptor; adenylyl cyclase ID LUNG-CANCER CELLS; ADENYLATE-CYCLASE; SIGNAL-TRANSDUCTION; I RECEPTOR; POLYPEPTIDE; PEPTIDE; INTERNALIZATION; PHARMACOLOGY; EXPRESSION; GROWTH AB PAC1 is a recently cloned and characterized heptahelical, G protein-coupled receptor with high affinity to PACAP-27 and PACAP-38 and is differentially coupled to activate intracellular Call and cAMP. PAC1 is expressed as four major splice variants, each possessing differential coupling to inositol phosphates and intracellular Ca2+. PAC1 has been shown previously to be expressed and regulate the growth and proliferation of nonsquamous cell lung cancer cells, as well as breast cancer cell lines. PAC1 is expressed on the HCT8 human colon cancer cell line and is coupled to the activation of both intracellular cAMP and Ca2+ with consequent stimulation of growth. In the current study, we contrast the effects of pituitary adenylate cyclase-activating polypeptide (PACAP) on the HCT8 colon cancer cell lines to the HCT116 and FET cell lines wherein PAC1 is expressed as the SV1 or HIP splice variant and is coupled to the activation only of cAMP but not of intracellular Ca2+. These data indicate that human colon tumor cells express PAC1 and are differentially coupled to intracellular signal transduction molecules. The ability to activate both cAMP and Ca2+ appears to be a prerequisite for activation of tumor proliferation, indicating a potentially important factor in how PACAP potentiates the growth of certain tumors. C1 Vet Adm Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90073 USA. RP Pisegna, JR (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. EM pgermano@ucla.edu; jpisegna@ucla.edu NR 17 TC 9 Z9 10 U1 0 U2 0 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0895-8696 J9 J MOL NEUROSCI JI J. Mol. Neurosci. PY 2004 VL 22 IS 1-2 BP 83 EP 91 DI 10.1385/JMN:22:1-2:83 PG 9 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 773LG UT WOS:000188924800010 PM 14742913 ER PT J AU Filley, CM Halliday, W Kleinschmidt-DeMasters, BK AF Filley, CM Halliday, W Kleinschmidt-DeMasters, BK TI The effects of toluene on the central nervous system SO JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY LA English DT Review DE dementia; magnetic resonance imaging; neurotoxin; solvent vapor abuse; toluene; leukoencephalopathy; white matter ID FETAL ALCOHOL SYNDROME; SOLVENT VAPOR ABUSE; WHITE-MATTER; MAGNETIZATION-TRANSFER; MRI ABNORMALITIES; PRENATAL EXPOSURE; EMBRYOPATHY; BRAIN; INHALATION; ENCEPHALOPATHY AB In recent decades the organic solvent toluene (methylbenzene) has emerged as one of the best-studied neurotoxins. Long-term and intense exposure to toluene vapors in humans who abuse spray paint and related substances has led to the recognition that toluene has a severe impact on central nervous system myelin. Chronic toluene abuse produces a devastating neurological disorder, of which dementia is the most disabling component. The clinical syndrome, toluene leukoencephalopathy, can be detected by a combination of characteristic symptoms and signs, detailed neurobehavioral evaluation, and brain magnetic resonance imaging. In this paper, we consider the impact of toluene abuse on our society, describe the specific neurobehavioral deficits in toluene leukoencephalopathy, review the spectrum of neuroimaging findings in patients with this disorder, summarize the teratogenic effects of toluene in both humans and animal models, and offer possible explanations for the range of neuropathological damage seen in brains of individuals who chronically abuse toluene. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pathol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurosurg, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Toronto Western Hosp, Toronto, ON M5T 2S8, Canada. RP Kleinschmidt-DeMasters, BK (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol, 4200 E 9th Ave, Denver, CO 80262 USA. NR 67 TC 74 Z9 84 U1 2 U2 14 PU AMER ASSN NEUROPATHOLOGISTS INC PI LAWRENCE PA 1041 NEW HAMPSHIRE ST, LAWRENCE, KS 66044 USA SN 0022-3069 J9 J NEUROPATH EXP NEUR JI J. Neuropathol. Exp. Neurol. PD JAN PY 2004 VL 63 IS 1 BP 1 EP 12 PG 12 WC Clinical Neurology; Neurosciences; Pathology SC Neurosciences & Neurology; Pathology GA 757HL UT WOS:000187556900001 PM 14748556 ER PT J AU Merriam, GR Carney, C Smith, LC Kletke, M AF Merriam, GR Carney, C Smith, LC Kletke, M TI Adult growth hormone deficiency: Current trends in diagnosis and dosing SO JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM LA English DT Article; Proceedings Paper CT 17th Annual National Cooperative Growth Study (NCGS)/4th Annual National Cooperative Somatropin Surveillance Investigator Meeting (NCSS) CY SEP 17-21, 2003 CL Baltimore, MD DE growth hormone; growth hormone deficiency; adults; diagnosis; growth hormone dosing ID GH-RELEASING-HORMONE; BODY-COMPOSITION; DOSE-RESPONSE; YOUNG-ADULTS; REPLACEMENT; SECRETION; THERAPY; AGE; ARGININE AB Only similar to 20 % of adults with GH deficiency (GHD) have a history of childhood-onset GHD; the remainder acquire GHD in adult life, usually through acquired damage to the pituitary-hypothalamic region. Diagnosis of GHD in adults is more difficult than in children and is made first from the clinical context, reinforced by signs and symptoms, and then confirmed by biochemical testing. The signs and symptoms, however, including altered body composition, reduced energy, and mild depression, are too common to have diagnostic value without a suggestive clinical context. Furthermore, biochemical tests for GH or IGF-I levels are imperfect, characterized by significant false-positive and-negative rates. GH dosing in adults has shifted to an individualized dose-titration approach, in which treatment is begun at a fixed dose and then titrated upward until IGF-I levels normalize, significant side effects develop, or beneficial effects plateau. Generally, women require higher GH doses than do men. Reflecting age-related differences in normal GH secretion, GH doses may be higher in young adults and lower in older patients. C1 VA Puget Sound Hlth Care Syst, Tacoma, WA 98493 USA. Univ Washington, Sch Med, Div Metab Endocrinol & Nutr, Tacoma, WA USA. Univ Washington, Sch Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. RP Merriam, GR (reprint author), VA Puget Sound Hlth Care Syst, Bldg 18C,Room 127 9600 Vet Dr SW, Tacoma, WA 98493 USA. EM merriam@u.washington.edu NR 34 TC 6 Z9 6 U1 0 U2 0 PU FREUND PUBLISHING HOUSE LTD PI LONDON PA STE 500, CHESHAM HOUSE, 150 REGENT ST, LONDON W1R 5FA, ENGLAND SN 0334-018X J9 J PEDIATR ENDOCR MET JI J. Pediatr. Endocrinol. Metab. PY 2004 VL 17 SU 4 BP 1307 EP 1320 PG 14 WC Endocrinology & Metabolism; Pediatrics SC Endocrinology & Metabolism; Pediatrics GA 951XV UT WOS:000230966600008 PM 15506077 ER PT J AU Wu, MF John, J Boehmer, LN Yau, D Nguyen, GB Siegel, JM AF Wu, MF John, J Boehmer, LN Yau, D Nguyen, GB Siegel, JM TI Activity of dorsal raphe cells across the sleep-waking cycle and during cataplexy in narcoleptic dogs SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID FREELY MOVING CATS; LOCUS-COERULEUS NEURONS; SINGLE-UNIT RESPONSES; IN-VIVO MICRODIALYSIS; BEHAVIORAL ORGANIZATION; RETICULAR-FORMATION; HYPOCRETIN NEURONS; CANINE NARCOLEPSY; UNRESTRAINED CAT; REM-SLEEP AB Cataplexy, a symptom associated with narcolepsy, represents a unique dissociation of behavioural states. During cataplectic attacks, awareness of the environment is maintained, as in waking, but muscle tone is lost, as in REM sleep. We have previously reported that, in the narcoleptic dog, noradrenergic cells of the locus coeruleus cease discharge during catapilexy. In the current study, we report on the activity of serotonergic cells of the dorsal raphe nucleus. The discharge patterns of serotonergic dorsal raphe cells across sleep-waking states did not differ from those of dorsal raphe and locus coeruleus cells recorded in normal rats, cats and monkeys, with tonic discharge in waking, reduced activity in non-REM sleep and cessation of activity in REM sleep. However, in contrast with locus coeruleus cells, dorsal raphe REM sleep-off neurones did not cease discharge during cateplexy. Instead, discharge continued at a level significantly higher than that seen in REM sleep and comparable to that seen in non-REM sleep. We also identified several cells in the dorsal raphe whose pattern of activity was the opposite of that of the presumed serotonergic cells. These cells were maximally active in REM sleep and minimally active in waking and increased activity during cataplexy. The difference between noradrenergic and serotonergic cell discharge profiles in cataplexy suggests different roles for these cell groups in the normal regulation of environmental awareness and muscle tone and in the pathophysiology of narcolepsy. C1 Vet Adm GLAHS Sepulveda, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90095 USA. RP Wu, MF (reprint author), Vet Adm GLAHS Sepulveda, Neurobiol Res 151A3,16111 Plummer St, Sepulveda, CA 91343 USA. EM mfwu@ucla.edu FU NHLBI NIH HHS [HL41370, R01 HL041370, R37 HL041370]; NIMH NIH HHS [MH64109, R01 MH064109]; NINDS NIH HHS [NS14610, R01 NS014610, R37 NS014610] NR 50 TC 64 Z9 65 U1 0 U2 4 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD JAN 1 PY 2004 VL 554 IS 1 BP 202 EP 215 DI 10.1113/jphysiol.2003.052134 PG 14 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 770XN UT WOS:000188756800020 PM 14678502 ER PT J AU Radulovic, M Spungen, AM Wecht, JM Korsten, MA Schilero, GJ Bauman, WA Lesser, M AF Radulovic, M Spungen, AM Wecht, JM Korsten, MA Schilero, GJ Bauman, WA Lesser, M TI Effects of neostigmine and glycopyrrolate on pulmonary resistance in spinal cord injury SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE glycopyrrolate; impulse oscillation; neostigmine; spinal cord injury ID AIRWAY HYPERRESPONSIVENESS; ATROPINE; INHALATION; MECHANICS; DISEASE; ASTHMA AB Preliminary findings in subjects with spinal cord injury (SCI) suggest that neostigmine administered intravenously increases colonic tone, increases colonic contractions, and facilitates bowel evacuation. Of concern are potential pulmonary side effects, including an increase in airway secretions and bronchospasm. The objectives of the study were to determine the effects of intravenously administered neostigmine or neostigmine combined with glycopyrrolate on forced oscillation indices in persons with SCI. Pulmonary resistances at 5 Hz (R5) and 20 Hz (R20) were measured with the use of an impulse oscillation system (IOS) in 11 subjects with SCI. Values were obtained before and after the intravenous administration of 2 mg of neostigmine alone and, on a separate day, before and after the administration of 2 mg of neostigmine combined with 0.4 mg of glycopyrrolate. Baseline R5 and R20 values before neostigmine correlated significantly with baseline values before neostigmine combined with glycopyrrolate. Following neostigmine, mean R5 values increased 25% and mean R20 values increased 18%. Following neostigmine combined with glycopyrrolate, mean R5 values fell 9% and mean R20 values fell 7%. In summary, baseline IOS values obtained on 2 different days were highly reproducible in this population. Neostigmine alone induced significant bronchoconstriction, whereas neostigmine combined with glycopyrrolate caused bronchodilation. C1 Bronx Vet Adm Med Ctr, Med Serv, Bronx, NY 10468 USA. Mt Sinai Med Ctr, Dept Med, New York, NY 10029 USA. RP Lesser, M (reprint author), Bronx Vet Adm Med Ctr, Med Serv, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Drmlesser@aol.com NR 17 TC 4 Z9 4 U1 0 U2 1 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD JAN-FEB PY 2004 VL 41 IS 1 BP 53 EP 57 DI 10.1682/JRRD.2004.01.0053 PG 5 WC Rehabilitation SC Rehabilitation GA 805XM UT WOS:000220399000008 PM 15273897 ER PT J AU Schilero, GJ Grimm, D Spungen, AM Lenner, R Lesser, M AF Schilero, GJ Grimm, D Spungen, AM Lenner, R Lesser, M TI Bronchodilator responses to metaproterenol sulfate among subjects with spinal cord injury SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE adrenergic beta-agonists; airway resistance; bronchodilator agents; paraplegia; spinal cord diseases; spirometry; tetraplegia; whole-body plethysmography ID HYPERREACTIVITY; OBSTRUCTION; THERAPY; LESIONS AB A previous study using spirometric methods demonstrated that 42% of subjects with tetraplegia experienced significant bronchodilation following inhalation of metaproterenol sulfate (MS). Comparative studies involving subjects with paraplegia were not performed and none has been performed in this population using body plethysmography, a more sensitive method used to assess airway responsiveness. Stable subjects with tetraplegia (n = 5) or paraplegia (n = 5) underwent spirometry and determination of specific airway conductance (sGaw) by body plethysmography at baseline and 30 minutes after nebulization of MS (0.3 mL of a 5% solution). Among subjects with tetraplegia, inhaled MS resulted in significant increases in spirometric indices and sGaw. Among subjects with paraplegia, only sGaw increased significantly, although this increase was considerably less than that seen in subjects with tetraplegia. Our findings indicate that subjects with tetraplegia exhibit greater bronchodilation in response to inhaled MS than do subjects with paraplegia and that sGaw measurements may confer greater sensitivity for assessing bronchodilator responsiveness in tetraplegia. C1 Bronx Dept Vet Affairs Med Ctr, Pulm Crit Care Med Sect, Bronx, NY USA. New York Chiropract Coll, Basic Sci Dept, Seneca Falls, NY USA. Mt Sinai Sch Med, Dept Med, New York, NY USA. Mt Sinai Sch Med, Dept Rehabil Med, New York, NY USA. RP Schilero, GJ (reprint author), Bronx Vet Adm Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM greg.schilero@med.va.gov NR 20 TC 10 Z9 11 U1 0 U2 0 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD JAN-FEB PY 2004 VL 41 IS 1 BP 59 EP 64 DI 10.1682/JRRD.2004.01.0059 PG 6 WC Rehabilitation SC Rehabilitation GA 805XM UT WOS:000220399000009 PM 15273898 ER PT J AU Korsten, MA Fajardo, NR Rosman, AS Creasey, GH Spungen, AM Bauman, WA AF Korsten, MA Fajardo, NR Rosman, AS Creasey, GH Spungen, AM Bauman, WA TI Difficulty with evacuation after spinal cord injury: Colonic motility during sleep and effects of abdominal wall stimulation SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE bowel care; colon; constipation; difficulty with evacuation; motility; neuromuscular stimulation; spinal cord injury ID TRANSIT AB Difficulty with evacuation (DWE) is common in individuals with spinal cord injury (SCI). Numerous studies have concluded that constipation, impaction, and incontinence cause significant morbidity and, collectively, constitute an important quality-of-life issue in individuals with SCI. Colonic motor activity was assessed using a solid-state manometry probe. We report here that colonic pressure activity is depressed during sleep compared to that observed in able-bodied controls. In addition, pressure activity was decreased during sleep compared to pre-sleep and post-sleep. We suspect that this may contribute to delayed colon transit time after SCI. In addition, since contraction of the abdominal wall musculature plays a role in normal defecation, we assessed whether an abdominal belt with implanted electrodes would improve DWE. In this respect, we demonstrated that neuromuscular stimulation of the abdominal wall improves a number of indices of defecatory function, including time to first stool and total bowel care time. C1 Bronx Vet Adm Med Ctr, Dept VA Rehabil Res, Spinal Cord Injury Serv & Med Serv, Bronx, NY 10468 USA. VA Med Ctr, Dev Ctr Excellence, Spinal Cord Injury Serv & Med Serv, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Med, New York, NY USA. Mt Sinai Sch Med, Dept Rehabil Med, New York, NY USA. Mt Sinai Sch Med, Spinal Cord Damage Res Ctr, New York, NY USA. Case Western Reserve Univ, Cleveland, OH 44106 USA. MetroHlth Med Ctr, Cleveland, OH 44109 USA. RP Korsten, MA (reprint author), Bronx Vet Adm Med Ctr, Dept VA Rehabil Res, Spinal Cord Injury Serv & Med Serv, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM mark.korsten@med.va.gov NR 12 TC 10 Z9 12 U1 0 U2 1 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD JAN-FEB PY 2004 VL 41 IS 1 BP 95 EP 99 DI 10.1682/JRRD.2004.01.0095 PG 5 WC Rehabilitation SC Rehabilitation GA 805XM UT WOS:000220399000013 PM 15273902 ER PT J AU Cooper, GS Treadwell, EL Dooley, MA St Clair, EW Gilkeson, GS Taylor, JA AF Cooper, GS Treadwell, EL Dooley, MA St Clair, EW Gilkeson, GS Taylor, JA TI N-acetyl transferase genotypes in relation to risk of developing systemic lupus erythematosus SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE systemic lupus erythematosus; autoimmune disease; N-acetyl transferase metabolism; tobacco; arylamines ID NAT1; POLYMORPHISMS; PHENOTYPE; CYP1A1 AB Objective. To examine the association between N-acetyl transferase (NAT) genotype (NAT1 and NAT2) and risk of developing systemic lupus erythematosus (SLE). Methods. DNA samples were collected from 243 recently diagnosed cases and 298 controls enrolled in a population based case-control study conducted in 60 counties in North Carolina and South Carolina, USA. Results. There was no association between SLE and NAT1 genotype (OR 0.96, 95% CI 0.65, 1.4 for the presence of a *10 allele) or NAT2 genotype (OR 1.1, 95 % CI 0.73, 1.6 for the slow- compared with fast-acetylation genotype). We saw some evidence of interaction between NAT genotypes and use of hair dyes (a source of arylamines), with higher risk seen among hair dye users who had both the *10 NAT1 allele and the NAT2 slow-acetylation genotype (OR 2.9, 95% CI 1.2, 6.9 in this subgroup compared with all others). Conclusion. Our results suggest that although there is little overall association between NAT genotypes and risk of developing SLE, the interaction between NAT1 and NAT2 and specific exposures such as hair dyes may be important. This finding highlights the need to consider exposure when assessing genetic susceptibility. C1 NIEHS, Epidemiol Branch, Res Triangle Pk, NC 27709 USA. Univ N Carolina, Div Rheumatol, Chapel Hill, NC 27515 USA. E Carolina Univ, Sch Med, Div Rheumatol, Greenville, NC 27858 USA. Duke Univ, Med Ctr, Div Rheumatol, Durham, NC 27706 USA. Ralph H Johnson Vet Adm Med Ctr, Med Res Serv, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Cooper, GS (reprint author), NIEHS, Epidemiol Branch, A3-05,POB 12233, Res Triangle Pk, NC 27709 USA. EM cooper1@niehs.nih.gov OI taylor, jack/0000-0001-5303-6398 NR 15 TC 8 Z9 12 U1 0 U2 0 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD JAN PY 2004 VL 31 IS 1 BP 76 EP 80 PG 5 WC Rheumatology SC Rheumatology GA 763GG UT WOS:000188066100015 PM 14705222 ER PT J AU Schilero, GJ Grimm, D Lesser, M AF Schilero, GJ Grimm, D Lesser, M TI Comparison of lung volume measurements in individuals with spinal cord injury by two different methods SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE lung volume measurements; paraplegia; plethysmography; whole body; nitrogen washout; spinal cord injuries; tetraplegia ID THORACIC GAS VOLUME; HEALTHY NONSMOKING ADULTS; MECHANICS; QUADRIPLEGIA; OBSTRUCTION; FREQUENCY AB Background/Objective: Few detailed studies have been performed among subjects with spinal cord injury (SCI) using whole body plethysmography for measurement of static lung volumes. Because abdominal gas volumes and respiratory patterns among subjects with varying levels of SCI may differ significantly from able-bodied individuals, methodological concerns related to this technique could conceivably lead to inaccuracies in lung volume measurements. The purpose of this study was to compare lung volume parameters obtained by whole body plethysmography with those determined by the commonly used nitrogen washout technique among individuals with SCI. Participants: Twenty-nine clinically stable men, 14 with chronic tetraplegia (injury C4-C7) and 15 with paraplegia (injury below T5) participated in the study. Methods: Lung volumes were obtained using whole body plethysmography and the open-circuit nitrogen washout technique. Within both study groups, data were evaluated by the paired Student's t test and by determination of correlation coefficients. Results: No statistically significant differences for any lung volume parameter were found within either group. In subjects with tetraplegia on paraplegia, respectively, strong correlation coefficients were found for measurements of total lung capacity (.86 and .97), functional residual capacity (.87 and .96), and residual volume (.77 and .85). Conclusion: These findings indicate that body plethysmography is a valid technique for determining lung volumes among subjects with SCI. Because airway resistance measurements can also be obtained during same study sessions for assessment of airway caliber and bronchial responsiveness, body plethysmography is a useful tool for examining multiple aspects of pulmonary physiology in this population. C1 Bronx Vet Affairs Med Ctr, Spinal Cord Damage Res Ctr, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Pulm Crit Care Med Sect, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Med, New York, NY USA. New York Chiropract Coll, Dept Basic Sci, Seneca Falls, NY USA. RP Schilero, GJ (reprint author), Bronx Vet Affairs Med Ctr, Spinal Cord Damage Res Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM greg.schilero@med.va.gov NR 26 TC 1 Z9 1 U1 0 U2 1 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2004 VL 27 IS 5 BP 443 EP 447 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 884GJ UT WOS:000226072500005 PM 15648798 ER PT J AU Fitzgerald, SG Cooper, RA Thorman, T Cooper, R Guo, SF Boninger, ML AF Fitzgerald, SG Cooper, RA Thorman, T Cooper, R Guo, SF Boninger, ML TI The GAME(Cycle) exercise system: Comparison with standard ergometry SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; wheelchair; exercise; computer games; cardiovascular fitness; ergometry ID SPINAL-CORD-INJURY; DENSITY-LIPOPROTEIN CHOLESTEROL; WHEELCHAIR ERGOMETRY; PHYSICAL-ACTIVITY; COMPUTER GAMES; HEART-DISEASE; ARM EXERCISE; RISK-FACTORS; VIDEO-GAME; INDIVIDUALS AB Background: It is well established that physical activity is beneficial to health. For the individual in a wheelchair, a regular exercise program might not be available or may be too difficult to participate in physically and/or psychologically. Many exercise devices and regimes are boring. The goal, therefore, is to develop a device that makes exercise more exciting and, thus, motivates a person to exercise more or for a longer period of time, yielding increased energy expenditure. Our laboratory developed an interface between an arm ergometer and a computer game that allows the user to control game play on the screen as if using a joystick. The purpose of this study was to determine (a) whether the GAME(Cycle) system would elicit an exercise effect similar to arm ergometry, (b) whether perceived exertion would be different between the 2 devices, and (c) individuals' impressions regarding the GAME(Cycle) system. Methods: Thirteen individuals who used wheelchairs participated in the study. Participants were asked to exercise for 2 separate, 19-minute sessions. For 1 session, a GAME(Cycle) system was used and for the other session, the same arm ergometer was used, but without the computer game being played. Physiologic data and perceived exertion were collected for each session. Results: There were significant differences between playing the game and not playing the game for VO2 (P = 0.03) and VCO2 (P = 0.02), with higher values being found when the game was played. Perceived exertion was not significantly different between the 2 trials. Conclusion: GAME(Cycle) appears to be similar in nature with respect to energy expenditure to arm ergometry. Because this study was conducted on athletes, further research is needed with sedentary individuals to determine exercise effects and perceived exertion. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Ctr Excellence Wheelchairs & Related Technol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. Forum Hlth Hillside Rehab Hosp, Warren, OH USA. RP Fitzgerald, SG (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Ctr Excellence Wheelchairs & Related Technol, 7180 Highland Dr,Bldg 4,2nd Floor E,151R-1, Pittsburgh, PA 15213 USA. EM sgf9@pitt.edu RI Loureiro, Nuno/I-6400-2012 OI Loureiro, Nuno/0000-0002-1166-3219; Boninger, Michael/0000-0001-6966-919X FU NICHD NIH HHS [1R41HD39535-01] NR 39 TC 16 Z9 16 U1 1 U2 5 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2004 VL 27 IS 5 BP 453 EP 459 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 884GJ UT WOS:000226072500007 PM 15648800 ER PT J AU Cooper, RA Wolf, E Fitzgerald, SG Kellerher, A Ammer, W Boninger, ML Cooper, R AF Cooper, RA Wolf, E Fitzgerald, SG Kellerher, A Ammer, W Boninger, ML Cooper, R TI Evaluation of selected sidewalk pavement surfaces for vibration experienced by users of manual and power wheelchairs SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE wheelchairs; vibration; injury; pavement surfaces ID WHOLE-BODY VIBRATION; LOW-BACK-PAIN; SEAT VIBRATION; SUSPENSION; DRIVERS AB Background: Obstacles such as bumps, curb descents, and uneven driving surfaces cause vibrations that affect the wheelchair, and in turn, the wheelchair user. Chronic exposure can cause low-back pain, disk degeneration, and other harmful effects. Little research has been conducted to assess the vibrations experienced by wheelchair users. Objective: The purpose of this study was to conduct an evaluation of the vibration exposure during electric-powered wheelchair driving and mechanical energy requirements for manual wheelchair propulsion over selected sidewalk surfaces. The goal was to determine the criteria for a wheelchair-pedestrian access route that does not require excessive propulsive work or expose wheelchair users to potentially harmful vibrations. Methods: Ten unimpaired individuals participated in this study. Six sidewalk surfaces were tested. Measured variables included power of the acceleration per octave, mechanical work to propel over surfaces, peak acceleration, and frequency at which peak acceleration occurs. Results: For both the manual and electric-powered wheelchair, at 1 m/s, significant differences were found in peak accelerations between the seat and footrest (P < 0.0001) and between the sidewalk surfaces (P = 0.004). The greatest risk for injury caused by shock and vibration exposure occurs at frequencies near the natural frequency of seated humans (4-15 Hz). The values for work required to propel over the surfaces tested were not statistically significantly different. Besides appearance and construction, the only distinguishing characteristic was surface roughness caused by the joints. Conclusion: When treating the poured concrete sidewalk as the standard, surfaces 2, 3, 5, and 6 compared most favorably in terms of vibration exposure, whereas surface 4 produced mixed results. Surfaces 2, 3, 5, and 6 yielded results that were similar to the poured concrete sidewalk and could be considered acceptable for wheelchair users. In conclusion, surfaces other than the traditional poured concrete can be used for pedestrian access routes without adding vibration exposure or reducing propulsion efficiency. C1 VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15260 USA. RP Cooper, R (reprint author), VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs, 151-R1,71080 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper+9@pitt.edu NR 26 TC 12 Z9 12 U1 0 U2 3 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2004 VL 27 IS 5 BP 468 EP 475 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 884GJ UT WOS:000226072500009 PM 15648802 ER PT J AU Tolbert, G Tuck, ML AF Tolbert, G Tuck, ML TI Ambulatory blood pressure monitoring in persons with chronic spinal cord injury SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE blood pressure; sympathetic nervous activities; spinal cord injuries; ambulatory blood pressure measurements ID AUTONOMIC HYPERREFLEXIA; ORTHOSTATIC HYPOTENSION; HYPERTENSION; VARIABILITY; DYSREFLEXIA; MANAGEMENT AB Background: Hypertension alone or in the presence of autonomic dysreflexia (AD) may be underdiagnosed and consequently mismanaged in people with chronic spinal cord injury (SCI). Blood pressure (BP) derangements caused by AD are characterized by labile BP, in addition to episodic hypertension. Consequently, random BP readings often prove insufficient, which makes traditional outpatient evaluation and management suboptimal. Because elevated BP is common to essential hypertension (EH) and AD, distinction between the 2 entities proves challenging. The distinction is imperative because the treatments differ. Conventional BP monitoring in the office may miss labile BP patterns and episodic BP elevations. Ambulatory BP monitoring (ABPM) is used in the general population to improve the diagnosis and management of hypertension. ABPM provides the average BP level, circadian rhythm, and short-term BP variability. There is a paucity of ABPM studies in persons with SCI. Objective: To explore the role of ABPM in individuals with SCI. Methods: This study is a case description and detailed analysis of the use of ambulatory blood pressure monitoring (ABPM) in 3 persons with chronic SCI. Results: Three cases were identified in which the diagnosis of autonomic dysreflexia, exaggerated blood pressure variability and disruption of circadian blood pressure pattern was delayed using conventional blood pressure evaluation. ABPM aided in diagnosis by providing the average blood pressure level, circadian rhythm and short-term BP variability. Conclusion: Because conventional office BP monitoring may miss labile BP patterns and episodic BP elevations, it is limited in the SCI population. ABPM may improve the outpatient management of blood pressure abnormalities in individuals with chronic SCI by clarifying mechanisms and patterns of BP in this patient population. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. RP Tolbert, G (reprint author), Ctr Rehabil & Wellness, 17609 Ventura Blvd,114, Encino, CA 91316 USA. EM gtolbert1@yahoo.com NR 21 TC 3 Z9 5 U1 0 U2 2 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2004 VL 27 IS 5 BP 476 EP 480 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 884GJ UT WOS:000226072500010 PM 15648803 ER PT J AU Peng, L Zhou, XH AF Peng, L Zhou, XH TI Local linear smoothing of receiver operating characteristic (ROC) curves SO JOURNAL OF STATISTICAL PLANNING AND INFERENCE LA English DT Article DE empirical distribution; empirical quantile; ROC curve; smoothing ID STATISTICS AB For measuring the accuracy of a continuous diagnostic test, the receiver operating characteristic (ROC) curve is often used. The empirical ROC curve is the most commonly used non-parametric estimator for the ROC curve. Recently, Lloyd (J. Amer. Statist. Assoc. 93(1998) 1356) proposed a kernel smoothing estimator for the ROC curve and showed his estimator has better mean square error than the empirical ROC curve estimator. However, Lloyd's estimator involves two bandwidths and has a boundary problem. In addition, his choice of bandwidths is ad hoc. In this paper. we propose another kernel smoothing estimator which involves only one bandwidth and does not have the boundary problem. Furthermore, our choice of the bandwidth is asymptotically optimal. (C) 2002 Elsevier B.V.. All rights reserved. C1 Georgia Inst Technol, Sch Math, Atlanta, GA 30332 USA. Indiana Univ, Sch Med, Div Biostat, Indianapolis, IN 46202 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98108 USA. RP Peng, L (reprint author), Georgia Inst Technol, Sch Math, Atlanta, GA 30332 USA. NR 12 TC 25 Z9 25 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-3758 J9 J STAT PLAN INFER JI J. Stat. Plan. Infer. PD JAN 1 PY 2004 VL 118 IS 1-2 BP 129 EP 143 AR PII S0378-3758(02)00394-4 DI 10.1016/S0378-3758(02)00394-4 PG 15 WC Statistics & Probability SC Mathematics GA 739ZM UT WOS:000186376500009 ER PT J AU Goldschmidt, L Goodrich, GL AF Goldschmidt, L Goodrich, GL TI Development and evaluation of a point-of-care interactive patient education kiosk SO JOURNAL OF TELEMEDICINE AND TELECARE LA English DT Article; Proceedings Paper CT 4th International Conference on Successes and Failurew in Telehealth CY JUL 22-23, 2004 CL Brisbane, AUSTRALIA ID COMPLICATIONS; INFORMATION; RISK AB We have developed an interactive patient education kiosk. The kiosk provides access to stored health information and to selected Websites via a high-speed Internet connection. The output is bilingual (English or Spanish) and an enclosed printer allows information to be printed and taken home for later reading. Each kiosk records patient usage, as well as the results of a brief, voluntary, online evaluation questionnaire. Three kiosks were placed in the patient waiting area of busy multi-specialty clinics. Two kiosks were active for 2.5 years and one was active for 1.5 years. There were 38,868 user sessions recorded and 2878 users participated in the online survey questionnaire (7% of all user sessions). Patient satisfaction was high; for example, 68% of respondents found some or all of the information they were looking for on the kiosk. In the year following the introduction of the first kiosk (the 2001/02 flu season), there was a 24% increase in the number of patients receiving flu vaccinations within the Palo Alto health-care system, compared with the previous year. Experience to date suggests that the kiosks may increase patient compliance with selected clinical guidelines and instructions. C1 VA Palo Alto Hlth Care Syst, Palo Alto, CA 94304 USA. US Dept Vet Affairs, Psychol Serv, Palo Alto, CA USA. RP Goldschmidt, L (reprint author), VA Palo Alto Hlth Care Syst, 3801 Miranda Ave, Palo Alto, CA 94304 USA. EM Leonard.Goldschmidt2@med.va.gov NR 11 TC 2 Z9 2 U1 0 U2 1 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1G 0AE, ENGLAND SN 1357-633X J9 J TELEMED TELECARE JI J. Telemed. Telecare PY 2004 VL 10 SU 1 BP S30 EP S32 PG 3 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 882NW UT WOS:000225946600010 ER PT J AU Hazzard, WR AF Hazzard, WR TI I am a geriatrician SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Editorial Material C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. RP Hazzard, WR (reprint author), Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. NR 1 TC 3 Z9 3 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JAN PY 2004 VL 52 IS 1 BP 161 EP 161 DI 10.1111/j.1532-5415.2004.52041.x PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 756DR UT WOS:000187451000028 PM 14687334 ER PT J AU Hardy, DJ Castellon, SA Hinkin, CH AF Hardy, DJ Castellon, SA Hinkin, CH TI Perceptual span deficits in adults with HIV SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article; Proceedings Paper CT 81st Annual Convention of the Western-Psychological-Association CY MAY, 2001 CL MAUI, HAWAII SP W Psycholog Assoc DE perceptual span; HIV infection; attention ID DEMENTIA COMPLEX; PERFORMANCE; INFECTION; TIME; SCHIZOPHRENICS; TASK AB Studies have found that infection with the Human Immunodeficiency Virus (HIV) leads to cognitive dysfunction. In fact, attention problems have been reported to be the most frequent cognitive symptom in HIV-infected adults. One question is how early in the course of information processing can attention impairment be detected? To address this issue, performance on a perceptual span task was examined in 54 HIV-infected adults and 19 seronegative controls. In this task a target had to be identified in a briefly presented (50 Pus) array of 1, 4, or 12 letter-characters. Response accuracy was differentially worse in the HIV+ group relative to seronegative controls in the most difficult condition, the 12-item array, but not in the easier conditions. There was no evidence of a group difference in response strategy due to disinhibition or in psychomotor speed. These data suggest that HIV infection leads to a reduction in early visual processing capacity (or span of apprehension). The present results illustrate a new type of attentional deficit in HIV and show the impact of HIV on cognition at an earlier point in information processing than has been previously reported. C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Hardy, DJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, 760 Westwood Plaza,Room C8-747, Los Angeles, CA 90024 USA. FU NIA NIH HHS [R03 AG-18549]; NIMH NIH HHS [R01 MH058552, R01 MH-58552] NR 29 TC 6 Z9 7 U1 0 U2 1 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4211 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD JAN PY 2004 VL 10 IS 1 BP 135 EP 140 PG 6 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 758ZQ UT WOS:000187713000014 PM 14751015 ER PT J AU Webber, AP Benjamin, C AF Webber, AP Benjamin, C TI Wandering hemiparesis SO JOURNAL OF THE ROYAL SOCIETY OF MEDICINE LA English DT Article ID HYPOGLYCEMIA C1 Univ Calif Los Angeles, Sch Med, Sepulveda, LA USA. GRECC, VA Greater Los Angeles, Sepulveda, LA USA. RP Webber, AP (reprint author), 10982 Roebling Ave,Unit 341, Los Angeles, CA 90024 USA. EM drawebber@hotmail.com NR 6 TC 1 Z9 1 U1 0 U2 0 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1G 0AE, ENGLAND SN 0141-0768 J9 J ROY SOC MED JI J. R. Soc. Med. PD JAN PY 2004 VL 97 IS 1 BP 26 EP 27 DI 10.1258/jrsm.97.1.26 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 767DW UT WOS:000188425800009 PM 14702361 ER PT J AU Resendiz, JC Feng, S Ji, G Kroll, MH AF Resendiz, JC Feng, S Ji, G Kroll, MH TI von Willebrand factor binding to platelet glycoprotein Ib-IX-V stimulates the assembly of an alpha-actinin-based signaling complex SO JOURNAL OF THROMBOSIS AND HAEMOSTASIS LA English DT Article DE actinin; polyphosphoinositides; shear stress; von Willebrand factor ID PATHOLOGICAL SHEAR-STRESS; PHOSPHOINOSITIDE 3-KINASE; INTEGRIN ALPHA(IIB)BETA(3); ACTIVATION; AGGREGATION; LOCALIZATION; CYTOSKELETON; 14-3-3-ZETA; ADHESION; GELSOLIN AB Background: Pathological shear stress induces platelet aggregation that is dependent on von Willebrand factor (VWF) binding to glycoprotein (Gp)Ib-IX-V and phosphatidylinositol 3-kinase activation. We tested the hypothesis that pathological shear stress stimulates phosphatidylinositol 3,4,5-trisphosphate (PIP3) synthesis by directing the assembly of a molecular signaling complex that includes class IA phosphatidylinositol 3-kinase (PI 3-KIA). Methods: Platelets were subjected to 120 dynes cm(-2) shear stress in a cone-plate viscometer. Resting and sheared platelets were lyzed, immunoprecipitations of PI 3-KIA performed, or lipids extracted for PIP3 measurements. alpha-Actinin was incubated with phosphatidylinositol 4,5-bisphosphate (PIP2), immunoprecipitated, and used as a substrate for in vitro PI 3-KIA activity. Results: Pathological shear stress induces biphasic PIP3 production. In resting platelets, PI 3-KIA associates with alpha-actinin and PIP2. After exposure to shear stress, alpha-actinin and PIP2 rapidly disassociate from PI 3-KIA. PI 3-KIA then gradually reassociates with PIP2 and alpha-actinin, and this complex becomes linked to GpIbalpha through the cytoskeleton. PIP3 production and the observed changes in the association between alpha-actinin, PIP2, and PI 3-KIA are inhibited when VWF binding to GpIbalpha is blocked. In a cell-free system, alpha-actinin binds PIP2 and when the alpha-actinin-PIP2 complex is added to platelet PI 3-KIA, PIP3 production is stimulated. Conclusions: These results suggest that pathological shear-induced VWF binding to GpIb-IX-V stimulates PIP3 production through the assembly of an alpha-actinin-based complex that colocalizes PI 3-KIA with substrate PIP2. C1 Wihuri Res Inst, SF-00140 Helsinki, Finland. Rice Univ, Baylor Coll Med, VA Med Ctr, Houston, TX 77251 USA. RP Resendiz, JC (reprint author), Wihuri Res Inst, Kalliolinnantie 4, SF-00140 Helsinki, Finland. EM julio.resendiz@wri.fi NR 33 TC 7 Z9 8 U1 0 U2 0 PU BLACKWELL PUBL LTD PI OXFORD PA 108 COWLEY RD, OXFORD OX4 1JF, OXON, ENGLAND SN 1538-7933 J9 J THROMB HAEMOST JI J. Thromb. Haemost. PD JAN PY 2004 VL 2 IS 1 BP 161 EP 169 DI 10.1111/j.1538-7836.2003.00497.x PG 9 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 767VT UT WOS:000188495100025 PM 14717980 ER PT J AU Elliott, MK Jarmi, T Ruiz, P Xu, YY Holers, VM Gilkeson, GS AF Elliott, MK Jarmi, T Ruiz, P Xu, YY Holers, VM Gilkeson, GS TI Effects of complement factor D deficiency on the renal disease of MRL/lpr mice SO KIDNEY INTERNATIONAL LA English DT Article DE lupus nephritis; animal models; complement alternative pathway ID SYSTEMIC LUPUS-ERYTHEMATOSUS; ISCHEMIA-REPERFUSION INJURY; FACTOR-B; ALTERNATIVE PATHWAY; MONOCLONAL-ANTIBODY; AUTOIMMUNE-DISEASE; COMPONENT C3; FACTOR-H; EXPRESSION; ACTIVATION AB Background. The alternative complement pathway (AP) is activated in individuals with lupus nephritis and in murine models of systemic lupus erythematosus, including MRL/lpr mice. A previous study from our laboratory evaluated the development of renal disease in MRL/lpr mice genetically deficient in factor B (Bf-/-), a protein necessary for AP activation. MRL/lpr Bf-/- mice developed less renal disease and had improved survival; however, these mice were also a different major histocompatibility complex (MHC) haplotype (H-2(b)) than their wild-type littermates (H-2(k)) due to the gene for Bf being located in the MHC gene complex. We undertook the current study to determine if the decreased renal disease in MRL/lpr Bf-/- mice was due to the lack of AP activation or the H-2(b) haplotype by studying the effects of factor D(Df) deficiency, a critical protein for AP activation, on disease development in MRL/lpr mice. Methods. Df-deficient mice were backcrossed with MRL/lpr mice for four to nine generations. MRL/lpr H-2(k) Df-/-,Df+/-, and Df +/+ littermates were evaluated for disease development. Lack of AP activation in MRL/lpr Df-/- mice was determined by the zymosan assay. Serum creatinine levels were measured using a creatinine kit. Proteinuria and autoantibody levels were determined by enzyme-linked immunosorbent assay (ELISA). Sections from one kidney were stained with fluorescein isothiocyanate (FITC) alpha-murine C3 or alpha-murine IgG to detect C3 and IgG deposition. The remaining kidney was cut in half with one half fixed, sectioned, and stained with hematoxylin and eosin and periodic acid-Schiff (PAS) to evaluate pathology and another half fixed in glutaraldehyde and examined via electron microscopy. Results. MRL/lpr Df-/- mice had similar glomerular IgG deposition, proteinuria and autoantibody levels, as Df+/+ and Df+/- littermates. However, glomerular C3 deposition, serum creatinine levels, and pathologic renal disease were significantly reduced in Df-/- mice. Despite the lack of renal disease in Df-/- mice, life span was not impacted by factor D deficiency. Conclusion. The absence of Df and AP activation is protective against the development of proliferative renal disease in MRL/lpr mice suggesting the similar effect of Bf deficiency in MRL/lpr mice was also due to the lack of AP activation. C1 Univ Nebraska, Med Ctr, Dept Internal Med, Omaha, NE USA. Med Univ S Carolina, Dept Med, Ralph H Johnson VA Med Ctr, Res Serv, Charleston, SC 29425 USA. Univ Miami, Sch Med, Dept Pathol, Miami, FL USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Colorado, Dept Med, Denver, CO USA. Univ Colorado, Dept Immunol, Denver, CO USA. RP Gilkeson, GS (reprint author), Med Univ S Carolina, Div Rheumatol Immunol, 96 Jonathan Lucas St,Suite 912,POB 250623, Charleston, SC 29425 USA. FU NIAID NIH HHS [AI47469]; NIAMS NIH HHS [AR39162, AR45476, P60AR20614] NR 46 TC 60 Z9 61 U1 0 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD JAN PY 2004 VL 65 IS 1 BP 129 EP 138 DI 10.1111/j.1523-1755.2004.00371.x PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 753YP UT WOS:000187276200013 PM 14675043 ER PT J AU Kestenbaum, B Seliger, SL Gillen, DL Wasse, H Young, B Sherrard, DJ Weiss, NS Stehman-Breen, CO AF Kestenbaum, B Seliger, SL Gillen, DL Wasse, H Young, B Sherrard, DJ Weiss, NS Stehman-Breen, CO TI Parathyroidectomy rates among United States dialysis patients: 1990-1999 SO KIDNEY INTERNATIONAL LA English DT Article DE parathyroidectomy; rates; incidence; dialysis; diabetes ID CHRONIC-RENAL-FAILURE; ADYNAMIC BONE-DISEASE; HEMODIALYSIS-PATIENTS; SECONDARY HYPERPARATHYROIDISM; DIABETIC-PATIENTS; REGULAR DIALYSIS; MORTALITY RISK; OSTEODYSTROPHY; HORMONE; TRANSPLANTATION AB Background. Medical therapy for secondary hyperparathyroidism (SHPTH) has evolved considerably during the past decade. It is not known how changes in medical therapy might impact the parathyroidectomy (PTX) rate among dialysis patients. Relatively low parathyroid hormone (PTH) levels have been found among elderly dialysis patients and those with diabetes. Clinical factors associated with differing PTX rates among United States dialysis patients have not been reported. We report PTX rates in the United States from 1990 to 1999 among persons with end- stage renal disease, accounting for changes in patient characteristics. Methods. Data from the United States Renal Database were utilized. Patients insured by Medicare or Medicaid and receiving renal replacement therapy between January 1, 1990, and December 31, 1999 were considered for analysis. PTX was determined by ICD- 9 procedure codes. Multivariate Poisson models were used to estimate adjusted PTX rates. Results. The overall observed PTX rate in the study sample was 7.16 per 1000 person- years at risk. After a slight rise during the early 1990s, adjusted PTX rates declined by approximately 30% between 1995 and 1999. Adjusted PTX rates were higher among patients who were younger, female, nondiabetic, receiving peritoneal dialysis, and those with a longer cumulative duration of dialysis. Conclusion. PTX rates have recently decreased in the United States, independent of changes in patient characteristics. The effectiveness of medical therapy in targeting secondary hyperparathyroidism may be improving. Younger, nondiabetic patients with a longer cumulative dialysis burden are at particularly high risk for PTX. C1 Univ Washington, Dept Med, Div Nephrol, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Gen Internal Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Nephrol, Seattle, WA 98195 USA. RP Kestenbaum, B (reprint author), Univ Washington, Dept Med, Div Nephrol, Box 3565221 BB 1265,Hlth Sci Bldg,1959 NE Pacific, Seattle, WA 98195 USA. RI Wasse, Haimanot/A-5726-2013 OI Wasse, Haimanot/0000-0001-5756-0242 NR 34 TC 46 Z9 48 U1 0 U2 3 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD JAN PY 2004 VL 65 IS 1 BP 282 EP 288 DI 10.1111/j.1523-1755.2004.00368.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 753YP UT WOS:000187276200031 PM 14675061 ER PT J AU Finch, RG Metlay, JP Davey, PG Baker, LJ AF Finch, RG Metlay, JP Davey, PG Baker, LJ CA Int Forum Antibiotic Resistance co TI Educational interventions to improve antibiotic use in the community: report from the International Forum on Antibiotic Resistance (IFAR) colloquium, 2002 SO LANCET INFECTIOUS DISEASES LA English DT Editorial Material ID RESPIRATORY-TRACT INFECTIONS; HEALTH-BEHAVIOR-CHANGE; STREPTOCOCCUS-PNEUMONIAE; PENICILLIN RESISTANCE; FAMILY-PRACTICE; ERYTHROMYCIN; CONSUMPTION; IMPACT; CARE; EXPECTATIONS AB National and international strategies for the control of antibiotic resistance recommend education for health-care professionals and the public to promote prudent antibiotic use. This paper, based on discussions at the 2002 colloquium of the International Forum on Antibiotic Resistance (IFAR), provides an international discourse between theoretical approaches to behaviour change and practical experience gained in large-scale antibiotic use educational campaigns. Interventions are more likely to be effective if their aim is to change behaviour, rather than provide information. They should target all relevant groups, especially parents, children, day-care staff, and health-care professionals. They should use clear and consistent messages concerning bacterial versus viral infection, prudent antibiotic use, symptomatic treatment, and infection-control measures (eg, handwashing). Campaigns should use a range of communications using pilot-testing, strong branding, and sociocultural adaptation. Prime-time television is likely to be the most effective public medium, while academic detailing is especially useful for health-care professionals. Multifaceted interventions can improve antibiotic prescribing to some degree. However, there are few data on their effects on resistance patterns and patient outcomes, and on their cost-effectiveness. Current research aims include the application of behaviour-change models, the development and validation of prudent antibiotic prescribing standards, and the refinement of tools to assess educational interventions. C1 City Hosp Nottingham, Nottingham NG5 1PB, England. Univ Nottingham, Nottingham NG7 2RD, England. Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Dundee, Ninewells Hosp & Med Sch, Med Monitoring Unit, Dundee DD1 9SY, Scotland. RP Finch, RG (reprint author), City Hosp Nottingham, Clin Sci Bldg,Hucknall Rd, Nottingham NG5 1PB, England. NR 60 TC 93 Z9 97 U1 1 U2 16 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1473-3099 J9 LANCET INFECT DIS JI Lancet Infect. Dis. PD JAN PY 2004 VL 4 IS 1 BP 44 EP 53 DI 10.1016/S1473-3099(03)00860-0 PG 12 WC Infectious Diseases SC Infectious Diseases GA 760HR UT WOS:000187806000023 PM 14720568 ER PT J AU McKeith, I Mintzer, J Aarsland, D Burn, D Chiu, H Cohen-Mansfield, J Dickson, D Dubois, B Duda, JE Feldman, H Gauthier, S Halliday, G Lawlor, B Lippa, C Lopez, OL Machado, JC O'Brien, J Playfer, J Reid, W AF McKeith, I Mintzer, J Aarsland, D Burn, D Chiu, H Cohen-Mansfield, J Dickson, D Dubois, B Duda, JE Feldman, H Gauthier, S Halliday, G Lawlor, B Lippa, C Lopez, OL Machado, JC O'Brien, J Playfer, J Reid, W CA Int Psychogeriatric Assoc Expert M TI Dementia with Lewy bodies SO LANCET NEUROLOGY LA English DT Article; Proceedings Paper CT Meeting of the International-Psychogeriatric-Association (IPA) CY NOV, 2002 CL BUDAPEST, HUNGARY SP Int Psychogeriatric Assoc ID SLEEP BEHAVIOR DISORDER; CLINICAL DIAGNOSTIC-CRITERIA; CSF AMYLOID BETA-42; NORMAL TAU LEVELS; ALZHEIMERS-DISEASE; PARKINSONS-DISEASE; ALPHA-SYNUCLEIN; BODY DEMENTIA; NEUROLEPTIC SENSITIVITY; VASCULAR DEMENTIA AB Dementia with Lewy bodies (DLB) is the second commonest cause of neurodegenerative dementia in older people. It is part of the range of clinical presentations that share a neuritic pathology based on abnormal aggregation of the synaptic protein alpha-synuclein. DLB has many of the clinical and pathological characteristics of the dementia that occurs during the course of Parkinson's disease. Here we review the current state of scientific knowledge on DLB. Accurate identification of patients is important because they have specific symptoms, impairments, and functional disabilities that differ from those of other common types of dementia. Severe neuroleptic sensitivity reactions are associated with significantly increased morbidity and mortality. Treatment with cholinesterase inhibitors is well tolerated by most patients and substantially improves cognitive and neuropsychiatric symptoms. Clear guidance on the management of DLB is urgently needed. Virtually unrecognised 20 years ago, DLB could within this decade be one of the most treatable neurodegenerative disorders of late life. C1 Royal Liverpool Hosp, Liverpool L7 8XP, Merseyside, England. Inst Res & Educ Aging, Aurus IEPE, Belo Horizonte, MG, Brazil. Univ Pittsburgh, Pittsburgh, PA 15260 USA. Drexel Univ, Coll Med, Philadelphia, PA 19104 USA. St James Hosp, Dublin 8, Ireland. Prince Wales Med Res Inst, Sydney, NSW, Australia. McGill Ctr Studies Aging, Quebec City, PQ, Canada. Vancouver Hosp & Hlth Sci Ctr, Vancouver, BC V5Z 1M9, Canada. Vet Affairs Med Ctr, Philadelphia, PA USA. Grp Hosp Pitie Salpetriere, F-75634 Paris, France. Mayo Clin, Jacksonville, FL 32224 USA. George Washington Univ, Washington, DC USA. Res Inst Aging Hebrew Home Greater Washington, Washington, DC USA. Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China. Rogaland Psychiat Hosp, Stavanger, Norway. Med Univ S Carolina, Charleston, SC 29425 USA. Univ Newcastle Upon Tyne, Inst Ageing & Hlth, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England. RP McKeith, I (reprint author), Newcastle Gen Hosp, Inst Ageing & Hlth, Westgate Rd, Newcastle Upon Tyne NE4 6BE, Tyne & Wear, England. RI Halliday, Glenda/E-8555-2011 OI Halliday, Glenda/0000-0003-0422-8398; Dickson, Dennis W/0000-0001-7189-7917; Feldman, Howard/0000-0002-9258-4538; Aarsland, Dag/0000-0001-6314-216X NR 110 TC 392 Z9 408 U1 7 U2 41 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1474-4422 J9 LANCET NEUROL JI Lancet Neurol. PD JAN PY 2004 VL 3 IS 1 BP 19 EP 28 DI 10.1016/S1474-4422(03)00619-7 PG 10 WC Clinical Neurology SC Neurosciences & Neurology GA 756BZ UT WOS:000187447100022 PM 14693108 ER PT J AU Novak, J Schleman, S Scott, J Balderman, VL Krech, L Kane, MA AF Novak, J Schleman, S Scott, J Balderman, VL Krech, L Kane, MA TI Dexamethasone regulation of gastrin-releasing peptide receptor in human lung cells SO LUNG CANCER LA English DT Article DE bombesin; gastrin-releasing peptide; receptors; gtucocorticoid; lung cancer; human; regulation ID CARCINOMA NCI-H345 CELLS; BOMBESIN-LIKE PEPTIDES; MESSENGER-RNA LEVELS; CANCER CELLS; BICINCHONINIC ACID; GENE-EXPRESSION; DOWN-REGULATION; IN-VITRO; GROWTH; GLUCOCORTICOIDS AB We investigated the effects of the glucocorticoid, dexamethasone (Dex), on expression of the gastrin-releasing peptide (GRP) receptor by human small cell lung carcinoma (SCLC) SHP77 cells. After 12 h of 10 nM Dex exposure, a six-fold increase in the peak of GRP receptor mRNA compared with untreated controls (10.5 +/- 4 versus 1.65 +/- 0.15 attomols/mug total RNA, respectively, P < 0.05) occurred. GRP receptor mRNA levels fell to less than 0.5 attomots/mug total RNA after 24h; in Dex-treated cells, these levels rose to 1.2 compared with 0.12 attomots/mug total RNA in the absence of Dex after 7 days. A significant increase (P < 0.05) in the GRP receptor-specific binding was also found. Stimulation of SHP77 cell proliferation (25-35% in the presence of 10-100nM Dex; P < 0.0001) was observed after 4-8 days of exposure; this stimulation was inhibited by GRP receptor antagonists. SHP77 cell content and concentration of bombesin-Like peptides (BLP) in conditioned medium (approximately 4nM) was unchanged by Dex. Stimulation of human SCLC SHP77 cell proliferation by Dex may, in part, occur via effects on the GRP autocrine system in these cells. Published by Elsevier Ireland Ltd. C1 Univ Colorado, Hlth Sci Ctr, Denver Vet Affairs Med Ctr, Sect Med Oncol, Denver, CO 80220 USA. Univ Colorado, Ctr Canc, Denver, CO 80220 USA. RP Kane, MA (reprint author), Univ Colorado, Hlth Sci Ctr, Denver Vet Affairs Med Ctr, Sect Med Oncol, 1055 Clermont St, Denver, CO 80220 USA. EM madeteine.kane@uchsc.edu NR 44 TC 8 Z9 9 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0169-5002 J9 LUNG CANCER-J IASLC JI Lung Cancer PD JAN PY 2004 VL 43 IS 1 BP 17 EP 28 DI 10.1016/j.lungan.2003.07.002 PG 12 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 766MT UT WOS:000188380700003 PM 14698533 ER PT J AU Person, SD Allison, JJ Kiefe, CI Weaver, MT Williams, OD Centor, RM Weissman, NW AF Person, SD Allison, JJ Kiefe, CI Weaver, MT Williams, OD Centor, RM Weissman, NW TI Nurse staffing and mortality for Medicare patients with acute myocardial infarction SO MEDICAL CARE LA English DT Article DE acute myocardial infarction; mortality; nurse staffing; Medicare ID QUALITY-OF-CARE; COOPERATIVE CARDIOVASCULAR PROJECT; LICENSED PRACTICAL NURSES; HOSPITAL MORTALITY; INTENSIVE-CARE; PARTNERSHIP MODEL; RISK ADJUSTMENT; ADVERSE EVENTS; US HOSPITALS; DRUG-THERAPY AB Context: Recent hospital reductions in registered nurses (RNs) for hospital care raise concerns about patient outcomes. Objective: Assess the association of nurse staffing with in-hospital mortality for patients with acute myocardial infarction (AMI). Design, Setting, and Patients. Medical record review data from the 1994-1995 Cooperative Cardiovascular Project were linked with American Hospital Association data for 118,940 fee-for-service Medicare patients hospitalized with AMI. Staffing levels were represented as nurse to patient ratios categorized into quartiles for RNs and for licensed practical nurses (LPNs). Main Outcome Measures. In-hospital mortality. Results: From highest to lowest quartile of RN staffing, in-hospital mortality was 17.8%, 17.4%, 18.5%, and 20.1%, respectively (P < 0.001 for trend). However, from highest to lowest quartile of LPN staffing, mortality was 20.1%, 18.7%, 17.9%, and 17.2%, respectively P < 0.001. After adjustment for patient demographic and clinical characteristics, treatment, and for hospital volume, technology index, and teaching and urban status, patients treated in environments with higher RN staffing were less likely to die in-hospital; odds ratios (95% confidence intervals) of quartiles 4, 3, and 2 versus quartile 1 were 0.91 (0.86-0.97), 0.94 (0.88-1.00), and 0.96 (0.90-1.02), respectively. Conversely, after adjustment, patients treated in environments with higher LPN staffing were more likely to die in-hospital; odds ratios (95% confidence intervals) of quartiles 4, 3, and 2 versus quartile 1 were 1.07 (1.00-1.15), 1.02 (0.96-1.09), and 1.00 (0.94-1.07), respectively. Conclusions: Even after extensive adjustment, higher RN staffing levels were associated with lower mortality. Our findings suggest an important effect of nurse staffing on in-hospital mortality. C1 Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL 35294 USA. Univ Alabama, Div Prevent Med, Birmingham, AL 35294 USA. Univ Alabama, Div Gen Internal Med, Birmingham, AL 35294 USA. Univ Alabama, Sch Nursing, Birmingham, AL 35294 USA. Univ Alabama, Dept Hlth Serv Adm, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Person, SD (reprint author), Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, MT 612,1530 3rd Ave S, Birmingham, AL 35294 USA. OI Allison, Jeroan/0000-0003-4472-2112 FU AHRQ HHS [HS08843, HS09446] NR 87 TC 64 Z9 64 U1 2 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2004 VL 42 IS 1 BP 4 EP 12 DI 10.1097/01.mlr.0000102369.67404.b0 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 758DP UT WOS:000187617900002 PM 14713734 ER PT J AU O'Brien, MM Shroyer, ALW Moritz, TE London, MJ Grunwald, GK Villanueva, CB Thottapurathu, LG MaWhinney, S Marshall, G McCarthy, M Henderson, WG Sethi, GK Grover, FL Hammermeister, KE AF O'Brien, MM Shroyer, ALW Moritz, TE London, MJ Grunwald, GK Villanueva, CB Thottapurathu, LG MaWhinney, S Marshall, G McCarthy, M Henderson, WG Sethi, GK Grover, FL Hammermeister, KE CA Participants VA Cooperative Study TI Relationship between processes of care and coronary bypass operative mortality and morbidity SO MEDICAL CARE LA English DT Article DE coronary bypass surgery; processes of care; perioperative mortality and morbidity; operative duration; inotropic agents; transesophageal echocardiography; hemoconcentration/ultrafiltration ID INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY; INDUCED MYOCARDIAL NECROSIS; CONGESTIVE-HEART-FAILURE; CONTRACTION BAND LESIONS; CARDIAC-SURGERY; ARTERY-BYPASS; RISK-FACTORS; CARDIOPULMONARY BYPASS; OUTCOMES; DYSFUNCTION AB Background: Information is limited regarding the effects of processes of care on cardiac surgical outcomes. Correspondingly, many recommended cardiac surgical processes of care are derived from animal experiments or clinical judgment. This report from the VA Cooperative Study in Health Services, "Processes, Structures, and Outcomes of Cardiac, Surgery," focuses on the relationships between 3 process groups (preoperative evaluation, intraoperative care, and supervision by senior physicians) and a composite outcome, perioperative mortality and morbidity. Methods: Data on 734 risk, process, and structure variables were collected prospectively on 3988 patients who underwent coronary artery bypass grafting at 14 VA medical centers between 1992 and 1996. Data reduction was accomplished by examining data completeness and variation across sites and surgeon, using previously published data and clinical judgment., We then applied multivariable logistic regression to the 39 remaining processes of care to determine which were related to the composite outcome after adjusting for 17 patient-related risk factors and controlling for intraoperative complications. Results: Our first analysis showed several measures of operative duration, the use of inotropic agents, transesophageal echo, lowest systemic temperature, and hemoconcentration/ultrafiltration, to be powerful predictors of the composite outcome. Because the use of inotropic agents and operative duration may be related to an intermediate outcome (eg, intraoperative complications), we performed a second analysis omitting the se processes. The use of intraoperative transesophageal echo and hemoconcentration/ultrafiltration remained significantly associated with an increased risk of an event (odds ratios 1.60 and 1.36, respectively). Conclusions: Our results viewed in the context of past studies suggest the possibility that, inotropic use, TEE, and hemoconcentration/ultrafiltration may have adverse effects on operative outcome. Further evaluation of these processes of care using observational data, as well as randomized trials when feasible, would be of interest. C1 Denver VA Med Ctr, Cardiol Sect, Denver, CO 80220 USA. Denver VA Med Ctr, Med Res Serv, Denver, CO 80220 USA. Denver VA Med Ctr, Surg Serv, Denver, CO 80220 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Cooperat Studies Program Coordinating Ctr, Hines, IL 60141 USA. San Francisco VA Med Ctr, Anesthesiol Serv, San Francisco, CA USA. Univ Calif San Francisco, Dept Anesthesiol, San Francisco, CA 94143 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Boulder, CO 80309 USA. Univ Colorado, Hlth Sci Ctr, Dept Surg, Boulder, CO 80309 USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Boulder, CO 80309 USA. Univ Colorado, Hlth Sci Ctr, Colorado Hlth Outcomes Program, Boulder, CO 80309 USA. Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA. Univ Arizona, Hlth Sci Ctr, Dept Surg, Tucson, AZ 85721 USA. Pontificia Univ Catolica Chile, Dept Salud Publ, Santiago, Chile. RP Hammermeister, KE (reprint author), Denver VA Med Ctr, Cardiol Sect, 111B,1055 Clermont, Denver, CO 80220 USA. RI Marshall, Guillermo/F-2302-2011; Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 NR 62 TC 15 Z9 17 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2004 VL 42 IS 1 BP 59 EP 70 DI 10.1097/01.mlr.0000102295.08379.57 PG 12 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 758DP UT WOS:000187617900008 PM 14713740 ER PT J AU Mendez, MF AF Mendez, MF TI Dementia as a window to the neurology of art SO MEDICAL HYPOTHESES LA English DT Article ID FRONTOTEMPORAL LOBAR DEGENERATION; POSITRON EMISSION TOMOGRAPHY; ALZHEIMERS-DISEASE; CORTICOBASAL DEGENERATION; CLINICAL CHARACTERISTICS; ARTISTIC CREATIVITY; SEMANTIC DEMENTIA; PREFRONTAL CORTEX; TEMPORAL VARIANT; PICKS-DISEASE AB Art is an expression of neurological function and how it organizes and interprets perception. Recent reports of changes in art performance among patients with frontotemporal dementia have provided an unexpected window to the neurology of art. They confirm that visual art is predominantly in the right hemisphere and suggest a neuroanatomical schema for artistic creativity. The right parietal region is critical for the visuospatial prerequisites of art, and the right temporal lobe integrates and interprets these percepts. The right temporal lobe appears necessary for extracting and exaggerating the essential features of an artistic composition. In contrast, the left parietal region and the left temporal lobe have inhibitory effects on artistic expression through attention to visuospatial detail and semantic labeling, respectively. Frontal-executive functions are also required for artistic expression, particularly right dorsolateral frontal initiation of a network for novelty-seeking behavior. Further study of art in dementia can profitably evaluate this proposed schema for the mechanisms of art in the brain. (C) 2004 Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, Focal Type Dementias Clin, Los Angeles, CA USA. RP Mendez, MF (reprint author), VA Greater LA Healthcare Syst, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu NR 65 TC 29 Z9 31 U1 4 U2 16 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0306-9877 J9 MED HYPOTHESES JI Med. Hypotheses PY 2004 VL 63 IS 1 BP 1 EP 7 DI 10.1016/j.mehy.2004.03.002 PG 7 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 832VA UT WOS:000222294200001 PM 15193339 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI We only see what we already know - a modified Bayes' formula to explain inherent limitations of diagnostic tests SO MEDICAL HYPOTHESES LA English DT Article ID ULTRASOUND AB In medical tests involving human judgment, human testers are inclined to diagnose only symptoms and signs that they already know. The present analysis delineates the relationship between prior knowledge and test characteristics. The relationship between test outcome and a given diagnosis is generally described in terms of sensitivity and specificity. In the present analysis, this relationship is broken down into two separate contributions: First, the association between the test measure and the presence of disease and second, the association between the actual test outcome and the presence of the test measure. The second relationship describes the performance of a human tester in assessing the presence of a test measure irrespective of the disease status. Bayes' formula can be adjusted to include contributions by both relationships. The ability to increase a diagnostic probability through testing depends on a tester's familiarity with the test measure and reliability in eliciting its presence. Testing yields the most reliable results if the test measure falls well within a tester's own level of competence. Test measures outside the tester's competence level lead to tests with worse outcome than no testing at all. Published by Elsevier Ltd. C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Div Gastroenterol Hepatol, Portland, OR 97239 USA. RP Sonnenberg, A (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, Div Gastroenterol Hepatol, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 13 TC 5 Z9 5 U1 0 U2 1 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0306-9877 J9 MED HYPOTHESES JI Med. Hypotheses PY 2004 VL 63 IS 4 BP 759 EP 763 DI 10.1016/j.mehy.2004.03.027 PG 5 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 855BD UT WOS:000223947000034 PM 15325029 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI Process and accomplishment in academic medicine SO MEDICAL HYPOTHESES LA English DT Article AB Medical academic systems are characterized by interplay between accomplishment and process. The term accomplishment refers to fulfillment of the system's original goats, such as education, research and medical care, whereas the term process refers to the culture and structure, which are developed to pursue these goals. A mathematical model is developed to simulate the mechanisms that govern growth of medical systems over time. Because system performance is easier to measure by process than accomplishment, in the long run investments in growth are shifted away from accomplishment towards process. In all aging medical systems alike, the proportion of process tends to increase at the expense of accomplishment. Published by Elsevier Ltd. C1 Portland VA Med Ctr, Gastroenterol Sect, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland, OR 97239 USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, Gastroenterol Sect, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 9 TC 3 Z9 3 U1 0 U2 0 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0306-9877 J9 MED HYPOTHESES JI Med. Hypotheses PY 2004 VL 62 IS 6 BP 1006 EP 1011 DI 10.1016/j.mehy.2004.01.005 PG 6 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 825FI UT WOS:000221741000032 PM 15142665 ER PT S AU Cardenas, VA Studholme, C AF Cardenas, VA Studholme, C BE Barillot, C Haynor, DR Hellier, P TI Co-analysis of maps of atrophy rate and atrophy state in neurodegeneration SO MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION - MICCAI 2004, PT 2, PROCEEDINGS SE LECTURE NOTES IN COMPUTER SCIENCE LA English DT Article; Proceedings Paper CT 7th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI 2004) CY SEP 26-29, 2004 CL St Malo, FRANCE SP IRISA, CNRS, Univ Rennes ID VOXEL-BASED MORPHOMETRY; ALZHEIMERS-DISEASE; ANATOMICAL MRI; BRAIN ATROPHY; DEFORMATION; VALIDATION; VOLUMETRY; DEMENTIA; AD AB The variability in atrophy rate in patients with neurodegenerative disease can be partially explained by disease stage. Since atrophy state (baseline scan tissue volume) correlates with cognitive impairment and disease stage, we use local atrophy state as a covariate in the analysis of local atrophy rate. A general linear model with a spatially varying dependent variable was employed to study the effects of disease over the brain. An efficient method of solving this spatially varying model was developed, implemented, and applied to maps of atrophy state and rate derived from serial MRI data of 13 Semantic Dementia (SD) and 13 control subjects. Our results demonstrate that group differences in atrophy rate are affected by the inclusion of atrophy state in the model. Specifically, estimated contrasts in atrophy rate between controls and SD in the left temporal lobe white matter increased when the local rate was covaried for atrophy state. C1 Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Cardenas, VA (reprint author), Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. NR 20 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER-VERLAG BERLIN PI BERLIN PA HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY SN 0302-9743 BN 3-540-22977-9 J9 LECT NOTES COMPUT SC PY 2004 VL 3217 BP 680 EP 687 PN 2 PG 8 WC Computer Science, Interdisciplinary Applications; Computer Science, Theory & Methods; Imaging Science & Photographic Technology; Radiology, Nuclear Medicine & Medical Imaging SC Computer Science; Imaging Science & Photographic Technology; Radiology, Nuclear Medicine & Medical Imaging GA BAZ67 UT WOS:000224322400083 ER PT S AU Brown, SH Elkin, PL Rosenbloom, ST Husser, C Bauer, BA Lincoln, MJ Carter, J Erlbaum, M Tuttle, MS AF Brown, SH Elkin, PL Rosenbloom, ST Husser, C Bauer, BA Lincoln, MJ Carter, J Erlbaum, M Tuttle, MS BE Fieschi, M Coiera, E Li, YCJ TI VA National Drug File Reference Terminology: A cross-institutional content coverage study SO MEDINFO 2004: PROCEEDINGS OF THE 11TH WORLD CONGRESS ON MEDICAL INFORMATICS, PT 1 AND 2 SE STUDIES IN HEALTH TECHNOLOGY AND INFORMATICS LA English DT Proceedings Paper CT 11th World Congress on Medical Informatics CY SEP 07-11, 2004 CL Amer Med Informat Assoc, San Francisco, CA SP Int Med Informat Assoc HO Amer Med Informat Assoc DE vocabulary; controlled; information storage and retrieval; information theory ID VOCABULARIES AB Background: Content coverage studies provide valuable information to potential users of terminologies. We detail the VA National Drug File Reference Terminology's (NDF-RT) ability to represent dictated medication list phrases from the Mayo Clinic. NDF-RT is a description logic-based resource created to support clinical operations at one of the largest healthcare providers in the US. Methods: Medication list phrases were extracted from dictated patient notes from the Mayo Clinic. Algorithmic mappings to NDF-RT using the SmartAccess Vocabulary Server (SAVS) were presented to two non-VA physicians. The physicians used a terminology browser to determine the accuracy of the algorithmic mapping and the content coverage of NDF-RT Results: The 509 extracted documents on 300 patients contained 847 medication concepts in medication lists. NDF-RT covered 97.8% of concepts. Of the 18 phrases that NDF-RT did not represent, 10 were for OTCs and food supplements, 5 were for prescription medications, and 3 were missing synonyms. The SA VS engine properly mapped 773 of 810 phrases with an overall sensitivity (precision) was 95.4% and positive predictive value (recall) of 99.9%. Conclusions: This study demonstrates that NDF-RT has more general utility than its initial design parameters dictated. C1 US Dept Vet Affairs, Nashville, TN USA. RP Brown, SH (reprint author), 1310 24th Ave S, Nashville, TN 37212 USA. NR 20 TC 22 Z9 22 U1 0 U2 0 PU I O S PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 0926-9630 BN 1-58603-444-8 J9 ST HEAL T PY 2004 VL 107 BP 477 EP 481 PG 5 WC Computer Science, Information Systems; Medical Informatics SC Computer Science; Medical Informatics GA BBO53 UT WOS:000226723300096 PM 15360858 ER PT J AU Shouse, MN Scordato, JC Farber, PR AF Shouse, MN Scordato, JC Farber, PR TI Sleep and arousal mechanisms in expeirjmental epilepsy: Epileptic components of NREM and antiepileptic components of REM sleep SO MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES RESEARCH REVIEWS LA English DT Review DE sleep; epilepsy; animal models; cats; amygdala kindling; penicillin epilepsy ID AMYGDALA-KINDLED KITTENS; SEIZURES; AUTISM AB Neural generators related to different sleep components have different effects on seizure discharge. These sleep-related systems can provoke seizure discharge propagation during nonrapid eye movement (NREM) sleep and can suppress propagation during REM sleep. Experimental manipulations of discrete physiological components were conducted in feline epilepsy models, mostly in the systemic penicillin epilepsy model of primary generalized epilepsy and the amygdala kindling model of the localization-related seizure disorder, temporal lobe epilepsy. The sleep-wake state distribution of seizures was quantified before and after discrete lesions, Systemic and localized drug administration, and/or photic stimulation, as well as in relation to microdialysis of norepinephrine. We found that (1) neural generators of synchronous EEG oscillations-including tonic background slow waves and phasic "arousal" events (sleep EEG transients such as sleep spindles and k-complexes)-combine to promote electrographic seizure propagation during NREM and drowsiness, and antigravity muscle tone permits seizure-related movement; (2) neural generators of asynchronous neuronal discharge patterns reduce electrographic seizures during alert waking and REM sleep, and skeletal motor paralysis blocks seizure-related movement during REM; (3) there are a number of similarities between amygdala-kindled kittens and children with Landau-Kleffner Syndrome (LKS) that suggest a link among seizures, sleep disorders, and behavioral abnormalities/regression. Published 2004 Wiley-Liss, Inc. C1 VA Greater Los Angeles Hlth Care Syst, Sleep Disturbance Res, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA USA. RP Shouse, MN (reprint author), 2242 S Bentley Ave, Los Angeles, CA 90064 USA. EM wshouse@ucla.edu NR 23 TC 16 Z9 16 U1 0 U2 2 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1080-4013 J9 MENT RETARD DEV D R JI Ment. Retard. Dev. Disabil. Res. Rev. PY 2004 VL 10 IS 2 BP 117 EP 121 DI 10.1002/mrdd.20022 PG 5 WC Clinical Neurology; Neurosciences; Pediatrics; Psychiatry SC Neurosciences & Neurology; Pediatrics; Psychiatry GA 857KL UT WOS:000224115100008 PM 15362167 ER PT J AU Wade, BK Burrus, JK Balkovetz, DF AF Wade, BK Burrus, JK Balkovetz, DF TI Hepatocyte growth factor inhibits intrinsic antibacterial activity of Madin-Darby canine kidney cells SO MICROBES AND INFECTION LA English DT Article DE Escherichia coli; uropathogenic; renal epithelia; defensins; hepatocyte growth factor ID ACUTE-RENAL-FAILURE; FACTOR ALTERS; MONOLAYERS; SUSCEPTIBILITY; EXPRESSION; COMPLEXES; POLARITY; TISSUES AB We investigated whether or not polarized renal epithelial cells produce antibacterial factors, which aid in host defense at the cell surface of renal epithelium. A model of polarized Madin-Darby canine kidney (MDCK) epithelial cells grown on filters was used to test for the presence of apically or basolaterally secreted factors on the growth of non-virulent (XLI-Blue) and uropathogenic (J96) strains of Escherichia coli (E. coli). Growth of both XLI-Blue and J96 strains of E. coli in medium on the apical and basolateral surface of MDCK cells was inhibited as compared to bacterial growth in medium not exposed to MDCK cells. The inhibition of bacterial growth was similar in both apical and basolateral surface medium. Pretreatment of MDCK cells with hepatocyte growth factor (HGF) blunted the inhibition of XLI-Blue and J96 growth in apical and basolateral surface medium as compared to growth in medium on the surfaces of untreated MDCK cells. Immunofluorescent analysis demonstrated the presence of P-defensin isoforms 1-3 in MDCK cells, with isoform I being the most prevalent form observed. HGF treatment reduced the amount of immunoreactive beta-defensin-1 in MDCK cells. These data demonstrate that polarized renal epithelium produce antibacterial factors. The renotropic growth factor HGF inhibits these antibacterial factors. beta-defensins may contribute to this antibacterial activity and play an important role in renal epithelial resistance to bacterial infections. (C) 2003 Elsevier SAS. All rights reserved. C1 Univ Alabama, Dept Surg, Birmingham, AL USA. Univ Alabama, Dept Cell Biol, Birmingham, AL 35294 USA. Univ Alabama, Dept Cell Biol, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Balkovetz, DF (reprint author), 668 LHRB,1530 3rd Ave, Birmingham, AL 35294 USA. EM balkovet@uab.edu NR 21 TC 3 Z9 3 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1286-4579 J9 MICROBES INFECT JI Microbes Infect. PD JAN PY 2004 VL 6 IS 1 BP 51 EP 57 DI 10.1016/j.micinf.2003.10.008 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 770HR UT WOS:000188717600007 PM 14738893 ER PT J AU Kilbourne, AM Schulberg, HC Post, EP Rollman, BL Belnap, BH Pincus, HA AF Kilbourne, AM Schulberg, HC Post, EP Rollman, BL Belnap, BH Pincus, HA TI Translating evidence-based depression management services to community-based primary care practices SO MILBANK QUARTERLY LA English DT Article DE patient care management; delivery of health care; integrated quality of care; depressive disorder; depression ID RANDOMIZED CONTROLLED-TRIAL; LATE-LIFE DEPRESSION; QUALITY IMPROVEMENT; MAJOR DEPRESSION; DISEASE MANAGEMENT; COLLABORATIVE CARE; COST-EFFECTIVENESS; CHRONIC ILLNESS; HEALTH; INTERVENTION AB Randomized controlled trials have demonstrated the efficacy and cost-effectiveness of using treatment models for major depression in primary care settings. Nonetheless, translating these models into enduring changes in routine primary care has proved difficult. Various health system and organizational barriers prevent the integration of these models into primary care settings. This article discusses barriers to introducing and sustaining evidence-based depression management services in community-based primary care practices and suggests organizational and financial solutions based on the Robert Wood Johnson Foundation Depression in Primary Care Program. It focuses on strategies to improve depression care in medical settings based on adaptations of the chronic care model and discusses the challenges of implementing evidence-based depression care given the structural, financial, and cultural separation between mental health and general medical care. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. Cornell Univ, Ithaca, NY 14853 USA. RP Kilbourne, AM (reprint author), VA Pittsburgh Ctr Hlth Equ Res & Promot, 151-C,Univ Dr C, Pittsburgh, PA 15240 USA. EM Amy.Kilbourne@med.va.gov FU NIMH NIH HHS [K23 MH001879, K23-MH01879] NR 48 TC 66 Z9 67 U1 2 U2 6 PU BLACKWELL PUBLISHERS PI MALDEN PA 350 MAIN STREET, STE 6, MALDEN, MA 02148 USA SN 0887-378X J9 MILBANK Q JI Milbank Q. PY 2004 VL 82 IS 4 BP 631 EP 659 DI 10.1111/j.0887-378X.2004.00326.x PG 29 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 880MQ UT WOS:000225794300002 PM 15595945 ER PT J AU Li, W Fan, JH Chen, M Guan, SX Sawcer, D Bokoch, GM Woodley, DT AF Li, W Fan, JH Chen, M Guan, SX Sawcer, D Bokoch, GM Woodley, DT TI Mechanism of human dermal fibroblast migration driven by type I collagen and platelet-derived growth factor-BB SO MOLECULAR BIOLOGY OF THE CELL LA English DT Article ID ACTIVATED PROTEIN-KINASE; CELL-MIGRATION; CHEMOTACTIC MIGRATION; GENE-EXPRESSION; MESSENGER-RNA; FACTOR-BETA; P38 MAPK; INTEGRIN; STIMULATION; INDUCTION AB Migration of human dermal fibroblasts (HDFs) is critical for skin wound healing. The mechanism remains unclear. We report here that platelet-derived growth factor-BB (PDGF-BB) is the major promotility factor in human serum for HDF motility on type I collagen. PDGF-BB recapitulates the full promotility activity of human serum and anti-PDGF neutralizing antibodies completely block it. Although collagen matrix initiates HDF migration without growth factors, PDGF-BB-stimulated migration depends upon attachment of the cells to a collagen matrix. The PDGF-BB's role is to provide directionality and further enhancement for the collagen-initiated HDF motility. To study the collagen and PDGF-BB "dual signaling" in primary HDF, we establish "gene cassettes" plus lentiviral gene delivery approach, in which groups of genes are studied individually or in combination for their roles in HDF migration. Focal adhesion kinase, p21(Rac,CDC42)-activated kinase and Akt are grouped into an upstream kinase gene cassette, and the four major mitogenactivated protein kinases (extracellular signal-regulated kinase 1/2, p38, c-Jun NH2-teriminal kinase, and extracellular signal-regulated kinase 5) are grouped into a downstream kinase gene cassette. The experiments demonstrate 1) the genes' individual roles and specificities, 2) their combined effects and sufficiency, and 3) the mechanisms of their intermolecular connections in HDF migration driven by collagen and PDGF-BB. C1 Univ So Calif, Keck Sch Med, Div Dermatol, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Norris Canc Ctr, Los Angeles, CA 90033 USA. Greater Los Angles Vet Adm Hlth Syst, Los Angeles, CA 90073 USA. Scripps Res Inst, Dept Immunol & Cell Biol, La Jolla, CA 92037 USA. RP Li, W (reprint author), Univ So Calif, Keck Sch Med, Div Dermatol, Los Angeles, CA 90033 USA. FU NIAMS NIH HHS [AR46538, R01 AR046538]; NIGMS NIH HHS [GM/AR67100-01] NR 55 TC 86 Z9 90 U1 3 U2 14 PU AMER SOC CELL BIOLOGY PI BETHESDA PA 8120 WOODMONT AVE, STE 750, BETHESDA, MD 20814-2755 USA SN 1059-1524 J9 MOL BIOL CELL JI Mol. Biol. Cell PD JAN PY 2004 VL 15 IS 1 BP 294 EP 309 PG 16 WC Cell Biology SC Cell Biology GA 760JT UT WOS:000187808400029 PM 14595114 ER PT J AU Guinn, KM Hickey, MJ Mathur, SK Zakel, KL Grotzke, JE Lewinsohn, DM Smith, S Sherman, DR AF Guinn, KM Hickey, MJ Mathur, SK Zakel, KL Grotzke, JE Lewinsohn, DM Smith, S Sherman, DR TI Individual RD1-region genes are required for export of ESAT-6/CFP-10 and for virulence of Mycobacterium tuberculosis SO MOLECULAR MICROBIOLOGY LA English DT Article ID BACILLUS-CALMETTE-GUERIN; NECROSIS-FACTOR-ALPHA; T-CELL ANTIGENS; BOVIS BCG; COMPARATIVE GENOMICS; PROTEIN SECRETION; ESAT-6; IDENTIFICATION; RD1; MONOCYTES AB The RD1 genomic region is present in virulent strains of Mycobacterium tuberculosis (MTB), missing from the vaccine strain M. bovis BCG, and its importance to virulence has been established experimentally. Based on in silico analysis, it has been suggested that RD1 may encode a novel secretion system, but the mechanism by which this region affects virulence is unknown. Here we examined mutants disrupted in five individual RD1 genes. Both in vitro and in vivo, each mutant displayed an attenuated phenotype very similar to a mutant missing the entire RD1 region. Genetic complementation of individual genes restored virulence. Attenuated mutants could multiply within THP-1 cells, but they were unable to spread to uninfected macrophages. We also examined export of two immunodominant RD1 proteins, CFP-10 and ESAT-6. Export of these proteins was greatly reduced or abolished in each attenuated mutant. Again, genetic complementation restored a wild-type phenotype. Our results indicate that RD1 genes work together to form a single virulence determinant, and argue that RD1 encodes a novel specialized secretion system that is required for pathogenesis of MTB. C1 Univ Washington, Dept Pathobiol, Seattle, WA 98195 USA. Oregon Hlth & Sci Univ, Div Pulm & Crit Care Med, Portland VA Med Ctr, Portland, OR 97239 USA. Univ Washington, Dept Pediat, Seattle, WA 98195 USA. RP Sherman, DR (reprint author), Univ Washington, Dept Pathobiol, Seattle, WA 98195 USA. RI Lewinsohn, David/I-4936-2013 OI Lewinsohn, David/0000-0001-9906-9494 FU NHLBI NIH HHS [R01 HL068533, HL64550, HL68533, R01 HL064550]; NIAID NIH HHS [N01 AI-75320] NR 53 TC 299 Z9 325 U1 0 U2 13 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0950-382X J9 MOL MICROBIOL JI Mol. Microbiol. PD JAN PY 2004 VL 51 IS 2 BP 359 EP 370 DI 10.1046/j.1365-2958.2003.03844.x PG 12 WC Biochemistry & Molecular Biology; Microbiology SC Biochemistry & Molecular Biology; Microbiology GA 761FN UT WOS:000187890800006 PM 14756778 ER PT J AU Samuels, SC Brickman, AM Burd, JA Purohit, DP Qureshi, PQ Serby, M AF Samuels, SC Brickman, AM Burd, JA Purohit, DP Qureshi, PQ Serby, M TI Depression in autopsy-confirmed dementia with Lewy bodies and Alzheimer's disease SO MOUNT SINAI JOURNAL OF MEDICINE LA English DT Article; Proceedings Paper CT 14th Annual Meeting of the American-Association-for-Geriatric-Psychiatry CY FEB 23-26, 2001 CL SAN FRANCISCO, CALIFORNIA SP Amer Assoc Geriatr Psychiat DE dementia; depression; Lewy bodies; Alzheimer's disease; autopsy ID MAJOR DEPRESSION; BODY DISEASE; DISTINGUISH PATIENTS; PARKINSONS-DISEASE; CLINICAL-CRITERIA; MINOR DEPRESSION; PREVALENCE AB Depression has frequently been cited as a manifestation of dementia with Lewy bodies (DLB). Previous studies have suggested an increase of depression in patients with DLB, compared to those with Alzheimer's disease (AD). The purpose of this study was to examine depressive symptomatology in nursing home residents, from a consecutive series of DLB (n=16) and AD (n=39) autopsy-confirmed cases. Subjects received standard neuropathological analysis and postmortem chart review for clinical assessment of depression. Depressive symptomatology did not differ between the AD and DLB groups, and there was no significant relationship between depression and cortical or subcortical Lewy body (LB) count in the locus ceruleus or substantia nigra. This study suggests that the presence or absence of depression cannot be used to distinguish between AD and DLB. Furthermore, depressive symptomatology in DLB does not appear to be related to severity of cortical or subcortical LB pathology. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Bronx, NY USA. CUNY, Queens Coll, Dept Psychol, New York, NY 10021 USA. CUNY, Grad Ctr, New York, NY 10021 USA. Beth Israel Med Ctr, Dept Psychiat, New York, NY 10003 USA. RP Samuels, SC (reprint author), Mt Sinai Sch Med, Dept Psychiat, Box 1230,1 E 100th St, New York, NY 10029 USA. EM Steven.Samuels@med.va.gov FU NIA NIH HHS [P50-AG05138, P01-AG02219] NR 39 TC 13 Z9 14 U1 0 U2 2 PU MOUNT SINAI HOSPITAL PI NEW YORK PA BOX 1094 ONE GUSTAVE L LEVY PLACE ATTN: CIRCULATION ASST, NEW YORK, NY 10029-6574 USA SN 0027-2507 J9 MT SINAI J MED JI Mt. Sinai J. Med. PD JAN PY 2004 VL 71 IS 1 BP 55 EP 62 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 766QF UT WOS:000188386500009 PM 14770251 ER PT J AU Gruenewald, DA Higginson, IJ Vivat, B Edmonds, P Burman, RE AF Gruenewald, DA Higginson, IJ Vivat, B Edmonds, P Burman, RE TI Quality of life measures for the palliative care of people severely affected by multiple sclerosis: a systematic review SO MULTIPLE SCLEROSIS LA English DT Review DE multiple sclerosis; quality of life; palliative care; outcome; audit; caregiver; review ID CHRONIC DISABLING CONDITIONS; INFLAMMATORY-BOWEL-DISEASE; SECONDARY PROGRESSIVE MS; ILLNESS INTRUSIVENESS; IMPACT PROFILE; HEALTH-STATUS; RHEUMATOID-ARTHRITIS; OUTCOME MEASURE; DISABILITY; QUESTIONNAIRE AB Although there is increasing interest in measuring the quality of life (QoL) of people with multiple sclerosis (MS), relatively little is known about the issues of importance to people severely affected by MS. In the first of two systematic reviews, we searched the literature to identify measures that have been used to assess health-related QoL in people with MS, and described their measurement properties in terms of validity, reliability, responsiveness to change, and appropriateness for QoL assessment in people severely affected by MS. In the second review, we identified care domains important to people with MS, by reviewing survey, focus group and interview studies involving people with MS and/or their caregivers. Forty-six studies evaluating 12 disease-specific and ten generic QoL measures for patients, and one disease-specific measure for caregivers, satisfied all inclusion criteria. Sixteen focus group or interview studies and 51 questionnaire-based studies evaluated domains of care important to people with MS, and seven qualitative and 11 questionnaire-based studies assessed domains of care important to their caregivers. From these studies, we identified 15 domains of care important to people with MS and 12 domains important to caregivers. QoL measures differed markedly in their coverage of these care domains. Moreover, each measure fulfilled some but not all criteria of validity, reliability, responsiveness, and appropriateness. Further work is needed to clarify the domains of care relevant to people with severe MS, and to measure health-related QoL in this population. C1 Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. Kings Coll London, Sch Med, Dept Palliat Care & Policy, London SE5 9RJ, England. RP Gruenewald, DA (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, S-182-GRECC,1660 S Columbian Way, Seattle, WA 98108 USA. EM dgruen@u.washington.edu OI Vivat, Bella/0000-0002-0587-5688 FU Multiple Sclerosis Society [676] NR 129 TC 44 Z9 45 U1 7 U2 10 PU ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 1352-4585 J9 MULT SCLER JI Mult. Scler. PY 2004 VL 10 IS 6 BP 690 EP 725 DI 10.1191/1352458504ms1116rr PG 36 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 871AQ UT WOS:000225101700016 PM 15584496 ER PT J AU Weisbord, SD Bruns, FJ Saul, MI Palevsky, PM AF Weisbord, SD Bruns, FJ Saul, MI Palevsky, PM TI Provider use of preventive strategies for radiocontrast nephropathy in high-risk patients SO NEPHRON CLINICAL PRACTICE LA English DT Article; Proceedings Paper CT 35th Annual Meeting of the American-Society-of-Nephrology CY NOV 01-06, 2002 CL PHILADELPHIA, PA SP Amer Soc Nephrol DE intravenous fluids; nonsteroidal anti-inflammatories; cyclo-oxygenase inhibitors; radiocontrast nephropathy ID ACUTE-RENAL-FAILURE; RADIOGRAPHIC-CONTRAST-AGENT; CARDIAC-CATHETERIZATION; PROSPECTIVE TRIAL; HYDRATION; NEPHROTOXICITY; INSUFFICIENCY; DYSFUNCTION; ANGIOGRAPHY; FUROSEMIDE AB Background/Aims: Radiocontrast nephropathy (RCN) is a common and costly form of acute renal failure. Current preventative strategies include the use of intravenous (IV) fluids and the discontinuation of nephrotoxic medications at the time of radiocontrast administration. We sought to determine whether providers employ these strategies in high-risk patients to limit the development of RCN. Methods: High-risk patients undergoing procedures using radiocontrast media over a 12-month period were identified. Medical records were reviewed for all subjects who developed RCN and a randomly selected 25% of patients without RCN. Patients with a contraindication to IV volume expansion were excluded. Medical records of the remaining patients were reviewed to determine whether IV fluids were administered and whether NSAIDs or COX-2 inhibitors were prescribed at the time of contrast administration. Results: RCN developed in 8% of patients overall. Of 144 patients eligible for IV volume expansion, 16% failed to receive any IV fluids. When IV fluids were employed, their dose and timing of administration varied significantly by treating specialty and procedure. NSAIDs and COX-2 inhibitors were prescribed to 8% of patients. Conclusions: Commonly accepted strategies for the prevention of RCN are underutilized. Quality improvement efforts are needed to increase the use of these two simple prophylactic measures. Copyright (C) 2004 S. Karger AG, Basel. C1 Univ Pittsburgh, Med Ctr, Renal Electrolyte Div, Sch Med, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Ctr Biomed Informat, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. RP Weisbord, SD (reprint author), Univ Pittsburgh, Med Ctr, Renal Electrolyte Div, Sch Med, A919 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15261 USA. EM weisbordsd@msx.upmc.edu OI Palevsky, Paul/0000-0002-7334-5400 FU NHLBI NIH HHS [T32HL07820-05] NR 41 TC 10 Z9 10 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1660-2110 J9 NEPHRON CLIN PRACT JI Nephron. Clin. Pract. PY 2004 VL 96 IS 2 BP C56 EP C62 DI 10.1159/000076400 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 778KL UT WOS:000189240700006 PM 14988599 ER PT J AU Bartzokis, G AF Bartzokis, G TI Age-related myelin breakdown: a developmental model of cognitive decline and Alzheimer's disease SO NEUROBIOLOGY OF AGING LA English DT Review DE aging; Alzheimer; myelin; degeneration; development; white matter; oligodendrocytes; amyloid; tau; neurons ID WHITE-MATTER CHANGES; CENTRAL-NERVOUS-SYSTEM; AMYLOID-BETA-PROTEIN; GROWTH-FACTOR-I; SYNAPTIC PLASMA-MEMBRANES; NORMAL ADULT BRAIN; TOTAL GRAY-MATTER; A-BETA; OXIDATIVE STRESS; PRECURSOR PROTEIN AB A hypothetical model of Alzheimer's disease (AD) as a uniquely human brain disorder rooted in its exceptional process of myelination is presented. Cortical regions with the most protracted development are most vulnerable to AD pathology, and this protracted development is driven by oligodendrocytes, which continue to differentiate into myelin producing cells late into the fifth decade of life. The unique metabolic demands of producing and maintaining their vast myelin sheaths and synthesizing the brain's cholesterol supply make oligodendrocytes especially susceptible to a variety of insults. Their vulnerability increases with increasing age at differentiation as later-differentiating cells myelinate increasing numbers of axonal segments. These vulnerable late-differentiating cells drive the protracted process of intracortical myelination and by increasing local cholesterol and iron levels, progressively increase the toxicity of the intracortical environment forming the basis for the age risk factor for AD. At older ages, the roughly bilaterally symmetrical continuum of oligodendrocyte vulnerability manifests as a progressive pattern of myelin breakdown that recapitulates the developmental process of myelination in reverse. The ensuing homeostatic responses to myelin breakdown further increase intracortical toxicity and results in the relentless progression and non-random anatomical distribution of AD lesions that eventually cause neuronal dysfunction and degeneration. This process causes a slowly progressive disruption of neural impulse transmission that degrades the temporal synchrony of widely distributed neural networks underlying normal brain function. The resulting network "disconnections" first impact functions that are most dependent on large-scale synchronization including higher cognitive functions and formation of new memories. Multiple genetic and environmental risk factors (e.g. amyloid beta-peptide and free radical toxicity, head trauma, anoxia, cholesterol levels, etc.) can contribute to the cognitive deficits observed in aging and AD through their impact on the life-long trajectory of myelin development and breakdown. This development-to-degeneration model is testable through imaging and post mortem methods and highlights the vital role of myelin in impulse transmission and synchronous brain function. The model offers a framework that explains the anatomical distribution and progressive course of AD pathology, some of the failures of promising therapeutic. interventions, and suggests further testable hypotheses as well as novel approaches for intervention efforts. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, Dept Neurol, Alzheimers Dis Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Lab Neuroimaging, Dept Neurol, Div Brain Mapping, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Dept Neurol, Alzheimers Dis Ctr, 710 Westwood Plaza,Room 2-238, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013 FU NIA NIH HHS [AG 16570]; NIMH NIH HHS [MH 635701A1] NR 272 TC 451 Z9 459 U1 4 U2 55 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD JAN PY 2004 VL 25 IS 1 BP 5 EP 18 DI 10.1016/j.neurobiolaging.2003.03.001 PG 14 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 759HT UT WOS:000187732800003 PM 14675724 ER PT J AU Bartzokis, G AF Bartzokis, G TI Quadratic trajectories of brain myelin content: unifying construct for neuropsychiatric disorders SO NEUROBIOLOGY OF AGING LA English DT Editorial Material DE brain development; aging; dementia; myelin; white matter; oligodendrocytes; Alzheimer; Parkinson; degeneration; amyloid; tau; alpha; synuclein; iron; cholesterol; free radicals; gender; head trauma; Lewy body; frontotemporal; FTD; ADHD; autism; learning disability; schizophrenia; addiction; impulse control; language; oscillations; processing speed; memory; medication; butyrylcholinesterase; evolution; brain; behavior; tauopathy; synucleinopathy; proteinopathy ID CENTRAL-NERVOUS-SYSTEM; WHITE-MATTER CHANGES; ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; BUTYRYLCHOLINESTERASE K-VARIANT; CHILDHOOD-ONSET SCHIZOPHRENIA; AMYLOID PRECURSOR PROTEIN; MILD COGNITIVE IMPAIRMENT; PRIMARY VISUAL-CORTEX; NORMAL ADULT BRAIN; TOTAL GRAY-MATTER AB Myelin plays an essential but largely underappreciated role in human brain structure and function. The central challenge raised by the six commentaries is whether the developmental model of age-related cognitive decline and Alzheimer's disease (AD) (Bartzokis, 2003, this issue) is applicable to a wider range of neurodegenerative and neuropsychiatric disorders. The model's premise that the trajectory of myelin development and breakdown is essential to our very uniqueness as a species, directly addresses this issue. In its widest perspective, the model primarily delineates a myelin hypothesis of human brain evolution and normal development and is "secondarily" useful in conceptualizing a wide range of age-related neuropsychiatric diseases. The unique vulnerabilities of oligodendrocytes and the highly protracted and extensive developmental process of human brain myelination delineated in the model are directly pertinent to many uniquely human brain functions and neuropsychiatric diseases including late-life neurodegenerative disorders. This lifelong perspective classifies AD as a disorder likely to arise in old age after a normal trajectory of myelin development. Genetic and environmental factors causing deviations in the myelination trajectory at any point in the lifespan will contribute to differences in the manifestations of later-life degenerative diseases and/or be detected in epidemiologic studies as risk factors or risk mitigators (age, cholesterol, iron, gender, education, brain, trauma, etc.). Ultimately, these perturbations of the myelination process could result in divergent-appearing disorders, such as frontotemporal dementia, dementia pugilistica, AD, dementia with Lewy bodies, and Parkinson's disease, that nonetheless have overlapping neuropathologic and/or clinical manifestations. Furthermore, the model's developmental perspective suggests that dysregulation in the uniquely vulnerable myelination process also contributes to highly prevalent early-life psychiatric disorders such as autism, attention deficit, schizophrenia, addiction, as well as their striking male predominance. Eventually, the dysregulated myelination associated with such disorders may have a direct and predictable impact on the appearance and manifestations of the later-life dementias. By increasing the scientific focus on the process of myelination, this model may facilitate our understanding of the pathophysiology of multiple disorders and pathophysiologic, processes that cut across our current classification of diseases. Ultimately, the model provides a rational framework for the development of novel, myelin-centered treatments that may have widespread efficacy across multiple disease states and could potentially be used in delaying or even preventing some of the most devastating of human disorders. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Lab Neuroimaging, Dept Neurol, Div Brain Mapping, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. RI Bartzokis, George/K-2409-2013 NR 162 TC 81 Z9 81 U1 6 U2 13 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD JAN PY 2004 VL 25 IS 1 BP 49 EP 62 DI 10.1016/j.neurobiolaging.2003.08.001 PG 14 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 759HT UT WOS:000187732800010 ER PT J AU Szekely, CA Thorne, JE Zandi, PP Ek, M Messias, E Breitner, JCS Goodman, SN AF Szekely, CA Thorne, JE Zandi, PP Ek, M Messias, E Breitner, JCS Goodman, SN TI Nonsteroidal anti-inflammatory drugs for the prevention of Alzheimer's disease: a systematic review SO NEUROEPIDEMIOLOGY LA English DT Review DE Alzheimer's disease; nonsteroidal anti-inflammatory agents; meta-analysis; systematic review; prevention; observational studies ID ESTROGEN REPLACEMENT THERAPY; RHEUMATOID-ARTHRITIS; CACHE COUNTY; NSAID USE; NEUROPATHOLOGICAL FINDINGS; CONTROLLED-TRIAL; SENILE DEMENTIA; RISK-FACTORS; PREVALENCE; COMMUNITY AB Objective: Alzheimer's disease, the most prevalent dementia, is a prominent source of chronic illness in the elderly. Laboratory evidence suggests that nonsteroidal anti-inflammatory drugs (NSAIDs) might prevent the onset of Alzheimer's disease. Since the early 1990s, numerous observational epidemiological studies have also investigated this possibility. The purpose of this meta-analysis is to summarize and evaluate available evidence regarding exposure to nonaspirin NSAIDs and risk of Alzheimer's disease using meta-analyses of published studies. Methods: A systematic search was conducted using Medline, Biological Abstracts, and the Cochrane Library for publications from 1960 onwards. All cross-sectional, retrospective, or prospective observational studies of Alzheimer's disease in relation to NSAID exposure were included in the analysis. At least 2 of 4 independent reviewers characterized each study by source of data and design, including method of classifying exposure and outcome, and evaluated the studies for eligibility. Discrepancies were resolved by consensus of all 4 reviewers. Results: Of 38 publications, 11 met the qualitative criteria for inclusion in the meta-analysis. For the 3 case-control and 4 cross-sectional studies, the combined risk estimate for development of Alzheimer's disease was 0.51 (95% CI = 0.40-0.66) for NSAID exposure. In the prospective studies, the estimate was 0.74 (95% CI = 0.62-0.89) for the 4 studies reporting lifetime NSAID exposure and it was 0.42 (95% CI = 0.26-0.66) for the 3 studies reporting a duration of use of 2 or more years. Conclusions: Based on analysis of prospective and nonprospective studies, NSAID exposure was associated with decreased risk of Alzheimer's disease. An issue that requires further exploration in future trials or observational studies is the temporal relationship between NSAID exposure and protection against Alzheimer's disease. Copyright (C) 2004 S. Karger AG, Basel. C1 Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA. Johns Hopkins Univ, Sch Med, Baltimore, MD USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Seattle, WA USA. RP Szekely, CA (reprint author), Johns Hopkins Bloomberg Sch Publ Hlth, Room 5010,615 N Wolfe St, Baltimore, MD 21205 USA. EM cszekely@jhsph.edu NR 70 TC 230 Z9 251 U1 3 U2 21 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0251-5350 J9 NEUROEPIDEMIOLOGY JI Neuroepidemiology PY 2004 VL 23 IS 4 BP 159 EP 169 DI 10.1159/000078501 PG 11 WC Public, Environmental & Occupational Health; Clinical Neurology SC Public, Environmental & Occupational Health; Neurosciences & Neurology GA 848TT UT WOS:000223490800001 PM 15279021 ER PT J AU Richardson, RD Engel, CC AF Richardson, RD Engel, CC TI Evaluation and management of medically unexplained physical symptoms SO NEUROLOGIST LA English DT Article DE review; somatization; fibrorryalgia; chronic fatigue syndrome ID CHRONIC-FATIGUE-SYNDROME; CHILDHOOD SEXUAL ABUSE; PRIMARY-CARE; SOMATIZATION DISORDER; PSYCHIATRIC-ILLNESS; LIFE EVENTS; NEUROLOGY OUTPATIENT; CHRONIC PAIN; BACK-PAIN; PATIENT AB Background: Medically unexplained physical symptoms (MUPS) and related syndromes are common in medical care and the general population, are associated with extensive morbidity, and have a large impact on functioning. Much of medical practice emphasizes specific pharmacological and surgical intervention for discrete disease states. Medical science, with its emphasis on identifying etiologically meaningful diseases comprised of homogeneous groups of patients, has split MUPS into a number of diagnostic entities or syndromes, each with its own hypothesized pathogenesis. However, research suggests these syndromes may be more similar than different, sharing extensive phenomenological overlap and similar risk factors, treatments, associated morbidities, and prognoses. Examples of syndromes consisting of MUPS include chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivities, somatoform disorders, and 'Gulf War Syndrome.' Review Summary: This paper is a narrative review of the increasing body of evidence suggesting that MUPS and related syndromes are common, disabling, and costly. It emphasizes that MUPS occur along a continuum of symptom count, severity, and duration and may be divided into acute, subacute (or recurrent), and chronic types. Predisposing, precipitating, and perpetuating factors influence the natural history of MUPS. Conclusion: Effective symptom management involves collaborative doctor-patient approaches for identification of problems based on a combination of medical importance and patient readiness to initiate behavioral change, negotiated treatment goals and outcomes, gradual physical activation and exercise prescription. Additionally, efforts should be made to teach and support active rather than passive coping with the symptoms. C1 Walter Reed Army Med Ctr, Deployment Hlth Clin Ctr, Washington, DC 20307 USA. VA Puget Sound Healthcare Syst, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Uniformed Serv Univ Hlth Sci, Dept Psychiat, Bethesda, MD 20814 USA. RP Engel, CC (reprint author), Walter Reed Army Med Ctr, Deployment Hlth Clin Ctr, Washington, DC 20307 USA. EM cengel@usuhs.mil NR 76 TC 49 Z9 53 U1 5 U2 16 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1074-7931 J9 NEUROLOGIST JI Neurologist PD JAN PY 2004 VL 10 IS 1 BP 18 EP 30 DI 10.1097/01.nrl.0000106921.76055.24 PG 13 WC Clinical Neurology SC Neurosciences & Neurology GA 768GE UT WOS:000188534600003 PM 14720312 ER PT J AU Johnson, SC Baxter, LC Susskind-Wilder, L Connor, DJ Sabbagh, MN Caselli, RJ AF Johnson, SC Baxter, LC Susskind-Wilder, L Connor, DJ Sabbagh, MN Caselli, RJ TI Hippocampal adaptation to face repetition in healthy elderly and mild cognitive impairment SO NEUROPSYCHOLOGIA LA English DT Article DE fMRI; hippocampus; memory; aging; mild cognitive impairment ID EARLY ALZHEIMERS-DISEASE; ENDURING MEMORY IMPAIRMENT; INFERIOR TEMPORAL CORTEX; RECOGNITION MEMORY; ENTORHINAL CORTEX; NOVELTY DETECTION; BRAIN ACTIVATION; FUNCTIONAL MRI; LOBE EPILEPSY; VERBAL MEMORY AB We examined the dynamic process of encoding novel repeating faces using functional MRI (fMRI) in non-demented elderly volunteers with and without diagnosed memory problems. We hypothesized that adaptation (repetition dependent reduction in activity) would occur in the mesial temporal lobe (MTL), and that this would be associated with cognitive status. Twenty-three right-handed volunteers were studied with an experimental encoding paradigm during fMRI scanning. Twelve participants had the diagnosis of mild cognitive impairment-amnestic type (MCI). The remaining 11 were cognitively healthy. All were diagnosed with a comprehensive neuropsychological battery and neurological evaluation prior to the study; they also received a brief cognitive battery the day of the scan. During the event-related fMRI task, participants viewed unfamiliar faces that repeated on average every 25 s with seven repetitions. The reduction in activation response as a function of repetition of unfamiliar faces was modeled in SPM99. Statistical parametric maps of adaptation slopes reflecting the decrease in activation with stimulus repetition were calculated for each participant, followed by a random-effects group analysis in which slope images were tested for significant group differences. Significant differences in adaptation slopes, with more negative slopes in the controls, were found in the medial temporal search region in the hippocampus and parahippocampal gyrus bilaterally, right more than left. Gray matter density analyses suggest the adaptation difference is not due to atrophy. Results suggest that the medial temporal response over repeated presentation is related to clinical status. Probes of incremental encoding processes over trials may be useful markers of medial temporal lobe integrity. (C) 2003 Elsevier Ltd. All rights reserved. C1 William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Madison, WI USA. St Josephs Hosp, Barrow Neurol Inst, Phoenix, AZ USA. Sun Hlth Res Inst, Cleo Roberts Ctr Clin Res, Sun City, AZ USA. Mayo Clin Scottsdale, Dept Neurol, Scottsdale, AZ USA. RP Johnson, SC (reprint author), William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, 2500 Overlook Terrace,11G, Madison, WI 53705 USA. EM scj@medicine.wisc.edu OI Johnson, Sterling/0000-0002-8501-545X FU NIA NIH HHS [P30 AG019610, AG18540]; NIMH NIH HHS [MH65723] NR 68 TC 65 Z9 69 U1 0 U2 8 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0028-3932 J9 NEUROPSYCHOLOGIA JI Neuropsychologia PY 2004 VL 42 IS 7 BP 980 EP 989 DI 10.1016/j.neuropsychologia.2003.11.015 PG 10 WC Behavioral Sciences; Neurosciences; Psychology, Experimental SC Behavioral Sciences; Neurosciences & Neurology; Psychology GA 804TZ UT WOS:000220322300013 PM 14998712 ER PT J AU Reger, MA Welsh, RK Watson, GS Cholerton, B Baker, LD Craft, S AF Reger, MA Welsh, RK Watson, GS Cholerton, B Baker, LD Craft, S TI The relationship between neuropsychological functioning and driving ability in dementia: A meta-analysis SO NEUROPSYCHOLOGY LA English DT Article ID MOTOR-VEHICLE CRASHES; SIMULATED CAR CRASHES; ALZHEIMERS-DISEASE; OLDER DRIVERS; PERFORMANCE; ATTENTION; RELIABILITY; IMPAIRMENT; FITNESS; SAFETY AB A meta-analysis of 27 primary studies was conducted to examine the relationship between neuropsychological functioning and driving ability for adults with dementia. When studies using a control group were included, the relationship between cognitive measures and on-road or non-road driving measures was significant for all reported domains; mean correlations ranged from .35 to .65. Caregiver reports of driving ability and cognitive variables were correlated significantly only on measures of mental status and visuospatial skills. When studies using a control group were excluded, moderate mean correlations were observed for visuospatial skills and on-road or non-road measures, and for mental status with non-road tests. Other effects were small or nonsignificant. Implications for basing driving recommendations on neuropsychological testing are, discussed. C1 Vet Affairs Puget Sound Hlth Care Syst, GRECC A182, Tacoma, WA 98493 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Reger, MA (reprint author), Vet Affairs Puget Sound Hlth Care Syst, GRECC A182, 9600 Vet Dr, Tacoma, WA 98493 USA. EM mreger@u.washington.edu FU NIA NIH HHS [T32 AG00258] NR 55 TC 108 Z9 110 U1 3 U2 13 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0894-4105 J9 NEUROPSYCHOLOGY JI Neuropsychology PD JAN PY 2004 VL 18 IS 1 BP 85 EP 93 DI 10.1037/0894-4105.18.1.85 PG 9 WC Psychology, Clinical; Neurosciences; Psychology SC Psychology; Neurosciences & Neurology GA 766WJ UT WOS:000188398100009 PM 14744191 ER PT J AU Cooper, RA Boninger, ML Cooper, R Fitzgerald, SG Kellerher, A AF Cooper, RA Boninger, ML Cooper, R Fitzgerald, SG Kellerher, A TI Preliminary assessment of a prototype advanced mobility device in the work environment of veterans with spinal cord injury SO NEUROREHABILITATION LA English DT Article ID WHEELCHAIRS AB The INDEPENDENCE(TM) 3000 IBOT(TM) Transporter (IBOT(TM) is an electronically stabilizing device for people with disabilities. The purpose of this study was to collect qualitative data on the potential for the IBOT(TM) to improve employment satisfaction of veterans who use wheelchairs to work. This study was based upon observations by trained clinicians, and responses to a survey completed by four men with traumatic spinal cord injury, who worked in an office environment. The mean age of the subjects was 52 +/- 8.8 years. The subjects used the devices to hold eye-level discussions with colleagues, climb stairs, ascend steep ramps, and negotiate curbs. When subjects were asked to rate the ease of getting around in the IBOT(TM) compared to their personal wheelchairs, they responded with a mean of 6.7 +/- 1.8 on a 10-point visual analog scale. The response to rating the overall function of the IBOT(TM) within their working environment yielded a rating of 6.0 +/- 2.8. Half of the users felt that the IBOT(TM) would help them at work and all thought it should be made available to veterans who use wheelchairs. A larger study should be conducted to determine if the IBOT(TM) affects work performance and the ability to return to work. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R1, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R1, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper+@pitt.edu OI Boninger, Michael/0000-0001-6966-919X NR 20 TC 11 Z9 12 U1 2 U2 2 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2004 VL 19 IS 2 BP 161 EP 170 PG 10 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 836YW UT WOS:000222593500010 PM 15201475 ER PT J AU Yang, H Wang, L Wu, SV Tay, J Goulet, M Boismenu, R Czimmer, J Wang, Y Wu, S Ao, Y Tache, Y AF Yang, H Wang, L Wu, SV Tay, J Goulet, M Boismenu, R Czimmer, J Wang, Y Wu, S Ao, Y Tache, Y TI Peripheral secretin-induced Fos expression in the rat brain is largely vagal dependent SO NEUROSCIENCE LA English DT Article DE capsaicin; secretin receptor; nodose ganglia; vagus; nucleus tractus solitarii; central nucleus of the amygdala ID PHASEOLUS-VULGARIS LEUKOAGGLUTININ; CORTICOTROPIN-RELEASING-FACTOR; NUCLEUS-TRACTUS-SOLITARIUS; CCK-A RECEPTORS; AREA POSTREMA; EFFERENT PROJECTIONS; C-FOS; PARABRACHIAL NUCLEUS; GENE-EXPRESSION; SUBREGIONAL TOPOGRAPHY AB I.v. injection of secretin activates neurons in brain areas controlling autonomic function and emotion. Peripheral administration of secretin inhibits gastric functions through a central mechanism that is mediated by vagal dependent pathways. We investigated whether the vagus nerve is involved in i.p. injection of secretin-induced brain neuronal activation in conscious rats as monitored by Fos immunohistochemistry. Secretin (40 or 100 mug/kg, i.p., 90 min) induced a dose-related increase in the number of Fos positive neurons in the central nucleus of the amygdala (CeA), and a plateau Fos response in the area postrema (AP), nucleus tractus solitarii (NTS), locus coeruleus (LC), Barrington's nucleus (Bar), external lateral subnucleus of parabrachial nucleus (PBel) and arcuate nucleus, and at 100 mug/kg, in the dorsal motor nucleus of the vagus (DMV) compared with i.p. injection of vehicle. Double immunohistochemistry showed that secretin (40 mug/kg, i.p.) activates tyrosine hydroxylase neurons in the NTS. Subdiaphragmatic vagotomy (7 days) abolished Fos expression-induced by i.p. secretin (40 mug/kg) in the NTS, DMV, LC, Bar, PBel and CeA, while a significant rise in the AP was maintained. In contrast, s.c. capsaicin (10 days) did not influence the Fos induction in the above nuclei. Reverse transcription polymerase chain reaction (RT-PCR) and quantitative real-time PCR showed that secretin receptor mRNA is expressed in the nodose ganglia and levels were higher in the right compared with the left ganglion. These results indicate that peripheral secretin activates catecholaminergic NTS neurons as well as neurons in medullary, pontine and limbic nuclei regulating autonomic functions and emotion through vagal-dependent capsaicin-resistant pathways. Secretin injected i.p. may signal to the brain by interacting with secretin receptors on vagal afferent as well as on AP neurons outside the blood-brain barrier. (C) 2004 IBRO. Published by Elsevier Ltd. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Ctr Neruovisceral Sci & Womens Hlth, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. RP Yang, H (reprint author), VA Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. EM hoyang@ucla.edu FU NIDDK NIH HHS [DK-41301] NR 75 TC 24 Z9 24 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2004 VL 128 IS 1 BP 131 EP 141 DI 10.1016/j.neuroscience.2004.06.027 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 855EE UT WOS:000223955100013 PM 15450360 ER PT J AU Sosa, MAG Wen, PH De Gasperi, R Perez, GM Senturk, E Friedrich, VL Elder, GA AF Sosa, MAG Wen, PH De Gasperi, R Perez, GM Senturk, E Friedrich, VL Elder, GA TI Entorhinal cortex lesioning promotes neurogenesis in the hippocampus of adult mice SO NEUROSCIENCE LA English DT Article DE ibotenic acid; 5'-bromo-2'-deoxyuridine; beta-III tubulin; calbindin; entorhinal cortex ID RAT DENTATE GYRUS; NMDA RECEPTOR ACTIVATION; REACTIVE SYNAPTOGENESIS; IBOTENIC ACID; GENETIC INFLUENCE; GRANULE NEURONS; FASCIA-DENTATA; PROLIFERATION; EXPRESSION; CELLS AB Hippocampal neurogenesis in adult mammals is influenced by many factors. Lesioning of the entorhinal cortex is a standard model used to study injury and repair in the hippocampus. Here we use bromodeoxyuridine (BrdU) labeling combined with immunohistochemical identification using cell type specific markers to follow the fate of neural progenitors in the hippocampus following entorhinal cortex lesioning in mice. We show that unilateral entorhinal cortex. lesioning does not alter the rate of neural progenitor proliferation in the ipsilateral dentate gyrus during the first 3 days after lesioning. However it enhances cell survival at 42 days post-lesioning leading to an increased number of beta-III tubulin and calbindin-immunoreactive neurons being produced. By contrast, when BrdU was administered 21 days post-lesioning, the number of surviving cells 21 days later was similar on the lesioned and non-lesioned sides. Thus, acutely entorhinal cortex lesioning promotes neurogenesis by enhancing survival of either neural progenitors or their progeny. However, this stimulus to neurogenesis is not sustained into the recovery period. (C) 2004 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Bronx Vet Adm Med Ctr, Psychiat Serv, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Mt Sinai Sch Med, Fishberg Res Ctr Neurobiol, New York, NY 10029 USA. RP Elder, GA (reprint author), Bronx Vet Adm Med Ctr, Psychiat Serv, 3F22,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM gregory.elder@mssm.edu NR 71 TC 14 Z9 14 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 EI 1873-7544 J9 NEUROSCIENCE JI Neuroscience PY 2004 VL 127 IS 4 BP 881 EP 891 DI 10.1016/j.neuroscience.2004.05.058 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 851NS UT WOS:000223692400009 ER PT J AU Szot, P Wilkinson, CW White, SS Leverenz, JB Greenup, JL Colasurdo, EA Peskind, ER Raskind, MA AF Szot, P Wilkinson, CW White, SS Leverenz, JB Greenup, JL Colasurdo, EA Peskind, ER Raskind, MA TI Chronic cortisol suppresses pituitary and hypothalamic peptide message expression in pigtailed macaques SO NEUROSCIENCE LA English DT Article DE hypercortisolemia; anterior pituitary; paraventricular nucleus (PVN); corticotropin-releasing factor (CRF); adrenocorticotropic hormone (ACTH); monkey ID CORTICOTROPIN-RELEASING HORMONE; MESSENGER-RIBONUCLEIC-ACID; PARAVENTRICULAR NUCLEUS; GLUCOCORTICOID REGULATION; DIFFERENTIAL REGULATION; ARGININE VASOPRESSIN; RECEPTOR EXPRESSION; ANTERIOR-PITUITARY; RNA LEVELS; RAT-BRAIN AB The effects of chronic elevations in circulating glucocorticoids on the expression of peptides and peptide receptors of the hypothalamic-pituitary-adrenal (HPA) axis have been studied extensively in rodents, but they have not been examined in primates. To determine the responses of the HPA axis in primates to elevated cortisol, hypothalamic and pituitary tissue from normal older pigtailed macaques (Macaca nemestrina) that had received daily oral administration of cortisol or placebo for 1 year were studied. Proopiomelanocortin in the anterior pituitary and corticotropin-releasing factor (CRF) mRNA expression in the hypothalamic paraventricular nucleus (PVN) were significantly reduced in cortisol-treated monkeys in comparison with controls. CRF receptor 1 (CRF-R1) expression in the anterior pituitary and arginine vasopressin mRNA expression in the PVN were unchanged by chronic cortisol administration. Sustained elevation of circulating glucocorticoids results in suppression of HPA peptide and peptide receptor expression in the PVN and anterior pituitary similar to those found in rodents. Chronic therapeutic administration of glucocorticoids in humans may have unintended consequences for hypothalamic and pituitary function. Published by Elsevier Ltd on behalf of IBRO. C1 Vet Affairs Puget Sound Hlth Care Syst, NW Network Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Geriat Res Educ & Clin Ctr, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Szot, P (reprint author), Vet Affairs Puget Sound Hlth Care Syst, NW Network Mental Illness Res Educ & Clin Ctr, S-116,1660 S Columbian Way, Seattle, WA 98108 USA. EM szot@u.washington.edu NR 36 TC 5 Z9 5 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2004 VL 126 IS 1 BP 241 EP 246 DI 10.1016/j.neuroscience.2004.03.030 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 824SP UT WOS:000221707100022 PM 15145089 ER PT J AU Sternini, C Anselmi, L Guerrini, S Cervio, E Pham, T Balestra, B Vicini, R Baiardi, P D'Agostino, GL Tonini, M AF Sternini, C Anselmi, L Guerrini, S Cervio, E Pham, T Balestra, B Vicini, R Baiardi, P D'Agostino, GL Tonini, M TI Role of galanin receptor 1 in peristaltic activity in the guinea pig ileum SO NEUROSCIENCE LA English DT Article DE cholinergic transmission; descending myenteric neurons; ascending myenteric neurons; longitudinal muscle-myenteric plexus preparations; noncholinergic; nonadrenergic inhibitory pathways ID MU-OPIOID RECEPTORS; SMALL-INTESTINE; MYENTERIC NEURONS; CHOLINERGIC NEUROTRANSMISSION; IMMUNOREACTIVITY; TRANSMISSION; SUBTYPES; GUT; INTERNALIZATION; ENDOMORPHIN-1 AB Galanin effects are mediated by distinct receptors, galanin receptor 1 (GAL-R1), GAL-R2 and GAL-R3. Here, we analyzed 1) the role of GAL-R1 in cholinergic transmission and peristalsis in the guinea-pig ileum using longitudinal muscle-myenteric plexus preparations and intact segments of the ileum in organ bath, and 2) the distribution of GAL-R1 immunoreactivity in the myenteric plexus with immunohistochemistry and confocal microscopy. Galanin inhibited electrically stimulated contractions of longitudinal muscle-myenteric plexus preparations with a biphasic curve. Desensitization with 1 muM galanin suppressed the high potency phase of the curve, whereas the GAL-R1 antagonist, RWJ-57408 (1 muM), inhibited the low potency phase. Galanin (3 muM) reduced the longitudinal muscle contraction and the peak pressure, and decreased the compliance of the circular muscle. All these effects were antagonized by RWJ-57408 (1 or 10 muM). RWJ-57408 (10 muM) per se did not affect peristalsis parameters in normal conditions, nor when peristalsis efficiency was reduced by partial nicotinic transmission blockade with hexamethonium. In the myenteric plexus, GAL-RI immunoreactivity was localized to neurons and to fibers projecting within the plexus and to the muscle. GAL-R1 was expressed mostly by cholinergic neurons and by some neurons containing vasoactive intestinal polypeptide or nitric oxide synthase. This study indicates that galanin inhibits cholinergic transmission to the longitudinal muscle via two separate receptors; GAL-R1 mediates the low potency phase. The reduced peristalsis efficiency could be explained by inhibition of the cholinergic drive, whereas the decreased compliance is probably due to inhibition of descending neurons and/or to the activation of an excitatory muscular receptor. Endogenous galanin does not appear to affect neuronal pathways subserving peristalsis in physiologic conditions via GAL-R1. (C) 2004 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Vet Adm Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Pavia, Dept Physiol & Pharmacol Sci, I-27100 Pavia, Italy. Univ Pavia, S Maugeri Fdn, I-27100 Pavia, Italy. Univ Pavia, Dept Expt & Appl Pharmacol, I-27100 Pavia, Italy. RP Sternini, C (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, CURE, Digest Dis Res Ctr, Bldg 115,Room 224,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM csternin@ucla.edu OI Cervio, Elisabetta/0000-0002-9922-077X FU NIDDK NIH HHS [DK35740, DK41301, DK57037] NR 44 TC 15 Z9 15 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2004 VL 125 IS 1 BP 103 EP 112 DI 10.1016/j.neuroscience.2003.12.043 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 812SA UT WOS:000220858000011 PM 15051149 ER PT J AU D'Angelo, I Brecha, NC AF D'Angelo, I Brecha, NC TI Y2 receptor expression and inhibition of voltage-dependent Ca2+ influx into rod bipolar cell terminals SO NEUROSCIENCE LA English DT Article DE retina; calcium imaging; fura-2 AM; Ca2+ channels; neuropeptides ID TIGER SALAMANDER RETINA; GAMMA-AMINOBUTYRIC-ACID; ROOT GANGLION NEURONS; NEUROPEPTIDE-Y; RAT RETINA; MAMMALIAN RETINA; NEUROTRANSMITTER RELEASE; IMMUNOREACTIVE NEURONS; SYNAPTIC TRANSMISSION; CALCIUM CURRENT AB Neuropeptide Y (NPY) is a potent inhibitory neuropeptide expressed by amacrine cells in the rat retina. NPY modulates the release of multiple neurotransmitters in mammalian retina, yet the mechanisms mediating this regulation are not well defined. To further understand the action of NPY in the retina, Y receptor coupling to voltage-dependent Ca2+ channels was investigated using Ca2+ imaging with fura-2 AM to measure [Ca2+](i) increases in rod bipolar cell terminals. Y receptor expression was studied in rat retinal tissue with reverse transcription-polymerase chain reaction (RT-PCR). NPY inhibited the depolarization-evoked Ca2+ influx into rod bipolar cell axon terminals and caused a dose-dependent reduction and an average maximal inhibition of 72% at 1 muM, which was reversed upon washout. K+-evoked Ca2+ increases were also inhibited by the selective Y2 receptor agonists, C2-NPY and NPY(13-36), at concentrations of 1 muM, but not by the selective Y1 receptor agonist, [Leu(31)Pro(34)]NPY, selective Y4 receptor agonist, rPP, or the selective Y5 receptor agonist, [D-Trp32]-NPY. Y receptor expression was determined using RT-PCR for all known Y receptor subtypes. Y2 receptor mRNA, as well as Y1, Y4, and Y5 receptor mRNAs, are present in the rat retina. Like the rod bipolar cell, other studies in central neurons have shown that the Y2 receptor is expressed predominantly as a presynaptic receptor and that it modulates transmitter release. Together, these findings suggest that NPY activates presynaptic Y2 receptors to inhibit voltage-dependent Ca2+ influx into rod bipolar cell terminals, and establishes one mechanism by which NPY may reduce L-glutamate release from the rod bipolar cell synapse. (C) 2004 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Los Angeles, CA 90095 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP D'Angelo, I (reprint author), Univ Calif Los Angeles, Dept Neurobiol, Box 951763, Los Angeles, CA 90095 USA. EM impact@ucla.edu FU NEI NIH HHS [EY07026, EY04067]; NINDS NIH HHS [NS07101] NR 69 TC 12 Z9 12 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2004 VL 125 IS 4 BP 1039 EP 1049 DI 10.1016/j.neuroscience.2003.10.041 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 824IF UT WOS:000221679300021 PM 15120863 ER PT J AU Patierno, S Raybould, HE Sternini, C AF Patierno, S Raybould, HE Sternini, C TI Abdominal surgery induces mu opioid receptor endocytosis in enteric neurons of the guinea-pig ileum SO NEUROSCIENCE LA English DT Article DE gastrointestinal transit; endogenous opioids; opiates; ascending pathway; descending pathway ID RAT GASTROINTESTINAL-TRACT; POSTOPERATIVE ILEUS; MYENTERIC NEURONS; CIRCULAR MUSCLE; INTESTINAL MOTILITY; ENDOGENOUS OPIOIDS; EXOGENOUS OPIOIDS; BOWEL DYSFUNCTION; NERVOUS-SYSTEM; PORCINE ILEUM AB Immunohistochemistry and confocal microscopy were used to investigate mu opioid receptor (muOR) internalization in enteric neurons of the guinea-pig ileum following abdominal surgery. The following surgical procedures were performed under halothane or isofluorane anesthesia: a) midline abdominal skin incision, b) laparotomy or c) laparotomy with intestinal manipulation. Gastrointestinal transit was evaluated by using a non-absorbable marker and measuring fecal pellet output. In neurons from normal and control (anesthesia alone) animals, muOR was predominantly at the cell surface. muOR endocytosis following skin incision was not significantly different from controls (21.2+/-3.5% vs. 13.7+/-2.1%, mean+/-S.E.M.), whereas it was significantly increased by laparotomy (46.5+/-6.1%; P<0.01 vs. controls) or laparotomy plus intestinal manipulation (40.5+/-6.1%; P<0.01 vs. controls) 30 min following surgery compared with controls. muOR endocytosis remained elevated at 4 h (38.6+/-1.2%; P<0.01 vs. controls), whereas it was similar to controls at 6 and 12 h (17.5+/-5.8% and 11.2+/-3.0%). muOR endocytosis occurred in cholinergic and nitrergic neurons. Gastrointestinal transit was significantly delayed by laparotomy or laparotomy plus intestinal manipulation (12.8+/-1.2 and 13.8+/-0.6 h vs. 7.0+/-0.5 in controls; P<0.01), but was not significantly changed by skin incision (8.2+/-0.6 h). The findings of the present study support the concept that the noxious stimulation caused by abdominal surgery induces release of endogenous opioids thus resulting in muOR endocytosis in neurochemically distinct enteric neurons. muOR internalization can serve as indirect evidence of opioid release and as a means to visualize neuronal pathways activated by opioids. (C) 2003 IBRO. Published by Elsevier Ltd. All rights reserved. C1 CURE Digest Dis Res Ctr, Vet Adm Greater Los Angeles Healthcare Syst, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Davis, Sch Vet Med, Dept Anat Physiol & Cell Biol, Davis, CA 95616 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. RP CURE Digest Dis Res Ctr, Vet Adm Greater Los Angeles Healthcare Syst, Div Digest Dis, Bldg 115,Room 224 VAGLAHS,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM kira@ucla.edu FU NIDA NIH HHS [DA 05010, P50 DA005010]; NIDDK NIH HHS [DK 41301, DK41004, DK54155] NR 76 TC 14 Z9 14 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 EI 1873-7544 J9 NEUROSCIENCE JI Neuroscience PY 2004 VL 123 IS 1 BP 101 EP 109 DI 10.1016/j.neuroscience.2003.08.052 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 757WK UT WOS:000187584300011 PM 14667445 ER PT J AU Mueller, JL Ellenberger, EA Vaughn, LK Belknap, JK Quock, RM AF Mueller, JL Ellenberger, EA Vaughn, LK Belknap, JK Quock, RM TI Detection and mapping of quantitative trait loci that determine responsive-ness of mice to nitrous oxide antinociception SO NEUROSCIENCE LA English DT Article DE nitrous oxide; antinociception; quantitative trait loci; mice ID INBRED MOUSE STRAINS; ANALGESIA; LINKAGE; ANTAGONISM; TOLERANCE; RATS; MAP AB Exposure to 70% N2O evokes a robust antinociceptive effect in C57BL/6 (B6) but not in DBA/2 (D2) inbred mice. This study was conducted to identify quantitative trait loci (QTL) in the mouse genome that might determine responsiveness to N2O. Offspring from the F-2 generation bred from B6 and D2 progenitors exhibited a broad range of responsiveness to N2O antinociception as determined by the acetic acid-induced abdominal constriction test. QTL analysis was then used to dissect this continuous trait distribution into component loci, and to map them to broad chromosomal regions. To this end, 24 spleens were collected from each of the following four groups: male and female F-2 mice responding to 70% N2O in oxygen with 100% response (high-responders); and male and female F-2 mice responding with 0% response (low-responders). Genomic DNA was extracted from the spleens and genotyped with simple sequence length polymorphism MapPairs markers. Findings were combined with findings from the earlier QTL analysis from BXD recombinant inbred mice [Brain Res 725 (1996) 23]. Combined results revealed two significant QTL that influence responsiveness to nitrous oxide on proximal chromosome 2 and distal chromosome 5, and one suggestive QTL on midchromosome 18. The chromosome 2 QTL was evident only in males. A significant interaction was found between a locus on chromosome 6 and another on chromosome 13 with a substantial effect on N2O antinociception. (C) 2003 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Washington State Univ, Coll Pharm, Dept Pharmaceut Sci, Pullman, WA 99164 USA. Oregon Hlth Sci Univ, Res Serv, Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97239 USA. Marquette Univ, Dept Biomed Sci, Milwaukee, WI 53201 USA. Univ Illinois, Coll Med, Dept Biomed Sci, Rockford, IL 61107 USA. RP Quock, RM (reprint author), Washington State Univ, Coll Pharm, Dept Pharmaceut Sci, POB 646534, Pullman, WA 99164 USA. EM quockr@wsu.edu FU NIAAA NIH HHS [P60 AA010760]; NIDA NIH HHS [DA05228, DA10913]; NIDCR NIH HHS [DE 10047] NR 27 TC 7 Z9 8 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2004 VL 123 IS 3 BP 743 EP 749 DI 10.1016/j.neuroscience.2003.10.020 PG 7 WC Neurosciences SC Neurosciences & Neurology GA 761YF UT WOS:000187942500018 PM 14706786 ER PT J AU Allison, DB Barnes, S Garvey, WT AF Allison, DB Barnes, S Garvey, WT TI Nutrigenomics special issue - Foreword SO NUTRITION LA English DT Editorial Material C1 Univ Alabama, Dept Biostat, Sect Stat Genet, Clin Nutr Res Ctr, Birmingham, AL 35294 USA. Univ Alabama, Purdue UAB Bot Ctr Age Related Dis, Dept Biochem & Mol Genet, Dept Pharmacol & Toxicol,UAB Ctr Nutrient Gene In, Birmingham, AL 35294 USA. Univ Alabama, Dept Nutr Sci, Birmingham VA Med Ctr, Birmingham, AL 35294 USA. RP Allison, DB (reprint author), Univ Alabama, Dept Biostat, Sect Stat Genet, Clin Nutr Res Ctr, Birmingham, AL 35294 USA. OI Allison, David/0000-0003-3566-9399 NR 2 TC 2 Z9 3 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0899-9007 J9 NUTRITION JI Nutrition PD JAN PY 2004 VL 20 IS 1 BP 1 EP 1 DI 10.1016/j.nut.2003.10.018 PG 1 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 763KD UT WOS:000188083300001 PM 14698005 ER PT J AU Nagy, TR Blaylock, ML Garvey, WT AF Nagy, TR Blaylock, ML Garvey, WT TI Role of UCP2 and UCP3 in nutrition and obesity SO NUTRITION LA English DT Article ID UNCOUPLING PROTEIN-3 GENE; BROWN-ADIPOSE-TISSUE; MESSENGER-RNA EXPRESSION; SKELETAL-MUSCLE MITOCHONDRIA; HUMAN ENERGY HOMEOSTASIS; FATTY-ACID METABOLISM; BODY-MASS INDEX; THYROID-HORMONE; TRANSGENIC MICE; PIMA-INDIANS C1 Univ Alabama, Dept Nutr Sci, Clin Nutr Res Ctr, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL USA. RP Nagy, TR (reprint author), Univ Alabama, Dept Nutr Sci, Clin Nutr Res Ctr, Birmingham, AL 35294 USA. EM tnagy@uab.edu FU NCI NIH HHS [CA47888]; NIDDK NIH HHS [DK47461, DK38765, DK56336, DK54918] NR 81 TC 24 Z9 27 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0899-9007 J9 NUTRITION JI Nutrition PD JAN PY 2004 VL 20 IS 1 BP 139 EP 144 DI 10.1016/j.nut.2003.09.024 PG 6 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 763KD UT WOS:000188083300025 PM 14698029 ER PT J AU Panagiotou, I Beer, TM Hsieh, YC Mori, M Peters, L Klein, T Garzotto, M AF Panagiotou, I Beer, TM Hsieh, YC Mori, M Peters, L Klein, T Garzotto, M TI Predictors of delayed therapy after expectant management for localized prostate cancer in the era of prostate-specific antigen SO ONCOLOGY LA English DT Article DE androgen deprivation; expectant management; prostate cancer; treatment ID BEAM RADIATION-THERAPY; RADICAL PROSTATECTOMY; NATURAL-HISTORY; CONSERVATIVE MANAGEMENT; DOUBLING TIME; CARCINOMA; PROGRESSION; DISEASE; MEN; RECURRENCE AB Objective: To identify risk factors for delayed cancer-directed intervention in modern era prostate cancer patients who initially elect expectant management. Materials and Methods: An observational, cohort study of expectantly managed patients, diagnosed with clinical T1-4NxM0 prostate cancer between 1993 and 2000 was carried out. Data including TNM stage, age, serum prostate-specific antigen (PSA), prostate gland volume by transrectal ultrasound, Gleason score, percent biopsies positive for cancer, imaging results, initial treatment selection, and outcome data were collected on all patients. Results: 192 of 561 patients (34.3%) elected expectant management, and follow-up data were available for 187 (97.4%) patients. With a median follow-up of 3.6 years, 90 (48.1%) patients had a cancer-directed intervention. Gleason score (p=0.0097) and percent of positive biopsy cores (p=0.03) were independent predictors of time to intervention. As expected, PSA doubling time became the most significant predictor of intervention (p=0.0057) when added to the model. These independent covariates are able to characterize low-, intermediate- and high-risk groups for cancer-directed intervention. Conclusions: Cancer-directed intervention is common in patients who choose expectant management in the PSA era. Gleason score and percent of positive biopsy cores predict cancer-directed interventions, thus, these patients may be least suitable for expectant management. Copyright (C) 2004 S. Karger AG, Basel. C1 Oregon Hlth & Sci Univ, Div Hematol & Med Oncol, Portland, OR USA. Oregon Hlth & Sci Univ, Inst Canc, Portland, OR USA. Portland VA Med Ctr, Div Urol, Portland, OR USA. Oregon Hlth & Sci Univ, Div Urol, Portland, OR USA. RP Garzotto, M (reprint author), Portland VA Med Ctr, Div Urol, 3710 SW US Vet Hosp Rd,Mailcode P3GU, Portland, OR 97201 USA. EM garzotto@ohsu.edu FU NCI NIH HHS [5P30 CA69533-04]; NCRR NIH HHS [5 M01 RR00334-33S2] NR 24 TC 6 Z9 6 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0030-2414 J9 ONCOLOGY-BASEL JI Oncology PY 2004 VL 67 IS 3-4 BP 194 EP 202 DI 10.1159/000081317 PG 9 WC Oncology SC Oncology GA 873DG UT WOS:000225258900003 PM 15557778 ER PT J AU Friedlander, AH Friedlander, IK Marder, SR AF Friedlander, AH Friedlander, IK Marder, SR TI Posttraumatic stress disorder: Psychopathology, medical management, and dental implications SO ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTICS LA English DT Review ID SEROTONIN REUPTAKE INHIBITORS; CHILDHOOD SEXUAL ABUSE; BURNING MOUTH SYNDROME; SCRIPT-DRIVEN IMAGERY; DYSFUNCTION SYNDROME; PSYCHOSOCIAL FACTORS; TEMPOROMANDIBULAR PAIN; HIPPOCAMPAL VOLUME; INDUCED BRUXISM; RISK-FACTORS AB PTSD is a chronic mental illness that may arise after an individual experiences or witnesses a life-threatening event. Symptoms consist of persistent reexperiencing of the event, avoidance of reminders of the event, a numbing of positive emotions, and social withdrawal. A depressed mood and excessive use of alcohol and tobacco may accompany the disorder. PTSD afflicts approximately 5% of men and 11% of women. Dental disease may be extensive because of neglect of oral hygiene compounded by cigarette smoking. Dental treatment includes preventive education, oral cancer screening, and prescribing saliva substitutes or stimulants and anticaries agents to combat medication-induced xerostomia. Precautions must be taken when prescribing or administering certain analgesics, antibiotics, or sedative agents that may adversely interact with the psychiatric medications or when performing surgery because of the long-term effects of alcohol abuse. C1 VA Greater Los Angeles Healthcare Syst, Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. W Valley Los Angeles Cty Dept Hlth, Van Nuys, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Friedlander, AH (reprint author), VA Greater Los Angeles Healthcare Syst, Vet Affairs Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM arthur.friedlander@med.va.gov NR 105 TC 8 Z9 8 U1 9 U2 11 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 1079-2104 J9 ORAL SURG ORAL MED O JI Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. PD JAN PY 2004 VL 97 IS 1 BP 5 EP 11 DI 10.1016/j.tripleo.2003.09.004 PG 7 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 763TD UT WOS:000188115800005 PM 14716250 ER PT J AU Redding, SW Dahiya, MC Kirkpatrick, WR Coco, BJ Patterson, TF Fothergill, AW Rinaldi, MG Thomas, CR AF Redding, SW Dahiya, MC Kirkpatrick, WR Coco, BJ Patterson, TF Fothergill, AW Rinaldi, MG Thomas, CR TI Candida glabrata is an emerging cause of oropharyngeal candidiasis in patients receiving radiation for head and neck cancer SO ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTICS LA English DT Article ID COLONIZATION; ALBICANS; EPIDEMIOLOGY; STRAINS; INFECTION AB Oropharyngeal candidiasis (OPC) is relatively common in patients receiving radiation for head and neck cancer occurring in approximately 25% of patients. Candida albicans has been described as the primary infecting organism. Recently, other organisms, particularly Candida glabrata, have emerged as causative agents of OPC among immunocompromised patients. This study describes the characteristics of 6 patients with head and neck cancer treated with radiotherapy at our institution, who were found to have Candida glabrata-associated OPC and their responses to oral fluconazole. All 6 patients were successfully treated with oral fluconazole. However, most did not respond to the usual dose of 100 mg/day necessitating doses ranging from 200 to 800 mg/day to achieve clinical cure. All 3 patients receiving radiation only,were successfully treated with up to 200 mg/day; 2 of 3 patients receiving concomitant chemoradiation required doses ranging from 400 to 800 mg/day. As with systemic infection, previous fluconazole use appears to be a risk factor for this infection, but not with all patients. C1 Univ Texas, Hlth Sci Ctr, S Texas Vet Healthcare Syst, Dept Gen Dent, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Healthcare Syst, Dept Radiat Oncol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Healthcare Syst, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Healthcare Syst, Dept Pathol, San Antonio, TX 78229 USA. RP Redding, SW (reprint author), Univ Texas, Hlth Sci Ctr, S Texas Vet Healthcare Syst, Dept Gen Dent, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM redding@uthscsa.edu NR 16 TC 32 Z9 36 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 1079-2104 J9 ORAL SURG ORAL MED O JI Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. PD JAN PY 2004 VL 97 IS 1 BP 47 EP 52 DI 10.1016/j.tripleo.2003.09.008 PG 6 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 763TD UT WOS:000188115800010 PM 14716255 ER PT J AU Miller, LL Harvath, TA Ganzini, L Goy, ER Delorit, MA Jackson, A AF Miller, LL Harvath, TA Ganzini, L Goy, ER Delorit, MA Jackson, A TI Attitudes and experiences of Oregon hospice nurses and social workers regarding assisted suicide SO PALLIATIVE MEDICINE LA English DT Article DE attitudes; euthanasia; hospice; nurses; physician-assisted suicide; social workers ID EUTHANASIA; CARE; PHYSICIANS AB Background: When the Oregon Death with Dignity Act ( ODDA) legalizing physician-assisted suicide was enacted into law in 1997, Oregon hospice clinicians were uncertain how involved they would be with patients who wanted this option. However, 86% of the 171 persons in Oregon who have died by lethal prescription were enrolled in hospice programmes. Method: A mailed questionnaire was sent to all hospice nurses and social workers in Oregon in 2001 (n = 573) to assess their attitudes about legalized assisted suicide and interactions with patients concerning this issue. Responses from 306 nurses and 85 social workers are included in this report. Findings: Almost two-thirds of respondents reported that at least one patient had discussed assisted suicide as a potential option in the past year. Social workers were generally more supportive of both the ODDA and of patients choosing assisted suicide compared to nurses. Twenty-two per cent of all respondents were not comfortable discussing assisted suicide with patients. Ninety-five per cent of both groups, however, favoured hospice policies that would allow a patient to choose assisted suicide while enrolled in hospice and allow hospice clinicians to continue to provide care. Interpretations: Nurses and social workers in hospices and other settings can expect to encounter patient questions about physician-assisted suicide, whether legalized or not, and must be prepared to have these discussions. Most hospice professionals in Oregon do not believe that assisted suicide and hospice enrolment are mutually exclusive alternatives. C1 Oregon Hlth Sci Univ, Sch Nursing, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Oregon Hospice Assoc, Portland, OR USA. RP Miller, LL (reprint author), Oregon Hlth Sci Univ, Sch Nursing, SN-5N,3455 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM millerlo@ohsu.edu NR 25 TC 14 Z9 14 U1 1 U2 9 PU ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 0269-2163 J9 PALLIATIVE MED JI Palliat. Med. PY 2004 VL 18 IS 8 BP 685 EP 691 DI 10.1191/0269216304pm961oa PG 7 WC Health Care Sciences & Services; Public, Environmental & Occupational Health; Medicine, General & Internal SC Health Care Sciences & Services; Public, Environmental & Occupational Health; General & Internal Medicine GA 881KB UT WOS:000225865300003 PM 15623164 ER PT J AU Schneider, A Barmada, MM Slivka, A Martin, JA Whitcomb, DC AF Schneider, A Barmada, MM Slivka, A Martin, JA Whitcomb, DC TI Transforming growth factor-beta(1), interleukin-10 and interferon-gamma cytokine polymorphisms in patients with hereditary, familial and sporadic chronic pancreatitis SO PANCREATOLOGY LA English DT Article DE chronic pancreatitis; gene polymorhisms; cytokines; hereditary pancreatitis ID TUMOR-NECROSIS-FACTOR; IDIOPATHIC CHRONIC-PANCREATITIS; FACTOR-ALPHA; GROWTH-FACTOR-BETA-1 GENE; TNF-ALPHA; ASSOCIATION; PROMOTER; DISEASE; SUSCEPTIBILITY; EXPRESSION AB Background: The genetic influence is undefined in about 40% of patients with hereditary and familial pancreatitis and in the majority of patients with sporadic chronic pancreatitis. The pathophysiological mechanisms underlying the progression from acute to chronic pancreatitis have not been clarified. Cytokines participate in the immunological progression of pancreatic inflammation and may play an important role in the development of pancreatic fibrosis. Aims: We determined whether functional polymorphisms in the transforming growth factor-beta(1) gene at positions -509, +869 (codon 10) and +915 (codon 25), in the interleukin-10 gene at position -1082, and in the intron 1 of the interferon-gamma gene at position +874 are associated with hereditary, familial or sporadic pancreatitis. Methods: We investigated 78 patients with hereditary and familial pancreatitis and 62 patients with sporadic pancreatitis that were tested negative for cationic trypsinogen gene mutations, and 73 controls. Mutational analysis was performed by direct DNA sequencing or by amplification refractory mutational system polymerase chain reaction. We used the age at onset as marker of disease severity. Results: The genotype frequencies were similar between patients and controls for all investigated cytokine polymorphisms (p > 0.05). We did not find an association between the different genotypes and the age at onset of the disease, and we did not detect different genotype distributions in patients with morphological alterations on pancreatic imaging after a disease duration of up to 5 years. Conclusion: These genetic variants do not play a dominant role in hereditary, familial or sporadic chronic pancreatitis. Copyright (C) 2004 S. Karger AG, Basel and IAP. C1 Univ Pittsburgh, Dept Med, Pittsburgh, PA 15101 USA. Univ Pittsburgh, Dept Human Genet, Pittsburgh, PA 15101 USA. Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA 15101 USA. Univ Pittsburgh, VA Pittsburgh Hlth Care Syst, Pittsburgh, PA 15101 USA. Univ Pittsburgh, Ctr Genom Sci, Pittsburgh, PA 15101 USA. Univ Heidelberg Hosp, Dept Med 2, D-68135 Mannheim, Germany. RP Whitcomb, DC (reprint author), Univ Pittsburgh, Dept Med, 571 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15101 USA. EM whitcomb@pitt.edu OI Barmada, M Michael/0000-0002-3604-6460 FU NIDDK NIH HHS [DK54709] NR 28 TC 9 Z9 10 U1 0 U2 1 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1424-3903 J9 PANCREATOLOGY JI Pancreatology PY 2004 VL 4 IS 6 BP 490 EP 494 DI 10.1159/000080245 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 883XH UT WOS:000226048500002 PM 15316224 ER PT J AU Gukovskaya, AS Pandol, SJ AF Gukovskaya, AS Pandol, SJ TI Cell death pathways in pancreatitis and pancreatic cancer SO PANCREATOLOGY LA English DT Review DE apoptosis; necrosis; caspases; mitochondrial dysfunction ID NF-KAPPA-B; EXTRACELLULAR-MATRIX PROTEINS; PERMEABILITY TRANSITION PORE; TUMOR-NECROSIS-FACTOR; CYTOCHROME-C RELEASE; INTRACELLULAR TRYPSINOGEN ACTIVATION; CERULEIN-INDUCED PANCREATITIS; HUMAN DUCTAL ADENOCARCINOMAS; BLOOD MONONUCLEAR-CELLS; HEAT-SHOCK PROTEINS AB The understanding of the regulation of apoptosis and necrosis, the two principal cell death pathways, is becoming exceedingly important in investigations of the pathogenesis and treatment of pancreatitis and pancreatic cancer. For example, in acute pancreatitis significant amounts of pancreatic necrosis are associated with increased morbidity and mortality. Thus, determining the key steps regulating necrosis should provide insights into potential therapeutic strategies for improving outcome in these patients. On the other hand, in pancreatic cancer various survival mechanisms act to prevent cell death, resulting in promotion of tumor growth and metastasis. Resistance of pancreatic cancer to apoptosis is the key factor preventing responses to therapies. Investigations of the regulation of cell death mechanisms specific to pancreatic cancer should lead to improvements in our current therapies for this disease. The present review is designed to provide information about cell death pathways in pancreatitis and pancreatic cancer with reference to areas that need further investigation, as well as to provide measurement techniques adapted to pancreatic tissue and cells. Copyright (C) 2004 S. Karger AG, Basel and IAP. C1 VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Gukovskaya, AS (reprint author), VA Greater Los Angeles Hlth Care Syst, Bldg 258,Room 340,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu FU NIDDK NIH HHS [DK59508, DK59936] NR 204 TC 105 Z9 110 U1 0 U2 3 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1424-3903 J9 PANCREATOLOGY JI Pancreatology PY 2004 VL 4 IS 6 BP 567 EP 586 DI 10.1159/000082182 PG 20 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 883XH UT WOS:000226048500015 PM 15550766 ER PT J AU Tran, AN Haidet, P Street, RL O'Malley, KJ Martin, F Ashton, CM AF Tran, AN Haidet, P Street, RL O'Malley, KJ Martin, F Ashton, CM TI Empowering communication: a community-based intervention for patients SO PATIENT EDUCATION AND COUNSELING LA English DT Article DE physician-patient relations; persuasive communication; patient-centered care patient activation; cross-cultural comparison; community networks ID PARTICIPATORY DECISION-MAKING; MEDICAL-CARE; IMPROVE COMMUNICATION; BREAST-CANCER; SATISFACTION; CONSULTATIONS; PHYSICIANS; PROVIDER; SKILLS; OUTCOMES AB The "How to Talk to Your Doctor" community education forums operate under the assumption that information exchange and consumer involvement in healthcare can empower communities in need. We report on the development and preliminary evaluation of this community-based intervention designed to activate and enhance patients' communicative abilities in the medical encounter. We review evidence supporting the feasibility of and benefits that can be expected from improving patients' communication competency. Our intervention is simple and flexible so, therefore, can be portable to a large number of communities. Our preliminary evaluation suggests that the intervention is well-received and produces improved self-perceptions of communication competence across diverse settings and participants. We describe our intervention and its development and dissemination as a model for improving patients' communicative abilities through a community-based, active learner approach. By sharing our experiences, the barriers we encountered, and our ongoing efforts to improve patient communication in the medical encounter, we hope to empower patients to communicate better with their physicians. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ N Carolina, Sch Publ Hlth, Dept Hlth Behav & Hlth Educ, Chapel Hill, NC 27599 USA. Texas A&M Univ, Dept Commun, College Stn, TX 77843 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Vet Affairs Med Ctr, Res Ctr Excellence, US Dept Vet Affairs,Hlth Serv, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. RP Tran, AN (reprint author), Univ N Carolina, Sch Publ Hlth, Dept Hlth Behav & Hlth Educ, CB 7440, Chapel Hill, NC 27599 USA. EM anhtran@email.unc.edu FU AHRQ HHS [P01 HS10876] NR 48 TC 41 Z9 42 U1 0 U2 10 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0738-3991 J9 PATIENT EDUC COUNS JI Patient Educ. Couns. PD JAN PY 2004 VL 52 IS 1 BP 113 EP 121 DI 10.1016/S0738-3991(03)00002-8 PG 9 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA 768WG UT WOS:000188592700015 PM 14729298 ER PT J AU Rai, S Engelberts, D Laffey, JG Frevert, C Kajikawa, O Martin, TR Post, M Kavanagh, BP AF Rai, S Engelberts, D Laffey, JG Frevert, C Kajikawa, O Martin, TR Post, M Kavanagh, BP TI Therapeutic hypercapnia is not protective in the in vivo surfactant-depleted rabbit lung SO PEDIATRIC RESEARCH LA English DT Article ID RESPIRATORY-DISTRESS-SYNDROME; NECROSIS-FACTOR-ALPHA; FREQUENCY OSCILLATORY VENTILATION; ARTERIAL BLOOD OXYGENATION; MECHANICAL VENTILATION; PERMISSIVE HYPERCAPNIA; PULMONARY-EDEMA; RAT LUNGS; INJURY; MODEL AB Permissive hypercapnia because of reduced tidal volume is associated with improved survival in lung injury, whereas therapeutic hypercapnia- deliberate elevation of arterial P-CO2-protects against in vivo reperfusion injury and injury produced by severe lung stretch. No published studies to date have examined the effects of CO2 on in vivo models of neonatal lung injury. We used an established in vivo rabbit model of surfactant depletion to investigate whether therapeutic hypercapnia would improve oxygenation and protect against ventilator-induced lung injury. Animals were randomized to injurious (tidal volume, 12 ML/kg; positive end-expiratory pressure, 0 cm H2O) or protective ventilatory strategy (tidal volume, 5 mL/kg; positive end-expiratory pressure, 12.5 cm H2O), and to receive either control conditions or therapeutic hypercapnia (fraction of inspired CO2, 0.12). Oxygenation (alveolar-arterial O-2 difference, arterial P-O2), lung injury (alveolar-capillary protein leak, impairment of static compliance), and selected bronchoalveolar lavage and plasma cytokines (IL-8, growth-related oncogene, monocyte chemoattractant protein-1, and tumor necrosis factor-alpha) were measured. Injurious ventilation resulted in a large alveolar-arterial O-2 gradient, elevated peak airway pressure, increased protein leak, and impaired lung compliance. Therapeutic hypercapnia did not affect any of these outcomes. Tumor necrosis factor-a was not increased by mechanical stretch in any of the groups. Therapeutic hypercapnia abolished the stretch-induced increase in bronchoalveolar lavage monocyte chemoattractant protein-1, but did not affect any of the other mediators studied. Therapeutic hypercapnia may attenuate the impairment in oxygenation and inhibit certain cytokines. Because hypercapnia inhibits certain cytokines but does not alter lung injury, the pathogenic role of these cytokines in lung injury is questionable. C1 Hosp Sick Children, Lung Biol Program, Toronto, ON M5G 1X8, Canada. Hosp Sick Children, Dept Crit Care Med & Anaesthesia, Toronto, ON M5G 1X8, Canada. Univ Toronto, Interdepartmental Div Crit Care Med, Toronto, ON M5G 1X8, Canada. Univ Washington, Dept Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Kavanagh, BP (reprint author), Hosp Sick Children, Dept Crit Care Med, 555 Univ Ave, Toronto, ON M5G 1X8, Canada. OI Laffey, John/0000-0002-1246-9573 NR 47 TC 26 Z9 26 U1 0 U2 0 PU INT PEDIATRIC RESEARCH FOUNDATION, INC PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 USA SN 0031-3998 J9 PEDIATR RES JI Pediatr. Res. PD JAN PY 2004 VL 55 IS 1 BP 42 EP 49 DI 10.1203/01.PDR.0000098502.72182.55 PG 8 WC Pediatrics SC Pediatrics GA 756UN UT WOS:000187502400006 PM 14561781 ER PT J AU Quinn, J Kaye, J Montine, T Stackman, R AF Quinn, J Kaye, J Montine, T Stackman, R TI Phytochemicals in Alzheimer disease: The development of clinical trials SO PHARMACEUTICAL BIOLOGY LA English DT Article DE Alzheimer disease; antioxidants; oxidative stress; polyphenolics ID BETA-AMYLOID NEUROTOXICITY; MILD COGNITIVE IMPAIRMENT; APP(SW) TRANSGENIC MICE; GINKGO-BILOBA; CEREBROSPINAL-FLUID; LIPID-PEROXIDATION; A-BETA; NEUROFIBRILLARY TANGLES; HIPPOCAMPAL VOLUME; UNCARIA-TOMENTOSA AB Polyphenolics and other phytochemicals may have a role in the prevention or treatment of Alzheimer disease. Targets of therapy in Alzheimer disease include neurotransmitter deficits, beta amyloid neurotoxicity, oxidative damage, and inflammation, to name a few. Challenges to the development of phytochemical and other neuroprotectant therapy in Alzheimer disease include the inability to measure pathology in living patients and the challenge of detecting modification of an indolent disease course. These challenges are partially surmounted by the use of animal models and of biomarkers of disease. This review describes currently available animal models and biomarkers and surveys clinical trials of phytochemical therapies that. are recently completed or currently under way. Both animal studies and clinical trials of Ginkgo biloba are described, as well as a trial of Uncaria tomentosa that has not been previously reported. C1 Portland Vet Affairs Med Ctr, Dept Neurol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. Univ Washington, Med Ctr, Dept Pathol, Seattle, WA 98195 USA. RP Quinn, J (reprint author), Portland Vet Affairs Med Ctr, Dept Neurol, P3 R&D,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. EM quinnj@ohsu.edu OI Stackman Jr, Robert/0000-0002-5950-046X; Kaye, Jeffrey/0000-0002-9971-3478 NR 64 TC 3 Z9 3 U1 3 U2 11 PU SWETS ZEITLINGER PUBLISHERS PI LISSE PA P O BOX 825, 2160 SZ LISSE, NETHERLANDS SN 1388-0209 J9 PHARM BIOL JI Pharm. Biol. PY 2004 VL 42 SU S BP 64 EP 73 DI 10.1080/138802090893531 PG 10 WC Plant Sciences; Medical Laboratory Technology; Pharmacology & Pharmacy SC Plant Sciences; Medical Laboratory Technology; Pharmacology & Pharmacy GA 890QU UT WOS:000226526700006 ER PT J AU Monnier, J Grubaugh, AL Knapp, RG Magruder, KM Frueh, BC AF Monnier, J Grubaugh, AL Knapp, RG Magruder, KM Frueh, BC TI US female veterans in VA primary care: post traumatic stress disorder symptoms and functional status SO PRIMARY CARE PSYCHIATRY LA English DT Article DE female veterans; PTSD symptoms ID VIETNAM VETERANS; PTSD CHECKLIST; SCREENING INSTRUMENT; HEALTH-STATUS; PREVALENCE; DIAGNOSIS; COMORBIDITY; PREDICTORS; SERVICES; CANCER AB We sought to examine the relationship between post traumatic stress disorder (PTSD) symptomatology, demographic variables, and functional status in US female veterans. One hundred ninety-one female veterans were identified from primary care clinics in four VA Medical Centers for participation in this study. The relationship between demographic variables, physical and mental health functional status on the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and PTSD severity on the PTSD Checklist (PCL) was examined using ANOVAs and simple and multiple linear regression modeling. After adjusting for other demographic covariates, PTSD severity was related to age (older patients reported less symptoms), and employment status (veterans who were not working due to disability reported significantly more PTSD symptoms than those who were working). Additionally, after adjusting for relevant demographic covariates, greater PTSD symptomatology was related to worse functioning across both physical and mental health domains on the SF-36. PTSD symptom severity was easily assessed in this primary care sample of female veterans using the PCL. Screening female veterans through primary care clinics is likely to identify women with PTSD who are not functioning as well as their peers and who are in need of specialized services. These findings are similar to those using men identified through VA primary care clinics. C1 Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. RP Monnier, J (reprint author), Med Univ S Carolina, Dept Psychiat & Behav Sci, POB 250681, Charleston, SC 29425 USA. EM monnierj@musc.edu NR 31 TC 5 Z9 5 U1 8 U2 8 PU LIBRAPHARM PI NEWBURY PA C/O DR. PETER L CLARKE, 26-32 VENTURE WEST, NEW GREENHAM PARK, NEWBURY RG19 6HX, BERKSHIRE, ENGLAND SN 1355-2570 J9 PRIMARY CARE PSYCHIA JI Prim. Care Psychiatry PY 2004 VL 9 IS 4 BP 145 EP 150 DI 10.1185/135525704X20394 PG 6 WC Medicine, General & Internal; Psychiatry SC General & Internal Medicine; Psychiatry GA 912WB UT WOS:000228109500006 ER PT S AU Cole, GM Morihara, T Lim, GP Yang, FS Begum, A Frautschy, SA AF Cole, GM Morihara, T Lim, GP Yang, FS Begum, A Frautschy, SA BE Lahiri, DK TI NSAID and antioxidant prevention of Alzheimer's disease lessons from in vitro and animal models SO PROTECTIVE STRATEGIES FOR NEURODEGENERATIVE DISEASES SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 7th International Conference on Protective Strategies for Neurodegenerative Diseases CY AUG 14-18, 2004 CL Univ British Columbia, Vancouver, CANADA SP NIH, Vancouver BioMed Hlth Res Fdn HO Univ British Columbia DE interleukin-1 beta; a-1-antichymotrypsin; docosahexaenoic acid; ibuprofen ID AMYLOID-BETA-PROTEIN; LONG-TERM POTENTIATION; NITRIC-OXIDE SYNTHASE; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; PRESENILIN-1 TRANSGENIC MICE; NEURONAL OXIDATIVE DAMAGE; PRECURSOR PROTEIN; SYNAPTIC PLASTICITY; LIPID-PEROXIDATION; MOUSE MODEL AB Both oxidative damage and inflammation are elevated in brains of Alzheimer's disease (AD) patients, but their pathogenic significance remains unclear. The reduced AD risk associated with high intake of both nonsteroidal anti-inflammatory drugs (NSAIDs) and antioxidants; suggests causal roles, but clinical trials in AD patients have yielded only limited or negative results. To test the potential efficacy and mechanisms of candidate approaches, we have explored conventional and unconventional MAIDS, antioxidants, and combined NSAID/antioxidants in cell culture and animal models for AD (including aging APPsw transgenic mice and soluble A beta rodent infusion models). The conventional NSAID ibuprofen has the strongest epidemiological support. At sustainable doses designed to mimic protective consumption in the epidemiology, ibuprofen reduces amyloid accumulation but suppresses a surprisingly limited subset of inflammatory markers in APPsw transgenic mice. Both A beta production (APP, beta- and gamma-secretases) and post-production pathways (those affecting A beta aggregation or clearance: e.g., IL-1 or alpha 1ACT) are potentially involved in ibuprofen and other NSAID anti-AD activities. The post-production pathways are predictably shared with other seemingly protective NSAIDs, including naproxen that do not lower A beta 42 in vitro. Using clinically feasible dosing, brain levels of NSAIDs appear too low to implicate a number of pharmacological dose targets that have been demonstrated in vitro. Ibuprofen did not suppress microglial markers related to phagocytosis. The putative anti-inflammatory omega-3 fatty acid DHA had a profound impact on pathogenesis but did not lower inflammation, while vitamin E was surprisingly ineffective in reducing oxidative damage or amyloid in the aged APPsw mouse. In contrast, the unconventional NSAID/antioxidant curcumin was effective, lowering oxidative damage, cognitive deficits, synaptic marker loss, and amyloid deposition. Curcumin proved to be immunomodulatory, simultaneously inhibiting cytokine and microglial activation indices related to neurotoxicity, but increasing an index of phagocytosis. Curcumin directly targeted A beta and was also effective in other models, warranting further preclinical and clinical exploration. C1 Greater Los Angeles Vet Affairs Healthcare Syst, Sepulveda, CA 91343 USA. Ctr Geriatr Res Educ & Clin, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. RP Cole, GM (reprint author), Vet Adm Med Ctr, Greater Los Angeles Healthcare Syst, 16111 Plummer St,Bldg 7,Room A102, North Hills, CA 91343 USA. EM gmcole@ucla.edu FU NCCIH NIH HHS [R01 AT003008]; NIA NIH HHS [R01 AG013741, AG13471, P50 AG016570, R01 AG010685, R01 AG016793, U01 AG028583]; NINDS NIH HHS [NS43946] NR 92 TC 82 Z9 89 U1 0 U2 11 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-529-X J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2004 VL 1035 BP 68 EP 84 DI 10.1196/annals.1332.005 PG 17 WC Multidisciplinary Sciences; Clinical Neurology; Neurosciences; Pharmacology & Pharmacy SC Science & Technology - Other Topics; Neurosciences & Neurology; Pharmacology & Pharmacy GA BBW48 UT WOS:000228130300005 PM 15681801 ER PT J AU Frazier, TW Strauss, ME Steinhauer, SR AF Frazier, TW Strauss, ME Steinhauer, SR TI Respiratory sinus arrhythmia as an index of emotional response in young adults SO PSYCHOPHYSIOLOGY LA English DT Article DE respiratory sinus arrhythmia; emotion; heart period; skin conductance; valence; arousal ID HEART-RATE-VARIABILITY; AUTONOMIC NERVOUS-SYSTEM; VAGAL TONE; INFANT TEMPERAMENT; REACTIVITY; BEHAVIOR; CHILDREN; IMAGERY; EXPRESSION; PHYSIOLOGY AB The relationship between respiratory sinus arrhythmia (RSA) and valence and arousal remains unclear. In the present study, the associations between emotion responses and tonic or task-related changes in RSA were assessed. Specifically; the sensitivities of changes in interbeat interval, RSA, and skin conductance to the valence and arousal values of emotional stimuli were examined. This study also explored the association between tonic RSA and subjective, expressive, and physiological emotional responses. Response measures were collected from 56 adults during baseline and film-viewing periods. Tonic RSA was not significantly related to any of the response measures. Increased skin conductance and decreased RSA were associated with arousal independent of valence. Interbeat interval was related to affective valence and not arousal. These findings suggest that RSA may be a useful adjunct to skin conductance measures in assessing emotional arousal. C1 Case Western Reserve Univ, Dept Psychol, Cleveland, OH 44106 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. RP Frazier, TW (reprint author), Case Western Reserve Univ, Dept Psychol, 10900 Euclid Ave, Cleveland, OH 44106 USA. EM twf3@po.cwru.edu FU NIA NIH HHS [AG08012-12A1]; NIMH NIH HHS [MH55762] NR 58 TC 76 Z9 77 U1 5 U2 15 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD JAN PY 2004 VL 41 IS 1 BP 75 EP 83 DI 10.1046/j.1469-8986.2003.00131.x PG 9 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 768WJ UT WOS:000188592900008 PM 14693002 ER PT J AU Siegle, GJ Silk, JS Forbes, EE Steinhauer, SR Dahl, RE Carter, CS Thase, ME AF Siegle, GJ Silk, JS Forbes, EE Steinhauer, SR Dahl, RE Carter, CS Thase, ME TI Sustained pupil dilation to emotional information in depression: Developmental and mechanistic considerations SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract CT 44th Annual Meeting of the Society-for-Psychophysiological-Research CY OCT 20-24, 2004 CL Santa Fe, NM SP Soc Pychophysiol Res C1 Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Calif Davis, Davis, CA 95616 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PY 2004 VL 41 SU 1 BP S9 EP S9 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 849RL UT WOS:000223558200026 ER PT J AU Yang, YL Raine, A Loeber, R Steinhauer, SR Lacasse, L AF Yang, YL Raine, A Loeber, R Steinhauer, SR Lacasse, L TI Abnormal EEG responses to an emotional stressor in antisocial adolescents SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract CT 44th Annual Meeting of the Society-for-Psychophysiological-Research CY OCT 20-24, 2004 CL Santa Fe, NM SP Soc Pychophysiol Res DE antisocial C1 Univ So Calif, Los Angeles, CA 90089 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 2 U2 3 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PY 2004 VL 41 SU 1 BP S50 EP S50 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 849RL UT WOS:000223558200187 ER PT S AU Bartzokis, G Tishler, TA Shin, IS Lu, PH Cummings, JL AF Bartzokis, G Tishler, TA Shin, IS Lu, PH Cummings, JL BE LeVine, SM Connor, JR Schipper, HM TI Brain ferritin iron as a risk factor for age at onset in neurodegenerative diseases SO REDOX-ACTIVE METALS IN NEUROLOGICAL DISORDERS SE Annals of the New York Academy of Sciences LA English DT Article DE iron; ferritin; risk factor; age at onset; aging; Alzheimer's disease; Parkinson's disease; dementia; sex; gender; brain development; myelin; oligodendrocytes; degeneration; amyloid; tau; alpha-synuclein; free radicals; Lewy body; neuritic plaques; synucleinopathy; proteinopathy; tauopathy; chelation; treatment; hemochromatosis ID IN-VIVO EVALUATION; PARKINSONS-DISEASE; ALZHEIMERS-DISEASE; HEMOCHROMATOSIS GENE; ALPHA-SYNUCLEIN; HEREDITARY HEMOCHROMATOSIS; RESPONSE FLUCTUATIONS; OXIDATIVE STRESS; PRECURSOR CELLS; MRI EVALUATION AB Tissue iron can promote oxidative damage. Brain iron increases with age and is abnormally elevated early in the disease process in several neurodegenerative disorders, including Alzheimer's disease (AD) and Parkinson's disease (PD). Higher iron levels in males may contribute to higher risk for younger-onset PD and recent studies have linked the presence of the hemo-chromatosis gene with a younger age at onset of AD. We examined whether age at onset of PD and AD was associated with increased brain ferritin iron. Ferritin iron can be measured with specificity in vivo with MRI utilizing the field-dependent relaxation rate increase (FDRI) method. FDRI was assessed in three basal ganglia regions (caudate, putamen, and globus pallidus) and frontal lobe white matter for younger- and older-onset male PD and AD patients and healthy controls. Significant increases in basal ganglia FDRI levels were observed in the younger-onset groups of both diseases compared to their respective control groups, but were absent in the older-onset patients. The results support the suggestion that elevated ferritin iron and its associated toxicity is a risk factor for age at onset of neurodegenerative diseases such as AD and PD. Clinical phenomena such as gender-associated risk of developing neurodegenerative diseases and the age at onset of such diseases may be associated with brain iron levels. In vivo MRI can measure and track brain ferritin iron levels and provides an opportunity to design therapeutic interventions that target high-risk populations early in the course of illness, possibly even before symptoms appear. C1 Univ Calif Los Angeles, Dept Neurol, Lab Neuroimaging, Div Brain Mapping, Los Angeles, CA 90024 USA. Greater Los Angeles VA Healthcare Syst, Dept Psychiat, Los Angeles, CA USA. Charles R Drew Univ Med & Sci, Dept Psychiat, Los Angeles, CA 90059 USA. Univ Calif Los Angeles, Neurosci Interdept Grad Program, Los Angeles, CA USA. Chonnam Natl Univ, Sch Med, Dept Psychiat, Kwangju, South Korea. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Alzheimers Dis Ctr, 710 Westwood Plaza,Room 2-238, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013 FU NIA NIH HHS [AG 16570] NR 76 TC 108 Z9 117 U1 0 U2 6 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-502-8 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2004 VL 1012 BP 224 EP 236 DI 10.1196/annals.1306.019 PG 13 WC Clinical Neurology SC Neurosciences & Neurology GA BAB76 UT WOS:000221503700019 PM 15105269 ER PT J AU Schuepbach, D Hill, SK Sanders, RD Hell, D Keshavan, MS Sweeney, JA AF Schuepbach, D Hill, SK Sanders, RD Hell, D Keshavan, MS Sweeney, JA TI Early treatment induced improvement of negative symptoms predicts cognitive functioning in treatment naive first episode schizophrenia: A 2-year followup SO SCHIZOPHRENIA BULLETIN LA English DT Article; Proceedings Paper CT 56th Annual Meeting of the Society-of-Biological-Psychiatry CY MAY 03-05, 2001 CL NEW ORLEANS, LA SP Soc Biol Psychiat DE schizophrenia; followup; verbal memory; learning; neuropsychology ID 1ST EPISODE SCHIZOPHRENIA; TREATMENT RESPONSE; NEUROPSYCHOLOGICAL DEFICITS; DISORDER; FORMS AB Studying neuroleptic-naive first episode schizophrenia is a strategy for investigating clinical and neuropsychological abnormalities at a very early phase of the disease without confounding influences of illness duration and medication effects. We examined the clinical and neuropsychological time course over 2 years in 32 neuroleptic-naive first episode patients (20 males, 12 females) and 21 healthy individuals with similar sociodemographic characteristics. Early treatment-induced reduction of negative symptoms predicted superior cognitive performance throughout followup in the domains of verbal fluency, attention, and nonverbal learning and memory. There were no associations between psychotic or disorganized symptoms and cognitive variables. These findings suggest an important relationship between treatment efficacy of antipsychotic medication and the longer term course of cognitive deficits in schizophrenia. C1 Psychiat Univ Hosp Zurich, CH-8029 Zurich, Switzerland. Univ Illinois, Ctr Cognit Med, Dept Psychiat, Chicago, IL USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Western Psychiat Inst & Clin, Pittsburgh, PA USA. Univ Illinois, Sch Med, Neurocognit Assessment & Brain Imaging Program, Chicago, IL USA. RP Schuepbach, D (reprint author), Psychiat Univ Hosp Zurich, POB 68, CH-8029 Zurich, Switzerland. EM daniel.schuepbach@puk.zh.ch FU NCRR NIH HHS [M01RR00056]; NIMH NIH HHS [MH62134, MH45156, MH01433, MH42969] NR 46 TC 13 Z9 13 U1 1 U2 1 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPERINTENDENT DOCUMENTS,, WASHINGTON, DC 20402-9325 USA SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PY 2004 VL 30 IS 4 BP 837 EP 848 PG 12 WC Psychiatry SC Psychiatry GA 910FN UT WOS:000227916000016 PM 15957199 ER PT J AU Reddy, RD Keshavan, MS Yao, JK AF Reddy, RD Keshavan, MS Yao, JK TI Reduced red blood cell membrane essential polyunsaturated fatty acids in first episode schizophrenia at neuroleptic-naive baseline SO SCHIZOPHRENIA BULLETIN LA English DT Article DE red blood cell; fatty acid composition; polyunsaturated fatty acids; first episode schizophrenia ID MAGNETIC-RESONANCE-SPECTROSCOPY; ETHYL-EICOSAPENTAENOIC ACID; PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; DOCOSAHEXAENOIC ACID; ERYTHROCYTE-MEMBRANES; TARDIVE-DYSKINESIA; PHOSPHOLIPASE A(2); SKIN FIBROBLASTS; PLASMA AB There is emerging evidence in schizophrenia of membrane abnormalities, primarily reductions in the essential omega-3 and omega-6 series of polyunsaturated fatty acids (PUFA). Because previous studies have largely been in chronic patients, it is not known whether these membrane abnormalities also occur early in illness. In the present study, red blood cell membrane fatty acid levels were determined by capillary gas chromatography from 24 neuroleptic-naive patients with first episode schizophrenia or schizoaffective disorder and 31 age-matched normal controls. Relative to normal subjects, patients had significant reductions in total PUFA (-13%) but not in monounsaturated or saturated fatty acids. Specifically, significant reductions were found in arachidonic acid (-18%), docosapentaenoic acid (-36%), and docosahexaenoic acid (-26%) concentrations. These reductions were not related to age, gender, smoking status, or cotinine levels. These results confirm previous findings of membrane deficits in schizophrenia and show that significant PUFA reductions occur early in the illness, prior to initiation of treatment, raising the possibility that these deficits are trait related. The findings also suggest that membrane fatty acid losses are quite specific to the highly unsaturated fatty acids. C1 Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Reddy, RD (reprint author), Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, 3811 O Hara St, Pittsburgh, PA 15213 USA. EM reddyr@upmc.edu FU NIMH NIH HHS [MH-45203, MH-58141, MH-64118] NR 80 TC 85 Z9 87 U1 2 U2 5 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPERINTENDENT DOCUMENTS,, WASHINGTON, DC 20402-9325 USA SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PY 2004 VL 30 IS 4 BP 901 EP 911 PG 11 WC Psychiatry SC Psychiatry GA 910FN UT WOS:000227916000020 PM 15957200 ER PT J AU Yao, JK Leonard, S Reddy, RD AF Yao, JK Leonard, S Reddy, RD TI Increased nitric oxide radicals in postmortem brain from patients with schizophrenia SO SCHIZOPHRENIA BULLETIN LA English DT Article DE nitric oxide; caudate; postmortem changes; schizophrenia ID ANTIOXIDANT DEFENSE SYSTEM; TARDIVE-DYSKINESIA; CEREBRAL EDEMA; VITAMIN-E; GLUTATHIONE-PEROXIDASE; REFLECT ABNORMALITIES; SERUM INTERLEUKIN-6; PARKINSONS-DISEASE; ALZHEIMERS-DISEASE; LIPID-PEROXIDATION AB Alterations in antioxidant status in schizophrenia suggest free radical-mediated neurotoxicity; this finding can be a consequence of increased free radical production. There are multiple pathways to excess free radical generation and subsequent oxidative stress. One such pathway is the formation of peroxynitrite by a reaction of nitric oxide (NO) and superoxide radical. NO is formed from L-arginine by nitric oxide synthase (NOS). A constitutive cytosolic isoform, neuronal NOS (nNOS), appears to be fairly stable in the postmortem brain tissues. Utilizing a sensitive fluorometric assay, NO levels were measured by its stable metabolites, nitrate and nitrite, in the caudate region of postmortem brain tissues from patients and control subjects. In the human brain, NO is metabolized primarily in the form of nitrate. A significantly increased level of NO was found in schizophrenia patients (241 +/- 146 pmol/mg dry weight, n = 18) than was found in those of normal (142 +/- 65 pmol/mg dry weight, n = 20) and psychiatric controls without schizophrenia (125 +/- 83 pmol/mg dry weight, n = 16) (analysis of covariance [ANCOVA], F = 6.446, df = 2,51, p = 0.003). These findings were independent of age, brain weight, postmortem interval (PMI), sample storage time, or cigarette smoking. Elevated NO levels in the brains of schizophrenia patients lend further support for the free radical pathology in schizophrenia. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, Pittsburgh, PA USA. Univ Pittsburgh, Sch Pharm, Pittsburgh, PA USA. Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. RP Yao, JK (reprint author), VA Pittsburgh Healthcare Syst, Bldg 13,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM jkyao@pitt.edu NR 79 TC 76 Z9 79 U1 1 U2 3 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPERINTENDENT DOCUMENTS,, WASHINGTON, DC 20402-9325 USA SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PY 2004 VL 30 IS 4 BP 923 EP 934 PG 12 WC Psychiatry SC Psychiatry GA 910FN UT WOS:000227916000022 PM 15954198 ER PT J AU Stehman-Breen, C AF Stehman-Breen, C TI Osteoporosis and chronic kidney disease SO SEMINARS IN NEPHROLOGY LA English DT Review ID BONE-MINERAL DENSITY; STAGE RENAL-DISEASE; HIP FRACTURE; RISK-FACTORS; DIALYSIS PATIENTS; POSTMENOPAUSAL WOMEN; PHYSICAL-ACTIVITY; HORMONE; OSTEODYSTROPHY; HEMODIALYSIS C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Washington Univ, Seattle, WA USA. RP Stehman-Breen, C (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,Mailstop 111A, Seattle, WA 98108 USA. EM cos@u.washington.edu NR 33 TC 29 Z9 29 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9295 J9 SEMIN NEPHROL JI Semin. Nephrol. PD JAN PY 2004 VL 24 IS 1 BP 78 EP 81 DI 10.1053/j.semnephrol.2003.08.013 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 768RJ UT WOS:000188588600011 PM 14730513 ER PT S AU Palevsky, PM AF Palevsky, PM BE Ronco, C Bellomo, R Brendolan, A TI CRRT: Selection of patients and starting criteria SO SEPSIS, KIDNEY AND MULTIPLE ORGAN DYSFUNCTION SE CONTRIBUTIONS TO NEPHROLOGY LA English DT Article; Proceedings Paper CT 3rd International Course on Critical Care Nephrology CY JUN 01-04, 2004 CL Vicenza, ITALY ID ACUTE-RENAL-FAILURE; CONTINUOUS VENOVENOUS HEMOFILTRATION; REPLACEMENT THERAPY; PROPHYLACTIC DIALYSIS; INTRACRANIAL-PRESSURE; INTERMITTENT; HEMODIALYSIS; EXPERIENCE; FILTRATION; ADSORPTION C1 Univ Pittsburgh, Dr Div, VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA 15240 USA. RP Palevsky, PM (reprint author), Univ Pittsburgh, Dr Div, VA Pittsburgh Healthcare Syst, Renal Sect, Room 7E123,111F-U, Pittsburgh, PA 15240 USA. EM palevsky@pitt.edu OI Palevsky, Paul/0000-0002-7334-5400 NR 37 TC 0 Z9 1 U1 0 U2 0 PU KARGER PI BASEL PA POSTFACH, CH-4009 BASEL, SWITZERLAND SN 0302-5144 BN 3-8055-7755-9 J9 CONTRIB NEPHROL JI Contrib.Nephrol. PY 2004 VL 144 BP 214 EP 221 PG 8 WC Critical Care Medicine; Urology & Nephrology SC General & Internal Medicine; Urology & Nephrology GA BAH25 UT WOS:000222209500018 PM 15264410 ER PT J AU Lu, JW Mann, GL Ross, R Morrison, AR Kubin, L AF Lu, JW Mann, GL Ross, R Morrison, AR Kubin, L TI REM sleep-suppressing effect of hypothalamic perifornical microperfusion with GABAA receptor antagonist, bicuculline, increases with the duration of sleep SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Univ Penn, Dept Anim Biol, Philadelphia, PA 19104 USA. Univ Penn, Ctr Sleep & Resp Neurobiol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Dept Psychiat, Philadelphia, PA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 031 BP 14 EP 14 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400033 ER PT J AU Gong, H McGinty, D Angara, C Xu, F Chew, K Szymusiak, R AF Gong, H McGinty, D Angara, C Xu, F Chew, K Szymusiak, R TI Retrograde labeling in the preoptic area of the hypothalamus following injections of fluoro-gold into perifornical lateral hypothalamus SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 VA Greater Los Angeles Hlth Syst, Sleeep Res Ctr, North Hills, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 036 BP 16 EP 17 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400038 ER PT J AU Jha, SK Pawlyk, AC Brennan, FX Ross, RJ Morrison, AR AF Jha, SK Pawlyk, AC Brennan, FX Ross, RJ Morrison, AR TI Conditioned fear cues suppress REM sleep in rats SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Univ Penn, Sch Vet Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 062 BP 28 EP 28 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400064 ER PT J AU Wu, M Nienhuis, R John, J Maidment, NT Lam, HA Boehmer, LN Siegel, JM AF Wu, M Nienhuis, R John, J Maidment, NT Lam, HA Boehmer, LN Siegel, JM TI Effects of drugs affecting blood pressure and heart rate on the release of hypocretin in normal dogs SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 VA GLAHS Sepulveda, Neurobiol Res 151A3, North Hills, CA USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 077 BP 35 EP 35 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400079 ER PT J AU Lyamin, O Mukhametov, L Siegel, J AF Lyamin, O Mukhametov, L Siegel, J TI Association between EEG asymmetry and eye state in bottlenose dolphins and northern fur seals SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Univ Calif Los Angeles, Dept Psychiat, North Hills, CA USA. VA GLAHS Sepulveda, North Hills, CA USA. Severtsov Inst Ecol & Evolut, Moscow, Russia. Utrish Dolphinarium, Moscow, Russia. NR 0 TC 0 Z9 0 U1 1 U2 2 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 EI 1550-9109 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 184 BP 84 EP 84 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400186 ER PT J AU Lyamin, O Mukhametov, L Siegel, J AF Lyamin, O Mukhametov, L Siegel, J TI Deprivation of bilateral sleep induces EEG asymmetry in the fur seal SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 UCLS, Dept Psychiat, North Hills, CA USA. VA GLAHS Sepulveda, North Hills, CA USA. Severtsov Inst Ecol & Evolut, Moscow, Russia. Utrish Dolphinarium, Moscow, Russia. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 316 BP 145 EP 145 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400318 ER PT J AU Weaver, EM Maynard, C Yueh, B AF Weaver, EM Maynard, C Yueh, B TI Mortality of veterans with sleep apnea: Untreated versus treated SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 VA Puget Sound Healthcare Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. Univ Washington, Harborview Med Ctr, Sleep Disorders Ctr, Seattle, WA 98104 USA. Univ Washington, Hlth Serv, Seattle, WA 98195 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 NR 0 TC 2 Z9 2 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 463 BP 208 EP 208 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400465 ER PT J AU Sharafkhaneh, A Sharafkhaneh, H Bozkurt, B Hirshkowitz, M AF Sharafkhaneh, A Sharafkhaneh, H Bozkurt, B Hirshkowitz, M TI Prevalence of self-reported sleepiness in patients with cardiac permanent pacemaker SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Baylor Coll Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 474 BP 212 EP 213 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400476 ER PT J AU Gurubhagavatula, I Wheeler, M AF Gurubhagavatula, I Wheeler, M TI In-office screening for obstructive sleep apnea in primary care SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Univ Penn, Sch Med, Ctr Sleep & Resp Med, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Pulm & Crit Care Sect, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 491 BP 219 EP 220 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400493 ER PT J AU Westbrook, PR Berka, C Levendowski, DJ Lumicao, M Davis, G Olmstead, R Petrovic, M Yuksel, Y Ramsey, C Zivkovic, V AF Westbrook, PR Berka, C Levendowski, DJ Lumicao, M Davis, G Olmstead, R Petrovic, M Yuksel, Y Ramsey, C Zivkovic, V TI Quantification of alertness, memory and neurophysiological changes in sleep apnea patients following treatment with nCPAP SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Adv Brain Monitoring Inc, Carlsbad, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 3 Z9 3 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 499 BP 223 EP 223 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400502 ER PT J AU Lajos, LE Molina, PE Im, SS Gonzales, TA Garza, PC Ingmundson, PT AF Lajos, LE Molina, PE Im, SS Gonzales, TA Garza, PC Ingmundson, PT TI Continuous positive airway pressure adherence among veterans with and without posttraumatic stress disorder SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Audie Murphy VA Hosp, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 511 BP 228 EP 228 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400514 ER PT J AU Martin, JL Webber, AP Josephson, KR Harker, JO Alessi, CA AF Martin, JL Webber, AP Josephson, KR Harker, JO Alessi, CA TI Observed versus actigraphically estimated daytime sleep in older adults undergoing subacute rehabilitation in a nursing home SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Greater Los Angeles VA Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 789 BP 353 EP 353 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400791 ER PT J AU Pawlyk, AC Jha, SK Brennan, FX Morrison, AR Ross, RJ AF Pawlyk, AC Jha, SK Brennan, FX Morrison, AR Ross, RJ TI The role of context in differential sleep architecture changes following footshock SO SLEEP LA English DT Meeting Abstract CT 18th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 05-10, 2004 CL Philadelphia, PA SP Associated Profess Sleep Soc C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2004 VL 27 SU S MA 910 BP 407 EP 408 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 844OX UT WOS:000223169400912 ER PT J AU Nakashima, J McGuire, J Berman, S Daniels, W AF Nakashima, J McGuire, J Berman, S Daniels, W TI Developing programs for homeless veterans: Understanding driving forces in implementation SO SOCIAL WORK IN HEALTH CARE LA English DT Article DE homelessness; housing; veterans; implementation AB Between 1992 and 2003, services for homeless veterans at the Veterans Affairs Greater Los Angeles Healthcare System went from inappropriate utilization of hospital medical and psychiatric beds, to a continuum of residential treatment, transitional housing, and employment programs through arrangements with private agencies. The authors use elements of Hasenfeld and Brock's Political Economy Model (1991) to explain this transformation in service delivery that was spearheaded by a VA social work leadership team. It is argued that three driving forces crucial to program implementation were present: technological certainty, economic stability, and concentration of power. Evidence of the implementation's impact includes creation of new homeless program beds, a reduction in use of medical/psychiatric beds, and a large number of formerly homeless veterans with housing and employment at program discharge. Study limitations and implications for future studies are discussed.(c) 2004 by The Haworth Press, Inc. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, Comprehens Homeless Ctr, Los Angeles, CA 90073 USA. RP Nakashima, J (reprint author), VA Greater Los Angeles Healthcare Syst, Comprehens Homeless Ctr, 11301 Wilshire Blvd,Bldg 500,Mail Code W10H5, Los Angeles, CA 90073 USA. EM john.nakashima@med.va.gov; james.mcguire@med.va.gov; stephen.berman@med.va.gov; william.daniels@med.va.gov NR 14 TC 6 Z9 6 U1 1 U2 6 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 0098-1389 J9 SOC WORK HEALTH CARE JI Soc. Work Health Care PY 2004 VL 40 IS 2 BP 1 EP 12 DI 10.1300/J010v40n02_01 PG 12 WC Social Work SC Social Work GA 920ZL UT WOS:000228733900001 PM 15774360 ER PT S AU Busuttil, RA Dolle, M Campisi, J Vijg, J AF Busuttil, RA Dolle, M Campisi, J Vijg, J BE DeGrey, ADN TI Genomic instability, aging, and cellular senescence SO STRATEGIES FOR ENGINEERED NEGLIGIBLE SENESCENCE: WHY GENUINE CONTROL OF AGING MAY BE FORESEEABLE SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 10th Congress of the International-Association-of-Biomedical-Gerontology CY SEP 19-23, 2003 CL Cambridge, ENGLAND SP Int Assoc Biomed Gerontol DE aging; cancer; oxidative damage; DNA damage; genomic integrity ID DIPLOID FIBROBLAST CELLS; TRANSGENIC MOUSE MODEL; REPLICATIVE LIFE-SPAN; OXIDATIVE DNA-DAMAGE; IN-VIVO MUTATIONS; SOMATIC MUTATIONS; CHROMOSOME-ABERRATIONS; OXYGEN; AGE; MICE AB Aging can be defined in practical terms as a series of time-related processes that ultimately bring life to a close. Genomic instability has been implicated as a major causal factor in aging. Here, we describe the use of a transgenic mouse model, harboring lacZ reporter genes as part of a plasmid construct integrated at one or more chromosomal locations, to study genomic instability during aging of different mouse organs and tissues as well as in mouse embryonic flbroblasts during primary culture. C1 Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Ctr Longev & Aging Studies, San Antonio, TX 78245 USA. Buck Inst Age Res, Novato, CA 94945 USA. Univ Calif Berkeley, Lawrence Berkeley Lab, Div Life Sci, Berkeley, CA 94720 USA. S Texas Vet Hlth Care Syst, Geriatr Res Educ & Clin Ctr, San Antonio, TX 78229 USA. RP Vijg, J (reprint author), Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Ctr Longev & Aging Studies, San Antonio, TX 78245 USA. EM vijg@uthscsa.edu NR 37 TC 30 Z9 33 U1 1 U2 2 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-496-X J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2004 VL 1019 BP 245 EP 255 DI 10.1196/annals.1297.041 PG 11 WC Biochemistry & Molecular Biology; Cell Biology; Geriatrics & Gerontology; Multidisciplinary Sciences SC Biochemistry & Molecular Biology; Cell Biology; Geriatrics & Gerontology; Science & Technology - Other Topics GA BAN77 UT WOS:000223002700041 PM 15247023 ER PT J AU Bruno, A McConnell, JP Cohen, SN Tietjen, GE Wallis, RA Gorelick, PB Bang, NU AF Bruno, A McConnell, JP Cohen, SN Tietjen, GE Wallis, RA Gorelick, PB Bang, NU TI Serial urinary 11-dehydrothromboxane B2 measurements in African Americans after cerebral infarction: Correlation with aspirin dose and vascular events SO STROKE LA English DT Meeting Abstract CT 29th International Stroke Conference CY FEB 05-07, 2004 CL SAN DIEGO, CALIFORNIA SP Amer Heart Assoc C1 Indiana Univ, Sch Med, Indianapolis, IN USA. Mayo Clin, Rochester, MN USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Rush Presbyterian St Lukes Med Ctr, Chicago, IL 60612 USA. Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD JAN PY 2004 VL 35 IS 1 BP 257 EP 257 PG 1 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 758JH UT WOS:000187630500162 ER PT J AU Howard, G Hobson, RW Brott, TG Cohen, SN Howard, VJ Petrossian, G Levy, D Mishkel, G Barnwell, SL AF Howard, G Hobson, RW Brott, TG Cohen, SN Howard, VJ Petrossian, G Levy, D Mishkel, G Barnwell, SL CA CREST Investigators TI Does the stroke risk of stenting increase at older ages? Thirty-day stroke-death rates in the CREST lead-in phase SO STROKE LA English DT Meeting Abstract CT 29th International Stroke Conference CY FEB 05-07, 2004 CL SAN DIEGO, CALIFORNIA SP Amer Heart Assoc C1 Univ Alabama, Birmingham, AL USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Newark, NJ 07103 USA. Mayo Clin Jacksonville, Jacksonville, FL 32224 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. St Francis Hosp, Port Washington, NY USA. Kaiser Permanente Med Ctr, San Diego, CA USA. St Johns Hosp, Springfield, IL USA. Mem Med Ctr, Springfield, IL 62781 USA. Oregon Hlth Sci Univ, Portland, OR USA. NR 0 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD JAN PY 2004 VL 35 IS 1 BP 258 EP 258 PG 1 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 758JH UT WOS:000187630500169 ER PT J AU Saam, T Ferguson, MS Yarnykh, VL Hatsukami, TS Yuan, C AF Saam, T Ferguson, MS Yarnykh, VL Hatsukami, TS Yuan, C TI Carotid atherosclerotic plaque composition has a direct impact on plaque burden and lumen narrowing SO STROKE LA English DT Meeting Abstract CT 29th International Stroke Conference CY FEB 05-07, 2004 CL SAN DIEGO, CALIFORNIA SP Amer Heart Assoc C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Surg, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Radiol, Seattle, WA 98195 USA. RI Yarnykh, Vasily/G-8757-2016; Yarnykh, Vasiliy/N-7635-2014 OI Yarnykh, Vasily/0000-0002-1583-8979; NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD JAN PY 2004 VL 35 IS 1 BP 307 EP 307 PG 1 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 758JH UT WOS:000187630500414 ER PT J AU Kerrigan, AJ Kaough, JE Wilson, BL Wilson, JB Bostick, R AF Kerrigan, AJ Kaough, JE Wilson, BL Wilson, JB Bostick, R TI Vocational rehabilitation of participants with severe substance use disorders in a VA Veterans Industries program SO SUBSTANCE USE & MISUSE LA English DT Article DE vocational rehabilitation; veterans industries; substance use; outcomes; work therapy ID ABUSE TREATMENT; WORK THERAPY AB There are approximately 100 Veterans Industries work therapy programs in the Veterans Health Administration (VHA) throughout the U.S. The majority of participants are veterans with severe substance use disorders and their length of stay ranges from 3 to 12 months. This study examines the Veterans Industries work therapy model at one site where veterans are referred from an addictions partial hospitalization treatment program. The study period was from 1996-97 and includes 80 patients. The characteristics of the participants are described. Barriers to employment are identified including unemployment rates, homelessness, drug of choice, age, and disability status. Outcome rates are reported including employment, abstinence, and housing support. C1 Dept Vet Affairs Med Ctr, Houston, TX USA. RP Kerrigan, AJ (reprint author), VA Med Ctr, Mental Hlth Care Line 116, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM kerrigan.anthonyj@med.va.gov NR 15 TC 2 Z9 2 U1 0 U2 4 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1082-6084 J9 SUBST USE MISUSE JI Subst. Use Misuse PY 2004 VL 39 IS 13-14 BP 2513 EP 2523 DI 10.1081/LSUM-200034695 PG 11 WC Substance Abuse; Psychiatry; Psychology SC Substance Abuse; Psychiatry; Psychology GA 910AO UT WOS:000227902000013 PM 15603012 ER PT J AU Kerrigan, AJ AF Kerrigan, AJ TI From work therapy to mainstream employment SO SUBSTANCE USE & MISUSE LA English DT Article C1 Dept Vet Affairs Med Ctr, Houston, TX USA. RP Kerrigan, AJ (reprint author), Dept Vet Affairs Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1082-6084 J9 SUBST USE MISUSE JI Subst. Use Misuse PY 2004 VL 39 IS 13-14 BP 2639 EP 2640 DI 10.1081/LSUM-200034700 PG 2 WC Substance Abuse; Psychiatry; Psychology SC Substance Abuse; Psychiatry; Psychology GA 910AO UT WOS:000227902000025 PM 15603024 ER PT J AU Holliday, SL Saklad, AR Garcia-Cavasos, R Fischbach, M Padilla, PA McGlasson, D Brey, RL AF Holliday, SL Saklad, AR Garcia-Cavasos, R Fischbach, M Padilla, PA McGlasson, D Brey, RL TI Risk factors for cognitive dysfunction in SLE: San Antonio lupus study of neuropsychiatric disease SO THROMBOSIS RESEARCH LA English DT Meeting Abstract CT 11th International Congress on Antiphospholipid Antibodies CY NOV 14-18, 2004 CL Sydney, AUSTRALIA C1 S Texas Vet Hlth Care Syst, San Antonio, TX USA. UTHSCSA, San Antonio, TX USA. Wilford Hall USAF Med Ctr, San Antonio, TX 78236 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0049-3848 J9 THROMB RES JI Thromb. Res. PY 2004 VL 114 IS 5-6 SI SI BP 629 EP 629 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 911OZ UT WOS:000228015200112 ER PT J AU Yost, MJ Baicu, CF Stonerock, CE Goodwin, RL Price, RL Davis, JM Evans, H Watson, PD Gore, CM Sweet, J Creech, L Zile, MR Terracio, L AF Yost, MJ Baicu, CF Stonerock, CE Goodwin, RL Price, RL Davis, JM Evans, H Watson, PD Gore, CM Sweet, J Creech, L Zile, MR Terracio, L TI A novel tubular scaffold for cardiovascular tissue engineering SO TISSUE ENGINEERING LA English DT Article ID BIOENGINEERED CARDIAC GRAFTS; ARTIFICIAL SKIN; IN-VITRO; DESIGN; MUSCLE; ORIENTATION; MYOCARDIUM; CONSTRUCT; ADHESION; MATRIX AB We have developed a counter rotating cone extrusion device to produce the next generation of three-dimensional collagen scaffold for tissue engineering. The device can produce a continuously varying fibril angle from the lumen to the outside of a 5-mm-diameter collagen tube, similar to the pattern of heart muscle cells in the intact heart. Our scaffold is a novel, oriented, type I collagen, tubular scaffold. We selected collagen because we believe there are important signals from the collagen both geometrically and biochemically that elicit the in vivo-like phenotypic response from the cardiomyocytes. We have shown that cardiomyocytes can be cultured in these tubes and resemble an in vivo phenotype. This new model system will provide important information leading to the design and construction of a functional, biologically based assist device. C1 Univ S Carolina, Sch Med, Dept Surg, Columbia, SC 29208 USA. Univ S Carolina, Sch Med, Dept Anat & Dev Biol, Columbia, SC 29208 USA. Univ S Carolina, Sch Med, Dept Chem Engn, Columbia, SC 29208 USA. Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Div Cardiol, Charleston, SC USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USA. Univ S Carolina, Sch Med, Dept Pharmacol & Physiol, Columbia, SC USA. NYU, Coll Dent, New York, NY USA. RP Yost, MJ (reprint author), Univ S Carolina, Sch Med, Dept Surg, Columbia, SC 29208 USA. EM Yost@med.sc.edu FU NHLBI NIH HHS [K25-HL67097, HL072096] NR 24 TC 47 Z9 48 U1 1 U2 19 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1076-3279 J9 TISSUE ENG JI Tissue Eng. PD JAN-FEB PY 2004 VL 10 IS 1-2 BP 273 EP 284 DI 10.1089/107632704322791916 PG 12 WC Cell & Tissue Engineering SC Cell Biology GA 775EW UT WOS:000189028600028 PM 15009952 ER PT J AU Knuefermann, P Vallejo, J Mann, DL AF Knuefermann, P Vallejo, J Mann, DL TI The role of innate immune responses in the heart in health and disease SO TRENDS IN CARDIOVASCULAR MEDICINE LA English DT Review ID TUMOR-NECROSIS-FACTOR; ISCHEMIA-REPERFUSION INJURY; TOLL-LIKE RECEPTOR-4; NF-KAPPA-B; LEUKEMIA-INHIBITORY FACTOR; ADULT FELINE MYOCARDIUM; FACTOR-ALPHA GENE; CARDIAC MYOCYTES; TRANSGENIC MICE; DILATED CARDIOMYOPATHY AB The ability of the myocardium to successfully adapt to environmental stress ultimately determines whether the heart will decompensate and fail, or whether it will maintain preserved function. Despite the importance of the myocardial response to environmental stress, very little is known with respect to the biochemical mechanisms that are responsible for mediating and integrating the stress response in the heart. The present review summarizes recent experimental material that suggests that the heart possesses a germ-line encoded "innate" stress response that is activated in response to diverse forms of tissue injury. The extant literature suggests that this innate stress response plays an important role in initiating and integrating homeostatic responses within the heart. Nonetheless, as will be discussed further herein, these inflammatory mediators all have the potential to produce cardiac decompensation when expressed at sufficiently high concentrations. (C) 2004, Elsevier Inc. C1 Winters Ctr Heart Failure Res, Houston, TX 77030 USA. Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Houston Vet Adm Med Ctr, Houston, TX USA. RP Mann, DL (reprint author), Winters Ctr Heart Failure Res, MS 524,6565 Fannin, Houston, TX 77030 USA. EM dmann@bcm.tmc.edu OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [HL 42250-10/10, R01 HL 58081-01, R01 HL 61543-01] NR 48 TC 25 Z9 25 U1 1 U2 4 PU ELSEVIER SCIENCE LONDON PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1050-1738 J9 TRENDS CARDIOVAS MED JI Trends Cardiovasc. Med. PD JAN PY 2004 VL 14 IS 1 BP 1 EP 7 AR PII S1050-1738(03)001677-1 DI 10.1016/j.tcm.2003.09.003 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 767GH UT WOS:000188431500001 PM 14720467 ER PT B AU Brau, N Torriani, FJ Rodriguez-Torres, M Rockstroh, JK Lissen, E Lazzarin, A Carosi, G Sasadeusz, J Katlama, C Hadziyannis, SJ Connell, E Yetzer, E Dieterich, DT AF Brau, N Torriani, FJ Rodriguez-Torres, M Rockstroh, JK Lissen, E Lazzarin, A Carosi, G Sasadeusz, J Katlama, C Hadziyannis, SJ Connell, E Yetzer, E Dieterich, DT CA AIDS Pegasys Ribavirin Int coinfec GP MEDIMOND TI Safety of peginterferon alfa-2a (PEGASYS) 180 mcg weekly plus ribavirin (RBV) 800 mg daily in HIV/HCV coinfection compared to HCV monoinfection. SO XV INTERNATIONAL AIDS CONFERENCE: CLINICAL RESEARCH, TREATMENT, AND CARE LA English DT Proceedings Paper CT 15th International AIDS Conference CY JUL 11-17, 2004 CL Bangkok, THAILAND C1 Bronx Vet Adm Med Ctr, Bronx, NY USA. RP Brau, N (reprint author), Bronx Vet Adm Med Ctr, Bronx, NY USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND PUBLISHING CO PI BOLOGNA PA VIA RUBBIANI 6/2, 40124 BOLOGNA, ITALY PY 2004 BP 109 EP 110 PG 2 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA BBR13 UT WOS:000227337100022 ER PT J AU Fudala, PJ Bridge, TP Chiang, CN AF Fudala, PJ Bridge, TP Chiang, CN TI Office-based treatment of opiate addiction - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NIH, Bethesda, MD 20892 USA. RP Fudala, PJ (reprint author), Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC/NEJM PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD DEC 25 PY 2003 VL 349 IS 26 BP 2567 EP 2568 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 757BT UT WOS:000187529500028 ER PT J AU Misra, A Haudek, SB Knuefermann, P Vallejo, JG Chen, ZJ Michael, LH Sivasubramanian, N Olson, EN Entman, ML Mann, DL AF Misra, A Haudek, SB Knuefermann, P Vallejo, JG Chen, ZJ Michael, LH Sivasubramanian, N Olson, EN Entman, ML Mann, DL TI Nuclear factor-kappa B protects the adult cardiac myocyte against ischemia-induced apoptosis in a murine model of acute myocardial infarction SO CIRCULATION LA English DT Article DE myocytes; apoptosis; myocardial infarction ID OVEREXPRESSION; HEART AB Background-Previous studies have shown that tumor necrosis factor (TNF) confers cytoprotective responses in cardiac myocytes. However, the mechanisms for the cytoprotective effects of TNF remain unknown. Given that TNF signals through nuclear factor kappaB (NF-kappaB) and given that NF-kappaB mediates cytoprotective responses, we asked whether NF-kappaB activation conferred cytoprotective responses in acute myocardial ischemia/infarction. Methods and Results-We examined infarct size and the prevalence of apoptosis in transgenic mice harboring cardiac-restricted expression of a mutated IkappaBalpha protein (IkappaBalphaDeltaN) that prevents nuclear translocation of NF-kappaB in cardiac myocytes. Triphenyltetrazolium chloride staining showed that infarct size was approximate to50% greater (P<0.02) in the IκBα&UDelta;N mice compared with littermate controls at 24 hours. The prevalence of cardiac myocyte apoptosis was significantly greater (P<0.008) in the IkappaBalphaDeltaN mice compared with the littermate control mice 3 and 6 hours after left anterior descending occlusion. To explore the mechanism for these findings, we examined protein levels of c-IAP1, c-IAP2, and Bcl-2 as well as manganese superoxide dismutase and c-Jun NH2-terminal kinase activity. These studies showed that protein levels of c-IAP1 and Bcl-2 were significantly lower in the IkappaBalphaDeltaN mice, whereas there was no change in c-IAP2 levels, manganese superoxide dismutase, or c-Jun NH2-terminal kinase activity. Conclusions-Transgenic mice with a defect in activation of NF-kappaB have increased susceptibility to tissue injury after acute left anterior descending occlusion. These studies suggest that the cytoprotective effects of NF-kappaB are mediated, at least in part, by Bcl-2 or c-IAP1. C1 Houston Vet Adm Med Ctr, Med Care Serv Line, Winters Ctr Heart Failure Res, Houston, TX 77030 USA. Baylor Coll Med, Methodist Hosp, DeBakey Heart Ctr, Houston, TX 77030 USA. Univ Texas, SW Med Ctr, Dept Mol Biol, Dallas, TX USA. RP Mann, DL (reprint author), Houston Vet Adm Med Ctr, Med Care Serv Line, Winters Ctr Heart Failure Res, 6565 Fannin,MS 524, Houston, TX 77030 USA. FU NHLBI NIH HHS [R01 HL-58081-01, R01 HL-61543-01, P50 HL-O6H, HL-42250-10/10]; NIGMS NIH HHS [R01 GM-59203-03] NR 9 TC 87 Z9 92 U1 1 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD DEC 23 PY 2003 VL 108 IS 25 BP 3075 EP 3078 DI 10.1161/01.CIR.0000108929.93074.0B PG 4 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 756ZA UT WOS:000187514600019 PM 14676146 ER PT J AU Van Remmen, H Ikeno, Y Hamilton, M Pahlavani, M Wolf, N Thorpe, SR Alderson, NL Baynes, JW Epstein, CJ Huang, TT Nelson, J Strong, R Richardson, A AF Van Remmen, H Ikeno, Y Hamilton, M Pahlavani, M Wolf, N Thorpe, SR Alderson, NL Baynes, JW Epstein, CJ Huang, TT Nelson, J Strong, R Richardson, A TI Life-long reduction in MnSOD activity results in increased DNA damage and higher incidence of cancer but does not accelerate aging SO PHYSIOLOGICAL GENOMICS LA English DT Article DE oxidative damage; mitochondria ID MANGANESE SUPEROXIDE-DISMUTASE; MITOCHONDRIAL TARGETING SEQUENCE; AGE-RELATED CATARACT; DIETARY RESTRICTION; OXIDATIVE DAMAGE; CALORIC RESTRICTION; TRANSGENIC MICE; KNOCKOUT MICE; C57BL/6 MICE; SPAN AB Mice heterozygous for the Sod2 gene (Sod2(+/)- mice) have been used to study the phenotype of life- long reduced Mn- superoxide dismutase ( MnSOD) activity. The Sod2(+/-) mice have reduced MnSOD activity ( similar to 50%) in all tissues throughout life. The Sod2(+/-) mice have increased oxidative damage as demonstrated by significantly elevated levels of 8- oxo- 2- deoxyguanosine ( 8oxodG) in nuclear DNA in all tissues of Sod2(+/-) mice studied. The levels of 8oxodG in nuclear DNA increased with age in all tissues of Sod2(+/-) and wild- type ( WT) mice, and at 26 mo of age, the levels of 8oxodG in nuclear DNA were significantly higher ( from 15% in heart to over 60% in liver) in the Sod2(+/-) mice compared with WT mice. The level of 8oxodG was also higher in mitochondrial DNA isolated from liver and brain in Sod2(+/-) mice compared with WT mice. The increased oxidative damage to DNA in the Sod2(+/-) mice is associated with a 100% increase in tumor incidence ( the number of mice with tumors) in old Sod2(+/-) mice compared with the old WT mice. However, the life spans ( mean and maximum survival) of the Sod2(+/-) and WT mice were identical. In addition, biomarkers of aging, such as cataract formation, immune response, and formation of glycoxidation products carboxymethyl lysine and pentosidine in skin collagen changed with age to the same extent in both WT and Sod2(+/-) mice. Thus life- long reduction of MnSOD activity leads to increased levels of oxidative damage to DNA and increased cancer incidence but does not appear to affect aging. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev Studies, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Res Serv, San Antonio, TX 78284 USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. Univ S Carolina, Dept Chem & Biochem, Columbia, SC 29208 USA. Univ Calif San Francisco, Dept Pediat, San Francisco, CA 94143 USA. Stanford Univ, Palo Alto, CA 94304 USA. RP Richardson, A (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr,MSC 7762, San Antonio, TX 78229 USA. FU NEI NIH HHS [R01-EY-11733]; NIA NIH HHS [P01-AG-19316, 1P30-AG-13319, P01-AG-020591, R01-AG-015908, R01-AG-16998]; NIDDK NIH HHS [R01-DK-19971] NR 50 TC 422 Z9 435 U1 1 U2 15 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1094-8341 J9 PHYSIOL GENOMICS JI Physiol. Genomics PD DEC 16 PY 2003 VL 16 IS 1 BP 29 EP 37 DI 10.1152/physiolgenomics.00122.2003 PG 9 WC Cell Biology; Genetics & Heredity; Physiology SC Cell Biology; Genetics & Heredity; Physiology GA 754PW UT WOS:000187327300005 PM 14679299 ER PT J AU Kanaya, AM Vittinghoff, E Shlipak, MG Resnick, HE Visser, M Grady, D Barrett-Connor, E AF Kanaya, AM Vittinghoff, E Shlipak, MG Resnick, HE Visser, M Grady, D Barrett-Connor, E TI Association of total and central obesity with mortality in postmenopausal women with coronary heart disease SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE body composition; body mass index; body weight; coronary disease; mortality; obesity ID BODY-MASS INDEX; CARDIOVASCULAR RISK-FACTORS; ESTROGEN PLUS PROGESTIN; ALL-CAUSE MORTALITY; FOLLOW-UP; FAT DISTRIBUTION; WEIGHT CHANGE; ESTROGEN/PROGESTIN REPLACEMENT; WAIST CIRCUMFERENCE; VISCERAL ADIPOSITY AB Overweight and abdominal obesity increase mortality risk, although the risk may be mediated by traditional cardiac risk factors. The authors assessed the association of baseline measures, change in overall body weight and abdominal obesity (waist circumference), and weight and waist circumference cycling with total mortality among postmenopausal women with known heart disease. They used data from 2,739 US women who participated in the Heart and Estrogen/progestin Replacement Study between 1993 and 2001. Over 6.8 years of follow-up, 498 women died. In adjusted Cox models that included either baseline waist circumference or body mass index (BMI), each was associated with mortality. However, after further adjustment for diabetes, hypertension, and lipoproteins, these associations disappeared. In models including both waist circumference and BMI, larger waist circumference (hazard ratio = 1.40 per standard deviation, 95% confidence interval: 1.16, 1.68) was associated with increased risk and higher BMI (hazard ratio = 0.81 per standard deviation, 95% confidence interval: 0.67, 0.97) was associated with decreased risk of total mortality, independent of cardiac risk factors. Weight and waist circumference cycling were not associated with mortality. Results show that both BMI and waist circumference are associated with mortality among postmenopausal women with established heart disease, but waist circumference may be more important than BMI, and their effects may be largely mediated by other cardiac risk factors. C1 Womens Hlth Clin Res Ctr, San Francisco, CA 94115 USA. Univ Calif San Francisco, Dept Med, Div Gen Internal Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA USA. MedStar Res Inst, Washington, DC USA. VU Univ Med Ctr, Inst Res Extramural Med, Amsterdam, Netherlands. Univ Calif San Diego, Dept Family & Prevent Med, La Jolla, CA 92093 USA. RP Kanaya, AM (reprint author), Womens Hlth Clin Res Ctr, 1635 Divisadero St,Suite 600, San Francisco, CA 94115 USA. FU NIAMS NIH HHS [5 K12 AR47659] NR 57 TC 67 Z9 68 U1 0 U2 2 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD DEC 15 PY 2003 VL 158 IS 12 BP 1161 EP 1170 DI 10.1093/aje/kwg271 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 753DK UT WOS:000187216600006 PM 14652301 ER PT J AU Fan, VS Bryson, CL Curtis, JR Fihn, SD Bridevaux, PO McDonell, MB Au, DH AF Fan, VS Bryson, CL Curtis, JR Fihn, SD Bridevaux, PO McDonell, MB Au, DH TI Inhaled corticosteroids in chronic obstructive pulmonary disease and risk of death and hospitalization - Time-dependent analysis SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE antiinflammatory agents; steroidal/therapeutic use; proportional hazards models; treatment outcome ID QUALITY-OF-LIFE; VETERANS-AFFAIRS; FLUTICASONE PROPIONATE; PHARMACY RECORDS; MORTALITY; VALIDATION; BUDESONIDE; DISTANCE; MODERATE; SURVIVAL AB Observational studies of inhaled corticosteroids in chronic obstructive pulmonary disease (COPD) have shown improved survival whereas randomized trials have not. It has been suggested that this difference may be due to immortal time bias. To investigate this further, we performed a prospective cohort study of patients with COPD, using time-dependent methods to determine whether use of inhaled corticosteroids more than 80% of the time reduced the risk of all-cause mortality and COPD exacerbations. Of 8,033 patients, 2,686 (33%) received inhaled corticosteroids. We did not find a significant reduction in mortality for average inhaled steroid use at either low (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.69-1.33) or medium/high dose (HR, 0.86; 95% CI, 0.67-1.10). Similarly, recent inhaled corticosteroid use was not associated with a reduction in mortality at low (HR, 0.80; 95% CI, 0.60-1.07) or medium/high doses (HR, 0.88; 95% CI, 0.71-1.09). There was no association between inhaled corticosteroid use and hospitalizations or exacerbations due to COPD. Patients using medium/high-dose inhaled corticosteroids did not have a significantly lower risk of COPD hospitalizations (HR, 0.85; 95% CI, 0.64-1.13) or COPD exacerbations (HR, 1.13; 95% CI, 0.94-1.36). In a time-dependent study of outpatients with COPD, adherence to inhaled corticosteroid use was not associated with a decreased risk of mortality or exacerbations. C1 Univ Washington, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dev Ctr Excellence, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res, Seattle, WA USA. RP Fan, VS (reprint author), Hlth Serv Res & Dev 152, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 29 TC 53 Z9 55 U1 1 U2 1 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD DEC 15 PY 2003 VL 168 IS 12 BP 1488 EP 1494 DI 10.1164/rccm.200301-019OC PG 7 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 753DB UT WOS:000187215700020 PM 14525798 ER PT J AU Mortensen, EM Kapoor, WN Chang, CCH Fine, MJ AF Mortensen, EM Kapoor, WN Chang, CCH Fine, MJ TI Assessment of mortality after long-term follow-up of patients with community-acquired pneumonia SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID NATIONAL DEATH INDEX; OLD MANS FRIEND; UNITED-STATES; PROGNOSIS; VALIDATION; RESIDUALS; OUTCOMES; SURVIVAL; COHORT; CARE AB Although studies have assessed short- term mortality among patients with community- acquired pneumonia, there is limited data on prognosis and risk factors that affect long- term mortality. The mortality among patients enrolled at 4 sites of the Pneumonia Patient Outcome Research Team cohort study who survived at least 90 days after presentation to the hospital was compared with that among age- matched control subjects. Overall, 1419 of 1555 patients survived for >90 days, with a mean follow- up period of 5.9 years. There was significantly higher long- term mortality among patients with pneumonia than among age- matched controls. Factors significantly associated with long- term mortality were age ( stratified by decade), do- not- resuscitate status, poor nutritional status, pleural effusion, glucocorticoid use, nursing home residence, high school graduation level or less, male sex, preexisting comorbid illnesses, and the lack of feverishness. This study demonstrates that there is significantly higher long- term mortality among patients with pneumonia than among age- matched controls and that long- term mortality largely is not affected by acute physiologic derangements. C1 Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA. Vet Affairs Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Mortensen, EM (reprint author), UTHSCSA, ALMD, VERDICT, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. OI Mortensen, Eric/0000-0002-3880-5563 FU AHRQ HHS [F32 HS00135, R01HSO6468] NR 32 TC 86 Z9 88 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD DEC 15 PY 2003 VL 37 IS 12 BP 1617 EP 1624 DI 10.1086/379712 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 749VJ UT WOS:000186949300016 PM 14689342 ER PT J AU Metzger, DS Navaline, H AF Metzger, DS Navaline, H TI Human immunodeficiency virus prevention and the potential of drug abuse treatment SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT Meeting on Bloodborne and Sexually Transmitted Infections among Intravenous Drug Users and Their Partners in the Western Hemisphere CY DEC 17-19, 2001 CL BUENOS AIRES, ARGENTINA SP Ctr AIDS & Other Med Consequences Drug Abuse, NIDA, NIH, US Dept HHS, Pan Amer Hlth Org, WHO Americas, Reg Off ID METHADONE-MAINTENANCE TREATMENT; OUT-OF-TREATMENT; RISK-REDUCTION; HIV SEROCONVERSION; FOLLOW-UP; USERS; AIDS; BEHAVIORS; INJECTORS AB Since first recognition of the scope of the acquired immunodeficiency syndrome epidemic among the drug-using community, substance abuse treatment has been viewed as playing an important role in preventing new infections. In the past 20 years, many studies have documented significantly lower rates of drug use, drug-related risk behaviors, and human immunodeficiency virus (HIV) infections among drug users who remain in treatment programs. There is also growing evidence that drug detoxification alone is insufficient to provide protection from HIV infection. These findings have important implications for users of cocaine and noninjection drugs, as well as heroin injectors. Despite strong evidence of effectiveness and widespread support for the important public health role of drug treatment, its impact has been compromised by limited availability and acceptability. The available data clearly establish drug abuse treatment as HIV prevention, yet without expansion of existing treatment programs and the continued development of treatments for addiction to cocaine and other widely used stimulants, its public health potential cannot be realized. C1 Univ Penn, Ctr Studies Addict, HIV Prevent Res Div, Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Metzger, DS (reprint author), Univ Penn, Ctr Studies Addict, HIV Prevent Res Div, Vet Affairs Med Ctr, 3535 Market St,Rm 4001, Philadelphia, PA 19104 USA. NR 37 TC 37 Z9 39 U1 1 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD DEC 15 PY 2003 VL 37 SU 5 BP S451 EP S456 DI 10.1086/377548 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 749VL UT WOS:000186949600022 PM 14648463 ER PT J AU Hillinger, S Yang, SK Zhu, L Huang, M Duckett, R Atianzar, K Batra, RK Strieter, RM Dubinett, SM Sharma, S AF Hillinger, S Yang, SK Zhu, L Huang, M Duckett, R Atianzar, K Batra, RK Strieter, RM Dubinett, SM Sharma, S TI EBV-induced molecule 1 ligand chemokine (ELC/CCL19) promotes IFN-gamma-dependent antitumor responses in a lung cancer model SO JOURNAL OF IMMUNOLOGY LA English DT Article ID MODIFIED DENDRITIC CELLS; ANGIOGENESIS IN-VIVO; GROWTH-FACTOR-BETA; X-C-CHEMOKINE; T-CELL; INTERFERON-GAMMA; MURINE TUMORS; INTRATUMORAL INJECTION; LYMPHOID ORGANS; CXC CHEMOKINES AB The antitumor efficacy of EBV-induced molecule I ligand CC chemokine (ELC/CCL19) was evaluated in a murine lung cancer model. The ability of ELC/CCL19 to chemoattract both dendritic cells and T lymphocytes formed the rationale for this study. Compared with diluent-treated tumor-bearing mice, intratumoral injection of recombinant ELC/CCL19 led to significant systemic reduction in tumor volumes (p < 0.01). ELC/CCL19-treated mice exhibited an increased influx of CD4 and CD8 T cell subsets as well as dendritic cells at the tumor sites. These cell infiltrates were accompanied by increases in IFN-gamma, MIG/CXCL9, IP-10/ CXCL10, GM-CSF, and IL-12 but a concomitant decrease in the immunosuppressive molecules PGE(2) and TGFbeta. Transfer of T lymphocytes from ELC/CCL19 treated tumor-bearing mice conferred the antitumor therapeutic efficacy of ELC/CCL19 to naive mice. ELC/CCL19 treated tumor-bearing mice showed enhanced frequency of tumor specific T lymphocytes secreting IFN-gamma. In vivo depletion of IFN-gamma, MIG/CXCL9, or IP-10/CXCL10 significantly reduced the antitumor efficacy of ELC/CCL19. These findings provide a strong rationale for further evaluation of ELC/CCL19 in tumor immunity and its use in cancer immunotherapy. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm & Crit Care Med, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Mol Gene Med Lab, Los Angeles, CA 90073 USA. RP Sharma, S (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm & Crit Care Med, Jonsson Comprehens Canc Ctr, 37-131 Ctr Hlth Sci,10833 LeConte Ave, Los Angeles, CA 90095 USA. FU NCI NIH HHS [CA90388, CA71818, R01 CA78654]; PHS HHS [1P50] NR 52 TC 47 Z9 50 U1 1 U2 2 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD DEC 15 PY 2003 VL 171 IS 12 BP 6457 EP 6465 PG 9 WC Immunology SC Immunology GA 753JF UT WOS:000187227700023 PM 14662845 ER PT J AU Shen, KZ Zhu, ZT Munhall, A Johnson, SW AF Shen, KZ Zhu, ZT Munhall, A Johnson, SW TI Synaptic plasticity in rat subthalamic nucleus induced by high-frequency stimulation SO SYNAPSE LA English DT Article DE short-term potentiation; long-term potentiation; long-term depression; EPSC ID LONG-TERM POTENTIATION; ADVANCED PARKINSONS-DISEASE; DEEP BRAIN-STIMULATION; IN-VITRO; SUBSTANTIA-NIGRA; DOPAMINE NEURONS; GLOBUS-PALLIDUS; DEPRESSION; TRANSMISSION; HIPPOCAMPUS AB The technique of deep brain stimulation (DBS) has become a preferred surgical choice for the treatment of advanced Parkinson's disease. The subthalamic nucleus (STN) is presently the most promising target for such DBS. In this study, whole-cell patch-clamp recordings were made from 46 STN neurons in rat brain slices to examine the effect of high-frequency stimulation (HIPS) of the STN on glutamatergic synaptic transmission in STN neurons. HFS, consisting of trains of stimuli at a frequency of 100 Hz for 1 min, produced three types of synaptic plasticity in 17 STN neurons. First, HIPS of the STN induced short-term potentiation (STP) of evoked postsynaptic current (EPSC) amplitude in four neurons. STP was associated with a reduction in the EPSC paired-pulse ratio, suggesting a presynaptic site of action. Second, HFS of the STN generated long-term potentiation (LTP) of EPSC amplitude in eight neurons. Although the EPSC paired-pulse ratio was reduced transiently in the first 2 min following HIPS, ratios measured 6-20 min after HFS were unchanged from control. This suggests that LTP is maintained by a postsynaptic mechanism. Third, HFS produced long-term depression (LTD) of EPSC amplitude in five STN neurons. LTD was associated with a significant increase in EPSC paired-pulse ratios, indicating a presynaptic site of action. These results suggest that HIPS can produce long-term changes in the efficacy of synaptic transmission in the STN. HFS-induced synaptic plasticity might be one mechanism underlying the effectiveness of DBS in the STN as a treatment of advanced Parkinson's disease. (C) 2003 Wiley-Liss, Inc. C1 Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97239 USA. Vet Adm Med Ctr, Portland, OR 97207 USA. RP Johnson, SW (reprint author), Portland VA Med Ctr, R&D 61,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. FU NINDS NIH HHS [NS 38175] NR 40 TC 68 Z9 70 U1 1 U2 8 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0887-4476 J9 SYNAPSE JI Synapse PD DEC 15 PY 2003 VL 50 IS 4 BP 314 EP 319 DI 10.1002/syn.10274 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 739ZF UT WOS:000186375900006 PM 14556236 ER PT J AU Bez, A Corsini, E Curti, D Biggiogera, M Colombo, A Nicosia, RF Pagano, SF Parati, EA AF Bez, A Corsini, E Curti, D Biggiogera, M Colombo, A Nicosia, RF Pagano, SF Parati, EA TI Neurosphere and neurosphere-forming cells: morphological and ultrastructural characterization SO BRAIN RESEARCH LA English DT Article DE neurosphere; neurosphere-forming cells; characterization ID NEURAL STEM-CELLS; CENTRAL-NERVOUS-SYSTEM; ADULT-MOUSE BRAIN; IN-VIVO; GROWTH-FACTOR; BONE-MARROW; SPINAL-CORD; NEURONS; CNS; ASTROCYTES AB Despite recent advances in our understanding of neural stem cell (NSQ biology, the free-floating structures generated by these cells in vitro, the "neurospheres", have not been fully characterized. To fill this gap, we examined neurospheres and neurosphere-derived NSCs by confocal microscopy, electron microscopy (EM) and cytofluorimetry. Here, we show that neurospheres and neurosphere-forming cells are morphologically and functionally heterogeneous. Confocal microscopy reveals differences in cell size, viability, cytoplasmic content and in the presence and distribution of active mitochondria. By electron microscopy, neurospheres appear as complex structures in which biological events such as mitosis, apoptosis and even phagocytosis are influenced by NSCs localization within the architecture of the neurosphere. NSCs derived from neurospheres are not synchronized and are represented in all phases of the cell cycle. Cytofluorimetric studies demonstrate NSCs' heterogeneity in cell size by forward scatter (FSC) analysis, and in cytoplasmic granularity by side scatter (SSC) profiling. These findings may contribute to our understanding of the morphogenesis of the neurospheres, particularly as this process relates to the high environmental adaptability of the NSCs and the reported existence of different subpopulations of neural stem cells. (C) 2003 Elsevier B.V All rights reserved. C1 Natl Neurol Inst C Besta, Dept Neurobiol & Neurorestorat Therapies, Neurobiol Lab, I-20133 Milan, Italy. Univ Pavia, Dept Physiol Sci & Cellular & Mol Pharmacol, I-27100 Pavia, Italy. Univ Pavia, Dept Biol Anim, I-27100 Pavia, Italy. ICP, Inst Obstet & Gynaecol L Mangiagalli, Milan, Italy. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. RP Parati, EA (reprint author), Natl Neurol Inst C Besta, Dept Neurobiol & Neurorestorat Therapies, Neurobiol Lab, Via Celoria 11, I-20133 Milan, Italy. RI Parati, Eugenio/G-8765-2011 NR 45 TC 150 Z9 160 U1 1 U2 13 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD DEC 12 PY 2003 VL 993 IS 1-2 BP 18 EP 29 DI 10.1016/j.brainres.2003.08.061 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 753UR UT WOS:000187249400003 PM 14642827 ER PT J AU Blevins, JE Eakin, TJ Murphy, JA Schwartz, MW Baskin, DG AF Blevins, JE Eakin, TJ Murphy, JA Schwartz, MW Baskin, DG TI Oxytocin innervation of caudal brainstem nuclei activated by cholecystokinin SO BRAIN RESEARCH LA English DT Article DE brainstem; adiposity; satiety; food intake ID C-FOS EXPRESSION; CORTICOTROPIN-RELEASING-FACTOR; HYPOTHALAMIC PARAVENTRICULAR NUCLEUS; CENTRAL-NERVOUS-SYSTEM; DORSAL VAGAL COMPLEX; AGOUTI-RELATED PROTEIN; CCK-A RECEPTORS; FOOD-INTAKE; RAT-BRAIN; SOLITARY TRACT AB The integration of 'long-term' adiposity signaling with the 'short-term' meal-related signal cholecystokinin (CCK) is proposed to involve descending hypothalamic projections to areas of the caudal brainstem (CBS) that regulate the amount of food consumed during a single meal. One such projection extends from cell bodies in the hypothalamic paraventricular nucleus (PVN) to the nucleus tractus solitarius (NTS), where cells that respond to peripheral CCK are concentrated. Candidate neuronal cell types that may comprise this PVN-NTS projection includes those expressing corticotropin-releasing hormone (CRH) or oxytocin. We therefore sought to determine whether oxytocin or CRH axons are preferentially located in close anatomical proximity to neurons of the NTS that are activated by peripheral administration of CCK, as determined by immunocytochemical staining for Fos protein. Rats received injections of either an anorexic dose of CCK (8 nmol/kg, i.p.) or vehicle and were perfused 2 h later with 4% paraformaldehyde. Immunocytochemistry was performed on cryostat sections (14 Inn) of caudal brainstem, using a polyclonal antibody to Fos protein and either a monoclonal antibody to oxytocin or a polyclonal antibody to CRH. As expected, CCK administration significantly increased the numbers of Fos-positive neurons by 489% (p < 0.0 1) and 400% (p < 0.0 1), respectively, in the medial and gelatinosus subdivisions of the NTS. These same regions received dense oxytocin axon innervation, whereas CRH immunoreactivity was not as prevalent in these areas. In areas outside the NTS, such as the dorsal motor nucleus of the vagus (DMV), Fos activation was absent despite a dense oxytocin and CRH innervation. To investigate whether CCK-induced reductions of food intake require intact oxytocin signaling, we performed a separate study in which CCK injection was preceded by injection into the fourth ventricle of an oxytocin receptor antagonist [d(CH2)(5), Tyr (Me)(2), Orn(8)]-vasotocin (OVT). This study showed CCK was 23% and 22% less effective at inhibiting food intake at 30 min (p < 0.05) and I h (p < 0.05) food intake, respectively, in the presence of OVT. Taken together, the data indicate that oxytocin axons within the descending pathway from the PVN to the NTS are anatomically positioned to interact with NTS neurons that respond to vagally mediated peripheral CCK signals such as those that occur following ingestion of a meal. These findings support the hypothesis that oxytocin exerts a tonic stimulatory effect on the response of key neurons within the NTS to CCK and further reduce meal size. Published by Elsevier B.V. C1 VA Puget Sound Hlth Care Syst, Res Serv 151, Div Endocrinol Metab, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Biol Struct, Seattle, WA 98195 USA. RP Blevins, JE (reprint author), VA Puget Sound Hlth Care Syst, Res Serv 151, Div Endocrinol Metab, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Schwartz, Michael/H-9950-2012 FU NIDDK NIH HHS [DK-14047, DK-52989]; NINDS NIH HHS [NS-32273] NR 66 TC 95 Z9 96 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD DEC 12 PY 2003 VL 993 IS 1-2 BP 30 EP 41 DI 10.1016/j.brainres.2003.08.036 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 753UR UT WOS:000187249400004 PM 14642828 ER PT J AU Lee, BY Hecht, T Volpp, K AF Lee, BY Hecht, T Volpp, K TI Lifestyle as a factor in medical students' career choices SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID TRENDS C1 Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. RP Lee, BY (reprint author), Univ Penn, Dept Med, Philadelphia, PA 19104 USA. NR 5 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD DEC 10 PY 2003 VL 290 IS 22 BP 2941 EP 2941 DI 10.1001/jama.290.22.2941-a PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 751WH UT WOS:000187112700021 PM 14665653 ER PT J AU Lieberman, DA Prindiville, S Weiss, DG Willett, W AF Lieberman, DA Prindiville, S Weiss, DG Willett, W CA VA Cooperative Study Grp 380 TI Risk factors for advanced colonic neoplasia and hyperplastic polyps in asymptomatic individuals SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID FECAL-OCCULT-BLOOD; MALE HEALTH-PROFESSIONALS; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; COLORECTAL-CANCER; PHYSICAL-ACTIVITY; ASPIRIN USE; LARGE-BOWEL; SCREENING SIGMOIDOSCOPY; SERUM-CHOLESTEROL; CIGARETTE-SMOKING AB Context Knowledge of risk factors for colorectal neoplasia could inform risk reduction strategies for asymptomatic individuals. Few studies have evaluated risk factors for advanced colorectal neoplasia in asymptomatic individuals, compared risk factors between persons with and without polyps, or included most purported risk factors in a multivariate analysis. Objective To determine risk factors associated with advanced colorectal neoplasia in a cohort of asymptomatic persons with complete colonoscopy. Design, Setting, and Participants Prospective, cross-sectional study of 3121 asymptomatic patients aged 50 to 75 years from 13 Veterans Affairs medical centers conducted between February 1994 and January 1997. All participants had complete colonoscopy to determine the prevalence of advanced neoplasia, defined as an adenoma that was 10 mm or more in diameter, a villous adenoma, an adenoma with high-grade dysplasia, or invasive cancer. Variables examined included history of first-degree relative with colorectal cancer, prior cholecystectomy, serum cholesterol level, physical activity, smoking, alcohol use, and dietary factors. Main Outcome Measures An age-adjusted analysis was performed for each variable to calculate the odds ratios (ORs) and 95% confidence intervals (CIS) associated with having advanced neoplasia compared with having no polyps. We developed a multivariate logistic regression model to identify the most informative risk factors. A secondary analysis examined risk factors for having hyperplastic polyps compared with having no polyps and compared with having advanced neoplasia. Results Three hundred twenty-nine participants had advanced neoplasia and 1441 had no polyps. In multivariate analyses, we found positive associations for history of a first-degree relative with colorectal cancer (OR, 1.66; 95% Cl, 1.16-2.35), current-smoking (OR, 1.85; 95% Cl, 1.33-2.58), and current moderate to heavy alcohol use (OR, 1.02; 95% Cl, 1.01 -1.03). Inverse associations were found for cereal fiber intake (OR, 0.95; 95% Cl, 0.91-0.99), vitamin D intake (OR, 0.94; 95% Cl, 0.90-0.99), and use of nonsteroidal anti-inflammatory drugs (NSAIDs) (OR, 0.66; 95% Cl, 0.48-0.91). In the univariate analysis, the inverse association was found with cereal fiber intake greater than 4.2 g/d, vitamin D intake greater than 645 IU/d, and daily use of NSAIDs. Marginal factors included physical activity, daily multivitamin use, and intake of calcium and fat derived from red meat. No association was found for body mass index, prior cholecystectomy, or serum cholesterol level. Three hundred ninety-one patients had hyperplastic polyps as the worst lesion found at colonoscopy. Risk variables were similar to those for patients with no polyps, except that past and current smoking were associated with an increased risk of hyperplastic polyps. Conclusions Our data endorse several important risk factors for advanced colonic neoplasia and provide a rationale for prudent risk reduction strategies. Further study is needed to determine if lifestyle changes can moderate the risk of colorectal cancer. C1 Dept Vet Affairs Med Ctr, Portland, OR USA. NCI, Bethesda, MD 20892 USA. Dept Vet Affairs Med Ctr, Perry Point, MD USA. Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. RP Lieberman, DA (reprint author), Portland VA Med Ctr, Div Gastroenterol, P3-GI,POB 1034, Portland, OR 97207 USA. FU NCI NIH HHS [K07CA75159] NR 57 TC 261 Z9 267 U1 1 U2 7 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD DEC 10 PY 2003 VL 290 IS 22 BP 2959 EP 2967 DI 10.1001/jama.290.22.2959 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 751WH UT WOS:000187112700027 PM 14665657 ER PT J AU Breitner, JCS Costa, PT AF Breitner, JCS Costa, PT TI "At my wits' end" - Neuroticism and dementia SO NEUROLOGY LA English DT Editorial Material ID DISEASE; BRAIN C1 Univ Washington, Ctr Geriatr Res Educ & Clin, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Div Geriatr Psychiat, Seattle, WA 98195 USA. NIA, Lab Personal & Cognit, NIH, Baltimore, MD 21224 USA. Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA. RP Breitner, JCS (reprint author), Univ Washington, Ctr Geriatr Res Educ & Clin, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. OI Costa, Paul/0000-0003-4375-1712 FU NIA NIH HHS [AG-15477, AG-11380] NR 11 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD DEC 9 PY 2003 VL 61 IS 11 BP 1468 EP 1469 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 751MG UT WOS:000187070400002 PM 14663023 ER PT J AU Reusch, JEB Regensteiner, JG Watson, PA AF Reusch, JEB Regensteiner, JG Watson, PA TI Novel actions of thiazolidinediones on vascular function and exercise capacity SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID ACTIVATED RECEPTOR-GAMMA; SMOOTH-MUSCLE-CELLS; BINDING PROTEIN-DELTA; FACTOR-ALPHA-RECEPTOR; LOW CARDIORESPIRATORY FITNESS; UPTAKE KINETIC RESPONSES; DIABETES-MELLITUS; INSULIN-RESISTANCE; GENE-EXPRESSION; BLOOD-PRESSURE AB The endothelium is the first line of defense for maintaining normal vascular function in the vessel wall; however, the endothelium is sensitive to metabolic stress. In patients with insulin resistance or type 2 diabetes mellitus, a set of metabolic insults-namely high plasma levels of glucose and free fatty acids, increased inflammation, dyslipidemia, and hypertension-cause endothelial dysfunction and a transition from an antiatherogenic endothelium to a proatherogenic endothelium. Disruption of endothelial function leads to activation of platelets and macrophages, increased thrombotic potential, transition of macrophages to foam cells, stimulation of cytokine secretion, and proliferation of vascular smooth muscle cells. Insulin-sensitizing agents, such as the thiazolidinediones (TZDs), improve flow-mediated vasodilation, decrease macrophage and smooth muscle cell activation, proliferation, and migration, and decrease plaque formation. The TZDs exert multifaceted effects on the vasculature by regulating the expression of transcription factors and orchestrating whole-gene programs that restore vascular physiology to the healthy state. Exercise training and increased levels of habitual physical activity have therapeutic benefit in terms of both preventing and treating insulin resistance and diabetes. However, this benefit of exercise training and increased physical activity is complicated by the fact that individuals with insulin resistance or type 2 diabetes have decreased maximal exercise capacity or maximal oxygen consumption and have slower oxygen uptake kinetics at the beginning of exercise. Both of these abnormalities contribute to the decreased levels of habitual physical activity observed in patients with diabetes. Preliminary data suggest that TZDs improve measures of cardiac function and exercise capacity, and investigators are assessing the impact of treatment with rosiglitazone on exercise capacity in an ongoing clinical trial. (C) 2003 by Excerpta Medica, Inc. C1 Denver VA Med Ctr 111H, Denver, CO 80220 USA. RP Reusch, JEB (reprint author), Denver VA Med Ctr 111H, 1055 Clermont St, Denver, CO 80220 USA. NR 53 TC 4 Z9 4 U1 2 U2 3 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD DEC 8 PY 2003 VL 115 SU 8A BP 69 EP 74 DI 10.1016/j.amjmed.2003.09.012 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 754JD UT WOS:000187311800012 ER PT J AU Pierluissi, E Fischer, MA Campbell, AR Landefeld, CS AF Pierluissi, E Fischer, MA Campbell, AR Landefeld, CS TI Discussion of medical errors in morbidity and mortality conferences SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID MISTAKES; PHYSICIANS; QUALITY; IMPACT; CARE AB Context Morbidity and mortality conferences in residency programs are intended to discuss adverse events and errors with a goal to improve patient care. Little is known about whether residency training programs are accomplishing this goal, Objective To determine the frequency at-which morbidity and mortality conference case presentations include adverse events and errors and whether the errors are discussed and attributed to a particular cause. Design, Setting, and Participants Prospective survey conducted by trained physician observers from July 2000 through April 2001 on 332 morbidity and mortality conference case presentations and discussions in internal medicine (n = 100) and surgery (n =232) at 4 US academic hospitals. Main Outcome Measures Frequencies of presentation of adverse events and errors, discussion of errors, and attribution of errors. Results In internal medicine morbidity and mortality conferences, case presentations and discussions were 3 times longer than in surgery conferences (34.1 minutes vs 11.7 minutes; P=.001), more time was spent listening to invited speakers (43.1% vs 0%; P<.001), and less time was spent in audience discussion (15.2% vs 36.6% P<.001). Fewer internal medicine case presentations included adverse events (37 [37%] vs 166 surgery case presentations [72%]; P<.001) or errors causing an adverse event (18 [18%] vs 98 [42%], respectively; P=.001). When an error caused an adverse event, the error was discussed as an error less often in internal medicine (10 errors [48%] vs 85 errors in surgery (77%]; P=.02). Errors were attributed to a particular cause less often in medicine than in surgery conferences (8 [38%] of 21 medicine errors vs 88 [79%] of 112 surgery errors; P<.001). In discussions of cases with errors, conference leaders in both internal medicine and surgery infrequently used explicit language to signal that an error was being discussed and infrequently acknowledged having made an error. Conclusions Our findings call into question whether adverse events and errors are routinely discussed in internal medicine training programs. Although adverse events and errors were discussed frequently in surgery cases, teachers in both surgery and internal medicine missed opportunities to model recognition of error and to use explicit language in error discussion by acknowledging their personal experiences with error. C1 Univ Calif San Francisco, Sch Med, San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, Sch Med, San Francisco Gen Hosp, San Francisco, CA USA. Univ Calif San Francisco, Sch Med, Dept Surg, San Francisco, CA 94143 USA. Univ Calif San Francisco, Sch Med, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Stanford Univ, Palo Alto Vet Affairs Med Ctr, Palo Alto, CA 94304 USA. RP Pierluissi, E (reprint author), San Mateo Med Ctr, 222 W 39th St, San Mateo, CA 94403 USA. FU NIA NIH HHS [K-07 AG00912] NR 27 TC 131 Z9 132 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD DEC 3 PY 2003 VL 290 IS 21 BP 2838 EP 2842 DI 10.1001/jama.290.21.2838 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 748QP UT WOS:000186872800026 PM 14657068 ER PT J AU Metlay, JP Fine, MJ AF Metlay, JP Fine, MJ TI Diagnostic and prognostic testing in pneumonia - In response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. RP Metlay, JP (reprint author), Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD DEC 2 PY 2003 VL 139 IS 11 BP 955 EP 955 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 748WW UT WOS:000186884800014 ER PT J AU Busuttil, RA Rubio, M Dolle, MET Campisi, J Vijg, J AF Busuttil, RA Rubio, M Dolle, MET Campisi, J Vijg, J TI Oxygen accelerates the accumulation of mutations during the senescence and immortalization of murine cells in culture SO AGING CELL LA English DT Article DE aging; cancer; DNA damage; genomic integrity; oxidative damage ID OXIDATIVE DNA-DAMAGE; DIPLOID FIBROBLAST CELLS; TRANSGENIC MOUSE MODEL; REPLICATIVE LIFE-SPAN; IN-VIVO MUTATIONS; GENOME REARRANGEMENTS; SOMATIC MUTATIONS; EMBRYO CELLS; MICE; GROWTH AB Oxidative damage is a causal factor in aging and cancer, but it is still not clear how DNA damage, the cellular responses to such damage and its conversion to mutations by misrepair or misreplication contribute to these processes. Using transgenic mice carrying a lacZ mutation reporter, we have previously shown that mutations increase with age in most organs and tissues in vivo. It has also been previously shown that mouse cells respond to oxidative stress, typical of standard culture conditions, by undergoing cellular senescence. To understand better the consequences of oxidative stress, we cultured mouse embryo fibroblasts (MEFs) from lacZ mice under physiological oxygen tension (3%) or the high oxygen tension (20%) associated with standard culture, and determined the frequency and spectrum of mutations. Upon primary culture, the mutation frequency was found to increase approximately three-fold relative to the embryo. The majority of mutations were genome rearrangements. Subsequent culture in 20% oxygen resulted in senescence, followed by spontaneous immortalization. Immortalization was accompanied by an additional three-fold increase in mutations, most of which were G:C to T:A transversions, a signature mutation of oxidative DNA damage. In 3% oxygen, by contrast, MEFs did not senesce and the mutation frequency and spectrum remained similar to primary cultures. These findings demonstrate for the first time the impact of oxidative stress on the genomic integrity of murine cells during senescence and immortalization. C1 Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Ctr Longev & Aging Studies, STCBM, San Antonio, TX 78245 USA. Lawrence Berkeley Lab, Div Life Sci, Berkeley, CA USA. Buck Inst Age Res, Novato, CA USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Vijg, J (reprint author), Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Ctr Longev & Aging Studies, STCBM, 15355 Lambda Dr,STCBM, San Antonio, TX 78245 USA. FU NIA NIH HHS [AG17242] NR 32 TC 107 Z9 112 U1 0 U2 2 PU BLACKWELL PUBL LTD PI OXFORD PA 108 COWLEY RD, OXFORD OX4 1JF, OXON, ENGLAND SN 1474-9718 J9 AGING CELL JI Aging Cell PD DEC PY 2003 VL 2 IS 6 BP 287 EP 294 DI 10.1046/j.1474-9728.2003.00066.x PG 8 WC Cell Biology; Geriatrics & Gerontology SC Cell Biology; Geriatrics & Gerontology GA 753GW UT WOS:000187224500001 PM 14677631 ER PT J AU Kampov-Polevoy, AB Ziedonis, D Steinberg, ML Pinsky, I Krejci, J Eick, C Boland, G Khalitov, E Crews, FT AF Kampov-Polevoy, AB Ziedonis, D Steinberg, ML Pinsky, I Krejci, J Eick, C Boland, G Khalitov, E Crews, FT TI Association between sweet preference and paternal history of alcoholism in psychiatric and substance abuse patients SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE sweet preference; alcoholism; genetic risk ID PITUITARY BETA-ENDORPHIN; HEDONIC RESPONSE; SACCHARIN INTAKE; TASTE RESPONSES; FAMILY-HISTORY; WISTAR RATS; SUCROSE; ETHANOL; CONSUMPTION; DRINKING AB Background: The relationship between preference for stronger sweet solutions and propensity to excessive alcohol drinking is supported by both animal and human studies. This study was designed to test the hypothesis that sweet preference is associated with the genetic risk of alcoholism as measured by a paternal history of alcoholism. Methods: Participants were 180 patients admitted to a residential treatment program for the treatment of alcoholism, drug dependence, or psychiatric conditions. In addition to a routine medical examination, patients completed the standard sweet preference test twice (on the 9th and 24th days after admission), and the family history of alcoholism was evaluated. Results: Sweet preference was shown to be stable over time. It was strongly associated with a paternal history of alcoholism, with family history-positive patients approximately 5 times more likely to prefer stronger sweet solutions than family history-negative subjects. Such factors as dependence on alcohol, cocaine, opiates, cannabis, other drugs (including prescription drugs), and tobacco smoking, as well as demographics (gender and age), did not significantly interfere with association between sweet preference and paternal history of alcoholism. Conclusions: These findings provide some support for the hypothesis that preference for stronger sweet solutions is associated with a genetic predisposition to alcoholism as measured by a paternal history of alcoholism. C1 Bronx Vet Affairs Med Ctr, Mt Sinai Sch Med, Div Addict Psychiat, Bronx, NY 10468 USA. Univ Med & Dent, Piscataway, NJ USA. Robert Wood Johnson Med Sch, Div Addict Psychiat, Piscataway, NJ USA. Pavillon Int, Mill Spring, NC USA. Univ Minnesota, Sch Stat, Minneapolis, MN 55455 USA. Univ N Carolina, Bowles Ctr Alcohol Studies, Chapel Hill, NC USA. RP Kampov-Polevoy, AB (reprint author), Bronx Vet Affairs Med Ctr, Mt Sinai Sch Med, Div Addict Psychiat, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. OI Steinberg, Marc/0000-0001-8180-8682 NR 68 TC 30 Z9 31 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD DEC PY 2003 VL 27 IS 12 BP 1929 EP 1936 DI 10.1097/01.ALC.0000099265.60216.23 PG 8 WC Substance Abuse SC Substance Abuse GA 758WF UT WOS:000187674000010 PM 14691380 ER PT J AU Bush, KR Kivlahan, DR Davis, TM Dobie, DJ Sporleder, JL Epler, AJ Bradley, KA AF Bush, KR Kivlahan, DR Davis, TM Dobie, DJ Sporleder, JL Epler, AJ Bradley, KA TI The TWEAK is weak for alcohol screening among female veterans affairs outpatients SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcohol screening; TWEAK; AUDIT; AUDIT-C ID BRIEF PHYSICIAN ADVICE; IDENTIFICATION TEST AUDIT; BENEFIT-COST-ANALYSIS; AT-RISK DRINKING; PRIMARY-CARE; BRIEF INTERVENTIONS; USE DISORDERS; GENERAL-POPULATION; PROBLEM DRINKERS; LIKELIHOOD RATIOS AB Background: The optimal brief questionnaire for alcohol screening among female patients has not yet been identified. This study compared the performance of the TWEAK (tolerance, worried, eye-opener, amnesia, cutdown), the Alcohol Use Disorders Identification Test (AUDIT), and the AUDIT Consumption (AUDIT-C) as self-administered screening tests for hazardous drinking and/or active alcohol abuse or dependence among female Veterans Affairs (VA) outpatients. Methods: Women were included in the study if they received care at VA Puget Sound and completed both a self-administered survey containing the AUDIT and TWEAK screening questionnaires and subsequent in-person inter-views with the Alcohol Use Disorders and Associated Disabilities Interview Schedule. Sensitivities, specificities, positive and negative likelihood ratios, and areas under Receiver Operating Characteristic curves were computed for each screening questionnaire compared with two interview-based comparison standards: (1) active DSM-IV alcohol abuse or dependence and (2) hazardous drinking and/or active DSM-IV alcohol abuse or dependence, the more appropriate target for primary care screening. Results: Of 393 women who completed screening questionnaires and interviews, 39 (9.9%) met diagnostic criteria for alcohol abuse or dependence, and 89 (22.7%) met criteria for hazardous drinking or alcohol abuse or dependence. The TWEAK had relatively low sensitivities (0.62 and 0.44) but adequate specificities (0.86 and 0.89) for both interview-based comparison standards, even at its lowest cut-point ( 1). The AUDIT and AUDIT-C were superior, with the following areas under the receiver operating characteristic curve for active alcohol abuse or dependence and hazardous drinking and/or active alcohol abuse or dependence, respectively: AUDIT, 0.90 [95% confidence interval (CI), 0.85-0.95] and 0.87 (95% CI, 0.84-0.91); AUDIT-C, 0.91 (95% CI, 0.88-0.95) and 0.91 (95% CI, 0.88-0.94); and TWEAK, 0.76 (95% CI, 0.66-0.86) and 0.67 (95% CI, 0.60-0.74). Conclusions: The TWEAK has low sensitivity as an alcohol-screening questionnaire among female VA outpatients and should be evaluated further before being used in other female primary care populations. The three-item AUDIT-C was the optimal brief alcohol-screening questionnaire in this study. C1 VA Puget Sound Hlth Care Syst, Ctr Excellence Subst Abuse Treatment & Educ, Dept Vet Affairs, Vet Hlth Adm, Seattle, WA 98108 USA. Veteran Womens Alcohol Problems Study, Hlth Serv Res & Dev Serv, Seattle, WA USA. Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. Primary & Specialty Med Care Serv, Seattle, WA USA. Washington Univ, Dept Psychiat, Seattle, WA USA. Washington Univ, Dept Behav Sci, Seattle, WA USA. Washington Univ, Dept Med, Seattle, WA USA. Washington Univ, Dept Hlth Serv, Seattle, WA USA. RP Bush, KR (reprint author), VA Puget Sound Hlth Care Syst, Ctr Excellence Subst Abuse Treatment & Educ, Dept Vet Affairs, Vet Hlth Adm, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIAAA NIH HHS [K23 AA00313] NR 57 TC 7 Z9 7 U1 4 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD DEC PY 2003 VL 27 IS 12 BP 1971 EP 1978 DI 10.1097/01.ALC.0000099262.50094.98 PG 8 WC Substance Abuse SC Substance Abuse GA 758WF UT WOS:000187674000015 PM 14691385 ER PT J AU Halpern, SD Karlawish, JHT Casarett, D Berlin, JA Townsend, RR Asch, DA AF Halpern, SD Karlawish, JHT Casarett, D Berlin, JA Townsend, RR Asch, DA TI Hypertensive patients' willingness to participate in placebo-controlled trials: Implications for recruitment efficiency SO AMERICAN HEART JOURNAL LA English DT Article ID RANDOMIZED CONTROLLED-TRIALS; ACTIVE-CONTROL TRIALS; CLINICAL-TRIALS; EQUIVALENCE TRIALS; PRACTICAL ISSUES; HEALTH RESEARCH; ETHICS; AIDS AB Background Underenrollment and selective enrollment plague many clinical trials. Little is known about why hypertensive patients agree or refuse to participate in placebo-controlled trials (PCT) of antihypertensive drugs, whether the prospect of receiving placebo influences willingness to participate (WTP), or whether patients who participate differ from those who do not. Methods We described a hypothetical PCT of a new antihypertensive drug to 126 patients who would be eligible for ongoing phase III trials. We solicited patient motivations and concerns regarding trial participation by using open-ended questions, assessed the patients' stated WTP, and used logistic regression to determine patient characteristics associated with WTP. We reassessed WTP in 62 patients after revealing,, in random order, that 10%, 30%, and 50% of patients would receive placebo. Results The most commonly cited motivations for participating included personal health benefits (40%), helping other patients (37%), and contributing to scientific knowledge (15%). The most common concerns were having to stop current medications (56%), inconvenience/annoyance (38%), fear of known side effects (35%), and the possibility of receiving placebo (24%). Overall, 47% of patients (95% confidence interval, 38% to 56%) were willing to participate. Younger patients (57% versus 37%; P = .01), nonsmokers (50% versus 24%; P = .04), and patients who had participated in research previously (77% versus 20%; P = .009) were all significantly more willing to participate. Fewer patients were willing to participate as the percentage who would receive placebo increased (P = .02), but randomly assigning fully half of patients to placebo still yielded maximal recruitment efficiency. Conclusions Hypertensive patients participate in trials for altruistic and personal health reasons. Differences between patients who do or do not participate may influence trial outcomes. The proportion of patients receiving placebo influences some patients' enrollment decisions but is not a key determinant of recruitment efficiency. C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Bioeth, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. RP Halpern, SD (reprint author), Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, 108 Blackley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. OI Asch, David/0000-0002-7970-286X NR 41 TC 44 Z9 45 U1 1 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD DEC PY 2003 VL 146 IS 6 BP 985 EP 992 DI 10.1016/S0002-8703(03)00507-6 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 751RF UT WOS:000187080200012 PM 14660989 ER PT J AU Mozaffarian, D Bryson, CL Spertus, JA McDonell, MB Fihn, SD AF Mozaffarian, D Bryson, CL Spertus, JA McDonell, MB Fihn, SD TI Anginal symptoms consistently predict total mortality among outpatients with coronary artery disease SO AMERICAN HEART JOURNAL LA English DT Article; Proceedings Paper CT 43rd Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 05-08, 2003 CL MIAMI, FLORIDA SP Amer Heart Assoc ID ACUTE MYOCARDIAL-INFARCTION; PROGNOSTIC IMPORTANCE; NONDIABETIC PATIENTS; FUNCTIONAL STATUS; STABLE ANGINA; HEART-DISEASE; HEALTH-STATUS; ANGIOGRAPHY; ASSOCIATION; ISCHEMIA AB Background Age, race, education, and diabetes have been associated with differences in anginal symptoms, treatments, and outcomes among outpatients with coronary artery disease (CAD), but there is little data on whether such characteristics affect relationships between anginal symptoms and mortality. Methods Using a prospective cohort design, we examined associations of anginal symptoms, as assessed by the Seattle Angina Questionnaire, with total mortality among 8908 outpatients with CAD to investigate whether this relationship is influenced by patient demographic or clinical characteristics. Potential effect modification was primarily assessed for age, race, education, and diabetes, and secondarily assessed for smoking, prevalent congestive heart failure (CHF), myocardial infarction, and coronary revascularization. Results Over 2 years mean follow-up, there were 896 deaths. After adjustment for potential confounders, persons reporting greater physical limitation due to angina had higher mortality: 27% higher with mild limitation (hazard ratio [HR] 1.27, 95% CI 0.98-1.64), 61% higher with moderate limitation (HR 1.61, 95% CI 1.27-2.05), and 2.5-fold higher with the greatest limitation (HR 2.55, 95% CI 1.97-3.30), compared with little or no limitation (P for trend <.001). Anginal instability was also independently predictive of mortality. There was little evidence that these relationships varied by age, race, education, diabetes, smoking, or presence of CHF, prior myocardial infarction, or prior coronary revascularization (P for each interaction >.28). Anginal symptoms predicted higher mortality risk comparable to a decade of age difference, presence of diabetes, or presence of CHF. Conclusions Among outpatients with CAD, self-reported anginal symptoms consistently predict mortality irrespective of differences in age, race, education, or clinical comorbidities. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98195 USA. Mid Amer Heart Inst, Kansas City, MO USA. RP Mozaffarian, D (reprint author), Harvard Univ, Sch Publ Hlth, 665 Huntington Ave,Bldg 2 Rm 315, Boston, MA 02115 USA. RI Mozaffarian, Dariush/B-2276-2008 NR 31 TC 48 Z9 51 U1 0 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD DEC PY 2003 VL 146 IS 6 BP 1015 EP 1022 DI 10.1016/S0002-8703(03)00436-8 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 751RF UT WOS:000187080200016 PM 14660993 ER PT J AU Hussein, MR Hassan, M Wood, GS AF Hussein, MR Hassan, M Wood, GS TI Morphological changes and apoptosis in radial growth phase melanoma cell lines following ultraviolet-B irradiation SO AMERICAN JOURNAL OF DERMATOPATHOLOGY LA English DT Article DE radial growth phase (RGP); transmission electron microscopy (TEM); terminal deoxymicleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick-end labeling (TUNEL); ultraviolet irradiation (UVR); Wistar melanoma (WM) ID CUTANEOUS MALIGNANT-MELANOMA; ELECTRON-MICROSCOPY; HUMAN MELANOCYTES; MISMATCH REPAIR; PROMOTER REGION; PIGMENTED NEVI; P53; UV; EXPRESSION; HMSH2 AB Background: Knowledge about the morphologic changes following ultraviolet irradiation in the earliest stages of melanomas is still lacking. Methods: To investigate these changes, an in vitro system consisting of radial growth phase Wistar melanoma cell lines (WM35 and WM3211) was established. Cells were irradiated with a single erythemogenic dose of UVB (10 mJ/cm(2)) and evaluated for morphologic changes. Results: When compared with the non-irradiated cells, inverted light microscopy revealed increased cellular branching, cytoplasmic size, and multinucleation in the irradiated cells. Transmission electron microscopy revealed the features of increased metabolic activity (hyperplasia of the mitochondria and Golgi) and those of ultrastructural atypia (pleomorphism of the nuclei and nucleoli, increased euchromatin, and nucleolar margination) in the irradiated cells. Moreover, UVB irradiation caused an increase in the apoptotic activity. These alterations were associated with up-regulation of p53, Bcl-2, and the second mismatch repair protein (hMSH2), as revealed by Western blot analysis. Conclusions: UVB irradiation can induce apoptosis, morphologic changes, and altered expression of p53, Bcl-2, and hMSH2 in radial growth phase melanoma cell lines. Up-regulation of p53, Bcl-2, and hMSH2 suggests that these factors are involved in the altered balance between survival and apoptosis induced by UVB. Further investigation will be needed to determine if apoptosis and ultrastructural atypia reflect underlying DNA damage and genomic instability induced by UVB. C1 Univ Wisconsin, Dept Dermatol, Madison, WI 53715 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. Case Western Reserve Univ, Dept Pathol, Vet Hosp, Cleveland, OH 44106 USA. Univ Hosp Cleveland, Cleveland, OH 44106 USA. RP Wood, GS (reprint author), Univ Wisconsin, Dept Dermatol, 1 S Pk,7th Floor, Madison, WI 53715 USA. FU NIAMS NIH HHS [AR02136] NR 41 TC 14 Z9 14 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0193-1091 J9 AM J DERMATOPATH JI Am. J. Dermatopathol. PD DEC PY 2003 VL 25 IS 6 BP 466 EP 472 DI 10.1097/00000372-200312000-00003 PG 7 WC Dermatology SC Dermatology GA 747FZ UT WOS:000186795700003 PM 14631187 ER PT J AU Skluzacek, PA Szewc, RG Nolan, CR Riley, DJ Lee, S Pergola, PE AF Skluzacek, PA Szewc, RG Nolan, CR Riley, DJ Lee, S Pergola, PE TI Prediction of GFR in liver transplant candidates SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE lothalamate; creatinine clearance (C-Cr); cirrhosis; ascites; Model for End-Stage Liver Disease (MELD) score; kidney function ID GLOMERULAR-FILTRATION RATE; PLASMA-CLEARANCE; CREATININE CLEARANCE; SERUM CREATININE; RENAL-FUNCTION; IOTHALAMATE; DISEASE; INULIN; INSUFFICIENCY; SURVIVAL AB Background Kidney function frequently is impaired in patients with cirrhosis; however, glomerular filtration rate (GFR) is difficult to estimate in these patients by using standard clinical markers. The aim of our study is to compare GFR calculated from renal clearance of iodine 125-labeled iothalamate (I-125-lothalamate) with the plasma decay technique and the Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault (CG) prediction equations. Methods: We performed a cross-sectional study of patients with liver cirrhosis being evaluated for transplantation (50% Child's class C); 89% had ascites or edema and 44% were men aged 55 +/- 2 years. Average pretest blood urea nitrogen level was 16 +/- 2 mg/dL (5.7 +/- 0.7 mmol/L); serum creatinine, 1.0 +/- 0.1 mg/dL (88 +/- 9 mumol/L; range, 0.6 to 1.7 mg/dL [53 to 150 mumol/L]); plasma albumin, 3.14 +/- 0.16 g/dL (31.4 +/- 1.6 g/L); and total bilirubin, 4.0 +/- 0.7 mg/dL (67 +/- 11.3 mumol/L). Kidney function was measured by means of simultaneous plasma and renal clearance of I-125-lothala mate (Glofil-125; Cypros Pharmaceutical Corp, Carlsbad, CA) and the MDRD and CG equations. Results: GFRs were 58.2 +/- 5.1 mL/min/1.73 m(2) by renal clearance of I-125-iothalamate and 76.7 +/- 7.2 mL/min/1.73 m(2) by the plasma decay technique (+18.5 mL/min, or 32%; P = 0.0004). GFR by the MDRD equation was 76.9 +/- 7.8 mL/min/1.73 m(2) (+18.7 mL/min, or 32%; P = 0.0004 versus renal lothalamate; r(2) = 0.57). GFR by the CG equation was the least accurate (+30.1 mL/min, or 52%; P = 0.0001 versus renal iothalamate). Conclusion: The current clinically used CG and MDRD equations to estimate kidney function in patients with cirrhosis and volume excess and the I-125-lothalamate plasma decay technique are inaccurate because they overestimate GFR. It seems very unlikely that accurate and reliable formulas will be developed that are able to replace the formal measurement of GFR in patients with liver cirrhosis. Therefore, we conclude that despite the additional complexity, renal clearance techniques should be used to assess GFR accurately in patients with liver cirrhosis and ascites. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78229 USA. Wilford Hall USAF Med Ctr, Dept Med, Lackland AFB, TX 78236 USA. S Texas Vet Hlth Care Syst, Res & Dev Serv, Audie L Murphy Div, San Antonio, TX USA. RP Pergola, PE (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, Mail Code 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 24 TC 80 Z9 83 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD DEC PY 2003 VL 42 IS 6 BP 1169 EP 1176 DI 10.1053/S0272-6386(03)01104-1 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 751RH UT WOS:000187080400009 PM 14655188 ER PT J AU Zabetian, CP Romero, R Robertson, D Sharma, S Padbury, JF Kuivaniemi, H Kim, KS Kim, CH Kohnke, MD Kranzler, HR Gelernter, J Cubells, JF AF Zabetian, CP Romero, R Robertson, D Sharma, S Padbury, JF Kuivaniemi, H Kim, KS Kim, CH Kohnke, MD Kranzler, HR Gelernter, J Cubells, JF TI A revised allele frequency estimate and haplotype analysis of the DBH deficiency mutation IVS1+2T -> C in African- and European-Americans SO AMERICAN JOURNAL OF MEDICAL GENETICS PART A LA English DT Letter ID DOPAMINE-BETA-HYDROXYLASE; NORADRENALINE; FAILURE C1 VA Puget Sound Hlth Care Syst, Dept Neurol, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. Wayne State Univ, NICHHD, Perinatol Res Branch, Detroit, MI USA. Vanderbilt Univ, Autonom Dysfunct Ctr, Dept Med, Nashville, TN USA. Vanderbilt Univ, Autonom Dysfunct Ctr, Dept Pharmacol, Nashville, TN USA. Vanderbilt Univ, Autonom Dysfunct Ctr, Dept Neurol, Nashville, TN USA. Brown Univ, Sch Med, Dept Pediat, Providence, RI 02912 USA. Womens & Childrens Hosp, Providence, RI USA. Wayne State Univ, Sch Med, Ctr Mol Med & Genet, Detroit, MI USA. Harvard Univ, McLean Hosp, Sch Med, Mol Neurobiol Lab, Belmont, MA 02178 USA. Tuebingen Univ Hosp, Univ Hosp Psychiat & Psychotherapy, Tubingen, Germany. Univ Connecticut, Sch Med, Alcohol Res Ctr, Dept Psychiat, Farmington, CT USA. Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. VA Connecticut Healthcare Syst, Dept Psychiat, West Haven, CT USA. RP Zabetian, CP (reprint author), VA Puget Sound Hlth Care Syst, Dept Neurol, 1660 S Columbian Way, Seattle, WA 98108 USA. EM zabetian@u.washington.edu OI Zabetian, Cyrus/0000-0002-7739-4306 NR 10 TC 6 Z9 6 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1552-4825 J9 AM J MED GENET A JI Am. J. Med. Genet. A PD DEC 1 PY 2003 VL 123A IS 2 BP 190 EP 192 DI 10.1002/ajmg.a.20300 PG 3 WC Genetics & Heredity SC Genetics & Heredity GA 744DK UT WOS:000186612500012 PM 14598346 ER PT J AU Sundgren, NC Giraud, GD Schultz, JM Lasarev, MR Stork, PJS Thornburg, KL AF Sundgren, NC Giraud, GD Schultz, JM Lasarev, MR Stork, PJS Thornburg, KL TI Extracellular signal-regulated kinase and phosphoinositol-3 kinase mediate IGF-1 induced proliferation of fetal sheep cardiomyocytes SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE hyperplasia; hypertrophy; UO-126; LY-294002 ID GROWTH-FACTOR-I; BINUCLEATED CARDIAC MYOCYTES; PHOSPHATIDYLINOSITOL 3-KINASE; TRANSGENIC MICE; MYOCARDIAL-CONTRACTILITY; ANGIOTENSIN-II; RAT-HEART; CELL-SIZE; INSULIN; HYPERTROPHY AB Growth of the fetal heart involves cardiomyocyte enlargement, division, and maturation. Insulin-like growth factor-1 (IGF-1) is implicated in many aspects of growth and is likely to be important in developmental heart growth. IGF-1 stimulates the IGF-1 receptor (IGF1R) and downstream signaling pathways, including extracellular signal-regulated kinase (ERK) and phosphoinositol-3kinase (PI3K). We hypothesized that IGF-1 stimulates cardiomyocyte proliferation and enlargement through stimulation of the ERK cascade and stimulates cardiomyocyte differentiation through the PI3K cascade. In vivo administration of Long R3 IGF-1 (LR3 IGF-1) did not stimulate cardiomyocyte hypertrophy but led to a decreased percentage of cells that were binucleated in vivo. In culture, LR3 IGF-1 increased myocyte bromodeoxyuridine (BrdU) uptake by three-to five-fold. The blockade of either ERK or PI3K signaling (by UO-126 or LY-294002, respectively) completely abolished BrdU uptake stimulated by LR3 IGF-1. LR3 IGF-1 did not increase footprint area, but as expected, phenylephrine stimulated an increase in binucleated cardiomyocyte size. We conclude that 1) IGF-1 through IGF1R stimulates cardiomyocyte division in vivo; hyperplastic growth is the most likely explanation of IGF-1 stimulated heart growth in vivo; 2) IGF-1 through IGF1R does not stimulate binucleation in vitro or in vivo; 3) IGF-1 through IGF1R does not stimulate hypertrophy either in vivo or in vitro; and 4) IGF-1 through IGF1R requires both ERK and PI3K signaling for proliferation of near-term fetal sheep cardiomyocytes in vitro. C1 Oregon Hlth & Sci Univ, Sch Med, Heart Res Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Med Cardiol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Surg, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Ctr Res Occupat & Environm Toxicol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Vollum Inst, Portland, OR 97239 USA. RP Thornburg, KL (reprint author), Oregon Hlth & Sci Univ, Sch Med, Heart Res Ctr, L464, Portland, OR 97239 USA. RI Powers, Donald/A-1704-2009 OI Powers, Donald/0000-0003-1126-7141; Thornburg, Kent/0000-0002-5561-4785 FU NICHD NIH HHS [2PO1-HD-4430] NR 50 TC 56 Z9 57 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD DEC 1 PY 2003 VL 285 IS 6 BP R1481 EP R1489 DI 10.1152/ajpregu.00232.2003 PG 9 WC Physiology SC Physiology GA 742ZE UT WOS:000186547300025 PM 12947030 ER PT J AU Budisavljevic, MN Hodge, L Barber, K Fulmer Jr Durazo-Arvizu, RA Self, SE Kuhlmann, M Raymond Jr Greene, EL AF Budisavljevic, MN Hodge, L Barber, K Fulmer, JR Durazo-Arvizu, RA Self, SE Kuhlmann, M Raymond, JR Greene, EL TI Oxidative stress in the pathogenesis of experimental mesangial proliferative glomerulonephritis SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE alpha-lipoic acid; anti-Thy 1 nephritis; extracellular signal-regulated kinase; alpha-smooth muscle actin; transforming growth factor-beta(1) ID ACTIVATED PROTEIN-KINASE; EXPERIMENTAL MESANGIOPROLIFERATIVE GLOMERULONEPHRITIS; ALPHA-LIPOIC ACID; SIGNAL-TRANSDUCTION; GLOMERULAR INJURY; CELLS; ANTIOXIDANT; ACTIN; DIFFERENTIATION; TRANSFORMATION AB Reactive oxygen species (ROS) are increasingly believed to be important intracellular signaling molecules in mitogenic pathways involved in the pathogenesis of glomerulonephritis (GN). We explored the effects of the antioxidants alpha-lipoic acid and N-acetyl-L-cysteine on ERK activation in cultured mesangial cells and the role of ERK activation in the severity of glomerular injury in a rat model of anti-Thy 1 GN. In cultured mesangial cells, growth factors stimulated ERK phosphorylation by 150 - 450%. Antioxidants reduced this increase by 50 - 60%. Induction of anti-Thy 1 nephritis in rats led to a 210% increase in glomerular ERK phosphorylation. This increase in phosphorylated ERK was reduced by 50% in animals treated with alpha-lipoic acid. Treatment with alpha-lipoic acid resulted in significant improvement of glomerular injury. Cellular proliferation was reduced by 100%, and the number of proliferating cell nuclear antigen-positive cells was reduced by 64%. The increased expression of glomerular transforming growth factor-beta(1) protein and mRNA in rats with anti-Thy 1 nephritis was significantly attenuated and mesangial cell transformation into myofibroblasts was completely prevented by treatment with alpha-lipoic acid. The effects of alpha-lipoic acid were at least partially due to inhibition of oxidative stress. In rats with anti-Thy 1 nephritis, ROS production was increased 400 - 500%, and this increase was inhibited by 55% by treatment with alpha-lipoic acid. We suggest that ROS may mediate glomerular injury by inducing ERK phosphorylation. alpha-Lipoic acid should be considered a potential therapeutic agent in certain types of human GN. C1 Med Univ S Carolina, Div Nephrol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biometry, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Med Serv, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC 29425 USA. Univ Saarlandes Kliniken, Dept Internal Med, D-66421 Homburg, Germany. Mayo Clin & Mayo Fdn, Dept Med, Div Nephrol, Rochester, MN 55905 USA. RP Budisavljevic, MN (reprint author), Med Univ S Carolina, Div Nephrol, 171 Ashley Ave, Charleston, SC 29425 USA. EM budisamn@musc.edu FU NHLBI NIH HHS [HL 03710]; NIDDK NIH HHS [DK 52448] NR 40 TC 38 Z9 42 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD DEC PY 2003 VL 285 IS 6 BP F1138 EP F1148 DI 10.1152/ajprenal.00397.2002 PG 11 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 739VH UT WOS:000186366800013 PM 14600028 ER PT J AU Mitelman, SA Shihabuddin, L Brickman, AM Hazlett, EA Buchsbaum, MS AF Mitelman, SA Shihabuddin, L Brickman, AM Hazlett, EA Buchsbaum, MS TI MRI assessment of gray and white matter distribution in Brodmann's areas of the cortex in patients with schizophrenia with good and poor outcomes SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 155th Annual Meeting of the American-Psychiatric-Association CY MAY 18-23, 2002 CL PHILADELPHIA, PENNSYLVANIA SP Amer Psychiat Assoc ID SCHIZOTYPAL PERSONALITY-DISORDER; TEMPORAL-LOBE; PREFRONTAL CORTEX; NEGATIVE SYMPTOMS; KRAEPELINIAN SCHIZOPHRENIA; GLUCOSE-METABOLISM; BRAIN MORPHOLOGY; VOLUME DEFICITS; ABNORMALITIES; REDUCTION AB Objective: High-resolution magnetic resonance imaging (MRI) was used to compare cortical gray and white matter and CSF volumes in schizophrenia patients with poor outcomes, schizophrenia patients with good outcomes, and healthy comparison subjects. Method: T-1-weighted, 1.2-mm-thick MR images were acquired for 37 patients with schizophrenia and 37 healthy, age- and sex-matched comparison subjects. The patients were assigned to subgroups with poor outcomes (N=13) and good outcomes (N=24) on the basis of clinical characteristics. Poor-outcome patients were those who were continuously hospitalized or completely dependent on others for basic needs, were unemployed, and had severe negative symptoms and severe formal thought disorder. The MR images were reoriented to standard position parallel to the anterior commissure-posterior commissure line and segmented into CSF, gray matter, and white matter tissue types. The tissue types were assigned to Brodmann's areas by using the Perry postmortem histological atlas, and tissue-type volumes in the three subject groups were compared. Results: Compared to the healthy subjects, the overall patient group had a significantly smaller mean cortical gray matter volume and significantly larger mean CSF volume, especially in the frontal lobe and left temporal lobe. The smaller frontal lobe volume in schizophrenia was confirmed for unadjusted volumes and for volumes with adjustment for whole brain volumes. Compared to patients with good outcomes, patients with poor outcomes (Kraepelinian schizophrenia) had significantly smaller gray matter volumes in the temporal and occipital lobes, but no difference between groups was found for total frontal lobe volume. Only 21% of the healthy subjects had volumes 0.5 standard deviations below the mean for healthy subjects in any area of the frontal or temporal lobes, compared with 62% of poor-outcome patients. Conclusions: Poor outcome in patients with schizophrenia may be associated with a more posterior distribution (posteriorization) of gray matter deficits across widely distributed cortical regions. C1 CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. RP Mitelman, SA (reprint author), CUNY Mt Sinai Sch Med, Dept Psychiat, Box 1505,1 Gustave L Levy Pl, New York, NY 10029 USA. FU NIMH NIH HHS [MH-60023, MH-42827, MH-56140, MH-56489, MH-60384] NR 60 TC 83 Z9 88 U1 1 U2 3 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD DEC PY 2003 VL 160 IS 12 BP 2154 EP 2168 DI 10.1176/appi.ajp.160.12.2154 PG 15 WC Psychiatry SC Psychiatry GA 748VN UT WOS:000186881900015 PM 14638586 ER PT J AU Lewinsohn, DA Heinzel, AS Gardner, JM Zhu, LQ Alderson, MR Lewinsohn, DM AF Lewinsohn, DA Heinzel, AS Gardner, JM Zhu, LQ Alderson, MR Lewinsohn, DM TI Mycobacterium tuberculosis-specific CD8(+) T cells preferentially recognize heavily infected cells SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE antigen presentation; CD4-positive T lymphocytes; CD8-positive T lymphocytes; cytotoxic T lymphocytes ID INTERFERON-GAMMA; CYTOLYTIC MECHANISMS; MACROPHAGE APOPTOSIS; MICE DEFICIENT; IN-VITRO; RESISTANCE; LYMPHOCYTES; RESPONSES; PERFORIN; CD4(+) AB Both CD4(+) and CD8(+) T cells are important for successful immunity to tuberculosis and have redundant effector functions, such as cytolysis and release of potent antimycobacterial cytokines such as interferon-gamma and tumor necrosis factor-alpha. We hypothesized that CD8(+) T cells play a unique role in host defense to Mycobacterium tuberculosis infection as well. Possibilities include preferential and/or enhanced release of granular constituents and/or preferential recognition of heavily infected cells. Utilizing human, Mycobacterium tuberculosis-specific, CD4(+) and CD8(+) T cell clones, we demonstrate that, after recognition of antigen-presenting cells displaying peptide antigen, CD4(+) T cells preferentially release interferon-gamma, whereas CD8(+) T cells preferentially lyse antigen-presenting cells. Furthermore, utilizing dendritic cells infected with Mycobacterium tuberculosis expressing green fluorescent protein, we show that CD8(+) T cells preferentially recognize heavily infected cells that constitute the minority of infected cells. These data support the hypothesis that the central role of CD8(+) T cells in the control of infection with Mycobacterium tuberculosis may be that of surveillance; in essence, recognition of cells in which the containment of Mycobacterium tuberculosis is no longer effective. C1 Oregon Hlth Sci Univ, Dept Pediat, CDRCP, Div Infect Dis, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Pediat, CDRCP, Div Infect Dis, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Mol Microbiol & Immunol, Vaccine & Gene Therapy Ctr, Div Infect Dis, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Med, Div Pulm & Crit Care Med, Portland, OR 97201 USA. Corixa Corp, Seattle, WA USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Lewinsohn, DA (reprint author), Oregon Hlth Sci Univ, Dept Pediat, CDRCP, Div Infect Dis, 707 SW Gaines Rd, Portland, OR 97239 USA. RI Lewinsohn, David/I-4936-2013 OI Lewinsohn, David/0000-0001-9906-9494 FU NIAID NIH HHS [R01AI48090, 1KO8AI01645, 1K08AI01644]; NICHD NIH HHS [HD33703] NR 55 TC 72 Z9 75 U1 1 U2 7 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD DEC 1 PY 2003 VL 168 IS 11 BP 1346 EP 1352 DI 10.1164/rccm.200306-837OC PG 7 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 747KU UT WOS:000186804300018 PM 12969871 ER PT J AU Gowda, V Roberts, M Wolfe, R Klaustermeyer, WB AF Gowda, V Roberts, M Wolfe, R Klaustermeyer, WB TI Recurrent cough and normal sweat chloride test SO ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY LA English DT Article ID ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS; CYSTIC-FIBROSIS; HEREDITARY PANCREATITIS; CFTR; MUTATION; GENE; PHENOTYPES; DIAGNOSIS; PATIENT C1 Univ Calif Los Angeles, Div Allergy & Immunol 111R, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med,David Geffen Sch Med, Los Angeles, CA 90073 USA. RP Klaustermeyer, WB (reprint author), Univ Calif Los Angeles, Div Allergy & Immunol 111R, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med,David Geffen Sch Med, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 25 TC 1 Z9 1 U1 0 U2 0 PU AMER COLL ALLERGY ASTHMA IMMUNOLOGY PI ARLINGTON HTS PA 85 WEST ALGONQUIN RD SUITE 550, ARLINGTON HTS, IL 60005 USA SN 1081-1206 J9 ANN ALLERG ASTHMA IM JI Ann. Allergy Asthma Immunol. PD DEC PY 2003 VL 91 IS 6 BP 527 EP 530 PG 4 WC Allergy; Immunology SC Allergy; Immunology GA 757KF UT WOS:000187561000006 PM 14700435 ER PT J AU Zeiss, CR Gomaa, A Murphy, FM Weissman, DN Hodgson, M Foster, D Dejativongse, S Colella, K Kestenberg, K Kurup, VP Bush, RK Chiu, AM Kelly, KJ Fink, JN AF Zeiss, CR Gomaa, A Murphy, FM Weissman, DN Hodgson, M Foster, D Dejativongse, S Colella, K Kestenberg, K Kurup, VP Bush, RK Chiu, AM Kelly, KJ Fink, JN TI Latex hypersensitivity in Department of Veterans Affairs health care workers: glove use, symptoms, and sensitization SO ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY LA English DT Article ID NATURAL-RUBBER LATEX; ALLERGY; PREVALENCE; PERFORMANCE AB Background: This report of the prevalence of latex glove allergy in 3 Department of Veterans Affairs (VA) medical centers was a collaboration of the VA, the Centers for Disease Control and Prevention, and the National Institute for Occupational Safety and Health. Objective: To enroll and evaluate personnel from across the entire hospital workforce for latex hypersensitivity and to determine the type and extent of latex glove use. Methods: A questionnaire was administered that covered demographics, job category, latex glove use, and current latex glove allergic symptoms. Skin testing to aeroallergens was performed to evaluate the presence of atopy. Blood was drawn for analyses of serum antilatex IgE antibody by CAP assay. Results: Of 1,959 subjects, 158 (8.1%) had latex glove-allergic symptoms, a positive latex CAP assay result, or both. In 1,003 subjects who reported latex glove use, 915 (91.4%) used nonpowdered gloves. A total of 133 subjects reported latex glove allergic symptoms, and 36 subjects had positive CAP assay results. Latex sensitization was correlated with atopy, race, and latex glove exposure. Latex symptoms were correlated with atopy, a positive CAP assay result, and latex glove exposure. Of the 133 subjects with latex glove allergic symptoms, only 11 had positive CAP assay results, giving a prevalence of confirmed latex glove allergy of 0.6%. Conclusions: Symptoms attributed to latex gloves and/or latex sensitization occurred in 8.1% of the employee population, with exposure, race, and atopy being the major risk factors. Few symptomatic individuals were sensitized to latex (0.6%). This low rate of confirmed latex glove allergy may have been related to nonpowdered glove use. C1 VA Chicago Hlth Care Syst, Lakeside Div, Chicago, IL 60611 USA. Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA. Univ Wisconsin, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. Med Coll Wisconsin, Milwaukee, WI 53226 USA. Zablocki Vet Adm Med Ctr, Milwaukee, WI 53295 USA. Vet Hlth Adm, Washington, DC USA. NIOSH, Ctr Dis Control & Prevent, Morgantown, WV USA. Northwestern Univ, Fineberg Sch Med, Chicago, IL 60611 USA. RP Zeiss, CR (reprint author), VA Chicago Hlth Care Syst, Lakeside Div, Room 160,333 E Huron St, Chicago, IL 60611 USA. NR 19 TC 9 Z9 9 U1 0 U2 1 PU AMER COLL ALLERGY ASTHMA IMMUNOLOGY PI ARLINGTON HTS PA 85 WEST ALGONQUIN RD SUITE 550, ARLINGTON HTS, IL 60005 USA SN 1081-1206 J9 ANN ALLERG ASTHMA IM JI Ann. Allergy Asthma Immunol. PD DEC PY 2003 VL 91 IS 6 BP 539 EP 545 PG 7 WC Allergy; Immunology SC Allergy; Immunology GA 757KF UT WOS:000187561000008 PM 14700437 ER PT J AU Netscher, DT Eladoumikdachi, F AF Netscher, DT Eladoumikdachi, F TI Two case reports of pollicization of a previously syndactylized index finger for congenitally absent thumb SO ANNALS OF PLASTIC SURGERY LA English DT Article ID RECONSTRUCTION AB Two patients with absent thumbs and complicated syndactyly were successfully treated by pollicization of the index finger. Prior surgical release of the index finger syndactyly and then pollicization of that digit carries with it an increased risk of neurovascular compromise, adverse placement of surgical scars, and a stiff or unstable thumb. With caution, very satisfying reconstructive results can nonetheless be attained. C1 Baylor Coll Med, Div Plast Surg, Houston, TX 77030 USA. Plast Surg Serv, Dept Vet Affairs Med Ctr, Houston, TX USA. RP Netscher, DT (reprint author), 6560 Fannin,Suite 800, Houston, TX 77030 USA. NR 11 TC 4 Z9 4 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0148-7043 J9 ANN PLAS SURG JI Ann. Plast. Surg. PD DEC PY 2003 VL 51 IS 6 BP 607 EP 610 DI 10.1097/01.SAP.0000067962.03244.D6 PG 4 WC Surgery SC Surgery GA 752QL UT WOS:000187178600017 PM 14646659 ER PT J AU Yarbrough, WM Mukherjee, R Escobar, GP Hendrick, JW Sample, JA Dowdy, KB McLean, JE Mingoia, JT Crawford, FA Spinale, FG AF Yarbrough, WM Mukherjee, R Escobar, GP Hendrick, JW Sample, JA Dowdy, KB McLean, JE Mingoia, JT Crawford, FA Spinale, FG TI Modulation of calcium transport improves myocardial contractility and enzyme profiles after prolonged ischemia-reperfusion SO ANNALS OF THORACIC SURGERY LA English DT Article ID EXCHANGE INHIBITOR CARIPORIDE; PORCINE HEARTS; INFARCT SIZE; INJURY; PROTECTION; THERAPY; TRIAL AB Background. Ischemia-reperfusion (IR) injury causes myocardial dysfunction in part through intracellular calcium overload. A recently described pharmacologic compound, MCC-135 (5-methyl-2[1-piperazinyl] benzenesulfonic acid monohydrate, Mitsubishi Pharma Corporation), alters intracellular calcium levels. This project tested the hypothesis that MCC-135 would influence regional myocardial contractility when administered at reperfusion and after a prolonged period of ischemia. Methods. A circumflex snare and sonomicrometry crystals within remote and area-at-risk regions were placed in pigs (n = 18, 32 kg). Coronary occlusion was instituted for 120 minutes followed by 180 minutes of reperfusion. At 105 minutes of ischemia pigs were randomly assigned to IR only (n = 11) or MCC-135 (IR-MCC [300 mug . kg(-1) . h(-1), n = 7]) administered intravenously. Regional myocardial contractility was determined by calculation of the regional end-systolic pressure-dimension relation (RESPDR [mm Hg/cm]). Myocardial injury was determined by measurement of plasma levels of myocyte-specific enzymes. Results. At 90 minutes ischemia, mean troponin-I was 35 +/- 8 ng/mL with no significant difference between groups. At 180 minutes reperfusion, heart rate was increased by 18% +/- 5% in the IR only group (p < 0.05) and was reduced by 11% +/- 4% with IR-MCC (p < 0.05). At 90 minutes ischemia RESPDR was reduced from baseline by 51% +/- 6% (P < 0.05). By 30 minutes reperfusion, reductions in RESPDR were attenuated with IR-MCC compared with IR only values. The CK-MB levels were increased at 180 minutes reperfusion in the IR only group (52 +/- 9 ng/mL) compared with baseline (6 +/- 1 ng/mL, p < 0.05) but were attenuated with IR-MCC (24 +/- 4 ng/mL, p < 0.05) compared with IR only values. Conclusions. Despite similar degrees of injury at 90 minutes ischemia MCC-135 improved regional contractility and reduced the egress of CK-MB. Moreover MCC-135 was associated with decreased heart rate, a determinant of myocardial oxygen demand. Pharmacologic modulation of calcium transport ameliorates myocardial dysfunction in the acute IR period. (C) 2003 by The Society of Thoracic Surgeons. C1 Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29425 USA. Ralph H Johnson Vet Assoc Med Ctr, Charleston, SC USA. RP Spinale, FG (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Strom Thurmond Res Bldg,770 MUCS Complex,Suite 62, Charleston, SC 29425 USA. FU NHLBI NIH HHS [HL-97012, HL-07260, HL-45024] NR 24 TC 12 Z9 13 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD DEC PY 2003 VL 76 IS 6 BP 2054 EP 2061 DI 10.1016/S0003-4975(03)01059-2 PG 8 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 750JA UT WOS:000186986500059 PM 14667641 ER PT J AU Vallieres, E Gonzalez, X Pedersen, KM Sears, GK Springmeyer, SC AF Vallieres, E Gonzalez, X Pedersen, KM Sears, GK Springmeyer, SC TI Novel surgical system for reducing lung tissue and preventing air leaks SO ANNALS OF THORACIC SURGERY LA English DT Article ID VOLUME REDUCTION SURGERY; RESECTION; EMPHYSEMA; DISEASE AB Purpose. This study assessed the feasibility of using the VALR surgical system (Spiration Inc, Redmond, WA), limited by federal law to investigational use, for capturing and reducing a selected portion of affected lobes in patients undergoing lobectomy. Description. The tested system consists of a hand-held vacuum-regulated introducer loaded with a flexible, silicone sleeve. Targeted tissue is drawn into the introducer and the silicone sleeve is deployed and sutured in place. The end of the proximal sleeve includes a compression band for applying uniform radial pressure, suture ports, and silicone lugs lining the inner lumen for reinforcing sleeve position. Evaluation. The system was effective in capturing 25% to 30% tissue of each lobe tested. Mean intraoperative test time was 8.5 minutes. The compression sleeve did not slip or dislodge after suturing, and no tissue damage or leaks were observed. Conclusions. It was feasible using vacuum to draw and isolate a portion of pulmonary tissue within a silicone sleeve. The system was intuitive to apply, easy to use, and produced effective reduction and sealing of tissue. (C) 2003 by The Society of Thoracic Surgeons. C1 Univ Washington, Vet Affairs Puget Sound Healthcare Syst, Div Cardiothorac Surg, Seattle, WA 98195 USA. RP Vallieres, E (reprint author), Univ Washington, Vet Affairs Puget Sound Healthcare Syst, Div Cardiothorac Surg, Box 356310, Seattle, WA 98195 USA. OI Vallieres, Eric/0000-0003-1732-2658 NR 10 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD DEC PY 2003 VL 76 IS 6 BP 2071 EP 2074 DI 10.1016/S0003-4975(03)00900-7 PG 4 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 750JA UT WOS:000186986500063 PM 14667645 ER PT J AU Andes, D Craig, WA AF Andes, D Craig, WA TI Pharmacodynamics of the new des-F(6)-quinolone garenoxacin in a murine thigh infection model SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID STREPTOCOCCUS-PNEUMONIAE; CIPROFLOXACIN; RESISTANCE; BMS-284756; PARAMETERS; QUINOLONE AB Garenoxacin is a new des-F(6)-quinolone with broad-spectrum activity against both gram-positive cocci and gram-negative bacilli. We used the neutropenic murine thigh infection model to characterize the time course of antimicrobial activity of garenoxacin and determine which pharmacokinetic-pharmacodynamic (PK-PD) parameter best correlated with efficacy. Serum drug levels following three fourfold-escalating single-dose levels of garenoxacin were measured by microbiologic assay. In vivo postantibiotic effects (PAEs) were determined after doses of 16 and 64 mg/kg of body weight. Mice had 10(6.5) to 10(6.7) CFU of Streptococcus pneumoniae strain ATCC 10813 or Staphylococcus aureus strain ATCC 33591 per thigh when they were treated for 24 h with garenoxacin at a dose of 4 to 128 mg/kg/day fractionated for 3-, 6-, 12-, and 24-hour dosing regimens. Nonlinear regression analysis was used to determine which PK-PD parameter best correlated with the measurement of CFU/thigh at 24 h. Pharmacokinetic studies yielded peak/dose values of 0.2 to 0.3, area under the concentration-time curve (AUC)/dose values of 0.1 to 0.5, and half-lives of 0.7 to 1.6 h. Garenoxacin produced in vivo PAEs of 1.4 to 8.2 h with S. pneumoniae ATCC 10813, 7.6 to > 12.4 h with S. aureus ATCC 25923, and 0 to 1.5 h with Klebsiella pneumoniae ATCC 43816. The 24-h AUC/MIC ratio was the PK-PD parameter that best correlated with efficacy (R-2 = 71 to 90% for the two organisms compared with 43 to 56% for the peak/MIC ratio and 47 to 75% for percent time above the MIC [% T>MIC]). In subsequent studies we used the neutropenic murine thigh infection model to determine if the magnitude of the AUC/MIC ratio needed for efficacy of garenoxacin varied among pathogens (including resistant strains). Mice had 10(5.9) to 10(7.2) CFU of 6 strains of S. aureus (2 methicillin resistant), 11 strains of S. pneumoniae (5 penicillin susceptible, 1 penicillin intermediate, and 5 penicillin resistant, and of the resistant strains, 3 were also ciprofloxacin resistant), and 4 gram-negative strains per thigh when treated for 24 h with 1 to 64 mg of garenoxacin per kg every 12 h. A sigmoid dose-response model was used to estimate the doses (mg/kg/24 h) required to achieve a net bacteriostatic effect over 24 h. MICs ranged from 0.008 to 4 mug/ml. The free drug 24-h AUC/MIC ratios for each static dose (2.8 to 128 mg/kg/day) varied from 8.2 to 145. The mean 24-h AUC/MIC ratios +/- standard deviations for S. pneumoniae, S. aureus, and gram-negative strains were 33 +/- 18, 81 +/- 37, and 33 +/- 30, respectively. Methicillin, penicillin, or ciprofloxacin resistance did not alter the magnitude of the AUC/MIC ratio required for efficacy. C1 Univ Wisconsin, Sch Med, Dept Med, Infect Dis Sect, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Dept Med, Clin Pharmacol Sect, Madison, WI USA. RP Andes, D (reprint author), Univ Wisconsin, Sch Med, Dept Med, Infect Dis Sect, Room H4-570,600 Highland Ave, Madison, WI 53792 USA. NR 18 TC 37 Z9 38 U1 0 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD DEC PY 2003 VL 47 IS 12 BP 3935 EP 3941 DI 10.1128/AAC.47.12.3935-3941.2003 PG 7 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 749LG UT WOS:000186921500041 PM 14638504 ER PT J AU Eibling, DE AF Eibling, DE TI To go home again SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Editorial Material C1 Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15213 USA. RP Eibling, DE (reprint author), Univ Pittsburgh, VA Pittsburgh Healthcare Syst, 200 Lothrop St,Suite 500, Pittsburgh, PA 15213 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0886-4470 J9 ARCH OTOLARYNGOL JI Arch. Otolaryngol. Head Neck Surg. PD DEC PY 2003 VL 129 IS 12 BP 1267 EP 1267 DI 10.1001/archotol.129.12.1267 PG 1 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 752QK UT WOS:000187178500001 ER PT J AU Rosenthal, MJ Felton, RM Nastasi, AE Naliboff, BD Harker, J Navach, JH AF Rosenthal, MJ Felton, RM Nastasi, AE Naliboff, BD Harker, J Navach, JH TI Healing of advanced pressure ulcers by a generic total contact seat: 2 randomized comparisons with low air loss bed treatments SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE beds; pressure; pressure ulcers; rehabilitation ID SORES; COMPLICATIONS; PREVENTION; THERAPY; REST AB Objective: To compare a therapeutic seat with low air loss bed treatment for healing rates of stage III and IV pressure ulcers. Design: Randomized prospective cohort study. Setting: Long-term care facilities. Participants: Two hundred seven subjects with stage III or IV pressure ulcers. Intervention: Two separate randomized control studies of advanced pressure ulcers that compared wound healing on 3 different support surfaces. Subjects were allocated to low air loss bed, upgraded bed overlay (only in study 1), or 4h/d sitting on an experimental generic total contact seat. The seat was designed using prosthetics principles aimed at distributing pressure off bony prominences onto. less pressure-sensitive areas. Subjects were followed for 6 months or until they were totally healed. Main Outcome Measures: Number of subjects who totally healed, time to total healing, and pressure ulcer status score after 4 weeks of treatment. Interface pressures and functional capacity were also measured at 4 weeks. Results: In study 1, 3 subjects worsened on the bed overlay condition and were withdrawn from the study. None worsened on low air loss or generic total contact seat. At 4 weeks in both studies, pressure ulcer status score was lowest for the generic total contact seat (P<.0001), compared with the other surfaces. Subject populations were similar, so to analyze total healing, results from both studies were combined. Total healing of pressure ulcers occurred as early as 4 weeks in some subjects using the generic total contact seat. Even at 8 weeks, total healing was primarily seen with use of that seat, on which interface pressures, function, and seating tolerance were best. Conclusions: Faster healing and better function indicate that treatment using the generic total contact seat is superior to low air loss bed therapy, which is standard care for advanced pressure ulcers. C1 Greater Los Angeles VAMC, Ctr Geriatr Res Educ & Clin, Sepulveda, CA USA. Greater Los Angeles VAMC, Spinal Cord Injury Disorders Serv, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Div Geriatr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Biomed Technol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Div Phys Med & Rehabil, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Rosenthal, MJ (reprint author), GRECC 11E, 16111 Plummer St, Sepulveda, CA 91343 USA. NR 26 TC 4 Z9 5 U1 2 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD DEC PY 2003 VL 84 IS 12 BP 1733 EP 1742 DI 10.1016/S0003-9993(03)00435-0 PG 10 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 751JY UT WOS:000187064400001 PM 14669176 ER PT J AU da Cunha, IT Henson, H Qureshy, H Williams, AL Holmes, SA Protas, EJ AF da Cunha, IT Henson, H Qureshy, H Williams, AL Holmes, SA Protas, EJ TI Differential responses to measures of gait performance among healthy and neurologically impaired individuals SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE cerebrovascular accident; gait; oxygen consumption; rehabilitation; spinal cord injuries ID 6-MINUTE WALK TEST; OXYGEN-UPTAKE; HEART-RATE; STROKE PATIENTS; AMBULATION; EXERCISE; REHABILITATION; IMPAIRMENTS; PARAPLEGIA AB Objectives: To compare gait during a 5-minute walk among healthy individuals, persons with spinal cord injury (SCI), and stroke survivors and to investigate whether simultaneous measures of oxygen consumption enhance information about performance. Design: Descriptive study. Setting: Veterans Affairs medical center. Participants: Thirty-nine healthy individuals, 10 persons with SCI, and 20 stroke survivors. Interventions: Participants were fitted with a portable gas analyzer and walked on a 5-m walkway for 5 minutes. Main Outcome Measures: Measures of walk distance, gait speed, gait energy expenditure (GEE), and gait cost were obtained, along with measures of ventilation ((V) over dot E), ventilation and carbon dioxide production slope ((V) over dot E.(V) over dot CO2), oxygen pulse, and heart rate. Results: The SCI group (127.65 +/- 81.74m) walked less than the stroke survivors (148.80+/-64.3m) or the healthy group (268.90+/-35.01m) but had higher energy demands, as shown by GEE (SCI group, 13.28 +/- 3.23mL.kg(-1).min(-1); stroke group, 10.18 +/- 2.14mL.kg(-1).min(-1); healthy group, 9.61 +/- I.90mL.kg(-1).min(-1)) and by gait cost (SCI group,.57+/-.40 mL.kg(-1).m(-1); stroke group, .40+/-.52mL.kg(-1).m(-1); healthy group,. 18+/-.02mL.kg(-1).m(-1)). Compared with the healthy group, the stroke group had higher (V) over dot E (stroke group, 22,34+/-5.20L/min vs healthy group, 16.11+/-3.22L/min) and (V) over dot E.(V) over dot CO2 slope (24.22 +/- 8.80 vs 18.73+/-5.44, respectively). Conclusion: Use of metabolic assessment during the 5-minute walk was feasible and provided further information for evaluating gait performance with the subjects studied. C1 Univ Texas, Med Branch, Dept Phys Therapy, Galveston, TX 77555 USA. Texas Womans Univ, Sch Phys Therapy, Houston, TX USA. Houston Vet Affairs Med Ctr, Phys Med & Rehabil Serv, Houston, TX USA. Houston Vet Affairs Med Ctr, Spinal Cord Injury Serv, Houston, TX USA. Houston Vet Affairs Med Ctr, Rehabil Res & Dev Ctr Excellence Healthy Aging Di, Houston, TX USA. UNI BH, Belo Horizonte, MG, Brazil. RP Protas, EJ (reprint author), Univ Texas, Med Branch, Dept Phys Therapy, 301 Univ Blvd, Galveston, TX 77555 USA. NR 23 TC 9 Z9 9 U1 1 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD DEC PY 2003 VL 84 IS 12 BP 1774 EP 1779 DI 10.1016/S0003-9993(03)00373-3 PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 751JY UT WOS:000187064400007 ER PT J AU Corfman, TA Cooper, RA Fitzgerald, SG Cooper, R AF Corfman, TA Cooper, RA Fitzgerald, SG Cooper, R TI Tips and falls during electric-powered wheelchair driving: Effects of seatbelt use, legrests, and driving speed SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE accidental falls; rehabilitation; safety; wheelchairs ID UNITED-STATES; ACCIDENTS; DUMMY AB Objective: To measure the response of a test dummy while traversing common obstacles encountered by users of electric-powered wheelchairs (EPWs) to determine whether optimal wheelchair fit, use of seatbelts, and driving speed affect the frequency and severity of EPW tips and falls. Design: Repeated-measures comparison study. Setting: Constructed environment both in and around a Veterans Affairs medical center. Participant: A 50th percentile Hybrid II anthropometric test dummy (ATD) was used to simulate a person driving an EPW. Interventions: The ATD was driven in 4 different EPWs over commonly encountered obstacles at speeds of 1 and 2m/s, with and without the use of a seatbelt, and at varying legrest heights. Main Outcome Measures: The response and motion of the ATD were observed and recorded as no fall, loss of control (the ATD falls forward or sideways but remains in the EPW), the ATD falls out of the EPW, or the EPW tips completely. Results: A total of 97 adverse events out of 1700 trials were recorded: 88 were losses of control (instability) and 9 were ATD falls. No complete tips of any EPW occurred. Univariate statistical analysis indicated a significant relationship between the adverse events and the use of seatbelts, legrest condition, and test obstacles (P<.05). A mixed-model analysis confirmed the significant relationships between the adverse events and the use of seatbelts, legrest condition, and test obstacles (P<.05). However, the mixed model indicated that (1) there was no significant relationship between the adverse events and driving speed and (2) no one obstacle was designated to be the most problematic. Conclusion: Persons who use EPWs should use seatbelts and legrests while driving their EPWs, and clinicians should include common driving tasks when assessing the proper set-up of EPWs. C1 Univ Pittsburgh, Dept Rehabil Sci & Technol Phys Med & Rehabil & B, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R1, VA Ctr Excellence Wheelchairs & Related Technol, 7180 Highland Dr, Pittsburgh, PA 15261 USA. FU ODCDC CDC HHS [R49/CCR 310285-04] NR 20 TC 20 Z9 20 U1 1 U2 4 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD DEC PY 2003 VL 84 IS 12 BP 1797 EP 1802 DI 10.1016/S0003-9993(03)00467-2 PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 751JY UT WOS:000187064400011 PM 14669186 ER PT J AU Goldstein, JL Gibofsky, A Eisen, G Lewis, B Gralnek, I Fort, JG Zlotnick, S Simms, L AF Goldstein, JL Gibofsky, A Eisen, G Lewis, B Gralnek, I Fort, JG Zlotnick, S Simms, L TI Small bowel mucosal lesions and drug tolerability with naproxen plus omeprazole, celecoxib and placebo in healthy subjects using capsule endoscopy: Results from a double-blind, randomized, controlled trial. SO ARTHRITIS AND RHEUMATISM LA English DT Meeting Abstract CT 67th Annual Scientific Meeting of the American-College-of-Rheumatology/38th Annual Scientific Meeting of the Association-of-Rheumatology-Health-Professionals CY OCT 23-28, 2003 CL ORLANDO, FLORIDA C1 Univ Chicago, Chicago, IL 60637 USA. New York Weill Cornell Med Ctr, New York, NY USA. Vanderbilt Univ, Nashville, TN USA. Mt Sinai Med Ctr, New York, NY 10029 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Pfizer Inc, Peapack, NJ USA. Pfizer, Markham, ON, Canada. NR 0 TC 2 Z9 2 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0004-3591 J9 ARTHRITIS RHEUM JI Arthritis Rheum. PD DEC PY 2003 VL 48 IS 12 BP 3662 EP 3662 PG 1 WC Rheumatology SC Rheumatology GA 752QR UT WOS:000187179100119 ER PT J AU Ding, D Cooper, RA Kaminski, BA Kanaly, JR Allegretti, A Chaves, E Hubbard, S AF Ding, D Cooper, RA Kaminski, BA Kanaly, JR Allegretti, A Chaves, E Hubbard, S TI Integrated control and related technology of assistive devices SO ASSISTIVE TECHNOLOGY LA English DT Review DE assistive device; integrated control; computer access; environment control unit; wheelchair guidance ID HANDICAPPED PEOPLE; SYSTEM; MOBILITY; DISABILITIES; WHEELCHAIRS; INTERFACE AB Assistive devices are now available that allow persons with severe physical disabilities to complete tasks independently. When the user has severe physical limitations, it may be advantageous to have an integrated control system where a single control interface (e.g., joystick, head switches, voice recognition system, keypad) is used to operate two or more assistive devices (e.g., power wheelchairs, augmentative communication devices, computers, environmental control units, and other devices that are controlled electronically). The advantages of integrated control are that persons with limited motor control can access several devices with one access site without assistance, and the user does not need to learn a different operating mechanism for each device. The purpose of this review is to convey the depth and breadth of the research that has been conducted on integrated control systems, as well as to provide some insights into future directions. We reviewed research works pertaining to communication and environmental control, computer access, and wheelchair guidance systems. Information gathered in this study will help people become fully aware of the status of contemporary integrated control technology in order to increase the quality of life of people who use electronic assistive devices. C1 Human Engn Res Labs, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Technol, Pittsburgh, PA 15260 USA. RP Cooper, RA (reprint author), Human Engn Res Labs, VA Pittsburgh Healthcare Syst, 151-R1,7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 53 TC 19 Z9 19 U1 1 U2 8 PU R E S N A PRESS PI ARLINGTON PA 1700 MOORE ST, STE 1540, ARLINGTON, VA 22209-1903 USA SN 1040-0435 J9 ASSIST TECHNOL JI Assist. Technol. PD WIN PY 2003 VL 15 IS 2 BP 89 EP 97 PG 9 WC Rehabilitation SC Rehabilitation GA 883OM UT WOS:000226022600001 PM 15137725 ER PT J AU Guo, SF Cooper, RA Corfman, T Ding, D Grindle, G AF Guo, SF Cooper, RA Corfman, T Ding, D Grindle, G TI Influence of wheelchair front caster wheel on reverse directional stability SO ASSISTIVE TECHNOLOGY LA English DT Article DE electric powered wheelchair; wheelchair reverse directional stability; caster wheel orientation; motor back-emf ID UNITED-STATES; ACCIDENTS; USERS AB The purpose of this research was to study directional stability during reversing of rear-wheel drive, electric-powered wheelchairs (EPW) under different initial front caster orientations. Specifically, the weight distribution differences caused by certain initial caster orientations were examined as a possible mechanism for causing directional instability that could lead to accidents. Directional stability was quantified by measuring the drive direction error of the EPW by a motion analysis system. The ground reaction forces were collected to determine the load on the front casters, as well as back-emf data to attain the speed of the motors. The drive direction error was found to be different for various initial caster orientations. Drive direction error was greatest when both casters were oriented 90degrees to the left or right, and least when both casters were oriented forward. The results show that drive direction error corresponds to the loading difference on the casters. The data indicates that loading differences may cause asymmetric drag on the casters, which in turn causes unbalanced torque load on the motors. This leads to a difference in motor speed and drive direction error. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, SHRS, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. RP Guo, SF (reprint author), VA Pittsburgh Healthcare Syst, 7180 Highland Dr 151R-1, Pittsburgh, PA 15206 USA. NR 15 TC 3 Z9 3 U1 1 U2 2 PU R E S N A PRESS PI ARLINGTON PA 1700 MOORE ST, STE 1540, ARLINGTON, VA 22209-1903 USA SN 1040-0435 J9 ASSIST TECHNOL JI Assist. Technol. PD WIN PY 2003 VL 15 IS 2 BP 98 EP 104 PG 7 WC Rehabilitation SC Rehabilitation GA 883OM UT WOS:000226022600002 PM 15137726 ER PT J AU Fitzgerald, SG Arva, J Cooper, RA Dvorznak, MJ Spaeth, DM Boninger, ML AF Fitzgerald, SG Arva, J Cooper, RA Dvorznak, MJ Spaeth, DM Boninger, ML TI A pilot study on community usage of a pushrim-activated, power-assisted wheelchair SO ASSISTIVE TECHNOLOGY LA English DT Article DE wheelchairs; propulsion; driving characteristics ID PROPULSION; USERS; PERFORMANCE; PEDOMETER; LIFE; PAIN AB Manual wheelchair propulsion combined with other stresses to the upper extremities may result in secondary injury. Possible solutions would be to devise alternative methods of propulsion, such as a pushrim-activated, power-assist wheelchair (PAPAW). The goals of this study were to examine the usage of the PAPAW in a real world setting and to characterize the driving habits of manual wheelchair users. Feedback was also obtained regarding subjects' opinions with respect to the PAPAW: their likes and dislikes. A PAPAW was provided to subjects for 2 weeks. Usage (average and total distance traveled and velocity) was tracked for both the PAPAW and the subjects' own wheelchairs. Significant differences in usage were not seen between the personal wheelchairs or the PAPAW. As a result, weeks were combined to provide an overall examination of driving characteristics. The average distance traveled over an average day was 1,671.4 +/- 314.8 m with an average velocity of 0.44 +/- 0.09 m/second. This pilot study provides an idea of manual wheelchair usage in a population of individuals with spinal cord injury. The lack of significant findings between the PAPAW and the subjects' own wheelchairs may be a function of study methodology such as sample size and length of follow-up in the new wheelchair. Future studies should expand upon the pilot work completed here, strengthening the design. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Ctr, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. Permobil Inc, Nashville, TN USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15260 USA. RP Fitzgerald, SG (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Ctr, 151-R1,7180 Highland Dr, Pittsburgh, PA 15206 USA. OI Boninger, Michael/0000-0001-6966-919X NR 24 TC 14 Z9 14 U1 2 U2 4 PU R E S N A PRESS PI ARLINGTON PA 1700 MOORE ST, STE 1540, ARLINGTON, VA 22209-1903 USA SN 1040-0435 J9 ASSIST TECHNOL JI Assist. Technol. PD WIN PY 2003 VL 15 IS 2 BP 113 EP 119 PG 7 WC Rehabilitation SC Rehabilitation GA 883OM UT WOS:000226022600004 PM 15137728 ER PT J AU DiGiovine, CP Cooper, RA Wolf, E Fitzgerald, SG Boninger, ML AF DiGiovine, CP Cooper, RA Wolf, E Fitzgerald, SG Boninger, ML TI Analysis of whole-body vibration during manual wheelchair propulsion: A comparison of seat cushions and back supports for individuals without a disability SO ASSISTIVE TECHNOLOGY LA English DT Article DE back supports; manual wheelchair propulsion; seat cushions; seating systems; wheelchairs; whole-body vibration ID VERTICAL VIBRATION; SUSPENSION DESIGN; APPARENT MASS; PAIN; TRANSMISSION; POSTURE; HEAD; DISCOMFORT; EXPOSURE; SUBJECT AB Whole-body vibration exposure has been found to be detrimental to the health of humans owing to effects such as degraded comfort, disc degeneration, and lower back pain. The purpose of this study was to determine if selected seat cushions and back supports minimize the transmission of vibrations during manual wheelchair propulsion. Ten unimpaired participants traversed an activities of daily living course using four seat cushions and four back supports. Vibrations were measured using triaxial accelerometers. The time domain and frequency domain transmissibility was used to determine if differences exist among seat cushions and back supports. Differences were found among the four seat cushions and four back supports. Seat cushion and back support manufacturers should concentrate on single-event shocks and repeated shocks, as opposed to oscillatory motions and self-generated vibrations, because the vibrations generated by these events tend to reside in the range of frequencies most sensitive to humans. Vibrations in this range of frequencies have the greatest effect on the transmission of whole-body vibration during manual wheelchair propulsion. Differences among the seat cushions and back supports appear to be due to the seat cushion/back support design and postural support. From a clinical perspective, the time domain transmissibility best describes the transmission of whole-body vibration. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Ctr Excellence Wheelchairs & Related Technol, VA Rehabil Res & Dev Ctr, Pittsburgh, PA 15206 USA. Univ Illinois, Dept Disabil & Human Dev, Assist Technol Unit, Chicago, IL 60680 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Ctr Excellence Wheelchairs & Related Technol, VA Rehabil Res & Dev Ctr, 151R-1,7180 Highland Dr, Pittsburgh, PA 15206 USA. RI DiGiovine, Carmen/E-2982-2011 OI Wolf, Erik/0000-0002-6353-7978; Boninger, Michael/0000-0001-6966-919X NR 43 TC 5 Z9 5 U1 0 U2 0 PU R E S N A PRESS PI ARLINGTON PA 1700 MOORE ST, STE 1540, ARLINGTON, VA 22209-1903 USA SN 1040-0435 J9 ASSIST TECHNOL JI Assist. Technol. PD WIN PY 2003 VL 15 IS 2 BP 129 EP 144 PG 16 WC Rehabilitation SC Rehabilitation GA 883OM UT WOS:000226022600006 PM 15137730 ER PT J AU Condray, R Siegle, GJ Cohen, JD van Kammen, DP Steinhauer, SR AF Condray, R Siegle, GJ Cohen, JD van Kammen, DP Steinhauer, SR TI Automatic activation of the semantic network in schizophrenia: Evidence from event-related brain potentials SO BIOLOGICAL PSYCHIATRY LA English DT Article DE schizophrenia; semantic priming; N400; automatic activation ID INFORMATION-PROCESSING DEFICITS; STIMULUS ONSET ASYNCHRONIES; BACKWARD-MASKING; WORD PRONUNCIATION; LEXICAL DECISION; WORKING-MEMORY; ABNORMALITIES; N400; FACILITATION; HALOPERIDOL AB Background: Language disorder associated with schizophrenia might be due to disturbances in both automatic activation and mechanisms of controlled attention. The contribution of each process to semantic memory dysfunction has not been determined for schizophrenia, and the semantic priming paradigm is well-suited for addressing this question. In the present report, event-related potentials (ERPs) elicited under conditions assumed to reveal automatic activation (short prime-target interval and low proportion of related words) are compared directly with ERPs elicited under conditions associated with controlled processing (long prime-target interval and high proportion of related words). Methods: Visual ERPs were recorded during a lexical decision task, in which semantic relationship (associated and unassociated words), expectancy (relatedness proportions), and prime-target interval (250- and 850-msec inter-stimulus intervals (ISIS)) were varied. Diagnosis and expectancy were between-subjects factors; semantic relationship and ISI were repeated measures. The N400 priming effect (enhanced negativity to unassociated words) was compared between 34 male normal control subjects tested once and 37 male schizophrenia inpatients evaluated during their participation in a double-blind haloperidol maintenance therapy and placebo replacement protocol. Results: The N400 priming effect for patients was significantly reduced during both pharmacologic phases, compared with controls. During haloperidol treatment, however, patients showed a significant N400 priming effect over the anterior scalp region and additionally under the automatic activation condition. The N400 priming effect was enhanced under the controlled processing condition for control subjects; this effect was not observed for patients. N400 amplitude elicited under the rapid presentation rate (250-msec ISI) differed between medicated patients and controls; groups did not differ for the 850-msec ISI. Conclusions: Findings suggest that automatic activation and mechanisms of controlled attention are both disrupted during semantic memory access for schizophrenia patients. Pharmacologic agents, such as haloperidol, might enhance automatic activation of the semantic network in this patient population, as indexed by the N400 component of the ERP. C1 Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Healthcare Syst, Highland Dr Div, Pittsburgh, PA USA. Princeton Univ, Dept Psychol, Princeton, NJ 08544 USA. Aventis Pharmaceut, Bridgewater, NJ USA. RP Condray, R (reprint author), Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, 3811 Ohara St, Pittsburgh, PA 15213 USA. FU NIMH NIH HHS [MH50631] NR 50 TC 49 Z9 50 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD DEC 1 PY 2003 VL 54 IS 11 BP 1134 EP 1148 DI 10.1016/S0006-3223(03)00699-1 PG 15 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 747EM UT WOS:000186792300002 PM 14643080 ER PT J AU Means, RT AF Means, RT TI Ras signaling in erythropoiesis: Going with the flow SO BLOOD LA English DT Editorial Material C1 Ralph H Johnson VA Med Ctr, Charleston, SC USA. Med Univ S Carolina, Charleston, SC USA. RP Means, RT (reprint author), Ralph H Johnson VA Med Ctr, Charleston, SC USA. RI Means, Robert/A-4454-2008 NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD DEC 1 PY 2003 VL 102 IS 12 BP 3858 EP 3859 DI 10.1182/blood-2003-09-3181 PG 2 WC Hematology SC Hematology GA 750JH UT WOS:000186987200006 ER PT J AU Knutson, MD Vafa, MR Haile, DJ Wessling-Resnick, M AF Knutson, MD Vafa, MR Haile, DJ Wessling-Resnick, M TI Iron loading and erythrophagocytosis increase ferroportin 1 (FPN1) expression in J774 macrophages SO BLOOD LA English DT Article ID AUTOSOMAL-DOMINANT HEMOCHROMATOSIS; NITRIC-OXIDE; HUMAN MONOCYTES; IDIOPATHIC HEMOCHROMATOSIS; DIFFERENTIAL REGULATION; ERYTHROLEUKEMIA-CELLS; REGULATORY PROTEINS; NATURAL-RESISTANCE; MOLECULAR CONTROL; OXIDATIVE STRESS AB The expression of ferroportin1 (FPN1) in reticuloendothelial macrophages supports the hypothesis that this iron-export protein participates in iron recycling from senescent erythrocytes. To gain insight into FPN1's role in macrophage iron metabolism, we examined the effect of iron status and erythrophagocytosis on FPN1 expression in J774 macrophages. Northern analysis indicated that FPN1 mRNA levels decreased with iron depletion and increased on iron loading. The iron-induced induction of FPN1 mRNA was blocked by actinomycin D, suggesting that transcriptional control was responsible for this effect. After erythrophagocytosis, FPN1 mRNA levels were also upregulated, increasing 8-fold after 4 hours and returning to basal levels by 16 hours. Western analysis indicated corresponding increases in FPN1 protein levels, with maximal induction after 10 hours. Iron chelation suppressed FPN1 mRNA and protein induction after erythrophagocytosis, suggesting that FPN1 induction results from erythrocyte-derived iron. Comparative Northern analyses of iron-related genes after erythrophagocytosis revealed a 16-fold increase in FPN1 levels after 3 hours, a 10-fold increase in heme oxygenase-1 (HO-1) after 3 hours, a 2-fold increase in natural resistance macrophage-associated protein 1 (Nramp1) levels after 6 hours, but no change in divalent metal ion transporter 1 (DMT1) levels. The rapid and strong induction of FPN1 expression after erythrophagocytosis suggests that FPN1 plays a role in iron recycling. (C) 2003 by The American Society of Hematology. C1 Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA. Rafsanjan Univ Med Sci, Dept Social Med, Sch Med, Rafsanjan, Iran. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Audie Murphy Vet Affairs Hosp, S Texas Vet Hlth Syst, San Antonio, TX USA. RP Wessling-Resnick, M (reprint author), Harvard Univ, Sch Publ Hlth, Dept Nutr, Bldg 2,Rm 205,665 Huntington Ave, Boston, MA 02115 USA. FU NIDDK NIH HHS [DK09998, DK56160, DK59429] NR 54 TC 136 Z9 141 U1 0 U2 7 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD DEC 1 PY 2003 VL 102 IS 12 BP 4191 EP 4197 DI 10.1182/blood-2003-04-1250 PG 7 WC Hematology SC Hematology GA 750JH UT WOS:000186987200055 PM 12907459 ER PT J AU Marvizon, JCG Wang, XR Lao, LJ Song, BB AF Marvizon, JCG Wang, XR Lao, LJ Song, BB TI Effect of peptidases on the ability of exogenous and endogenous neurokinins to produce neurokinin 1 receptor internalization in the rat spinal cord SO BRITISH JOURNAL OF PHARMACOLOGY LA English DT Article DE Aminopeptidase; C-fiber; dorsal horn; dipeptidyl carboxypeptidase; EC 3.4.15.1; EC 3.4.24.11; neutral endopeptidase; neurokinin 1 receptor; neurokinin; primary afferent; substance P; tachykinin ID DORSAL-HORN NEURONS; SUBSTANCE-P RELEASE; TACHYKININ NK1 RECEPTOR; ANGIOTENSIN-CONVERTING ENZYME; ENKEPHALIN-DEGRADING ENZYMES; PRIMARY AFFERENT SYNAPSES; CAPSAICIN-EVOKED RELEASE; MIXED INHIBITOR PRODRUG; LONG-TERM DEPRESSION; MU-OPIOID RECEPTOR AB 1 The ability of peptidases to restrict neurokinin I receptor (NK1R) activation by exogenously applied or endogenously released neurokinins was investigated by measuring NK1R internalization in rat spinal cord slices. 2 Concentration-response curves for substance P and neurokinin A were obtained in the presence and absence of 10 muM thiorphan, an inhibitor of neutral endopeptidase (EC 3.4.24.11), plus 10 muM captopril, an inhibitor of dipeptidyl carboxypeptidase (EC 3.4.15.1). These inhibitors significantly decreased the EC50 of substance P to produce NK1R internalization from 32 to 9 rim, and the EC50 Of neurokinin A from 170 to 60 rim. 3 Substance P was significantly more potent than neurokinin A, both with and without these peptidase inhibitors. 4 In the presence of peptidase inhibitors, neurokinin B was 10 times less potent than neurokinin A and 64 times less potent than substance P (EC50 = 573 nM). 5 Several aminopeptidase inhibitors (actinonin, amastatin, bacitracin, bestatin and puromycin) failed to further increase the effect of thiorphan plus captopril on the NK1R internalization produced by 10 nM substance P. 6 Electrical stimulation of the dorsal root produced NK1R internalization by releasing endogenous neurokinins. Thiorphan plus captopril increased NK1R internalization produced by 1 Hz stimulation, but not by 30 Hz stimulation. 7 Therefore, NEN and DCP restrict NK1R activation by endogenous neurokinins when they are gradually released by low-frequency firing of primary afferents, but become saturated or inhibited when primary afferents fire at a high frequency. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med,Div Digest Dis,CURE Digest Dis Res Ctr, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90095 USA. RP Marvizon, JCG (reprint author), Vet Adm Greater Los Angeles Hlth Ctr, Bldg 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDA NIH HHS [R01-DA12609, R01 DA012609] NR 62 TC 13 Z9 13 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0007-1188 J9 BRIT J PHARMACOL JI Br. J. Pharmacol. PD DEC PY 2003 VL 140 IS 8 BP 1389 EP 1398 DI 10.1038/sj.bjp.0705578 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 755PZ UT WOS:000187419400006 PM 14623771 ER PT J AU Freedland, SJ Aronson, WJ Terris, MK Kane, CJ Amling, CL Dorey, F Presti, JC AF Freedland, SJ Aronson, WJ Terris, MK Kane, CJ Amling, CL Dorey, F Presti, JC TI The percentage of prostate needle biopsy cores with carcinoma from the more involved side of the biopsy as a predictor of prostate specific antigen recurrence after radical prostatectomy - Results from the shared equal access regional cancer hospital (SEARCH) database SO CANCER LA English DT Article DE prostate carcinoma; radical prostatectomy; prostate needle biopsy; cores; prostate specific antigen recurrence ID SEXTANT BIOPSIES; EXTRACAPSULAR EXTENSION; BIOCHEMICAL RECURRENCE; INDEPENDENT PREDICTOR; SYSTEMATIC SEXTANT; POSITIVE BIOPSIES; GLEASON SCORE; STAGE; RISK; MEN AB BACKGROUND. The authors previously found that, although the total percentage of prostate needle biopsy cores with carcinoma was a significant predictor of prostate specific antigen (PSA) failure among men undergoing radical prostatectomy (RP), there was a trend toward a lower risk of recurrence in patients with positive bilateral biopsies, suggesting that high-volume, unilateral disease was a worse predictor of outcome than an equivalent number of positive cores distributed over two lobes. In the current study, the authors sought to compare the total percentage of cores with carcinoma directly with the percentage of cores from the more involved or dominant side of the prostate with carcinoma for their ability to predict outcome among men who underwent RP. METHODS. A retrospective survey of 535 patients from the Shared Equal Access Regional Cancer Hospital database who underwent RP at 4 different equal-access medical centers between 1988 and 2002 was undertaken. The total percentage of cores positive was compared with the percentage of cores positive from the dominant and nondominant sides for their ability to predict biochemical recurrence after RP. The best predictor then was compared with the standard clinical variables PSA, biopsy Gleason score, and clinical stage in terms of ability to predict time to PSA recurrence after RIP using multivariate analysis. RESULTS. The adverse pathologic features of positive surgical margins and extracapsular extension were significantly more likely to be ipsilateral to the dominant side on the prostate biopsy. The percentage of cores positive from the dominant side provided slightly better prediction (concordance index [C] = 0.636) for PSA failure than the total percentage of cores positive (C = 0.596) and markedly better than the percentage of cores from the nondominant side (C = 0.509). Cutoff points for percentage of cores positive from the dominant side were identified (< 34%, 34-67%, and > 67%) that provided significant risk stratification for PSA failure (P < 0.001). On multivariate analysis, the percentage of cores positive from the dominant side was the strongest independent predictor of PSA recurrence (P < 0.001). Biopsy Gleason score (P = 0.017) also was a significant, independent predictor of recurrence. There was a trend, which did not reach statistical significance, toward an association between greater PSA values and biochemical failure (P = 0.052). Combining the PSA level, biopsy Gleason score, and percentage of cores positive from the dominant side of the prostate resulted in a model that provided a high degree of prediction for PSA failure (C = 0.671). CONCLUSIONS. The percentage of cores positive from the dominant side of the prostate was a slightly better predictor of PSA recurrence than was the total percentage of cores positive. Using the percentage of cores from the dominant side along with the PSA level and the biopsy Gleason score provided significant risk stratification for PSA failure. Published 2003 by the American Cancer Society. C1 Univ Calif Los Angeles, Dept Urol, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA USA. Vet Affairs Palo Alto Hlth Care Syst, Urol Sect, Palo Alto, CA USA. Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. USN, Ctr Med, Dept Urol, San Diego, CA 92152 USA. Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. RP Freedland, SJ (reprint author), Johns Hopkins Sch Med, Brady Urol Inst, Dept Urol, Marburg 130,600 N Wolfe St, Baltimore, MD 21287 USA. NR 24 TC 29 Z9 33 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD DEC 1 PY 2003 VL 98 IS 11 BP 2344 EP 2350 DI 10.1002/cncr.11809 PG 7 WC Oncology SC Oncology GA 745EU UT WOS:000186677000006 PM 14635068 ER PT J AU Dieter, RS Patel, AK Yandow, D Pacanowski, JP Bhattacharya, A Gimelli, G Kosolcharoen, P Russell, D AF Dieter, RS Patel, AK Yandow, D Pacanowski, JP Bhattacharya, A Gimelli, G Kosolcharoen, P Russell, D TI Conservative vs. invasive treatment of aortocoronary saphenous vein graft aneurysms: treatment algorithm based upon a large series SO CARDIOVASCULAR SURGERY LA English DT Article DE coronary artery bypass graft; saphenous vein graft; aneurysm; treatment; complication ID VENOUS BYPASS GRAFT; CORONARY-ARTERY; COMPUTED-TOMOGRAPHY; FALSE ANEURYSM; RIGHT ATRIUM; DIAGNOSIS; SURGERY; EMBOLIZATION; FISTULA AB Background. The development of a saphenous vein graft aneurysm (SVGA) after coronary artery bypass graft surgery is a rare occurrence. There are approximately 60 cases reported in the literature, the majority being single case reports. There is no consensus on the treatment of SVGA. Methods: Retrospective analysis of the patients treated with SVGA was performed at our institution. Demographic and co-morbidity data were acquired on the patients. Patients who underwent surgical treatment were compared to those treated conservatively with the primary outcome being survival time from diagnosis of the SVGA. Results: Thirteen patients with 15 SVGA were identified. The average age at the time of the most recent coronary artery bypass grafting (CABG) was similar in the conservative and the surgically treated groups (55 vs. 56.5 years, respectively). The average number of grafts per patient at the most recent CABG was similar (3.83 vs. 4.0, respectively). The average time from CABG to diagnosis was similar in both the groups (12.6 vs. IS years, respectively). The average survival from diagnosis was similar in both the groups (2.3 vs. 1.5 years, respectively, p > 0.05). Conclusions: Early surgical treatment of SVGA does not provide longer short-term survival compared with conservative management. A treatment algorithm for SVGA based upon patient co-morbidities and aneurysm characteristics is proposed. (C) 2003 The International Society for Cardiovascular Surgery. Published by Elsevier Ltd. All rights reserved. C1 Univ Wisconsin, Sect Cardiovasc Med, Dept Med, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Cardiol Sect, Madison, WI USA. Univ Wisconsin, Dept Radiol, Madison, WI 53792 USA. Univ Tennessee, Vasc Surg Sect, Knoxville, TN 37996 USA. Univ Wisconsin, Gen Clin Res Ctr, Madison, WI 53792 USA. RP Dieter, RS (reprint author), Univ Wisconsin, Sect Cardiovasc Med, Dept Med, 600 Highland Ave, Madison, WI 53792 USA. FU NHLBI NIH HHS [T32 HL07936] NR 31 TC 31 Z9 31 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0967-2109 J9 CARDIOVASC SURG JI Cardiovasc. Surg. PD DEC PY 2003 VL 11 IS 6 BP 507 EP 513 DI 10.1016/S0967-2109(03)00108-X PG 7 WC Cardiac & Cardiovascular Systems; Surgery SC Cardiovascular System & Cardiology; Surgery GA 752RL UT WOS:000187180900013 PM 14627974 ER PT J AU Heinrich, MC AF Heinrich, MC TI Is KIT an important therapeutic target in small cell lung cancer? Commentary re: B. E. Johnson et al., phase II study of imatinib in patients with small cell lung cancer. Clin. Cancer Res., 9 : 5880-5887, 2003. SO CLINICAL CANCER RESEARCH LA English DT Editorial Material ID GASTROINTESTINAL STROMAL TUMORS; C-KIT; KINASE INHIBITORS; GROWTH; EXPRESSION; MUTATIONS; STI571; ACTIVATION; CARCINOMA; EFFICACY C1 Oregon Hlth Sci Univ, Inst Canc, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Heinrich, MC (reprint author), R&D 19 3710 SW,US Vet Hosp Rd, Portland, OR 97201 USA. NR 26 TC 12 Z9 12 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD DEC 1 PY 2003 VL 9 IS 16 BP 5825 EP 5828 PN 1 PG 4 WC Oncology SC Oncology GA 756FC UT WOS:000187454300004 PM 14676102 ER PT J AU Parada, JP Deloria-Knoll, M Chmiel, JS Arozullah, AM Phan, L Ali, SN Goetz, MB Weinstein, RA Campo, R Jacobson, J Dehovitz, J Berland, D Bennett, CL AF Parada, JP Deloria-Knoll, M Chmiel, JS Arozullah, AM Phan, L Ali, SN Goetz, MB Weinstein, RA Campo, R Jacobson, J Dehovitz, J Berland, D Bennett, CL TI Relationship between health insurance and medical care for patients hospitalized with human immunodeficiency virus-related Pneumocystis carinii pneumonia, 1995-1997: Medicaid, bronchoscopy, and survival SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID MORTALITY; HIV; COVERAGE; THERAPY AB In the late 1980s, Medicaid-insured human immunodeficiency virus (HIV)-infected patients with Pneumocystis carinii pneumonia (PCP) were 40% less likely to undergo diagnostic bronchoscopy and 75% more likely to die than were privately insured patients, whereas rates of use of other, less resource-intensive aspects of PCP care were similar. We reviewed 1395 medical records at 59 hospitals in 6 cities for the period 1995-1997 to examine the impact of insurance status on PCP-related care. Medicaid patients were only one-half as likely to undergo diagnostic bronchoscopy as were privately insured patients, yet we found no evidence that mortality was greater among patients who received empirical treatment. The bronchoscopy rates were primarily related to patients' personal insurance status. A weaker hospital-level effect was seen that was related to hospitals' Medicaid/private insurance case mix ratios. The situation has evolved from one in which Medicaid coverage was associated with underuse of bronchoscopy and poorer survival among empirically treated persons with HIV-related PCP to one in which empirical therapy is effective in treating this disease and expensive diagnostic procedures may be overused for privately insured patients. C1 Edward Hines Jr Vet Adm Hosp, Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Dept Med, Maywood, IL 60153 USA. Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL USA. Northwestern Univ, Feinberg Sch Med, Dept Med, Chicago, IL USA. Vet Affairs Chicago Healthcare Syst, Lakeside Div, Chicago, IL USA. Vet Affairs Chicago Healthcare Syst, Westside Div, Chicago, IL USA. Univ Illinois, Coll Med, Dept Med, Chicago, IL USA. Cook Cty Hosp, Dept Med, Chicago, IL USA. Rush Med Coll, Chicago, IL 60612 USA. Sinai Hlth Syst, Dept Med, Chicago, IL USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Miami, Sch Med, Div Infect Dis, Miami, FL USA. Mt Sinai Med Ctr, AIDS Ctr, New York, NY USA. SUNY Hlth Sci Ctr, Dept Med, Brooklyn, NY USA. RP Parada, JP (reprint author), Edward Hines Jr Vet Adm Hosp, Ctr Hlth Serv & Policy Res, 151H,Roosevelt Ave,5th Ave, Hines, IL 60141 USA. RI Bennett, Charles/C-2050-2008 OI Goetz, Matthew/0000-0003-4542-992X FU NIDA NIH HHS [5R01 DA10628-02] NR 19 TC 6 Z9 6 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD DEC 1 PY 2003 VL 37 IS 11 BP 1549 EP 1555 DI 10.1086/379512 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 743LD UT WOS:000186572500018 PM 14614679 ER PT J AU Gulec, SA Faries, MB Lee, CC Kirgan, D Glass, C Morton, DL Essner, R AF Gulec, SA Faries, MB Lee, CC Kirgan, D Glass, C Morton, DL Essner, R TI The role of fluorine-18 deoxyglucose positron emission tomography in the management of patients with metastatic melanoma: Impact on surgical decision making SO CLINICAL NUCLEAR MEDICINE LA English DT Article DE FDG; PET; melanoma; metastases; therapeutic decisions; surgery ID CUTANEOUS MALIGNANT-MELANOMA; FDG-PET; FLUORODEOXYGLUCOSE; CANCER; 2-FLUORINE-18-FLUORO-2-DEOXY-D-GLUCOSE; FLUORINE-18-FLUORODEOXYGLUCOSE; SURVIVAL AB Malignant melanoma can metastasize to almost any organ site. Optimal management requires sensitive radiographic evaluation of the entire body. The optimal management of patients with metastatic melanoma requires accurate assessment of extent of disease (EOD). The objective of this study was to evaluate the accuracy of fluorine-18 deoxyglucose (FDG) whole-body positron emission tomography (PET) in determination of EOD in patients with metastatic melanoma and its impact on surgical and medical management decisions. Forty-nine patients (30 men, 19 women; aged 25-83 years) with known or suspected metastatic melanoma under-went EOD evaluation using computerized tomography (CT) of the chest, abdomen, and pelvis, and magnetic resonance imaging (MRI) of the brain. After formulation of an initial treatment plan, the patients underwent FDG-PET imaging. The EOD determined by PET was compared with physical examination and conventional radiography findings. Fifty-one lesions were pathologically evaluated. The impact of PET on patient management was assessed based on the alterations made in the initial treatment plan after reevaluation of the patients using the information obtained by PET. The PET scan identified more metastatic sites in 27 of 49 (55%) of the patients who had undergone a complete set of imaging studies, including CT scans of the chest, abdomen, and pelvis, and MRI of the brain. In 6 of those 27 patients, PET detected disease outside the fields of CT and MRI. Fifty-one lesions were resected surgically. Of these, 44 were pathologically confirmed to be melanoma. All lesions larger than I cm (29 of 29) were positive on PET, whereas only 2 of 15 (13%) lesions smaller than I cm were detected by PET. The results of PET led treatment changes in 24 patients (49%). Eighteen of these changes (75%) were surgical. In 12 cases (67%), the planned operative procedure was cancelled, and in 6 cases (33%), an additional operation(s) was performed. In 6 of 24 (25%) patients, biochemotherapy, radiation therapy, or an experimental immunotherapy protocol was prompted by identification of new foci of disease. Compared with conventional imaging, FDG-PET provides more accurate assessment of EOD in patients with metastatic melanoma. Significant surgical and medical treatment alterations were made based on PET results. C1 John Wayne Canc Inst, Santa Monica, CA 90404 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. RP Essner, R (reprint author), John Wayne Canc Inst, 2200 Santa Monica Blvd, Santa Monica, CA 90404 USA. NR 27 TC 72 Z9 75 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0363-9762 J9 CLIN NUCL MED JI Clin. Nucl. Med. PD DEC PY 2003 VL 28 IS 12 BP 961 EP 965 DI 10.1097/01.rlu.0000099805.36471.aa PG 5 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 746WR UT WOS:000186771100002 PM 14663316 ER PT J AU McCollum, M Rhew, DC Parodi, S AF McCollum, M Rhew, DC Parodi, S TI Cost analysis of switching from IV vancomycin to PO linezolid for the management of methicillin-resistant Staphylococcus species SO CLINICAL THERAPEUTICS LA English DT Article DE pharmacoeconomics; linezolid; vancomycin; costs; Staphylococcus; drug resistance ID INSERTED CENTRAL CATHETERS; BLOOD-STREAM INFECTIONS; INTENSIVE-CARE-UNIT; PHARMACOECONOMIC ANALYSES; ATTRIBUTABLE MORTALITY; ANTIMICROBIAL THERAPY; AUREUS INFECTION; CANCER-PATIENTS; HOSPITALS; COMMUNITY AB Background: Infections with methicillin-resistant Staphylococcus species (MRSS) are associated with higher treatment costs than infections with methicillin-sensitive Staphylococcus species in the United States-partly because of an increased length of hospital stay (LOS). Objective: This study used pharmacoeconomic modeling to evaluate the costs and outcomes associated with the use of IV vancomycin compared with PO linezolid in the treatment of MRSS-infected patients. Methods: A retrospective chart review was used to determine the number of cases with confirmed or presumed MRSS infections treated with IV vancomycin during calendar-year 2000 at the Veterans Affairs Greater Los Angeles Healthcare System inpatient facility Patients who were eligible for a switch to PO linezolid with or without early discharge to home were identified. Cost differences associated with conversion from IV to PO therapy (compared with continued IV therapy) were estimated based on a mean decreased LOS and a decrease in the costs associated with catheter-related adverse events. Rates and costs of catheter-related adverse events were based on estimates from the literature. Sensitivity analyses were performed by variation of the estimated mean LOS decrease in the SD and by variation of the estimates for incidence and costs related to catheter complications. Costs were measured in year-2000 US dollars, and differences were not assessed for statistical significance. Results: Of 177 patients treated with IV vancomycin, 103 (58%) were eligible for conversion to PO linezolid and 55 (31%) were eligible for early discharge from the hospital with continuation of PO therapy Early discharge was associated with a mean (SD) LOS decrease of 3.3 (2.9) days. Annual mean total cost savings in patients eligible for conversion from TV vancomycin to PO linezolid with early discharge were $294,750 (range, $35,730-$553,790). For cases eligible for inpatient conversion from IV vancomycin to PO linezolid therapy (n = 48), the mean total annual cost difference was an increase of $6340 for PO linezolid (range, -$12,910 to $11,900). Conclusion: These results-although partly based on estimates from the literature, rather than direct measurements-support the use of PO linezolid with or without early discharge as a potential cost-savings alternative for eligible patients treated with a full course of IV vancomycin for suspected or confirmed MRSS infection. Copyright (C) 2003 Excerpta Medica, Inc. C1 Univ Colorado, Hlth Sci Ctr, Dept Clin Pharm, Sch Pharm, Denver, CO USA. Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Cedars Sinai Hlth Syst, Dept Med, Zynx Hlth Inc, Los Angeles, CA USA. Cedars Sinai Hlth Syst, Dept Hlth Serv Res, Zynx Hlth Inc, Los Angeles, CA USA. RP McCollum, M (reprint author), 4200 E 9th Ave,Box C-238, Denver, CO 80262 USA. EM marianne.mccollum@uchsc.edu NR 50 TC 18 Z9 19 U1 0 U2 4 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0149-2918 J9 CLIN THER JI Clin. Ther. PD DEC PY 2003 VL 25 IS 12 BP 3173 EP 3189 DI 10.1016/S0149-2918(03)90101-9 PG 17 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 763MK UT WOS:000188089600013 PM 14749155 ER PT J AU Pisegna, JR Oh, D Karlstadt, R Graepel, J Field, B AF Pisegna, JR Oh, D Karlstadt, R Graepel, J Field, B TI Perioperative use of IV pantoprazole (FVP) effectively controls gastric volume (GV) and acid output (GAO) in NPO patients in the perioperative period: Analysis of results from the perioperative IVP pilot study SO CRITICAL CARE MEDICINE LA English DT Meeting Abstract CT 33rd Critical Care Congress of the Society-of-Critical-Care-Medicine CY FEB 20-25, 2004 CL ORLANDO, FLORIDA SP Soc Critical Care Med C1 VA Greater LA Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Wyeth Pharmaceut, Collegeville, PA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD DEC PY 2003 VL 31 IS 12 SU S MA 308 BP A84 EP A84 PN 2 PG 1 WC Critical Care Medicine SC General & Internal Medicine GA 758LW UT WOS:000187636500298 ER PT J AU Ghosh, PM Malik, S Bedolla, R Kreisberg, JI AF Ghosh, PM Malik, S Bedolla, R Kreisberg, JI TI Akt in prostate cancer: Possible role in androgen-independence SO CURRENT DRUG METABOLISM LA English DT Review DE Akt; PI3K; androgen receptor; MAPK; PTEN; prostate cancer ID ACTIVATED PROTEIN-KINASE; PHOSPHOINOSITIDE 3-KINASE/AKT PATHWAY; CARCINOMA CELL-LINE; B C-AKT; BETA-CATENIN; SIGNAL-TRANSDUCTION; RECEPTOR GENE; GROWTH-FACTOR; PHOSPHATIDYLINOSITOL 3-KINASE; TRANSCRIPTIONAL ACTIVITY AB Akt, a downstream effector of phosphatidylinositol 3-kinase (PI3K), has often been implicated in prostate cancer. Studies in prostate tumor cell lines revealed that Akt activation is probably important for the progression of prostate cancer to an androgen-independent state. Investigations of human prostate cancer tissues show that although there is neither Akt gene amplification nor enhanced protein expression in prostate cancer compared to normal tissue, poorly differentiated tumors exhibit increased expression of a phosphorylated (activated) form of Akt compared to normal tissue, prostatic intraepithelial neoplasia (PIN) or well-differentiated prostate cancer. Akt phosphorylation is accompanied by the inactivation of ERK, a member of the mitogen activated protein kinase (MAPK) family. In this article, we postulate that Akt promotes androgen-independent survival of prostate tumor cells by modulating the expression and activation of the androgen receptor (AR). C1 Univ Texas, Hlth Sci Ctr, Dept Surg, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Vet Adm Hosp, San Antonio, TX USA. RP Kreisberg, JI (reprint author), Univ Texas, Hlth Sci Ctr, Dept Surg, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 101 TC 68 Z9 71 U1 2 U2 7 PU BENTHAM SCIENCE PUBL LTD PI HILVERSUM PA PO BOX 1673, 1200 BR HILVERSUM, NETHERLANDS SN 1389-2002 J9 CURR DRUG METAB JI Curr. Drug Metab. PD DEC PY 2003 VL 4 IS 6 BP 487 EP 496 DI 10.2174/1389200033489226 PG 10 WC Biochemistry & Molecular Biology; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Pharmacology & Pharmacy GA 751LD UT WOS:000187067800002 PM 14683476 ER PT J AU Goodman, RB Pugin, J Lee, JS Matthay, MA AF Goodman, RB Pugin, J Lee, JS Matthay, MA TI Cytokine-mediated inflammation in acute lung injury SO CYTOKINE & GROWTH FACTOR REVIEWS LA English DT Review DE chemokine; interleukins; acute respiratory distress syndrome (ARDS); pulmonary edema ID RESPIRATORY-DISTRESS-SYNDROME; TUMOR-NECROSIS-FACTOR; BRONCHOALVEOLAR LAVAGE FLUID; MIGRATION-INHIBITORY FACTOR; TRANSFORMING GROWTH FACTOR-BETA-1; INTERLEUKIN-1 RECEPTOR ANTAGONIST; NEUTROPHIL-ACTIVATING PEPTIDE-2; PULMONARY-EDEMA FLUID; RANDOMIZED CONTROLLED-TRIAL; ALVEOLAR EPITHELIAL REPAIR AB Clinical acute lung injury (ALI) is a major cause of acute respiratory failure in critically ill patients. There is considerable experimental and clinical evidence that pro- and anti-inflammatory cytokines play a major role in the pathogenesis of inflammatory-induced lung injury from sepsis, pneumonia, aspiration, and shock. A recent multi-center clinical trial found that a lung-protective ventilatory strategy reduces mortality by 22% in patients with ALI. Interestingly, this protective ventilatory strategy was associated with a marked reduction in the number of neutrophils and the concentration of pro- inflammatory cytokines released into the airspaces of the injured lung. Further research is needed to establish the contribution of cytokines to both the pathogenesis and resolution of ALI. (C) 2003 Elsevier Ltd. All rights reserved. C1 Univ Calif San Francisco, Cardiovasc Res Inst, Dept Med, San Francisco, CA 94143 USA. Univ Washington, Sch Med,Div Pulm & Crit Care, VA Puget Sound Med Ctr,Dept Vet Affairs, VA Puget Sound Hlth Care Syst,VA Pulm Res Labs, Seattle, WA 98108 USA. Univ Washington, Sch Med,Div Pulm & Crit Care, VA Puget Sound Med Ctr,Dept Med, VA Puget Sound Hlth Care Syst,VA Pulm Res Labs, Seattle, WA 98108 USA. Univ Hosp Geneva, Dept Med, Div Med Intens Care, CH-1211 Geneva 14, Switzerland. Univ Calif San Francisco, Cardiovasc Res Inst, Dept Anesthesia, San Francisco, CA 94143 USA. RP Matthay, MA (reprint author), Univ Calif San Francisco, Cardiovasc Res Inst, Dept Med, 505 Parnassus Ave,HSW-825, San Francisco, CA 94143 USA. FU NHLBI NIH HHS [HL51854, HL30542, HL51856, HL69955, HL70178, HR46059] NR 170 TC 304 Z9 341 U1 1 U2 38 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1359-6101 J9 CYTOKINE GROWTH F R JI Cytokine Growth Factor Rev. PD DEC PY 2003 VL 14 IS 6 BP 523 EP 535 DI 10.1016/S1359-6101(03)00059-5 PG 13 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 741ZX UT WOS:000186491200007 PM 14563354 ER PT J AU Rasmussen, DD AF Rasmussen, DD TI Chronic daily ethanol and withdrawal - 5. Diurnal effects on plasma thyroid hormone levels SO ENDOCRINE LA English DT Article DE alcohol; ethanol; thyroid; T3; T4; TSH; diurnal ID LONG-TERM CHANGES; GENE-EXPRESSION; ALCOHOL INTAKE; AXIS; DEPRESSION; RATS; TRH; HYPOTHYROIDISM; STIMULATION; INHIBITION AB We previously demonstrated that chronic daily ethanol consumption and daily withdrawal by male rats in a modified ethanol liquid diet paradigm produced (a) chronically increased adrenal glucocorticoid activity; (b) decreased plasma testosterone; (c) decreased fore-brain proopiomelanocortin gene expression; and (d) corresponding alterations in plasma leptin levels-all of which are consistent with reported changes during alcohol abuse and alcoholism. Each of these systems interact with hypothalamo-pituitary-thyroid (HPT) regulation, and links between chronic alcohol abuse and thyroid dysfunction have been suggested by both human and rat studies. Accordingly, we have begun to investigate potential HPT mediation of, or response to, alterations in these systems by investigating plasma thyroid hormone levels in the same chronic daily ethanol/withdrawal paradigm. Chronic daily episodes of ethanol consumption and withdrawal by male Sprague-Dawley rats decreased plasma levels of free (non-protein-bound) triiodothyronine (T3) (p < 0.01) and free thyroxine (T4) (p < 0.05) in the morning but not in the afternoon, relative to both ad libitum-fed and pair-fed controls (n = 9/treatment). Plasma total T4 levels were likewise suppressed (p < 0.01) in the morning, whereas total T3 levels were increased (p < 0.05) in the afternoon. These changes eliminated normal diurnal patterns (higher in the morning) of plasma free T3, free T4, and total T3 concentrations. Three weeks after cessation of ethanol consumption, morning plasma levels of free and total T3 and T4, as well as plasma thyroid-stimulating hormone (TSH), were all not significantly changed by the prior ethanol consumption or pair-feeding. These results reveal that plasma thyroid hormone concentrations are suppressed in a time of day dependent manner by chronic daily ethanol consumption and daily withdrawal in this model of chronic ethanol abuse. During subsequent long-term "abstinence," these thyroid hormones returned to control levels. These results are consistent with evidence that thyroid function is commonly diminished in alcoholism, with variable reports of recovery during abstinence. Further investigations with this rat model of daily ethanol consumption and daily withdrawal will help resolve interactions and roles of the HPT axis in alcohol abuse. C1 VA Puget Sound Hlth Care Syst, VA Med Ctr, MIRECC S116, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Rasmussen, DD (reprint author), VA Puget Sound Hlth Care Syst, VA Med Ctr, MIRECC S116, 1660 S Columbian Way, Seattle, WA 98108 USA. EM drasmuss@u.washington.edu FU NIAAA NIH HHS [AA 10567] NR 27 TC 6 Z9 6 U1 1 U2 4 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0969-711X J9 ENDOCRINE JI Endocrine PD DEC PY 2003 VL 22 IS 3 BP 329 EP 334 DI 10.1385/ENDO:22:3:329 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 766YW UT WOS:000188412200016 PM 14709806 ER PT J AU Williams, DL Grill, HJ Cummings, DE Kaplan, JM AF Williams, DL Grill, HJ Cummings, DE Kaplan, JM TI Vagotomy dissociates short- and long-term controls of circulating ghrelin SO ENDOCRINOLOGY LA English DT Article ID ACYLATED PEPTIDE; ACTIVE FORM; SECRETION; RATS; ENDOCRINE; ANOREXIA; FEEDBACK; AFFERENT; STOMACH; NEURONS AB Plasma ghrelin levels are responsive to short- and long-term nutrient fluctuation, rapidly decreasing with food consumption and increasing with food deprivation or weight loss. We hypothesized a vagal contribution to both responses. Nutrient-related ghrelin suppression may be mediated by gastrointestinal load-related vagal afferent activity, or depend upon vagal efferent input to the foregut, where most ghrelin is produced. Similarly, the deprivation-induced ghrelin rise could require state-related vagal afferent or efferent activity. Here, we examined the role of the vagus nerve in the regulation of plasma ghrelin by sampling blood from rats with subdiaphragmatic vagotomy and from sham-operated controls over 48 h of food deprivation, and before and after gastric gavage of liquid diet. Vagotomy affected neither baseline ghrelin levels nor the suppression of ghrelin by a nutrient load. The food deprivation-induced elevation of plasma ghrelin levels ( similar to 160% of baseline), however, was completely prevented by subdiaphragmatic vagotomy. In a separate experiment, the deprivation-related rise in plasma ghrelin was substantially reduced by atropine methyl nitrate treatment, indicating that the response to fasting is driven by increased vagal efferent tone. The dissociation between nutrient load- and deprivation-related ghrelin responses indicates that the regulation of circulating ghrelin levels involves separate mechanisms operating through anatomically distinct pathways. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA 98108 USA. Univ Penn, Dept Psychol, Philadelphia, PA 19104 USA. RP Williams, DL (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, 1660 S Columbian Way,Mail Stop 111-ENDO, Seattle, WA 98108 USA. RI Williams, Diana/C-1699-2014 OI Williams, Diana/0000-0002-3548-7440 FU NIDDK NIH HHS [DK-21397, DK-42284, DK-61516] NR 22 TC 159 Z9 165 U1 2 U2 3 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD DEC 1 PY 2003 VL 144 IS 12 BP 5184 EP 5187 DI 10.1210/en.2003-1059 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 746WZ UT WOS:000186771800009 PM 14525914 ER PT J AU Fujikawa, DG AF Fujikawa, DG TI Neuronal death in mesial temporal sclerosis: Separating morphology from mechanism SO EPILEPSIA LA English DT Letter ID INTERNUCLEOSOMAL DNA CLEAVAGE; CELL-DEATH; APOPTOSIS; SEIZURES C1 VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Fujikawa, DG (reprint author), VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. NR 6 TC 2 Z9 2 U1 0 U2 0 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD DEC PY 2003 VL 44 IS 12 BP 1607 EP 1607 DI 10.1111/j.0013-9580.2003.t01-3-33003.x PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 755RF UT WOS:000187424700025 PM 14636340 ER PT J AU Maganti, R Rutecki, P Bell, B Woodard, A Jones, JC Ramirez, L Iskandar, B AF Maganti, R Rutecki, P Bell, B Woodard, A Jones, JC Ramirez, L Iskandar, B TI Epilepsy surgery outcome among US veterans SO EPILEPSY & BEHAVIOR LA English DT Article DE temporal lobectomy; outcome; quality of life; employment outcome ID TEMPORAL-LOBE EPILEPSY; QUALITY-OF-LIFE; REFRACTORY EPILEPSY; INTRACTABLE EPILEPSY; LOBECTOMY; SEIZURES; MULTIVARIATE; RESECTION AB We retrospectively studied the outcome of anterior temporal lobectomy (ATL) among a population of veterans and evaluated outcome related to comorbidities. Veterans who underwent ATL between 1990 and 2001 at the Veterans Administration Hospital in Madison, Wisconsin. were included. Data related to postoperative seizure outcome, quality of life outcome, and employment outcome were collected. Factors associated with favorable outcome and outcome related to comorbidities were evaluated. Twenty-seven patients were entered into the study. The mean age at onset of seizures was 25 years (+/-10.2). History of a non-substance abuse psychiatric diagnosis, and substance abuse was present in 26% (7/27) and 30% (9/27), respectively, prior to surgery. While 66.6% (18/27) had a good outcome (Engel's Class 1), no difference in the frequency of good outcome was seen among the patients with a history of substance abuse, other psychiatric diagnosis (71%), or no psychiatric diagnosis (67%). There was a significant correlation between seizure outcome and quality of life score (r(s) = 0.67, p < 0.001) and postoperative employment gains (r(s) = 0.48, p = 0.01). Outcomes among veterans that underwent ATL can be satisfactory even in the context of the late mean age of epilepsy onset and the psychiatric diagnoses that were present in this sample. (C) 2003 Elsevier Inc. All rights reserved. C1 Univ Wisconsin, Dept Neurol, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53792 USA. Univ Wisconsin, Dept Neurosurg, Madison, WI 53792 USA. RP Maganti, R (reprint author), Univ Wisconsin, Dept Neurol, Madison, WI 53792 USA. NR 28 TC 11 Z9 11 U1 0 U2 1 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1525-5050 J9 EPILEPSY BEHAV JI Epilepsy Behav. PD DEC PY 2003 VL 4 IS 6 BP 723 EP 728 DI 10.1016/j.yebeh.2003.08.026 PG 6 WC Behavioral Sciences; Clinical Neurology; Psychiatry SC Behavioral Sciences; Neurosciences & Neurology; Psychiatry GA 753RA UT WOS:000187243300018 PM 14698707 ER PT J AU Shen, KZ Zhu, ZT Munhall, A Johnson, SW AF Shen, KZ Zhu, ZT Munhall, A Johnson, SW TI Dopamine receptor supersensitivity in rat subthalamus after 6-hydroxydopamine lesions SO EUROPEAN JOURNAL OF NEUROSCIENCE LA English DT Article DE basal ganglia; GABA; glutamate; Parkinson's disease; presynaptic inhibition ID NEURONS IN-VITRO; NIGRA PARS RETICULATA; NUCLEUS NEURONS; MESSENGER-RNA; HORSERADISH-PEROXIDASE; NIGROSTRIATAL LESIONS; BASAL GANGLIA; TRANSMISSION; BRAIN; STIMULATION AB The subthalamic nucleus (STN) receives direct dopaminergic innervation from the substantia nigra pars compacta, but the importance of this input in the pathophysiology of parkinsonism remains to be determined. We used whole-cell patch-clamp recordings in brain slices to study presynaptic dopaminergic modulation of synaptic inputs to the STN in unilateral 6-hydroxydopamine (6-OHDA)-lesioned rats. Here, we report that dopamine was more potent for inhibiting GABA IPSCs and glutamate EPSCs in the STN ipsilateral to the lesion, and was less potent for suppressing IPSCs and EPSCs in the STN contralateral to the lesion, compared with the effects of dopamine in control STN. Dopamine reduced IPSCs with an IC50 value of 20.9 +/- 3.6 mum in control STN, whereas IC50 values were 0.83 +/- 0.15 and 55.1 +/- 11.1 mum in STN ipsilateral and contralateral to 6-OHDA lesions, respectively. Dopamine also inhibited EPSCs with an IC50 value of 12.8 +/- 2.8 mum in control STN, whereas IC50 values were 4.5 +/- 0.9 and 41.6 +/- 9.8 mum in STN ipsilateral and contralateral to 6-OHDA lesions, respectively. Results with paired stimuli to evoke EPSCs and IPSCs suggest that endogenous dopamine acts presynaptically to inhibit transmitter release in the STN. These results show that chronic dopamine denervation significantly alters the regulation of synaptic input to the STN. Our results also suggest that the STN may be an important target for levodopa therapy in Parkinson's disease. C1 Portland VA Med Ctr, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97239 USA. RP Johnson, SW (reprint author), Portland VA Med Ctr, R&D 61,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. FU NINDS NIH HHS [NS38175] NR 51 TC 19 Z9 20 U1 1 U2 1 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0953-816X J9 EUR J NEUROSCI JI Eur. J. Neurosci. PD DEC PY 2003 VL 18 IS 11 BP 2967 EP 2974 DI 10.1046/j.1460-9568.2003.03058.x PG 8 WC Neurosciences SC Neurosciences & Neurology GA 750PZ UT WOS:000187006400006 PM 14656292 ER EF