FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Steinman, MA Sauala, A Maselli, J Houck, P Gonzales, R AF Steinman, MA Sauala, A Maselli, J Houck, P Gonzales, R TI Processes and outcomes of care in elderly patients with acute bronchitis. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Ctr Medicare & Medicaid Serv, 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 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD APR PY 2003 VL 18 SU 1 BP 296 EP 297 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 673DF UT WOS:000182564301236 ER PT J AU Rodriguez-Torres, M Gonzalez-Garcia, J Mendes-Correa, M Katlama, C Nelson, M Cooper, D Staszewski, S Carosi, G Smaill, F Brau, N Torriani, FJ AF Rodriguez-Torres, M Gonzalez-Garcia, J Mendes-Correa, M Katlama, C Nelson, M Cooper, D Staszewski, S Carosi, G Smaill, F Brau, N Torriani, FJ TI Prevalence of occult HBV in HIV/HCV coinfected patients in a large, multinational trial (APRICOT) SO JOURNAL OF HEPATOLOGY LA English DT Meeting Abstract CT 38th Annual Meeting of the European-Association-for-the-Study-of-the-Liver CY MAR 29-APR 01, 2003 CL ISTANBUL, TURKEY SP European Assoc Study Liver C1 Hosp La Paz, Madrid, Spain. Univ Sao Paulo, BR-05508900 Sao Paulo, Brazil. Grp Hosp Pitie Salpetriere, F-75634 Paris, France. Chelsea & Westminster Hosp, London, England. St Vincents Hosp, Sydney, NSW 2010, Australia. Univ Frankfurt, D-6000 Frankfurt, Germany. Clin Infect & Trop Dis, Brescia, Italy. Chedoke McMaster Hosp, Hamilton, ON, Canada. Bronx Vet Adm Med Ctr, New York, NY USA. Univ Calif San Diego, San Diego, CA 92103 USA. RI mendes correa, maria cassia /A-6779-2013 NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD APR PY 2003 VL 38 SU 2 MA 571 BP 165 EP 166 DI 10.1016/S0168-8278(03)80837-1 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 666JQ UT WOS:000182174500564 ER PT J AU Shiffman, ML Goncales, FL Bronowicki, JP Fried, MW Wright, T Hadziyannis, S Brouwer, J Zeuzem, S Sederati, F Hoffman, J AF Shiffman, ML Goncales, FL Bronowicki, JP Fried, MW Wright, T Hadziyannis, S Brouwer, J Zeuzem, S Sederati, F Hoffman, J TI Hepatitis C virus (HCV) genotypes 2/3 infection: A curable disease SO JOURNAL OF HEPATOLOGY LA English DT Meeting Abstract CT 38th Annual Meeting of the European-Association-for-the-Study-of-the-Liver CY MAR 29-APR 01, 2003 CL ISTANBUL, TURKEY SP European Assoc Study Liver C1 Virginia Commonwealth Univ, Med Coll Virginia, Liver Transplant Program, Richmond, VA 23298 USA. UNICAMP, Hosp Das Clin, Sao Paulo, Brazil. CHU Nancy HE, Nancy, France. Univ N Carolina, Chapel Hill, NC 27599 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Henry Dunant Hosp, Athens, Greece. Univ Frankfurt, D-6000 Frankfurt, Germany. Hoffmann La Roche Inc, Nutley, NJ 07110 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD APR PY 2003 VL 38 SU 2 MA 590 BP 171 EP 171 DI 10.1016/S0168-8278(03)80856-5 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 666JQ UT WOS:000182174500583 ER PT J AU Zhu, LX Sharma, S Gardner, B Escuadro, B Atianzar, K Tashkin, DP Dubinett, SM AF Zhu, LX Sharma, S Gardner, B Escuadro, B Atianzar, K Tashkin, DP Dubinett, SM TI IL-10 mediates sigma(1) receptor-dependent suppression of antitumor immunity SO JOURNAL OF IMMUNOLOGY LA English DT Article ID GROWTH-FACTOR-BETA; CLASS-I EXPRESSION; TUMOR-CELL-LINES; TGF-BETA; LUNG-CANCER; T-CELL; CYTOKINE PRODUCTION; PROSTAGLANDIN E(2); HABITUAL SMOKERS; DENDRITIC CELLS AB Sigma receptors are unique endoplasmic reticulum proteins that mediate signaling for a variety of drugs. We determined the effect of sigma(1) receptor agonists on immune responses in a syngeneic lung cancer model. Sigma(1) receptor agonists, including cocaine, up-regulated splenocyte IL-10 mRNA and protein production in vitro in a sigma receptor-dependent, pertussis toxin-sensitive manner. In vivo, sigma(1) receptor agonists promoted tumor growth and induced IL-10 at the tumor site. Increased tumor growth was prevented by administration of specific Abs to IL-10 or by administration of specific sigma(1) receptor antagonists. We report that sigma(1) receptor ligands, including cocaine, augment tumor growth through an IL-10 dependent mechanism. C1 Univ Calif Los Angeles, Lung Canc Res Program, David Geffen Sch Med, Jonsson Comprehens Canc Ctr,Ctr Hlth Sci 37 131, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, 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. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, Lung Canc Res Program, David Geffen Sch Med, Jonsson Comprehens Canc Ctr,Ctr Hlth Sci 37 131, 10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu FU NCI NIH HHS [R01 CA71818]; NIDA NIH HHS [R01 DA08254]; PHS HHS [P50 90388] NR 60 TC 26 Z9 27 U1 0 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 APR 1 PY 2003 VL 170 IS 7 BP 3585 EP 3591 PG 7 WC Immunology SC Immunology GA 659AL UT WOS:000181754100018 PM 12646621 ER PT J AU Mitsumori, LM Hatsukami, TS Ferguson, MS Kerwin, WS Cai, JM Yuan, C AF Mitsumori, LM Hatsukami, TS Ferguson, MS Kerwin, WS Cai, JM Yuan, C TI In vivo accuracy of multisequence MR imaging for identifying unstable fibrous caps in advanced human carotid plaques SO JOURNAL OF MAGNETIC RESONANCE IMAGING LA English DT Article DE magnetic resonance imaging; plaque rupture; atherosclerosis; carotid arteries; vulnerable plaque ID ATHEROSCLEROTIC PLAQUE; IN-VIVO; LIPID-RICH; RUPTURE; ULTRASOUND; ARTERY; COMPONENTS; DISEASE AB Purpose: To evaluate the in vivo accuracy of a multisequence MRI technique for prospectively identifying one feature of the vulnerable plaque-an unstable fibrous cap-in human carotid atherosclerosis. Materials and Methods: The carotid arteries of 18 endarterectomy patients were preoperatively imaged in a 1.5T scanner using a multisequence protocol that generated four contrast weightings (3D time of flight (ToF), T1, proton density (PD), and T2) at each slice location. With the use of previously published MR criteria, the images of the vessel wall were first examined for evidence of an unstable fibrous cap. The imaging findings were then correlated with the histology from the surgical specimens. Results: A blinded review of the MR findings with the histologic state of the fibrous cap revealed that 1) assessing the preoperative appearance of the fibrous cap has a high test sensitivity (0.81) and specificity (0.90) for identifying an unstable cap in vivo; and 2) the availability of different contrast weightings facilitated image interpretation when intimal. calcifications or flow artifacts obscured the lumen surface. Conclusion: Multisequence MRI can accurately characterize the in vivo state of the fibrous cap. This finding supports the use of these noninvasive techniques to prospectively identify vulnerable plaques. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Surg Serv, Seattle, WA USA. Marina Ferguson Inc, Seattle, WA USA. Peoples Liberat Army Gen Hosp, Beijing, Peoples R China. RP Yuan, C (reprint author), Univ Washington, Dept Radiol, 1959 Pacific St NE,Box 357115, Seattle, WA 98195 USA. FU NHLBI NIH HHS [R01 HL56874, R01 HL60213] NR 28 TC 138 Z9 155 U1 0 U2 6 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1053-1807 J9 J MAGN RESON IMAGING JI J. Magn. Reson. Imaging PD APR PY 2003 VL 17 IS 4 BP 410 EP 420 DI 10.1002/jmri.10264 PG 11 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 671EW UT WOS:000182453200003 PM 12655579 ER PT J AU Bounpheng, M McGrath, S Macias, D van Orsouw, N Suh, Y Rines, D Vijg, J AF Bounpheng, M McGrath, S Macias, D van Orsouw, N Suh, Y Rines, D Vijg, J TI Rapid, inexpensive scanning for all possible BRCA1 and BRCA2 gene sequence variants in a single assay: implications for genetic testing SO JOURNAL OF MEDICAL GENETICS LA English DT Article ID MUTATIONS; ELECTROPHORESIS; ACCURATE C1 Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Ctr Longev & Aging Studies, San Antonio, TX 78245 USA. Accelerated Genom Inc, San Antonio, TX 78229 USA. Seoul Natl Univ, Coll Med, Dept Biochem & Mol Biol, Seoul 110799, South Korea. Seoul Natl Univ, Coll Med, Canc Res Inst, Seoul 110799, South Korea. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Vijg, J (reprint author), Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Ctr Longev & Aging Studies, 15355 Lambda Dr,STCBM 2-200, San Antonio, TX 78245 USA. FU NCI NIH HHS [P30 CA 54174] NR 17 TC 7 Z9 7 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0022-2593 J9 J MED GENET JI J. Med. Genet. PD APR PY 2003 VL 40 IS 4 AR e33 DI 10.1136/jmg.40.4.e33 PG 3 WC Genetics & Heredity SC Genetics & Heredity GA 666BN UT WOS:000182155900015 PM 12676906 ER PT J AU Southwick, SM Axelrod, SR Wang, S Yehuda, R Morgan, CA Charney, D Rosenheck, R Mason, JW AF Southwick, SM Axelrod, SR Wang, S Yehuda, R Morgan, CA Charney, D Rosenheck, R Mason, JW TI Twenty-four-hour urine cortisol in combat veterans with PTSD and comorbid borderline personality disorder SO JOURNAL OF NERVOUS AND MENTAL DISEASE LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER C1 VA Connecticut Healthcare Syst, Clin Neurosci Div, Natl Ctr PTSD 116A, West Haven, CT 06516 USA. Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. NIA, Baltimore, MD 21224 USA. Bronx Vet Adm Med Ctr, Dept Psychiat, Bronx, NY USA. NIMH, Bethesda, MD 20892 USA. VA Connecticut Healthcare Syst, NE Program Evaluat Ctr, West Haven, CT 06516 USA. RP Southwick, SM (reprint author), VA Connecticut Healthcare Syst, Clin Neurosci Div, Natl Ctr PTSD 116A, 950 Campbell Ave, West Haven, CT 06516 USA. NR 7 TC 9 Z9 9 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-3018 J9 J NERV MENT DIS JI J. Nerv. Ment. Dis. PD APR PY 2003 VL 191 IS 4 BP 261 EP 262 DI 10.1097/00005053-200304000-00009 PG 2 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 668NL UT WOS:000182300000008 PM 12695738 ER PT J AU Quinn, J Montine, T Morrow, J Woodward, WR Kulhanek, D Eckenstein, F AF Quinn, J Montine, T Morrow, J Woodward, WR Kulhanek, D Eckenstein, F TI Inflammation and cerebral amyloidosis are disconnected in an animal model of Alzheimer's disease SO JOURNAL OF NEUROIMMUNOLOGY LA English DT Article DE Alzheimer; animal model; cyclooxygenase; nonsteroidal anti-inflammatory drug; oxidative stress; indomethacin; F2-isoprostanes ID TRANSGENIC MOUSE MODEL; LIPID-PEROXIDATION; PLAQUE PATHOLOGY; OXIDATIVE DAMAGE; MICROGLIAL CELLS; MESSENGER-RNA; TG2576 MICE; PROSTAGLANDINS; CYTOKINES; PROTEIN AB The hypothesis that inflammation and beta amyloid deposition are causally linked in Alzheimer's disease (AD) was tested in a transgenic mouse model. Untreated beta amyloid plaque-bearing Tg2576 mice did not differ from wild type animals in brain levels of most inflammatory mediators. Indomethacin treatment suppressed brain levels of prostaglandins by 90%, but reduced hippocampal beta amyloid by only 20%, with no effect on cortical beta amyloid. The discordant effects on beta amyloid and cyclooxygenase (COX) suggest that these effects of nonsteroidal anti-inflammatory drugs (NSAIDs) are not causally linked. Further evidence against a causal relationship is seen in an unexpected trend to lower levels of beta amyloid after an inflammatory stimulus [lipopolysaccharide (LPS)]. (C) 2003 Elsevier Science B.V. All rights reserved. C1 Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Univ Washington, Med Ctr, Dept Pathol, Seattle, WA 98195 USA. Vanderbilt Univ, Med Ctr, Dept Pathol, Nashville, TN 37232 USA. Univ Vermont, Med Ctr, Dept Neurol, Burlington, VT USA. RP Quinn, J (reprint author), Portland Vet Affairs Med Ctr, P3 R&D,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. FU NCCIH NIH HHS [AT00066-01]; NIA NIH HHS [AG00774, AG08017, AG16835, AG07424] NR 45 TC 71 Z9 79 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-5728 J9 J NEUROIMMUNOL JI J. Neuroimmunol. PD APR PY 2003 VL 137 IS 1-2 BP 32 EP 41 DI 10.1016/S0165-5728(03)00037-7 PG 10 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 671AZ UT WOS:000182443700004 PM 12667645 ER PT J AU Sayin, U Osting, S Hagen, J Rutecki, P Sutula, T AF Sayin, U Osting, S Hagen, J Rutecki, P Sutula, T TI Spontaneous seizures and loss of axo-axonic and axo-somatic inhibition induced by repeated brief seizures in kindled rats SO JOURNAL OF NEUROSCIENCE LA English DT Article DE hippocampus; dentate gyrus; GABA; CCK; GAT-1; damage; epilepsy ID TEMPORAL-LOBE EPILEPSY; FIBER SYNAPTIC REORGANIZATION; GABA-MEDIATED INHIBITION; PAIRED-PULSE DEPRESSION; GAMMA-AMINOBUTYRIC-ACID; DENTATE GYRUS; GRANULE CELLS; IMMUNOREACTIVE NEURONS; HIPPOCAMPAL SCLEROSIS; STATUS EPILEPTICUS AB Repeated brief seizures evoked by kindling progressively increase seizure susceptibility and eventually induce spontaneous seizures. Previous studies have demonstrated that the initial seizures evoked by kindling increase paired-pulse inhibition at 15-25 msec interpulse intervals in the dentate gyrus and also induce apoptosis, progressive neuronal loss, mossy fiber sprouting, and neurogenesis, which could potentially alter the balance of excitation and/or inhibition and modify functional properties of hippocampal circuits. In these experiments, paired-pulse inhibition in the dentate gyrus was reduced or lost after similar to90-100 evoked seizures in association with emergence of spontaneous seizures. Evoked IPSCs examined by single electrode voltage-clamp methods in granule cells from kindled rats experiencing spontaneous seizures demonstrated altered kinetics (reductions of similar to48% in 10-90% decay time, similar to40% in tau, and similar to65% in charge transfer) and confirmed that decreased inhibition contributed to the reduced paired-pulse inhibition. The loss of inhibition was accompanied by loss of subclasses of inhibitory interneurons labeled by cholecystokinin and the neuronal GABA transporter GAT-1, which project axo-somatic and axo-axonic GABAergic inhibitory terminals to granule cells and axon initial segments. Seizure-induced loss of interneurons providing axo-somatic and axo-axonic inhibition may regulate spike output to pyramidal neurons in CA3 and could play an important role in generation of spontaneous seizures. The sequence of progressive cellular alterations induced by repeated seizures, particularly loss of GABAergic interneurons providing axo-somatic and axo-axonic inhibition, may be important in the development of intractable epilepsy. C1 Univ Wisconsin, Dept Neurol, Madison, WI 53792 USA. Univ Wisconsin, Dept Anat, Madison, WI 53792 USA. Univ Wisconsin, Dept Neurol Surg, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53792 USA. RP Sutula, T (reprint author), Univ Wisconsin, Dept Neurol, H6-570,600 Highland Ave, Madison, WI 53792 USA. FU PHS HHS [R01 25020] NR 67 TC 93 Z9 97 U1 1 U2 3 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 APR 1 PY 2003 VL 23 IS 7 BP 2759 EP 2768 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 665ET UT WOS:000182107200029 PM 12684462 ER PT J AU Glorioso, JC Mata, M Fink, DJ AF Glorioso, JC Mata, M Fink, DJ TI Therapeutic gene transfer to the nervous system using viral vectors SO JOURNAL OF NEUROVIROLOGY LA English DT Article DE gene therapy; pain; Parkinson disease; mucopolysaccharidosis; neuropathy ID MUCOPOLYSACCHARIDOSIS TYPE-VII; NEUROTROPHIC FACTOR; PARKINSONS-DISEASE; LYSOSOMAL STORAGE; IN-VIVO; ADENOVIRAL VECTOR; SPINAL-CORD; MEDIATED EXPRESSION; BETA-GLUCURONIDASE; FACTOR PROTECTS AB The past few years have been marked by substantial progress in preclinical studies of therapeutic gene transfer for neurologic disease using viral-based vectors. In this article, the authors review the data regarding (1) treatment of focal neuronal degeneration, exemplified by Parkinson disease, ischemia, and trauma models; (2) treatment of global neurologic dysfunction, exemplified by the mucopolysaccharidoses and other storage diseases; (3) peripheral nervous system diseases including motor neuron disease and sensory neuropathies; and (4) the use of vectors expressing neurotransmitters to modulate functional neural activity in the treatment of pain. The results suggest that a number of different viral vectors may be appropriate for gene transfer to the central nervous system for specific disease processes, and that for the peripheral nervous system herpes simplex virus-based vectors appear to have special utility. The results of the first human gene therapy trials for neurologic disease, which are just now beginning, will be crucial in defining the next step in the development of this therapy. C1 Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Mol Genet & Biochem, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA USA. RP Fink, DJ (reprint author), S-520 BST,200 Lothrop St, Pittsburgh, PA 15213 USA. NR 62 TC 29 Z9 34 U1 0 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1355-0284 J9 J NEUROVIROL JI J. Neurovirol. PD APR PY 2003 VL 9 IS 2 BP 165 EP 172 DI 10.1080/13550280390193984 PG 8 WC Neurosciences; Virology SC Neurosciences & Neurology; Virology GA 671LQ UT WOS:000182466600004 PM 12707847 ER PT J AU Casarett, DJ AF Casarett, DJ TI Assessing decision-making capacity in the setting of palliative care research SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article; Proceedings Paper CT Meeting on the Ethics of End-of-Life Research CY SEP 12-13, 2002 CL NIH CAMPUS, BETHESDA, MARYLAND SP NINR, Off Rare Dis HO NIH CAMPUS DE palliative medicine research; decision-making capacity; informed consent; research ethics; competence ID RANDOMIZED CONTROLLED TRIAL; INFORMED CONSENT PROCESS; ILL CANCER-PATIENTS; CLINICAL-TRIALS; HOSPICE INPATIENTS; DEPRESSED-PATIENTS; PAIN; MORPHINE; DELIRIUM; COMPREHENSION AB This paper begins with a discussion of why concerns about decision-making capacity are warranted in palliative medicine research. Next, procedures for assessing decision-making capacity are discussed. It concludes with recommendations to guide the judicious use of these procedures in the design of palliative care research. (C) 2003 U.S. Cancer Pain Relief Committee. Published by Else-vier All rights reserved. C1 Univ Penn, Div Geriatr, Philadelphia, PA 19104 USA. Philadelphia Vet Adm Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Casarett, DJ (reprint author), Univ Penn, Div Geriatr, 3615 Chestnut St, Philadelphia, PA 19104 USA. NR 69 TC 12 Z9 12 U1 0 U2 1 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 APR PY 2003 VL 25 IS 4 BP S6 EP S13 DI 10.1016/S0885-3924(03)00097-6 PG 8 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 666HJ UT WOS:000182171300016 PM 12691692 ER PT J AU Casarett, DJ Knebel, A Helmers, K AF Casarett, DJ Knebel, A Helmers, K TI Ethical challenges of palliative care research SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Editorial Material C1 Univ Penn, Div Geriatr, Philadelphia, PA 19104 USA. Philadelphia Vet Adm Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. NINR, Dept Hlth & Human Serv, NIH, Bethesda, MD 20892 USA. RP Casarett, DJ (reprint author), Univ Penn, Div Geriatr, 3615 Chestnut St, Philadelphia, PA 19104 USA. NR 8 TC 18 Z9 18 U1 1 U2 3 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 APR PY 2003 VL 25 IS 4 BP S3 EP S5 DI 10.1016/S0885-3924(03)00058-7 PG 3 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 666HJ UT WOS:000182171300015 PM 12723543 ER PT J AU Daly, BJ Rosenfeld, K AF Daly, BJ Rosenfeld, K TI Maximizing benefits and minimizing risks in health services research near the end of life SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article; Proceedings Paper CT Meeting on the Ethics of End-of-Life Research CY SEP 12-13, 2002 CL NIH CAMPUS, BETHESDA, MARYLAND SP NINR, Off Rare Dis HO NIH CAMPUS DE health services research; informed consent; research ethics; quality improvement ID PALLIATIVE CARE; CONSENT AB This article explores the ethical issues specific to Health Services Research (HSR) in palliative care, with particular attention to similarities and differences between HSR and institutional quality improvement (QI) initiatives. We focus on the challenges of determining what level of protection is warranted by investigations of health services and programs of care, in contrast to the traditional randomized clinical trial design, and how best to assure subject protection. A decision algorithm regarding the requirements for full IRB review and informed consent is proposed as a mechanism to assure that the level of protection is commensurate with the level of fisk. (C) 2003 U.S. Cancer Pain Relief Committee. Published by Elsevier. All rights reserved. C1 Case Western Reserve Univ, Sch Nursing, Cleveland, OH 44106 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Daly, BJ (reprint author), Case Western Reserve Univ, Sch Nursing, Cleveland, OH 44106 USA. NR 15 TC 4 Z9 4 U1 0 U2 1 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 APR PY 2003 VL 25 IS 4 BP S33 EP S42 DI 10.1016/S0885-3924(03)00059-9 PG 10 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 666HJ UT WOS:000182171300019 PM 12691695 ER PT J AU Przybylowski, T Bangash, MF Reichmuth, K Morgan, BJ Skatrud, JB Dempsey, JA AF Przybylowski, T Bangash, MF Reichmuth, K Morgan, BJ Skatrud, JB Dempsey, JA TI Mechanisms of the cerebrovascular response to apnoea in humans SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID CEREBRAL-BLOOD-FLOW; OBSTRUCTIVE SLEEP-APNEA; MUELLER MANEUVER; CARBON-DIOXIDE; HEMODYNAMICS; PRESSURE; VELOCITY; ARTERY; PERFUSION; DIAMETER AB We measured ventilation, arterial O-2 saturation, end-tidal CO2 (P-ET,P-CO2), blood pressure (intra-arterial catheter or photoelectric plethysmograph), and flow velocity in the middle cerebral artery (CFV) (pulsed Doppler ultrasound) in 17 healthy awake subjects while they performed 20 s breath holds under control conditions and during ganglionic blockade (intravenous trimethaphan, 4.4 +/- 1.1 mg min(-1) (mean +/- S.D.)). Under control conditions, breath holding caused increases in P-ET,P-CO2 (7 +/- 1 mmHg) and in mean arterial pressure (MAP) (15 +/- 2 mmHg). A transient hyperventilation (P-ET,P-CO2 -7 +/- 1 mmHg vs. baseline) occurred post-apnoea. CFV increased during apnoeas (by 42 +/- 3%) and decreased below baseline (by 20 +/- 2%) during post-apnoea hyperventilation. In the post-apnoea recovery period, CFV returned to baseline in 45 +/- 4 s. The post-apnoea decrease in CFV did not occur when hyperventilation was prevented. During ganglionic blockade, which abolished the increase in MAP, apnoea-induced increases in CFV were partially attenuated (by 26 +/- 2%). Increases in P-ET,P-CO2 and decreases in oxyhaemoglobin saturation (S-a,S-O2) (by 2 +/- 1%) during breath holds were identical in the intact and blocked conditions. Ganglionic blockade had no effect on the slope of the CFV response to hypocapnia but it reduced the CFV response to hypercapnia (by 17 +/- 5%). We attribute this effect to abolition of the hypercapnia-induced increase in MAP. Peak increases in CFV during 20 s Mueller manoeuvres (40 +/- 3%) were the same as control breath holds, despite a 15 mmHg initial, transient decrease in MAP. Hyperoxia also had no effect on the apnoea-induced increase in CFV (40 +/- 4%). We conclude that apnoea-induced fluctuations in CFV were caused primarily by increases and decreases in arterial partial pressure of CO2 (P-a,P-CO2) and that sympathetic nervous system activity was not required for either the initiation or the maintenance of the cerebrovascular response to hyper- and hypocapnia. Increased MAP or other unknown influences of autonomic activation on the cerebral circulation played a smaller but significant role in the apnoea-induced increase in CFV; however, negative intrathoracic pressure and the small amount of oxyhaemoglobin desaturation caused by 20 s apnoea did not affect CFV. C1 Univ Wisconsin, John Rankin Lab Pulm Med, Dept Populat Hlth Sci, Madison, WI 53705 USA. Univ Wisconsin, John Rankin Lab Pulm Med, Dept Med, Madison, WI 53705 USA. Univ Wisconsin, John Rankin Lab Pulm Med, Dept Orthopaed & Rehabil, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Przybylowski, T (reprint author), Katedra & Klin Chorob Wewnetrznych, Ul Banacha 1A, PL-02097 Warsaw, Poland. NR 31 TC 56 Z9 57 U1 2 U2 8 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD APR 1 PY 2003 VL 548 IS 1 BP 323 EP 332 DI 10.1113/jphysiol.2002.029678 PG 10 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 690VH UT WOS:000183570800026 PM 12588894 ER PT J AU Zimmerer, JL Leon, JB Covinsky, KE Desai, U Sehgal, AR AF Zimmerer, JL Leon, JB Covinsky, KE Desai, U Sehgal, AR TI Diet monotony as a correlate of poor nutritional intake among hemodialysis patients SO JOURNAL OF RENAL NUTRITION LA English DT Article ID FOOD-INTAKE; VARIETY; MEAL; WEIGHT AB Objective: Nutritional guidelines recommend eating a variety of foods, yet the renal diet restricts the intake of many foods. Poor appetite, present in 10% to 30% of hemodialysis patients, further narrows the range of foods consumed. We sought to determine the relationship between diet monotony and nutritional intake in patients on chronic hemodialysis. Design: Cross-sectional study. Setting: Eight freestanding hemodialysis units in northeast Ohio. Subjects: Forty-eight randomly selected hemodialysis patients. Intervention: We used the Block-National Cancer Institute questionnaire to obtain a detailed food frequency and also asked patients to rate their appetite for 10 specific high-protein foods. Outcome Measure: We adapted the Herfindahl index (a measure of hospital market concentration) to calculate a diet monotony index and then examined the relationship between monotony index and energy and protein intake. Results: When stratified into tertiles by monotony index, patients with the most varied diets had the highest energy (33 kcal/kg/d) and protein (1.35 g/kg/d) intake, whereas patients with the most monotonous diets had the lowest energy (21 kcal/kg/d) and protein (0.83 g/kg/d) intake. A 5-point increase in monotony index was independently associated with a 10 kcal/kg/d decrease in energy intake (P = .004) and a 0.43 g/kg/d decrease in protein intake (P = .006) after adjustment for patient demographic and medical characteristics. Patients with the most monotonous diets reported a good appetite for an average of 3.1 high-protein foods that they were eating less than once per week. Conclusion: Diet monotony strongly correlates with nutritional intake. However, patients with monotonous diets have a good appetite for several high-protein foods that they are not eating. Helping patients to identify and increase the intake of these foods may both enhance diet variety and improve nutritional status. (C) 2003 by the National Kidney Foundation, Inc. C1 Metrohlth Med Ctr, Div Nephrol, Cleveland, OH 44109 USA. San Francisco Vet Adm Med Ctr, Div Geriatr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Case Western Reserve Univ, Dept Med, Cleveland, OH 44106 USA. Metrohlth Med Ctr, Ctr Hlth Care Res & Policy, Cleveland, OH USA. Case Western Reserve Univ, Dept Epidemiol & Biostat, Cleveland, OH 44106 USA. Case Western Reserve Univ, Ctr Biomed Eth, Cleveland, OH 44106 USA. RP Zimmerer, JL (reprint author), Metrohlth Med Ctr, Div Nephrol, 2500 MetroHlth Dr-R229, Cleveland, OH 44109 USA. FU NIDDK NIH HHS [DK54178, DK51472] NR 24 TC 7 Z9 8 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 1051-2276 J9 J RENAL NUTR JI J. Renal Nutr. PD APR PY 2003 VL 13 IS 2 BP 72 EP 77 DI 10.1053/jren.2003.50025 PG 6 WC Nutrition & Dietetics; Urology & Nephrology SC Nutrition & Dietetics; Urology & Nephrology GA 666TB UT WOS:000182191600002 PM 12671828 ER PT J AU Molz, FJ Partin, JI Kirkpatrick, JS AF Molz, FJ Partin, JI Kirkpatrick, JS TI The acute effects of posterior fusion instrumentation on kinematics and intradiscal pressure of the human lumbar spine SO JOURNAL OF SPINAL DISORDERS & TECHNIQUES LA English DT Article; Proceedings Paper CT Annual Meeting of the SOA CY JUL 20-22, 2000 CL SOUTHHAMPTON, BERMUDA SP SOA DE lumbar spine; biomechanics; nondestructive testing; spinal instrumentation; adjacent segment degeneration; intradiscal pressure; range of motion ID POSTEROLATERAL FUSION; ADJACENT-SEGMENT; BIOMECHANICAL ANALYSIS; HYDROSTATIC-PRESSURE; INTERVERTEBRAL DISC; LUMBOSACRAL SPINE; MATRIX SYNTHESIS; DISCOGENIC PAIN; MOTION SEGMENTS; AXIAL ROTATION AB Nine cadaver lumbar spines were analyzed by applying nonconstraining nondestructive bending moments while measuring global range of motion, mechanical reaction at the sacrum, applied moment at the top of the specimen, segmental range of motion at L1-L5, and IDP at L1-L4. Each specimen was examined in an intact and instrumented state (with L3-L4 posterior instrumentation) using range of motion-based biomechanical testing, while achieving a similar global ROM in the sagittal, frontal, and transverse planes. An increase in applied moment was required during instrumented testing when compared with intact, and a significant increase in segmental range of motion during instrumented testing was found at all uninstrumented levels. Significant decreases in segmental range of motion were measured at the instrumented level when compared with intact testing. The most significant decreases and increases in IDP occurred at the instrumented level during sagittal and transverse plane testing. C1 Birmingham VA Med Ctr, Spine Biomech Lab, Birmingham, AL USA. Univ Alabama, Dept Biomed Engn, Birmingham, AL 35294 USA. Univ Alabama, Div Orthopaed Surg, Birmingham, AL 35294 USA. RP Molz, FJ (reprint author), Medtron Sofamore Danek, Technol Dev, 1800 Pyramid Pl, Memphis, TN 38132 USA. NR 55 TC 10 Z9 13 U1 3 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1536-0652 J9 J SPINAL DISORD TECH JI J. Spinal Disord. Tech. PD APR PY 2003 VL 16 IS 2 BP 171 EP 179 PG 9 WC Clinical Neurology; Orthopedics SC Neurosciences & Neurology; Orthopedics GA 664HM UT WOS:000182055700009 PM 12679672 ER PT J AU Covinsky, KE Palmer, RM Fortinsky, RH Counsell, SR Stewart, AL Kresevic, D Burant, CJ Landefeld, CS AF Covinsky, KE Palmer, RM Fortinsky, RH Counsell, SR Stewart, AL Kresevic, D Burant, CJ Landefeld, CS TI Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: Increased vulnerability with age SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE hospitalization; activities of daily living; frail elderly; geriatric assessment; health status ID FUNCTIONAL STATUS; SERIOUSLY ILL; ACUTE-CARE; OUTCOMES; TRIAL; VALIDATION; MORBIDITY; ADMISSION; MORTALITY; SUPPORT AB OBJECTIVES: To describe the changes in activities of daily living (ADL) function occurring before and after hospital admission in older people hospitalized with medical illness and to assess the effect of age on loss of ADL function. DESIGN: Prospective observational study. SETTING: The general medical service of two hospitals. PARTICIPANTS: Two thousand two hundred ninety-three patients aged 70 and older (mean age 80, 64% women, 24% nonwhite). MEASUREMENTS: At the time of hospital admission, patients or their surrogates were interviewed about their independence in five ADLs (bathing, dressing, eating, transferring, and toileting) 2 weeks before admission (baseline) and at admission. Subjects were interviewed about ADL function at discharge. Outcome measures included functional decline between baseline and discharge and functional changes between baseline and admission and between admission and discharge. RESULTS: Thirty-five percent of patients declined in ADL function between baseline and discharge. This included the 23% of patients who declined between baseline and admission and failed to recover to baseline function between admission and discharge and the 12% of patients who did not decline between baseline and admission but declined between hospital admission and discharge. Twenty percent of patients declined between baseline and admission but recovered to baseline function between admission and discharge. The frequency of ADL decline between baseline and discharge varied markedly with age (23%, 28%, 38%, 50%, and 63% in patients aged 70-74, 75-79, 80-84, 85-89, and greater than or equal to90, respectively, P < .001). After adjustment for potential confounders, age was not associated with ADL decline before hospitalization (odds ratio (OR) for patients aged greater than or equal to90 compared with patients aged 70-74 = 1.26, 95% confidence interval (CI) = 0.88-1.82). In contrast, age was associated with the failure to recover ADL function during hospitalization in patients who declined before admission (OR for patients aged greater than or equal to90 compared with patients aged 70-74 = 2.09, 95% CI = 1.20-3.65) and with new losses of ADL function during hospitalization in patients who did not decline before admission (OR for patients aged greater than or equal to90 compared with patients aged 70-74 = 3.43, 95% CI = 1.92-6.12). CONCLUSION: Many hospitalized older people are discharged with ADL function that is worse than their baseline function. The oldest patients are at particularly high risk of poor functional outcomes because they are less likely to recover ADL function lost before admission and more likely to develop new functional deficits during hospitalization. C1 San Francisco VAMC, San Francisco, CA 94122 USA. Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. Univ Calif San Francisco, Inst Hlth & Aging, San Francisco, CA 94143 USA. Cleveland Clin Fdn, Dept Gen Internal Med, Cleveland, OH 44195 USA. Univ Connecticut, Ctr Hlth, Ctr Aging, Farmington, CT USA. Univ Connecticut, Ctr Hlth, Div Geriatr, Farmington, CT USA. Case Western Reserve Univ, Dept Sociol & Bioeth, Cleveland, OH 44106 USA. RP Covinsky, KE (reprint author), San Francisco VAMC, 181G,4150 Clement, San Francisco, CA 94122 USA. FU AHRQ HHS [K02HS00006-01]; NIA NIH HHS [AG00912] NR 37 TC 446 Z9 455 U1 9 U2 37 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 APR PY 2003 VL 51 IS 4 BP 451 EP 458 DI 10.1046/j.1532-5415.2003.51152.x PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 659XD UT WOS:000181803000002 PM 12657063 ER PT J AU Unutzer, J Katon, W Callahan, CM Williams, JW Hunkeler, E Harpole, L Hoffing, M Della Penna, RD Noel, PH Lin, EHB Tang, LQ Oishi, S AF Unutzer, J Katon, W Callahan, CM Williams, JW Hunkeler, E Harpole, L Hoffing, M Della Penna, RD Noel, PH Lin, EHB Tang, LQ Oishi, S TI Depression treatment in a sample of 1,801 depressed older adults in primary care SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE depression; primary care; quality of care ID LATE-LIFE DEPRESSION; RANDOMIZED CONTROLLED TRIAL; MENTAL-HEALTH-SERVICES; PATIENTS AGED 65; MAJOR DEPRESSION; MINOR DEPRESSION; ANTIDEPRESSANT PHARMACOTHERAPY; MEDICAID POPULATION; DISORDERS; SYMPTOMS AB OBJECTIVES: To examine rates and predictors of lifetime and recent depression treatment in a sample of 1,801 depressed older primary care patients DESIGN: Cross sectional survey data collected from 1999 to 2001 as part of a treatment effectiveness trial. SETTING: Eighteen primary care clinics belonging to eight organizations in five states. PARTICIPANTS: One thousand eight hundred one clinic users aged 60 and older who met diagnostic criteria for major depression or dysthymia. MEASUREMENTS: Lifetime depression treatment was defined as ever having received a prescription medication, counseling, or psychotherapy for depression. Potentially effective recent depression treatment was defined as 2 or more months of antidepressant medications or four or more sessions of counseling or psychotherapy for depression in the past 3 months. RESULTS: The mean age +/- standard deviation was 71.2 +/- 7.5; 65% of subjects were women. Twenty-three percent of the sample came from ethnic minority groups (12% were African American, 8% were Latino, and 3% belonged to other ethnic minorities). The median household income was $23,000. Most study participants (83%) reported depressive symptoms for 2 or more years, and most (71%) reported two or more prior depressive episodes. About 65% reported any lifetime depression treatment, and 46% reported some depression treatment in the past 3 months, although only 29% reported potentially effective recent depression treatment. Most of the treatment provided consisted of antidepressant medications, with newer antidepressants such as selective serotonin reuptake inhibitors constituting the majority (78%) of antidepressants used. Most participants indicated a preference for counseling or psychotherapy over antidepressant medications, but only 8% had received such treatment in the past 3 months, and only 1% reported four or more sessions of counseling. Men, African Americans, Latinos, those without two or more prior episodes of depression, and those who preferred counseling to antidepressant medications reported significantly lower rates of depression care. CONCLUSION: The findings suggest that there is considerable opportunity to improve care for older adults with depression. Particular efforts should be focused on improving access to depression care for older men, African Americans, Latinos, and patients who prefer treatments other than antidepressants. C1 Univ Calif Los Angeles, Inst Neuropsychiat, Ctr Hlth Serv Res, Los Angeles, CA 90024 USA. Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. Indiana Univ, Ctr Aging Res, Regenstrief Inst Hlth Care, Indianapolis, IN 46204 USA. Durham Vet Affairs Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. Duke Univ, Med Ctr, Durham, NC USA. Kaiser Permanente No Calif, Div Res, Oakland, CA USA. Desert Med Grp, Palm Springs, CA USA. Kaiser Permanente So Calif, San Diego, CA USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Grp Hlth Cooperat Puget Sound, Seattle, WA 98121 USA. RP Unutzer, J (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, Ctr Hlth Serv Res, 10920 Wilshire Blvd, Los Angeles, CA 90024 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558; Penna, Maria Pietronilla/0000-0002-0982-3893 NR 74 TC 124 Z9 125 U1 11 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 APR PY 2003 VL 51 IS 4 BP 505 EP 514 DI 10.1046/j.1532-5415.2003.51159.x PG 10 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 659XD UT WOS:000181803000009 PM 12657070 ER PT J AU Ahmed, A Allman, RM DeLong, JF AF Ahmed, A Allman, RM DeLong, JF TI Pattern of cardiology consultation by primary care physician specialty and its association with quality and outcomes of care. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Alabama, Div Geriatr Med, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, GRECC, Birmingham, AL USA. Alabama Qual Assurance Fdn, Heart Failure Study Grp, Birmingham, AL 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P233 BP S122 EP S122 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100279 ER PT J AU Ahmed, A Allman, RM DeLong, JF AF Ahmed, A Allman, RM DeLong, JF TI Association between physician specialty and inappropriate use of digoxin in older adults with heart failure. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Alabama, Div Geriatr Med, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, GRECC, Birmingham, AL USA. Alabama Qual Assurance Fdn, Birmingham, AL USA. RI Ahmed, Ali/A-2934-2008 OI Ahmed, Ali/0000-0002-6832-6424 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P222 BP S118 EP S119 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100268 ER PT J AU Braun, UK Urbauer, D Wray, NP Beyth, RJ AF Braun, UK Urbauer, D Wray, NP Beyth, RJ TI Racial disparities in tube feeding practices for patients with dementia SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Baylor Coll Med, Houston, TX 77030 USA. VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, HSR&D Ctr Excellence, Houston, TX 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P373 BP S167 EP S167 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100417 ER PT J AU Burton, LC Leff, B Guido, S Greenough, W Steinwachs, D Naughton, B Mader, S Burl, J Donius, M Saltzman, S AF Burton, LC Leff, B Guido, S Greenough, W Steinwachs, D Naughton, B Mader, S Burl, J Donius, M Saltzman, S TI Importance of having of an accessible confidant in patients' decision to be treated in a home hospital SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA. Johns Hopkins Sch Med, Baltimore, MD USA. Portland Vet Affairs Med Ctr, Portland, OR USA. SUNY Buffalo, Buffalo, NY 14260 USA. Fallon Hlth Syst, Worcester, MA 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P376 BP S168 EP S168 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100420 ER PT J AU Carey, EC Walter, LC Lindquist, K Covinsky, KE AF Carey, EC Walter, LC Lindquist, K Covinsky, KE TI Development of a functional morbidity index to predict mortality in community-dwelling elders. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Calif San Francisco, Dept Med, Div Geriatr, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, Div Geriatr, Dept Med, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P182 BP S105 EP S105 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100228 ER PT J AU Casarett, D Crowley, R Hirschman, KB AF Casarett, D Crowley, R Hirschman, KB TI If only we had known: What should physicians tell patients and families about hospice? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Penn, Sch Social Work, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P496 BP S209 EP S209 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100541 ER PT J AU Chong, K Olson, E Banc, T Cohen, S Anderson-Malico, R Penrod, J AF Chong, K Olson, E Banc, T Cohen, S Anderson-Malico, R Penrod, J TI Types and rate of implementation of palliative care team recommendations for care of hospitalized veterans. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 New York Med Coll, Valhalla, NY 10595 USA. Bronx Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. Mt Sinai Sch Med, Brookdale Dept Geriatr & Adult Dev, New York, NY 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P535 BP S223 EP S223 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100580 ER PT J AU Chun, AK Cohen, S Penrod, JD AF Chun, AK Cohen, S Penrod, JD TI Effect of palliative care education on housestaff practice. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Mt Sinai Sch Med, Brookdale Dept Geriatr & Adult Dev, New York, NY USA. Bronx Vet Adm Med Ctr, GRECC, Bronx, NY 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P56 BP S62 EP S63 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100102 ER PT J AU Collins, J Conn, V Fox, A Guthrie, M Siddle, J AF Collins, J Conn, V Fox, A Guthrie, M Siddle, J TI Tools and autonomy: Recipe for successful nursing case management in diabetes care. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 VA Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Home Based Primary Care, Pittsburgh, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P534 BP S222 EP S223 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100579 ER PT J AU Collins, M Crowley, R Karlawish, J Casarett, D AF Collins, M Crowley, R Karlawish, J Casarett, D TI Are depressed patients near the end of life more likely to delegate decision-making to others? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P386 BP S171 EP S172 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100430 ER PT J AU Day, HD Tulsky, AA Fox, AR Hennon, J Granieri, EC AF Day, HD Tulsky, AA Fox, AR Hennon, J Granieri, EC TI Jump starting the future: A geriatrics track within an internal medicine residency training program. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA USA. Univ Pittsburgh, UCSUR, Pittsburgh, PA 15260 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P52 BP S61 EP S61 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100098 ER PT J AU Fan, E Royall, DR Chiodo, L Polk, MJ Mouton, C AF Fan, E Royall, DR Chiodo, L Polk, MJ Mouton, C TI Insight into financial capacity in non-institutionalized retirees. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX USA. NR 0 TC 1 Z9 1 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 APR PY 2003 VL 51 IS 4 SU S MA P108 BP S80 EP S80 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100154 ER PT J AU Joudeh, F Gleason, CE Baker, LD Lofgreen, T Cholerton, B Craft, S Asthana, S AF Joudeh, F Gleason, CE Baker, LD Lofgreen, T Cholerton, B Craft, S Asthana, S TI Raloxifene improves cognitive function for older women with Alzheimer's disease. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Wisconsin, Geriatr & Gerontol Sect, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, GRECC, Madison, WI USA. Geriatr Res Educ VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, GRECC, Tacoma, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P104 BP S79 EP S79 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100150 ER PT J AU Karlawish, JH Casarett, D Coyne, J Katz, I AF Karlawish, JH Casarett, D Coyne, J Katz, I TI Are depressed elderly more likely to refuse a screening colonoscopy? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P199 BP S110 EP S111 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100245 ER PT J AU Karlawish, JH James, BD Casarett, DJ Kim, S Sankar, P AF Karlawish, JH James, BD Casarett, DJ Kim, S Sankar, P TI Can people with Alzheimers disease make a decision about treating Alzheimers disease? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Rochester, Rochester, NY 14627 USA. NR 0 TC 1 Z9 1 U1 0 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 APR PY 2003 VL 51 IS 4 SU S MA A34 BP S39 EP S39 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100035 ER PT J AU Legner, VJ Doerner, D Reilly, DF McCormick, WC AF Legner, VJ Doerner, D Reilly, DF McCormick, WC TI Risk factors for nursing home placement following non-emergent major surgery. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 VA Puget Sound Hlth Care Syst, GRECC, Seattle, WA USA. Univ Washington, Seattle, WA 98195 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P568 BP S234 EP S234 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100613 ER PT J AU Silverman, GK Justice, AC AF Silverman, GK Justice, AC TI Why are older patients better at adhering to medication: Patient-provider relationship and other factors SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P375 BP S168 EP S168 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100419 ER PT J AU Sims, RV Ball, K Roth, D Clay, O McKinney, Y Allman, RM AF Sims, RV Ball, K Roth, D Clay, O McKinney, Y Allman, RM TI Shared associations for falls and motor vehicle crashes among older veterans. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Birmingham VAMC, Birmingham, AL USA. Univ Alabama, Birmingham, AL 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P476 BP S202 EP S202 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100521 ER PT J AU Sims, RV Ball, K Roth, D McKinney, Y Clay, O Allman, RM AF Sims, RV Ball, K Roth, D McKinney, Y Clay, O Allman, RM TI Falls among older veteran drivers. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Birmingham VAMC, Birmingham, AL USA. Univ Alabama, Birmingham, AL 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA A44 BP S42 EP S42 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100045 ER PT J AU Vernon, C Vig, EK AF Vernon, C Vig, EK TI Stability of views about the end of life. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Western Univ Hlth Sci, Pomona, CA USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Geriatr & Extended Care, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P129 BP S87 EP S87 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100175 ER PT J AU Vig, EK Hopley, EK AF Vig, EK Hopley, EK TI What do surrogate decision-makers know about hospice? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Geriatr & Extended Care, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P131 BP S87 EP S88 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100177 ER PT J AU Walter, LC de Garmo, P Covinsky, KE AF Walter, LC de Garmo, P Covinsky, KE TI Older age and female sex are associated with inadequate reach of screening flexible sigmoidoscopy. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Oregon Hlth Sci Univ, Portland, OR 97201 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA P123 BP S85 EP S85 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100169 ER PT J AU Wenger, N Solomon, DH Roth, CP MacLean, CH Saliba, D Kamberg, CJ Rubenstein, LZ Young, RT Sloss, EM Adams, J Louie, R Venus, P Schnelle, J Shekelle, P AF Wenger, N Solomon, DH Roth, CP MacLean, CH Saliba, D Kamberg, CJ Rubenstein, LZ Young, RT Sloss, EM Adams, J Louie, R Venus, P Schnelle, J Shekelle, P TI The quality of medical care provided to vulnerable older patients. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 14-18, 2003 CL BALTIMORE, MARYLAND SP American Geriatr Soc C1 RAND Corp, Hlth, Santa Monica, CA 90406 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. United Hlth Grp, Ctr Hlth Policy & Evaluat, Minneapolis, MN USA. Borun Ctr Gerontol Res, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2003 VL 51 IS 4 SU S MA A20 BP S33 EP S34 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 667VP UT WOS:000182255100021 ER PT J AU Smith, KD Wrenshall, LE Nicosia, RF Pichler, R Marsh, CL Alpers, CE Polissar, N Davis, CL AF Smith, KD Wrenshall, LE Nicosia, RF Pichler, R Marsh, CL Alpers, CE Polissar, N Davis, CL TI Delayed graft function and cast nephropathy associated with tacrolimus plus rapamycin use SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID RENAL-ALLOGRAFT REJECTION; ACUTE TUBULAR-NECROSIS; NEOINTIMAL PROLIFERATION; INTRAVASCULAR ULTRASOUND; EPITHELIAL-CELLS; VASCULAR-DISEASE; PROXIMAL TUBULE; RISK-FACTORS; FOLLOW-UP; SIROLIMUS AB Delayed graft function (DGF) occurs in 15 to 25% (range, 10 to 62%) of cadaveric kidney transplant recipients and up to 9% of living donor recipients. In addition to donor, recipient, and procedural factors, the choice of immunosuppression may influence the development of DGF. The impact of immunosuppression on DGF was studied. The frequency of DGF was evaluated in first cadaveric or living donor kidney allograft recipients (n = 144) transplanted at the University of Washington from November 1999 through September 1, 2001. Donor, recipient, and procedural factors, as well as biopsy results, were compared between patients who developed DGF and those who did not. DGF was more common in patients treated with rapamycin than without (25% versus 8.9%, P = 0.02) and positively correlated with rapamycin dose (P = 0.008). In those developing DGF, the duration of posttrans- plant dialysis increased with donor age (P = 0.003) but decreased with mycophenolate mofetil use (P = 0.01). All biopsies during episodes of DGF demonstrated changes of acute tubular injury. Of the patients with tubular injury, 12 treated with rapamycin and tacrolimus developed intratubular cast formation indistinguishable from myeloma cast nephropathy. Histologic, immunohistochemical, and ultrastructural studies indicated that these casts were composed at least in part of degenerating renal tubular epithelial cells. These findings suggest that rapamycin therapy exerts increased toxicity on tubular epithelial cells and/or retards healing, leading to an increased incidence of DGF. Additionally, raparnycin treatment combined with a calcineurin inhibitor may lead to extensive tubular cell injury and death and a unique form of cast nephropathy. C1 Univ Washington, Med Ctr, Dept Pathol, Seattle, WA 98195 USA. Univ Washington, Med Ctr, Dept Surg, Seattle, WA 98195 USA. Univ Washington, Med Ctr, Dept Med, Seattle, WA 98195 USA. Univ Washington, Med Ctr, Div Transplantat, Seattle, WA 98195 USA. Mt Whisper Light Stat Consulting, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Davis, CL (reprint author), Box 356174,1959 NE Pacific St, Seattle, WA 98195 USA. EM cdavis@u.washington.edu NR 48 TC 105 Z9 109 U1 1 U2 2 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 APR PY 2003 VL 14 IS 4 BP 1037 EP 1045 DI 10.1097/01.ASN.0000057542.86377.5A PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 659LD UT WOS:000181777400024 PM 12660339 ER PT J AU Freedland, SJ deGregorio, F Sacoolidge, JC Elshimali, YI Csathy, GS Dorey, F Reiter, RE Aronson, WJ AF Freedland, SJ deGregorio, F Sacoolidge, JC Elshimali, YI Csathy, GS Dorey, F Reiter, RE Aronson, WJ TI Preoperative p27 status is an independent predictor of prostate specific antigen failure following radical prostatectomy SO JOURNAL OF UROLOGY LA English DT Article DE prostatic neoplasms; prostatectomy; prostate-specific antigen; cell cycle proteins ID DEPENDENT KINASE INHIBITOR; RADIATION-THERAPY; P27(KIP1) PROTEIN; CANCER; EXPRESSION; RECURRENCE; SURVIVAL; ADENOCARCINOMA; MARKERS; STAGE AB Purpose: p27 is an important cell cycle regulator, and decreased expression in radical prostatectomy specimens is associated with an increased risk of prostate specific antigen (PSA) failure. To our knowledge no prior study has shown that preoperative p27 status independently predicts recurrence after radical prostatectomy. Materials and Methods: The prostate needle biopsy specimens of 161 men treated with radical prostatectomy were examined for p27 expression using immunohistochemistry. Various p27 cut points were examined for their ability to separate patients into groups with different risk for time to biochemical recurrence following radical prostatectomy. The best p27 cut point was compared to other clinical variables (PSA, clinical stage, age, biopsy Gleason score and percent of prostate needle biopsy with cancer) on multivariate analysis to determine which variables independently predicted biochemical failure. Results: A p27 cut point of less than 45% positive staining cells resulted in significant preoperative risk stratification for time to PSA failure (HR 2.41, p = 0.010). On multivariate analysis serum PSA (HR 1.04, p = 0.011), biopsy Gleason score (HR 1.51, p = 0.011), percent of biopsy tissue with cancer (HR 10.01, p = 0.001) and less than 45% p27 positive cells (HR 2.44, p = 0.014) were all independent predictors of biochemical recurrence. Conclusions: Preoperative p27 expression is an independent predictor of time to biochemical recurrence following radical prostatectomy. Patients with less than 45% p27 positive cells in the prostate needle biopsy specimen have almost a 2.5-fold increased risk of biochemical recurrence. To our knowledge this study is the first to show that p27 status of the prostate needle biopsy specimen can be used before radical prostatectomy to predict biochemical failure. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA 90095 USA. Olive View UCLA Med Ctr, Dept Pathol, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Dept Pathol, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Aronson, WJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Box 951738, Los Angeles, CA 90095 USA. FU NCI NIH HHS [P50 CA92131-01A1] NR 22 TC 32 Z9 32 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD APR PY 2003 VL 169 IS 4 BP 1325 EP 1330 DI 10.1097/01.ju.0000054004.08958.f3 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 656YY UT WOS:000181639700023 PM 12629353 ER PT J AU Latini, DM Penson, DF Lubeck, DP Wallace, KL Henning, JM Lue, TF AF Latini, DM Penson, DF Lubeck, DP Wallace, KL Henning, JM Lue, TF TI Longitudinal differences in disease specific quality of life in men with erectile dysfunction: Results from the exploratory comprehensive evaluation of erectile dysfunction study SO JOURNAL OF UROLOGY LA English DT Article DE penis; impotence; quality of life; questionnaires ID OF-LIFE; PROSTATE-CANCER; INTERNATIONAL INDEX; SILDENAFIL CITRATE; SEXUAL FUNCTION; EFFICACY; UROLOGY AB Purpose: We assessed the impact of erectile dysfunction therapy on 1-year health related quality of life using a validated erectile dysfunction specific instrument. Materials and Methods: Using an observational erectile dysfunction registry clinical, sociodemographic and health related quality of life information was collected at baseline, and 3, 6 and 12 months later. Only men who reported undergoing erectile dysfunction treatment were included in this analysis sub-sample. Patients were classified as treatment responders based on improvements in International Index of Erectile Function scores. Changes in health related quality of life scores from baseline were compared between responders and nonresponders. Results: The cohort consisted of 89 patients, of whom 40 (45%) responded to therapy by International Index of Erectile Function criteria. Responders and nonresponders had comparable baseline disease severity and health related quality of life. At 1 year responders reported significantly better health related quality of life and greater improvement from baseline in sexual experience (mean change -1.64 versus 3.19) and emotional life (mean -3.01 for responders versus 1.75) domains of the Psychological Impact of Erectile Dysfunction scales (p <0.01). This 4.5 to 5 point difference in mean change score (1/2 SD) was considered moderately clinically significant. Conclusions: Men who respond to erectile dysfunction treatment report significantly better health related quality of life 1 year after initial presentation for erectile dysfunction than nonresponders. This finding should motivate providers to be more proactive in diagnosing and treating men with erectile dysfunction since successful therapy appears to improve health related quality of life. These data suggest that men in whom primary therapy for erectile dysfunction fails should be offered secondary treatment because many men in this study in whom previous therapies failed reported improved health related quality of life when they began effective secondary treatment. C1 Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Urol Outcomes Res Grp, San Francisco, CA 94143 USA. Univ Washington, Dept Urol, Seattle, WA 98195 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. TAP Pharmaceut Prod Inc, Lake Forest, IL USA. RP Latini, DM (reprint author), Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. OI Latini, David/0000-0002-6161-4861 NR 18 TC 37 Z9 37 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD APR PY 2003 VL 169 IS 4 BP 1437 EP 1442 DI 10.1097/01.ju.0000049203.33463.9e PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 656YY UT WOS:000181639700049 PM 12629379 ER PT J AU Penson, DF Latini, DM Lubeck, DP Wallace, K Henning, JM Lue, T AF Penson, DF Latini, DM Lubeck, DP Wallace, K Henning, JM Lue, T TI Is quality of life different for men with erectile dysfunction and prostate cancer compared to men with erectile dysfunction due to the exceed other causes? Results from data base SO JOURNAL OF UROLOGY LA English DT Article DE impotence; prostate neoplasms; quality of life ID OF-LIFE; PATIENT PREFERENCES AB Purpose: To our knowledge the relationship between the underlying etiology of erectile dysfunction and its impact on health related quality of life has not been studied. Such a study is important for men with prostate cancer, as the potential negative quality of life impact of erectile dysfunction may affect clinical decision making in newly diagnosed disease. We compare health related quality of life in impotent men with prostate cancer to that of impotent men without prostate cancer using the Exploratory and Comprehensive Evaluation of Erectile Dysfunction (ExCEED, TAP Pharmaceutical Products, Inc., Lake Forest, Illinois) data base, which is a multicenter, observational disease registry of men with erectile dysfunction. Materials and Methods: The cohort included 168 men in ExCEED who had baseline health related quality of life measurement. Of these men 47 reported a history of prostate cancer while 121 did not. Appropriate univariate and multivariate analyses were performed comparing health related quality of life outcomes between impotent men with and without prostate cancer. Results: Men with erectile dysfunction and prostate cancer had worse sexual self-efficacy, erectile function, intercourse satisfaction and orgasmic function than those with erectile dysfunction without prostate cancer (all p <0.001). However, men with erectile dysfunction and prostate cancer experienced less psychological impact of erectile dysfunction on sexual experience (p = 0.05) and emotional life (p = 0.03) than those with erectile dysfunction without prostate cancer. The findings regarding the psychological impact of erectile dysfunction persisted in multivariate linear regression models. Conclusions: Men with erectile dysfunction and prostate cancer appear to have better disease specific health related quality of life than those with erectile dysfunction and no history of prostate cancer. This finding has important ramifications for clinicians when counseling patients newly diagnosed with prostate cancer and also when treating patients who present with erectile dysfunction of various etiologies. C1 VA Puget Sound Hlth Care Syst, Urol Sect, Seattle, WA 98108 USA. Univ Washington, Dept Urol, Seattle, WA 98195 USA. Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. TAP Pharmaceut Prod Inc, Lake Forest, IL USA. RP Penson, DF (reprint author), VA Puget Sound Hlth Care Syst, Urol Sect, Seattle, WA 98108 USA. NR 14 TC 27 Z9 28 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD APR PY 2003 VL 169 IS 4 BP 1458 EP 1461 DI 10.1097/01.ju.0000054462.88306.43 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 656YY UT WOS:000181639700053 PM 12629383 ER PT J AU Asthana, S AF Asthana, S TI Estrogen and cognition: The story so far SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Editorial Material ID HORMONE REPLACEMENT THERAPY; POSTMENOPAUSAL WOMEN; ALZHEIMERS-DISEASE; CONTROLLED TRIAL; DOUBLE-BLIND; DEMENTIA C1 Univ Wisconsin, Madison Med Sch, Sect Geriatr & Gerontol, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr, Madison, WI USA. RP Asthana, S (reprint author), Univ Wisconsin, Madison Med Sch, Sect Geriatr & Gerontol, Madison, WI 53706 USA. NR 18 TC 17 Z9 17 U1 1 U2 1 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD APR PY 2003 VL 58 IS 4 BP 322 EP 323 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 663NN UT WOS:000182011800005 PM 12663695 ER PT J AU Gopal, DV Rosen, HR AF Gopal, DV Rosen, HR TI Duration of antiviral therapy for cholestatic HCV recurrence may need to be indefinite SO LIVER TRANSPLANTATION LA English DT Article ID ORTHOTOPIC LIVER-TRANSPLANTATION; HEPATITIS-C RECURRENCE; COMBINATION INTERFERON; RIBAVIRIN; EFFICACY; INJURY AB Progressive liver allograft injury related to hepatitis C virus (HCV) recurrence occurs in 20% to 30% of liver transplant recipients within the first 5 years. In particular the subset of patients who develop the severe cholestatic variant has an extremely high mortality. We report our center's experience with 7 cholestatic patients who were treated with interferon alfa-2b (3 million IU three times per week initially) in combination with ribavirin. In 4 of the 7 patients, HCV-RNA in serum became undetectable, and in an additional patient, normalization of serum bilirubin was achieved despite persistent viremia. Discontinuation of antiviral therapy by patient choice, intolerance of side effects, or occurrence of infection were followed temporally by rapid relapses of the cholestatic syndrome, allograft failure, and death. The only 2 patients alive in remission of this syndrome have been maintained on antiviral therapy for an average of 32 months. Thus, based on our experience, we recommend that duration of antiviral therapy in the subset of patients with cholestatic HCV recurrence should be indefinite. C1 US Vet Hosp, Portland Vet Affairs Med Ctr, Div Gastroenterol Hepatol, Hepatol Liver Transplantat Program, Portland, OR 97207 USA. Oregon Hlth & Sci Ctr, Div Gastroenterol, Portland, OR USA. RP Gopal, DV (reprint author), US Vet Hosp, Portland Vet Affairs Med Ctr, Div Gastroenterol Hepatol, Hepatol Liver Transplantat Program, 3710 SW,P3-GI, Portland, OR 97207 USA. NR 18 TC 46 Z9 46 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 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD APR PY 2003 VL 9 IS 4 BP 348 EP 353 DI 10.1053/jlts.2003.50062 PG 6 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 663ML UT WOS:000182009300004 PM 12682884 ER PT J AU Cooper, LA Gonzales, JJ Gallo, JJ Rost, KM Meredith, LS Rubenstein, LV Wang, NY Ford, DE AF Cooper, LA Gonzales, JJ Gallo, JJ Rost, KM Meredith, LS Rubenstein, LV Wang, NY Ford, DE TI The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients SO MEDICAL CARE LA English DT Article; Proceedings Paper CT 12th International-National-Institute-of-Mental-Health Conference on Mental Health Problems in the General Health Sector CY JUL 13-14, 1998 CL BALTIMORE, MARYLAND SP Int Natl Inst Mental Hlth DE depression; patient attitudes; ethnic minorities; disparities; African Americans; Hispanics ID MENTAL-HEALTH-CARE; MAJOR DEPRESSION; QUALITY IMPROVEMENT; SERVICE UTILIZATION; MEXICAN-AMERICANS; ATTITUDE-CHANGE; UNITED-STATES; PREFERENCES; DISORDERS; PREVALENCE AB BACKGROUND. Ethnic minority patients are less likely than white patients to receive guideline-concordant care for depression. It is uncertain whether racial and ethnic differences exist in patient beliefs, attitudes, and preferences for treatment. METHODS. A telephone survey was conducted of 829 adult patients (659 non-Hispanic whites, 97 African Americans, 73 Hispanics) recruited from primary care offices across the United States who reported 1 week or more of depressed mood or loss of interest within the past month and who met criteria for Major Depressive Episode in the past year. Within this cohort, we examined differences among African Americans, Hispanics, and whites in acceptability of antidepressant medication and acceptability of individual counseling. RESULTS. African Americans (adjusted OR, 0.30; 95% CI 0.19-0.48) and Hispanics (adjusted OR, 0.44; 95% CI, 0.26-0.76) had lower odds than white persons of finding antidepressant medications acceptable. African Americans had somewhat lower odds (adjusted OR, 0.63; 95% CI, 0.35-1.12), and Hispanics had higher odds (adjusted OR, 3.26; 95% CI, 1.08-9.89) of finding counseling acceptable than white persons. Some negative beliefs regarding treatment were more prevalent among ethnic minorities; however adjustment for these beliefs did not explain differences in acceptability of treatment for depression. CONCLUSIONS. African Americans are less likely than white persons to find antidepressant medication acceptable. Hispanics are less likely to find antidepressant medication acceptable, and more likely to find counseling acceptable than white persons. Racial and ethnic differences in beliefs about treatment modalities were found, but did not explain differences in the acceptability of depression treatment. Clinicians should consider patients' cultural and social context when negotiating treatment decisions for depression. Future research should identify other attitudinal barriers to depression care among ethnic minority patients. C1 Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD 21205 USA. NIMH, Rockville, MD 20857 USA. Univ Penn, Dept Family Med, Philadelphia, PA 19104 USA. Univ Colorado, Hlth Sci Ctr, Dept Family Med, Denver, CO 80202 USA. RAND Corp, Hlth Program, Santa Monica, CA USA. VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Cooper, LA (reprint author), Welch Ctr Prevent Epidemiol & Clin Res, 2024 E Monument St,Suite 2-500, Baltimore, MD 21205 USA. OI Wang, Nae-Yuh/0000-0001-6513-9730 FU NIMH NIH HHS [MH5443, MH5444, MH57992] NR 43 TC 373 Z9 375 U1 4 U2 16 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 APR PY 2003 VL 41 IS 4 BP 479 EP 489 DI 10.1097/00005650-200304000-00004 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 663LE UT WOS:000182006400004 PM 12665712 ER PT J AU Jafari, M Leaf, DA MacRae, H Kasem, J O'Conner, P Pullinger, C Malloy, M Kane, JP AF Jafari, M Leaf, DA MacRae, H Kasem, J O'Conner, P Pullinger, C Malloy, M Kane, JP TI The effects of physical exercise on plasma prebeta-1 high-density lipoprotein SO METABOLISM-CLINICAL AND EXPERIMENTAL LA English DT Article ID APOLIPOPROTEIN-A-I; CHOLESTEROL ACYLTRANSFERASE ACTIVITY; ESTER TRANSFER PROTEIN; PROLONGED EXERCISE; HDL-CHOLESTEROL; SERUM-LIPIDS; OVERWEIGHT MEN; WEIGHT-LOSS; METABOLISM; LIPASE AB The impact of physical exercise on high-density lipoprotein (HDL) metabolism is recognized as a major mechanism of coronary artery disease (CAD) risk reduction. Prebeta-1 HDL subparticle species play a pivotal role in initiating reverse cholesterol transport (IRCT). We examined the effect of acute physical exercise on plasma prebeta-1 HDL levels. Nineteen nonsmoking, healthy men (n = 11) and women (n = 8) not receiving lipid-altering medications completed dietary surveys, and had percent body fat determinations, and fasting blood drawn for measurements of plasma lipids, lipoproteins, apolipoprotein A-I (Apo A-I), and absolute and percent prebeta-1 HDL. Each subject completed cardiopulmonary exercise stress testing to Vo(2max) followed by a 4-km course of run-jogging. Laboratory measurements were repeated from blood drawn immediately after exercise. Mean +/- SD values were determined for age, percent body fat, dietary calories, dietary cholesterol, dietary fat, and plasma lipids, lipoproteins, Apo A-I, and absolute and percent prebeta-1 HDL using 1-way analysis of variance (ANOVA). One-way ANOVA comparisons were made for measurements of plasma lipids, lipoproteins, Apo A-I, and absolute and percent prebeta HDL measurements taken before and after exercise for all subjects combined. Entry characteristics showed the following (mean SD): age, 24 +/- 5.8 years; body mass index (BMI), 22.4 +/- 2.6; percent body fat, 13 +/- 5.7; and Vo(max), 49.1 +/- 7.9 mL O-2/kg/min. Exercise significantly increased absolute plasma prebeta HDL (0.10 +/- 0.05 to 0.130 +/- 0.07 mug/mL, P = .039) and decreased plasma HDL-triglycerides (23.3 +/- 10.8 to 12.5 +/- 5.6 mg/dL, P = .012). Our findings indicate that prebeta-1 HDL and HDL-triglyceride metabolism are significant components of the effect of acute exercise on RCT. These findings have important relevance for studies pertaining to exercise-related effects on HDL metabolism as pertains to CAD risk reduction. Copyright 2003 Elsevier, Inc. All rights reserved. C1 Univ Calif Irvine, Dept Med, Irvine, CA 92717 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Greater Los Angeles VA Healthcare Syst, Div Gen Internal Med, Los Angeles, CA 90073 USA. Pepperdine Univ, Dept Sports Med, Malibu, CA 90265 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. RP Leaf, DA (reprint author), Greater Los Angeles VA Healthcare Syst, Div Gen Internal Med, 111G,Wilshire & Sawtelle Blvd, Los Angeles, CA 90073 USA. NR 59 TC 20 Z9 20 U1 1 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0026-0495 J9 METABOLISM JI Metab.-Clin. Exp. PD APR PY 2003 VL 52 IS 4 BP 437 EP 442 DI 10.1053/meta.2003.50086 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 668YX UT WOS:000182326000010 PM 12701055 ER PT J AU Bingaman, S Huxley, VH Rumbaut, RE AF Bingaman, S Huxley, VH Rumbaut, RE TI Fluorescent dyes modify properties of proteins used in microvascular research SO MICROCIRCULATION LA English DT Article DE alpha-lactalbumin; arteriole; bovine serum albumin; coronary; electrophoresis; fluorescent dyes; isoelectric point; pig; venule ID PAIRWISE MULTIPLE COMPARISONS; HAMSTER-CHEEK POUCH; NITRIC-OXIDE; ALBUMIN; PERMEABILITY; GLYCOCALYX; VOLUME; MICROSCOPY; MECHANISMS; VARIANCE AB Objective: Fluorescent dyes, used frequently to label proteins for microvascular experiments, are assumed to not alter the protein's physicochemical characteristics. We tested the validity of that assumption for two probes, bovine serum albumin (BSA) and alpha-lactalbumin. Methods: Standard electrophoretic techniques were used to examine the influence of five fluorescent dyes on the following three properties of BSA: molecular size (sodium dodecyl sulfate-polyacrylamide gel electrophoresis [PAGE])- relative molecular charge (native PACE); and isoelectric point (pI) (i.e., isoelectric focusing). Also examined were the influence of the dyes on the relative charge of alpha-lactalbumin (native PAGE). Paired measures of single-vessel flux were made using two commercial preparations of dye-BSA on porcine coronary arterioles and ventiles. Results: The addition of fluorescein isothiocyanate (FITC) to BSA altered significantly its size (p < 0.01; n = 6), relative charge (p < 0.02; n = 7), and pI. The other dyes caused minimal, yet significant, changes on the relative charge of BSA without influencing size or pI. Only FITC altered the relative charge of a-lactalbumin. While arteriolar fluxes of FITC-BSA and tetramethyl rhodamine isothiocyanate (TRITC)-BSA did not differ (p = 0.43; n = 5), in venules the FITC-B A flux was greater than the TRITC-BSA flux (p < 0.001; n = 6). Conclusions: The addition of fluorescent dyes, particularly FITC, alters the physicochemical characteristics of two widely used protein probes. These findings may affect the interpretation of microvascular permeability experiments performed using fluorescent dyes, and they suggest care in the selection of dyes for such experiments. C1 Univ Missouri, Dept Physiol, Columbia, MO 65212 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. RP Huxley, VH (reprint author), Univ Missouri, Dept Physiol, MA 415,Med Sci Bldg, Columbia, MO 65212 USA. FU NHLBI NIH HHS [P01 HL052490, R01 HL-64721, R01 HL064721, R37 HL-42528] NR 38 TC 37 Z9 37 U1 0 U2 15 PU NATURE PUBLISHING GROUP PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 1073-9688 J9 MICROCIRCULATION JI Microcirculation PD APR PY 2003 VL 10 IS 2 BP 221 EP 231 DI 10.1038/sj.mn.7800186 PG 11 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 670VM UT WOS:000182429900010 PM 12700589 ER PT J AU Faber, R Hill, VM Kim, BJ AF Faber, R Hill, VM Kim, BJ TI Frontotemporal dementia affecting a US Air Force officer SO MILITARY MEDICINE LA English DT Article ID FRONTAL-LOBE DEGENERATION; NON-ALZHEIMER TYPE; CLINICAL PICTURE; TESTS; PERFORMANCE; DIAGNOSIS; CRITERIA; DISEASE AB We present the case of a 51-year-old former U.S. Air Force officer who developed marked behavioral and personality changes over a 9-year period, ultimately leading to his discharge from the Air Force at a rank below that which he achieved during service. Clinical diagnostic features, neuropsychological testing and neuroimaging together confirmed a diagnosis of frontotemporal dementia. This form of presenile dementia is discussed with reference to his case. C1 Audie L Murphy Mem Vet Adm Med Ctr, Psychiat Serv, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. RP Faber, R (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, Psychiat Serv, 7400 Merton Minter, San Antonio, TX 78229 USA. NR 21 TC 0 Z9 0 U1 0 U2 0 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD APR PY 2003 VL 168 IS 4 BP 333 EP 336 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 743AE UT WOS:000186549600013 PM 12733681 ER PT J AU Payami, H Nutt, J Gancher, S Bird, T McNeal, MG Seltzer, WK Hussey, J Lockhart, P Gwinn-Hardy, K Singleton, AA Singleton, AB Hardy, J Farrer, M AF Payami, H Nutt, J Gancher, S Bird, T McNeal, MG Seltzer, WK Hussey, J Lockhart, P Gwinn-Hardy, K Singleton, AA Singleton, AB Hardy, J Farrer, M TI SCA2 may present as levodopa-responsive parkinsonism SO MOVEMENT DISORDERS LA English DT Article DE parkinsonism; SCA2 mutation; levodopa ID SPINOCEREBELLAR ATAXIA TYPE-2; DISEASE; EXPANSION AB Some kindreds with familial parkinsonism exhibit genetic anticipation, suggesting possible involvement of trinucleotide repeat expansion. Recent reports have shown trinucleotide repeat expansions in the spinocerebellar ataxia 2 (SCA2) gene in patients with levodopa-responsive parkinsonism. We tested 136 unrelated patients with familial parkinsonism for SCA2 mutations. Two probands had borderline mutations; the rest were normal. (less than or equal to31 repeats is normal, 32-35 is borderline, greater than or equal to36 is pathogenic). The expanded allele segregated with neurological signs in one kindred. The absence of borderline mutations in the normal population, and the co-segregation of the expanded allele with neurological signs in one kindred suggest that SCA2 mutations may be responsible for a subset of familial parkinsonism. (C) 2002 Movement Disorder Society. C1 Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Kaiser Permanente, Portland, OR USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Oregon Hlth Sci Univ, Dept Mol Genet, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med Genet, Portland, OR 97201 USA. Athena Diagnost Inc, Worcester, MA USA. Mayo Clin, Dept Neurosci, Jacksonville, FL 32224 USA. Mayo Clin, Dept Neurol, Jacksonville, FL 32224 USA. NIA, Neurogenet Lab, Bethesda, MD 20892 USA. NINDS, Neurogenet Lab, Bethesda, MD 20892 USA. Wadsworth Ctr, Albany, NY 12208 USA. RP Payami, H (reprint author), Wadsworth Ctr, 120 New Scotland Ave, Albany, NY 12208 USA. RI Gwinn, Katrina/C-2508-2009; Singleton, Andrew/C-3010-2009; Hardy, John/C-2451-2009; Lockhart, Paul/E-7753-2011 OI Lockhart, Paul/0000-0003-2531-8413; Gwinn, Katrina/0000-0002-8277-651X FU NCRR NIH HHS [5M01 RR00334]; NIA NIH HHS [AG0817]; NINDS NIH HHS [NS40256, R01 NS36960] NR 10 TC 45 Z9 46 U1 0 U2 2 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 APR PY 2003 VL 18 IS 4 BP 425 EP 429 DI 10.1002/mds.10375 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 667ZH UT WOS:000182264800011 PM 12671950 ER PT J AU Buchler, P Gukovskaya, TS Mouria, T Buchler, MC Buchler, MW Friess, H Pandol, TJ Reber, HA Hines, OJ AF Buchler, P Gukovskaya, TS Mouria, T Buchler, MC Buchler, MW Friess, H Pandol, TJ Reber, HA Hines, OJ TI Prevention of metastatic pancreatic cancer growth in vivo by induction of apoptosis with genistein, a naturally occurring isoflavonoid SO PANCREAS LA English DT Article DE apoptosis; genistein; isoflavonoid; metastasis; pancreatic cancer ID NF-KAPPA-B; CELL-DEATH; IN-VITRO; EPITHELIAL-CELLS; ANGIOGENESIS; CARCINOMA; ADENOCARCINOMA; INHIBITION; PROLIFERATION; ACTIVATION AB Introduction: The critical need for novel therapeutic approaches to pancreatic cancer treatment is clear. Genistein, a naturally occurring isoflavonoid, is active against certain solid malignancies, but its effect on pancreatic cancer is unknown. Aims: To investigate the bioactivity of genistein in experimental pancreatic cancer in vitro and in vivo. Methodology: The effect of intraperitoneal genistein administration on local tumor growth and metastatic disease was determined in an orthotopic nude mouse model. Apoptosis in tumor specimens was determined by the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) technique. In vitro, the effect of genistein on cell growth was assessed by cell count and MTT (3-[4,5-dimethylthiazol-2yl]-2,5-diphenyl tetrazolium bromide) colorimetric assay. Apoptosis was determined in vitro by DNA laddering and annexin-V. Caspase-3 and nuclear factor-kappaB activity were measured following genistein treatment. Results: In vivo, genistein significantly improved survival, almost completely inhibited metastasis, and increased apoptosis in an orthotopic model of pancreatic cancer. In vitro genistein treatment resulted in apoptosis in all pancreatic cancer cell lines tested, and this appeared to be mediated by activation of caspase-3. Conclusion: These findings suggest that the antimetastatic effect of genistein treatment in vivo is mediated by induction of apoptosis. Genistein may have a therapeutic benefit for patients with pancreatic cancer, in particular after surgery, to prevent recurrence of metastatic disease. C1 Univ Calif Los Angeles, Sch Med, Div Gen Surg, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Bern, Dept Surg, Bern, Switzerland. Insel Hosp, Bern, Switzerland. RP Hines, OJ (reprint author), Univ Calif Los Angeles, Sch Med, Div Gen Surg, Dept Surg, 72-231 CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA. NR 49 TC 54 Z9 58 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD APR PY 2003 VL 26 IS 3 BP 264 EP 273 DI 10.1097/00006676-200304000-00010 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 661TL UT WOS:000181905800010 PM 12657953 ER PT J AU Solomon, TE Keire, DA Gong, PX Zong, YM Reeve, JR AF Solomon, TE Keire, DA Gong, PX Zong, YM Reeve, JR TI Receptor subtypes: Species variations in secretin affect potency for pancreatic but not gastric secretion SO PANCREAS LA English DT Article DE rat; secretin biochemistry; secretin physiology ID ACID-SECRETION; RAT; MECHANISM; SEQUENCE; PACAP; VIP AB Introduction: Receptor subtypes can be distinguished by different actions of agonists on physiologic responses. In this study, we compared effects of four species variants of secretin (rat, porcine, canine, and human) on pancreatic secretion and gastrin-induced acid secretion in urethane-anesthetized rats. These secretins differ by one to three residues in position 14, 15, or 16 and were used to probe for the presence of different secretin receptor subtypes in the rat. Methodology: Pancreatic responses were measured in a two-point parallel line bioassay with porcine secretin (3 and 30 pmol/kg IV bolus) as standard. Inhibition of gastric acid secretion by each secretin (100 pmol/[kg (.) h]) was quantitated against a threshold dosage of gastrin-17 (200 pmol/[kg (.) h]), and percent inhibition of incremental acid responses was determined. Results: Rat secretin was significantly more potent than other secretins for pancreatic secretion, in the order of rat > porcine > canine > human. The four secretins significantly inhibited gastrin-induced acid secretion by 37% to 49%, with no statistically significant differences among the forms. Conclusions: Stimulation of pancreatic secretion was influenced by species variations in secretin structure, but inhibition of gastric acid secretion was not. This finding suggests that secretin receptor subtypes with different recognition patterns mediate these responses. C1 VA Greater Los Angeles Healthcare Syst, Res Serv 151, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA USA. RP Reeve, JR (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv 151, CURE Digest Dis Res Ctr, Bldg 115,Room 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK41301] NR 20 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD APR PY 2003 VL 26 IS 3 BP 300 EP 305 DI 10.1097/00006676-200304000-00015 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 661TL UT WOS:000181905800015 PM 12657958 ER PT J AU Natarajan, S Nietert, PJ AF Natarajan, S Nietert, PJ TI National trends in screening, prevalence, and treatment of cardiovascular risk factors SO PREVENTIVE MEDICINE LA English DT Article; Proceedings Paper CT 22nd Annual Meeting of the Society-of-General-Internal-Medicine CY APR 29-MAY 01, 1999 CL SAN FRANCISCO, CALIFORNIA SP Soc Gen Internal Med DE hypertension; hypercholesterolemia; smoking; trends; population survey ID MINNESOTA-HEART-SURVEY; CIGARETTE-SMOKING; UNITED-STATES; HYPERTENSION PREVALENCE; SOCIOECONOMIC-STATUS; SECULAR TRENDS; TIME TRENDS; DISEASE; CHOLESTEROL; HEALTH AB Background. Few studies have documented national trends in screening, awareness, and treatment of cardiovascular risk factors. We evaluated trends in screening, prevalence, and treatment of hypertension, hypercholesterolemia, and smoking. Methods. Data were analyzed from the 1984-1998 Behavioral Risk Factor Surveillance System, a series of yearly cross-sectional population-based surveys of U.S. adults. Unadjusted and adjusted time trends (age-, gender-, ethnicity-, education-, and income-adjusted) in screening, prevalence, and treatment were evaluated. Results. From 1984 to 1998, a larger proportion of U.S. adults were older, more educated, richer, and Hispanic. Hypertension screening was >97% (1988-1998), prevalence ranged from 21 to 24% (1984-1998), and approximately 58% (1984-1992) were prescribed blood-pressure-lowering medications. Hypercholesterolemia screening increased from 47 to 67% (1987-1998), prevalence from 18 to 31% (1987-1998), and cholesterol-lowering prescriptions from 22 to 25% (1988-1990). Smoking prevalence remained around 28% (19841998), while quit attempts declined from 63 to 47% (1990-1998). Conclusions. Although screening for hypertension and hypercholesterolemia has increased, a substantial proportion of cases were not being prescribed medications. While the prevalence of smoking remains constant, quit attempts have fallen. Continuing challenges for cardiovascular disease prevention include identification of individuals with hypercholesterolemia, appropriate prescription (initiation and/or maintenance) of antihypertensive and lipid-lowering medications, and intensifying smoking cessation efforts. (C) 2003 American Health Foundation and Elsevier Science (USA). All rights reserved. C1 Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. Med Univ S Carolina, Ctr Hlth Care Res, Charleston, SC 29425 USA. Med Univ S Carolina, Div Gen Internal Med, Charleston, SC 29425 USA. RP Natarajan, S (reprint author), VA New York Harbor Healthcare Syst, Dept Med, 423 E 23rd St,Room 11101-5, New York, NY 10010 USA. OI Nietert, Paul/0000-0002-3933-4986 NR 42 TC 14 Z9 14 U1 0 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0091-7435 J9 PREV MED JI Prev. Med. PD APR PY 2003 VL 36 IS 4 BP 389 EP 397 DI 10.1016/S0091-7435(02)00057-9 PG 9 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 662RK UT WOS:000181961700001 PM 12649046 ER PT J AU Kern, RS Green, MF Mintz, J Liberman, RP AF Kern, RS Green, MF Mintz, J Liberman, RP TI Does 'errorless learning' compensate for neurocognitive impairments in the work rehabilitation of persons with schizophrenia? SO PSYCHOLOGICAL MEDICINE LA English DT Article ID COGNITIVE REMEDIATION; SUPPORTED EMPLOYMENT; ENHANCEMENT THERAPY; MEMORY; PERFORMANCE; DISORDERS; INDIVIDUALS; DEFICITS; CAPACITY; TIME AB Background. Because neurocognitive impairments of schizophrenia appear to be 'rate limiting' in the acquisition of skills for community functioning, it is important to develop efficacious rehabilitative interventions that can compensate for these impairments. Procedures based on errorless learning may facilitate work rehabilitation because they effectively automate training of work and other skills, thereby reducing the cognitive burden on persons with schizophrenia. Method. The present study examined the ability of a training method based on errorless learning to compensate for neurocognitive deficits in teaching two entry-level job tasks (index card filing and toilet-tank assembly) to a sample of 54 unemployed, clinically stable schizophrenic and schizo-affective disorder out-patients. Participants were randomly assigned to one of two training groups, errorless learning v. conventional trial-and-error type instruction. Prior to randomization, all subjects were administered a neurocognitive battery. Job task performance was assessed by percentage accuracy scores immediately after training. Results. For three of the six inter-relationships among neurocognitive functioning and training condition, the pattern was the same: the errorless learning group scored high in job task performance regardless of neurocognitive impairment, whereas the conventional instruction group showed a close correspondence between job task performance and degree of neurocognitive impairment. Conclusions. These findings support errorless learning as a technique that can compensate for neurocognitive deficits as they relate to the acquisition of new skills and abilities in the work rehabilitation of persons with schizophrenia. C1 Dept Vet Affairs, VISN 22, MIRECC, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Kern, RS (reprint author), VA Greater Los Angeles Healthcare ctr, MIRECC 210 A,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIMH NIH HHS [MH 30911-21S1] NR 59 TC 37 Z9 37 U1 4 U2 8 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0033-2917 J9 PSYCHOL MED JI Psychol. Med. PD APR PY 2003 VL 33 IS 3 BP 433 EP 442 DI 10.1017/S0033291702007298 PG 10 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 671TB UT WOS:000182479200006 PM 12701664 ER PT J AU Miller, YE Fain, P AF Miller, YE Fain, P TI Genetic susceptibility to lung cancer SO SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review DE lung cancer; genetic susceptibility; genomic instability; carcinogen metabolism ID OBSTRUCTIVE PULMONARY-DISEASE; GROWTH-FACTOR-I; BREAST-CANCER; ENVIRONMENTAL COMPONENTS; CARDIOVASCULAR-DISEASE; NEUTRAL ENDOPEPTIDASE; SEGREGATION ANALYSIS; FAMILIAL BREAST; BETA-CAROTENE; RECEPTOR GENE AB Lung cancer is the most common cause of cancer death in the world. Environmental factors, particularly cigarette smoking, are of paramount importance in determining lung cancer risk. Lung cancer and chronic obstructive lung disease are likely to share some common susceptibility genes, but these have not yet been identified. Evidence from various sources, including twin studies, segregation analyses, and case-control studies, support a heritable component to lung cancer risk in humans. As with many common diseases, susceptibility genes for lung cancer appear to be of low penetrance. Family studies of lung cancer susceptibility using linkage analysis and positional cloning have not been reported; however, a consortium is currently carrying out such studies, and results may soon be available. Association studies support lung cancer risk being partly determined by genes that control the metabolism of carcinogens found in tobacco smoke, with the heritable effects being most prominent in smokers with shorter smoking histories. Of these, the CYP1A1 and GSTM1 polymorphisms have been most consistently implicated. In the mouse, an oligonucleotide repeat polymorphism within an intron of the Ki-ras oncogene is the major lung cancer susceptibility locus; however this locus is not clearly involved in susceptibility to lung cancer in the human. Further understanding of the genetic basis of lung cancer susceptibility has many important implications, ranging from targeting prevention and screening efforts to the most highly susceptible population to developing novel chemopreventive therapies. C1 Univ Colorado, Hlth Sci Ctr, Div Pulm Sci & Crit Care Med, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Ctr Canc, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver Vet Affairs Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Div Renal Dis & Hypertens, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Barbara Davis Ctr Childhood Diabet, Denver, CO USA. RP Miller, YE (reprint author), VA Med Ctr, Respir 111A,1055 Clermont St, Denver, CO 80220 USA. NR 63 TC 7 Z9 8 U1 3 U2 4 PU THIEME MEDICAL PUBL INC PI NEW YORK PA 333 SEVENTH AVE, NEW YORK, NY 10001 USA SN 1069-3424 J9 SEM RESP CRIT CARE M JI Semin. Respir. Crit. Care Med. PD APR PY 2003 VL 24 IS 2 BP 197 EP 204 DI 10.1055/s-2003-39018 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 674XY UT WOS:000182663900008 PM 16088539 ER PT J AU Ubel, PA Jepson, C Baron, J Hershey, JC Asch, DA AF Ubel, PA Jepson, C Baron, J Hershey, JC Asch, DA TI The influence of cost-effectiveness information on physicians' cancer screening recommendations SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE decision making; physician survey; cost-effectiveness; USA ID MAIL SURVEYS AB Physicians are increasingly faced with choices in which one screening strategy is both more effective and more expensive than another. One way to make such choices is to examine the cost-effectiveness of the more costly strategy over the less costly one. However, little is known about how cost-effectiveness information influences physicians' screening decisions. We surveyed 900 primary care US physicians, and presented each with a hypothetical cancer-screening scenario. We created three familiar screening scenarios, involving cervical, colon, and breast cancer. We also created three unfamiliar screening scenarios. Physicians were randomized to receive one of nine questionnaires, each containing one screening scenario. Three questionnaires posed one of the familiar screening scenarios without cost-effectiveness information, three posed one of the familiar scenarios with cost-effectiveness information, and three posed one of the unfamiliar scenarios with cost-effectiveness information. The cost-effectiveness information for familiar scenarios was drawn from the medical literature. The cost-effectiveness information for unfamiliar scenarios was fabricated to match that of a corresponding familiar scenario. In all questionnaires, physicians were asked what screening alternative they would recommend. A total of 560 physicians responded (65%). For familiar scenarios, providing cost-effectiveness information had at most a small influence on physicians' screening recommendations; it reduced the proportion of physicians recommending annual Pap smears (p = 0.003), but did not significantly alter the aggressiveness of colon cancer and breast cancer screening (both p's < 0.1). For all three unfamiliar scenarios, physicians were significantly less likely to recommend expensive screening strategies than in corresponding familiar scenarios (all p's < 0.001). Physicians' written explanations revealed a number of factors that moderated the influence of cost-effectiveness information on their screening recommendations. Providing physicians with cost-effectiveness information had only a moderate influence on their screening recommendations for cervical, colon, and breast cancer. Significantly, fewer physicians recommended aggressive screening for unfamiliar cancers than for familiar ones, despite similar cost-effectiveness. Physicians are relatively reluctant to abandon common screening strategies, even when they learn that they are expensive, and are hesitant to adopt unfamiliar screening strategies, even when they learn that they are inexpensive. Published by Elsevier Science Ltd. C1 Univ Michigan, Program Improving Hlth Care Decis, Ann Arbor, MI 48109 USA. VA Ann Arbor Healthcare Syst, VA Hlth Serv, Res & Dev Ctr Excellence, Ann Arbor, MI USA. Univ Michigan, Div Gen Internal Med, Ann Arbor, MI 48109 USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychol, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Ubel, PA (reprint author), Univ Michigan, Program Improving Hlth Care Decis, 300 N Ingalls,Room 7B20, Ann Arbor, MI 48109 USA. FU NCI NIH HHS [R01-CA78052-01] NR 16 TC 24 Z9 24 U1 1 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD APR PY 2003 VL 56 IS 8 BP 1727 EP 1736 AR PII S0277-9536(02)00167-3 DI 10.1016/S0277-9536(02)00167-3 PG 10 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 665HJ UT WOS:000182113700012 PM 12639589 ER PT J AU Freedland, SJ Presti, JC Amling, CL Kane, CJ Aronson, WJ Dorey, F Terris, MK AF Freedland, SJ Presti, JC Amling, CL Kane, CJ Aronson, WJ Dorey, F Terris, MK CA Search Database Study Grp TI Time trends in biochemical recurrence after radical prostatectomy: Results of the search database SO UROLOGY LA English DT Article ID SEXTANT BIOPSIES; EXTRACAPSULAR EXTENSION; CANCER INCIDENCE; ANTIGEN; RATES; MORTALITY; STAGE; DISEASE; ERA AB Objectives. To determine whether in the prostate-specific antigen (PSA) era stage and/or grade migration of patients treated with radical prostatectomy (RP) has occurred. We also examined whether the biochemical recurrence rates after RIP have changed with time. Methods. A total of 1654 patients from the Shared Equal Access Regional Cancer Hospital (SEARCH) database were analyzed for time trends in age, preoperative PSA level, clinical stage, biopsy Gleason score, prostatectomy Gleason grade, pathologic stage, margin status, and recurrence rates after RP. Results were stratified into three 4-year blocks of time between 1988 and 2002 for analysis. Results. The preoperative PSA level, patient age, tumor stage, rate of capsular penetration, and lymph node involvement decreased with time. Both biopsy and pathologic Gleason grade steadily increased with time. The positive margin rate and incidence of seminal vesicle involvement remained stable. On multivariate analysis, only serum PSA level (P <0.001) and biopsy Gleason score (P <0.001) were significant independent predictors of the time to recurrence after RP. The year of surgery was not a significant independent predictor of biochemical recurrence after RP in multivariate analysis. Conclusions. Despite lower stage and lower PSA levels with time, we found no improvement in PSA recurrence rates over time. This may reflect lead-time bias in detecting PSA recurrence by the use of more sensitive PSA assays. in recent years. (C) 2003, Elsevier Science Inc. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA. USN, Med Ctr, Dept Urol, San Diego, CA 92152 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA USA. Med Coll Georgia, Div Urol, Augusta, GA 30912 USA. RP Freedland, SJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, 10833 Le Comte Ave,66-124 CHS,Box 951738, Los Angeles, CA 90095 USA. OI Terris, Martha/0000-0002-3843-7270 NR 27 TC 73 Z9 77 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 APR PY 2003 VL 61 IS 4 BP 736 EP 741 DI 10.1016/S0090-4295(02)02526-8 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 666TX UT WOS:000182193500015 PM 12670557 ER PT J AU Freedland, SJ Aronson, WJ Csathy, GS Kane, CJ Amling, CL Presti, JC Dorey, F Terris, MK AF Freedland, SJ Aronson, WJ Csathy, GS Kane, CJ Amling, CL Presti, JC Dorey, F Terris, MK CA Search Database Study Grp TI Comparison of percentage of total prostate needle biopsy tissue with cancer to percentage of cores with cancer for predicting PSA recurrence after radical prostatectomy: Results from the search database SO UROLOGY LA English DT Article ID SEXTANT BIOPSIES; EXTRACAPSULAR EXTENSION; CLINICAL UTILITY; RELAPSE; RISK AB Objectives. Tumor volume in the prostate needle biopsy is an important prognosticator for patients with prostate cancer. However, the best method to measure tumor volume in the prostate needle biopsy is unknown. We compared the total percentage of biopsy tissue with cancer to the percentage of cores positive for their ability to predict adverse pathologic findings and biochemical failure after radical prostatectomy (RP). Methods. A retrospective survey of 355 patients from the Shared Equal Access Regional Cancer Hospital database treated with RID between 1990 and 2002 was undertaken. Multivariate analysis was used to compare the percentage of cores and percentage of tissue with cancer to the standard clinical variables of age, prostate-specific antigen (PSA) level, biopsy Gleason score, and clinical stage for their ability to predict positive surgical margins, non-organ-confined disease, seminal vesicle invasion, and time to PSA recurrence after RP. Results. On multivariate analysis, the percentage of tissue with cancer significantly predicted non-organ-confined disease and seminal vesicle invasion, but the percentage of cores did not significantly predict any of the pathologic features examined. In separate multivariate analysis, only the percentage of tissue with cancer, but not the percentage of cores with cancer, significantly predicted PSA failure. Moreover, when compared in the same multivariate analysis, only the percentage of tissue with cancer (hazard ratio 8.25, 95% confidence interval 3.06 to 22.22, P <0.001) was a significant predictor. The area under the receiver operating curves for predicting PSA failure was significantly greater for the percentage of tissue with cancer (0.697) than for the percentage of cores (0.644, P = 0.022). Cutpoints for the percentage of tissue with cancer (less than 20%, 20% to 40%, and greater than 40%) and the percentage of cores (less than 34%, 34% to 50%, greater than 50%) both provided significant preoperative risk stratification for biochemical failure, although the percentage of tissue with cancer cutpoints provided better risk stratification (higher hazard ratios and lower P value). Cutpoints for the percentage of tissue with cancer but not the percentage of cores positive further stratified patients who were at low (P = 0.041), intermediate (P = 0.002), and high (P = 0.023) risk on the basis of the PSA level and biopsy Gleason score. Conclusions. The percentage of tissue with cancer was better than the percentage of cores at predicting advanced pathologic features and PSA recurrence after RP. Unlike the percentage of cores, the percentage of tissue with cancer cutpoints further stratified low, intermediate, and high-risk patients on the basis of PSA level and biopsy Gleason score. Although the percentage of tissue with cancer is a slightly more cumbersome measurement than the percentage of positive cores, it provided statistically and clinically superior preoperative risk stratification for biochemical failure after RP. (C) 2003, Elsevier Science Inc. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Surg & Pathol, Los Angeles, CA USA. USN, Med Ctr, Dept Urol, San Diego, CA 92152 USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA USA. Med Coll Georgia, Div Urol, Augusta, GA 30912 USA. RP Freedland, SJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, 10833 Le Conte Ave,66-124 CHS,Box 951738, Los Angeles, CA 90095 USA. OI Terris, Martha/0000-0002-3843-7270 NR 15 TC 45 Z9 47 U1 0 U2 1 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 APR PY 2003 VL 61 IS 4 BP 742 EP 747 DI 10.1016/S0090-4295(02)02525-6 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 666TX UT WOS:000182193500016 PM 12670558 ER PT J AU Takahashi, S Riley, DE Krieger, JN AF Takahashi, S Riley, DE Krieger, JN TI Application of real-time polymerase chain reaction technology to detect prostatic bacteria in patients with chronic prostatitis/chronic pelvic pain syndrome SO WORLD JOURNAL OF UROLOGY LA English DT Article DE chronic prostatitis; chronic pelvic pain syndrome; bacteria; polymerase chain reaction ID DNA-SEQUENCES; RESPIRATORY SPECIMENS; RAPID DETECTION; PCR ASSAYS; LIGHTCYCLER; MEN; TISSUE AB To investigate the potential association between prostate infection and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), we used molecular approaches described in previous reports. These methods employed standard polymerase chain (PCR) reaction assays to provide a qualitative evaluation of prostatic bacterial species. Here, we report on the detection of prostatic bacteria using a real-time PCR. Template DNAs were examined from prostatic tissue samples from patients with CP/CPPS. Two PCR primer sets were used: one that amplifies a portion of all known bacterial ribosomal DNAs (16S rDNAs) and one that is specific for Escherichia coli as opposed to related, E. coli-like bacteria. The 16S rDNA real-time PCR assay detected bacterial DNAs in eight (26%) of 31 samples from patients with CP/CPPS, including three samples (10%) that were also positive by the E. coli real-time PCR assay. These E. coli positives were quantified at approximately 10(3) cfu/ml of tissue digested. Quantification, speed and specificity make real-time PCR a promising approach for the quantitative detection and identification of prostatic bacteria from CP/CPPS patients. C1 Univ Washington, Sch Med, Dept Urol, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Krieger, JN (reprint author), Univ Washington, Sch Med, Dept Urol, VA Puget Sound Hlth Care Syst, 112-GU,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [DK38955] NR 20 TC 8 Z9 11 U1 1 U2 1 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0724-4983 J9 WORLD J UROL JI World J. Urol. PD APR PY 2003 VL 21 IS 2 BP 100 EP 104 DI 10.1007/s00345-003-0326-3 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 692AY UT WOS:000183639200011 PM 12743735 ER PT J AU Zimmerman, RK Raymund, M Janosky, JE Nowalk, MP Fine, MJ AF Zimmerman, RK Raymund, M Janosky, JE Nowalk, MP Fine, MJ TI Sensitivity and specificity of patient self-report of influenza and pneumococcal polysaccharide vaccinations among elderly outpatients in diverse patient care strata SO VACCINE LA English DT Article DE validity; vaccination; self-report ID QUESTIONNAIRE; VALIDATION AB National surveys of adult vaccination indicate moderate self-reported immunization rates in the US, with limited validity data. We compared self-report with medical record abstraction for 820 persons aged greater than or equal to66 years from inner-city health centers, Veterans Affairs (VA) outpatient clinics, rural and suburban practices. For influenza vaccine, sensitivity was 98% (95% CI: 96-99%); specificity was 38% (95% CI: 33-43%). For pneurnococcal polysaccharide vaccine, sensitivity was 85% (95% CI: 82-89%) and specificity was 46% (95% CI: 42-50%). The VA had the highest sensitivity and lowest specificity for both vaccines while the converse was true in inner-city centers. High negative predictive values indicate that clinicians can confidently vaccinate based on negative patient self-report. (C) 2002 Elsevier Science Ltd. All rights reserved. C1 Univ Pittsburgh, Sch Med, Dept Family Med & Clin Epidemiol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Behav Sci & Community Hlth, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, VA Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP Zimmerman, RK (reprint author), Univ Pittsburgh, Sch Med, Dept Family Med & Clin Epidemiol, 3518 5th Ave, Pittsburgh, PA 15261 USA. OI Zimmerman, Richard/0000-0001-5941-6092 NR 16 TC 170 Z9 181 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD MAR 28 PY 2003 VL 21 IS 13-14 BP 1486 EP 1491 AR PII S0264-410X(02)00700-4 DI 10.1016/S0264-410X(02)00700-4 PG 6 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 663LV UT WOS:000182007800023 PM 12615445 ER PT J AU Cole, GM AF Cole, GM TI Ironic fate: Can a banned drug control metal heavies in neurodegenerative diseases? SO NEURON LA English DT Editorial Material C1 Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, Alzheimers Dis Res Ctr, Sepulveda, CA 91343 USA. RP Cole, GM (reprint author), Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, Alzheimers Dis Res Ctr, Sepulveda, CA 91343 USA. NR 12 TC 14 Z9 14 U1 0 U2 2 PU CELL PRESS PI CAMBRIDGE PA 1100 MASSACHUSETTS AVE, CAMBRIDGE, MA 02138 USA SN 0896-6273 J9 NEURON JI Neuron PD MAR 27 PY 2003 VL 37 IS 6 BP 889 EP 890 DI 10.1016/S0896-6273(03)00160-0 PG 2 WC Neurosciences SC Neurosciences & Neurology GA 661PU UT WOS:000181899600001 PM 12670416 ER PT J AU Shekelle, PG Hardy, ML Morton, SC Maglione, M Mojica, WA Suttorp, MJ Rhodes, SL Jungvig, L Gagne, J AF Shekelle, PG Hardy, ML Morton, SC Maglione, M Mojica, WA Suttorp, MJ Rhodes, SL Jungvig, L Gagne, J TI Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance - A meta-analysis SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Review ID DOUBLE-BLIND; CONTROLLED TRIAL; ENERGY-EXPENDITURE; COMBINED CAFFEINE; BODY-COMPOSITION; CLINICAL-TRIALS; OBESE PATIENTS; SIBUTRAMINE; ORLISTAT; INGESTION AB Context Ephedra and ephedrine sometimes are used for weight loss or enhanced athletic performance, but the efficacy and safety of these compounds are uncertain. Objective To assess the efficacy and safety of ephedra and ephedrine used for weight loss and enhanced athletic performance. Data Sources We searched 9 databases using the terms ephedra, ephedrine, adverse effect, side effect, efficacy, effective, and toxic. We included unpublished trials and non-English-language documents. Adverse events reported to the US Food and Drug Administration MedWatch program were assessed. Study Selection Eligible studies were controlled trials of ephedra or ephedrine used for weight loss or athletic performance and case reports of adverse events associated with such use. Eligible studies for weight loss were human studies with at least 8 weeks of follow-up; and for athletic performance, those having no minimum follow-up. Eligible case reports documented that ephedra or ephedrine was consumed within 24 hours prior to an adverse event or that ephedrine or an associated product was found in blood or urine, and that other potential causes had been excluded. Of the 530 articles screened, 52 controlled trials and 65 case reports were included in the adverse events analysis. Of more than 18000 other case reports screened, 284 underwent detailed review. Data Extraction Two reviewers independently identified trials of efficacy and safety of ephedra and ephedrine on weight loss or athletic performance; disagreements were resolved by consensus. Case reports were reviewed with explicit and implicit methods. Data Synthesis No weight loss trials assessed duration of treatment greater than 6 months. Pooled results. for trials comparing placebo with ephedrine (n=5), ephedrine and caffeine (n=12), ephedra (n=1), and ephedra and herbs containing caffeine (n=4) yielded estimates of weight loss (more than placebo) of 0.6 (95% confidence interval, 0.2-1.0), 1.0 (0.7-1.3), 0:8 (0.4-1.2), and 1.0 (0.6-1.3) kg/mo, respectively. Sensitivity analyses did not substantially alter the latter 3 results. No trials of ephedra and athletic performance were found; 7 trials of ephedrine were too heterogeneous to synthesize. Safety data from 50 trials yielded estimates of 2.2- to 3.6-fold increases in odds of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations. Data are insufficient to draw conclusions about adverse events occurring at a rate less than 1.0 per thousand. The majority of case reports are insufficiently documented to allow meaningful assessment. Conclusions Ephedrine and ephedra promote modest short-term weight loss (approximate to0.9 kg/mo more than placebo) in clinical trials. There are no data regarding long-term weight loss, and evidence to support use of ephedra for athletic performance is insufficient. Use of ephedra or ephedrine and caffeine is associated with increased risk of psychiatric, autonomic, or gastrointestinal symptoms, and heart palpitations. C1 RAND Corp, So Calif Evidence Based Practice Ctr, Santa Monica, CA 90407 USA. Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. Univ So Calif, Dept Family Med, Los Angeles, CA USA. RP Shekelle, PG (reprint author), RAND Corp, So Calif Evidence Based Practice Ctr, 1700 Main St,POB 2138, Santa Monica, CA 90407 USA. FU PHS HHS [290-97-0001] NR 56 TC 247 Z9 266 U1 3 U2 41 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 26 PY 2003 VL 289 IS 12 BP 1537 EP 1545 DI 10.1001/jama.289.12.1537 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 659XE UT WOS:000181803100032 PM 12672771 ER PT J AU Murray, DR Freeman, GL AF Murray, DR Freeman, GL TI Proinflammatory cytokines - Predictors of a failing heart? SO CIRCULATION LA English DT Editorial Material DE editorials; heart failure; cytokines; tumor necrosis factor; interleukins ID NECROSIS-FACTOR-ALPHA; LEFT-VENTRICULAR DYSFUNCTION; DILATED CARDIOMYOPATHY; MYOCARDIAL-INFARCTION; CARDIAC MYOCYTES; FAILURE; INTERLEUKIN-6; RECEPTORS; RISK C1 Univ Texas, Hlth Sci Ctr, Dept Med Cardiol, San Antonio, TX 78229 USA. S Texas Vet Healthcare Syst, Audie L Murphy Div, San Antonio, TX USA. RP Murray, DR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Cardiol, 7703 Floyd Curl Dr,MSC 7872, San Antonio, TX 78229 USA. EM MurrayD@uthscsa.edu NR 25 TC 39 Z9 42 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAR 25 PY 2003 VL 107 IS 11 BP 1460 EP 1462 DI 10.1161/01.CIR.0000060808.79274.0C PG 3 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 659EM UT WOS:000181764600002 PM 12654598 ER PT J AU Donta, ST Clauw, DJ Engel, CC Guarino, P Peduzzi, P Williams, DA Skinner, JS Barkhuizen, A Taylor, T Kazis, LE Sogg, S Hunt, SC Dougherty, CM Richardson, RD Kunkel, C Rodriguez, W Alicea, E Chiliade, P Ryan, M Gray, GC Lutwick, L Norwood, D Smith, S Everson, M Blackburn, W Martin, W Griffiss, JM Cooper, R Renner, E Schmitt, J McMurtry, C Thakore, M Mori, D Kerns, R Park, M Pullman-Mooar, S Bernstein, J Hershberger, P Salisbury, DC Feussner, JR AF Donta, ST Clauw, DJ Engel, CC Guarino, P Peduzzi, P Williams, DA Skinner, JS Barkhuizen, A Taylor, T Kazis, LE Sogg, S Hunt, SC Dougherty, CM Richardson, RD Kunkel, C Rodriguez, W Alicea, E Chiliade, P Ryan, M Gray, GC Lutwick, L Norwood, D Smith, S Everson, M Blackburn, W Martin, W Griffiss, JM Cooper, R Renner, E Schmitt, J McMurtry, C Thakore, M Mori, D Kerns, R Park, M Pullman-Mooar, S Bernstein, J Hershberger, P Salisbury, DC Feussner, JR CA VA Cooperative Study 470 Study Grp TI Cognitive behavioral therapy and aerobic exercise for Gulf War veterans' illnesses - A randomized controlled trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID CHRONIC-FATIGUE-SYNDROME; LINEAR MIXED MODELS; FIBROMYALGIA; HEALTH; QUESTIONNAIRE; INTERVENTIONS; MANAGEMENT; INFERENCE; ADHERENCE; OUTCOMES AB Context Gulf War veterans' illnesses (GWVI), multisymptom illnesses characterized by persistent pain, fatigue, and cognitive symptoms, have been reported by many Gulf War veterans. There are currently no effective therapies available to treat GWVI. Objective To compare the effectiveness of cognitive behavioral therapy (CBT), exercise, and the combination of both for improving physical functioning and reducing the symptoms,of GWVI. Design, Setting, and Patients Randomized controlled 2 x 2 factorial trial conducted from April 1999 to September 2001 among 1092 Gulf War veterans who reported at least 2 of 3 symptom types (fatigue, pain, and cognitive) for more than 6 months and at the time of screening. Treatment assignment was unmasked except or a masked assessor of study outcomes at each clinical site (18 Department of Veterans Affairs [VA] and 2 Department of Defense [DOD] medical centers). Interventions Veterans were randomly assigned to receive usual care (n=271), consisting of any and all care received from inside or outside the VA or DOD health care systems; CBT plus usual care (n=286); exercise plus usual care (n=269); or CBT plus exercise plus usual care (n=266). Exercise sessions were 60 minutes and CBT sessions were 60 to 90 minutes; both met weekly for 12 weeks. Main Outcome Measures The primary end point was a 7-point or greater increase (improvement) on the Physical Component Summary scale of the Veterans Short Form 36-Item Health Survey at 12 months. Secondary outcomes were standardized measures of pain, fatigue, cognitive symptoms, distress, and mental health functioning. Participants were evaluated at baseline and at 3, 6, and 12 months. Results The percentage of veterans with improvement in physical function at 1 year was 11.5% for usual care, 11.7% for exercise alone, 18.4% for CBT plus exercise, and 18.5% for CBT alone. The adjusted odds ratios (OR) for improvement in exercise, CBT, and exercise plus CBT vs usual care were 1.07 (95% confidence interval [CI], 0.63-1.82), 1.72 (95% CI, 0.91-3.23), and 1.84 (95% CI, 0.95-3.55), respectively. OR for the overall (marginal) effect of receiving CBT (n=552) vs no CBT (n=535) was 1.71 (95% CI, 1.15-2.53) and for exercise (n=531) vs no exercise (n=556) was 1.07 (95% CI, 0.76-1.50). For secondary outcomes, exercise alone or in combination with CBT significantly improved fatigue, distress, cognitive symptoms, and mental health functioning, while CBT alone significantly improved cognitive symptoms and menial health functioning. Neither treatment had a significant impact on pain. Conclusion Our results suggest that CBT and/or exercise can provide modest relief for some of the symptoms of chronic multisymptom illnesses such as GWVI. C1 VA Connecticut Healthcare Syst, Cooperat Studies Program Coordinating Ctr 151A, West Haven, CT 06516 USA. VA Med Ctr, Boston, MA USA. Univ Michigan, Med Ctr, Ann Arbor, MI USA. Walter Reed Army Med Ctr, Bethesda, MD USA. Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. Indiana Univ, Bloomington, IN USA. Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR USA. VA Med & Reg Off Ctr, White River Jct, VT USA. VA Med Ctr, Bedford, MA USA. VA Puget Sound Healthcare Syst, Seattle Div, Seattle, WA USA. New Mexico VA Hlth Care Syst, Albuquerque, NM USA. San Juan VA Med Ctr, San Juan, PR USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. USN, Hlth Res Ctr, San Diego, CA 92152 USA. New York Harbor VA Healthcare Syst, New York, NY USA. Birmingham VA Med Ctr, Birmingham, AL USA. John Cochran VA Med Ctr, St Louis, MO USA. San Francisco VA Med Ctr, San Francisco, CA USA. Fargo VA Med & Reg Off Ctr, Fargo, ND USA. HH McGuire VA Med Ctr, Richmond, VA USA. VA New Jersey Hlth Care Syst, E Orange, NJ USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. Dayton VA Med Ctr, Dayton, OH USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Peduzzi, P (reprint author), VA Connecticut Healthcare Syst, Cooperat Studies Program Coordinating Ctr 151A, 950 Campbell Ave, West Haven, CT 06516 USA. RI Williams, David/A-1180-2007 NR 51 TC 61 Z9 61 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 MAR 19 PY 2003 VL 289 IS 11 BP 1396 EP 1404 DI 10.1001/jama.289.11.1396 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 656PM UT WOS:000181616200031 PM 12636462 ER PT J AU Samaha, FF Seshadri, P Iqbal, N Stern, L AF Samaha, FF Seshadri, P Iqbal, N Stern, L TI Effects of a carbohydrate-restricted diet versus a fat-and calorie-restricted diet on lipid subtractions SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 52nd Annual Scientific Session of the American-College-of-Cardiology CY MAR 30-APR 02, 2003 CL CHICAGO, ILLINOIS SP American Coll Cardiol C1 Philadephia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 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 19 PY 2003 VL 41 IS 6 SU A BP 243A EP 243A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 657LW UT WOS:000181669501057 ER PT J AU Sonel, AF Good, CB Kelley, ME Wall, L Whittle, J Fine, MJ AF Sonel, AF Good, CB Kelley, ME Wall, L Whittle, J Fine, MJ TI A deadly combination: Elevated troponin I and peripheral white blood cell count imply poor prognosis in patients with suspected myocardial injury SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 52nd Annual Scientific Session of the American-College-of-Cardiology CY MAR 30-APR 02, 2003 CL CHICAGO, ILLINOIS SP American Coll Cardiol C1 Univ Pittsburgh, Cardiovasc Inst, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 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 19 PY 2003 VL 41 IS 6 SU A BP 341A EP 342A PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 657LW UT WOS:000181669501491 ER PT J AU Samaha, FF Varello, M Kahn, ML AF Samaha, FF Varello, M Kahn, ML TI Platelet collagen receptor glycoprotein VI as a novel risk factor for myocardial infarction SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 52nd Annual Scientific Session of the American-College-of-Cardiology CY MAR 30-APR 02, 2003 CL CHICAGO, ILLINOIS SP American Coll Cardiol C1 Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 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 19 PY 2003 VL 41 IS 6 SU A BP 404A EP 404A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 657LW UT WOS:000181669501750 ER PT J AU Rumsfeld, JS Magid, DJ Plomondon, ME Westfall, JM Peterson, LA Sales, AE AF Rumsfeld, JS Magid, DJ Plomondon, ME Westfall, JM Peterson, LA Sales, AE TI The impact of admission to primary versus tertiary care VA medical centers on outcomes following acute coronary syndromes: The VA access to cardiology study SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 52nd Annual Scientific Session of the American-College-of-Cardiology CY MAR 30-APR 02, 2003 CL CHICAGO, ILLINOIS SP American Coll Cardiol C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Vet Adm Med Ctr, Denver, CO 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 19 PY 2003 VL 41 IS 6 SU A BP 533A EP 533A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 657LW UT WOS:000181669502304 ER PT J AU Sonel, AF Good, CB Kelley, ME Wall, L Whittle, J Fine, MJ AF Sonel, AF Good, CB Kelley, ME Wall, L Whittle, J Fine, MJ TI What is the meaning of high-risk? A prospective comparison of three risk stratification models recommended in non-ST elevation myocardial infarction and unstable angina SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 52nd Annual Scientific Session of the American-College-of-Cardiology CY MAR 30-APR 02, 2003 CL CHICAGO, ILLINOIS SP American Coll Cardiol C1 Univ Pittsburgh, Va Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 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 19 PY 2003 VL 41 IS 6 SU A BP 534A EP 534A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 657LW UT WOS:000181669502309 ER PT J AU Bent, S Tiedt, TN Odden, MC Shlipak, MG AF Bent, S Tiedt, TN Odden, MC Shlipak, MG TI The relative safety of ephedra compared with other herbal products SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID MA-HUANG; SUPPLEMENTS; TOXICITY; SYSTEM AB Background: Ephedra is widely used in dietary supplements that are marketed to promote weight loss or increase energy; however, the safety of this product has been questioned because of numerous case reports of adverse events. Objective: To compare the risk for adverse events attributable to ephedra and other herbal products. Design: Comparative case series. Setting: American Association of Poison Control Centers Toxic Event Surveillance System Database Annual Report, 2001. Measurements: The relative risk and 95% confidence interval for experiencing an adverse reaction after ephedra. use compared with other herbs. This risk was defined as the ratio of adverse reactions to ephedra. versus other products, divided by the ratio of their relative use in the United States. Results: Products containing ephedra accounted for 64% of all adverse reactions to herbs in the United States, yet these products represented only 0.82% of herbal product sales. The relative risks for an adverse reaction in persons using ephedra compared with other herbs were extremely high, ranging from 100 (95% Cl, 83 to 140) for kava to 720 (Cl, 520 to 1100) for Ginkgo biloba. Conclusions: Ephedra use is associated with a greatly increased risk for adverse reactions compared with other herbs, and its use should be restricted. C1 San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Osher Ctr Integrat Med, San Francisco, CA 94143 USA. Med Tox Grp, Longboat Key, FL USA. RP Bent, S (reprint author), San Francisco Vet Affairs Med Ctr, 111-A1,4150 Clement St, San Francisco, CA 94121 USA. FU NCCIH NIH HHS [1 K08 AT01338-01] NR 16 TC 75 Z9 81 U1 1 U2 5 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 18 PY 2003 VL 138 IS 6 BP 468 EP 471 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 655PV UT WOS:000181562400004 PM 12639079 ER PT J AU Burns, AR Gagen, D Murphy, A Zheng, ZL Bowden, RA Smith, CW Rumbaut, RE AF Burns, AR Gagen, D Murphy, A Zheng, ZL Bowden, RA Smith, CW Rumbaut, RE TI PECAM-1 (CD31): A novel regulator of neutrophil transendothelial migration velocity and endothelial barrier function SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Baylor Coll Med, Houston, TX 77025 USA. WRAIR, Silver Spring, MD USA. VA Med Ctr, Med Care Line, Houston, TX 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 17 PY 2003 VL 17 IS 5 SU S BP A1188 EP A1188 PN 2 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 659UY UT WOS:000181796902053 ER PT J AU Garnovskaya, MN Mukhin, YV Raymond, JR AF Garnovskaya, MN Mukhin, YV Raymond, JR TI The Na+/H+ exchanger regulates mitogen-activated protein kinase upstream of Ras in vascular smooth muscle cells SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29425 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 17 PY 2003 VL 17 IS 5 SU S BP A1016 EP A1016 PN 2 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 659UY UT WOS:000181796901245 ER PT J AU Harimoto, J Maarek, JM Holschneider, DP Yang, J Scremin, OU AF Harimoto, J Maarek, JM Holschneider, DP Yang, J Scremin, OU TI Functional brain mapping using an implantable microbolus infusion pump: Validation in a locomotor paradigm SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Univ So Calif, Los Angeles, CA 90089 USA. Univ So Calif, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90089 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 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 17 PY 2003 VL 17 IS 5 SU S BP A1211 EP A1211 PN 2 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 659UY UT WOS:000181796902159 ER PT J AU Mukhin, YV Raymond, JR Garnovskaya, MN AF Mukhin, YV Raymond, JR Garnovskaya, MN TI Novel mechanism of EGF receptor transactivation by bradykinin B-2 receptor in kidney cells SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29425 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 17 PY 2003 VL 17 IS 5 SU S BP A1013 EP A1013 PN 2 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 659UY UT WOS:000181796901229 ER PT J AU Scremin, OU Shih, TM Huynh, LTK Rocb, MM Sun, W Chialvo, DR D'Elia, J Cable, C Jenden, DJ AF Scremin, OU Shih, TM Huynh, LTK Rocb, MM Sun, W Chialvo, DR D'Elia, J Cable, C Jenden, DJ TI Delayed effects of low-dose cholinesterase inhibitors on cardiovascular regulation SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Sch Med, Los Angeles, CA 90073 USA. USA, Med Res Inst Chem Def, Aberdeen Proving Ground, MD 21010 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 17 PY 2003 VL 17 IS 5 SU S BP A875 EP A875 PN 2 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 659UY UT WOS:000181796900571 ER PT J AU Turner, JH Garnovskaya, MN Mukhin, YV Raymond, JR AF Turner, JH Garnovskaya, MN Mukhin, YV Raymond, JR TI Regulation of the type 1 Na+/H+ exchanger by Janus kinase 2 and Ca2+/calmodulin SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 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 17 PY 2003 VL 17 IS 5 SU S BP A1029 EP A1029 PN 2 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 659UY UT WOS:000181796901306 ER PT J AU Van Auken, K Nesterova, A Shao, JH Friedman, J AF Van Auken, K Nesterova, A Shao, JH Friedman, J TI Insulin suppression of hepatic PEPCK gene transcription via C/EBP beta requires glucose metabolism SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Univ Colorado, Hlth Sci Ctr, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Denver Vet Affairs Med Ctr, Denver Res Inst, Denver, CO 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 17 PY 2003 VL 17 IS 5 SU S BP A1020 EP A1020 PN 2 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 659UY UT WOS:000181796901263 ER PT J AU Van Winkle, DM Cao, ZP Liu, LJ AF Van Winkle, DM Cao, ZP Liu, LJ TI Cellular signaling associated with enkephalin-induced cardioprotection SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Portland VA Med Ctr, Portland, OR 97201 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 17 PY 2003 VL 17 IS 5 SU S BP A877 EP A877 PN 2 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 659UY UT WOS:000181796900578 ER PT J AU Mairbaurl, H Weymann, J Mohrlein, A Swenson, ER Maggiorini, M Gibbs, JSR Bartsch, P AF Mairbaurl, H Weymann, J Mohrlein, A Swenson, ER Maggiorini, M Gibbs, JSR Bartsch, P TI Nasal epithelium potential difference at high altitude (4,559 m) - Evidence for secretion SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE hypoxia; nasal potential; sodium ion transport; chloride ion secretion; nasal dryness ID CYSTIC-FIBROSIS; PULMONARY-EDEMA; FLUID TRANSPORT; SODIUM-CHANNELS; ION-TRANSPORT; LIQUID CLEARANCE; MESSENGER-RNAS; NA-TRANSPORT; LUNG; EXPRESSION AB Hypoxia inhibits activity and expression of ion transport proteins of cultured lung alveolar epithelial cells. Here we tested, whether in vivo hypoxia at high altitude (4,559 m) also inhibits lung ion transport. Transepithelial nasal potentials (NP) were determined as a surrogate measure of lung ion transport activity before and during the stay at altitude. In normoxia, total NP was approximately 20% higher in control subjects than in susceptibles to high-altitude pulmonary edema, but there was no difference between groups I amiloride-inhibitable NPs. At high altitude total NP increased 250% in both groups, whereas amiloride-sensitive NP decreased in control subjects only (-80%), and the chloride ion (Cl-)-sensitive portion of NP almost doubled. Because many mountaineers suffer from nasal dryness at high altitude, a control study was performed in normobaric hypoxia (12% oxygen, 6 hours) at a controlled humidity of 50%. In this study, no change in total NP or its amiloride- and Cl-sensitive portions was observed. The increased Cl- secretion at high altitude but no such change in normobaric hypoxia suggests that nasal dryness may stimulate local active Cl- and fluid secretion in the upper respiratory tract. It is therefore uncertain whether similar changes also occur at the alveolar epithelium. C1 Univ Heidelberg, Dept Med, Div Sports Med, D-69115 Heidelberg, Germany. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Med & Res Serv, Seattle, WA 98195 USA. Univ Zurich Hosp, Dept Internal Med, Intens Care Unit, Zurich, Switzerland. Univ London Imperial Coll Sci Technol & Med, Sch Sci Technol & Med, Natl Heart & Lung Inst, London, England. RP Mairbaurl, H (reprint author), Univ Heidelberg, Dept Med, Div Sports Med, Luisenstr 5,Geb 4100, D-69115 Heidelberg, Germany. NR 38 TC 35 Z9 36 U1 0 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 MAR 15 PY 2003 VL 167 IS 6 BP 862 EP 867 DI 10.1164/rccm.200208-864OC PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 653MA UT WOS:000181439100011 PM 12522027 ER PT J AU Kohen, R Neumaier, JF Hamblin, MW Edwards, E AF Kohen, R Neumaier, JF Hamblin, MW Edwards, E TI Congenitally learned helpless rats show abnormalities in intracellular signaling SO BIOLOGICAL PSYCHIATRY LA English DT Article DE depression; mood disorders; learned helplessness; animal models; gene expression; second messengers ID PROTEIN-KINASE-C; BIPOLAR AFFECTIVE-DISORDER; ELEMENT-BINDING PROTEIN; AMP-RESPONSIVE ELEMENT; CHRONIC ANTIDEPRESSANT TREATMENT; GLYCOGEN-SYNTHASE KINASE-3-BETA; RECURRENT MAJOR DEPRESSION; GENE-TRANSCRIPTION FACTOR; NEUROTROPHIC-FACTOR BDNF; MOOD-STABILIZING AGENTS AB Background: Affective disorders and the drugs used to treat them lead to changes in intracellular signaling. We used a genetic animal model to investigate to what extent changes in intracellular signal transduction confer a vulnerability to mood or anxiety disorders. Methods: Levels of gene expression in a selectively bred strain of rats with a high vulnerability to develop congenitally learned helplessness (cLH), a strain highly resistant to the same behavior (cNLH) and outbred Sprague-Dawley (SD) control animals were compared using quantitative reverse transcription polymerase chain reaction. Results: Congenitally learned helpless animals had a 24%-30% reduced expression of the cyclic adenosine monophosphate response element binding protein messenger ribonucleic acid (mRNA) in the hippocampus and a 40%-41% increased level of the antiapoptotic protein bcl-2 mRNA in the prefrontal cortex compared to cNLH and SD rats. Other significant changes included changes in the expression levels of the alpha catalytic subunit of protein kinase A, glycogen synthase kinase 3beta, and protein kinase C epsilon. Conclusions: Congenitally learned helpless animals show evidence of altered signal transduction and regulation of apoptosis compared to cNLH and SD control animals. (C) 2003 Society of Biological Psychiatry. C1 GRECC 182B, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Washington, DC USA. Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. Univ Maryland, Sch Pharm, Dept Pharmaceut Sci, Baltimore, MD 21201 USA. NINDS, Bethesda, MD 20892 USA. RP Kohen, R (reprint author), GRECC 182B, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIMH NIH HHS [MH57049, MH63303] NR 77 TC 18 Z9 18 U1 3 U2 5 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 15 PY 2003 VL 53 IS 6 BP 520 EP 529 DI 10.1016/S0006-3223(03)01503-2 PG 10 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 655TZ UT WOS:000181569900007 PM 12644357 ER PT J AU Ganz, T Gabayan, V Liao, HI Liu, LD Oren, A Graf, T Cole, AM AF Ganz, T Gabayan, V Liao, HI Liu, LD Oren, A Graf, T Cole, AM TI Increased inflammation in lysozyme M-deficient mice in response to Micrococcus luteus and its peptidoglycan SO BLOOD LA English DT Article ID GRAM-NEGATIVE BACTERIA; CELL WALL COMPONENTS; RECOGNITION PROTEIN; STAPHYLOCOCCUS-AUREUS; RESPIRATORY BURST; ACTIVATION; DROSOPHILA; COMPLEMENT; NEUTROPHILS; DUPLICATION AB More than 70 years ago, Alexander Fleming discovered lysozyme and proposed that nonpathogenic bacteria fall to cause disease because they are very susceptible to destruction by lysozyme, an enzyme that is one of the principal proteins of phagocytes. Although much has been learned about the effects of lysozyme in vitro, its biological role in vivo has not been determined. We examined transgenic mice deficient in lysozyme M after challenge by the normally nonpathogenic and highly lysozyme-sensitive bacterium Micrococcus luteus. Despite partial compensation by newly expressed lysozyme P in macrophages, lysozyme M-deficient mice developed much more severe lesions than wild-type mice. The tissue injury was due to the failure of lysozyme M-deficient mice to inactivate peptidoglycan, resulting in an intense and prolonged inflammatory response. Our data indicate that tissue injury is normally limited by prompt degradation of bacterial macromolecules that trigger innate immunity and inflammation. C1 Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Pathol, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, W Los Angeles Vet Adm Hosp, Los Angeles, CA USA. Albert Einstein Coll Med, Bronx, NY USA. RP Ganz, T (reprint author), Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, 37-055 CHS, Los Angeles, CA 90095 USA. RI Graf, Thomas/B-4252-2015 OI Graf, Thomas/0000-0003-2774-4117; Ganz, Tomas/0000-0002-2830-5469 FU NCI NIH HHS [R01 CA89590-01] NR 32 TC 51 Z9 52 U1 4 U2 10 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 MAR 15 PY 2003 VL 101 IS 6 BP 2388 EP 2392 DI 10.1182/blood-2002-07-2319 PG 5 WC Hematology SC Hematology GA 653JT UT WOS:000181432600050 PM 12411294 ER PT J AU Barnett, BE Josiassen, RC AF Barnett, BE Josiassen, RC TI Risk factors for suicide in schizophrenia and schizoaffective disorder SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 VA Pittsburgh Healthcare Syst, MISN Mental Illness Res Educ & Clin Ctr 4, Pittsburgh, PA USA. NR 1 TC 2 Z9 2 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 15 PY 2003 VL 60 IS 1 SU S BP 3 EP 4 DI 10.1016/S0920-9964(03)80004-X PG 2 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705700005 ER PT J AU Shemansky, WJ Barnett, BE Goldstein, G AF Shemansky, WJ Barnett, BE Goldstein, G TI Suicide in "neuropsychologically normal" schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 VA Pittsburgh Healthcare Syst, VISN Mental Illness Res Educ & Clin Ctr 4, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 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 MAR 15 PY 2003 VL 60 IS 1 SU S BP 8 EP 8 DI 10.1016/S0920-9964(03)80020-8 PG 1 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705700021 ER PT J AU Yao, JK Thomas, EA Reddy, RD Keshavan, MS AF Yao, JK Thomas, EA Reddy, RD Keshavan, MS TI Association of apolipoproteins D with membrane arachidonic acid levels in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 VA Pittsburgh Healthcare Syst, Med Res Serv, Pittsburgh, PA USA. NR 0 TC 1 Z9 1 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 MAR 15 PY 2003 VL 60 IS 1 SU S BP 103 EP 103 DI 10.1016/S0920-9964(03)80834-4 PG 1 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705700307 ER PT J AU Wood, AE Kern, RS Tapp, A AF Wood, AE Kern, RS Tapp, A TI Errorless learning in patients with schizophrenia and non-affected controls SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 VA Puget Sound Hlth Care Syst, Tacoma, WA USA. NR 0 TC 0 Z9 0 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 MAR 15 PY 2003 VL 60 IS 1 SU S BP 186 EP 186 DI 10.1016/S0920-9964(03)81089-7 PG 1 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705700561 ER PT J AU Koenigsberg, HW Buchsbaum, MS Harvey, PD Tang, C New, AS Goodman, M Siever, LJ AF Koenigsberg, HW Buchsbaum, MS Harvey, PD Tang, C New, AS Goodman, M Siever, LJ TI Bold fMRI activation in schizotypal personality disorder patients during a visuospatial working memory task SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 Bronx Vet Adm Med Ctr, Mental Hlth PCC, Bronx, NY USA. NR 0 TC 0 Z9 0 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 MAR 15 PY 2003 VL 60 IS 1 SU S BP 226 EP 226 DI 10.1016/S0920-9964(03)81203-3 PG 1 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705700677 ER PT J AU Adler, LE Cawthra, EM Nagamoto, HT McRae, KA Waldo, MC AF Adler, LE Cawthra, EM Nagamoto, HT McRae, KA Waldo, MC TI Atypical antipsychotics differ in effects on P50 auditory sensory gating SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 Denver VAMC, Mental Hlth Serv, Denver, CO USA. Denver VAMC, Res Serv, Denver, CO USA. NR 2 TC 1 Z9 1 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 MAR 15 PY 2003 VL 60 IS 1 SU S BP 248 EP 248 DI 10.1016/S0920-9964(03)81264-1 PG 1 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705700737 ER PT J AU Casey, D Saha, A Marcus, R Carson, WH McQuade, RD Torbeyns, AF Stock, E AF Casey, D Saha, A Marcus, R Carson, WH McQuade, RD Torbeyns, AF Stock, E TI Aripiprazole versus placebo for relapse prevention in patients with chronic schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 Portland Vet Affairs Med Ctr, Portland, OR USA. NR 0 TC 6 Z9 6 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 MAR 15 PY 2003 VL 60 IS 1 SU S BP 276 EP 276 DI 10.1016/S0920-9964(03)80440-1 PG 1 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705700819 ER PT J AU Rossotto, E Wirshing, D Wirshing, W Boyd, J Liberman, R Marder, S AF Rossotto, E Wirshing, D Wirshing, W Boyd, J Liberman, R Marder, S TI Reducing rehospitalization rates for patients with schizophrenia: The community re-entry supplemental intervention SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 W Los Angeles Vet Affairs, Schizophrenia Res Clin, Los Angeles, CA USA. NR 0 TC 3 Z9 3 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 15 PY 2003 VL 60 IS 1 SU S BP 328 EP 328 DI 10.1016/S0920-9964(03)80300-6 PG 1 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705700975 ER PT J AU Matchett, JL Fishman, NB Radmaker, SB Casey, DE AF Matchett, JL Fishman, NB Radmaker, SB Casey, DE TI The effect of atypical antipsychotic drugs in patients with preexisting diabetes SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 9th International Congress on Schizophrenia Research CY MAR 29-APR 02, 2003 CL COLORADO SPINGS, COLORADO C1 Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 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 MAR 15 PY 2003 VL 60 IS 1 SU S BP 362 EP 362 DI 10.1016/S0920-9964(03)80185-8 PG 1 WC Psychiatry SC Psychiatry GA 658DE UT WOS:000181705701077 ER PT J AU Strong, R Reddy, V Morley, JE AF Strong, R Reddy, V Morley, JE TI Cholinergic deficits in the septal-hippocampal pathway of the SAM-P/8 senescence accelerated mouse SO BRAIN RESEARCH LA English DT Article DE SAM-P/8 mouse; SAM-R/l; senescence accelerated mouse; aging; Alzheimer's disease; choline acetyltransferase; glutamic acid decarboxylase; muscarinic acetylcholine receptor; nicotinic acetylcholine receptor; cerebral cortex; hippocampus; septal nucleus/nucleus of the diagonal band nucleus basalis ID AGE-RELATED-CHANGES; BASAL FOREBRAIN; SAMP8 MICE; MEMORY; RETENTION; NEURONS; BRAIN; FACILITATION; ACQUISITION; HYPOTHESIS AB Senescence accelerated prone mouse strains (SAM-P) and resistant strains (SAM-R) have proven useful in elucidating aspects of the aging process. The senescence accelerated mouse SAM-P/8 strain exhibits severe age-related learning and memory impairments well before the median age of survival. Disruption of the brain cholinergic system produces learning and memory impairments as severe as those seen in aging SAM-P/8 mice. Therefore, we compared the effects of aging on cholinergic parameters in the septal-hippocampal pathway, a region known to play a role in learning and memory, in SAM-P/8 mice and mice of the senescence resistant SAM-R/1 strain. Between 4 and 12 months of age we observed a 40-50% decrease in choline acetyltransferase (ChAT) activity in two of three subregions of the hippocampus in the SAM-P/8, but not the SAM-R/1 strain. Between 4 and 12 months, SAM-P/8 mice also showed a 40-50% decrease in ChAT activity in the septal region that was maximal by 8 months of age. By contrast, these age-related changes were not observed in the control SAM-R/1 mouse strain. The changes in ChAT in the SAMP/8 mouse strain were limited to the septal-hippocampal cholinergic pathway. There were no differences in ChAT activity in the nucleus basalis of Meynert, nor any of several neocortical areas to which it projects. To determine the neurochemical specificity of these alterations, the activity of glutamic acid decarboxylase (GAD), was also measured in the septum and hippocampus of SAM-P/8 mice. There were no age-related alterations in the hippocampus, but a significant 50% increase in GAD activity in the septal nucleus at 12 months of age. There were no age-related alterations in either nicotinic (H-3-cytisine) or muscarinic (H-3-QNB) cholinergic receptor binding in the cortex or hippocampus of SAM-P/8 mice. However, there were significant strain differences. At 2 months of age, 3H-QNB binding was higher in hippocampus of the SAM-R/1 than in SAM-P/8 mice. Similarly, H-3-cytisine binding in cortex of SAM-R/1 mice was higher at both 2 and 13 months than in SAM-P/8 mice. The results suggest that a compromised septal-hippocampal cholinergic pathway may contribute to the previously reported early onset of impaired learning and memory in the SAM-P/8 mouse strain. Published by Elsevier Science B.V. C1 Audie L Murphy Mem Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr 182, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78284 USA. St Louis Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, St Louis, MO 63125 USA. St Louis Univ, Sch Med, Dept Internal Med, St Louis, MO 63125 USA. RP Strong, R (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr 182, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. RI morley, john/F-9177-2011 OI morley, john/0000-0001-6444-2965 FU NIA NIH HHS [AG14674] NR 25 TC 36 Z9 38 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD MAR 14 PY 2003 VL 966 IS 1 BP 150 EP 156 DI 10.1016/S0006-8993(02)04192-6 PG 7 WC Neurosciences SC Neurosciences & Neurology GA 654KG UT WOS:000181495400017 PM 12646318 ER PT J AU Ball, SS Nhalil, A Mah, VH AF Ball, SS Nhalil, A Mah, VH TI Senex: An electronic reference for medicine and molecular pathology SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 VA Greater Los Angeles Healtcare Syst, GRECC, Los Angeles, CA 90073 USA. Senex, Anat, Los Angeles, CA USA. Senex, Pathol, Los Angeles, 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 14 PY 2003 VL 17 IS 4 SU S BP A387 EP A387 PN 1 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 658QZ UT WOS:000181733101840 ER PT J AU Kahn, NN Bauman, WA Sinha, AK AF Kahn, NN Bauman, WA Sinha, AK TI Circulating IgG recognizes platelet receptors of both prostacyclin and insulin SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Mt Sinai Sch Med, Bronx, NY 10468 USA. Bronx Vet Adm Med Ctr, Bronx, NY 10468 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 14 PY 2003 VL 17 IS 4 SU S BP A512 EP A512 PN 1 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 658QZ UT WOS:000181733102414 ER PT J AU Khan, M Sekhon, BK Sekhon, CS Singh, I Singh, AK AF Khan, M Sekhon, BK Sekhon, CS Singh, I Singh, AK TI Protection by N-acetyl cysteine against brain injury in a rat model of stroke SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph Johnson VA Med Ctr, Charleston, SC 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 14 PY 2003 VL 17 IS 4 SU S BP A606 EP A606 PN 1 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 658QZ UT WOS:000181733102858 ER PT J AU Khan, M Sekhon, BK Sekhon, CS Kawada, Y Singh, I Singh, AK AF Khan, M Sekhon, BK Sekhon, CS Kawada, Y Singh, I Singh, AK TI S-nitrosoglutathione modulates cerebroprotection and activities of sphingomyelinases and phospholipases in a rat model of experimental stroke SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph Johnson VA Med Ctr, Charleston, SC 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 14 PY 2003 VL 17 IS 4 SU S BP A607 EP A607 PN 1 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 658QZ UT WOS:000181733102861 ER PT J AU Luckey, AE Suto, G Kiraly, A Tache, Y AF Luckey, AE Suto, G Kiraly, A Tache, Y TI Endotoxin(EDX)-induced inhibition of gastric emptying (GE) involves interleukin-1 beta (IL-1 beta) and CRF2 receptors SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 VA Greater LA Healthcare Syst, UCLA CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Pecs, Dept Med 1, Pecs, Hungary. 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 14 PY 2003 VL 17 IS 4 SU S BP A41 EP A42 PN 1 PG 2 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 658QZ UT WOS:000181733100202 ER PT J AU Perell, KL Scremin, OU Chialvo, DR AF Perell, KL Scremin, OU Chialvo, DR TI The relationship between plantar pressure and plantar kin perfusion in diabetic peripheral neuropathy older adults SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RI Chialvo, Dante/A-4658-2009 OI Chialvo, Dante/0000-0002-1038-3637 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 14 PY 2003 VL 17 IS 4 SU S BP A127 EP A127 PN 1 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 658QZ UT WOS:000181733100613 ER PT J AU Shah, EH Giri, S Singh, I Singh, AK AF Shah, EH Giri, S Singh, I Singh, AK TI Molecular mechanism of Psychosine induced oligodendrocyte cell death SO FASEB JOURNAL LA English DT Meeting Abstract CT Experimental Biology 2003 Meeting CY APR 11-15, 2003 CL SAN DIEGO, CALIFORNIA C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 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 14 PY 2003 VL 17 IS 4 SU S BP A171 EP A171 PN 1 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 658QZ UT WOS:000181733100826 ER PT J AU Sato, M Markiewicz, M Yamanaka, M Bielawska, A Mao, CG Obeid, LM Hannun, YA Trojanowska, M AF Sato, M Markiewicz, M Yamanaka, M Bielawska, A Mao, CG Obeid, LM Hannun, YA Trojanowska, M TI Modulation of transforming growth factor-beta (TGF-beta) signaling by endogenous sphingolipid mediators SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID ALPHA-2(I) COLLAGEN GENE; FYVE DOMAIN PROTEIN; SACCHAROMYCES-CEREVISIAE; SPHINGOSINE KINASE; EXPRESSION; SMAD; CERAMIDE; RECEPTOR; TRANSCRIPTION; FIBROBLASTS AB Transforming growth factor-beta (TGF-beta) is a multifunctional growth factor that plays a critical role in tissue repair and fibrosis. Sphingolipid signaling has been shown to regulate a variety of cellular processes and has been implicated in collagen gene regulation. The present study was undertaken to determine whether endogenous sphingolipids are involved in the TGF-beta signaling pathway. TGF-beta treatment induced endogenous ceramide levels in a time-dependent manner within 5-15 min of cell stimulation. Using human fibroblasts transfected with a alpha2(l) collagen promoter/reporter gene construct (COL1A2), C.-ceramide (10 muM) exerted a stimulatory effect on basal and TGF-beta-induced activity of this promoter. Next, to define the effects of endogenous sphingolipids on TGF-beta signaling we employed ectopic expression of enzymes involved in sphingolipid metabolism. Sphingosine 1-phosphate phosphatase (YSR2) stimulated basal COL1A2 promoter activity and cooperated with TGF-beta in activation of this promoter. Furthermore, overexpression of YSR2 resulted in the pronounced increase of COL1A1 and COL1A2 mRNA levels. Conversely, overexpression of sphingosine kinase (SPHK1) inhibited basal and TGF-beta-stimulated COL1A2 promoter activity. These results suggest that endogenous ceramide, but not sphingosine or sphingosine 1-phosphate, is a positive regulator of collagen gene expression. Mechanistically, we demonstrate that Smad3 is a target of YSR2. TGF-beta-induced Smad3 phosphorylation was elevated in the presence of YSR2. Cotransfection of YSR2 with wild-type Smad3, but not with the phosphorylation-deficient mutant of Smad3 (Smad3A), resulted in a dramatic increase of COL1A2 promoter activity. In conclusion, this study demonstrates a direct role for the endogenous sphingolipid mediators in regulating the TGF-beta signaling pathway. C1 Med Univ S Carolina, Div Rheumatol & Immunol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Hosp, Div Gen Internal Med, Charleston, SC 29425 USA. RP Trojanowska, M (reprint author), Med Univ S Carolina, Div Rheumatol & Immunol, 96 Jonathan Lucas St,Suite 912, Charleston, SC 29425 USA. OI Trojanowska, Maria/0000-0001-9550-7178 FU NIA NIH HHS [AG16583]; NIAMS NIH HHS [AR 42334, AR 44883]; NIGMS NIH HHS [GM43825] NR 43 TC 37 Z9 37 U1 1 U2 2 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 MAR 14 PY 2003 VL 278 IS 11 BP 9276 EP 9282 DI 10.1074/jbc.M211529200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 654YF UT WOS:000181524000052 PM 12515830 ER PT J AU Bozkurt, B Mann, DL AF Bozkurt, B Mann, DL TI Use of biomarkers in the management of heart failure - Are we there yet? SO CIRCULATION LA English DT Editorial Material DE editorials; heart failure; morbidity; mortality ID LEFT-VENTRICULAR DYSFUNCTION; BRAIN NATRIURETIC PEPTIDE; ENALAPRIL; SURVIVAL; THERAPY C1 Baylor Coll Med, Dept Med, Winters Ctr Heart Failure Res, Houston, TX 77030 USA. Houston Vet Adm Med Ctr, Houston, TX USA. Methodist Hosp, Houston, TX 77030 USA. RP Mann, DL (reprint author), Baylor Coll Med, Dept Med, Winters Ctr Heart Failure Res, MS 524,6565 Fannin, Houston, TX 77030 USA. OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [R01 HL61543-01, HL-42250-10/10, P50 HL-O6H, R01 HL58081-01] NR 12 TC 21 Z9 30 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAR 11 PY 2003 VL 107 IS 9 BP 1231 EP 1233 DI 10.1161/01.CIR.0000057608.97285.20 PG 3 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 653ZM UT WOS:000181467000002 PM 12628938 ER PT J AU Douglas, JG Bakris, GL Epstein, M Ferdinand, KC Ferrario, C Flack, JM Jamerson, KA Jones, WE Haywood, J Maxey, R Ofili, EO Sanders, E Schiffrin, EL Sica, DA Sowers, JR Vidt, DG AF Douglas, JG Bakris, GL Epstein, M Ferdinand, KC Ferrario, C Flack, JM Jamerson, KA Jones, WE Haywood, J Maxey, R Ofili, EO Sanders, E Schiffrin, EL Sica, DA Sowers, JR Vidt, DG CA Hypertension African Amer Working TI Management of high blood pressure in African Americans - Consensus statement of the hypertension in African Americans Working Group of the International Society on Hypertension in Blacks SO ARCHIVES OF INTERNAL MEDICINE LA English DT Review ID CONVERTING-ENZYME-INHIBITOR; HEALTH-CARE PROFESSIONALS; TO-MODERATE HYPERTENSION; LEFT-VENTRICULAR DYSFUNCTION; RANDOMIZED CONTROLLED TRIAL; PRACTICE GUIDELINES COMMITTEE; ASSOCIATION TASK-FORCE; COLLEGE-OF-CARDIOLOGY; CHRONIC HEART-FAILURE; END-POINT REDUCTION AB The purpose of this consensus statement is to offer primary care providers (including physicians, nurse practitioners, and physician assistants) a practical, evidence-based clinical tool for achieving blood pressure goals in African American patients. The need for specific recommendations for African Americans is highlighted by compelling evidence of a higher prevalence of hypertension and poorer cardiovascular and renal outcomes in this group than in white Americans. African Americans have disturbingly higher rates of cardiovascular mortality, stroke, hypertension-related heart disease, congestive heart failure, type 2 diabetes mellitus, hypertensive nephropathy, and end-stage renal disease (ESRD). C1 Case Western Reserve Univ, Dept Med, Sch Med, Cleveland, OH 44106 USA. Rush Presbyterian St Lukes Med Ctr, Chicago, IL 60612 USA. Univ Miami, Sch Med, Miami, FL 33152 USA. Heartbeats Life Ctr, New Orleans, LA USA. Wake Forest Univ, Sch Med, Hypertens & Vasc Dis Ctr, Winston Salem, NC 27109 USA. Wayne State Univ, Sch Med, Detroit, MI USA. Univ Michigan, Hlth Syst, Ann Arbor, MI 48109 USA. S Texas Vet Hlth Syst, San Antonio, TX USA. Univ So Calif, Med Ctr, Los Angeles, CA USA. Natl Med Assoc Board Trustees, Los Angeles, CA USA. Morehouse Sch Med, Atlanta, GA 30310 USA. Univ Maryland, Sch Med, Baltimore, MD 21201 USA. Clin Res Inst Montreal, Montreal, PQ H2W 1R7, Canada. Virginia Commonwealth Univ, Med Coll Virginia, Richmond, VA 23298 USA. SUNY Hlth Sci Ctr, Brooklyn, NY 11203 USA. Cleveland Clin Fdn, Cleveland, OH 44195 USA. RP Douglas, JG (reprint author), Case Western Reserve Univ, Dept Med, Sch Med, Room W-165,10900 Euclid Ave, Cleveland, OH 44106 USA. NR 132 TC 258 Z9 261 U1 2 U2 13 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 10 PY 2003 VL 163 IS 5 BP 525 EP 541 DI 10.1001/archinte.163.5.525 PG 17 WC Medicine, General & Internal SC General & Internal Medicine GA 655PH UT WOS:000181561000003 PM 12622600 ER PT J AU Johnson, KM Alarcon, J Watts, DM Rodriguez, C Velasquez, C Sanchez, J Lockhart, D Stoner, BP Holmes, KK AF Johnson, KM Alarcon, J Watts, DM Rodriguez, C Velasquez, C Sanchez, J Lockhart, D Stoner, BP Holmes, KK TI Sexual networks of pregnant women with and without HIV infection SO AIDS LA English DT Article DE HIV-1; sexual network; pregnant women; Peru; heterosexual transmission ID HETEROSEXUAL TRANSMISSION; CONDOMS AB Objectives: To determine the relationship of HIV infection in pregnant women to sexual network size and other risk factors. Design: Case-control study of women attending the public maternity hospital in Lima, Peru. Methods: We interviewed 75 HIV-seropositive women, 41 of their most recent male partners, and two control groups totaling 137 uninfected pregnant women and 70 of their most recent male partners. Each woman's sexual network size was estimated through second and third-generation partnerships over the past year, 5 years and lifetime. Results: Few HIV-seropositive women reported behavioral risk factors for HIV infection, but 79% of male partners were HIV seropositive. Risk factors in male partners included sex with a female sex worker (FSW) or with another man (MSM). The mean 5-year sexual network sizes through the second generation (8.4 persons for HIV-seropositive women, and 2.5 and 1.9 for women in the two control groups) predicted HIV in the women, independently of her own number of partners. These differences were largely attributable to the number of partners reported by male partners. Using data from concurrent studies of FSW and MSM, estimates of 5-year sexual network sizes through the third-generation, excluding contacts with FSW which were protected by consistent condom use, were 672 persons for HIV-seropositive women, and 160 and 224 for women in the two control groups. Conclusions: HIV infection risk among pregnant women in Lima depends largely on their male partners' risk behaviors. Even monogamous women had very large sexual networks. (C) 2003 Lippincott Williams Wilkins. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Ctr AIDS & STD, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Nacl Mayor San Marcos, Inst Trop Med, San Marcos, TX USA. Minist Hlth, Inst Materno Perinatal, Limu, Peru. Minist Hlth, Program Control STDs & AIDS, Limu, Peru. Washington Univ, Sch Med, Dept Med, St Louis, MO 63130 USA. Washington Univ, Sch Med, Dept Anthropol, St Louis, MO 63130 USA. RP Johnson, KM (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Mailstop 111WOM,1660 S Columbian Way, Seattle, WA 98108 USA. OI Alarcon, Jorge/0000-0002-0800-2380 FU FIC NIH HHS [T22 TW00001]; NIAID NIH HHS [AI-27757] NR 21 TC 26 Z9 26 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD MAR 7 PY 2003 VL 17 IS 4 BP 605 EP 612 DI 10.1097/01.aids.0000050785.28043.b9 PG 8 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 653KT UT WOS:000181434900016 PM 12598781 ER PT J AU Alarcon, JO Johnson, KM Courtois, B Rodriguez, C Sanchez, J Watts, DM Holmes, KK AF Alarcon, JO Johnson, KM Courtois, B Rodriguez, C Sanchez, J Watts, DM Holmes, KK TI Determinants and prevalence of HIV infection in pregnant Peruvian women SO AIDS LA English DT Article DE heterosexual transmission; risk factors; sexual behavior; South America ID IMMUNODEFICIENCY-VIRUS INFECTION; POPULATION; RISK AB Objectives: To determine age-specific seroprevalence, risk factors, and risk markers for heterosexually-acquired HIV infection among pregnant women. Design: Cross-sectional study of 12 436 consecutive pregnant women in Lima, Peru in 1996-1997. Methods: Standardized interviews, serologic tests for HIV and syphilis, bivariate and multivariate analysis. Results: HIV seropositivity was confirmed in 58 women (0.5%). Only 22.6% were married, and only 12% of HIV infected women reported greater than or equal to2 sex partners ever. In multivariate analyses HIV infection was associated with: short duration of current relationship; two risk behaviors of women themselves (early onset of sexual activity and number of past sexual relationships); women's perceptions of two risk behaviors of partners (partner is a 'womanizer,' and partner uses illegal drugs); inadequate prenatal care; and four additional risk factors or markers (history of sexually transmitted disease, tuberculosis, or abortion in the women; and diagnosis of HIV/AIDS in a partner). Conclusions: HIV infection was related both to women's own risk behaviors and to the perceived risk behaviors of their sexual partners. Underlying societal factors related to heterosexual HIV infection, including deferral of marriage, warrant further study. (C) 2003 Lippincott Williams Wilkins. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Nacl Mayor San Marcos, Inst Trop Med, Lima 14, Peru. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Ctr AIDS & STD, Seattle, WA 98195 USA. Inst Materno Perinatal Lima, Lima, Peru. Minist Hlth, Program AIDS & STD, Lima, Peru. USN, Med Res Ctr, Lima, Peru. RP Johnson, KM (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Mailstop 111WOM,1660 S Columbian Way, Seattle, WA 98108 USA. OI Alarcon, Jorge/0000-0002-0800-2380 FU NIAID NIH HHS [P30AI27757] NR 25 TC 36 Z9 39 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 MAR 7 PY 2003 VL 17 IS 4 BP 613 EP 618 DI 10.1097/01.aids.0000042973.95433.22 PG 6 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 653KT UT WOS:000181434900017 PM 12598782 ER PT J AU Niquet, J Baldwin, RA Allen, SG Fujikawa, DG Wasterlain, CG AF Niquet, J Baldwin, RA Allen, SG Fujikawa, DG Wasterlain, CG TI Hypoxic neuronal necrosis: Protein synthesis-independent activation of a cell death program SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID CYTOCHROME-C RELEASE; MITOCHONDRIAL PERMEABILITY TRANSITION; CNS MITOCHONDRIA; GLOBAL-ISCHEMIA; APOPTOSIS; HIPPOCAMPUS; EXPRESSION; INDUCTION; MECHANISM; SURVIVAL AB Hypoxic necrosis of dentate gyrus neurons in primary culture required the activation of an orderly cell death program independent of protein synthesis. Early mitochondrial swelling and loss of the mitochondrial membrane potential were accompanied by release of cytochrome c and followed by caspase-9-dependent activation of caspase-3. Caspase-3 and -9 inhibitors reduced neuronal necrosis. Calcium directly induced cytochrome c release from isolated mitochondria. Hypoxic neuronal necrosis may be an active process in which the direct effect of hypoxia on mitochondria may lead to the final common pathway of caspase-3-mediated neuronal death. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Expt Neurol Labs, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Brain Res Inst, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Niquet, J (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Res 151,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NINDS NIH HHS [NS13515, R01 NS013515] NR 35 TC 53 Z9 60 U1 1 U2 3 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 MAR 4 PY 2003 VL 100 IS 5 BP 2825 EP 2830 DI 10.1073/pnas.0530113100 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 652DR UT WOS:000181365000117 PM 12606726 ER PT J AU Bonner, LT AF Bonner, LT TI On bridging the gap SO ACADEMIC PSYCHIATRY LA English DT Editorial Material ID HEALTH-CARE C1 NW Network Mental Illness Res Educ & Clin Ctr, Dept Vet Affairs, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Bonner, LT (reprint author), VA Puget Sound Hlth Care Syst, MIRECC, S-116,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIA NIH HHS [R01 AG18644] NR 5 TC 11 Z9 11 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1042-9670 J9 ACAD PSYCHIATR JI Acad. Psych. PD SPR PY 2003 VL 27 IS 1 BP 29 EP 30 DI 10.1176/appi.ap.27.1.29 PG 2 WC Education & Educational Research; Psychiatry SC Education & Educational Research; Psychiatry GA 649NR UT WOS:000181215300005 PM 12824118 ER PT J AU Rumsfeld, JS Magid, DJ Plomondon, ME Sales, AE Grunwald, GK Every, NR Spertus, JA AF Rumsfeld, JS Magid, DJ Plomondon, ME Sales, AE Grunwald, GK Every, NR Spertus, JA TI History of depression, angina, and quality of life after acute coronary syndromes SO AMERICAN HEART JOURNAL LA English DT Article; Proceedings Paper CT 74th Annual Scientific Sessions of the American-Heart-Association CY NOV 11-14, 2001 CL ANAHEIM, CALIFORNIA SP Amer Heart Assoc ID SEROTONIN REUPTAKE INHIBITORS; MYOCARDIAL-INFARCTION; OF-LIFE; ARTERY DISEASE; FUNCTIONAL STATUS; UNSTABLE ANGINA; HEALTH; OUTPATIENTS; PROGNOSIS; MORTALITY AB Background Depression has been associated with higher mortality and morbidity rates after acute coronary syndromes (ACS), but little is known about the association between depression, angina burden, and quality of life. We evaluated the association between a history of depression and patient-reported angina frequency, physical limitation, and quality of life 7 months after discharge from the hospital for ACS. Methods Patients were enrolled in the Department of Veterans Affairs Access to Cardiology Study, a cohort study of all patients with acute myocardial infarction or unstable. angina who were discharged, from 24 Veterans Affairs medical centers between March 1998 and February 1999. Data from 1957 patients who completed a 7-month postdischarge Seattle Angina Questionnaire were analyzed. Multivariate logistic regression was used to evaluate a history of depression as an independent predictor of angina frequency, physical limitation, and quality of life 7 months after ACS, as measured with the Seattle Angina Questionnaire. Results A total of 526 patients (26.7%) had a history of depression. After adjustment for a wide array of demographic, cardiac, and comorbid factors, a history of depression was significantly associated with more frequent angina (odds ratio [OR] 2.40; 95 % CI 1.86-3.10, P < .001), greater physical limitation (OR 2.89, 95 % CI 2.17-3.86, P < .001), and worse quality of life (OR 2.84, 95 % CI 2.16-3.72, P < .001) after ACS. Conclusion We found a strong association between a history of depression and both heavier angina burden and worse health status after ACS. These findings further support the importance of depression as a risk marker for adverse outcomes after ACS. C1 Denver VA Med Ctr, Denver, CO 80206 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Colorado Permanente Med Grp, Denver, CO USA. Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Missouri, Kansas City, MO 64110 USA. RP Rumsfeld, JS (reprint author), Denver VA Med Ctr, 1055 Clermont St, Denver, CO 80206 USA. OI Sales, Anne/0000-0001-9360-3334 NR 32 TC 87 Z9 100 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 MAR PY 2003 VL 145 IS 3 BP 493 EP 499 DI 10.1067/mhj.2003.177 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 663QG UT WOS:000182015800020 PM 12660673 ER PT J AU Baker, LD Sambamurti, K Craft, S Cherrier, M Raskind, MA Stanczyk, FZ Plymate, SR Asthana, S AF Baker, LD Sambamurti, K Craft, S Cherrier, M Raskind, MA Stanczyk, FZ Plymate, SR Asthana, S TI 17 beta-estradiol reduces plasma A beta 40 for HRT-naive postmenopausal women with Alzheimer disease - A preliminary study SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article; Proceedings Paper CT International Meeting on Alzbeimers Disease and Related Disorders CY JUL, 2002 CL STOCKHOLM, SWEDEN ID ESTROGEN REPLACEMENT THERAPY; CENTRAL-NERVOUS-SYSTEM; BETA-AMYLOID PEPTIDES; CEREBROSPINAL-FLUID; PRECURSOR PROTEIN; CONTROLLED TRIAL; DOUBLE-BLIND; DEMENTIA; OVARIECTOMY; METABOLISM AB One mechanism to support the potentially ben, the brain for postmenopausal women potentially involves the hormone's ability to favorably alter the processing of amyloid-precursor protein (APP), believed to play an important role in the pathobiology of Alzheimer disease (AD). The authors evaluated the effects of estrogen administration on plasma concentration of one by-product of APP processing, Abeta40, for postmenopausal women with AD. Methods: In a placebo-controlled, double blind, parallel-group design study, 20 women were randomized to receive either 0.10 mg/day of transdermal 17beta-estradiol or a placebo for 8 weeks and were retrospectively evaluated as to whether basal levels of Abeta40 were affected by pre-study use of hormone replacement therapy (HRT). Blood samples were collected and cognitive tests were administered at baseline; at Weeks 3, 5, and 8 during treatment,and again 8 weeks after treatment termination. Results: For the group as a whole, plasma Abeta40 was not reliably reduced in response to short-term estradiol administration. For HRT-naive subjects, baseline Abeta40 concentrations were higher than those of previous HRT users, and controlled estradiol administration significantly reduced plasma Abeta40 by the end of the 8-week treatment period. Conclusions: These results provide preliminary clinical evidence to support an effect of estradiol on Abeta-processing for AD women who are HRT-naive. This finding suggests that the hormone may serve as an AA lowering agent for HRT-naive AD women, which may in turn, have ultimate ramifications for the progression of AD pathology. C1 Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53705 USA. GRECC, LDB, SC, MAR,SRP, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Mayo Clin, Dept Pharmacol, Jacksonville, FL 32224 USA. Univ So Calif, Dept Obstet & Gynecol, Los Angeles, CA 90089 USA. William S Middleton Vet Affairs Hosp, GRECC, Madison, WI USA. RP Asthana, S (reprint author), Univ Wisconsin, Sch Med, Dept Med, 2870 Univ Ave,Suite 100, Madison, WI 53705 USA. NR 32 TC 19 Z9 22 U1 3 U2 4 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAR-APR PY 2003 VL 11 IS 2 BP 239 EP 244 DI 10.1176/appi.ajgp.11.2.239 PG 6 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 649LL UT WOS:000181209900014 PM 12611754 ER PT J AU Wang, Q Bernardini, J Piraino, B Fried, L AF Wang, Q Bernardini, J Piraino, B Fried, L TI Albumin at the start of peritoneal dialysis predicts the development of peritonitis SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE incidence; peritoneal dialysis (PD); peritonitis; albumin; hypoalbuminemia ID MORBIDITY; INDEX AB Background. Both Peritonitis and serum albumin level are associated with morbidity and mortality in peritoneal dialysis (PD) patients. Severe cases of peritonitis result in hypoalbuminemia. However, it is not clear whether hypoalbuminemia predicts the development of peritonitis. Methods: We performed a retrospective analysis of a prospectively collected database from six centers in western Pennsylvania and West Virginia. Incident PD patients with a Charlson Comorbidity Index (CCI) score at the start of PD therapy and serum albumin level measured within 30 days of initiation were selected. Poisson regression was used to analyze predictors of peritonitis. Results: Three hundred ninety-three patients had a CCI score and serum albumin level measured at the start of PD therapy. Overall peritonitis rate was 0.65 episodes/dialysis-year. Significant univariate predictors were albumin level (rate ratio [RR], 0.79 per 1-g/dL [10-g/L] increase; 95% confidence interval [CI], 0.65 to 0.95; P = 0.015), male sex (P = 0.003), and being dialyzed in the Veterans Administration (RR, 1.97; 95% Cl, 1.48 to 2.62; P < 0.001) or other center (RR, 1.68; 95% Cl, 1.92 to 5.62; P < 0.001). Although CCI score correlated inversely with albumin level (r = -0.305; P < 0.001), CCI score was only marginally predictive of peritonitis (P = 0.068). In multivariate analysis, predictors were albumin level (RR, 0.74; 95% Cl, 0.31 to 1.75; P = 0.002) and race (RR, 1.36; P = 0.024). Patients with an initial serum albumin level less than 2.9 g/dL (29 g/L) had a peritonitis rate of 1.5 episodes/dialysis-year compared with 0.6 episodes/ dialysis-year for patients with an initial serum albumin level of 2.9 g/dL or greater (P < 0.001). Conclusion Hypoalbuminemia at the start of PD therapy is an independent predictor of subsequent peritonitis. Intervention studies to decrease peritonitis risk in this high-risk subset of patients are needed. C1 Univ Pittsburgh, Sch Med, Renal Electrolyte Div, Pittsburgh, PA USA. Vet Adm Hosp, Vet Adm Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Fried, L (reprint author), VA Pittsburgh Healthcare Syst, Renal Sect, 4N167,Mailstop 111F-U,Univ Dr C, Pittsburgh, PA 15240 USA. OI Piraino, Beth/0000-0001-5061-0841 NR 17 TC 55 Z9 61 U1 0 U2 4 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 MAR PY 2003 VL 41 IS 3 BP 664 EP 669 DI 10.1053/ajkd.2003.50128 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 651MP UT WOS:000181324000018 PM 12612991 ER PT J AU Kovac, SH Klapow, JC Kroenke, K Spitzer, RL Williams, JBW AF Kovac, SH Klapow, JC Kroenke, K Spitzer, RL Williams, JBW TI Differing symptoms of abused versus nonabused women in obstetric-gynecology settings SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article; Proceedings Paper CT 23rd Annual Meeting of the Society-of-Behavioral-Medicine CY APR 03-06, 2002 CL WASHINGTON, D.C. SP Soc Behav Med DE obstetrics-gynecology; abuse; symptom; patient health questionnaire ID INTIMATE PARTNER VIOLENCE; PRIMARY-CARE PRACTICE; DOMESTIC VIOLENCE; PREVALENCE; PHYSICIANS; EMERGENCY; VALIDITY; VICTIMS; UTILITY; MD AB OBJECTIVE: The purpose of this study was to document the prevalence rates of reported abuse in obstetric/gynecology settings and to characterize physical symptoms, function, and psychologic distress of women who report abuse. STUDY DESIGN: This was a descriptive study of 118 patients who reported physical or sexual abuse in the past year and 2800 patients who reported no abuse at seven obstetric/gynecology practices. The Patient Health Questionnaire measured psychiatric diagnoses, somatic complaints, and psychosocial stressors. The Medical Outcomes Study Short Form 20 assessed health status, and self-reported health care use was measured. RESULTS: Four percent of women reported recent abuse. Patients who reported abuse had more psychiatric diagnoses, more severe psychologic distress, more somatic symptoms, more psychosocial stressors, more physician visits, and poorer reported health status compared with nonreporters of abuse. CONCLUSION: Enhanced recognition of possible abuse through screening may identify women in need of intervention and help to reduce the need for continued medical intervention. C1 Birmingham Vet Aff Med Ctr, Targeted Res Enhancement Program, Birmingham, AL 35233 USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL USA. Univ Alabama, Div Prevent Med, Birmingham, AL USA. Univ Alabama, Dept Psychol, Birmingham, AL USA. Univ Alabama, Dept Hlth Care Org & Policy, Birmingham, AL USA. Indiana Univ, Regenstrief Inst Hlth Care, Indianapolis, IN 46204 USA. Indiana Univ, Dept Med, Indianapolis, IN 46204 USA. New York State Psychiat Inst & Hosp, Biometr Res Dept, New York, NY 10032 USA. Columbia Univ, Dept Psychiat, New York, NY 10027 USA. RP Kovac, SH (reprint author), Birmingham Vet Aff Med Ctr, Targeted Res Enhancement Program, 700 19th St S, Birmingham, AL 35233 USA. EM skovac@dopm.uab.edu NR 25 TC 31 Z9 31 U1 1 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD MAR PY 2003 VL 188 IS 3 BP 707 EP 713 DI 10.1067/mob.2003.193 PG 7 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 658XH UT WOS:000181746000018 PM 12634645 ER PT J AU Boninger, ML Cooper, RA Fitzgerald, SG Lin, J Cooper, R Dicianno, B Liu, B AF Boninger, ML Cooper, RA Fitzgerald, SG Lin, J Cooper, R Dicianno, B Liu, B TI Investigating neck pain in wheelchair users SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE wheelchair; neck pain; vibration ID SPINAL-CORD INJURIES; RISK-FACTORS; BACK; PREVALENCE; SATISFACTION; RELIABILITY; DISABILITY; DISORDERS; OPERATORS; HEALTH AB Objective: Despite the fact that wheelchair users are exposed to risk factors for neck and upper back pain (NP), little is known about the impact and possible diagnoses associated with NP. The purpose of this study was to examine the significance of NP in wheelchair users and to determine if a portion of the NP may be myofascial in origin. Design: Cross-sectional cohort study using questionnaires and physical exams to evaluate NP in a convenience sample of wheelchair users from the National Veteran's Wheelchair Games. Main outcome measures included reported NP, visual analog scale of neck complaints, Neck Disability Index, and physical examination findings of trigger points. Results: Sixty-six percent of subjects reported NP since becoming a wheelchair user and, 60% reported pain during the past month. Neither age nor length of time in a wheelchair was significantly different between those subjects who did and those subjects who did not report pain. Of those respondents who reported NP, 60% visited the doctor about the pain and 40% limited their daily activities due to the pain. Trigger-point palpation reproduced pain in 54% of those respondents who experienced pain in the past month (n = 34). Conclusion: This study provides a first step in defining the prevalence and significance of NP among wheelchair users. Clinicians who work with this population need to ask subjects about symptoms and consider a myofascial origin for that pain when considering treatment. C1 Univ Pittsburgh, Dept Phys Med & Rehabil, Human Engn Res Labs, Pittsburgh, PA USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Ctr Excellence Wheelchairs & Related Technol, Pittsburgh, PA 15206 USA. RP Boninger, ML (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Ctr Excellence Wheelchairs & Related Technol, 7180 Highland Dr,Bldg 4,2nd Floor E,151R-1, Pittsburgh, PA 15206 USA. OI Boninger, Michael/0000-0001-6966-919X; Dicianno, Brad/0000-0003-0738-0192 NR 30 TC 14 Z9 14 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0894-9115 J9 AM J PHYS MED REHAB JI Am. J. Phys. Med. Rehabil. PD MAR PY 2003 VL 82 IS 3 BP 197 EP 202 DI 10.1097/01.PHM.0000054217.17816.DD PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 648LQ UT WOS:000181153200008 PM 12595772 ER PT J AU Raybould, HE Glatzle, J Robin, C Meyer, JH Phan, T Wong, H Sternini, C AF Raybould, HE Glatzle, J Robin, C Meyer, JH Phan, T Wong, H Sternini, C TI Expression of 5-HT3 receptors by extrinsic duodenal afferents contribute to intestinal inhibition of gastric emptying SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE glucose; carbohydrate; monosaccharide; enterochromaffin cells; 5-hydroxytryptamine ID ENTEROCHROMAFFIN CELLS; SIGNALING MECHANISMS; RAT JEJUNUM; VAGAL; NEURONS; SECRETION; PIG; 5-HYDROXYTRYPTAMINE; SEROTONIN; PATHWAYS AB Intestinal perfusion with carbohydrates inhibits gastric emptying via vagal and spinal capsaicin-sensitive afferent pathways. The aim of the present study was to determine the role of 1) 5-hydroxytryptamine (5-HT)(3) receptors (5-HT3R) in mediating glucose-induced inhibition of gastric emptying and 2) 5-HT3R expression in vagal and spinal afferents in innervating the duodenum. In awake rats fitted with gastric and duodenal cannulas, perfusion of the duodenum with glucose (50 and 100 mg) inhibited gastric emptying. Intestinal perfusion of mannitol inhibited gastric emptying only at the highest concentration (990 mosm/kgH(2)O). Pretreatment with the 5-HT3R antagonist tropisetron abolished both glucose- and mannitol-induced inhibition of gastric emptying. Retrograde labeling of visceral afferents by injection of dextran-conjugated Texas Red into the duodenal wall was used to identify extrinsic primary afferents. Immunoreactivity for 5-HT3R, visualized with an antibody directed to the COOH terminus of the rat 5-HT3R, was found in >80% of duodenal vagal and spinal afferents. These results show that duodenal extrinsic afferents express 5-HT3R and that the receptor mediates specific glucose- induced inhibition of gastric emptying. These findings support the hypothesis that enterochromaffin cells in the intestinal mucosa release 5-HT in response to glucose, which activates 5-HT3R on afferent nerve terminals to evoke reflex changes in gastric motility. The primary glucose sensors of the intestine may be mucosal enterochromaffin cells. C1 Univ Calif Davis, Sch Vet Med, Dept Anat Physiol & Cell Biol, Davis, CA 95616 USA. Univ Calif Los Angeles, Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr,Dept Med,Div Digest Dis, Los Angeles, CA 95616 USA. Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA 95616 USA. RP Raybould, HE (reprint author), Univ Calif Davis, Sch Vet Med, Dept Anat Physiol & Cell Biol, 1321 Haring Hall, Davis, CA 95616 USA. FU NIDDK NIH HHS [DK 57037, DK 35740, DK 41004, DK 41301] NR 34 TC 85 Z9 89 U1 0 U2 4 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 2003 VL 284 IS 3 BP G367 EP G372 DI 10.1152/ajpgi.00292.2001 PG 6 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 642WC UT WOS:000180827600003 PM 12409280 ER PT J AU Leaf, DA Macrae, HSH Grant, E Kraut, J AF Leaf, DA Macrae, HSH Grant, E Kraut, J TI Isometric exercise increases the size of forearm veins in patients with chronic renal failure SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Article DE physical exercise; Cimino-Brescia fistula; hemodialysis; veins; renal failure ID HEMODIALYSIS AB Objectives: Delay in maturation or failure of maturation of Cimino-Brescia fistulae contributes to the significant vascular access-related morbidity of chronic hemodialysis patients. Increased size and capacitance of native veins before the formation of vascular access has been considered an important variable in the success rate of native fistulae. We evaluated whether a formal exercise program might alter the size of native veins. Methods: The effect of exercise on venous size was evaluated in 5 patients with severe chronic renal failure [glomerular filtration rate, 30.6 +/- 5.3 mL/min (mean +/- SD)]. Five male patients with a mean age of 57 +/- 9 years underwent a 6-week forearm exercise training program, involving nondominant arms, that included isometric hand-grip contractions to 25 to 35% of MVC lasting 40 to 120 seconds and repetitive squeezing of squash and racquet balls. Both the volume and intensity of exercise training was increased weekly based on strength measured by hand-grip dynamometer and on the patients' indicated level of comfort. Cephalic vessel size in both the nondominant (trained) and dominant (control) arms, with and without a tourniquet, were obtained using Doppler ultrasound before and after the 6-week exercise training program. Results: The size of the cephalic vein of the exercised arm increased significantly (P < 0.05) compared with the control arm when measured in both the absence (048 +/- 0.016 versus 0.024 +/- 0.023 cm(2)) and the presence of a tourniquet (0.056 +/- 0.022 versus 028 +/- 0.027 cm(2)). Conclusions: These findings indicate that a simple, incremental resistance, exercise-training program can cause a significant increase in the size of the cephalic vein commonly used in the creation of an arteriovenous fistula. The increase in size and resultant probable increase in blood flow might accelerate the maturation of native arteriovenous fistulae, thereby lessening the morbidity associated with vascular access. C1 Greater Los Angeles VA Healthcare Syst, Div Gen Med, Los Angeles, CA 90073 USA. Greater Los Angeles VA Healthcare Syst, Div Nephrol, Los Angeles, CA 90073 USA. Greater Los Angeles VA Healthcare Syst, Div Radiol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. Pepperdine Univ, Dept Sports Med, Malibu, CA 90265 USA. RP Leaf, DA (reprint author), Greater Los Angeles VA Healthcare Syst, Div Gen Med, 111G,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM david.leaf@med.va.gov NR 14 TC 20 Z9 22 U1 0 U2 5 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 MAR PY 2003 VL 325 IS 3 BP 115 EP 119 DI 10.1097/00000441-200303000-00003 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 659LF UT WOS:000181777600003 PM 12640286 ER PT J AU Collins, TC Beyth, RJ AF Collins, TC Beyth, RJ TI Process of care and outcomes in peripheral arterial disease SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Review DE process of care; outcomes; peripheral arterial disease ID CORONARY-HEART-DISEASE; LIMB-THREATENING ISCHEMIA; ANKLE-ARM INDEX; INTERMITTENT CLAUDICATION; RISK-FACTORS; VASCULAR-DISEASE; FEMORAL ATHEROSCLEROSIS; DEFINED POPULATION; OCCLUSIVE DISEASE; LOWER-EXTREMITIES AB Peripheral arterial disease (PAD) is a prevalent illness that most commonly affects patients older than 60 years. As the population ages, the prevalence of PAD and its associated, adverse outcomes will also increase. Adverse outcomes in PAD are either systemic (ie, cardiovascular events such as myocardial infarctions or strokes) or localized to the legs (ie, bypass surgery or amputation). Although much research has focused on adverse systemic outcomes in patients with PAD, less is known about those factors related to adverse limb events. The Centers for Disease Control and Prevention estimate that more than 100,000 amputations are performed in the United States each year. What remains to be determined is the association between how physicians manage patients with PAD (ie, process of care) and the development of adverse limb outcomes. Determining the association of the management of PAD with adverse limb outcomes will highlight those areas in which to focus to improve the quality of care for patients with this disease. Understanding the relationship between risk factors, process of care, and outcomes will be of importance to patients, clinicians, and policy makers.. The purpose of this article is to review the burden of PAD and to discuss the association of process of care with adverse limb outcomes in patients with PAD. C1 Houston VAMC, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Div Hlth Serv Res, Houston, TX 77030 USA. RP Collins, TC (reprint author), Houston VAMC, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. FU NIA NIH HHS [K08-AG00712] NR 78 TC 8 Z9 8 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-9629 EI 1538-2990 J9 AM J MED SCI JI Am. J. Med. Sci. PD MAR PY 2003 VL 325 IS 3 BP 125 EP 134 DI 10.1097/00000441-200303000-00005 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 659LF UT WOS:000181777600005 PM 12640288 ER PT J AU Martin, B Clapp, L Bialkowski, D Bridgeford, D Amponsah, A Lyons, L Beresford, TP AF Martin, B Clapp, L Bialkowski, D Bridgeford, D Amponsah, A Lyons, L Beresford, TP TI Compliance to supervised disulfiram therapy: A comparison of voluntary and court-ordered patients SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID ALCOHOLISM AB We hypothesized that court mandate would significantly enhance compliance with supervised disulfiram therapy. We conducted a twelve-week prospective study of outpatient compliance with court-ordered, monitored disulfiram treatment as compared to voluntary, monitored treatment. The court ordered group (n = 19) was significantly more compliant than the voluntary group (n = 22). Legally mandated subjects attended an average of 87% (+/- 21%) of scheduled visits, versus 42% (+/- 35%) for the group without court order. Court mandate roughly doubles the compliance rate of monitored disulfiram therapy, effectively enhancing clinic attendance during the first twelve weeks of treatment. C1 Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. RP Beresford, TP (reprint author), Denver Vet Affairs Med Ctr, 151,1055 Clermont St, Denver, CO 80220 USA. NR 19 TC 12 Z9 12 U1 2 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 MAR PY 2003 VL 12 IS 2 BP 137 EP 143 DI 10.1080/10550490390201399 PG 7 WC Substance Abuse SC Substance Abuse GA 671MP UT WOS:000182468800004 PM 12746088 ER PT J AU Doyle, PJ McNeil, MR Hula, WD AF Doyle, PJ McNeil, MR Hula, WD TI The Burden of Stroke Scale (BOSS): Validating patient-reported communication difficulty and associated psychological distress in stroke survivors SO APHASIOLOGY LA English DT Article ID QUALITY-OF-LIFE; HEALTH; SYMPTOMS AB Background: The Burden of Stroke Scale (BOSS) (Doyle et al., 2002) is a health-status assessment instrument designed to measure patient-reported difficulty in multiple domains of functioning, psychological distress associated with specific functional limitations, and general well-being in stroke survivors. Aims: This study was designed to examine the discriminative and concurrent validity of the BOSS Communication Difficulty (CD) and Communication-Associated Psychological Distress (CAPD) scales. A secondary purpose was to provide a preliminary examination of the relationships between the BOSS CD and CAPD scales and aspects of subjective well-being, including the frequency with which participants reported experiencing general positive and negative emotional states. Methods & Procedures: The BOSS was administered as a face-to-face interviewer-assisted survey to 281 medically stable, community-dwelling stroke survivors selected from five collaborating centres in the USA. Prior to administration of the BOSS, all subjects were rated for severity of communication impairment using the Boston Diagnostic Aphasia Examination (BDAE) Severity Rating Scale (Goodglass, Kaplan, & Baressi, 2001) and were administered Subtest 8 of the Revised Token Test (RTT), (McNeil & Prescott, 1978). The discriminant validity of the BOSS CD and CAPD scales was examined by comparing scores in stroke survivors with (N = 135) and without (N = 146) communication impairment, and within the communicatively impaired sample when classified according to BDAE ratings and RTT performance. Concurrent validity of the BOSS CD and CAPD scales was examined by correlating BOSS scores with BDAE ratings and RTT performance. Finally, correlations between the BOSS CAPD, BOSS CD, Positive Mood, and Negative Mood scales were calculated. Outcomes & Results: Statistical analyses revealed significant differences between communicatively impaired and non-communicatively impaired subjects on the BOSS CD and CAPD scales, as well as significant differences between communicatively impaired subjects of differing severity levels classified both by BDAE severity ratings and RTT performance. Correlational analyses revealed moderately strong relationships among the BOSS CD scale, BDAE severity ratings, and RTT performance. Finally, correlations among the BOSS CAPD, CD, Positive Mood, and Negative Mood scales revealed true covarying relationships of moderate strength between the BOSS CAPD and CD scales, and also between the CAPD and Negative Mood Scales. Conclusions: These findings provide preliminary support for the discriminant and construct validity of the BOSS Communication Difficulty (CD) and Communication Associated Distress (CAPD) Scales, and provide an empirical rationale for further research into the relationships between functional status, patient-reported health perceptions, and subjective well-being in stroke survivors with communication disorders. C1 VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr 132AH, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. RP Doyle, PJ (reprint author), VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr 132AH, 7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 32 TC 27 Z9 28 U1 2 U2 7 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD MAR PY 2003 VL 17 IS 3 BP 291 EP 304 DI 10.1080/02687030244000680 PG 14 WC Clinical Neurology SC Neurosciences & Neurology GA 656MD UT WOS:000181610800005 ER PT J AU Clarke, P Tyler, KL AF Clarke, P Tyler, KL TI Reovirus-induced apoptosis: A minireview SO APOPTOSIS LA English DT Article DE apoptosis; caspases; death receptors; mitochondria; reovirus ID NF-KAPPA-B; ATTACHMENT PROTEIN SIGMA-1; STRUCTURAL BASIS; DEATH RECEPTORS; SIALIC-ACID; CANCER-CELLS; INHIBITION; ACTIVATION; BINDING; TRAIL AB Reoviruses infect a variety of mammalian hosts and serve as an important experimental system for studying the mechanisms of virus-induced injury. Reovirus infection induces apoptosis in cultured cells in vitro and in target tissues in vivo, including the heart and central nervous system (CNS). In epithelial cells, reovirus-induced apoptosis involves the release of tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) from infected cells and the activation of TRAIL-associated death receptors (DRs) DR4 and DR5. DR activation is followed by activation of caspase 8, cleavage of Bid, and the subsequent release of pro-apoptotic mitochondrial factors. By contrast, in neurons, reovirus-induced apoptosis involves a wider array of DRs, including TNFR and Fas, and the mitochondria appear to play a less critical role. These results show that reoviruses induce apoptotic pathways in a cell and tissue specific manner. In vivo there is an excellent correlation between the location of viral infection, the presence of tissue injury and apoptosis, indicating that apoptosis is a critical mechanism by which disease is triggered in the host. These studies suggest that inhibition of apoptosis may provide a novel strategy for limiting virus-induced tissue damage following infection. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Microbiol & Immunol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol B 182, 4200 E 9th Ave, Denver, CO 80262 USA. EM Ken.Tyler@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 FU NIA NIH HHS [1R01AG14071] NR 51 TC 54 Z9 55 U1 0 U2 5 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 1360-8185 J9 APOPTOSIS JI Apoptosis PD MAR PY 2003 VL 8 IS 2 BP 141 EP 150 DI 10.1023/A:1022966508671 PG 10 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 659GF UT WOS:000181768400003 PM 12766474 ER PT J AU Pompl, PN Yemul, S Xiang, ZM Ho, L Haroutunian, V Purohit, D Mohs, R Pasinetti, GM AF Pompl, PN Yemul, S Xiang, ZM Ho, L Haroutunian, V Purohit, D Mohs, R Pasinetti, GM TI Caspase gene expression in the brain as a function of the clinical progression of Alzheimer disease SO ARCHIVES OF NEUROLOGY LA English DT Article ID APOPTOTIC CELL-DEATH; NEUROFIBRILLARY TANGLE FORMATION; AMYLOID-BETA; IN-SITU; REGIONAL DISTRIBUTION; PRECURSOR PROTEIN; ENTORHINAL CORTEX; DNA FRAGMENTATION; PLAQUE-FORMATION; PLASMA-LEVELS AB Background: Caspase gene expression has previously been reported in terminal Alzheimer disease (AD) brain, but, currently, little is known about the temporal pattern of caspase gene expression relative to the onset and clinical progression of AD. Objective: To derive a profile of caspase gene expression and proapoptotic indexes as a function of the clinical and neuropathologic progression of AD dementia. Setting and Patients: Postmortem survey of nursing home patients characterized clinically by Clinical Dementia Rating (CDR) and neuropathologically by Consortium to Establish a Registry for Alzheimer's Disease criteria. Design and Outcome Measures: To assess messenger RNA expression of caspase-1, -2L, -2S, -3, -5, -6, -7, -8, and -9; apoptotic cell death by TUNEL assay; and poly (ADP-ribose) polymerase cleavage in postmortem brain tissue samples from cognitively normal (CDR 0), high risk of developing AD dementia (CDR 0.5), and severe dementia (CDR 5) cases. Results: Compared with CDR 0 cases, elevated messenger RNA expression of caspase-1 and caspase-7 in the entorhinal cortex of CDR 0.5 cases coincided with increased poly (ADP-ribose) polymerase cleavage but not apoptotic cell injury. In the entorhinal cortex of CDR 5 cases, we found elevation of caspase-1 -2L, -3, -5, -6, -7, -8, and -9 and a greater than 4-fold increase in TUNEL-positive cells. Caspase messenger RNA expression was closely associated with neurofibrillary tangle and, to a lesser extent; neuritic plaque density. Conclusions: Proapoptotic mechanisms may be at play early in the onset of AD (before overt signs of apoptosis) and maybe a conditional factor for later apoptotic cell injury or death. These data have relevance to potential therapeutic interventions for AD using selective caspase inhibitors. C1 Mt Sinai Sch Med, Neuroinflammat Res Labs, Dept Psychiat, New York, NY 10029 USA. Mt Sinai Sch Med, Dept Pathol, New York, NY 10029 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Dept Psychiat, Bronx, NY USA. RP Pasinetti, GM (reprint author), Mt Sinai Sch Med, Neuroinflammat Res Labs, Dept Psychiat, 1 Gustave L Levy Pl, New York, NY 10029 USA. FU NIA NIH HHS [AG 02219] NR 59 TC 69 Z9 76 U1 0 U2 5 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 MAR PY 2003 VL 60 IS 3 BP 369 EP 376 DI 10.1001/archneur.60.3.369 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 655PM UT WOS:000181561500008 PM 12633148 ER PT J AU Bartzokis, G Cummings, JL Sultzer, D Henderson, VW Nuechterlein, KH Mintz, J AF Bartzokis, G Cummings, JL Sultzer, D Henderson, VW Nuechterlein, KH Mintz, J TI White matter structural integrity in healthy aging adults and patients with Alzheimer disease - A magnetic resonance imaging study SO ARCHIVES OF NEUROLOGY LA English DT Article ID MYELINATED NERVE-FIBERS; PRIMARY VISUAL-CORTEX; IN-VIVO EVALUATION; BRAIN IRON; OXIDATIVE STRESS; RHESUS-MONKEY; NITRIC-OXIDE; AGE; DEMENTIA; OLIGODENDROCYTES AB Background: Imaging and postmortem studies suggest that frontal lobe white matter (FLWM) volume expands until about the age of 44.6 years and then declines. Postmortem evidence indicates that the structural integrity of myelin sheaths deteriorates during normal aging, especially in late myelinating regions such as the frontal lobes. Objectives: To assess the integrity of FLWM by magnetic resonance imaging and, thus, to provide an important index of brain aging and its relationship to Alzheimer disease (AD). Design: Cross-sectional study. Setting: Two metropolitan university hospitals and AD research centers. Participants: Two hundred fifty-two healthy adults (127 men and 125 women), aged 19 to 82 years, and 34 subjects with AD (16 men and 18 women), aged 59 to 85 years. Main Outcome Measure: Calculated transverse relaxation rate (R-2) of the FLWM (an indirect measure of the structural integrity of white matter). Results: As expected from prior imaging data on FLWM volume, the quadratic function best represented the relationship between age and the FLWM R-2 (P<.001). In healthy individuals, the FLWM R-2 increased until the age of 38 years and then declined markedly with age. The R-2 of subjects with AD was significantly lower than that of a group of healthy control subjects who were of similar age and sex (P<.001). Conclusions: The R-2 change"s in white matter suggest that the healthy adult brain is in a constant state of change, roughly defined as periods of maturation continuing into middle age followed by progressive loss of myelin integrity. Clinically diagnosed AD is associated with more severe myelin breakdown. Noninvasive measures, such as the determination of the R-2, may have the potential to track prospectively the trajectory of deteriorating white matter integrity during normal aging and the development of AD and, thus, may be a useful marker for medication development aimed at the prevention of AD. C1 Univ Calif Los Angeles, Sch Med, Rush Alzheimers Dis Ctr, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Div Brain Mapping, Lab Neuroimaging, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. Univ Arkansas Med Sci, Dept Geriatr, Little Rock, AR 72205 USA. Univ Arkansas Med Sci, Dept Neurol, Little Rock, AR 72205 USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Sch Med, Rush Alzheimers Dis Ctr, Dept Neurol, 710 Westwood Plaza,Room 2-238, Los Angeles, CA 90095 USA. RI Bartzokis, George/K-2409-2013; Mintz, Jim/N-7385-2014 OI Mintz, Jim/0000-0002-8299-5851 FU NIA NIH HHS [AG 16570]; NIMH NIH HHS [MH-30911, MH-37705, MH-51928] NR 77 TC 213 Z9 223 U1 0 U2 7 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 MAR PY 2003 VL 60 IS 3 BP 393 EP 398 DI 10.1001/archneur.60.3.393 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 655PM UT WOS:000181561500011 PM 12633151 ER PT J AU Garb, HN AF Garb, HN TI Observations on the validity of neuropsychological and personality assessment testing SO AUSTRALIAN PSYCHOLOGIST LA English DT Article ID RORSCHACH-COMPREHENSIVE-SYSTEM; CLINICAL-ASSESSMENT; PSYCHOLOGICAL-ASSESSMENT; DAUBERT STANDARD; NORMS; TESTIMONY; ACCURACY; PSYCHOPATHOLOGY; MISPERCEPTION; METAANALYSES AB The validity of neuropsychological testing is evaluated in the context of a growing controversy surrounding personality assessment, Claims made by a committee established by the American Psychological Association are disputed (e.g., that psychological tests are as valid as medical tests). Also, normative data for projective techniques and neuropsychological tests are contrasted. Normative data is not available for many projective techniques, and norms for the Rorschach Comprehensive System (Exner, 1993) have been seriously flawed. In contrast, norms for neuropsychological tests are widely available and fundamentally sound. Finally, with regard to the validity of judgments made by psychologists, results for projective techniques have been disappointing while results for neuropsychological tests have generally been positive. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. RP Garb, HN (reprint author), VA Pittsburgh Healthcare Syst, 116A-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 77 TC 0 Z9 0 U1 3 U2 8 PU AUSTRALIAN PSYCHOLOGICAL SOC PI CARLTON PA 1 GRATTAN STREET, CARLTON, VICTORIA 3053, AUSTRALIA SN 0005-0067 J9 AUST PSYCHOL JI Aust. Psychol. PD MAR PY 2003 VL 38 IS 1 BP 14 EP 21 DI 10.1080/00050060310001706977 PG 8 WC Psychology, Multidisciplinary SC Psychology GA 650HN UT WOS:000181257700003 ER PT J AU Zhao, HY Tian, W Xu, HS Cohen, DM AF Zhao, HY Tian, W Xu, HS Cohen, DM TI Urea signalling to immediate-early gene transcription in renal medullary cells requires transactivation of the epidermal growth factor receptor SO BIOCHEMICAL JOURNAL LA English DT Article DE heparin-binding epidermal growth factor; hypertonicity; metalloproteinase ID DIPHTHERIA-TOXIN RECEPTOR; PROTEIN-COUPLED RECEPTORS; SMOOTH-MUSCLE CELLS; DUCT MIMCD3 CELLS; FACTOR HB-EGF; METALLOPROTEINASE CLEAVAGE; INTEGRIN ALPHA-3-BETA-1; EXTRACELLULAR CALCIUM; EPITHELIAL-CELLS; TYROSINE KINASE AB Signalling by physiological levels of urea (e.g. 200 nM) in cells of the mammalian renal medulla is reminiscent of activation of a receptor tyrosine kinase. The epidermal growth factor (EGF) receptor may be transactivated by a variety of G-protein-coupled receptors, primarily through metalloproteinase-dependent cleavage of a membrane-anchored EGF precursor. In the murine inner medullary collecting duct (mIMCD3) cell line, urea (200 mM) induced prompt (1-5 min) tyrosine phosphorylation of the EGF receptor. Pharmacological inhibition of EGF receptor kinase activity with AG1478 or PD153035 blocked urea-inducible transcription and expression of the immediate-early gene, Egr-1. AG1478 blocked, either fully or partially, other hallmarks of urea signalling including Elk-l activation and extracellular signal-regulated kinase phosphorylation. EGF receptor kinase inhibition also blocked the cytoprotective effect of urea observed in the context of hypertonicity-inducible apoptosis. EGF receptor transactivation was likely to be attributable to metalloproteinase-dependent ectodomain shedding of an EGF receptor agonist because both specific and non-specific inhibitors of metalloproteinases blocked the urea effect. Heparin-binding EGF (HB-EGF), in particular, was implicated because the diphtheria toxin analogue and highly specific antagonist of HB-EGF, CRM197, also blocked urea-inducible transcription. In aggregate, these data indicate that signalling in response to Urea in renal medullary cells requires EGF receptor transactivation, probably through autocrine action of HB-EGF. C1 Oregon Hlth Sci Univ, Div Nephrol, Dept Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Dev & Cell Biol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. RP Cohen, DM (reprint author), Oregon Hlth Sci Univ, Div Nephrol, Dept Med, Mailcode PP262,3314 SW US Vet Hosp Rd, Portland, OR 97201 USA. NR 60 TC 11 Z9 11 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 MAR 1 PY 2003 VL 370 BP 479 EP 487 DI 10.1042/BJ20020565 PN 2 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 654BB UT WOS:000181471700013 PM 12466022 ER PT J AU Bartzokis, G Nuechterlein, KH Lu, PH Gitlin, M Rogers, S Mintz, J AF Bartzokis, G Nuechterlein, KH Lu, PH Gitlin, M Rogers, S Mintz, J TI Dysregulated brain development in adult men with schizophrenia: A magnetic resonance imaging study SO BIOLOGICAL PSYCHIATRY LA English DT Article DE schizophrenia; brain; development; myelin; MRI; white matter; gray matter ID CHILDHOOD-ONSET SCHIZOPHRENIA; PREFRONTAL GRAY-MATTER; HUMAN CEREBRAL-CORTEX; CORPUS-CALLOSUM SIZE; AGE-RELATED-CHANGES; WHITE-MATTER; EPISODE SCHIZOPHRENIA; NEUROLEPTIC-NAIVE; IN-VIVO; VOLUMES AB Background: Recent imaging evidence suggests that normal brain development/maturation of the frontal lobes and association areas is a well-regulated process consisting of continued myelination and expansion of white matter volumes into the late 40s accompanied by complementary reductions in gray matter volumes. The possibility that a dysregulation of this process may contribute to the syndrome of schizophrenia was investigated using magnetic resonance imaging. Methods: Fifty-two normal adult males and 35 males with schizophrenia underwent magnetic resonance imaging. Coronal images were acquired using pulse sequences that maximized myelin signal. The age-related change in the gray to white matter ratio was used as a measure of developmental dysregulation in the schizophrenic subjects and contrasted to the age-related changes of the normal control group. Results: Regression analyses on frontal and temporal gray to white matter ratio yielded highly significant interactions of diagnosis and age for both regions (p = .0003 and p =.01, respectively). In the normal group, both frontal and temporal gray to white matter ratios decreased significantly and linearly across the age range. In contrast, neither ratio showed meaningful age-related change in the schizophrenia group. Thus, differences in gray to white matter ratio between the groups increased markedly with age, driven primarily by the absence of a white matter volume expansion in the patient group. Conclusions: The absence of the normal complementary volume changes in the gray and white matter with age in the schizophrenic sample suggests that this dynamic developmental process is dysregulated in adult schizophrenic subjects. The importance of myelination to the continued maturation and normal functioning of the brain has implications for the diagnosis, treatment, and prognosis of schizophrenia. C1 Univ Calif Los Angeles, Sch Med, Dept Neurol, Alzheimers Dis Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Neurol, Div Brain Mapping,Lab Neuroimaging, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Sch Med, Dept Neurol, Alzheimers Dis Ctr, 710 Westwood Plaza,RNRC,Room 2-238, Los Angeles, CA 90095 USA. RI Bartzokis, George/K-2409-2013 FU NIMH NIH HHS [MH-30911, MH-37705, MH-51928] NR 74 TC 83 Z9 86 U1 2 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 2003 VL 53 IS 5 BP 412 EP 421 DI 10.1016/S0006-3223(03)01835-8 PG 10 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 649RA UT WOS:000181220700006 PM 12614994 ER PT J AU Kogai, T Kanamoto, Y Brent, GA AF Kogai, T Kanamoto, Y Brent, GA TI The modified firefly luciferase reporter gene (luc+) but not Renilla luciferase is induced by all-trans retinoic acid in MCF-7 breast cancer cells SO BREAST CANCER RESEARCH AND TREATMENT LA English DT Article DE all-trans retinoic acid; MCF-7 cells; modified firefly luciferase; Renilla luciferase; reporter assay ID THYROID-HORMONE RECEPTOR; DIMETHYL-SULFOXIDE; GROWTH-INHIBITION; EXPRESSION; PROMOTER; BETA; MODULATION; ELEMENT; METABOLISM; INDUCTION AB Luciferase genes are widely used as reporters to analyze promoter and regulatory elements. We found that a luciferase reporter gene vector with a modified firefly luciferase gene (luc+), but not Renilla luciferase (Rluc), was induced by all-trans retinoic acid (tRA) in the MCF-7 breast cancer cell line. tRA (5 x 10(-6) M) increased luciferase activity of the pGL3 promoter vector (containing luc+)up to similar to3.8-fold in MCF-7 cells, but not in LNCaP prostate cancer cells or JEG-3 choriocarcinoma cells. Chimeric plasmids were constructed and showed that tRA-induction required the luc+ gene, but not any specific promoter or vector sequence. Time course and dose-response studies of tRA-induction indicated that longer treatment (>24 h) and higher tRA dose (>10(-6) M) were required for luc+ induction compared with those for a positive retinoic acid response element (maximum induction at 6 h and 10(-8) M tRA). Studies with the translation inhibitor, cycloheximide, indicated the half-life of the luc+ protein was increased from 9.7 +/- 1.5 to 22.1 +/- 3.1 h with tRA treatment. Other retinoids, TTNPB, a retinoic acid receptor beta/gamma-specific ligand, and a retinoid X receptor ligand, did not significantly increase luc+ expression. Caution is needed in analysis of retinoid responsive gene regulation with the luciferase reporter system in MCF-7 cells, especially at high retinoid concentrations. C1 VA Greater Los Angeles Healthcare Syst, Mol Endocrinol Lab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90024 USA. RP Brent, GA (reprint author), VA Greater Los Angeles Healthcare Syst, Mol Endocrinol Lab, 11301 Wilshire Blvd,Bldg 114,Room 230, Los Angeles, CA 90073 USA. FU NCI NIH HHS [CA8936401] NR 39 TC 13 Z9 14 U1 0 U2 2 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0167-6806 J9 BREAST CANCER RES TR JI Breast Cancer Res. Treat. PD MAR PY 2003 VL 78 IS 1 BP 119 EP 126 DI 10.1023/A:1022179717847 PG 8 WC Oncology SC Oncology GA 639WD UT WOS:000180651700014 PM 12611464 ER PT J AU Shekelle, P AF Shekelle, P TI New contract for general practitioners - A bold initiative to improve quality of care, but implementation will be difficult SO BRITISH MEDICAL JOURNAL LA English DT Editorial Material C1 Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90073 USA. RP Shekelle, P (reprint author), Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, 11731 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 2 TC 56 Z9 57 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL 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 1 PY 2003 VL 326 IS 7387 BP 457 EP 458 DI 10.1136/bmj.326.7387.457 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 653EC UT WOS:000181421400001 PM 12609914 ER PT J AU Bauer, S Corless, CL Heinrich, MC Dirsch, O Antoch, G Kanja, J Seeber, S Schutte, J AF Bauer, S Corless, CL Heinrich, MC Dirsch, O Antoch, G Kanja, J Seeber, S Schutte, J TI Response to imatinib mesylate of a gastrointestinal stromal tumor with very low expression of KIT SO CANCER CHEMOTHERAPY AND PHARMACOLOGY LA English DT Article DE gastrointestinal stromal tumor; GIST; imatinib; KIT immunonegativity ID MUTATIONS; EFFICACY; ST1571; SAFETY AB More than 90% of gastrointestinal stromal tumors (GISTs) express the receptor tyrosine kinase KIT, and activating mutations of the KIT gene are detectable in the vast majority of these tumors. Imatinib mesylate (formerly STI571) is a potent inhibitor of KIT kinase activity and has been proven to be highly active in patients with unresectable or metastatic GIST expressing immunohistochemically detectable KIT protein. Here we report a patient with metastatic GIST who responded well to imatinib mesylate treatment despite the near absence of KIT expression in two different samples of his tumor. The tumor was morphologically typical for a GIST, stained positively for CD34, and harbored an in-frame deletion (WK 557-558) in KIT exon 11 that is common in GISTs. Our experience with this patient suggests that even GISTs with very low levels of KIT expression may respond to imatinib mesylate therapy. C1 Univ Essen Gesamthsch, Sch Med, Dept Internal Med Canc Res, Essen, Germany. Oregon Hlth Sci Univ, Dept Pathol, OHSU Canc Inst, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med, OHSU Canc Inst, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Univ Essen Gesamthsch, Sch Med, Dept Pathol, Essen, Germany. Univ Essen Gesamthsch, Sch Med, Dept Diagnost & Intervent Radiol, Essen, Germany. Univ Essen Gesamthsch, Sch Med, Dept Nucl Med, Essen, Germany. Univ Klinikum Essen, Westdeutsch Tumorzentrum, Innere Klin & Poliklin Tumorforsch, D-5545122 Essen, Germany. RP Bauer, S (reprint author), Univ Essen Gesamthsch, Sch Med, Dept Internal Med Canc Res, Essen, Germany. RI Bauer, Sebastian/D-8120-2012 OI Bauer, Sebastian/0000-0001-5949-8120 NR 12 TC 53 Z9 61 U1 0 U2 1 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0344-5704 J9 CANCER CHEMOTH PHARM JI Cancer Chemother. Pharmacol. PD MAR PY 2003 VL 51 IS 3 BP 261 EP 265 DI 10.1007/s00280-002-0564-x PG 5 WC Oncology; Pharmacology & Pharmacy SC Oncology; Pharmacology & Pharmacy GA 671TF UT WOS:000182479600012 PM 12655446 ER PT J AU Da Silva, MS Horton, JA Wijelath, JM Blystone, LW Fish, WR Wijelath, E Strand, K Blystone, SD Sobel, M AF Da Silva, MS Horton, JA Wijelath, JM Blystone, LW Fish, WR Wijelath, E Strand, K Blystone, SD Sobel, M TI Heparin modulates integrin-mediated cellular adhesion: Specificity of interactions with alpha and beta integrin subunits SO CELL COMMUNICATION AND ADHESION LA English DT Article DE cellular adhesion; glycosaminoglycans; heparins; integrins ID MOLECULAR-WEIGHT HEPARIN; BINDING DOMAIN; UNFRACTIONATED HEPARIN; HUMAN PLATELETS; INHIBITION; RECEPTOR; ALPHA(V)BETA(3); ALPHA(5)BETA(1); MIGRATION; PEPTIDE AB Heparin is known to influence the growth, proliferation, and migration of vascular cells, but the precise mechanisms are unknown. We previously demonstrated that unfractionated heparin (UH) binds to the platelet integrin alpha(IIb)beta(3) , and enhances ligand binding. To help define the specificity and site(s) of heparin-integrin interactions, we employed the erythroleukemic K562 cell line, transfected to express specific integrins (alpha(v)beta(3) , alpha(v)beta(5) , and alpha(IIb)beta(3)). By comparing K562 cells expressing a common alpha subunit (Kalpha (v)beta(3) , Kalpha(v)beta(5)) with cells expressing a common beta subunit (Kalpha (v)beta(3) , Kalpha(IIb)beta(3)), we observed that heparin differentially modulated integrin-mediated adhesion to vitronectin. UH at 0.5-7.5 mug/ml consistently enhanced the adhesion of beta(3) expressing cells (Kalpha(v)beta(3) ,Kalpha(IIb)beta(3)). In contrast, UH at 0.5-7.5 mug/ml inhibited Kalpha(v)beta(5) adhesion. Experiments using integrin-blocking antibodies, appropriate control ligands, and nontransfected native K562 cells revealed that heparin's actions were mediated by the specific integrins under study. Preincubation of heparin with Kalpha(v)beta(3) cells enhanced adhesion, while preincubation of heparin with the adhesive substrate (vitronectin) had minimal effect. There was a structural specificity to heparin's effect, in that a low molecular weight heparin and chondroitin sulfate showed significantly less enhancement of adhesion. These findings suggest that heparin's modulation of integrin-ligand interactions occurs through its action on the integrin. The inhibitory or stimulatory effects of heparin depend on the beta subunit type, and the potency is dictated by structural characteristics of the glycosaminoglycan. C1 VA Puget Sound HCS, Dept Surg, Div Vasc Surg, Seattle, WA 98108 USA. SUNY Upstate Med Univ, Dept Surg, Syracuse, NY USA. Vet Affairs Med Ctr, Syracuse, NY USA. Univ Washington, Sch Med, Seattle, WA USA. SUNY Upstate Med Univ, Dept Cell & Dev Biol, Syracuse, NY USA. RP Sobel, M (reprint author), VA Puget Sound HCS, Dept Surg, Div Vasc Surg, Mailstop 112,1660 S Columbian Way, Seattle, WA 98108 USA. FU NHLBI NIH HHS [F32 HL 0442, HL 39903]; NIAID NIH HHS [AI 40602] NR 31 TC 17 Z9 19 U1 0 U2 2 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1061-5385 J9 CELL COMMUN ADHES JI Cell Commun. Adhes. PD MAR-APR PY 2003 VL 10 IS 2 BP 59 EP 67 DI 10.1080/15419060390260905 PG 9 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 755BF UT WOS:000187367400001 PM 14681057 ER PT J AU Littner, MR AF Littner, MR TI Continuous positive airway pressure - By nose or mouth? SO CHEST LA English DT Editorial Material ID OBSTRUCTIVE SLEEP-APNEA; CPAP THERAPY; MASK C1 Vet Affairs Greater Los Angeles Healthcare Syst, Pulm Crit Care & Sleep Med Div, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Littner, MR (reprint author), Dept Pulm, 16111 Plummer St 111P,Bldg 200,Room 3534, North Hills, CA 91343 USA. NR 7 TC 1 Z9 1 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAR PY 2003 VL 123 IS 3 BP 662 EP 664 DI 10.1378/chest.123.3.662 PG 3 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 655DR UT WOS:000181536500003 PM 12628854 ER PT J AU Malave, HA Taylor, AA Nattama, J Deswal, A Mann, DL AF Malave, HA Taylor, AA Nattama, J Deswal, A Mann, DL TI Circulating levels of tumor necrosis factor correlate with indexes of depressed heart rate variability - A study in patients with mild-to-moderate heart failure SO CHEST LA English DT Article DE cytokine; heart failure; heart rate variability; norepinephrine; tumor necrosis factor ID LEFT-VENTRICULAR DYSFUNCTION; CORONARY-ARTERY DISEASE; FACTOR-ALPHA; DILATED CARDIOMYOPATHY; EJECTION FRACTION; CARDIAC MYOCYTES; SECONDARY; IMPAIRMENT; MECHANISM; SEVERITY AB Objectives: Patients with heart failure have increased circulating levels of tumor necrosis factor (TNF) and TNF receptors. It is not known whether TNF, which is known to blunt beta-adrenergic responsiveness in experimental models, contributes to the loss of heart rate variability in patients with heart failure. Therefore, we examined heart rate variability in relation to circulating levels of TNF, TNF receptors, and norepinephrine in patients with heart failure and in control subjects. Methods: Heart rate variability was obtained from 24-h ambulatory ECG recordings in age-matched control subjects (n=10)and patients with mild (n=15) to moderate (n=14) heart failure. Plasma levels of TNF and soluble type 1 and 2 TNF receptors were measured by enzyme-linked immunoassay; plasma norepinephrine levels were measured by high-performance liquid chromatography. Results: There was a significant inverse linear correlation between increased circulating levels of TNF, TNF receptors, and norepinephrine for time-domain and frequency-domain indexes of heart rate variability among patients with heart failure and control subjects. Multiple stepwise linear regression analysis showed that TNF was a stronger independent predictor of frequency-domain indexes of heart rate variability than norepinephrine. Conclusions: TNF is an independent predictor of depressed heart rate variability in patients with heart failure. insofar as TNF blunts beta-adrenergic signaling, this study suggests the possibility that overexpression of TNF and subsequent loss of beta-adrenergic responsiveness contributes to the decrease in heart rate variability observed in heart failure. C1 Winters Ctr Heart Failure Res, Houston, TX 77030 USA. Baylor Coll Med, Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Ctr Expt Therapeut, Houston, TX USA. Houston Vet Affairs Med Ctr, Houston, TX USA. RP Mann, DL (reprint author), Winters Ctr Heart Failure Res, 6565 Fannin,MS 524, Houston, TX 77030 USA. OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [R01 HL58081-01, P50 HL-06H, HL-42250-10/10, R01 HL61543-01] NR 36 TC 50 Z9 51 U1 0 U2 2 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAR PY 2003 VL 123 IS 3 BP 716 EP 724 DI 10.1378/chest.123.3.716 PG 9 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 655DR UT WOS:000181536500017 PM 12628868 ER PT J AU Chen, M Li, W Fan, J Kasahara, N Woodley, D AF Chen, M Li, W Fan, J Kasahara, N Woodley, D TI An efficient gene transduction system for studying gene function in primary human dermal fibroblasts and epidermal keratinocytes SO CLINICAL AND EXPERIMENTAL DERMATOLOGY LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; NONDIVIDING CELLS; LENTIVIRAL VECTOR; EXPRESSION; TRANSFECTION; INTEGRATION; TRANSGENE; DELIVERY AB One of the critical challenges for cellular genetic studies in primary human skin cells is lack of a gene delivery system that provides efficient transduction and sustained expression of the transgenes. Due to the limited time of survival in culture, the processes of drug selection and clonal expansion for establishing gene stably expressing cell lines are not a realistic option for primary skin cells. We have examined various gene transduction techniques in primary dermal fibroblasts and epidermal keratinocytes of human skin. We report here that vectors based on the human immunodeficiency virus (HIV, lentivirus) offer more than 90% gene transduction efficiency and sustained expression of transgenes in both human skin cell types. In contrast, most of the commonly used techniques have at best 30% transduction efficiency in these cells. Using two previously reported migration control genes, protein kinase Cdelta and p38alpha-MAPK, as examples, we provide evidence that the unprecedented efficiency of the lentiviral system enables a clear detection of the genes' dominant negative effects, which are otherwise greatly compromised by ordinary transfection techniques. We believe that a wide application of this gene transduction system will greatly benefit studies of gene function in human skin cells. C1 Univ So Calif, Keck Sch Med, Dept Med, Div Dermatol, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, USC Norris Canc Ctr, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Inst Med Genet, Los Angeles, CA 90033 USA. Greater Los Angles Vet Adm Hlth Syst, Los Angeles, CA USA. RP Chen, M (reprint author), Univ So Calif, Keck Sch Med, Dept Med, Div Dermatol, Los Angeles, CA 90033 USA. EM cherm@hsc.usc.edu FU NIAMS NIH HHS [AR47981, AR46538] NR 15 TC 26 Z9 27 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0307-6938 J9 CLIN EXP DERMATOL JI Clin. Exp. Dermatol. PD MAR PY 2003 VL 28 IS 2 BP 193 EP 199 DI 10.1046/j.1365-2230.2003.01191.x PG 7 WC Dermatology SC Dermatology GA 659QV UT WOS:000181789700019 PM 12653712 ER PT J AU Sharma, S Stolina, M Yang, SC Baratelli, F Lin, JF Atianzar, K Luo, J Zhu, L Lin, Y Huang, M Dohadwala, M Batra, RK Dubinett, SM AF Sharma, S Stolina, M Yang, SC Baratelli, F Lin, JF Atianzar, K Luo, J Zhu, L Lin, Y Huang, M Dohadwala, M Batra, RK Dubinett, SM TI Tumor cyclooxygenase 2-dependent suppression of dendritic cell function SO CLINICAL CANCER RESEARCH LA English DT Article ID MHC CLASS-I; ENDOTHELIAL GROWTH-FACTOR; ANTIGEN-PRESENTING CELLS; COLON-CANCER CELLS; LUNG-CANCER; PROSTAGLANDIN E-2; INTERLEUKIN-12 PRODUCTION; EXPRESSION; MATURATION; IL-10 AB Dendritic cells (DCs) serve as professional antigen-presenting cells and are pivotal in the host immune response to tumor antigens. To define the pathways limiting DC function in the tumor microenvironment, we assessed the impact of tumor cyclooxygenase (COX)-2 expression on DC activities. Bone marrow-derived DCs were cultured in either tumor supernatant (TSN) or TSN from COX-2-inhibited tumors. After culture, DCs were pulsed with tumor-specific peptides, and their ability to generate antitumor immune responses was assessed following injection into established murine lung cancer. In vitro, DC phenotype, alloreactivity, antigen processing and presentation, and interleukin (IL)-10 and IL-12 secretion were evaluated. DCs cultured in TSN failed to generate antitumor immune responses and caused immunosuppressive effects that correlated with enhanced tumor growth. However, genetic or pharmacological inhibition of tumor COX-2 expression restored DC function and effective antitumor immune responses. Functional analyses indicated that TSN causes a decrement in DC capacity to (a) process and present antigens, (b) induce alloreactivity, and (c) secrete IL-12. Whereas TSN DCs showed a significant reduction in cell surface expression of CD11c, DEC-205, MHC class I antigen, MHC class II antigen, CD80, and CD86 as well as a reduction in the transporter-associated proteins, transporter associated with antigen processing 1 and 2, the changes in phenotype and function were not evident when DCs were cultured in supernatant from COX2-inhibited tumors. We conclude that inhibition of tumor COX-2 expression or activity can prevent tumor-induced suppression of DC activities. C1 Univ Calif Los Angeles, Sch Med, Div Pulm & Crit Care Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Wadsworth Pulm Immunol Lab, Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Sch Med, Los Angeles, CA 90024 USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, Sch Med, Ctr Hlth Sci 37 131, Div Pulm & Crit Care Med, 10833 LeConte Ave, Los Angeles, CA 90095 USA. FU NCI NIH HHS [R01 CA078654-02, CA 71818, P50 CA 90388, R01 CA 78654] NR 41 TC 139 Z9 160 U1 0 U2 3 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD MAR PY 2003 VL 9 IS 3 BP 961 EP 968 PG 8 WC Oncology SC Oncology GA 653JA UT WOS:000181430400006 PM 12631593 ER PT J AU Zile, MR AF Zile, MR TI Peter C. Gazes: Physician, teacher, scholar SO CLINICAL CARDIOLOGY LA English DT Biographical-Item C1 Med Univ S Carolina, Div Cardiol, Gazes Cardiac Res Inst, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Zile, MR (reprint author), Med Univ S Carolina, Div Cardiol, Gazes Cardiac Res Inst, Dept Med, 96 Jonathan Lucas St,Suite 816,POB 250623, Charleston, SC 29425 USA. NR 1 TC 0 Z9 0 U1 0 U2 1 PU CLINICAL CARDIOLOGY PUBL CO PI MAHWAH PA PO BOX 832, MAHWAH, NJ 07430-0832 USA SN 0160-9289 J9 CLIN CARDIOL JI Clin. Cardiol. PD MAR PY 2003 VL 26 IS 3 BP 158 EP 159 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 655AH UT WOS:000181528800012 PM 12685625 ER PT J AU Hayashi, T Boyko, EJ Leonetti, DL McNeely, MJ Newell-Morris, L Kahn, SE Fujimoto, WY AF Hayashi, T Boyko, EJ Leonetti, DL McNeely, MJ Newell-Morris, L Kahn, SE Fujimoto, WY TI Visceral adiposity and the risk of impaired glucose tolerance - A prospective study among Japanese Americans SO DIABETES CARE LA English DT Article ID CORONARY-HEART-DISEASE; BODY-FAT DISTRIBUTION; INSULIN SENSITIVITY; INTRAABDOMINAL FAT; DIABETES-MELLITUS; ABDOMINAL FAT; MEN; NIDDM; RESISTANCE; OBESITY AB OBJECTIVE - Greater visceral adiposity, higher insulin resistance, and impaired insulin secretion increase the risk of type 2 diabetes. Whether visceral adiposity increases risk of impaired glucose tolerance (IGT) independent of other adipose depots, insulin resistance, and insulin secretion is not known. RESEARCH DESIGN AND METHODS - Study subjects included 128 Japanese Americans with normal glucose tolerance at entry. Baseline variables included plasma glucose and insulin measured after an overnight fast and during a 75-g oral glucose tolerance test, fat areas by computed tomography, insulin secretion (incremental insulin response [IIR] [30 min insulin fasting insulin]/30 min glucose), and insulin resistance index (homeostasis model assessment for insulin resistance [HOMA-IR]). RESULTS - During the 10- to 11-year follow-up period, we confirmed 57 cases of IGT. Significant predictors of IGT included intra-abdominal fat area (IAFA) (odds ratio [OR] for a I SD increase 3.82, 95% CI 1.63-8.94 at a fasting plasma glucose [FPG] level of 4.5 mmol/l), HOMA-IR (2.41, 1.15-5.04), IIR (0.30, 0.13-0.69 at an FPG level of 4.5 mmol/l), the interactions of IAFA by FPG (P = 0.003), and IIR by FPG (P = 0.030) after adjusting for age, sex, FPG, and BMI. The multiple-adjusted OR of IAFA increased and that of IIR decreased as FPG level decreased because of these interactions. Even after adjustment for total fat area, total subcutaneous fat area, or abdominal subcutaneous fat area, all of these associations remained a significant predictor of IGT incidence. CONCLUSIONS - Greater visceral adiposity increases the risk of IGT independent of insulin resistance, insulin secretion, and other adipose depots in Japanese Americans. C1 Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. RP Boyko, EJ (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, S-152E,1660 S Columbian Way, Seattle, WA 98108 USA. RI Hayashi, Tomoshige/N-8508-2015 OI Kahn, Steven/0000-0001-7307-9002; Boyko, Edward/0000-0002-3695-192X FU NCRR NIH HHS [RR-00037]; NHLBI NIH HHS [HL-49293]; NIDDK NIH HHS [DK-02654, DK-17047, DK-31170, DK-35816] NR 26 TC 103 Z9 111 U1 0 U2 1 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 MAR PY 2003 VL 26 IS 3 BP 650 EP 655 DI 10.2337/diacare.26.3.650 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 724UM UT WOS:000185505100016 PM 12610016 ER PT J AU McNeely, MJ Boyko, EJ Leonetti, DL Kahn, SE Fujimoto, WY AF McNeely, MJ Boyko, EJ Leonetti, DL Kahn, SE Fujimoto, WY TI Comparison of a clinical model, the oral glucose tolerance test, and fasting glucose for prediction of type 2 diabetes risk in Japanese Americans SO DIABETES CARE LA English DT Article ID OPERATING CHARACTERISTIC CURVES; LIFE-STYLE; MELLITUS; PREVENTION; DIAGNOSIS; CRITERIA; POPULATION; OVERWEIGHT; HOORN; AREAS AB Objective-To test the validity of a published clinical model for predicting incident diabetes in Japanese Americans. Research Design and Methods-A total of 465 nondiabetic Japanese Americans (243 men, 222 women), aged 34-75 years, were studied at baseline and at 5-6 years. A total of 412 subjects were studied at 10 years. The clinical model included age, sex, ethnicity, BMI, systolic blood pressure, fasting plasma glucose (FPG), HDL cholesterol, and family history of diabetes at baseline. Diabetes status at 5-6 and 10 years was determined by 75-g oral glucose tolerance test. The clinical model, 2-h glucose, and FPG were compared using receiver-operating characteristic (RCC) curves. Results-The diabetes risk associated with BMI, sex, and HDL cholesterol differed by age (Pless than or equal to0.011). At 5-6 years, the clinical model ROC curve area (0.896) was higher than that for FPG (0.776, P=0.008), but not for 2-h glucose (0.851, P=0.341), for subjects aged less than or equal to55 years. For older subjects, the clinical model ROC curve area (0.599) was lower than that for 2-h glucose (0.792, Pless than or equal to0.001), but not for FPG (0.627, P=0.467). At 10 years, there were no significant differences between the clinical model, FPG, and 2-h glucose ROC curve areas in either age group. Conclusions-In Japanese Americans aged less than or equal to55 years, a clinical model was better than FPG for predicting diabetes after 5-6 years but not after 10 years. The model was not useful in older Japanese Americans, whereas 2-h glucose was useful for predicting diabetes risk regardless of age. C1 Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA 98196 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Vet Affairs Epidemiol Res & Informat Ctr, Seattle, WA USA. Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. RP McNeely, MJ (reprint author), Univ Washington, Dept Med, Div Gen Internal Med, Box 356429, Seattle, WA 98196 USA. OI Kahn, Steven/0000-0001-7307-9002; Boyko, Edward/0000-0002-3695-192X FU NCRR NIH HHS [RR-00037]; NHLBI NIH HHS [HL-49292]; NIDDK NIH HHS [DK-31170, DK-02654, DK-17047, DK-35816] NR 22 TC 74 Z9 75 U1 1 U2 8 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 MAR PY 2003 VL 26 IS 3 BP 758 EP 763 DI 10.2337/diacare.26.3.758 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 724UM UT WOS:000185505100034 PM 12610034 ER PT J AU Jenkins, AJ Lyons, T Zheng, DY Otvos, JD Lackland, DT McGee, D Garvey, WT Klein, RL AF Jenkins, AJ Lyons, T Zheng, DY Otvos, JD Lackland, DT McGee, D Garvey, WT Klein, RL CA DCCT EDIC Res Grp TI Serum lipoproteins in the diabetes control and complications trial/epidemiology of diabetes intervention and complications cohort - Associations with gender and glycemia SO DIABETES CARE LA English DT Article ID LOW-DENSITY-LIPOPROTEIN; CORONARY-ARTERY-DISEASE; GRADIENT GEL-ELECTROPHORESIS; ISCHEMIC-HEART-DISEASE; POSTMENOPAUSAL WOMEN; FOLLOW-UP; PROGRESSION; SUBCLASSES; TRIAL; ATHEROSCLEROSIS AB Objective-To relate the nuclear magnetic resonance (NMR)-determined lipoprotein profile, conventional lipid and apolipoprotein measures, and in vitro oxidizibility of LDL with gender and glycemia in type 1 diabetes. Research Design and Methods-in the 1997-1999 Diabetes Control and Complications Trial/Epidemiology of Diabetes Intervention and Complications (DCCT/EDIC) cohort, serum from 428 women and 540 men were characterized by conventional lipids, NMR, apolipoprotein levels, and LDL susceptibility to in vitro oxidation. Simple and partial correlation coefficients were calculated for each lipoprotein-related parameter versus gender, with and without covariates (age, diabetes duration, concurrent HbA(1c), DCCT randomization, hypertension, BMI, waist-to-hip ratio, and albuminuria). For concurrent HbA(1c), data were analyzed as above, exchanging gender for HbA(1c). Associations were significant if P<0.05. Results-Although men and women had similar total and LDL cholesterol and triglycerides, men exhibited the following significant percent differences in NMR profiles versus women: small VLDL 41; IDL -30; medium LDL 39; small LDL 2 1; large HDL -32; small HDL 35; LDL particle concentration 4; VLDL and HDL diameters -8 and -4, respectively. Small VLDL, small HDL, medium LDL (women only), small LDL (men only), and LDL particle concentration were positively correlated, and HDL size was inversely correlated, with concurrent HbA(1c). NMR profile was unrelated to prior DCCT randomization. Susceptibility of LDL to oxidation was unrelated to gender and glycemia. Conclusions-Male gender and poor glycemia are associated with a potentially more. atherogenic NMR lipoprotein profile. Neither gender nor glycemia influence LDL oxidation in vitro. C1 Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Biometry, Charleston, SC 29425 USA. N Carolina State Univ, Dept Biochem, Raleigh, NC 27695 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. NDIC Epidemiol Diabet Intervent & Complicat, Bethesda, MD USA. RP Klein, RL (reprint author), Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, POB 250766,114 Doughty St, Charleston, SC 29403 USA. EM kleinrl@musc.edu FU NHLBI NIH HHS [P01 HL55782] NR 50 TC 71 Z9 74 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 EI 1935-5548 J9 DIABETES CARE JI Diabetes Care PD MAR PY 2003 VL 26 IS 3 BP 810 EP 818 DI 10.2337/diacare.26.3.810 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 724UM UT WOS:000185505100042 PM 12610042 ER PT J AU Davis, TM Baer, JS Saxon, AJ Kivlahan, DR AF Davis, TM Baer, JS Saxon, AJ Kivlahan, DR TI Brief motivational feedback improves post-incarceration treatment contact among veterans with substance use disorders SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE motivational interviewing; treatment; veterans; criminal justice; prisons ID INTERVENTION; DRINKERS; OUTPATIENTS; READINESS; PROGRAM AB Objectives: To test the efficacy of providing brief motivational feedback to increase post-incarceration substance use disorders (SUD) treatment contact. Design: Randomized clinical trial (feedback vs. control) with a 2-month post-incarceration follow-up. Participants: Veterans (N = 73) incarcerated in a county jail system who met SUD diagnostic criteria. Measures: Baseline assessment included the Addiction Severity Index, the Form-90 assessment of recent alcohol use, and a DSM-IV SUD criteria checklist. The primary outcome was Veterans Adminstration (VA) appointments. Secondary outcomes were the Addiction Severity Index-Followup and the Treatment Services Review. Intervention: All participants received baseline assessment. The feedback condition received personalized feedback and encouragement to explore ambivalence about change and treatment in a single interview. Results: Participants receiving feedback were more likely to schedule appointments at a VA addictions clinic within 60 days of their jail release dates (67 vs. 41%; P <0.03). Though differences were not statistically significant, more feedback participants attended addictions clinic appointments (47 vs. 32%; ns) and were retained in addictions treatment at 90 days (31 vs. 14%; P < 0.08). Treatment appointments were more likely when intervention occurred close to release. Loss of participants to post-release follow-up interviews was > 50%, limiting power to detect significant differences by self-report. Conclusion: Brief motivational feedback shows promise as a way to link incarcerated individuals to SUD treatment services. Published by Elsevier Science Ireland Ltd. C1 VA Puget Sound Hlth Care Syst, Seattle Div, Ctr Excellence Substance Abuse Treatment & Educ, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. RP Davis, TM (reprint author), VA Puget Sound Hlth Care Syst, Seattle Div, Ctr Excellence Substance Abuse Treatment & Educ, S116ATC,1660 S Columbian Way, Seattle, WA 98108 USA. NR 32 TC 30 Z9 30 U1 0 U2 6 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 MAR 1 PY 2003 VL 69 IS 2 BP 197 EP 203 AR PII S0376-8716(02)00317-4 DI 10.1016/S0376-8716(02)00317-4 PG 7 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 650PP UT WOS:000181272800010 PM 12609701 ER PT J AU Silverman, SL AF Silverman, SL TI Calcitonin SO ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA LA English DT Article ID INTRANASAL SALMON-CALCITONIN; POSTMENOPAUSAL BONE LOSS; OSTEOPOROTIC VERTEBRAL FRACTURES; ESTABLISHED OSTEOPOROSIS; RANDOMIZED TRIAL; DOUBLE-BLIND; NASAL CALCITONIN; MINERAL DENSITY; DOSE-RESPONSE; PREVENTION AB Calcitonin is FDA approved for the treatment of postmenopausal osteoporosis but not for prevention. The preferred delivery system is nasal. Nasal calcitonin is safe and well tolerated. The vertebral fracture efficacy of calcitonin is less robust than the two approved bisphosphonates (alendronate and risedronate) but is similar to raloxifene in the treatment of established osteoporosis. Calcitonin has not been demonstrated to reduce hip fracture risk, although a post-hoc pooled analysis suggests potential effectiveness of nasal calcitonin. Calcitonin produces small increments in bone mass of the spine and modestly reduces bone turnover in women with osteoporosis. Calcitonin may have analgesic benefit in patients with acute painful vertebral fractures. Treatment with calcitonin should be considered for older women with osteoporosis with painful vertebral fractures and for women who fail to respond to or cannot tolerate bisphosphonates. Calcitonin may also be indicated for women who are unable to take bisphosphonates because of impaired renal function. C1 OMC Clin Res Ctr, Beverly Hills, CA 90211 USA. Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, Los Angeles, CA 90073 USA. RP Silverman, SL (reprint author), OMC Clin Res Ctr, 8641 Wilshire Blvd,Suite 301, Beverly Hills, CA 90211 USA. NR 53 TC 25 Z9 30 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-8529 J9 ENDOCRIN METAB CLIN JI Endocrinol. Metabol. Clin. North Amer. PD MAR PY 2003 VL 32 IS 1 BP 273 EP + DI 10.1016/S0889-8529(02)00060-9 PG 13 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 661UH UT WOS:000181907900016 PM 12699303 ER PT J AU Wu, MT Kelsey, K Schwartz, J Sparrow, D Weiss, S Hu, H AF Wu, MT Kelsey, K Schwartz, J Sparrow, D Weiss, S Hu, H TI A delta-aminolevulinic acid dehydratase (ALAD) polymorphism may modify the relationship of low-level lead exposure to uricemia and renal function: The Normative Aging Study SO ENVIRONMENTAL HEALTH PERSPECTIVES LA English DT Article DE delta-aminolevulinic; acid dehydratase; bone lead; serum creatinine; serum uric acid ID BLOOD LEAD; BONE LEAD; ELDERLY MEN; WORKERS; ASSOCIATIONS; TOXICITY; GENOTYPE; MARKER AB In this study we investigated whether a known delta-aminolevulinic acid dehydratase (ALAD) exon 4 polymorphism has a modifying effect on the association of blood or bone lead level with uricemia and indices of renal function among middle-aged and elderly men. We performed a cross-sectional study of subjects who participated between 1991 and 1995 in the Department of Veterans Affairs Normative Aging Study. Information on blood lead levels, bone lead levels (measured by K-shell X-ray fluorescence), serum uric acid, serum creatinine, estimated creatinine clearance, and ALAD polymorphism status was available in 709 subjects. Regression models were constructed to examine the relationships of serum uric acid, serum creatinine, and estimated creatinine clearance to blood or bone lead level, stratified by genotype. We also adjusted for age, body mass index, blood pressure, smoking, alcohol consumption, and ingestion of analgesic medications (n = 638). Of the 709 subjects, 7 (1%) and 107 (15%) were homozygous and heterozygous for the variant (ALAD-2) allele, respectively. The mean (range) serum uric acid and creatinine levels were 6.5 (2.9-10.6) and 1.2 (0.6-2.5) mg/dL. No significant differences were found in serum uric acid, serum creatinine, or estimated creatinine, clearance by ALAD genotype. However, after adjusting for other potential confounders, we found a significant linear relationship between serum uric acid and patella bone lead (p = 0.040) among the ALAD 1-2/2-2 genotype individuals above a threshold patellar lead level of 15 mug/g. In contrast, among the wild-type (ALAD 1-1) individuals, there was a suggestion of a significant linear relationship of serum uric acid with patella bone lead (p = 0.141), but only after a threshold of 101 mug/g. There was evidence of a significant (P = 0.025) interaction of tibia lead with genotype (ALAD 1-1 vs. ALAD 1-212-2) regarding serum creatinine as an outcome, but in the same linear regression model tibia lead alone was not a significant predictor of serum creatinine. Conversely, for estimated creatinine clearance, patella lead,,but not the interaction of patella lead with genotype, was a significantly independent predictor (p = 0.026). Our findings suggest that ALAD genotype may modify the effect of lead on the renal excretion of uric acid as well as overall renal function among middle-aged and elderly men who had community (nonoccupational) exposures to lead. Additional research is needed to ascertain whether this constitutes a true gene-environment interaction and, if so, its clinical impact. C1 Harvard Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA. Kaohsiung Med Univ Hosp, Grad Inst Occupat Safety & Hlth, Kaohsiung, Taiwan. Kaohsiung Med Univ Hosp, Dept Occupat Med, Kaohsiung, Taiwan. Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med,Channing Lab, Boston, MA 02115 USA. US Dept Vet Affairs, Normat Aging Study, Boston, MA USA. RP Hu, H (reprint author), Harvard Univ, Sch Med, Channing Lab, 181 Longwood Ave, Boston, MA 02115 USA. RI Wu, Ming-Tsang/G-5637-2012 FU NCRR NIH HHS [M01RR02635]; NIEHS NIH HHS [ES 05257-06A1, 2 P30 ES00002, 2R44 ES03918-02, P42-ES05947] NR 33 TC 28 Z9 29 U1 0 U2 3 PU US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE PI RES TRIANGLE PK PA NATL INST HEALTH, NATL INST ENVIRONMENTAL HEALTH SCIENCES, PO BOX 12233, RES TRIANGLE PK, NC 27709-2233 USA SN 0091-6765 J9 ENVIRON HEALTH PERSP JI Environ. Health Perspect. PD MAR PY 2003 VL 111 IS 3 BP 335 EP 340 DI 10.1289/ehp.5504 PG 6 WC Environmental Sciences; Public, Environmental & Occupational Health; Toxicology SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Toxicology GA 655ZJ UT WOS:000181583200030 PM 12611663 ER PT J AU Hagopian, K Ramsey, JJ Weindruch, R AF Hagopian, K Ramsey, JJ Weindruch, R TI Influence of age and caloric restriction on liver glycolytic enzyme activities and metabolite concentrations in mice SO EXPERIMENTAL GERONTOLOGY LA English DT Article DE caloric restriction; glucose; glycolysis; glycolytic metabolites; glycolytic enzymes ID GLUCOKINASE GENE-TRANSCRIPTION; RAT-LIVER; PYRUVATE-KINASE; MESSENGER-RNA; FRUCTOSE 2,6-BISPHOSPHATE; GLYCERALDEHYDE-3-PHOSPHATE DEHYDROGENASE; DIETARY RESTRICTION; RHESUS-MONKEYS; MAMMARY-GLAND; REDOX STATUS AB The influence of caloric restriction (CR) from 2 months of age on the activities of liver glycolytic enzymes and metabolite levels was studied in young and old mice. Livers were sampled 48 h after the last scheduled feeding time. Old mice on CR showed significant decreases in the activities of all the enzymes studied, except for aldolase, triosephosphate isomerase and phosphoglycerate mutase, which were unchanged. The metabolites glucose, glucose-6-phosphate, fructose-6-phosphate, pyruvate and lactate were lower while fructose-1,6-bisphosphate, glyceraldehyde-3-phosphate, dihydroxyacetone phosphate, 3-phosphoglycerate and phosphoenolpyruvate were increased in old CR. Young mice on CR also showed reduced enzyme activities, except for aldolase, triosephosphate isomerase and enolase which were unchanged when compared with young controls. The metabolites glucose, glucose-6-phosphate, fructose-6-phosphate and pyruvate were decreased when compared with young controls, while phosphoenolpyruvate was increased. Ketone bodies increased (65%) in old, but not young, CR mice while fructose-2,6-bisphosphate decreased in both young (22%) and old CR (28%) mice. The results indicate that decreased hepatic glucose levels in CR mice are associated with decreased enzyme activities but not a uniform decrease in metabolite levels. Increased ketone body levels indicate increased utilization of non-carbohydrate fuels while decreased fructose- 2,6-bisphosphate level suggests its importance in the control of glycolysis in CR. (C) 2002 Elsevier Science Inc. All rights reserved. C1 Univ Calif Davis, Dept Mol Biosci, Sch Vet Med, Davis, CA 95616 USA. Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. Univ Wisconsin, Wisconsin Reg Primate Res Ctr, Madison, WI 53715 USA. RP Hagopian, K (reprint author), Univ Calif Davis, Dept Mol Biosci, Sch Vet Med, 1 Shield Ave, Davis, CA 95616 USA. EM khagopian@ucdavis.edu FU NIA NIH HHS [P01 AG11915, R01 AG17902] NR 59 TC 44 Z9 46 U1 0 U2 4 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0531-5565 J9 EXP GERONTOL JI Exp. Gerontol. PD MAR PY 2003 VL 38 IS 3 BP 253 EP 266 AR PII S0531-5565(02)00203-6 DI 10.1016/S0531-5565(02)00203-6 PG 14 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 653HL UT WOS:000181429100006 PM 12581789 ER PT J AU Hagopian, K Ramsey, JJ Weindruch, R AF Hagopian, K Ramsey, JJ Weindruch, R TI Caloric restriction increases gluconeogenic and transaminase enzyme activities in mouse liver SO EXPERIMENTAL GERONTOLOGY LA English DT Article DE caloric restriction; gluconeogenesis; phosphoenolpyruvate carboxykinase; pyruvate carboxylase; fructose-1,6-bisphosphatase; glucose-6-phosphatase; transaminase ID FOOD RESTRICTION; GENE-EXPRESSION; RAT-LIVER; ASPARTATE-AMINOTRANSFERASE; PYRUVATE-CARBOXYLASE; PROTEIN-TURNOVER; PHOSPHOENOLPYRUVATE CARBOXYKINASE; HEPATIC GLUCONEOGENESIS; DIETARY RESTRICTION; FISCHER-344 RAT AB Long-term caloric restriction (CR) has been shown to extend maximum life span in laboratory rodents. We investigated the activities of gluconeogenic and transaminase enzymes in the livers of old and young mice fed either control or calorie-restricted diets. Livers were sampled 48 h after the last scheduled feeding time. Old mice on CR showed significant increases in the activities of pyruvate carboxylase, phosphoenolpyruvate carboxykinase, fructose-1,6-bisphosphatase and glucose-6-phosphatase when compared with controls, indicating increased gluconeogenesis. Increased activities of tyrosine, tryptophan, histidine, phenylalanine, alanine and aspartate transaminases, as well as of malate and glutamate dehydrogenases were also observed, while branched-chain amino acid transaminase was unchanged. Young mice on CR showed a significant increase only in the phosphoenolpyruvate carboxykinase activity in the gluconeogenic pathway, while transaminases were increased significantly, except for tryptophan and branched-chain amino acid transaminases. Glutamate dehydrogenase also showed increased activity but malate dehydrogenase was unchanged. Increases in the level of acetyl-CoA and [Acetyl-CoA]/[CoA] ratio were observed only in the old CR mice. Our results demonstrate increased gluconeogenic activity in CR mice and are consistent with a state of increased hepatic gluconeogenesis and protein turnover during CR. (C) 2002 Elsevier Science Inc. All rights reserved. C1 Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. Univ Calif Davis, Dept Mol Biosci, Sch Vet Med, Davis, CA 95616 USA. Univ Wisconsin, Wisconsin Reg Primate Res Ctr, Madison, WI 53715 USA. RP Hagopian, K (reprint author), Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53705 USA. EM khagopian@ucdavis.edu FU NIA NIH HHS [P01 AG11915, R01 AG17902] NR 63 TC 75 Z9 77 U1 1 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0531-5565 J9 EXP GERONTOL JI Exp. Gerontol. PD MAR PY 2003 VL 38 IS 3 BP 267 EP 278 AR PII S0531-5565(02)00202-4 DI 10.1016/S0531-5565(02)00202-4 PG 12 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 653HL UT WOS:000181429100007 PM 12581790 ER PT J AU Armstrong, K Weiner, J Weber, B Asch, DA AF Armstrong, K Weiner, J Weber, B Asch, DA TI Early adoption of BRCA1/2 testing: Who and why SO GENETICS IN MEDICINE LA English DT Article DE BRCA1/2 genetic testing; utilization; diffusion ID OVARIAN-CANCER SUSCEPTIBILITY; HEREDITARY BREAST; HEALTH PROMOTION; DIFFUSION-THEORY; MUTATIONS; FAMILIES; RISK; POPULATION; PREVENTION; DECISIONS AB Purpose: Relatively little is known about the characteristics of women who chose to undergo BRCA1/2 testing soon after testing became available, including how they became aware of and chose to pursue testing. Diffusion of innovation theory states that acceptance of an innovation is a function of the potential adopter's value for innovation and perceptions of the compatibility, complexity, and relative advantage of the innovation. These factors may contribute to early uptake of BRCA1/2 testing. The purpose of this study was to describe the characteristics of women who were "early adopters" of clinical BRCA1/2 testing and to determine whether diffusion theory explains variation in uptake of testing after participation in genetic counseling for BRCA1/2 testing. Methods: A retrospective cohort study of participants in genetic counseling for BRCA1/2 testing was conducted at a clinical program in a large academic health system. Measures included components of diffusion of innovation theory (participant's value for innovation, i.e., "innovativeness," and perceptions of the compatibility, complexity, and relative advantage of BRCA1/2 testing), characteristics of how the participant became aware of and sought BRCA1/2 testing, and decisions about testing after counseling. Results: From the 229 respondents, 71 (31%) had undergone testing at the time of the survey. Fifty-seven women (25%) had sought BRCA1/2 testing because a family member had breast or ovarian cancer and 37 (16%) because they had breast or ovarian cancer. Only 15 women (7%) reported seeking testing because of a physician's recommendation. After multivariate adjustment, higher innovativeness and higher ratings of the compatibility of BRCA1/2 testing were associated with undergoing testing after counseling [relative risk (RR) 1.76, 95% confidence interval (CI) 1.2-2.6]. However, ratings of the complexity or relative advantage of testing were not associated with testing decisions. Higher innovativeness was associated with being the first in the family to undergo testing (RR 4.85, 95% Cl 1.6-14.9), becoming aware of BRCA1/2 testing through the media (RR 1.50, 95% CI 1.0-2.4), and being aware of BRCA1/2 testing prior to counseling (RR 1.25, 95% CI 1.1-1.4). Conclusions: The uptake of BRCA1/2 testing among women undergoing genetic counseling was associated with innovative characteristics of the participant and the perceived compatibility of the test with existing values and needs, but not with the complexity or relative advantage of the test. Most "early adopters" had heard of BRCA1/2 testing from a source other than their physician and had sought testing because of a personal or family member's cancer diagnosis. These findings can inform predictions surrounding the introduction of future genetic susceptibility tests and strategies for guiding the further diffusion of BRCA1/2 testing. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Ctr Canc, Abramson Family Canc Res Inst, 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. Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Armstrong, K (reprint author), 1233 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. OI Weiner, Janet/0000-0001-5810-5807; Asch, David/0000-0002-7970-286X FU NCI NIH HHS [CA57601, CA82393] NR 34 TC 23 Z9 24 U1 2 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1098-3600 J9 GENET MED JI Genet. Med. PD MAR-APR PY 2003 VL 5 IS 2 BP 92 EP 98 DI 10.1097/01.GIM.0000056829.76915.2A PG 7 WC Genetics & Heredity SC Genetics & Heredity GA 709QM UT WOS:000184635900007 PM 12644778 ER PT J AU Schneider, A Pogue-Geile, K Barmada, MM Myers-Fong, E Thompson, BS Whitcomb, DC AF Schneider, A Pogue-Geile, K Barmada, MM Myers-Fong, E Thompson, BS Whitcomb, DC TI Hereditary, familial, and idiopathic chronic pancreatitis are not associated with polymorphisms in the tumor necrosis factor alpha (TNF-alpha) promoter region or the TNF receptor 1 (TNFR1) gene SO GENETICS IN MEDICINE LA English DT Article DE chronic pancreatitis; gene polymorphisms; hereditary pancreatitis; soluble tumor necrosis factor receptors; tumor necrosis factor alpha ID SERINE-PROTEASE INHIBITOR; CYSTIC-FIBROSIS GENE; INSULIN-RESISTANCE; SOLUBLE RECEPTORS; KAZAL TYPE-1; CELL-DEATH; MUTATIONS; IDENTIFICATION; EXPRESSION; CLONING AB Purpose: Genetic alterations that are associated with acute and chronic pancreatitis remain to be identified. Methods: The authors investigated two functionally active tumor necrosis factor (TNF) promoter region polymorphisms at positions -238 and -308 and the entire coding region of the corresponding TNF receptor 1 (TNFR1) gene in 54 patients with hereditary, familial, and idiopathic chronic pancreatitis who were previously tested negative for cationic trypsinogen mutations by direct DNA sequencing. Results: In three patients, we detected novel DNA variants in the TNFR1 gene that did not segregate with the disease. The genotype frequencies of the TNF promoter polymorphisms were similar between patients and controls. Conclusion: These polymorphisms are not associated with hereditary, familial, or idiopathic chronic pancreatitis. 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 Hlth Care Syst, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Ctr Genom Sci, Pittsburgh, PA 15213 USA. RP Schneider, A (reprint author), Univ Pittsburgh, Dept Med, 571 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15213 USA. OI Barmada, M Michael/0000-0002-3604-6460 FU NIDDK NIH HHS [DK54709] NR 43 TC 17 Z9 17 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1098-3600 J9 GENET MED JI Genet. Med. PD MAR-APR PY 2003 VL 5 IS 2 BP 120 EP 125 DI 10.1097/01.GIM.0000055199.32817.CA PG 6 WC Genetics & Heredity SC Genetics & Heredity GA 709QM UT WOS:000184635900011 PM 12644782 ER PT J AU Wertheimer, AM Miner, C Lewinsohn, DM Sasaki, AW Kaufman, E Rosen, HR AF Wertheimer, AM Miner, C Lewinsohn, DM Sasaki, AW Kaufman, E Rosen, HR TI Novel CD4(+) and CD8(+) T-cell determinants within the NS3 protein in subjects with spontaneously resolved HCV infection SO HEPATOLOGY LA English DT Article; Proceedings Paper CT 21st Annual AASLD Meeting CY 2001 CL DALLAS, TEXAS SP AASLD ID HEPATITIS-C VIRUS; DENDRITIC CELLS; NONSTRUCTURAL PROTEIN-3; LYMPHOCYTE-RESPONSES; EFFECTOR FUNCTION; PERIPHERAL-BLOOD; IMMUNE-RESPONSES; EPITOPE; RNA; SPECIFICITY AB Spontaneous resolution of hepatitis C virus (HCV) infection is a relatively infrequent event, and these individuals provide a unique opportunity to characterize correlates of protective immunity as an important first step in the development of vaccine candidates. The aim of this study was to directly and comprehensively enumerate I-ICY-nonstructural protein 3 (NS3) specific CD4(+) and CD8(+) T cells ex vivo from HLA diverse individuals who had been successful in spontaneously resolving HCV infection. We measured interferon gamma (IFN-gamma) production with an ELISPOT assay using magnetic bead-separated CD4(+) or CD8(+) T cells in response to autologous DCs that had been pulsed with 15mer per peptides overlapping by 11 amino acids and spanning all of the NS3 protein (150 total peptides). All subjects with spontaneously recovered HCV infection demonstrated vigorous and multispecific CD4(+) T-cell responses to NS3 peptides, and 6 of 10 subjects demonstrated CD8(+) T-cell responses. More importantly, we identified novel, previously unpredicted antigenic regions, which in most cases elicited high frequencies within a given individual. In conclusion, subjects who have spontaneously eradicated HCV infection up to 35 years earlier demonstrate persistent CD4(+) and CD8(+) T-cell responses specific to NS3. By providing a comprehensive screening of all potential T-cell epitopes contained in the NS3 region, our strategy defines the breadth of the T-cell response and identifies novel, unpredicted specificities. C1 Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Div Gastroenterol Hepatol, Dept Med, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Div Gastroenterol Hepatol & Liver Transplantat, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Res Serv, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Dept Mol Microbiol & Immunol, Portland, OR 97207 USA. Chiron Corp, Emeryville, CA 94608 USA. RP Rosen, HR (reprint author), Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Div Gastroenterol Hepatol, Dept Med, 3710 SW US Vet Hosp Rd,P3-G1, Portland, OR 97207 USA. RI Yang, Chen/G-1379-2010; Lewinsohn, David/I-4936-2013 OI Lewinsohn, David/0000-0001-9906-9494 FU NIDDK NIH HHS [DK60590-01] NR 43 TC 103 Z9 109 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD MAR PY 2003 VL 37 IS 3 BP 577 EP 589 DI 10.1053/jhep.2003.50115 PG 13 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 650RJ UT WOS:000181276800014 PM 12601356 ER PT J AU Lopes, HF Martin, KL Nashar, K Morrow, JD Goodfriend, TL Egan, BM AF Lopes, HF Martin, KL Nashar, K Morrow, JD Goodfriend, TL Egan, BM TI DASH diet lowers blood pressure and lipid-induced oxidative stress in obesity SO HYPERTENSION LA English DT Article DE obesity; insulin resistance; fatty acids; F-2-isoprostanes; oxidative stress; antioxidants ID INSULIN-RESISTANCE; ASCORBIC-ACID; HYPERTENSION; PLASMA; POTASSIUM; HYPERINSULINEMIA; COMPLICATIONS; CHOLESTEROL; ACTIVATION; OXIDASE AB Evidence suggests that obesity may raise blood pressure (BP) through oxidative stress-sensitive mechanisms and that the Dietary Approaches to Stop Hypertension combination diet (DASH-CD) may decrease BP by enhancing antioxidant capacity. To address this question, 12 obese patients with high-normal-to-stage 1 hypertension (hypertensives) and 12 lean normotensives were studied on their usual diets and after following the DASH-CD and a low-antioxidant diet in random sequence for 4 weeks each. Acute oxidative stress was induced by a 4-hour infusion of intralipid and heparin. Ferric-reducing activity of plasma (FRAP) and plasma F-2-isoprostanes were measured as biomarkers of antioxidant capacity and oxidative stress, respectively. BP was lower in obese hypertensives on the DASH-CD than on the usual and low-antioxidant diets (-8.1+/-1.5/-7.4+/-1.6 mm Hg, P<0.05). BP did not change significantly in lean normotensives after 4 weeks on the DASH-CD but tended to rise on the low-antioxidant diet. FRAP on usual diets was higher in lean subjects than in obese subjects. FRAP increased in obese but not lean volunteers on the DASH-CD compared with usual diet, and the group difference disappeared. F-2-isoprostanes increased from baseline during intralipid and heparin in both groups on the low-antioxidant diet but not in obese hypertensives on the DASH-CD. Among free-living obese hypertensives, the DASH-CD raises antioxidant capacity, lowers BP, and reduces oxidative stress induced by acute hyperlipidemia. The findings are consistent with evidence that elevated BP in obese subjects may reflect an imbalance between antioxidant capacity and oxidative stress that is improved by the DASH-CD. C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pharmacol, Charleston, SC 29425 USA. Med Univ S Carolina, Gen Clin Res Ctr, Charleston, SC 29425 USA. USP, HCFM, Unidade Hipertensao Heart Inst InCor, BR-09500900 Sao Paulo, Brazil. Vanderbilt Univ, Sch Med, Dept Pharmacol, Nashville, TN 37212 USA. Vanderbilt Univ, Sch Med, Dept Med, Nashville, TN 37212 USA. Univ Wisconsin, Dept Pharmacol, Madison, WI 53706 USA. Univ Wisconsin, Dept Med, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Egan, BM (reprint author), Med Univ S Carolina, Dept Med, 96 Jonathan Lucas St,CSB 826H, Charleston, SC 29425 USA. FU NCI NIH HHS [CA77839]; NCRR NIH HHS [RR-01070]; NHLBI NIH HHS [HL55782, HL58794, HL04290]; NIDDK NIH HHS [DK26657, DK48831]; NIGMS NIH HHS [GM42056] NR 41 TC 104 Z9 109 U1 2 U2 5 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 2003 VL 41 IS 3 BP 422 EP 430 DI 10.1161/01.HYP.0000053450.19998.11 PG 9 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 653QD UT WOS:000181447500008 PM 12623938 ER PT J AU Queiroz-Telles, F McGinnis, MR Salkin, I Graybill, JR AF Queiroz-Telles, F McGinnis, MR Salkin, I Graybill, JR TI Subcutaneous mycoses SO INFECTIOUS DISEASE CLINICS OF NORTH AMERICA LA English DT Article ID SPOROTHRIX-SCHENCKII; FONSECAEA-PEDROSOI; SYSTEMIC SPOROTRICHOSIS; AMPHOTERICIN-B; CUTANEOUS SPOROTRICHOSIS; ANTIFUNGAL ACTIVITY; FILAMENTOUS FUNGI; AIDS PATIENT; CHROMOBLASTOMYCOSIS; ITRACONAZOLE AB Subcutaneous mycoses include a heterogeneous group of fungal infections that develop at the site of transcutaneous trauma. Infection slowly evolves as the etiologic agent survives and adapts to the adverse host tissue environment. Diagnosis rests on clinical presentation, histopathology, and culture of the etiologic agents. This article considers sporotrichosis, chromoblastomycosis, and mycetoma. C1 Univ Texas, Med Branch, Dept Pathol, Galveston, TX 77555 USA. Univ Fed Parana, Hosp Clin, BR-80060000 Curitiba, Parana, Brazil. Informat Sci, W Sand Lake, NY 12196 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP McGinnis, MR (reprint author), Univ Texas, Med Branch, Dept Pathol, 301 Univ Blvd, Galveston, TX 77555 USA. NR 94 TC 56 Z9 64 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 0891-5520 J9 INFECT DIS CLIN N AM JI Infect. Dis. Clin. North Am. PD MAR PY 2003 VL 17 IS 1 BP 59 EP + DI 10.1016/S0891-5520(02)00066-1 PG 28 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 672BK UT WOS:000182500800005 PM 12751261 ER PT J AU Carey, K AF Carey, K TI Hospital cost efficiency and system membership SO INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING LA English DT Article ID HEALTH-CARE PROVIDERS; MULTIHOSPITAL SYSTEMS; FINANCIAL PERFORMANCE; STOCHASTIC FRONTIER; MERGERS; MARKETS; COMPETITION; NONPROFIT; CONSOLIDATION; OWNERSHIP AB Using a recently developed taxonomy of hospital organizations, this paper estimates a stochastic frontier cost function to test for inefficiency differences among system hospitals having common strategic and/or structural characteristics. System hospitals that centralized around physician arrangements and insurance products display the smallest deviations from the least cost locus. This suggests efficiency benefits from organization of physician and insurance activities at the system level, with discretion over the array of service offerings left to individual members. Policymakers should be mindful of potential efficiency gains from hospital consolidations and be aware that common ownership alone may be too general a rubric for evaluating those gains usefully. C1 US Dept Vet Affairs, VA Management Sci Grp, Bedford, MA 01730 USA. Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. RP Carey, K (reprint author), US Dept Vet Affairs, VA Management Sci Grp, Bldg 12,200 Springs Rd, Bedford, MA 01730 USA. NR 45 TC 38 Z9 39 U1 2 U2 11 PU BLUE CROSS BLUE SHIELD ASSOC PI ROCHESTER PA 150 EAST MAIN ST, ROCHESTER, NY 14647 USA SN 0046-9580 J9 INQUIRY-J HEALTH CAR JI Inquiry-J. Health Care Organ. Provis. Financ. PD SPR PY 2003 VL 40 IS 1 BP 25 EP 38 PG 14 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 691JH UT WOS:000183602500003 PM 12836906 ER PT J AU Huerta, S Harris, DM Jazirehi, A Bonavida, B Elashoff, D Livingston, EH Heber, D AF Huerta, S Harris, DM Jazirehi, A Bonavida, B Elashoff, D Livingston, EH Heber, D TI Gene expression profile of metastatic colon cancer cells resistant to cisplatin-induced apoptosis SO INTERNATIONAL JOURNAL OF ONCOLOGY LA English DT Article DE colon cancer; apoptosis; SW480; SW620; caspases; cisplatin; microarray ID OLIGONUCLEOTIDE ARRAYS; PHASE-II; LINES; MODEL; PROGRESSION; CARCINOMA AB The current chemotherapeutic modalities for advanced colorectal cancer are limited. DNA-platinating drugs such as cisplatin have poor efficacy against this malignancy. The aim of this study was to identify genes that render survival advantage after cisplatin treatment in metastatic colon cancer. Cell lines SW480 (primary colon cancer) and SW620 (metastatic lesion from the same patient) were obtained from ATCC. Apoptosis was measured by FACS analysis of cisplatin-treated (0.01-10 mug/ml) and untreated cells. Simultaneous analysis of similar to1200 cDNAs was performed by microarray technique on untreated and treated cells from lines. Microarray results were confirmed by RT-PCR. The SW620 cell line was more resistant to apoptosis induced by cisplatin. Western blot analysis revealed equal expression of pro-caspases 3, 8, and 9 in both cell lines. Microarray analysis identified 15 genes and 9 expressed sequence tags (ESTs) significantly altered both by cell type (metastatic vs. non-metastatic) and treatment vs. non-treatment. Several of these transcripts are well-characterized genes including MCT, GAD67, P19, GSTM3, Cyclin D1, ATM, and CO-029 that have been implicated in various malignancies. In the present study, we have identified a set of genes responsible for apoptosis resistance following treatment with cisplatin in the late stages of carcinogenesis. Targeting these genes may increase chemotherapy effectiveness in advanced colon cancer and reduce toxicity in normal tissue. C1 Univ Calif Los Angeles, Ctr Human Nutr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, VA Greater Los Angeles, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Microbiol Immunol & Mol Genet, Los Angeles, CA 90095 USA. RP Huerta, S (reprint author), Univ Calif Los Angeles, Ctr Human Nutr, 900 Vet Ave,12-217 Warren Hall, Los Angeles, CA 90095 USA. FU NCI NIH HHS [CA42710] NR 25 TC 50 Z9 55 U1 1 U2 1 PU PROFESSOR D A SPANDIDOS PI ATHENS PA 1, S MERKOURI ST, EDITORIAL OFFICE,, ATHENS 116 35, GREECE SN 1019-6439 J9 INT J ONCOL JI Int. J. Oncol. PD MAR PY 2003 VL 22 IS 3 BP 663 EP 670 PG 8 WC Oncology SC Oncology GA 645KP UT WOS:000180975000024 PM 12579322 ER PT J AU Fujiwara, I Aravindan, R Horst, RL Drezner, MK AF Fujiwara, I Aravindan, R Horst, RL Drezner, MK TI Abnormal regulation of renal 25-hydroxyvitamin D-1 alpha-hydroxylase activity in X-linked hypophosphatemia: A translational or post-translational defect SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article DE rickets; phosphate; CYP27B1; parathyroid hormone; thyrocalcitonin ID VITAMIN-D METABOLISM; D-3 1-ALPHA-HYDROXYLASE GENE; PARATHYROID-HORMONE; HYP MICE; 25-HYDROXYVITAMIN-D-1-ALPHA-HYDROXYLASE ACTIVITY; D-3-1-ALPHA-HYDROXYLASE GENE; CALCITRIOL PRODUCTION; HUMAN KERATINOCYTES; GENERALIZED DEFECT; MAMMALIAN KIDNEY AB The hyp mouse exhibits abnormal metabolic/hormonal regulation of renal 25(OH)D-1alpha-hydroxylase activity. Whether this results from aberrant transcriptional regulation of the 1alpha-hydroxylase gene, CYP27B1, remains unknown. To investigate this possibility, we compared phosphate and parathyroid hormone effects on renal proximal convoluted tubule and thyrocalcitonin effects on proximal straight tubule enzyme activity and mRNA expression in normal and hyp mice. We assayed 25(OH)D-1alpha-hydroxylase activity by measuring 1,25(OH)(2)D production and mRNA by ribonuclease protection. Phosphate-depleted mice exhibited a 3-fold increment of 25(OH)D-1alpha-hydroxylase activity compared with normals, whereas hyp mice displayed no enhanced enzyme function. Phosphate-depleted mice concurrently displayed a 2-fold increase in mRNA transcripts; in contrast, despite failure to alter enzyme activity, hyp mice exhibited a similar increment in mRNA transcripts. Parathyroid hormone stimulation of normal mice increased 25(OH)D-1alpha-hydroxylase activity 10-fold,while eliciting only a 2-fold increment in hyp mouse enzyme function. This disparity occurred despite increments of mRNA transcripts to comparable levels (22.2 +/- 3.5- vs. 19.9 +/- 1.8-fold). The dissociation between phosphate- and parathyroid hormone-mediated transcriptional activity and protein function was not universal. Thus, thyrocalcitonin stimulation of normal and hyp mice resulted in comparable enhancement of mRNA transcripts and enzyme activity. These observations indicate that abnormal regulation of vitamin D metabolism in hyp mice occurs in the proximal convoluted tubule and results, not from aberrant transcriptional regulation, but from a defect in translational or post-translational activity. C1 Univ Wisconsin, Sch Med, Clin Sci Ctr H4 554, Dept Med, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, CRECC, Madison, WI USA. Tohoku Univ, Dept Pediat, Sendai, Miyagi 980, Japan. ARS, Natl Anim Dis Ctr, USDA, Ames, IA USA. RP Drezner, MK (reprint author), Univ Wisconsin, Sch Med, Clin Sci Ctr H4 554, Dept Med, 600 Highland Ave, Madison, WI 53792 USA. FU PHS HHS [R01-27032-22] NR 45 TC 17 Z9 17 U1 0 U2 2 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD MAR PY 2003 VL 18 IS 3 BP 434 EP 442 DI 10.1359/jbmr.2003.18.3.434 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 648YC UT WOS:000181178400007 PM 12619927 ER PT J AU Glorioso, JC Krisky, D Wolfe, D Goins, W Goss, J Hao, SL Chattopadhyay, M Mata, M Fink, D AF Glorioso, JC Krisky, D Wolfe, D Goins, W Goss, J Hao, SL Chattopadhyay, M Mata, M Fink, D TI Treatment of sensory neuron disease using HSV gene vectors SO JOURNAL OF GENE MEDICINE LA English DT Meeting Abstract CT 2nd International Symposium on Molecular Diagnostics and Skin Gene therapy CY MAR 27-29, 2003 CL DUSSELDORF, GERMANY C1 Univ Pittsburgh, Sch Med, Dept Mol Genet & Biochem, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15261 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1099-498X J9 J GENE MED JI J. Gene. Med. PD MAR PY 2003 VL 5 IS 3 BP S15 EP S15 PG 1 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine GA 662WU UT WOS:000181972700050 ER PT J AU Bean-Mayberry, BA Chang, CCH McNeil, MA Whittle, J Hayes, PM Scholle, SH AF Bean-Mayberry, BA Chang, CCH McNeil, MA Whittle, J Hayes, PM Scholle, SH TI Patient satisfaction in women's clinics versus traditional primary care clinics in the Veterans Administration SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT VA Health Services Resarch and Development Annual Meeting CY FEB, 2002 CL WASHINGTON, D.C. DE patient satisfaction; primary health care; quality of health care; veterans; women ID NATIONAL CENTERS; GENERAL-PRACTICE; HEALTH CENTERS; HOSPITAL-CARE; GENDER; EXCELLENCE; OUTCOMES; SETTINGS AB OBJECTIVE: To compare patient satisfaction in women's clinics (WCs) versus traditional primary care clinics (TCs). DESIGN: Anonymous, cross-sectional mailed survey. SETTING: Eight Department of Veterans Affairs (VA) medical centers in 3 states. PATIENTS: A random sample of women stratified by site and enrollment in WC versus TC (total response rate = 61%). MEASURES: Overall satisfaction and gender-specific satisfaction as measured by the Primary Care Satisfaction Survey for Women (PCSSW). ANALYSIS: We dichotomized the satisfaction scores (excellent versus all other), and compared excellent satisfaction in WCs versus TCs using logistic regression, controlling for demographics, health status, health care use, and location. RESULTS: Women enrolled in WCs were more likely than those in TCs to report excellent overall satisfaction (odds ratio, 1.42; 95% confidence interval, 1.00 to 2.02; P = .05). Multivariate models demonstrated that receipt of care in WCs was a significant positive predictor for all 5 satisfaction domains (i.e., getting care, privacy and comfort, communication, complete care, and follow-up care) with the gender-specific satisfaction instrument (PCSSW). CONCLUSIONS: This study is the first to consistently show higher satisfaction in WCs versus TCs despite age and race differences and comparable health status. Since these WCs show better quality in terms of satisfaction, other quality indicators should be evaluated. If WCs reduce fragmentation and improve health care delivery, the model will be applicable in VA and non-VA outpatient settings. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Ctr Res Hlth Care, Div Gen Med, Pittsburgh, PA USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. Kansas City VA Hosp, Kansas City, MO USA. Univ Kansas, Med Ctr, Kansas City, KS 66103 USA. RP Bean-Mayberry, BA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C 130-U, Pittsburgh, PA 15240 USA. NR 26 TC 34 Z9 34 U1 0 U2 1 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 MAR PY 2003 VL 18 IS 3 BP 175 EP 181 DI 10.1046/j.1525-1497.2003.20512.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 657EL UT WOS:000181652400003 PM 12648248 ER PT J AU Wyrwich, KW Fihn, SD Tierney, WM Kroenke, K Babu, AN Wolinsky, FD AF Wyrwich, KW Fihn, SD Tierney, WM Kroenke, K Babu, AN Wolinsky, FD TI Clinically important changes in health-related quality of life for patients with chronic obstructive pulmonary disease - An expert consensus panel report SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT Annual Meeting of the Academy-of-Health-Services-Research-and-Health-Policy CY JUN, 2002 CL WASHINGTON, D.C. SP Acad Hlth Serv Res & Hlth Policy DE quality of life; COPD; important change; consensus panel; RAND method; Delphi process ID OF-LIFE; INTRAINDIVIDUAL CHANGES; IMPORTANT DIFFERENCE; FUNCTIONAL STATUS; LUNG-DISEASE; QUESTIONNAIRE; DYSPNEA; COPD; RELIABILITY; OUTCOMES AB OBJECTIVE: Without clinical input on what constitutes a significant change, health-related quality of life (HRQoL) measures are less likely to be adopted by clinicians for use in daily practice. Although standards can be determined empirically by within-person change studies based on patient self-reports, these anchor-based methods incorporate only the patients' perspectives of important HRQoL change, and do not reflect an informed clinical evaluation. The objective of this study was to establish clinically important difference standards from the physician's perspective for use of 2 HRQoL measures among patients with chronic obstructive pulmonary disease (COPD). DESIGN: We assembled a 9-person expert panel of North American physicians familiar with the use of the Chronic Respiratory Questionnaire (CRQ), a disease-specific HRQoL measure, or the generic Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36, Version 2.0) among patients with COPD. RESULTS: Using 2 rounds of the Delphi process, 1 in-person meeting, and an iterative improvement process for circulating and correcting the final report, the expert panel established small, moderate, and large clinically important change levels for the CRQ and SF-36. CONCLUSIONS: For this expert physician panel, levels for detecting clinically important differences on the CRQ were equal to or slightly higher than previous studies based on patient-reported differences. Clinically important differences on the SF-36, Version 2.0, were noticeably larger than previous estimates based on cross-sectional differences between clinically defined patient groups. C1 St Louis Univ, Dept Res Methodol, Sch Publ Hlth, St Louis, MO 63103 USA. St Louis Univ, Sch Med, St Louis, MO USA. Vet Adm Med Ctr, St Louis, MO 63125 USA. Univ Washington, Med Ctr, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Indiana Univ, Sch Med, Regrenstrief Inst Hlth Care, Indianapolis, IN 46202 USA. Richard L Roudebush Vet Adm Med Ctr, Indianapolis, IN 46202 USA. RP Wyrwich, KW (reprint author), 221 N Grand Ave, St Louis, MO 63103 USA. RI Wolinsky, Fredric/F-9231-2011 OI Wolinsky, Fredric/0000-0002-0916-4955 FU AHRQ HHS [K02 HS011635, HS10234, K02 HS11635, R01 HS010234] NR 42 TC 72 Z9 72 U1 0 U2 2 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 MAR PY 2003 VL 18 IS 3 BP 196 EP U6 DI 10.1046/j.1525-1497.2003.20203.x PG 13 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 657EL UT WOS:000181652400006 PM 12648251 ER PT J AU Bonner, LT Tsuang, DW Cherrier, MM Eugenio, CJ Du, JQ Steinbart, EJ Limprasert, P La Spada, AR Seltzer, B Bird, TD Leverenz, JB AF Bonner, LT Tsuang, DW Cherrier, MM Eugenio, CJ Du, JQ Steinbart, EJ Limprasert, P La Spada, AR Seltzer, B Bird, TD Leverenz, JB TI Familial dementia with Lewy bodies with an atypical clinical presentation SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article DE Lewy bodies; familial dementia; Alzheimer's disease ID ALZHEIMERS-DISEASE; PARKINSONS-DISEASE; BODY-DISEASE; FEATURES; MUTATION; CONSORTIUM; CONSENSUS; PATHOLOGY; DLB AB The authors report a case of a 64-year-old male with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) pathology at autopsy who did not manifest the core symptoms of DLB until very late in his clinical course. His initial presentation of early executive and language dysfunction suggested a cortical dementia similar to frontotemporal lobar degeneration (FTLD). Core symptoms of DLB including dementia, hallucination, and parkinsonian symptoms were not apparent until late in the course of his illness. Autopsy revealed both brainstem and cortical Lewy bodies and AD pathology. Family history revealed 7 relatives with a history of dementia including 4 with possible or probable DLB. This case is unique because of the FTLD-like presentation, positive family history of dementia, and autopsy confirmation of DLB. C1 Univ Washington, Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA 98195 USA. Univ Washington, Dept Lab Med, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Tulane Univ, Sch Med, Dept Psychiat & Neurol, New Orleans, LA 70112 USA. Dept Vet Affairs S Cent MIRECC, New Orleans, LA USA. RP Leverenz, JB (reprint author), VA Puget Sound Hlth Care Syst, MIRECC, 116 MIRECC,1660 S Columbian Way, Seattle, WA 98108 USA. EM leverenz@u.washington.edu RI Tsuang, Debby/L-7234-2016 OI Tsuang, Debby/0000-0002-4716-1894; Limprasert, Pornprot/0000-0001-5022-5361 FU NIA NIH HHS [P50 AG05136, R01 AG018644, P50 AG005136, R01-AG18644]; NINDS NIH HHS [R01 NS048595] NR 34 TC 12 Z9 12 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD MAR PY 2003 VL 16 IS 1 BP 59 EP 64 DI 10.1177/0891988702250585 PG 6 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 847GH UT WOS:000223380200011 PM 12641375 ER PT J AU Niswender, KD Gallis, B Blevins, JE Corson, MA Schwartz, MW Baskin, DG AF Niswender, KD Gallis, B Blevins, JE Corson, MA Schwartz, MW Baskin, DG TI Immunocytochemical detection of phosphatidylinositol 3-kinase activation by insulin and leptin SO JOURNAL OF HISTOCHEMISTRY & CYTOCHEMISTRY LA English DT Article DE phosphatidylinositol 3-kinase; PIP3; insulin; leptin; endothelium; hepatocyte ID NITRIC-OXIDE SYNTHASE; SIGNAL-TRANSDUCTION; RECEPTOR SUBSTRATE-2; HYPOTHALAMIC NEURONS; ENDOTHELIAL-CELLS; GLUCOSE-TRANSPORT; KINASE; MUSCLE; PHOSPHORYLATION; ASSOCIATION AB Intracellular signaling mediated by phosphatidylinositol 3-kinase (PI3K) is important for a number of cellular processes and is stimulated by a variety of hormones, including insulin and leptin. A histochemical method for assessment of PI3K signaling would be an important advance in identifying specific cells in histologically complex organs that are regulated by growth factors and peptide hormones. However, current methods for detecting PI3K activity require either homogenization of the tissue or cells or the ability to transfect probes that bind to phosphatidylinositol 3,4,5 trisphosphate (PIP3), the reaction product of PI3K catalysis. Here we report the validation of an immunocytochemical method to detect changes in PI3K activity, using a recently developed monoclonal antibody to PIP3, in paraformaldehyde-fixed bovine aortic endothelial cells (BAECs) in culture and in hepatocytes of intact rat liver. Treatment with either insulin or leptin increased BAEC PIP3 immunoreactivity, and these effects were blocked by pretreatment with PI3K inhibitors. Furthermore, infusion of insulin into the hepatic portal vein of fasted rats caused an increase of PIP3 immunostaining in hepatocytes that was associated with increased serine phosphorylation of the downstream signaling molecule protein kinase B/Akt (PKB/Akt). We conclude that immunocytochemical PIP3 staining can detect changes in PI3K activation induced by insulin and leptin in cell culture and intact liver. C1 Univ Washington, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Univ Washington, Div Cardiol, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Biol Struct, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Div Endocrinol & Metab, Seattle, WA USA. RP Niswender, KD (reprint author), Harborview Med Ctr, Box 359757,300 9th Ave, Seattle, WA 98104 USA. RI Schwartz, Michael/H-9950-2012 FU NIDDK NIH HHS [DK12829, DK17047, DK52989, T32 DK07247]; NINDS NIH HHS [NS32273] NR 35 TC 82 Z9 85 U1 0 U2 4 PU HISTOCHEMICAL SOC INC PI SEATTLE PA UNIV WASHINGTON, DEPT BIOSTRUCTURE, BOX 357420, SEATTLE, WA 98195 USA SN 0022-1554 J9 J HISTOCHEM CYTOCHEM JI J. Histochem. Cytochem. PD MAR PY 2003 VL 51 IS 3 BP 275 EP 283 PG 9 WC Cell Biology SC Cell Biology GA 648YX UT WOS:000181180400002 PM 12588955 ER PT J AU Virella, G Thorpe, SR Alderson, NL Stephan, EM Atchley, D Wagner, F Lopes-Virella, MF AF Virella, G Thorpe, SR Alderson, NL Stephan, EM Atchley, D Wagner, F Lopes-Virella, MF CA DCCT EDIC Res Grp TI Autoimmune response to advanced glycosylation end-products of human LDL SO JOURNAL OF LIPID RESEARCH LA English DT Article DE modified lipoproteins; diabetes; immunogenicity of advanced glycosylation end-products-LDL; advanced glycosylation end-products-LDL antibodies ID LOW-DENSITY-LIPOPROTEIN; CONTAINING IMMUNE-COMPLEXES; ADVANCED GLYCATION ENDPRODUCTS; MONOCYTE-DERIVED MACROPHAGES; CORONARY-ARTERY DISEASE; ATHEROSCLEROTIC LESIONS; DIABETES-MELLITUS; OXIDIZED LDL; OXIDATIVE STRESS; HEALTHY CONTROLS AB Advanced glycosylation end-products (AGES) are believed to play a significant role in the development of vascular complications in diabetic patients. One such product, AGE-L LDL,has been shown to be immunogenic. In this report, we describe the isolation and characterization of human AGE-LDL antibodies from the sera of seven patients with Type 1 diabetes by affinity chomatography using an immobilized AGE-LDL preparation that contained primarily the AGE NE(carboxymethyl)lysine (CML, 14.6 mmol/mol lysine), and smaller amounts of N-epsilon (carboxyethyl)lysine (CEL, 2.7 mmol/mol lysine). The isolated antibodies were predominantly IgG of subclasses 1 and 3, and considered proinflammatory because of their ability to promote FcgammaR-mediated phagocytosis and to activate complement. We determined dissociation constants (K-d) for the purified antibodies. The average K-d values (4.76 +/- 2.52 x 10(-9) mol/l) indicated that AGE-LDL antibodies are of higher avidity than oxidized LDL antibodies measured previously (K-d = 1.53 07 x 10(-8) ml/l), but of lower avidity than rabbit polyclonal LDL antibodies (K-d = 9.34 x 10(-11)). Analysis of the apolipoprotein B-rich lipoproteins isolated with polyethylene glycol-precipitated antigen-antibody complexes from the same patients showed the presence of both CML and CEL, thus confirming that these two modifications are recognized by human autoantibodies.jlr A comparative study of the reactivity of purified AGE-LDL antibodies with CML-LDL and CML-serum albumin showed no cross-reactivity. C1 Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Univ S Carolina, Dept Chem & Biochem, Columbia, SC 29208 USA. Med Univ S Carolina, Div Endocrinol Metab Nutr, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson VAMC, Charleston, SC 29425 USA. RP Virella, G (reprint author), Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. FU NHLBI NIH HHS [P01-HL55782]; NIDDK NIH HHS [DK19971] NR 50 TC 50 Z9 53 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 2003 VL 44 IS 3 BP 487 EP 493 DI 10.1194/jlr.M200370-JLR200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 653XF UT WOS:000181461800007 PM 12562876 ER PT J AU Vergnes, L Phan, J Stolz, A Reue, K AF Vergnes, L Phan, J Stolz, A Reue, K TI A cluster of eight hydroxysteroid dehydrogenase genes belonging to the aldo-keto reductase supergene family on mouse chromosome 13 SO JOURNAL OF LIPID RESEARCH LA English DT Article DE gene identification; gene expression; alternative splicing ID HEPATIC 3-ALPHA-HYDROXYSTEROID DEHYDROGENASE; BILE-ACID BINDERS; IN-SITU HYBRIDIZATION; RADIATION HYBRID MAP; RAT-LIVER CYTOSOL; DIHYDRODIOL DEHYDROGENASE; 20-ALPHA-HYDROXYSTEROID DEHYDROGENASE; TYPE-5 17-BETA-HYDROXYSTEROID-DEHYDROGENASE; GENOMIC ORGANIZATION; TISSUE DISTRIBUTION AB A subclass of hydroxysteroid dehydrogenases (HSD) are NADP(H)-dependent oxidoreductases that belong to the aldo-keto reductase (AKR) superfamily. They are involved in prereceptor or intracrine steroid modulation, and also act as bile acid-binding proteins. The HSD family members characterized thus far in human and rat have a high degree of protein sequence similarity but exhibit distinct substrate specificity. Here we report the identification of nine murine AKR genes in a cluster on chromosome 13 by a combination of molecular cloning and in silico analysis of this region. These include four previously isolated mouse HSD genes (Akr1c18, Akr1c6, Akr1c12, Akr1c13), the more distantly related Akr1e1, and four novel HSD genes. These genes exhibit highly conserved exon/intron organization and protein sequence predictions indicate 75% amino acid similarity. The previously identified AKR protein active site residues are invariant among all nine proteins, but differences are observed in regions that have been implicated in determining substrate specificity. Differences also occur in tissue expression patterns, with expression of some genes restricted to specific tissues and others expressed at high levels in multiple tissues.jlr Our findings dramatically expand the repertoire of AKR genes and identify unrecognized family members with potential roles in the regulation of steroid metabolism. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet & Med, Los Angeles, CA 90095 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ So Calif, Keck Sch Med, Div Gastrointestinal & Liver Dis, Los Angeles, CA 90033 USA. RP Reue, K (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet & Med, Los Angeles, CA 90095 USA. FU NHLBI NIH HHS [HL-58267, HL-28481]; NIDDK NIH HHS [DK-41014, 5P30DK048522]; NIGMS NIH HHS [GM08042] NR 46 TC 40 Z9 43 U1 1 U2 3 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 2003 VL 44 IS 3 BP 503 EP 511 DI 10.1194/jlr.M200399-JLR200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 653XF UT WOS:000181461800009 PM 12562828 ER PT J AU Bohning, DE Shastri, A Lomarev, MP Lorberbaum, JP Nahas, Z George, MS AF Bohning, DE Shastri, A Lomarev, MP Lorberbaum, JP Nahas, Z George, MS TI BOLD-fMRI response vs. transcranial magnetic stimulation (TMS) pulse-train length: Testing for linearity SO JOURNAL OF MAGNETIC RESONANCE IMAGING LA English DT Article; Proceedings Paper CT 8th Annual Meeting of the International-Society-for-Magnetic-Resonance-in-Medicine CY APR 01-07, 2000 CL DENVER, COLORADO SP Int Soc Magnet Resonance Med DE transcranial magnetic stimulation (TMS); fMRI; train-length; BOLD response linearity; motor cortex ID CEREBRAL BLOOD-FLOW; FUNCTIONAL MRI; MOTOR CORTEX; CORTICAL ACTIVATION; SENSORY STIMULATION; BRAIN ACTIVATION; AUDITORY-CORTEX; SIGNAL; CONNECTIVITY; MOVEMENT AB Purpose: To measure motor and auditory cortex blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) response to impulse-like transcranial magnetic stimulation (TMS) pulses as a function of train length. Materials and Methods: Interleaved with fMRI at 1.5 T, TMS pulses 0.3-msec long were applied at 1 Hz to the motor cortex area for thumb. Six subjects were studied in a TR = 1 second session administering trains of 1, 2, 4, 8, and 16 pulses, and a TR = 3 seconds session administering trains of 1, 2, 4, 8, 16, and 24 pulses. A simple hemodynamic model with finite recovery and saturation was used to quantitatively characterize the BOLD-fMRI response as a function of train length. Results: In both the activations directly induced in motor cortex by TMS and the indirect activation sin auditory cortex caused by the sound of the TMS coil firing, the BOLD-fMRI responses to multiple pulses were well described by a summation of single-pulse impulse functions. Conclusion: Up to 24 discrete pulses, BOLD-fMRI response to 1 Hz TMS in both motor cortex and auditory cortex were consistent with a linear increase in amplitude and length with train length, possibly suggesting that stimuli of 1 to 2 seconds may be too long to represent impulses. C1 Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Inst Human Brain, St Petersburg, Russia. Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurol, Charleston, SC 29425 USA. Ralph H Johnson Vet Hosp, Charleston, SC USA. RP Bohning, DE (reprint author), Med Univ S Carolina, Dept Radiol, 169 Ashley Ave, Charleston, SC 29425 USA. FU PHS HHS [R21] NR 40 TC 19 Z9 19 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1053-1807 J9 J MAGN RESON IMAGING JI J. Magn. Reson. Imaging PD MAR PY 2003 VL 17 IS 3 BP 279 EP 290 DI 10.1002/jmri.10271 PG 12 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 670JF UT WOS:000182403600001 PM 12594717 ER PT J AU Stewart, JA Wei, CC Brower, GL Rynders, PE Hankes, GH Dillon, AR Lucchesi, PA Janicki, JS Dell'Italia, LJ AF Stewart, JA Wei, CC Brower, GL Rynders, PE Hankes, GH Dillon, AR Lucchesi, PA Janicki, JS Dell'Italia, LJ TI Cardiac mast cell- and chymase-mediated matrix metalloproteinase activity and left ventricular remodeling in mitral regurgitation in the dog SO JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY LA English DT Article DE matrix metalloproteinase; angiotensin-converting enzyme; myocardial remodeling; volume overload; heart failure ID CONGESTIVE-HEART-FAILURE; ANGIOTENSIN-II; DILATED CARDIOMYOPATHY; MYOCARDIAL-INFARCTION; COLLAGEN LATTICES; IN-VIVO; ACTIVATION; INHIBITION; FIBROSIS; RAT AB The present study tested the hypothesis that cardiac mast cells and chymase are associated with matrix metalloproteinase (MMP) activation and extracellular matrix (ECM) degradation in the evolution of left ventricular (LV) chamber remodeling secondary to experimental mitral regurgitation (MR) in dogs. LV mast cell density, chymase activity, and angiotensin II (ANG II) levels were significantly increased 2 and 4 weeks post-MR, while an increase in angiotensin-converting enzyme (ACE) activity was not seen prior to the chronic 24 week stage. As early as 2 and 4 weeks, there was a significant decrease in interstitial myocardial collagen content that was associated with an increase in LV end-diastolic diameter (LVEDD) but a normal LVEDD/wall thickness ratio. While mast cell density decreased to normal at 24 weeks, both chymase and MMP-2 activity remained increased throughout the entire 24-week period post-MR. By 24 weeks a transition to an adverse pattern of LV remodeling characterized by a 2-fold increase in the LVEDD/wall thickness ratio had occurred. Thus, this study supports the hypothesis that mast cells and chymase are important modulators of MMP activity and ECM degradation, contributing to adverse LV remodeling in chronic volume overload secondary to MR. (C) 2003 Elsevier Science Ltd. All fights reserved. C1 Auburn Univ, Dept Anat Physiol & Pharmacol, Auburn, AL 36849 USA. Univ Alabama, Birmingham Vet Affairs Med Ctr, Dept Med,Div Cardiovasc Dis, Vasc Biol & Hypertens Program, Birmingham, AL 35294 USA. Dept Clin Sci, Auburn, AL 36849 USA. Univ Stn, Dept Physiol & Biophys, Birmingham, AL 35924 USA. RP Janicki, JS (reprint author), Auburn Univ, Dept Anat Physiol & Pharmacol, 106 Greene Hall, Auburn, AL 36849 USA. EM janjanicjs@auburwn.edu RI Lucchesi, Pamela/E-3558-2011 FU NHLBI NIH HHS [R01-HL54816, R01-HL59981, R01-HL62228] NR 52 TC 89 Z9 92 U1 1 U2 4 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0022-2828 EI 1095-8584 J9 J MOL CELL CARDIOL JI J. Mol. Cell. Cardiol. PD MAR PY 2003 VL 35 IS 3 BP 311 EP 319 DI 10.1016/S0022-2828(03)00013-0 PG 9 WC Cardiac & Cardiovascular Systems; Cell Biology SC Cardiovascular System & Cardiology; Cell Biology GA 667CE UT WOS:000182212600010 PM 12676546 ER PT J AU Romeo, HE Tio, DL Taylor, AN AF Romeo, HE Tio, DL Taylor, AN TI Effects of glossopharyngeal nerve transection on central and peripheral cytokines and serum corticosterone induced by localized inflammation SO JOURNAL OF NEUROIMMUNOLOGY LA English DT Article DE glossopharyngeal nerve transection; lipopolysaccharide; interleukin-1 beta; interleukin-1ra; corticosterone; soft palate; rat ID INTERLEUKIN-1 RECEPTOR ANTAGONIST; TO-BRAIN COMMUNICATION; FETAL ALCOHOL EXPOSURE; INTRAPERITONEAL LIPOPOLYSACCHARIDE; CIRCULATING PYROGENS; FEBRILE RESPONSE; INDUCED FEVER; VAGUS NERVE; IMMUNE; VAGOTOMY AB Bilateral transection of the glossopharyngeal nerves (GLOx) disrupts the immune-to-brain communication from the posterior oral cavity. The current report tested whether this effect is due to the afferent (sensory) or efferent (parasympathetic motor) components of the nerve. Injection of lipopolysaccharide (LPS) into the soft palate (ISP) of GLOx or sham-operated (SHAM) rats increased the circulating levels of interleukin-1beta (IL-1beta), interleukin-1 receptor antagonist (IL-1ra) and corticosterone (CORT), as well the hypothalamic content of IL-1beta; no difference in circulating levels and hypothalamic content was found between GLOx and SHAM at 2 and 4.5 h after LPS injection. These results indicate that glossopharyngeal neural efferents do not mediate the effects of GLOx on the immune-to-brain communication. (C) 2003 Elsevier Science B.V. All rights reserved. C1 Univ Calif Los Angeles, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Brain Res Inst, David Geffen Sch Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, West Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. RP Romeo, HE (reprint author), Univ Calif Los Angeles, Dept Neurobiol, 10833 Le Conte Ave, Los Angeles, CA 90095 USA. FU NIAAA NIH HHS [AA09850] NR 42 TC 7 Z9 7 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-5728 J9 J NEUROIMMUNOL JI J. Neuroimmunol. PD MAR PY 2003 VL 136 IS 1-2 BP 104 EP 111 DI 10.1016/S0165-5728(0300033-X PG 8 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 660PC UT WOS:000181840700012 PM 12620648 ER PT J AU Clark, DG Mendez, ME Farag, E Vinters, HV AF Clark, DG Mendez, ME Farag, E Vinters, HV TI Clinicopathologic case report: Progressive aphasia in a 77-year-old man SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID ALZHEIMERS-DISEASE; PICKS DISEASE; LANGUAGE; DEMENTIA; PATHOLOGY; FEATURES; ATROPHY C1 Univ Calif Los Angeles, Dept Neurol, Med Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Med Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Pathol & Lab Med Neuropathol, Med Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Brain Res Inst & Neuropsychiat Inst, Med Ctr, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Mendez, ME (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIA NIH HHS [P50-AG-16570]; PHS HHS [T32-N507356] NR 26 TC 7 Z9 7 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SPR PY 2003 VL 15 IS 2 BP 231 EP 238 DI 10.1176/appi.neuropsych.15.2.231 PG 8 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 672VQ UT WOS:000182544000016 PM 12724467 ER PT J AU Assal, F Mendez, MF AF Assal, F Mendez, MF TI Intermetamorphosis in a patient with Alzheimer's disease SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Letter ID MISIDENTIFICATION C1 VA Greater Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Alzheimers Dis Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, VA Greater Los Angeles Neurobehav Unit, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Neurol & Psychiat, Los Angeles, CA USA. RP Assal, F (reprint author), VA Greater Los Angeles, Los Angeles, CA USA. NR 5 TC 3 Z9 3 U1 0 U2 1 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SPR PY 2003 VL 15 IS 2 BP 246 EP 247 DI 10.1176/appi.neuropsych.15.2.246 PG 2 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 672VQ UT WOS:000182544000023 PM 12724474 ER PT J AU Long, Y Zou, LL Liu, H Lu, H Yuan, XQ Robertson, CS Yang, KY AF Long, Y Zou, LL Liu, H Lu, H Yuan, XQ Robertson, CS Yang, KY TI Altered expression of randomly selected genes in mouse hippocampus after traumatic brain injury SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE microarray; hippocampus; gene expression; brain; trauma ID CORTICAL IMPACT INJURY; SERINE-PROTEASE INHIBITORS; PLATELET-ACTIVATING-FACTOR; CENTRAL-NERVOUS-SYSTEM; MESSENGER-RNA; CELL-DEATH; RAT-BRAIN; MICROARRAY ANALYSIS; KINASE-C; UTEROGLOBIN AB Using a cDNA microarray method, we analyzed gene expression profiles in mouse hippocampus after traumatic brain injury (TBI). Of 6,400 randomly selected arrayed genes and expressed sequence tags from a mouse cDNA library, 253 were found to be differentially expressed (106 increased and 147 decreased). Genes involved in cell homeostasis and calcium signaling were primarily up-regulated while those encoding mitochondrial enzymes, metabolic molecules, and structural proteins were predominantly down-regulated. Equal numbers of genes related to inflammatory reactions showed increased or decreased expression. Importantly, a large proportion of the dysregulated genes we identified have not been reported as differentially expressed in TBI models. Semiquantitative reverse-transcriptase polymerase chain reaction (RT-PCR) analyses of representative genes confirmed the validity of the corresponding microarray findings. Thus, our microarray-based evaluation of gene expression in traumatically injured hippocampus identified both known and novel genes that respond to TBI. Further investigation of these candidate molecules may suggest new ways to attenuate the traumatic effects of brain injury. (C) 2002 Wiley-Liss, Inc. C1 Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA. Baylor Coll Med, Ctr Cell & Gene Therapy, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. PADRECC, Neurol Care Line, VA Med Ctr, Houston, TX USA. RP Yang, KY (reprint author), Baylor Coll Med, Dept Neurosurg, 1 Baylor Plaza, Houston, TX 77030 USA. FU NINDS NIH HHS [P01-NS38660, R01-NS35502-04] NR 48 TC 51 Z9 56 U1 1 U2 2 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD MAR 1 PY 2003 VL 71 IS 5 BP 710 EP 720 DI 10.1002/jnr.10524 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 650CK UT WOS:000181244700010 PM 12584729 ER PT J AU Hussein, MR Haemel, AK Wood, GS AF Hussein, MR Haemel, AK Wood, GS TI Apoptosis and melanoma: molecular mechanisms SO JOURNAL OF PATHOLOGY LA English DT Review DE pro-apoptotic molecules; anti-apoptotic molecules; CMM; cutaneous malignant melanoma; programmed cell death ID NF-KAPPA-B; TRAIL-INDUCED APOPTOSIS; ANTISENSE OLIGODEOXYNUCLEOTIDES ENHANCE; CUTANEOUS MALIGNANT-MELANOMA; LIGAND-INDUCED APOPTOSIS; CYTOCHROME-C RELEASE; UV-INDUCED APOPTOSIS; HAMSTER OVARY CELLS; P53 GENE MUTATION; DOWN-REGULATION AB Melanoma cells can undergo self-destruction via programmed cell death, i.e. apoptosis. In these tumours, the molecular components of apoptosis include positive (apoptotic) and negative (anti-apoptotic) regulators. The former include p53, Bid, Noxa, PUMA, Bax, TNF, TRAIL, Fas/FasL, PITSLRE, interferons, and c-KIT/SCF. The latter include Bcl-2, Bcl-X-L, Mcl-1, NF-B-K, survivin, livin, and ML-IAP. Alternatively, some molecules such as TRAF-2, c-Myc, endothelins, and integrins may have either pro- or anti-apoptotic effects. Some of these molecules are of potential therapeutic use, such as: (1) p53, which influences resistance to chemotherapy; (2) Mcl-1 and Bcl-X-L, which can override apoptosis; (3) TRAIL, which has selective fatal effects on tumour cells; (4) NF-B-K, which when downregulated sensitizes cells to TRAIL and TNF; (5) the PITSLRE kinases, whose alteration appears to result in Fas resistance; (6) interferons, which sensitize cells to other factors; and (7) survivin and other IAPs that inhibit apoptosis. This review summarizes the state of current knowledge about the key molecular components and mechanisms of apoptosis in melanoma, discusses potential therapeutic ramifications, and provides directions for future research. Copyright (C) 2003 John Wiley Sons, Ltd. C1 Univ Wisconsin, Dept Dermatol, Madison, WI 53715 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 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 121 TC 145 Z9 158 U1 0 U2 6 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 0022-3417 J9 J PATHOL JI J. Pathol. PD MAR PY 2003 VL 199 IS 3 BP 275 EP 288 DI 10.1002/path.1300 PG 14 WC Oncology; Pathology SC Oncology; Pathology GA 651YA UT WOS:000181350100001 PM 12579529 ER PT J AU Mukhin, YV Garnovsky, EA Ullian, ME Garnovskaya, MN AF Mukhin, YV Garnovsky, EA Ullian, ME Garnovskaya, MN TI Bradykinin B2 receptor activates extracellular signal-regulated protein kinase in mIMCD-3 cells via epidermal growth factor receptor transactivation SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID SMOOTH-MUSCLE CELLS; EGF RECEPTOR; COUPLED RECEPTORS; ANGIOTENSIN-II; MESANGIAL CELLS; LYSOPHOSPHATIDIC ACID; COLLECTING DUCT; PATHWAY; MAPK; PYK2 AB Bradykinin (BK) has been implicated in the regulation of renal function. Activation of extracellular signal-regulated protein kinase (ERK1/2) has been demonstrated in several models of toxic or proliferative renal injury. We studied activation of ERK1/2 by BK in a cell model of the most distal part of the nephron, inner medullary collecting duct (mIMCD-3) cells. Exposure of mIMCD-3 cells to BK (10(-10)-10(-5) M) resulted in a concentration-dependent increase in tyrosine phosphorylation of ERK1/2, with maximal effect at 10(-8) M BK. ERK1/2 activation by BK was observed as early as 1 min, peaked at 5 min, and was sustained at least for 1 h. The effect of BK was mediated by the B-2 receptor and was pertussis toxin-independent. Inhibition of phospholipase C, protein kinase C, or phosphatidylinositol 3-kinase did not alter ERK1/2 activation by BK. BK-induced ERK1/2 activation was Ca2+-calmodulin-independent but was sensitive to genistein, an inhibitor of tyrosine kinase(s). AG1478, a specific inhibitor of epidermal growth factor receptor (EGFR) kinase, completely blocked the effect of BK, suggesting an essential role of EGFR in ERK1/2 activation by BK. Immunoprecipitation/ Western blot studies revealed that BK stimulated tyrosine phosphorylation of EGFR, its association with an adapter molecule Grb2, and complex formation between Grb2 and the adapter protein Shc. Activation studies of monomeric G protein Ras showed that BK-induced stimulation of Ras was dependent on EGFR tyrosine kinase activity. These studies demonstrate that BK stimulates Ras-dependent activation of ERK1/2 in mIMCD-3 cells via transactivation of EGFR through a novel mechanism. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Med Serv, Charleston, SC USA. Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC USA. RP Garnovskaya, MN (reprint author), Med Univ S Carolina, Dept Med, Div Nephrol, Room 829 CSB,171 Ashley Ave, Charleston, SC 29425 USA. FU NIDDK NIH HHS [K01-DK02694] NR 40 TC 25 Z9 26 U1 0 U2 0 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0022-3565 J9 J PHARMACOL EXP THER JI J. Pharmacol. Exp. Ther. PD MAR PY 2003 VL 304 IS 3 BP 968 EP 977 DI 10.1124/jpet.102.043943 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 648XP UT WOS:000181176900009 PM 12604671 ER PT J AU Rasmussen, DD Marck, BT Boldt, BM Yellon, SM Matsumoto, AM AF Rasmussen, DD Marck, BT Boldt, BM Yellon, SM Matsumoto, AM TI Suppression of hypothalamic pro-opiomelanocortin (POMC) gene expression by daily melatonin supplementation in aging rats SO JOURNAL OF PINEAL RESEARCH LA English DT Article DE aging; gene expression; hypothalamus; melatonin; POMC; proopiomelanocortin; mRNA ID PROOPIOMELANOCORTIN MESSENGER-RNA; AGE-RELATED-CHANGES; ARCUATE NUCLEUS; OVARIECTOMIZED RATS; RIBONUCLEIC-ACID; DIURNAL RHYTHM; PLASMA LEPTIN; PINEAL-GLAND; LONG-TERM; LIGHT AB Both plasma melatonin levels and hypothalamic arcuate nucleus pro-opiomelanocortin (POMC) (biosynthetic precursor to the endogenous opioid ss-endorphin and other opiomelanocortins) mRNA content decrease with aging. To test whether the decline in melatonin is responsible for the decline in POMC mRNA, we investigated the effects of daily melatonin treatment on hypothalamic POMC mRNA content in middle-aged and older Sprague-Dawley rats. Daily nocturnal melatonin treatment (50 mug kg bw(-1) night(-1) , in the night-time drinking water) for 7 months, starting at 13 months of age, did not significantly alter female arcuate nucleus POMC mRNA content determined at the end of the light period (i.e., before nightly melatonin administration), but suppressed (24%, P < 0.05) POMC mRNA content at the end of the dark period (i.e., following melatonin administration). Likewise, nocturnal administration of 50 or 500 mug melatonin kg bw(-1) night(-1) to male rats for 7 months suppressed (31 or 28%, respectively; P < 0.05) POMC mRNA content at the middle of the dark period at 20 months of age. Finally, 10 wk administration of 30 mug melatonin kg bw(-1) day(-1) suppressed (31%, P < 0.01) POMC mRNA content in middle-aged male rats killed at the end of the dark period. Melatonin treatments did not significantly alter estradiol or testosterone levels. Thus, moderate-dosage nocturnal melatonin supplementation suppressed nocturnal hypothalamic POMC gene expression in both middle-aged males and females, suggesting that melatonin supplementation during aging decreases, rather than increases, forebrain opiomelanocortinergic activity. These POMC responses were apparently not dependent on gonadal steroid responses and did not become refractory to melatonin treatment maintained until old age. C1 VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Ctr Geriatr Res Educ & Clin, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA USA. Loma Linda Univ, Dept Physiol, Loma Linda, CA 92350 USA. RP Rasmussen, DD (reprint author), VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, 116 MIRECC,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIAAA NIH HHS [AA10567] NR 34 TC 8 Z9 8 U1 0 U2 0 PU BLACKWELL MUNKSGAARD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 0742-3098 J9 J PINEAL RES JI J. Pineal Res. PD MAR PY 2003 VL 34 IS 2 BP 127 EP 133 DI 10.1034/j.1600-079X.2003.00019.x PG 7 WC Endocrinology & Metabolism; Neurosciences; Physiology SC Endocrinology & Metabolism; Neurosciences & Neurology; Physiology GA 641JM UT WOS:000180741700007 PM 12562504 ER PT J AU Goldman, RJ Reinbold, KA Iglarsh, A Neustadter, LM Oatis, CA Schumacher, HR AF Goldman, RJ Reinbold, KA Iglarsh, A Neustadter, LM Oatis, CA Schumacher, HR TI Phase I design and evaluation of an isometric muscle reeducation device for knee osteoarthritis rehabilitation SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE biofeedback device; isometric exercise; muscle reeducation; osteoarthritis of the knee; patient compliance ID RANDOMIZED CONTROLLED TRIAL; EXERCISE THERAPY; OSTEO-ARTHRITIS; CLINICAL-TRIAL; PRESSURE; STRENGTH; HIP; AGE; PROGRAM; TORQUE AB Our long-term goal is to improve adherence to a home-based isometric program for rehabilitation of knee osteoarthritis (OA) using a force-biofeedback device (Isopad(TM)). Our goal for Phase I was to design and evaluate an Isopad-based program in a supervised clinical setting. Our subjects were five patients with knee OA of Kellgren stage II or greater. A capacitive force sensor was tested for accuracy, repeatability, and durability. An Arthritis Foundation home-based isometric program inspired the Isopad design. The Isopad provided visual and auditory feedback instantaneously and continuously about force generated between the ankles. The five subjects completed a supervised 8-week progressive isometric program using the Isopad. Absolute isolated quadriceps and hamstring torques were quantified with a dynamometer, and patients completed a self-assessment of symptoms (Western Ontario and McMaster Universities Osteoarthritis Index). The capacitive sensor accuracy error averaged 10% and repeatability 4%. Cognitively intact subjects used the Isopad successfully for isometric progressive resistance training. Quadriceps and hamstrings absolute torques increased an average of 30%. Patients reported decreased functional complaints (Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index). All changes were trends. The Isopad helped subjects with knee OA adhere to a supervised isometric program and meet progressive strength targets. The next-generation Isopad will be employed in a home-based program. C1 SensorPad Syst Inc, Norristown, PA USA. Univ Sci Philadelphia, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Arcadia Univ, Glenside, PA USA. RP Goldman, RJ (reprint author), SensorPad Syst Inc, 527 W Sedgwick St, Philadelphia, PA USA. FU NIAMS NIH HHS [1 R43 AR45153-01] NR 47 TC 1 Z9 1 U1 1 U2 3 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 MAR-APR PY 2003 VL 40 IS 2 BP 95 EP 107 DI 10.1682/JRRD.2003.03.0095 PG 13 WC Rehabilitation SC Rehabilitation GA 674DU UT WOS:000182622400002 PM 15077636 ER PT J AU Hsu, FC Starkebaum, G Boyko, EJ Dominitz, JA AF Hsu, FC Starkebaum, G Boyko, EJ Dominitz, JA TI Prevalence of rheumatoid arthritis and hepatitis C in those age 60 and older in a US population based study SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE hepatitis C virus; rheumatoid arthritis; rheumatoid factor ID VIRUS-INFECTION; UNITED-STATES; AUTOIMMUNITY; DISEASE AB Objective. A positive association between rheumatoid arthritis (RA) and hepatitis C virus (HCV) infection has been reported in clinic based cross sectional studies. We investigated if RA and HCV are associated in a population based survey. Methods. Using data from the National Health and Nutrition Examination Survey III, hepatitis C and RA status were determined for subjects greater than or equal to 60 years of age. RA was defined to be present when 3 of 6 American College of Rheumatology (ACR) criteria were met. Results. Of 6596 subjects, 1827 (27.7%) were excluded due to missing data. Of the remaining 4769, 196 subjects (4.1%) met our modified ACR criteria for probable RA: 63 tested positive for anti-HCV antibodies (1.3%) while 35 were HCV RNA positive (0.7%). Two subjects had both HCV antibodies and RA, while one subject was both HCV RNA positive and had RA. HCV antibody positivity was not associated with RA (OR 0.44, 95% Cl 0.07-2.80). Similarly, HCV positivity by polymerase chain reaction was not associated with RA (OR 0.77, 95% Cl 0.10-6.19). Conclusion. These results argue against a potential role for HCV in the etiology of RA in the US population aged 60 years and over. C1 VA Puget Sound Hlth Care Syst, Arthrit Sect, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Gastroenterol Sect, Seattle, WA 98108 USA. Univ Washington, Sch Med,VA Puget Sound Hlth Care Syst, Seattle Epidemiol Res & Informat Ctr, Dept Med,Div Gen Internal Med, Seattle, WA USA. Univ Washington, Sch Med, Div Rheumatol, Dept Med, Seattle, WA 98195 USA. RP Dominitz, JA (reprint author), VA Puget Sound Hlth Care Syst, Arthrit Sect, 111 Gastro,1660 S Columbian Way, Seattle, WA 98108 USA. OI Dominitz, Jason/0000-0002-8070-7086; Boyko, Edward/0000-0002-3695-192X NR 18 TC 13 Z9 14 U1 2 U2 2 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 2003 VL 30 IS 3 BP 455 EP 458 PG 4 WC Rheumatology SC Rheumatology GA 652GU UT WOS:000181372100007 PM 12610800 ER PT J AU O'Malley, KJ Suarez-Almazor, M Aniol, J Richardson, P Kuykendall, DH Moseley, JB Wray, NP AF O'Malley, KJ Suarez-Almazor, M Aniol, J Richardson, P Kuykendall, DH Moseley, JB Wray, NP TI Joint-specific multidimensional assessment of pain (J-MAP): Factor structure, reliability, validity, and responsiveness in patients with knee osteoarthritis SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE joint pain; outcome measure; osteoarthritis; validity; equal interval scaling ID QUALITY-OF-LIFE; HEALTH-STATUS; INTRAINDIVIDUAL CHANGES; RHEUMATOID-ARTHRITIS; IMPORTANT DIFFERENCE; WESTERN ONTARIO; WOMAC; QUESTIONNAIRE; SCALE; INDEX AB Objective. To develop a reliable and valid instrument for measuring and monitoring joint-specific pain. Methods. Developed using patient interviews, reviews of pain literature, and expert input from orthopedic surgeons, the final Joint-Specific Multidimensional Assessment of Pain (J-MAP) includes the 6-item Pain Sensory and the 4-item Pain Affect subscales. Scores on the J-MAP Pain Sensory and Affect subscales range from 0 to 100, with higher scores indicating more pain intensity and worse pain distastefulness; respectively. Following the assessment of the factor structure, patients' scores (n = 180) on the J-MAP subscales were converted to equal interval scores using Rasch analyses. A psychometric evaluation of the items and Rasch-calibrated scores was conducted and included an assessment of reliability, validity, and responsiveness for use with patients with radiographic knee osteoarthritis. Results. Evidence from the factor analyses showed that the J-MAP Pain Sensory and Affect items made up 2 distinct factors. Internal consistency estimates for the J-MAP subscales exceeded 0.85. The J-MAP subscales showed evidence for validity and were shown to be internally and externally responsive, demonstrating greater responsiveness than the Arthritis Impact Measurement Scale or the Medical Outcome Study Short Form-36 pain subscales. Finally, evidence was found supporting the J-MAP subscales' ability to distinguish target joint pain from pain emanating from other musculoskeletal conditions. Conclusion. The J-MAP is a reliable, valid, and responsive measure for assessing joint-specific pain at a single time point, or changes over time for one or a group of patients with knee osteoarthritis. With this initial evidence of its psychometric rigor, further testing of the measurement properties of the J-MAP in other joints and in other populations should be undertaken. C1 Baylor Coll Med, VAMC 152, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Houston VAMC, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Int Survey Res, London, England. Baylor Coll Med, Dept Orthoped Surg, Houston, TX 77030 USA. RP O'Malley, KJ (reprint author), Baylor Coll Med, VAMC 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 67 TC 11 Z9 11 U1 11 U2 12 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 2003 VL 30 IS 3 BP 534 EP 543 PG 10 WC Rheumatology SC Rheumatology GA 652GU UT WOS:000181372100021 PM 12610814 ER PT J AU Guihan, M Simmons, B Nelson, A Bosshart, HT Burns, SP AF Guihan, M Simmons, B Nelson, A Bosshart, HT Burns, SP TI Spinal cord injury providers' perceptions of barriers to implementing selected clinical practice guideline recommendations SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article; Proceedings Paper CT Annual Conference of the American-Paraplegia-Society CY SEP, 2002 CL LAS VEGAS, NEVADA SP Amer Paraplegia Soc DE clinical practice guideline; spinal cord injuries; rehabilitation; thromboembolism; neurogenic bowel; quality enhancement research initiative; health services research; health care outcomes; focus groups AB Background/Objective: Twelve focus groups were conducted at 6 Department of Veterans Affairs (DVA) Spinal Cord Injury (SCI) Centers. The purpose of these focus groups was to identify provider-perceived barriers to implementing selected recommendations of two clinical practice guidelines (CPGs)-Prevention of Thromboembolism in Spinal Cord Injury and Management of Neurogenic Bowel in Adults With Spinal Cord Injury-at their sites. Methods: A total of 75 SCI direct-care staff (including physicians, nurses, dieticians, rehabilitation therapists, psychologists, and social workers) participated in the focus groups, which were conducted by trained focus group facilitators. Woolf's framework was used to classify perceived barriers into I of 4 categories: (a) lack of knowledge, (b) lack of agreement, (c) lack of ability, or (d) lack of systematic reminders for implementation. The "lack of ability" category was further expanded to reflect which specific aspect of the environment was seen as the obstacle: (a) patient, (b) provider, (c) SCI unit, (d) hospital or medical center, or (e) non-Veterans Affairs (VA) hospital setting. Results: Providers disagreed with the recommendation to reinstitute prophylaxis in patients with nonacute SCI to prevent deep vein thrombosis and identified a number of system-level problems with providing appropriate prophylaxis. Providers identified patient reluctance to changing their bowel programs and difficulties in documenting changes in the patients' bowel program as obstacles to implementing the neurogenic bowel CPG. Conclusion: Based on this feedback, interventions were developed to address provider-perceived barriers. These interventions were implemented at 6 Veterans Affairs SCI Centers. C1 Edward Hines Jr Vet Adm Hosp, Midwest Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. Edward Hines Jr Vet Adm Hosp, Spinal Cord Injury Qual Enhancement Res Initiat R, Hines, IL USA. Northwestern Univ, Inst Hlth Serv Res & Policy Studies, Evanston, IL USA. Tampa Vet Affairs Med Ctr, Tampa, FL USA. Vet Hlth Adm, Patient Safety Ctr Inquiry, Tampa, FL USA. Tampa Vet Affairs Med Ctr, Tampa, FL USA. Univ S Florida, Coll Nursing, Tampa, FL USA. Augusta Vet Affairs Med Ctr, Augusta, GA USA. Vet Affairs Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Guihan, M (reprint author), Edward Hines Jr Vet Adm Hosp, Midwest Ctr Hlth Serv & Policy Res, 151H,5th Ave & Roosevelt Rd, Hines, IL 60141 USA. NR 28 TC 5 Z9 5 U1 0 U2 0 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. PD SPR PY 2003 VL 26 IS 1 BP 48 EP 58 PG 11 WC Clinical Neurology SC Neurosciences & Neurology GA 739PG UT WOS:000186355200011 PM 12830970 ER PT J AU Komar, JC James, JJ Little, JW AF Komar, JC James, JJ Little, JW TI Scheuermann's kyphosis following cervical spinal cord injury SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE Scheuermann's kyphosis; spinal cord injuries; rehabilitation; neurologic complications; tetraplegia ID COMPRESSION AB Background: Scheuermann's kyphosis is an uncommon autosomal dominant disease that manifests as a progressive thoracic skeletal deformity. It can lead to severe restrictive lung disease or predispose to spinal cord injury (SCI). Neurologic sequelae are rarely reported in the literature. Method: Case Presentation Summary: A 47-year-old man sustained a cervical SCI requiring surgical anterior fusion and reoperation for fracture of the affected vertebra. One year after SCI, he presented with further kyphotic progression and cervical spine instability. Clinical presentation and family history led to a diagnosis of Scheuermann's kyphosis. To prevent further progression, he underwent extensive multilevel anterior and posterior surgical stabilization. Conclusion: This case illustrates the importance of early diagnosis and treatment of progressive spinal deformities. With proper surgical correction, this patient made substantial gains in mobility, self-care, and respiratory status. C1 Univ Washington, Dept Rehabil Med, VA Puget Sound Hlth Care Syst, Spinal Cord Injury Unit, Seattle, WA 98195 USA. RP Komar, JC (reprint author), Univ Washington, Dept Rehabil Med, VA Puget Sound Hlth Care Syst, Spinal Cord Injury Unit, 1959 NE Pacific St,Box 356490, Seattle, WA 98195 USA. NR 7 TC 1 Z9 2 U1 0 U2 0 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. PD SPR PY 2003 VL 26 IS 1 BP 92 EP 94 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 739PG UT WOS:000186355200017 PM 12830976 ER PT J AU Bates-Jensen, BM Alessi, CA Al-Samarrai, NR Schnelle, JF AF Bates-Jensen, BM Alessi, CA Al-Samarrai, NR Schnelle, JF TI The effects of an exercise and incontinence intervention on skin health outcomes in nursing home residents SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE pressure ulcer prevention; exercise; incontinence ID PRESSURE ULCER DEVELOPMENT; RISK-FACTORS; PREVENTIVE INTERVENTIONS; NIGHTTIME INCONTINENCE; HOSPITALIZED-PATIENTS; SORES; CARE AB OBJECTIVES: To examine skin health outcomes of an exercise and incontinence intervention. DESIGN: Randomized controlled trial with blinded assessments of outcomes at three points over 8 months. SETTING: Four nursing homes (NHs). PARTICIPANTS: One hundred ninety incontinent NH residents. INTERVENTION: In the intervention group, research staff provided exercise and incontinence care every 2 hours from 8:00 a.m. to 4:30 p.m. (total of four daily care episodes) 5 days a week for 32 weeks. The control group received usual care from NH staff. MEASUREMENTS: Perineal skin wetness and skin health outcomes (primarily blanchable erythema and pressure ulcers) as measured by direct assessments by research staff, urinary and fecal incontinence frequency, and percentage of behavioral observations with resident engaged in standing or walking. RESULTS: Intervention subjects were significantly better in urinary and fecal incontinence, physical activity, and skin wetness outcome measures than the control group. However, despite these improvements, differences in skin health measures were limited to the back distal perineal area, which included the sacral and trochanter regions. There was no difference between groups in the incidence rate of pressure ulcers as measured by research staff, even though those residents who improved the most on fecal incontinence showed improvement in pressure ulcers in one area. CONCLUSION: A multifaceted intervention improved four risk factors related to skin health but did not translate into significant improvements in most measures of skin health. Even if they had adequate staffing resources, NHs might not be able to improve skin health quality indicators significantly if they attempt to implement preventive interventions on all residents who are judged at risk because of their incontinence status. C1 Univ Calif Los Angeles, Jewish Home Borun Ctr, Sch Med, Div Geriatr, Reseda, CA 91335 USA. Univ Calif Los Angeles, Jewish Home Aging Borun Ctr Gerontol Res, Reseda, CA 91335 USA. Univ Calif Los Angeles, Multicampus Program Geriatr Med & Gerontol, Sepulveda, CA USA. Sepulveda Geriatr Res Educ & Clin Ctr, Vet Adm Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. RP Bates-Jensen, BM (reprint author), Univ Calif Los Angeles, Jewish Home Borun Ctr, Sch Med, Div Geriatr, 7150 Tampa Ave, Reseda, CA 91335 USA. FU NIA NIH HHS [AG 10415, AG 13013] NR 40 TC 36 Z9 36 U1 3 U2 7 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 2003 VL 51 IS 3 BP 348 EP 355 DI 10.1046/j.1532-5415.2003.51108.x PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 646GW UT WOS:000181028100008 PM 12588578 ER PT J AU Satre, DD Knight, BG Dickson-Fuhrmann, E Jarvik, LF AF Satre, DD Knight, BG Dickson-Fuhrmann, E Jarvik, LF TI Predictors of alcohol-treatment seeking in a sample of older veterans in the GET SMART program SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE alcohol; substance abuse treatment; structural equation modeling ID CAGE QUESTIONNAIRE; ABUSE; DIAGNOSIS; CARE AB OBJECTIVES: To examine the predictive value of demographic characteristics and substance abuse indicators to explain treatment seeking for substance abuse problems by older male medical patients. DESIGN: Longitudinal analysis of screening data and treatment-seeking behavior. SETTING: Inpatient medical and outpatient substance abuse treatment center. PARTICIPANTS: Participants in the study were 855 medically ill male veterans aged 55 and older, who were screened for alcohol problems during inpatient medical treatment after clinician referral. MEASUREMENTS: The CAGE alcohol screen (Cut down on your drinking, Annoyed by criticism of your drinking, Guilty about your drinking, Eye-opener), drug use, and demographic measures administered at time of screening. Predictors of treatment seeking in the sample were examined using structural equation modeling. RESULTS: Expressed interest in treatment and later attendance at a pretreatment evaluation were associated with younger age and a higher CAGE alcohol screening score. Being unmarried and using drugs in addition to alcohol were associated with treatment interest but not with evaluation attendance. In the path model tested, the effect of higher CAGE score partially explained the effect of younger age on treatment seeking. CONCLUSION: The model examined shows utility in predicting alcohol-treatment seeking in this sample. Age-related factors may deter treatment seeking by older male medical inpatients. C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. Univ So Calif, Andrus Gerontol Ctr, Los Angeles, CA USA. Va Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Satre, DD (reprint author), Univ Calif San Francisco, 401 Parnassus Ave,Box 0984-OVS, San Francisco, CA 94143 USA. FU NIA NIH HHS [2T32 AG 00037] NR 29 TC 13 Z9 13 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 MAR PY 2003 VL 51 IS 3 BP 380 EP 386 DI 10.1046/j.1532-5415.2003.51112.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 646GW UT WOS:000181028100012 PM 12588582 ER PT J AU Jacobson, AF Williams, JE AF Jacobson, AF Williams, JE TI Bone scintigraphic findings in patients with foot ulcers and normal plain film radiographs SO JOURNAL OF THE AMERICAN PODIATRIC MEDICAL ASSOCIATION LA English DT Article ID DIABETIC-PATIENTS; PEDAL OSTEOMYELITIS; LEUKOCYTE SCINTIGRAPHY; TC-99M MDP; DIAGNOSIS; IN-111; MR; INFECTION; ABNORMALITIES; THERAPY AB A prospective study was performed to examine the performance of bone scintigraphy in the earliest stage of soft-tissue foot ulceration with potential risk for progression to osteomyelitis. Twenty-three podiatry clinic patients with new or recurrent foot ulcers but negative plain film radiographs of the foot underwent 24 (one patient was studied twice) multiphase bone scans (flow, blood pool, and 3- and 24-hour delayed images) that were visually scored for severity of increased uptake on a scale of 0 to 3+, with 0 indicating normal and 3+ indicating severe. Twenty-one scans (88%) showed abnormal uptake on at least one phase, with 17 (71%) having increased bone uptake on late images. Ulcer healing without complications occurred in 20 cases (83%), whereas 4 cases had adverse outcomes, 3 requiring surgical resection for failure to heal and 1 having radiographic progression to frank osteomyelitis. All three patients whose bone scans showed severe abnormal uptake had an adverse clinical outcome. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA USA. RP Jacobson, AF (reprint author), Amersham Hlth, 101 Carnegie Ctr, Princeton, NJ 08540 USA. NR 25 TC 1 Z9 1 U1 0 U2 1 PU AMER PODIATRIC MED ASSN PI BETHESDA PA 9312 OLD GEORGETOWN ROAD, BETHESDA, MD 20814-1621 USA SN 8750-7315 J9 J AM PODIAT MED ASSN JI J. Am. Podiatr. Med. Assoc. PD MAR-APR PY 2003 VL 93 IS 2 BP 91 EP 96 PG 6 WC Orthopedics SC Orthopedics GA 722DC UT WOS:000185359300001 PM 12644514 ER PT J AU Takahashi, TA Merrill, JO Boyko, EJ Bradley, KA AF Takahashi, TA Merrill, JO Boyko, EJ Bradley, KA TI Type and location of injection drug use-related soft tissue infections predict hospitalization SO JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE LA English DT Article DE abscess; cellulitis; health care utilization; injection drug use; soft tissue infection ID NECROTIZING FASCIITIS; MEDICAL-CARE; EMERGENCY; ABUSE; COSTS; ACCIDENT; CHARGES AB The prevalence of soft tissue infections (abscesses, cellulitides, infected ulcers) among injection drug users (IDUs) is estimated to be between 21% and 32%. Little is known regarding the health care utilization associated with these infections. This study describes IDUs seeking emergency department (ED) care for soft tissue infections, their inpatient health care utilization, including operating room procedures, and the types and locations of infections associated with increased inpatient health care utilization. This study used a medical record case series of all ID Us seeking initial care for soft tissue infections at an urban, public emergency department from November 1999 through April 2000. Initial care for IDU-related soft tissue infections was sought by 242 patients. Most were male (63.6%), Caucasian (69.4%) and without health insurance (S2.0%), and most bad abscesses (72.3%). All patients with only cellulitis bad arm or leg infections, while most abscesses were arm, deltoid, or buttock infections (81.1%). Forty percent of the patients were hospitalized, and 44.3 % of the hospitalizations were for 3 or more days. Patients with only cellulitis were more likely to be hospitalized compared to those with abscesses. Among those with abscesses, deltoid abscesses were 5.2 times more likely to receive an operating room procedure compared to other abscess locations. IDUs with cellulitis and deltoid abscesses commonly required inpatient care and operating room procedures. The morbidity associated with such infections and the intensive use of hospital services needed to treat these infections provide strong rationale for the development of preventive interventions and improved care for this neglected clinical problem. C1 VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Takahashi, TA (reprint author), VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, 1660 S Columbian Way.S-111-GIMC, Seattle, WA 98108 USA. OI Boyko, Edward/0000-0002-3695-192X FU NIAAA NIH HHS [K23AA00313] NR 24 TC 21 Z9 21 U1 0 U2 1 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1099-3460 J9 J URBAN HEALTH JI J. Urban Health PD MAR PY 2003 VL 80 IS 1 BP 127 EP 136 DI 10.1093/jurban/jtg127 PG 10 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 655KK UT WOS:000181550800014 PM 12612102 ER PT J AU Freedland, SJ Kane, CJ Presti, JC Terris, MK Amling, CL Dorey, F Aronson, WJ AF Freedland, SJ Kane, CJ Presti, JC Terris, MK Amling, CL Dorey, F Aronson, WJ TI Comparison of preoperative prostate specific antigen density and prostate specific antigen for predicting recurrence after radical prostatectomy: Results from the search data base SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; prostatectomy; prostate-specific antigen; tumor markers, biological ID SEXTANT BIOPSIES; EXTRACAPSULAR EXTENSION; CANCER; PERCENTAGE; PSA AB Purpose: Prostate specific antigen (PSA) density based on the surgical weight of the radical prostatectomy specimen has previously been shown to be an independent predictor of biochemical recurrence after radical prostatectomy. We determined whether preoperative PSA density calculated using transrectal ultrasound prostate volume was a better predictor of advanced pathological findings or biochemical recurrence after radical prostatectomy relative to PSA. Materials and Methods: We examined 552 men from the newly established Shared Equal Access Regional Cancer Hospital data base of men treated with radical prostatectomy at equal access medical centers to determine whether preoperative PSA density was a significant predictor of an adverse pathological condition or PSA recurrence after radical prostatectomy. Models using PSA density were compared with models using PSA to determine whether PSA density improved risk stratification relative to PSA. PSA density was examined as a continuous and a categorical variable using cutoffs to separate patients into groups at different risks for PSA failure. Results: PSA density and PSA were significant predictors of adverse pathological findings on univariate analysis. Using PSA density in the multivariate model resulted in slightly better but statistically insignificant improvement in prediction of positive surgical margins (p = 0.134) and extracapsular extension (p = 0.771) relative to using PSA in the model. Neither PSA nor PSA density were significant independent predictors of seminal vesicle invasion. Area under the ROC curves for predicting biochemical recurrence for PSA and PSA density were not significantly different (0.589 and 0.58, respectively, p = 0.691). On separate multivariate analyses PSA density and PSA were significant independent predictors of biochemical failure. The multivariate model using PSA density provided only slight improvement in risk assessment relative to the model using PSA (index C = 0.589 and 0.581, respectively). To determine whether using PSA density as a categorical variable would result in improved prognostication we evaluated PSA density to determine the cutoff points that would provide the greatest risk stratification. PSA density cutoffs of less than 0.4, 0.4 to 1 and greater than 1 ng./ml./cc separated patients into 3 distinct groups at increasing risk for biochemical failure (p < 0.001). While these cutoffs provided better risk stratification than when PSA density was examined as a continuous variable (index C = 0.684 versus 0.58), they provided only marginal improvement relative to the standard PSA cutoffs of less than 10, 10 to 20 and greater than 20 ng./ml. (index C = 0.676). Conclusions: The use of preoperative PSA density relative to PSA provided only slight improvement for predicting adverse pathological findings and biochemical recurrence after radical prostatectomy. The minimal and statistically insignificant improvement in preoperative risk assessment provided by PSA density does not justify the time and effort necessary to calculate this value. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. Univ Calif San Francisco, Dept Urol, Sch Med, San Francisco, CA 94143 USA. Stanford Univ, Sch Med, Dept Urol, Stanford, CA 94305 USA. San Diego Naval Hosp, Dept Urol, San Diego, CA USA. Med Coll Georgia, Div Urol, Augusta, GA 30912 USA. RP Kane, CJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90024 USA. OI Terris, Martha/0000-0002-3843-7270 NR 16 TC 27 Z9 27 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD MAR PY 2003 VL 169 IS 3 BP 969 EP 973 DI 10.1097/01.ju.0000051400.85694.bb PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 644KM UT WOS:000180916500039 PM 12576824 ER PT J AU Zhu, WH Han, JH Nicosia, RF AF Zhu, WH Han, JH Nicosia, RF TI Requisite role of p38 MAPK in mural cell recruitment during angiogenesis in the rat aorta model SO JOURNAL OF VASCULAR RESEARCH LA English DT Article DE angiogenesis; p38 MAPK; mural cells; pericytes; angiopoietin-1 ID ACTIVATED PROTEIN-KINASE; SMOOTH-MUSCLE CELLS; GROWTH-FACTOR; TIE2 RECEPTOR; PDGF-B; ANGIOPOIETIN-1; PERICYTE; DIFFERENTIATION; PROLIFERATION; INHIBITION AB During the early stage of angiogenesis, neovascular sprouts are composed primarily of endothelial cells. As they mature, microvessels acquire a coating of mural cells, which are critical for the development and maintenance of a functional vasculature. Though growth factor regulation of mural cell recruitment has been extensively investigated, the intracellular signaling events involved in this process remain poorly understood. Among the intracellular kinases implicated in angiogenesis, the p38 MAPK has been shown to transduce signals critical for vascular remodeling and maturation. The rat aorta model of angiogenesis was used to further investigate the role of this signaling pathway in the recruitment of mural cells during angiogenesis. The p38 MAPK inhibitor SB203580 selectively blocked mural cell recruitment, resulting in the formation of naked endothelial tubes without mural cells. SB203580 inhibited angiopoietin-1-induced mural cell recruitment without influencing angiopoietin-1-stimulated endothelial sprouting. Adenoviral vector-mediated expression of a dominant negative form of p38 MAPK significantly reduced mural cell recruitment, whereas overexpression of a constitutively activated form of MKK6, an upstream activator of p38 MAPK, increased mural cell number. These results indicate that the p38 MAPK signaling pathway plays a critical role in mural cell recruitment during neovascularization and may represent a therapeutic target in angiogenesis-related disorders. Copyright (C) 2003 S. Karger AG, Basel. C1 VA Puget Sound Hlth Care Syst, Div Pathol & Lab Med, Lab S113, Seattle, WA 98108 USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. Scripps Res Inst, Dept Immunol, La Jolla, CA USA. RP Nicosia, RF (reprint author), VA Puget Sound Hlth Care Syst, Div Pathol & Lab Med, Lab S113, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Han, J/G-4671-2010 FU NHLBI NIH HHS [HL52585] NR 29 TC 26 Z9 26 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1018-1172 J9 J VASC RES JI J. Vasc. Res. PD MAR-APR PY 2003 VL 40 IS 2 BP 140 EP 148 DI 10.1159/000070711 PG 9 WC Physiology; Peripheral Vascular Disease SC Physiology; Cardiovascular System & Cardiology GA 694ZD UT WOS:000183804800007 PM 12808350 ER PT J AU von Lindern, JJ Rojo, D Grovit-Ferbas, K Yeramian, C Deng, C Herbein, G Ferguson, MR Pappas, TC Decker, JM Singh, A Collman, RG O'Brien, WA AF von Lindern, JJ Rojo, D Grovit-Ferbas, K Yeramian, C Deng, C Herbein, G Ferguson, MR Pappas, TC Decker, JM Singh, A Collman, RG O'Brien, WA TI Potential role for CD63 in CCR5-mediated human immunodeficiency virus type 1 infection of macrophages SO JOURNAL OF VIROLOGY LA English DT Article ID CD4(+) T-CELLS; MONONUCLEAR PHAGOCYTES; CHEMOKINE RECEPTORS; MEMBRANE CHOLESTEROL; SYNCYTIUM FORMATION; HIV-1 ENTRY; LIPID RAFTS; IN-VIVO; HLA-DR; FUSION AB Macrophages and CD4(+) lymphocytes are the principal target cells for human immunodeficiency virus type 1 (HIV-1) infection, but the molecular details of infection may differ between these cell types. During studies to identify cellular molecules that could be involved in macrophage infection, we observed inhibition of HIV-1 infection of macrophages by monoclonal antibody (MAb) to the tetraspan transmembrane glycoprotein CD63. Pretreatment of primary macrophages with anti-CD63 MAb, but not MAbs to other macrophage cell surface tetraspanins (CD9, CD81, and CD82), was shown to inhibit infection by several R5 and dualtropic strains, but not by X4 isolates. The block to productive infection was postfusion, as assessed by macrophage cell-cell fusion assays, but was prior to reverse transcription, as determined by quantitative PCR assay for new viral DNA formation. The inhibitory effects of anti-CD63 in primary macrophages could not be explained by changes in the levels of CD4, CCR5, or beta-chemokines. Infections of peripheral blood lymphocytes and certain cell lines were unaffected by treatment with anti-CD63, suggesting that the role of CD63 in HIV-1 infection may be specific for macrophages. C1 Univ Texas, Med Branch, Div Infect Dis, Dept Microbiol & Immunol, Galveston, TX 77555 USA. Univ Texas, Med Branch, Dept Internal Med, Galveston, TX 77555 USA. Univ Texas, Med Branch, Dept Pathol, Galveston, TX 77555 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, AIDS Inst, Los Angeles, CA 90095 USA. Univ Alabama, Howard Hughes Med Inst, Birmingham, AL 35294 USA. Univ Penn, Dept Med, Philadelphia, PA 19104 USA. RP O'Brien, WA (reprint author), Univ Texas, Med Branch, Div Infect Dis, Dept Microbiol & Immunol, 301 Univ Blvd, Galveston, TX 77555 USA. FU NHLBI NIH HHS [R01 HL088999, R01 HL088999-05]; NIAID NIH HHS [T32 AI007388, AI52041, AI35502, T32/AI07388, AI46250, R01 AI052041, R01 AI035502, R56 AI052041]; NINDS NIH HHS [NS27405, P01 NS027405] NR 61 TC 50 Z9 52 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD MAR PY 2003 VL 77 IS 6 BP 3624 EP 3633 DI 10.1128/JVI.77.6.3624-3633.2003 PG 10 WC Virology SC Virology GA 652FZ UT WOS:000181370300029 PM 12610138 ER PT J AU Intano, GW Cho, EJ McMahan, CA Walter, CA AF Intano, GW Cho, EJ McMahan, CA Walter, CA TI Age-related base excision repair activity in mouse brain and liver nuclear extracts SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID DNA-POLYMERASE-BETA; OLD MICE; GENE; EXPRESSION; CELLS; MUTATION; PROTEIN; DAMAGE; SITES; RECONSTITUTION AB To assess DNA repair activity relative to age, in vitro base excision repair assays were performed using brain and liver nuclear extracts prepared from mice of various ages. An 85% decline in repair activity was observed in brain nuclear extracts and a 50% decrease in liver nuclear extracts prepared from old mice compared with 6-day-old mice. Brain nuclear extracts prepared from old mice showed a decreased abundance of DNA polymerase-beta, but the addition of purified protein did not restore base excision repair activity. Abundances of other tested base excision repair proteins did not change relative to age. The conclusion is that, during aging, a decline in DNA repair could contribute to increased levels of DNA damage and mutagenesis. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Audie L Murphy Hosp, S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Walter, CA (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, Mail Code 7762,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIA NIH HHS [AG14674, AG19360, AG00205, AG13560]; NIEHS NIH HHS [ESO9136] NR 44 TC 53 Z9 53 U1 0 U2 3 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD MAR PY 2003 VL 58 IS 3 BP 205 EP 211 PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 653QA UT WOS:000181447200002 PM 12634285 ER PT J AU Schnelle, JF AF Schnelle, JF TI Guest editorial - Improving nursing home quality assessment: Capturing the voice of cognitively impaired elders SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Editorial Material ID RESIDENTS; SATISFACTION; CARE C1 Univ Calif Los Angeles, Dept Med, Div Geriatr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Reseda, CA USA. Jewish Home Aging, Borun Ctr Gerontol Res, Reseda, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Sepulveda Geriatr Res Educ & Clin Ctr, Sepulveda, CA USA. RP Schnelle, JF (reprint author), Univ Calif Los Angeles, Dept Med, Div Geriatr, Los Angeles, CA 90024 USA. NR 11 TC 8 Z9 8 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD MAR PY 2003 VL 58 IS 3 BP 238 EP 239 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 653QA UT WOS:000181447200007 PM 12634290 ER PT J AU Kondo, S Stevens, J AF Kondo, S Stevens, J TI IACUC should "get tough" SO LAB ANIMAL LA English DT Editorial Material C1 Univ Hawaii, Lab Anim Serv, Honolulu, HI 96822 USA. Univ Colorado, Sch Med, Denver, CO USA. Denver VAMC, Denver, CO USA. RP Kondo, S (reprint author), Univ Hawaii, Lab Anim Serv, Honolulu, HI 96822 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU NATURE AMERICA INC PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 0093-7355 J9 LAB ANIMAL JI Lab Anim. PD MAR PY 2003 VL 32 IS 3 BP 21 EP 21 DI 10.1038/laban0303-21 PG 1 WC Veterinary Sciences SC Veterinary Sciences GA 651EX UT WOS:000181308500004 ER PT J AU Berner, ES Baker, CS Funkhouser, E Heudebert, GR Allison, JJ Fargason, CA Li, Q Person, SD Kiefe, CI AF Berner, ES Baker, CS Funkhouser, E Heudebert, GR Allison, JJ Fargason, CA Li, Q Person, SD Kiefe, CI TI Do local opinion leaders augment hospital quality improvement efforts? A randomized trial to promote adherence to unstable angina guidelines SO MEDICAL CARE LA English DT Article DE qpinion leaders; unstable angina; practice guidelines ID CLINICAL-PRACTICE; CARE; PHYSICIANS; INFORMATION; FEEDBACK; MANAGEMENT; DISEASE; IMPACT AB BACKGROUND. The influence of an opinion leader intervention on adherence to Unstable Angina (UA) guidelines compared with a traditional quality improvement model was investigated. RESEARCH DESIGN. A group-randomized controlled trial with 2210 patients from 21 hospitals was designed. There were three intervention arms: (1) no intervention (NI); (2) a traditional Health Care Quality Improvement Program (HCQIP); and (3) a physician opinion leader in addition to the HCQIP model (OL). Quality indicators included: electrocardiogram within 20 minutes, antiplatelet therapy within 24 hours and at discharge, and heparin and beta-blockers during hospitalization. Hospitals could determine the specific indicators they wished to target. Potential cases of UA were identified from Medicare claims data. UA confirmation was determined by a clinical algorithm based on data abstracted from medical records. Data analyses included both hospital level analysis (analysis of variance) and patient level analysis (generalized, linear models). RESULTS. The only statistically significant postintervention difference in percentage compliant was greater improvement for the OL group in the use of antiplatelet therapy at 24 hours in both hospital level (P = 0.01) and patient level analyses (P <0.05) compared with the HCQIP and NI groups. When analyses were confined to hospitals that targeted specific indicators, compared with the HCQIP hospitals, the OL hospitals showed significantly greater change in percentage compliant postintervention in both antiplatelet therapy during the first 24 hours (20.2% vs. -3.9%, P = 0.02) and heparin (31.0% vs.9.1%, P = 0.05). CONCLUSIONS. The influence of physician opinion leaders was unequivocally positive for only one of five quality indicators. To maximize adherence to best practices through physician opinion leaders, more research on how these physicians influence health care delivery in their organizations will be required. C1 Univ Alabama, Sch Hlth Related Profess, Hlth Serv Adm Dept, Birmingham, AL 35294 USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL 35294 USA. Univ Alabama, Div Gen Internal Med, Birmingham, AL 35294 USA. Univ Alabama, Div Prevent Med, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Sch Med, Dept Pediat, Birmingham, AL 35294 USA. Univ Alabama, Sch Publ Hlth, Dept Epidemiol, Birmingham, AL 35294 USA. Univ Alabama, Sch Publ Hlth, Dept Hlth Care Org & Policy, Birmingham, AL 35294 USA. Univ Alabama, Birmingham Vet Affairs Med Ctr, Birmingham, AL 35294 USA. RP Berner, ES (reprint author), Univ Alabama, Sch Hlth Related Profess, Hlth Serv Adm Dept, 1530 3rd Ave S,WEBB 544, Birmingham, AL 35294 USA. OI Allison, Jeroan/0000-0003-4472-2112; Berner, Eta/0000-0003-4319-2949 NR 38 TC 45 Z9 45 U1 5 U2 5 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 MAR PY 2003 VL 41 IS 3 BP 420 EP 431 DI 10.1097/00005650-200303000-00010 PG 12 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 653EQ UT WOS:000181422600010 PM 12618645 ER PT J AU Weisbart, RH Yang, FS Chan, G Wakelin, R Ferreri, K Zack, DJ Harrison, B Leinwand, LA Cole, GM AF Weisbart, RH Yang, FS Chan, G Wakelin, R Ferreri, K Zack, DJ Harrison, B Leinwand, LA Cole, GM TI Cell type specific targeted intracellular delivery into muscle of a monoclonal antibody that binds myosin IIb SO MOLECULAR IMMUNOLOGY LA English DT Article DE antibodies; cell trafficking; molecular biology ID DNA ANTIBODIES; MURINE; AUTOANTIBODY; CHAINS AB Methods for cell type specific targeted intracellular delivery of proteins in vivo remain limited. A murine monoclonal anti-dsDNA antibody, rnAb 3E10, was selectively transported into skeletal muscle cells in vivo. The antibody bound a 200 kDa protein only found in lysates of skeletal muscle by Western blotting. The 200 kDa protein was purified from muscle lysate by antibody affinity chromatography and identified as the skeletal muscle specific heavy chain of myosin IIb by electrospray mass spectrometry. Antibody binding specificity for myosin Ilb was demonstrated in Western blots by binding myosin in skeletal muscle lysates from mice null for myosin lid but not in mice null for myosin IIb. Myosin IIb is implicated in the specific targeting of mAb 3E10 to skeletal muscle. Published by Elsevier Science Ltd. C1 Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Med, Div Rheumatol, Sepulveda, CA 91343 USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Geriatr, Sepulveda, CA 91343 USA. City Hope Natl Med Ctr, Dept Endocrinol, Duarte, CA 91010 USA. Univ Colorado, Dept Mol Cellular & Dev Biol, Boulder, CO 80309 USA. RP Weisbart, RH (reprint author), Vet Affairs Greater Los Angeles Hlth Care Syst, Dept Med, Div Rheumatol, Sepulveda, CA 91343 USA. OI LEINWAND, LESLIE/0000-0003-1470-4810; Ferreri, Kevin/0000-0003-0379-0389 NR 15 TC 8 Z9 8 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0161-5890 J9 MOL IMMUNOL JI Mol. Immunol. PD MAR PY 2003 VL 39 IS 13 BP 783 EP 789 DI 10.1016/S0161-5890(03)00003-8 PG 7 WC Biochemistry & Molecular Biology; Immunology SC Biochemistry & Molecular Biology; Immunology GA 657FJ UT WOS:000181654700003 PM 12617993 ER PT J AU Resendiz, JC Feng, SJ Ji, GL Francis, KA Berndt, MC Kroll, MH AF Resendiz, JC Feng, SJ Ji, GL Francis, KA Berndt, MC Kroll, MH TI Purinergic P2Y(12) receptor blockade inhibits shear-induced platelet phosphatidylinositol 3-kinase activation SO MOLECULAR PHARMACOLOGY LA English DT Article ID BETA-GAMMA-SUBUNITS; PHOSPHOINOSITIDE 3-KINASE; ADENOSINE-DIPHOSPHATE; INTEGRIN ALPHA(IIB)BETA(3); THROMBUS FORMATION; FLOW CONDITIONS; COATED SURFACE; AGGREGATION; STRESS; IB AB Pathologically elevated shear stress triggers aspirin-insensitive platelet thrombosis. Signaling mechanisms involved in shear-induced platelet thrombosis are not well understood. To investigate these, we examined the hypothesis that functionally important platelet phosphatidylinositol 3-kinase (PI3-K) activity is stimulated by an in vitro shear stress of 120 dynes/cm(2) (shear rate of 6000 sec(-1)). Phosphatidylinositol 3,4,5-trisphosphate (PIP3) production was examined in washed human platelets subjected to pathological shear stress in a cone-plate viscometer. PIP3 production peaks 30 s after shear begins and is initiated by von Willebrand factor (VWF) binding to the glycoprotein (Gp) Ib-IX-V complex. Inhibiting PI3-K with wortmannin or 2-(4-morpholinyl)-8-phenyl-4H-1-benzopyran-4-one (LY294002) results in the inhibition of shear-induced platelet aggregation. In resting platelets, class IA PI3-K associates with the tyrosine kinase Syk. Within 30 s of beginning shear, PI3-K-associated Syk becomes tyrosine phosphorylated. Inhibiting Syk activation with piceatannol results in the inhibition of PIP3 production and aggregation. Selective blockade of the P2Y(12) receptor results in the inhibition of Syk phosphorylation, PIP3 production, and aggregation. These results indicate that shear-induced VWF binding to platelet GpIb-IX-V stimulates functionally important PI3-K activity. PI3-K activation is signaled by rapid feedback amplification that involves P2Y(12) receptor-mediated activation of Syk. C1 Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. Rice Univ, Houston, TX 77251 USA. Wihuri Res Inst, SF-00140 Helsinki, Finland. Monash Univ, Clayton, Vic 3168, Australia. RP Kroll, MH (reprint author), Baylor Coll Med, VA Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. RI Berndt, Michael/D-5580-2012 FU NHLBI NIH HHS [HL18454, HL65967] NR 42 TC 42 Z9 42 U1 0 U2 0 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 PY 2003 VL 63 IS 3 BP 639 EP 645 DI 10.1124/mol.63.3.639 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 649HL UT WOS:000181201400022 PM 12606772 ER PT J AU Virella, G Lopes-Virella, MF AF Virella, G Lopes-Virella, MF TI Humoral immunity and atherosclerosis SO NATURE MEDICINE LA English DT Letter C1 Med Univ S Carolina, Dept Microbiol & Immunol, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. RP Virella, G (reprint author), Med Univ S Carolina, Dept Microbiol & Immunol, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. NR 0 TC 15 Z9 16 U1 0 U2 0 PU NATURE AMERICA INC PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 1078-8956 J9 NAT MED JI Nat. Med. PD MAR PY 2003 VL 9 IS 3 BP 243 EP 244 DI 10.1038/nm0303-243 PG 2 WC Biochemistry & Molecular Biology; Cell Biology; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Cell Biology; Research & Experimental Medicine GA 651GN UT WOS:000181312300005 PM 12612552 ER PT J AU Chimowitz, M Howlett-Smith, H Calcaterra, A Lessard, N Stern, B Lynn, M Hertzberg, V Cotsonis, G Swanson, S Tutu-Gxashe, T Griffin, P Kosinski, A Chester, C Asbury, W Rogers, S Chimowitz, M Stern, B Frankel, M Howlett-Smith, H Hertzberg, V Lynn, M Levine, S Chaturvedi, S Benesch, C Woolfenden, A Sila, C Zweifler, R Lyden, P Barnett, H Easton, D Fox, A Furlan, A Gorelick, P Hart, R Meldrum, H Sherman, D Cloft, H Hudgins, P Tong, F Caplan, L Anderson, D Miller, V Sperling, L Weintraub, W Marshall, J Manoukian, S Chimowitz, M Stern, B Frankel, M Samuels, O Howlett-Smith, H Lessard, N Lane, B Braimah, J Sailor-Smith, S Asbury, B Chester, C Chaturvedi, S Levine, S Wiseman, D Andersen, J Sampson-Haggood, A Kasner, S Liebeskind, D Cucchiara, B Chalela, J McGarvey, M Luciano, J Shaw, S Corrozi, M Rockwell, K Benesch, C Zentner, J Bean, S Cole, D Sila, C Katzan, I Rudd, N Horvat, M Bragg, L Begany, K Mazzoli, G Woolfenden, A Teal, P Johnston, C Synnot, D Busser, J Lyden, P Jackson, C Werner, J Kelly, N McClean, T Gonzales, J Adams, C Romano, J Forteza, A Hidalgo, A Concha, M Koch, S Ferreira, A Wityk, R Aldrich, E Lane, K Rice, S White, L Traill, T Hemphill, C Smith, W Hewlett, L Reed, C Fields, S Nehira, J Wechsler, L Gebel, J Goldstein, S Jovin, T DeCesare, S Harbison, B Bernstein, R Zweifler, R Mendizabal, J Alday, D Yunker, R Umana, E Neal, T Cruz-Flores, S Selhorst, J Leira, E Holzemer, E Armbruster, J Walden, H Olsen, T Chan, R Pullicino, P Harrington, S Hopkins, L Crone, K Seyse, S Hanna, J Winkelman, M Liskay, A Schella, M Lewayne, N Gullion, L Thakore, N Tong, D Garcia, M Kemp, S Shen, H Tuholski, M LaFranchise, E Reel, S Maddox, R Rice, D Mitsias, P Papamitsakis, N Reuther, J Marchese, P Kaatz, S McCord, J Bruno, A Sears, A Pettigrew, T Unwin, D Johnson, M Graybeal, D Redhead, A Stanford, J Croft, C Lee, R Culebras, A Vertino, M Dean, M Ayers, J Zaleski, J Silliman, S Ray, W Ballew, K Darracott, D Robinson, K Malcolm, K Johnston, K Haley, E Nathan, B Maupin, K Grandinetti, C Adams, A Libman, R Benson, R Bhatnagar, R Gonzaga-Camfield, R Grant, Y Kwiatkowski, T Alagappan, K Saver, J Kidwell, C Liebeskind, D Leary, M Ferguson, K Llanes, J Melamed, F Cohen, S Krauss, T Jolly, T Date, L Abedi, G Song, A Wells, M Dandapani, B Waddill, A Parker, L Vicari, R Howard, M Tuhrim, S Wright, P Augustine, S Ali, J Halperin, J Rothlauf, E Kelley, R Pajeau, A Jinkins, P Wang, Y Booth, A Middlebrook, M Grotta, J Campbell, M Shaw, S Boudreaux, R Hickey, J Munson, R Homer, D McGinn, T Small, B Feinberg, A Shim, B Nichols, F Sahm, M Kutlar, A Belden, J Diconzo-Fanning, D Carr, A Allan, W Spiro, R Thaler, D Scandura, T Douglass, L Libenson, M Kase, C Licata-Gehr, E Ansell, J McDonough, M Babikian, V Allen, N Brophy, M Reilly, C Slivka, A Notestine, P Marcy, L Anderson, L Labadie, E Bruck, D Rensuold, D Devine, J Kistler, S Gaines, K Abbott, F Leedom, K Beyer, S Lutsep, H Clark, W Vaishnav, A Gaul, M Doherty, A Pasco, S Brown, J Hollander, J Honch, G Weber, C Sass, A Porter, B Lynch, J Chaves, C Linfante, I Horkan, C Barron, L Ryan, P Tarsey, D Karanjia, P St Louis, E Stephani, L Matit, C Bachhuber, M Thorne, W Schneck, M Whited, K Frame, D Ruderman, G Johnson, C Kaminski, M Hill, L Pitts, D Naftilan, A Dandapani, B Salanga, V Patino-Pauo, R Piccarillo, M Grove, M Rosenthal, R Sloan, M Shuler, L Vaughan, S Chacko, B Tietjen, G Korsnack, A Scotton, S Alberts, M Goldstein, L Edwards, G Thames, B Mohammad, Y Roach, C Martin, T King, J Hurst, D Tindall, M Beasley, K Sleeper, R Gaines, K Johnson, C Kirshner, I Sweeney, B Haden, K Abbatte, M Gateley, K Azhar, S Latwis-Viellette, E Cameron, A Nazarian, S Metzer, W Epperson, E Sanders, P Powell, B Verro, P Rudisill, N Kelly-Messineo, A Branch, J Ramos, L Kalafut, M Kampelman, J Perlman, M Lewis, M Wozniak, M Kittner, S Zappala, N Haines, S Seitzman-Siegel, A Felberg, R Soldani, J Deitelzweig, S Frisard, C Hickenbottom, S Maddox, K Ahmed, A Tamer, H Tilley, B Ansell, J Smith, K Khan, J Radziszewska, B Marler, J Powers, W Thompson, J Simon, R Brass, L Furie, K AF Chimowitz, M Howlett-Smith, H Calcaterra, A Lessard, N Stern, B Lynn, M Hertzberg, V Cotsonis, G Swanson, S Tutu-Gxashe, T Griffin, P Kosinski, A Chester, C Asbury, W Rogers, S Chimowitz, M Stern, B Frankel, M Howlett-Smith, H Hertzberg, V Lynn, M Levine, S Chaturvedi, S Benesch, C Woolfenden, A Sila, C Zweifler, R Lyden, P Barnett, H Easton, D Fox, A Furlan, A Gorelick, P Hart, R Meldrum, H Sherman, D Cloft, H Hudgins, P Tong, F Caplan, L Anderson, D Miller, V Sperling, L Weintraub, W Marshall, J Manoukian, S Chimowitz, M Stern, B Frankel, M Samuels, O Howlett-Smith, H Lessard, N Lane, B Braimah, J Sailor-Smith, S Asbury, B Chester, C Chaturvedi, S Levine, S Wiseman, D Andersen, J Sampson-Haggood, A Kasner, S Liebeskind, D Cucchiara, B Chalela, J McGarvey, M Luciano, J Shaw, S Corrozi, M Rockwell, K Benesch, C Zentner, J Bean, S Cole, D Sila, C Katzan, I Rudd, N Horvat, M Bragg, L Begany, K Mazzoli, G Woolfenden, A Teal, P Johnston, C Synnot, D Busser, J Lyden, P Jackson, C Werner, J Kelly, N McClean, T Gonzales, J Adams, C Romano, J Forteza, A Hidalgo, A Concha, M Koch, S Ferreira, A Wityk, R Aldrich, E Lane, K Rice, S White, L Traill, T Hemphill, C Smith, W Hewlett, L Reed, C Fields, S Nehira, J Wechsler, L Gebel, J Goldstein, S Jovin, T DeCesare, S Harbison, B Bernstein, R Zweifler, R Mendizabal, J Alday, D Yunker, R Umana, E Neal, T Cruz-Flores, S Selhorst, J Leira, E Holzemer, E Armbruster, J Walden, H Olsen, T Chan, R Pullicino, P Harrington, S Hopkins, L Crone, K Seyse, S Hanna, J Winkelman, M Liskay, A Schella, M Lewayne, N Gullion, L Thakore, N Tong, D Garcia, M Kemp, S Shen, H Tuholski, M LaFranchise, E Reel, S Maddox, R Rice, D Mitsias, P Papamitsakis, N Reuther, J Marchese, P Kaatz, S McCord, J Bruno, A Sears, A Pettigrew, T Unwin, D Johnson, M Graybeal, D Redhead, A Stanford, J Croft, C Lee, R Culebras, A Vertino, M Dean, M Ayers, J Zaleski, J Silliman, S Ray, W Ballew, K Darracott, D Robinson, K Malcolm, K Johnston, K Haley, E Nathan, B Maupin, K Grandinetti, C Adams, A Libman, R Benson, R Bhatnagar, R Gonzaga-Camfield, R Grant, Y Kwiatkowski, T Alagappan, K Saver, J Kidwell, C Liebeskind, D Leary, M Ferguson, K Llanes, J Melamed, F Cohen, S Krauss, T Jolly, T Date, L Abedi, G Song, A Wells, M Dandapani, B Waddill, A Parker, L Vicari, R Howard, M Tuhrim, S Wright, P Augustine, S Ali, J Halperin, J Rothlauf, E Kelley, R Pajeau, A Jinkins, P Wang, Y Booth, A Middlebrook, M Grotta, J Campbell, M Shaw, S Boudreaux, R Hickey, J Munson, R Homer, D McGinn, T Small, B Feinberg, A Shim, B Nichols, F Sahm, M Kutlar, A Belden, J Diconzo-Fanning, D Carr, A Allan, W Spiro, R Thaler, D Scandura, T Douglass, L Libenson, M Kase, C Licata-Gehr, E Ansell, J McDonough, M Babikian, V Allen, N Brophy, M Reilly, C Slivka, A Notestine, P Marcy, L Anderson, L Labadie, E Bruck, D Rensuold, D Devine, J Kistler, S Gaines, K Abbott, F Leedom, K Beyer, S Lutsep, H Clark, W Vaishnav, A Gaul, M Doherty, A Pasco, S Brown, J Hollander, J Honch, G Weber, C Sass, A Porter, B Lynch, J Chaves, C Linfante, I Horkan, C Barron, L Ryan, P Tarsey, D Karanjia, P St Louis, E Stephani, L Matit, C Bachhuber, M Thorne, W Schneck, M Whited, K Frame, D Ruderman, G Johnson, C Kaminski, M Hill, L Pitts, D Naftilan, A Dandapani, B Salanga, V Patino-Pauo, R Piccarillo, M Grove, M Rosenthal, R Sloan, M Shuler, L Vaughan, S Chacko, B Tietjen, G Korsnack, A Scotton, S Alberts, M Goldstein, L Edwards, G Thames, B Mohammad, Y Roach, C Martin, T King, J Hurst, D Tindall, M Beasley, K Sleeper, R Gaines, K Johnson, C Kirshner, I Sweeney, B Haden, K Abbatte, M Gateley, K Azhar, S Latwis-Viellette, E Cameron, A Nazarian, S Metzer, W Epperson, E Sanders, P Powell, B Verro, P Rudisill, N Kelly-Messineo, A Branch, J Ramos, L Kalafut, M Kampelman, J Perlman, M Lewis, M Wozniak, M Kittner, S Zappala, N Haines, S Seitzman-Siegel, A Felberg, R Soldani, J Deitelzweig, S Frisard, C Hickenbottom, S Maddox, K Ahmed, A Tamer, H Tilley, B Ansell, J Smith, K Khan, J Radziszewska, B Marler, J Powers, W Thompson, J Simon, R Brass, L Furie, K CA Warfarin-Aspirin Symptomat Intracran TI Design, progress and challenges of a double-blind trial of warfarin versus aspirin for symptomatic intracranial arterial stenosis SO NEUROEPIDEMIOLOGY LA English DT Article DE intracranial atherosclerosis; stroke; warfarin; aspirin; clinical trial; cerebral angiography ID TRANSIENT ISCHEMIC ATTACKS; MIDDLE CEREBRAL-ARTERY; ATRIAL-FIBRILLATION; STROKE PREVENTION; FOLLOW-UP; OCCLUSIVE DISEASE; ANGIOGRAPHY; ANTICOAGULANTS; HYPOTHESES; INFARCTION AB Background and Relevance: Atherosclerotic stenosis of the major intracranial arteries is an important cause of transient ischemic attack (TIA) or stroke. Of the 900,000 patients who suffer a TIA or stroke each year in the USA, intracranial stenosis is responsible for approximately 10%, i.e. 90,000 patients. There have been no prospective trials evaluating antithrombotic therapies for preventing recurrent vascular events in these patients. The main objective of this trial is to compare warfarin [international Normalized Ratio (INR) 2-3] with aspirin (1,300 mg/day) for preventing stroke (ischemic and hemorrhagic) and vascular death in patients presenting with TIA or stroke caused by stenosis of a major intracranial artery. Study Design: Prospective, randomized, double-blind, multicenter trial. The sample size required will be 403 patients per group, based on stroke and vascular death rates of 33% per 3 years in the aspirin group vs. 22% per 3 years in the warfarin group, a p value of 0.05, power of 80%, a 24% rate of 'withdrawal of therapy', and a 1% rate of 'lost to follow-up'. Conduct of Trial. Patients with TIA or nondisabling stroke caused by greater than or equal to50% stenosis of a major intracranial artery documented by catheter angiography are randomized to warfarin or aspirin. Patients are contacted monthly by phone and examined every 4 months until a common termination date. Mean follow-up in the study is expected to be 3 years. Conclusion: This study will determine whether warfarin or aspirin is superior for patients with symptomatic intracranial arterial stenosis. Furthermore, it will identify patients whose rate of ischemic stroke in the territory of the stenotic intracranial artery on best medical therapy is sufficiently high to justify a subsequent trial comparing intracranial angioplasty/stenting with best medical therapy in this subset of patients. Copyright (C) 2003 S. Karger AG, Basel. C1 Emory Clin, Dept Neurol, Atlanta, GA 30322 USA. Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. Emory Univ Hosp, Atlanta, GA 30322 USA. Wayne State Univ, Detroit, MI 48202 USA. Univ Penn, Philadelphia, PA 19104 USA. Univ Rochester, Rochester, NY 14627 USA. Cleveland Clin Fdn, Cleveland, OH 44195 USA. Vancouver Gen Hosp, Vancouver, BC, Canada. Univ Calif San Diego, San Diego VA Med Ctr, San Diego, CA 92103 USA. Univ Miami, Coral Gables, FL 33124 USA. Johns Hopkins Med Ctr, Baltimore, MD USA. Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. Univ S Alabama, Mobile, AL 36688 USA. St Louis Univ, St Louis, MO 63103 USA. Buffalo Gen Hosp, Buffalo, NY 14203 USA. Metrohlth Med Ctr, Cleveland, OH USA. Stanford Stroke Ctr, Stanford, CA USA. Neurol Inst Savannah, Savannah, GA USA. Henry Ford Hosp, Detroit, MI 48202 USA. Indiana Univ, Bloomington, IN 47405 USA. SW Texas State Univ, San Marcos, TX 78666 USA. Syracuse VA Med Ctr, Syracuse, NY USA. Univ Florida, Jacksonville, FL USA. Univ Virginia, Charlottesville, VA 22903 USA. Long Isl Jewish Med Ctr, New Hyde Pk, NY 11042 USA. Univ Calif Los Angeles, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Melbourne Internal Med Associates, Melbourne, FL USA. Mt Sinai Med Ctr, New York, NY 10029 USA. Louisiana State Univ, Baton Rouge, LA 70803 USA. Univ Texas, Houston, TX USA. Evanston Hosp Corp, Evanston, IL 60201 USA. Med Coll Georgia, Augusta, GA 30912 USA. Maine Med Ctr, Portland, ME 04102 USA. Tufts Univ New England Med Ctr, Boston, MA 02111 USA. Boston Univ, Boston, MA 02215 USA. Boston VA Med Ctr, Boston, MA USA. Ohio State Univ, Columbus, OH 43210 USA. Univ Arizona, Tucson, AZ 85721 USA. Field Neurosci Inst, Saginaw, MI USA. Rochester Gen Hosp, Rochester, NY 14621 USA. Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. Marshfield Clin Fdn Med Res & Educ, Marshfield, WI USA. Rush Presbyterian St Lukes Med Ctr, Chicago, IL 60612 USA. Cleveland Clin Florida, Weston, FL 33331 USA. Harbin Clin, Rome, GA USA. Med Coll Ohio, Toledo, OH 43699 USA. Duke Univ, Durham, NC 27706 USA. Univ Mississippi, University, MS 38677 USA. Texas Tech, Lubbock, TX USA. Williamson Med Ctr, Franklin, TN USA. St Lukes Roosevelt Hosp, New York, NY USA. Cent Arkansas VA, Little Rock, AR USA. Univ Calif Davis, Davis, CA 95616 USA. Scripps Clin, La Jolla, CA USA. Univ Maryland, College Pk, MD 20742 USA. Ochsner Fdn Clin & Hosp, New Orleans, LA USA. Univ Michigan, Ann Arbor, MI 48109 USA. RP Chimowitz, M (reprint author), Emory Clin, Dept Neurol, 4th Floor,Clin A Bldg,1365 Clifton Rd, Atlanta, GA 30322 USA. EM mchimow@emory.edu RI Kasner, Scott/C-6109-2011; Gaines, Kenneth/D-4730-2011; Zweifler, Richard/K-1314-2015 NR 50 TC 58 Z9 58 U1 0 U2 10 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0251-5350 J9 NEUROEPIDEMIOLOGY JI Neuroepidemiology PD MAR-APR PY 2003 VL 22 IS 2 BP 106 EP 117 DI 10.1159/000068744 PG 12 WC Public, Environmental & Occupational Health; Clinical Neurology SC Public, Environmental & Occupational Health; Neurosciences & Neurology GA 657ZC UT WOS:000181695400003 ER PT J AU Gordon, LK AF Gordon, LK TI Diagnostic dilemmas in orbital inflammatory disease SO OCULAR IMMUNOLOGY AND INFLAMMATION LA English DT Review DE inflammation; orbit; myositis; pseudotumor ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; TOLOSA-HUNT-SYNDROME; FINE-NEEDLE ASPIRATION; IDIOPATHIC SCLEROSING INFLAMMATION; THYROID-ASSOCIATED ORBITOPATHY; POSTERIOR SCLERITIS; OPTIC PERINEURITIS; WEGENERS GRANULOMATOSIS; RADIATION-THERAPY; PSEUDOTUMOR AB Orbital inflammatory disease (OID) broadly describes a variety of pathologic processes and clinical presentations. OID may be idiopathic or may be secondary to a systemic inflammatory disease, retained foreign body, or infectious disease. OID includes the spectrum of bacterial or fungal infections, diffuse inflammation of multiple tissues (e.g., sclerosing orbititis or diffuse anterior OID), and preferential involvement of specific orbital structures (e.g., orbital myositis or optic perineuritis). Mimics of OID include congenital orbital mass lesions or orbital neoplastic disease such as lymphoma or rhabdomyosarcoma. The ultimate diagnosis and treatment plan relies on a careful history and detailed clinical examination followed by the judicious use of ancillary diagnostic testing and a comprehensive treatment plan. The purpose of this review is to provide an overview of the spectrum of diseases known as OID, with emphasis on specific diagnostic challenges in the evaluation and management of patients with idiopathic OID. C1 Univ Calif Los Angeles, Jules Stein Eye Inst, Ctr Hlth Sci, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RP Gordon, LK (reprint author), Univ Calif Los Angeles, Jules Stein Eye Inst, Ctr Hlth Sci, 100 Stein Plaza, Los Angeles, CA 90095 USA. NR 91 TC 24 Z9 26 U1 0 U2 1 PU SWETS ZEITLINGER PUBLISHERS PI LISSE PA P O BOX 825, 2160 SZ LISSE, NETHERLANDS SN 0927-3948 J9 OCUL IMMUNOL INFLAMM JI Ocul. Immunol. Inflamm. PD MAR PY 2003 VL 11 IS 1 BP 3 EP 15 DI 10.1076/ocii.11.1.3.15577 PG 13 WC Ophthalmology SC Ophthalmology GA 706UD UT WOS:000184472700001 PM 12854023 ER PT J AU Osorio, Y Melby, PC Pirmez, C Chandrasekar, B Guarin, N Travi, BL AF Osorio, Y Melby, PC Pirmez, C Chandrasekar, B Guarin, N Travi, BL TI The site of cutaneous infection influences the immunological response and clinical outcome of hamsters infected with Leishmania panamensis SO PARASITE IMMUNOLOGY LA English DT Article DE cutaneous leishmaniasis; cytokines; immunity; Leishmania panamensis ID TRANSFORMING-GROWTH-FACTOR; EXPERIMENTAL VISCERAL LEISHMANIASIS; IMMUNE-RESPONSE; INTERFERON-GAMMA; FACTOR-BETA; NITRIC-OXIDE; BALB/C MICE; KALA-AZAR; IFN-GAMMA; MURINE LEISHMANIASIS AB We determined that the site of inoculation (foot or snout) influences the clinical evolution and immune responses of hamsters infected with Leishmania (Viannia) panamensis. Hamsters infected in the snout showed (i) a more rapid and severe lesion evolution at multiple time points ( P < 0.05), (ii) a more extensive inflammatory infiltrate and tissue necrosis, (iii) a higher tissue parasite burden, (iv) a higher antibody titre ( P < 0.01), but lower antigen-specific spleen cell proliferative response ( P = 0.02), and (v) a slower response to anti-leishmanial drug treatment ( P < 0.002). In both inoculation groups there was co-expression of type 1 (IFN-gamma and IL-12) and some type 2 (IL-10 and TGF-beta, but not IL-4) cytokines in the cutaneous lesions and spleen. Early in the course of infection, hamsters infected in the snout showed higher expression of splenic IL-10 ( P = 0.04) and intra-lesional IFN-gamma ( P = 0.02) than foot infections. No expression of IL-12p40 or IL-4 was detected. During the chronic phase, snout lesions expressed more IFN-gamma ( P = 0.001), IL-12p40 ( P = 0.01), IL-10 ( P = 0.009) and TGF-beta ( P = 0.001), and the level of expression of each of these cytokines correlated with lesion size ( P less than or equal to 0.01). These results suggest that the site of infection influences the clinical outcome in experimental cutaneous leishmaniasis, and that the expression of macrophage-deactivating type 2 cytokines and/or an exaggerated type 1 proinflammatory cytokine response may contribute to lesion severity. C1 CIDEIM, Cali, Colombia. S Texas Vet Hlth Care Syst, Dept Vet Affairs Med Ctr, Med Serv, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Inst Oswaldo Cruz, FIOCRUZ, Dept Bioquim & Biol Mol, BR-20001 Rio De Janeiro, Brazil. RP Osorio, Y (reprint author), CIDEIM, AA5390, Cali, Colombia. RI Pirmez, Claude/K-8579-2012 OI Pirmez, Claude/0000-0002-7443-0455 NR 58 TC 17 Z9 20 U1 0 U2 2 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0141-9838 J9 PARASITE IMMUNOL JI Parasite Immunol. PD MAR PY 2003 VL 25 IS 3 BP 139 EP 148 DI 10.1046/j.1365-3024.2003.00615.x PG 10 WC Immunology; Parasitology SC Immunology; Parasitology GA 711HD UT WOS:000184732800005 PM 12911522 ER PT J AU Sannicandro, T Means, RT Aquino, LZ Cagle, SW Collier, SL Cooper, SL Gray, AL Magill, MF Powell, BA Smith, KI Styk, DL AF Sannicandro, T Means, RT Aquino, LZ Cagle, SW Collier, SL Cooper, SL Gray, AL Magill, MF Powell, BA Smith, KI Styk, DL TI Improving patient safety in the antineoplastic medication-use system at a VA medical center with the development of a multidisciplinary clinical team. SO PHARMACOTHERAPY LA English DT Meeting Abstract CT Spring Practice and Research Forum of the American-College-of-Clinical-Pharmacy CY APR 27-30, 2003 CL PALM SPRINGS, CALIFORNIA SP American Coll Clin Pharmacy C1 Ralph H Johnson Vet Adm Med Ctr, Charleston, SC USA. RI Means, Robert/A-4454-2008 NR 0 TC 0 Z9 0 U1 0 U2 0 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 2003 VL 23 IS 3 MA 184 BP 419 EP 419 PG 1 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 650JL UT WOS:000181259900156 ER PT J AU Taub, PJ Rudkin, GH Clearihue, WJ Miller, TA AF Taub, PJ Rudkin, GH Clearihue, WJ Miller, TA TI Prefabricated alloplastic implants for cranial defects SO PLASTIC AND RECONSTRUCTIVE SURGERY LA English DT Editorial Material ID RECONSTRUCTION; HYDROXYAPATITE; CRANIOPLASTY; PROSTHESES C1 Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Taub, PJ (reprint author), 11761 Sunset Blvd, Los Angeles, CA 90049 USA. NR 12 TC 13 Z9 16 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 2003 VL 111 IS 3 BP 1233 EP 1240 DI 10.1097/01.PRS.0000046048.77472.23 PG 8 WC Surgery SC Surgery GA 651MM UT WOS:000181323800039 PM 12621197 ER PT J AU Basile, JN AF Basile, JN TI Heart failure - A three-article symposium SO POSTGRADUATE MEDICINE LA English DT Editorial Material C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. RP Basile, JN (reprint author), Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MCGRAW HILL HEALTHCARE PUBLICATIONS PI MINNEAPOLIS PA 4530 WEST 77TH ST, MINNEAPOLIS, MN 55435-5000 USA SN 0032-5481 J9 POSTGRAD MED JI Postgrad. Med. PD MAR PY 2003 VL 113 IS 3 BP 29 EP 30 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 835TX UT WOS:000222509500004 ER PT J AU Basile, JN AF Basile, JN TI Titration of beta-blockers in heart failure - How to maximize benefit while minimizing adverse events SO POSTGRADUATE MEDICINE LA English DT Article ID RANDOMIZED INTERVENTION TRIAL; LEFT-VENTRICULAR FUNCTION; MERIT-HF; DILATED CARDIOMYOPATHY; ADRENERGIC-BLOCKADE; METOPROLOL CR/XL; CARVEDILOL; THERAPY; MORTALITY; DISEASE AB Despite extensive data supporting the use of beta-blockers in patients with chronic heart failure, fewer than one third of eligible patients receive these agents. Furthermore, some patients who do receive beta-blocker therapy are given suboptimal doses. In this article, Dr Basile discusses the careful adjustment of beta-blocker dose during initiation of therapy to successfully manage chronic heart failure and minimize adverse events. C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. RP Basile, JN (reprint author), Med Univ S Carolina, Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. EM jan.basile@med.va.gov NR 27 TC 4 Z9 4 U1 0 U2 1 PU MCGRAW HILL HEALTHCARE PUBLICATIONS PI MINNEAPOLIS PA 4530 WEST 77TH ST, MINNEAPOLIS, MN 55435-5000 USA SN 0032-5481 J9 POSTGRAD MED JI Postgrad. Med. PD MAR PY 2003 VL 113 IS 3 BP 63 EP 70 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 835TX UT WOS:000222509500007 PM 12647475 ER PT J AU Alterman, AI McDermott, PA Mulvaney, FD Cacciola, JS Rutherford, MJ Searles, JS Lynch, K Cnaan, A AF Alterman, AI McDermott, PA Mulvaney, FD Cacciola, JS Rutherford, MJ Searles, JS Lynch, K Cnaan, A TI Comparison of embedded and isolated administrations of the California Psychological Inventory's socialization subscale SO PSYCHOLOGICAL ASSESSMENT LA English DT Article ID SCALE DEVELOPMENT; YOUNG MEN; PERSONALITY; QUESTIONNAIRE; ALCOHOLICS; VALIDITY; ANTISOCIALITY; RISK AB Alternate administration methods were tested for the Socialization (So) subscale of the California Psychological Inventory (CPI; H. G. Gough, 1994; H. G. Gough & P. Bradley, 1996) in 437 young adult men. One method administered the 46 CPI-So items in isolation from the CPI, whereas the 2nd method administered the 46 items embedded in the CPI. External validity measures of antisociality were also administered over the 2 sessions. Isolated administration produced somewhat higher internal consistency and significantly better concurrent validity and demonstrated construct validity as a measure of antisociality. Additional factor analytic studies of the CPI-So and CPI revealed that the 2 CPI-So versions had different factorial structures and that the embedded CPI-So subscale did not retain factorial integrity or an appreciable amount of reliable and uniquely interpretable variance. C1 Univ Penn, Sch Med, Ctr Treatment & Evaluat, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Grad Sch Educ, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Washington, Alcohol & Drug Inst, Seattle, WA 98195 USA. Univ Vermont, Dept Psychiat, Burlington, VT 05405 USA. Childrens Hosp Philadelphia, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. RP Alterman, AI (reprint author), Univ Penn, Sch Med, Ctr Treatment & Evaluat, Dept Psychiat, 3440 Market St,Suite 370, Philadelphia, PA 19104 USA. FU NIAAA NIH HHS [AA 07361] NR 38 TC 6 Z9 6 U1 1 U2 1 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 1040-3590 J9 PSYCHOL ASSESSMENT JI Psychol. Assess. PD MAR PY 2003 VL 15 IS 1 BP 64 EP 70 DI 10.1037/1040-3590.15.1.64 PG 7 WC Psychology, Clinical SC Psychology GA 656BV UT WOS:000181589700006 PM 12674725 ER PT J AU Freytes, CO AF Freytes, CO TI Progress in central venous access? SO SUPPORTIVE CARE IN CANCER LA English DT Editorial Material ID ULTRASOUND GUIDANCE; SUCCESS RATE C1 Univ Texas, Hlth Sci Ctr, Adult Bone Marrow Transplant Program, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Freytes, CO (reprint author), Univ Texas, Hlth Sci Ctr, Adult Bone Marrow Transplant Program, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0941-4355 J9 SUPPORT CARE CANCER JI Support. Care Cancer PD MAR PY 2003 VL 11 IS 3 BP 135 EP 136 DI 10.1007/s00520-002-0430-8 PG 2 WC Oncology; Health Care Sciences & Services; Rehabilitation SC Oncology; Health Care Sciences & Services; Rehabilitation GA 657JT UT WOS:000181663300002 PM 12618921 ER PT J AU Hunt, DP Haidet, P Coverdale, JH Richards, B AF Hunt, DP Haidet, P Coverdale, JH Richards, B TI The effect of using team learning in an evidence-based medicine course for medical students SO TEACHING AND LEARNING IN MEDICINE LA English DT Article ID EDUCATION AB Background: We implemented team learning, an instructional method that fosters small-group learning, in an evidence-based medicine (EBM) course. Our goal was to align instructional methods with EBM practices. Description: Team learning provides an alternative to lectures in large-group settings. It involves out-of-class preparation followed by in-class readiness assurance tests and group application activities. We used the method to teach a 7-week course in EBM for 2nd-year students. We evaluated the course using student performance, external observation, and student focus groups. Evaluation: Students performed well on all written assignments, indicating attainment of learning objectives. Observation data revealed a high level of student engagement in the classroom. Focus group data indicated that desired learning behaviors tended to occur but that many students devalued the method. Conclusion: Team learning served as a useful framework, enabling a large enrollment course to have small-group experiences without large numbers of faculty. The method fostered individual accountability and promoted teamwork-behaviors consistent with effective EBM practice. Students' lack of enthusiasm for the method may stem from their comfort with didactic lectures. C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Off Curriculum, Houston, TX 77030 USA. RP Hunt, DP (reprint author), Baylor Coll Med, Dept Med Gen Med, 1 Baylor Plaza,Mail Code BTGH, Houston, TX 77030 USA. NR 19 TC 70 Z9 71 U1 2 U2 6 PU LAWRENCE ERLBAUM ASSOC INC PI MAHWAH PA 10 INDUSTRIAL AVE, MAHWAH, NJ 07430-2262 USA SN 1040-1334 J9 TEACH LEARN MED JI Teach. Learn. Med. PD SPR PY 2003 VL 15 IS 2 BP 131 EP 139 DI 10.1207/S15328015TLM1502_11 PG 9 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 666UF UT WOS:000182194300011 PM 12708072 ER PT J AU Wessells, H Roy, J Bannow, J Grayhack, J Matsumoto, AM Tenover, L Herlihy, R Fitch, W Labasky, R Auerbach, S Parra, R Rajfer, J Culbertson, J Lee, M Bach, MA Waldstreicher, J AF Wessells, H Roy, J Bannow, J Grayhack, J Matsumoto, AM Tenover, L Herlihy, R Fitch, W Labasky, R Auerbach, S Parra, R Rajfer, J Culbertson, J Lee, M Bach, MA Waldstreicher, J CA PLESS study Grp TI Incidence and severity of sexual adverse experiences in finasteride and placebo-treated men with benign prostatic hyperplasia SO UROLOGY LA English DT Article ID OBSTRUCTION SYMPTOMATIC BPH; URINARY-TRACT SYMPTOMS; MALE PSEUDOHERMAPHRODITISM; CONTROLLED TRIAL; TERAZOSIN; TAMSULOSIN; MULTICENTER; ANTAGONIST; COMMUNITY; EFFICACY AB Objectives. To evaluate the incidence and resolution of sexual adverse experiences (AEs) in men with benign prostatic hyperplasia treated with finasteride 5 mg compared with placebo. Methods. The Proscar Long-term Efficacy and Safety Study (PLESS) was a 4-year, randomized, double-blind, placebo-controlled trial assessing the efficacy and safety of finasteride 5 mg in 3040 men, aged 45 to 78 years, with symptomatic benign prostatic hyperplasia, enlarged prostates, and no evidence of prostate cancer. Patients completed a questionnaire at screening regarding their history of sexual dysfunction. During treatment, spontaneously self-reported sexual AEs were recorded. Results. At screening, 46% of patients in each treatment group reported some history of sexual dysfunction. During year 1 of the study, 15% of finasteride-treated patients and 7% of placebo-treated patients had sexual AEs that were considered drug related by the investigator (P < 0.001). During years 2 to 4, no between-group difference was noted in the incidence of new sexual AEs (7% in each group). The drug-related sexual AE profile for finasteride was similar for men with or without a history of sexual dysfunction. Sexual AEs resolved while continuing therapy in 12% of finasteride patients and 19% of placebo patients. Only 4% of finasteride and 2% of placebo patients discontinued the study because of sexual AEs. In men who discontinued with a sexual AE, 50% and 41% experienced resolution of their sexual AE after discontinuing finasteride or placebo therapy, respectively. Conclusions. Compared with placebo, men treated with finasteride experienced new drug-related sexual AEs with an increased incidence only during the first year of therapy. (C) 2003, Elsevier Science Inc. C1 Merck Res Labs, Rahway, NJ 07065 USA. Edmond, Oklahoma City, OK USA. Cedarwood Med Ctr, St Joseph, MI USA. NW Univ, Chicago, IL USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Wesley Woods Hlth Ctr, Atlanta, GA USA. Oklahoma City Clin, Oklahoma City, OK USA. St Louis Univ Hosp, St Louis, MO USA. Univ Calif Los Angeles, Ctr Med, Los Angeles, CA USA. RP Waldstreicher, J (reprint author), Merck Res Labs, 126 E Lincoln Ave,RY34-212, Rahway, NJ 07065 USA. NR 24 TC 51 Z9 56 U1 0 U2 1 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 2003 VL 61 IS 3 BP 579 EP 584 DI 10.1016/S0090-4295(02)02401-9 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 662CJ UT WOS:000181928200022 PM 12639651 ER PT J AU Washington, DL Caffrey, C Goldzweig, C Simon, B Yano, EM AF Washington, DL Caffrey, C Goldzweig, C Simon, B Yano, EM TI Availability of comprehensive women's health care through Department of Veterans Affairs medical center SO WOMENS HEALTH ISSUES LA English DT Article DE women's health services; health services accessibility; hospitals, veterans; ambulatory care/utilization AB Despite increased numbers of women veterans, little is known about health services delivery to women across the Department of Veterans Affairs (VA). To assess VA availability of women's health services, we surveyed the senior clinician at each VA site serving 400 or more women veterans. We found that virtually all sites have developed arrangements, either directly or through off-site contracts, to ensure availability of comprehensive women's health care. On-site care, however, is routinely available only for basic services. Future work should evaluate cost and quality trade-offs between using non-VA sites to increase specialized service availability and using VA sites to enhance continuity of care. C1 VA Greater Los Angeles Healthcare Syst, R&D Ctr Excellence, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Kaiser Permanente, Lancaster, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RP Washington, DL (reprint author), VA Greater Los Angeles Healthcare Syst, R&D Ctr Excellence, 11301 Wilshire Blvd,111G, Los Angeles, CA 90073 USA. NR 14 TC 37 Z9 37 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1049-3867 J9 WOMEN HEALTH ISS JI Womens Health Iss. PD MAR-APR PY 2003 VL 13 IS 2 BP 50 EP 54 AR PII S1049-3867(02)00195-0 DI 10.1016/S1049-3867(02)00195-0 PG 5 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA 674EF UT WOS:000182623700003 PM 12732440 ER PT J AU Baumgarten, M Margolis, D Berlin, JA Strom, BL Garino, J Kagan, SH Kavesh, W Carson, JL AF Baumgarten, M Margolis, D Berlin, JA Strom, BL Garino, J Kagan, SH Kavesh, W Carson, JL TI Risk factors for pressure ulcers among elderly hip fracture patients SO WOUND REPAIR AND REGENERATION LA English DT Article ID DECUBITUS ULCERS; CLINICAL-TRIAL; NURSING-HOMES; FEMORAL-NECK; SORES; PREVENTION; EPIDEMIOLOGY; PREVALENCE; MANAGEMENT; OPERATIONS AB The purpose of this study was to estimate the incidence of hospital-acquired pressure ulcers among elderly patients hospitalized for hip fracture surgery and to identify extrinsic factors that are associated with increased risk. We conducted a secondary analysis of data abstracted from medical records at 20 hospitals in Pennsylvania, Texas, New Jersey, and Virginia. Participants were patients aged 60 years and older admitted with hip fracture to the study hospitals between 1983 and 1993. The incidence of hospital-acquired pressure ulcers was 8.8% (95% confidence interval 8.2%-9.4%). After adjusting for confounding variables, longer wait before surgery, intensive care unit stay, longer surgical procedure, and general anesthesia were significantly associated with higher pressure ulcer risk. Extrinsic factors may be important markers for high pressure ulcer risk in hospitalized hip fracture patients. Although it is not possible to eliminate factors such as requiring an intensive care unit stay or having a long surgical procedure, it may be possible to develop interventions that minimize pressure ulcer risk in patients who experience these factors. C1 Univ Maryland, Sch Med, Dept Epidemiol & Prevent Med, Baltimore, MD 21201 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Piscataway, NJ 08854 USA. RP Baumgarten, M (reprint author), Univ Maryland, Sch Med, Dept Epidemiol & Prevent Med, 660 W Redwood St,Suite 200, Baltimore, MD 21201 USA. FU AHRQ HHS [1-R01-HS07322] NR 67 TC 48 Z9 51 U1 1 U2 3 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 1067-1927 J9 WOUND REPAIR REGEN JI Wound Repair Regen. PD MAR-APR PY 2003 VL 11 IS 2 BP 96 EP 103 DI 10.1046/j.1524-475X.2003.11204.x PG 8 WC Cell Biology; Dermatology; Medicine, Research & Experimental; Surgery SC Cell Biology; Dermatology; Research & Experimental Medicine; Surgery GA 654GJ UT WOS:000181485600002 PM 12631296 ER PT J AU Hasty, P Campisi, J Hoeijmakers, J van Steeg, H Vijg, J AF Hasty, P Campisi, J Hoeijmakers, J van Steeg, H Vijg, J TI Aging and genome maintenance: Lessons from the mouse? SO SCIENCE LA English DT Review ID WERNER-SYNDROME HELICASE; EXCISION-REPAIR GENE; MICE LACKING; STRESS-RESPONSE; DEFICIENT MICE; CANCER; SENESCENCE; PROTEIN; P53; KU AB Recent progress in the science of aging is driven largely by the use of model systems, ranging from yeast and nematodes to mice. These models have revealed conservation in genetic pathways that balance energy production and its damaging by-products with pathways that preserve somatic maintenance. Maintaining genome integrity has emerged as a major factor in longevity and cell viability. Here we discuss the use of mouse models with defects in genome maintenance for understanding the molecular basis of aging in humans. C1 Univ Texas, Hlth Sci Ctr, Dept Mol Med, San Antonio, TX 78245 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78245 USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev & Aging Studies, San Antonio, TX 78245 USA. Lawrence Berkeley Natl Lab, Div Life Sci, Berkeley, CA 94720 USA. Buck Inst Age Res, Novato, CA USA. Erasmus Univ, Dept Cell Biol & Genet, CBG, NL-3000 DR Rotterdam, Netherlands. Natl Inst Publ Hlth & Environm, NL-3720 BA Bilthoven, Netherlands. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Hasty, P (reprint author), Univ Texas, Hlth Sci Ctr, Dept Mol Med, San Antonio, TX 78245 USA. FU NIA NIH HHS [AG17242] NR 55 TC 375 Z9 383 U1 1 U2 22 PU AMER ASSOC ADVANCEMENT SCIENCE PI WASHINGTON PA 1200 NEW YORK AVE, NW, WASHINGTON, DC 20005 USA SN 0036-8075 J9 SCIENCE JI Science PD FEB 28 PY 2003 VL 299 IS 5611 BP 1355 EP 1359 DI 10.1126/science.1079161 PG 5 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 649DU UT WOS:000181192300041 PM 12610296 ER PT J AU Volpp, KGM Grande, D AF Volpp, KGM Grande, D TI Patient safety - Residents' suggestions for reducing errors in teaching hospitals SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID OF-MEDICINE REPORT; ADVERSE EVENTS; HOUSE OFFICERS; PERFORMANCE; CARE; INTERVENTION; DEPRIVATION; SYSTEMS; STAFF; SLEEP C1 Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Dept Hlth Care Syst, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Volpp, KGM (reprint author), Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. NR 35 TC 161 Z9 168 U1 1 U2 6 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 27 PY 2003 VL 348 IS 9 BP 851 EP 855 DI 10.1056/NEJMsb021667 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 648WE UT WOS:000181173300014 PM 12606742 ER PT J AU Bryson, CL Ioannou, G Rulyak, S Critchlow, C AF Bryson, CL Ioannou, G Rulyak, S Critchlow, C TI The association between gestational diabetes and pregnancy-induced hypertension SO CIRCULATION LA English DT Meeting Abstract CT 43rd Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 05-08, 2003 CL MIAMI, FLORIDA SP Amer Heart Assoc C1 VA Puget Sound Healthcare Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 25 PY 2003 VL 107 IS 7 MA P111 BP E7032 EP E7032 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 653GX UT WOS:000181427800192 ER PT J AU Bryson, CL Mozaffarian, D Spertus, J McDonell, MB Fihn, SD AF Bryson, CL Mozaffarian, D Spertus, J McDonell, MB Fihn, SD TI Anginal symptoms predict total mortality among outpatients with coronary disease irrespective of age, race, education, or comorbidities SO CIRCULATION LA English DT Meeting Abstract CT 43rd Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 05-08, 2003 CL MIAMI, FLORIDA SP Amer Heart Assoc C1 VA Puget Sound Healthcare Syst, Seattle, WA USA. St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. RI Mozaffarian, Dariush/B-2276-2008 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 25 PY 2003 VL 107 IS 7 MA P103 BP E7030 EP E7030 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 653GX UT WOS:000181427800184 ER PT J AU Bryson, CL Smith, NL Kuller, L Manolio, T Paulo, C Lewis, W Boyko, E Furberg, C Psaty, BM AF Bryson, CL Smith, NL Kuller, L Manolio, T Paulo, C Lewis, W Boyko, E Furberg, C Psaty, BM TI Relative risk of heart failure in an elderly population treated with peripheral alpha-1 antagonists SO CIRCULATION LA English DT Meeting Abstract CT 43rd Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 05-08, 2003 CL MIAMI, FLORIDA SP Amer Heart Assoc C1 VA Puget Sound Healthcare Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. Univ Pittsburgh, Pittsburgh, PA USA. NHLBI, Bethesda, MD 20892 USA. Johns Hopkins, Baltimore, MD USA. Univ Calif Davis, Sacramento, CA 95817 USA. Wake Forest Univ, Winston Salem, NC 27109 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 25 PY 2003 VL 107 IS 7 MA P52 BP E7020 EP E7020 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 653GX UT WOS:000181427800133 ER PT J AU Figlewicz, DP Evans, SB Murphy, J Hoen, M Baskin, DG AF Figlewicz, DP Evans, SB Murphy, J Hoen, M Baskin, DG TI Expression of receptors for insulin and leptin in the ventral tegmental area/substantia nigra (VTA/SN) of the rat SO BRAIN RESEARCH LA English DT Article DE dopamine; fluorescence immunocytochemistry; reward; ingestive behavior ID SENSITIVE POTASSIUM CHANNELS; CONDITIONED PLACE PREFERENCE; SUBSTANTIA-NIGRA; MESSENGER-RNA; FOOD-DEPRIVATION; DOPAMINE TRANSPORTER; HYPOTHALAMIC NEURONS; PARKINSONS-DISEASE; ADIPOSITY SIGNALS; K+ CHANNELS AB Recent studies have demonstrated that the metabolic hormones insulin and leptin can modulate behavioral performance in reward-related paradigms. However, specific anatomical substrate(s) within the CNS for these effects remain to be identified. We hypothesize that midbrain dopamine neurons, which have been implicated to be critical in the mediation of motivational and reward aspects of stimuli, contribute to these behavioral effects of insulin and leptin. As one approach to evaluate this hypothesis, we used double-labeling fluorescence immunohistochemistry to determine whether the raidbrain dopamine neurons express insulin receptors or leptin receptors. Extensive co-expression of tyrosine hydroxylase (a marker for dopamine neurons) with both the insulin receptor and the leptin receptor was observed in the ventral tegmentum and substantia nigra. These findings suggest that midbrain dopamine neurons are direct targets of insulin and leptin, and that they participate in mediating the effects of these hormones on reward-seeking behavior. (C) 2002 Elsevier Science B.V. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Biol Struct, Seattle, WA 98195 USA. RP Figlewicz, DP (reprint author), VA Puget Sound Hlth Care Syst, 1660 So Columbian Way, Seattle, WA 98108 USA. EM latte@u.washington.edu FU NIDDK NIH HHS [DK-17047, R01DK-40963] NR 46 TC 251 Z9 253 U1 1 U2 6 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 EI 1872-6240 J9 BRAIN RES JI Brain Res. PD FEB 21 PY 2003 VL 964 IS 1 BP 107 EP 115 DI 10.1016/S0006-8993(02)04087-8 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 647TZ UT WOS:000181111300012 PM 12573518 ER PT J AU Rose, ME Huerbin, MB Melick, J Marion, DW Palmer, AM Schiding, JK Kochanek, PM Graham, SH AF Rose, ME Huerbin, MB Melick, J Marion, DW Palmer, AM Schiding, JK Kochanek, PM Graham, SH TI Regulation of interstitial excitatory amino acid concentrations after cortical contusion injury (vol 943, pg 15, 2002) SO BRAIN RESEARCH LA English DT Correction C1 Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Anesthesiol & Crit Care Med, Pittsburgh, PA USA. Univ Pittsburgh, Dept Neurosurg, Pittsburgh, PA USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Pittsburgh, PA USA. Univ Pittsburgh, Brain Trauma Res Ctr, Pittsburgh, PA USA. Vernalis Ltd, Wokingham, England. Vet Affairs Pittsburgh Hlth Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. RP Graham, SH (reprint author), Univ Pittsburgh, Dept Neurol, 526 S BST, Pittsburgh, PA 15213 USA. RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X NR 1 TC 0 Z9 0 U1 1 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD FEB 21 PY 2003 VL 964 IS 1 BP 168 EP 168 DI 10.1016/S0006-8993(02)04214-2 PG 1 WC Neurosciences SC Neurosciences & Neurology GA 647TZ UT WOS:000181111300021 ER PT J AU Tyler, KL AF Tyler, KL TI Creutzfeldt-Jakob disease SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. OI Tyler, Kenneth/0000-0003-3294-5888 NR 0 TC 10 Z9 10 U1 1 U2 1 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 20 PY 2003 VL 348 IS 8 BP 681 EP 682 DI 10.1056/NEJMp020187 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 646BF UT WOS:000181014400002 PM 12594311 ER PT J AU Plymate, SR Haugk, KH Sprenger, CC Nelson, PS Tennant, MK Zhang, YP Oberley, LW Zhong, WX Drivdahl, R Oberley, TD AF Plymate, SR Haugk, KH Sprenger, CC Nelson, PS Tennant, MK Zhang, YP Oberley, LW Zhong, WX Drivdahl, R Oberley, TD TI Increased manganese superoxide dismutase (SOD-2) is part of the mechanism for prostate tumor suppression by Mac25/insulin-like growth factor binding-protein-related protein-1 SO ONCOGENE LA English DT Article DE SOD-2; Mac25; prostate; cancer; IGFBP-rP1 ID CANCER CELL-LINE; EPITHELIAL-CELLS; T-ANTIGEN; HYDROGEN-PEROXIDE; EXPRESSION; APOPTOSIS; FIBROBLASTS; P53; OVEREXPRESSION; ACTIVATION AB Increased expression of mac25/insulin-like growth factor binding-protein related protein-1 (IGFBP-rP1) in human breast and prostate epithelial cell lines results in the suppression of tumor growth. CDNA expression array analysis revealed increased manganese superoxide dismutase (SOD-2) expression in the mac25/IGFBP-rP1-transfected M12 human prostate cancer cell line compared to M12 control cells. SOD-2 has been postulated to be a tumor suppressor. SOD-2 was also increased in LNCaP cells stably transfected with mac25/IGFBP-rP1, but not in mac25/IGFBP-rP1-transfected PC-3 cells. Mac25 LNCaP cells had a marked decrease in tumor growth in nude mice compared to controls, but there was no difference in tumor growth in mac25 PC-3 cells compared to control. Phosphorylated Erk and Akt were increased in the M12 and LNCaP transfected mac25/ IGFBP-rP1 cells but not PC-3 mac25. Inhibition of PI-3 kinase results in a marked decrease in viability of the M12-mac25 cells compared to M12 controls. Cells treated with H2O2 result, in an increase in phospho-ERK. Transfection of SOD-2 in M12 cells markedly decreased tumor growth, apoptosis, G1 delay in the cell cycle, and expression of senescence associated beta-galactosidase. These results suggest that one of the downstream mediators of the senescence-associated tumor suppression effect of mac25/IGFBP-rP1 is SOD-2. C1 Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98105 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98105 USA. Univ Washington, Sch Med, Dept Mol, Seattle, WA 98105 USA. Univ Washington, Sch Med, Cell Biol Program, Seattle, WA 98105 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98107 USA. Univ Iowa, Dept Radiol, Iowa City, IA 52242 USA. Univ Wisconsin, Dept Pathol & Lab Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Pathol Serv, Madison, WI 53705 USA. RP Plymate, SR (reprint author), Univ Washington, Harborview Med Ctr, 325 9Th Ave,Box 359755, Seattle, WA 98104 USA. FU NCI NIH HHS [P01-CA 85859]; NIDDK NIH HHS [DK52683] NR 34 TC 41 Z9 43 U1 1 U2 2 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 20 PY 2003 VL 22 IS 7 BP 1024 EP 1034 DI 10.1038/sj.onc.1206210 PG 11 WC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity GA 644PB UT WOS:000180926100008 PM 12592389 ER PT J AU Lincoff, AM Bittl, JA Harrington, RA Feit, F Kleiman, NS Jackman, JD Sarembock, IJ Cohen, DJ Spriggs, D Ebrahimi, R Keren, G Carr, J Cohen, EA Betriu, A Desmet, W Kereiakes, DJ Rutsch, W Wilcox, RG de Feyter, PJ Vahanian, A Topol, EJ AF Lincoff, AM Bittl, JA Harrington, RA Feit, F Kleiman, NS Jackman, JD Sarembock, IJ Cohen, DJ Spriggs, D Ebrahimi, R Keren, G Carr, J Cohen, EA Betriu, A Desmet, W Kereiakes, DJ Rutsch, W Wilcox, RG de Feyter, PJ Vahanian, A Topol, EJ CA REPLACE 2 Investigators TI Bivalirudin and provisional glycoprotein IIb/IIIa blockade compared with heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention - REPLACE-2 Randomized Trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ACTIVE-CONTROL TRIALS; POSTINFARCTION ANGINA; ISCHEMIC EVENTS; ABCIXIMAB; INHIBITORS; THROMBIN; REVASCULARIZATION; THROMBOCYTOPENIA; ANGIOPLASTY; PLACEBO AB Context The direct thrombin inhibitor bivalirudin has been associated with better efficacy and less bleeding than heparin during coronary balloon angioplasty but has not been widely tested during contemporary percutaneous coronary intervention (PCI). Objective To determine the efficacy of bivalirudin, with glycoprotein Ilb/IIIa (Gp IIb/IIia) inhibition on a provisional basis for complications during PCI, compared with heparin plus planned Gp IIb/IIIa blockade with regard to protection from periprocedural ischemic and hemorrhagic complications. Design Setting, and Participants The Randomized Evaluation in PCI Linking Angiomax Reduced Clinical Events (REPLACE)72 trial, a randomized, double-blind, active-controlled trial conducted among 6010 patients undergoing urgent or elective PCI at 233 community or referral hospitals in 9 countries from October 2001 through August 2002. Interventions Patients were randomly assigned to receive intravenous bivalirudin (0.75-mg/kg bolus plus 1.75 mg/kg per hour for the duration of PCI), with provisional Gp IIb/IIIa inhibition (n=2999), or heparin (65-U/kg bolus) with planned Gp IIb/IIIa inhibition (abciximab or eptifibatide) (n=3011). Both groups received daily aspirin and a thienopyridine for at least 30 days after PCI. Main Outcome Measures The primary composite end point was 30-day incidence of death, myocardial infarction, urgent repeat revascularization, or in-hospital major bleeding; the secondary composite end point was 30-day incidence of death, myocardial infarction, or urgent repeat revascularization. Results Provisional Gp IIb/IIIa blockade was administered to 7.2%of patients in the bivalirudin group. By 30 days, the primary composite end point had occurred among 9.2% of patients in the bivalirudin group vs 10.0% of patients in the Neparin-plus-Gp IIb/IIIa group (odds ratio, 0.92; 95% confidence interval, 0.77-1.09; P=32). The secondary composite end point occurred in 7.6% of patients in the bivalirudin vs 7.1% of patients in the heparin-plus-Gp IIb/IIIa groups (odds ratio, 1.09; 95% confidence interval 0.90-1.32; P=.40). Prespecified statistical criteria for noninferiority to heparin plus Gp IIb/IIIa were satisfied for both end points. In-hospital major bleeding rates were significantly reduced by bivalirudin (2.4% vs 4.1%; P<.001). Conclusions Bivalirudin with provisional Gp IIb/IIIa blockade is statistically not inferior to heparin plus planned Go IIb/IIIa blockade during contemporary PCI with regard to suppression of acute ischemic end points and is associated with less bleeding. C1 Cleveland Clin Fdn, Dept Cardiovasc Med, Cleveland, OH 44195 USA. Munroe Reg Med Ctr, Ocala Heart Inst, Ocala, FL USA. Duke Clin Res Inst, Durham, NC USA. NYU, Sch Med, New York, NY USA. Baylor Coll Med, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. Trinity Mother Frances Hosp, Tyler Cardiovasc Consultants, Tyler, TX USA. Univ Virginia Hlth Syst, Charlottesville, VA USA. Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. Clearwater Cardiovasc Consultants, Clearwater, FL USA. W Los Angeles VA, Los Angeles, CA USA. Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel. E Texas Med Ctr, Tyler, TX USA. Sunnybrook & Womens Coll Hlth Sci Ctr, Toronto, ON, Canada. Univ Barcelona, Hosp Clin, Barcelona, Spain. Univ Hosp Gasthuisberg, B-3000 Louvain, Belgium. Ohio Heart Hlth Ctr, Lindner Ctr, Cincinnati, OH USA. Univ Clin Charite Berlin, Berlin, Germany. Univ Nottingham Hosp, Nottingham NG7 2UH, England. Univ Hosp Dijkzigt, NL-3015 GD Rotterdam, Netherlands. Hop Bichat, F-75877 Paris, France. RP Lincoff, AM (reprint author), Cleveland Clin Fdn, Dept Cardiovasc Med, Desk F25,9500 Euclid Ave, Cleveland, OH 44195 USA. OI Topol, Eric/0000-0002-1478-4729 NR 37 TC 771 Z9 802 U1 1 U2 17 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 19 PY 2003 VL 289 IS 7 BP 853 EP 863 DI 10.1001/jama.289.7.853 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 647BW UT WOS:000181072200029 PM 12588269 ER PT J AU Kerwin, W Hooker, A Spilker, M Vicini, P Ferguson, M Hatsukami, T Yuan, C AF Kerwin, W Hooker, A Spilker, M Vicini, P Ferguson, M Hatsukami, T Yuan, C TI Quantitative magnetic resonance imaging analysis of neovasculature volume in carotid atherosclerotic plaque SO CIRCULATION LA English DT Article DE magnetic resonance imaging; contrast media; carotid arteries; atherosclerosis ID ENHANCED MRI; NEOVASCULARIZATION; ANGIOGENESIS; PERMEABILITY; ANGIOGRAPHY; ASSOCIATION; ARTERIES; RUPTURE; AGENT; WALL AB Background-Neovasculature within atherosclerotic plaques is believed to be associated with infiltration of inflammatory cells and plaque destabilization. The aim of the present investigation was to determine whether the amount of neovasculature present in advanced carotid plaques can be noninvasively measured by dynamic, contrast-enhanced MRI. Methods and Results-A total of 20 consecutive patients scheduled for carotid endarterectomy were recruited to participate in an MRI study. Images were obtained at 15-second intervals, and a gadolinium contrast agent was injected coincident with the second of 10 images in the sequence. The resulting image intensity within the plaque was tracked over time, and a kinetic model was used to estimate the fractional blood volume. For validation, matched sections from subsequent endarterectomy were stained with ULEX and CD-31 antibody to highlight microvessels. Finally, all microvessels within the matched sections were identified, and their total area was computed as a fraction of the plaque area. Results were obtained from 16 participants, which showed fractional blood volumes ranging from 2% to 41%. These levels were significantly higher than the histological measurements of fractional vascular area. Nevertheless, the 2 measurements were highly correlated, with a correlation coefficient of 0.80 (P<0.001). Conclusions-Dynamic contrast-enhanced MRI provides an indication of the extent of neovasculature within carotid atherosclerotic plaque. MRI therefore provides a means for prospectively studying the link between neovasculature and plaque vulnerability. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Surg, Seattle, WA 98195 USA. Univ Washington, Dept Bioengn, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Dept Surg & Perioperat Care, Seattle, WA USA. RP Kerwin, W (reprint author), Univ Washington, Dept Radiol, Box 357115,1959 NE Pacific Ave, Seattle, WA 98195 USA. RI Hooker, Andrew/A-7794-2015 OI Hooker, Andrew/0000-0002-2676-5912 FU NCRR NIH HHS [RR-12609]; NHLBI NIH HHS [R01 HL56874] NR 20 TC 210 Z9 240 U1 1 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 18 PY 2003 VL 107 IS 6 BP 851 EP 856 DI 10.1161/01.CIR.0000048145.52309.31 PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 651AV UT WOS:000181298600014 PM 12591755 ER PT J AU Kim, DK Zhu, JL Kozyak, BW Burkman, JM Rubinstein, NA Lankford, EB Stedman, HH Nguyen, T Levine, S Shrager, JB AF Kim, DK Zhu, JL Kozyak, BW Burkman, JM Rubinstein, NA Lankford, EB Stedman, HH Nguyen, T Levine, S Shrager, JB TI Myosin heavy chain and physiological adaptation of the rat diaphragm in elastase-induced emphysema SO RESPIRATORY RESEARCH LA English DT Article DE Ca2+-transporting ATPase; muscle fatigue; myosin; respiratory muscles ID SKELETAL-MUSCLE; CELLULAR ADAPTATIONS; MESSENGER-RNA; RESPIRATORY MUSCLES; VENTILATORY MUSCLES; HAMSTER DIAPHRAGM; LUNG-FUNCTION; SINGLE-FIBER; ISOFORMS; EXPRESSION AB Background: Several physiological adaptations occur in the respiratory muscles in rodent models of elastase-induced emphysema. Although the contractile properties of the diaphragm are altered in a way that suggests expression of slower isoforms of myosin heavy chain (MHC), it has been difficult to demonstrate a shift in MHCs in an animal model that corresponds to the shift toward slower MHCs seen in human emphysema. Methods: We sought to identify MHC and corresponding physiological changes in the diaphragms of rats with elastase-induced emphysema. Nine rats with emphysema and 11 control rats were studied 10 months after instillation with elastase. MHC isoform composition was determined by both reverse transcriptase polymerase chain reaction (RT-PCR) and immunocytochemistry by using specific probes able to identify all known adult isoforms. Physiological adaptation was studied on diaphragm strips stimulated in vitro. Results: In addition to confirming that emphysematous diaphragm has a decreased fatigability, we identified a significantly longer time-to-peak-tension (63.9 +/- 2.7 ms versus 53.9 +/- 2.4 ms). At both the RNA (RT-PCR) and protein (immunocytochemistry) levels, we found a significant decrease in the fastest, MHC isoform (IIb) in emphysema. Conclusion: This is the first demonstration of MHC shifts and corresponding physiological changes in the diaphragm in an animal model of emphysema. It is established that rodent emphysema, like human emphysema, does result in a physiologically significant shift toward slower diaphragmatic MHC isoforms. In the rat, this occurs at the faster end of the MHC spectrum than in humans. C1 Univ Penn, Sch Med, Dept Surg, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Penn Muscle Inst, Philadelphia, PA 19104 USA. Thomas Jefferson Univ, Dept Pathol Anat & Cell Biol, Philadelphia, PA 19107 USA. Philadelphia Vet Affairs Med Ctr, Dept Surg, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Dept Med, Philadelphia, PA USA. RP Shrager, JB (reprint author), Univ Penn, Sch Med, Dept Surg, Philadelphia, PA 19104 USA. NR 51 TC 23 Z9 23 U1 0 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1465-993X J9 RESPIR RES JI Respir. Res. PD FEB 17 PY 2003 VL 4 IS 1 AR 1 DI 10.1186/rr196 PG 10 WC Respiratory System SC Respiratory System GA 648JB UT WOS:000181146600001 PM 12617755 ER PT J AU Wang, V Saab, S AF Wang, V Saab, S TI Ammonia levels and the severity of hepatic encephalopathy SO AMERICAN JOURNAL OF MEDICINE LA English DT Editorial Material ID PATHOGENESIS C1 Univ Calif Los Angeles, Med Ctr, Div Digest Dis, Dept Med,Liver Transplant Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Liver transplant Ctr, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90095 USA. RP Saab, S (reprint author), Univ Calif Los Angeles, Med Ctr, Div Digest Dis, Dept Med,Liver Transplant Ctr, 44-138 CHS MC 168417,10833 Le Conte Ave, Los Angeles, CA 90095 USA. NR 11 TC 9 Z9 9 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 FEB 15 PY 2003 VL 114 IS 3 BP 237 EP 238 DI 10.1016/S0002-9343(02)01571-1 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 653YZ UT WOS:000181465800013 PM 12637141 ER PT J AU Pastore, YD Jelinek, J Ang, S Guan, YL Liu, EL Jedlickova, K Krishnamurti, L Prchal, JT AF Pastore, YD Jelinek, J Ang, S Guan, YL Liu, EL Jedlickova, K Krishnamurti, L Prchal, JT TI Mutations in the VHL gene in sporadic apparently congenital polycythemia SO BLOOD LA English DT Article ID DOMINANT PRIMARY POLYCYTHEMIA; HIPPEL-LINDAU-DISEASE; PROLYL HYDROXYLATION; HIF-ALPHA; ERYTHROPOIETIN; FAMILY; HEMANGIOBLASTOMA; ERYTHROCYTOSIS; PHENOTYPE AB The congenital polycythemic disorders with elevated erythropoietin (Epo) have been until recently an enigma, and abnormality in the hypoxia-sensing pathway has been hypothesized as a possible mechanism. The tumor suppressor von Hippel-Lindau (VHL) participates in the hypoxia-sensing pathway, as it binds to the proline-hydroxylated form of the hypoxia-inducible factor 1alpha (HIF-1alpha) and mediates its ubiquitination and proteosomal degradation. The loss of VHL function may result in the accumulation of HIF-1alpha and overproduction of HIF-1 downstream target genes including Epo. VHL syndrome is an autosomal dominant disorder predisposing to the development of tumors, due to inherited mutations in the VHL gene. Some rare patients with VHL syndrome have polycythemia, which has been attributed to Epo production by a tumor. It was recently found that homozygosity for the VHL Arg200Trp mutation is the cause of Chuvash polycythemia, an autosomal recessive polycythemic disorder characterized by elevated serum Epo and hypersensitivity of erythroid cells to Epo. We evaluated the role of VHL in 8 children with a history of polycythemia and an elevated serum Epo level and found 3 different germline VHL mutations in 4 of them. One child was homozygous for the Arg200Trp VHL mutation, and another compound heterozygous for the Arg200Trp and the Val130Leu mutations. Two children (siblings) were heterozygous for an Asp126Tyr mutation, one of them fulfilling some criteria of VHL syndrome. We propose that mutations of the VHL gene represent an important cause of pediatric sporadic polycythemias with an inappropriately high serum Epo concentration. (C) 2003 by The American Society of Hematology. C1 Baylor Coll Med, Houston, TX 77030 USA. Texas Childrens Canc Ctr, Houston, TX USA. Hematol Serv, Houston, TX USA. Vet Adm Hosp, Houston, TX USA. Univ Minnesota, Minneapolis, MN USA. RP Prchal, JT (reprint author), Baylor Coll Med, 1 Baylor Plaza,Suite 802E, Houston, TX 77030 USA. RI Jelinek, Jaroslav/A-8476-2008; Jelinek, Jaroslav/D-2282-2012 OI Jelinek, Jaroslav/0000-0002-2533-0220 FU NHLBI NIH HHS [R01HL5007-08, R01HL66333-01] NR 30 TC 102 Z9 108 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 FEB 15 PY 2003 VL 101 IS 4 BP 1591 EP 1595 DI 10.1182/blood-2002-06-1843 PG 5 WC Hematology SC Hematology GA 643DM UT WOS:000180846700057 PM 12393546 ER PT J AU Heuze-Vourc'h, N Zhu, L Krysan, K Batra, RK Sharma, S Dubinett, SM AF Heuze-Vourc'h, N Zhu, L Krysan, K Batra, RK Sharma, S Dubinett, SM TI Abnormal interleukin 10R alpha expression contributes to the maintenance of elevated cyclooxygenase-2 in non-small cell lung cancer cells SO CANCER RESEARCH LA English DT Article ID EPITHELIAL-CELLS; IL-10; RECEPTOR; BALANCE AB Non-small cell lung cancer (NSCLC) cells are known to constitutively overexpress cyclooxygenase (COX)-2. Tumor COX-2-dependent production of PGE(2) triggers the synthesis of lymphocyte and macrophage interleukin (IL)-10 that, in turn, is known to potently suppress COX-2 in normal cells. Thus, we investigated the capacity of IL-10 to down-regulate COX-2 expression in NSCLC cells. Western blotting and ELISA analyses revealed that IL-10 did not affect COX-2 expression and subsequent PGE(2) production in NSCLC cells. Although normal human bronchial epithelial cells expressed both intracellular and membrane IL-10Ralpha, NSCLC cells only expressed intracellular but not cell surface membrane IL-10R. Unresponsiveness of COX-2 to IL-10 is due to the deficiency of IL-10Ralpha on the surface of NSCLC cells. Our findings highlight a novel mechanism contributing to maintenance of elevated COX-2 and PGE(2) in the lung tumor environment. C1 Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Div Pulm & Crit Care Med,Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Lung Canc Res Program, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Div Pulm & Crit Care Med,Dept Med, 10833 Conte Ave,37-131 CHS, Los Angeles, CA 90095 USA. RI HEUZE-VOURC'H, Nathalie/P-8081-2016 FU NCI NIH HHS [R01 CA85686, 1P50 CA90388, CA-16042, R01 CA71818]; NIAID NIH HHS [AI-28697] NR 28 TC 24 Z9 25 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD FEB 15 PY 2003 VL 63 IS 4 BP 766 EP 770 PG 5 WC Oncology SC Oncology GA 645XV UT WOS:000181006500007 PM 12591723 ER PT J AU Guzman, Y Stone, EA Fung, HB Brau, N AF Guzman, Y Stone, EA Fung, HB Brau, N TI Clostridium difficile colitis after forced anal-receptive intercourse SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID HOMOSEXUAL MEN; CHEMOTHERAPY; DIARRHEA; PACLITAXEL AB Colitis caused by Clostridium difficile toxin has been reported in homosexual men. We report a case of C. difficile colitis that occurred in an immunocompetent heterosexual man after forced anal-receptive intercourse. C1 Bronx Vet Affairs Med Ctr, Pharm Program, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Crit Care Sect, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Infect Dis Sect, Program Med, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY USA. RP Brau, N (reprint author), Bronx Vet Adm Med Ctr, Infect Dis Sect 111F, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. NR 9 TC 0 Z9 0 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 FEB 15 PY 2003 VL 36 IS 4 BP E61 EP E62 DI 10.1086/367652 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 642AE UT WOS:000180778700031 PM 12567322 ER PT J AU Davis, L Roullet, JB Thornburg, KL Shokry, M Hohimer, AR Giraud, GD AF Davis, L Roullet, JB Thornburg, KL Shokry, M Hohimer, AR Giraud, GD TI Augmentation of coronary conductance in adult sheep made anaemic during fetal life SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID LEFT-VENTRICULAR HYPERTROPHY; MYOCARDIAL BLOOD-FLOW; RESISTANCE VESSELS; RESERVE; HEART; GROWTH; YOUNG; RATS; AGE AB Maximal coronary conductance with adenosine in anaemic fetal sheep is twice that of non-anaemic fetuses. To investigate whether this increase in conductance persists into adulthood we studied twin sheep as fetuses and again as adults. Nine anaemic fetuses (118 days gestation) underwent isovolaemic haemorrhage for 18.0 +/- 4.6 days (means +/- S.D.) during which time the haematocrit was reduced from 39.9 +/- 5.2 % to 16.3 +/- 3.4 % and oxygen content from 8.6 +/- 1.3 to 2.3 +/- 0.2 ml dl(-1). At 138 days the anaemic fetuses were transfused; at delivery the haematocrit was 29.3 +/- 6.8 % compared to nine control fetuses in which the haematocrit was 38.5 +/- 4.3 %. The weight at delivery was 3.5 +/- 0.36 kg in the anaemic fetuses vs. 4.2 +/- 0.83 kg in controls. Twenty-eight weeks later, we placed an occluder on the descending thoracic aorta and inferior vena cava, a flow probe around the proximal left circumflex coronary artery, and catheters in the left atrial appendage, jugular and carotid vessels. Maximal coronary conductance was determined in the adults by recording coronary blood flow as driving pressure was altered by inflating the occluders while adenosine was infused into the left atrium. Right atrial, left atrial, systolic and mean arterial pressures, systemic vascular resistance and haematocrit were not different between 'in utero anaemic' and control adults. The adults that were anaemic in utero weighed less than the controls 39.4 +/- 4.6 kg vs. 45.0 +/- 5.6 kg. Maximal conductance was greater in the adults that were anaemic in utero: 11.2 +/- 4.0 ml min(-1) (100 g)(-1) mmHg(-1) as compared to 6.1 +/- 1.8 ml min(-1) (100 g)(-1) mmHg(-1) in the controls. Vascular reactivity of the mesenteric arteries was not different. These data suggest that coronary conductance can be modified in utero by anaemia (high flow and hypoxaemia) and that the remodelled coronary tree persists to adulthood. C1 Oregon Hlth Sci Univ, Dept Obstet, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Internal Med, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Heart Res Ctr, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR 97239 USA. RP Davis, L (reprint author), Oregon Hlth Sci Univ, Dept Obstet, Portland, OR 97239 USA. FU NHLBI NIH HHS [R01 HL045043, HL45043]; NICHD NIH HHS [P01HD34430, P01 HD034430] NR 19 TC 26 Z9 26 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD FEB 15 PY 2003 VL 547 IS 1 BP 53 EP 59 DI 10.1113/jphysiol.2002.023283 PG 7 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 690VD UT WOS:000183570400009 PM 12562949 ER PT J AU Steinman, MA Landefeld, CS Gonzales, R AF Steinman, MA Landefeld, CS Gonzales, R TI Predictors of broad-spectrum antibiotic prescribing for acute respiratory tract infections in adult primary care SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ACUTE BRONCHITIS; PATIENTS EXPECTATIONS; EDUCATIONAL OUTREACH; PHYSICIANS BEHAVIOR; CLINICAL-PRACTICE; CONTROLLED TRIAL; DRUG COMPANIES; PERCEPTIONS; PRESCRIPTION; PRINCIPLES AB Context Broad-spectrum antibiotics are commonly prescribed, but little is known about the physicians who prescribe and the patients who take these agents. Objective To identify factors associated with prescribing of broad-spectrum antibiotics by physicians caring for patients with nonpneumonic acute respiratory tract infections (ARTIs). Design, Setting, and Patients Cross-sectional study using data from the National Ambulatory Medical Care Survey between 1997 and 1999. Information was collected on a national sample of 1981 adults seen by physicians for the common cold and nonspecific upper respiratory tract infections (URTIs) (24%), acute sinusitis (24%), acute bronchitis (23%), otitis media (5%), pharyngitis, laryngitis, and tracheitis (11%), or more than 1 of the above diagnoses (13%). Main Outcome Measure Prescription of broad-spectrum antibiotics, defined for this study as quinolones; amoxicillin/clavulanate, second- and third-generation cephalosporins, and azithromycin and clarithromycin. Results, Antibiotics were prescribed to 63% of patients with an ARTI, ranging from 46% of patients with,the common cold or nonspecific URTIs to 69% of patients with acute sinusitis. Broad-spectrum agents were chosen in 54% of patients prescribed an antibiotic, including 51% of patients with the common cold and nonspecific URTIs, 53% with acute sinusitis, 62% with acute bronchitis, and 65% with otitis media. Multivariable analysis identified several clinical and nonclinical factors associated with choice of a broad-spectrum agent. After adjusting for diagnosis and chronic comorbid illnesses, the strongest independent predictors of broad-spectrum antibiotic prescribing were physician specialty (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.6-3.5 for internal medicine physicians compared with general and family physicians) and geographic region (OR, 2.6; 95% CI, 1.4-4.8 for Northeast and OR, 2.4; 95% CI, 1.4-4.2 for South [both compared with West]). Other independent predictors of choosing a broad-spectrum agent included black race, lack of health insurance, and health maintenance organization membership, each of which was associated with lower rates of broad-spectrum prescribing. Patient age, sex, and urban vs rural location were not significantly associated with prescribing choice. Conclusions Broad-spectrum antibiotics are commonly prescribed for the treatment of ARTIs, especially by internists and physicians in the Northeast and South. These high rates of prescribing, wide variations in practice patterns, and the strong association of nonclinical factors with antibiotic choice suggest opportunities to improve prescribing patterns. C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, VA Natl Qual Scholars Program, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. RP Steinman, MA (reprint author), San Francisco VA Med Ctr, Div Geriatr, 4150 Clement St,Box 181-G, San Francisco, CA 94121 USA. NR 58 TC 161 Z9 165 U1 2 U2 13 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 12 PY 2003 VL 289 IS 6 BP 719 EP 725 DI 10.1001/jama.289.6.719 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 643WP UT WOS:000180886000026 PM 12585950 ER PT J AU Banfi, B Clark, RA Steger, K Krause, KH AF Banfi, B Clark, RA Steger, K Krause, KH TI Two novel proteins activate superoxide generation by the NADPH oxidase NOX1 SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID NAD(P)H OXIDASE; DOMAIN; PHOSPHORYLATION; SUBUNIT; CELLS; IDENTIFICATION; EXPRESSION; P67(PHOX); P47(PHOX); HOMOLOG AB NOX1, an NADPH oxidase expressed predominantly in colon epithelium, shows a high degree of similarity to the phagocyte NADPH oxidase. However, superoxide generation by NOX1 has been difficult to demonstrate. Here we show that NOX1 generates superoxide when co-expressed with the p47(phox) and p67(phox) subunits of the phagocyte NADPH oxidase but not when expressed by itself. Since p47(phox) and p67(phox) are restricted mainly to myeloid cells, we searched for their homologues and identified two novel cDNAs. The mRNAs of both homologues were found predominantly in colon epithelium. Differences between the homologues and the phagocyte NADPH oxidase subunits included the lack of the auto-inhibitory domain and the protein kinase C phosphorylation sites in the p47(phox) homologue as well as the absence of the first Src homology 3 domain and the presence of a hydrophobic stretch in the p67(phox) homologue. Co-expression of NOX1 with the two novel proteins led to stimulus-independent high level superoxide generation. Stimulus dependence of NOX1 was restored when p47(phox) was used to replace its homologue. In conclusion, NOX1 is a superoxide-generating enzyme that is activated by two novel proteins, which we propose to name NOXO1 (NOX organizer 1) and NOXA1 (NOX activator 1). C1 Univ Hosp Geneva, Dept Geriatr, Biol Ageing Lab, CH-1225 Geneva, Switzerland. Inst Vet Anat, D-35392 Giessen, Germany. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. RP Banfi, B (reprint author), Univ Hosp Geneva, Dept Geriatr, Biol Ageing Lab, 2 Ch Petit Bel Air, CH-1225 Geneva, Switzerland. RI Krause, Karl-Heinz/E-8030-2011 FU NIA NIH HHS [AG19519, R01 AG019519]; NIAID NIH HHS [AI20866, R01 AI020866, R37 AI020866] NR 27 TC 322 Z9 333 U1 1 U2 4 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 7 PY 2003 VL 278 IS 6 BP 3510 EP 3513 DI 10.1074/jbc.C200613200 PG 4 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 643PM UT WOS:000180869700002 PM 12473664 ER PT J AU Saint, S Lipsky, BA Goold, SD AF Saint, S Lipsky, BA Goold, SD TI Urinary catheters: A one-point restraint? - Response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Vet Affairs Ann Arbor Hlth Care Syst, Ann Arbor, MI 48109 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Michigan, Ann Arbor, MI 48109 USA. RP Saint, S (reprint author), Vet Affairs Ann Arbor Hlth Care Syst, Ann Arbor, MI 48109 USA. NR 5 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 FEB 4 PY 2003 VL 138 IS 3 BP 238 EP 239 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 646DB UT WOS:000181018600021 ER PT J AU Danforth, W Bigger, JT Davidoff, F Delaney, MJ Dentzer, S Ehringhaus, SH Graham, G Hellmann, S Kahn, J Kalb, M Kaufman, RE Kelch, RP Laret, MR Leonard, JS Levy, R Lieber, CE Martin, JB Miller, ED Murray, TH O'Brien, CP Porter, JE Porter, R Ramsey, PG Robinson, DK Smith, H Visco, FM Woo, S Wood, AJJ Turman, RJ Korn, D Kulynych, J AF Danforth, W Bigger, JT Davidoff, F Delaney, MJ Dentzer, S Ehringhaus, SH Graham, G Hellmann, S Kahn, J Kalb, M Kaufman, RE Kelch, RP Laret, MR Leonard, JS Levy, R Lieber, CE Martin, JB Miller, ED Murray, TH O'Brien, CP Porter, JE Porter, R Ramsey, PG Robinson, DK Smith, H Visco, FM Woo, S Wood, AJJ Turman, RJ Korn, D Kulynych, J CA AAMC Task Force Financial Conflict TI Protecting subjects, preserving trust, promoting progress I: Policy and guidelines for the oversight of individual financial interests in human subjects research SO ACADEMIC MEDICINE LA English DT Article AB In December 2001, the AAMC Task Force on Financial Conflicts of Interest in Clinical Research released this report, the first of two (both published in this issue of Academic Medicine). This report focuses on gaps in existing federal financial disclosure regulations of individual conflicts of interests, finding that additional scrutiny is recommended in two areas: human subjects research and privately sponsored research. The task force suggests that when potential conflicts exist, a conflicts of interest committee should apply a rebuttable presumption against engaging in human subjects research. The task force recommends that the circumstances giving rise to the presumption against the proposed activity be balanced against compelling circumstances in favor of the conduct of the research. The AAMC task force delineates core principles to guide institutional policy development. First, an institution should regard all significant financial interests in human subjects research as requiring close scrutiny. Second, in the event of compelling circumstances, an individual holding a significant financial interest may be permitted to conduct the research. Whether circumstances are deemed compelling will depend in each case upon the nature of the science, the nature of the interest, how closely the interest is related to the research, and the degree to which the interest may be affected by the research. Four other core principles for development of institutional policies are identified in the report, pertaining to reporting, monitoring, management of conflicts, and accountability. C1 Assoc Amer Med Coll, DBHSR, Washington, DC 20037 USA. Washington Univ, Board Trustees, St Louis, MO 63130 USA. Columbia Univ, New York, NY 10027 USA. Univ N Carolina, Chapel Hill, NC 27515 USA. Guidant Corp, Indianapolis, IN 46244 USA. Genentech Inc, San Francisco, CA 94080 USA. Univ Minnesota, Minneapolis, MN 55455 USA. John F Kennedy Sch Govt, Joan Shorenstein Ctr Press Polit & Publ Policy, Washington, DC USA. Duke Univ, Sch Med, Durham, NC 27706 USA. Univ Iowa, Coll Med, Iowa City, IA 52242 USA. Univ Calif San Francisco, Med Ctr, San Francisco, CA 94143 USA. Howard Hughes Med Inst, Coconut Grove, FL 33133 USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. Harvard Univ, Sch Med, Fac Med, Cambridge, MA 02138 USA. Hastings Ctr, Garrison, NY USA. Univ Penn, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Hogan & Hartson LLP, Washington, DC 20004 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Yale Univ, New Haven, CT 06520 USA. Mt Sinai Sch Med, Inst Gene Therapy, New York, NY 10029 USA. Vanderbilt Univ, Sch Med, Nashville, TN 37240 USA. Assoc Amer Univ, New York, NY 10012 USA. Assoc Amer Med Coll, Div Biomed & Hlth Sci Res, Washington, DC 20037 USA. RP Korn, D (reprint author), Assoc Amer Med Coll, DBHSR, 2450 N St NW, Washington, DC 20037 USA. NR 7 TC 0 Z9 0 U1 0 U2 0 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD FEB PY 2003 VL 78 IS 2 BP 226 EP 236 PG 11 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 647CG UT WOS:000181073900018 ER PT J AU Danforth, W Bigger, JT Davidoff, F Delaney, M Dentzer, S Ehringhaus, SH Graham, G Hellmann, S Kahn, J Kalb, M Kaufman, RE Kelch, RP Laret, MR Leonard, JS Levy, R Lieber, CE Martin, JB Miller, ED Murray, TH O'Brien, CP Porter, JE Porter, R Ramsey, PG Robinson, DK Visco, FM Woo, S Wood, AJJ Turman, RJ Korn, D Kulynych, J AF Danforth, W Bigger, JT Davidoff, F Delaney, M Dentzer, S Ehringhaus, SH Graham, G Hellmann, S Kahn, J Kalb, M Kaufman, RE Kelch, RP Laret, MR Leonard, JS Levy, R Lieber, CE Martin, JB Miller, ED Murray, TH O'Brien, CP Porter, JE Porter, R Ramsey, PG Robinson, DK Visco, FM Woo, S Wood, AJJ Turman, RJ Korn, D Kulynych, J CA AAMC Task Force Financial Conflict TI Protecting subjects, preserving trust, promoting progress II: Principles and recommendations for oversight of an institution's financial interests in human subjects research SO ACADEMIC MEDICINE LA English DT Article AB The AAMC Task Force on Financial Conflicts of Interest in Clinical Research issued this report, the second of two, in October 2002. (The first report is also published in this issue of Academic Medicine.) This report offers a unique perspective on the new phenomenon of "institutional" conflicts of interest. The task force acknowledges the diverse obligations of academic institutions that conduct research and also invest in-and accept the philanthropy of-commercial research sponsors. The task force emphasizes the importance of disclosing institutional financial interests as an integral part of the research process, critical to allaying public concerns, and to strengthening the trust relationship between research subjects, the public and the scientific community. The task force found that the safety and welfare of research subjects and the objectivity of the research could be-or could appear to be-compromised whenever an institution holds a significant financial interest that may be affected by the outcome of the research. Thus, the task force recommends separating the functional and administrative responsibilities related to human subjects research from those related to investment managing and technology licensing, and encourages the establishment of institutional conflicts-of-interest committees. As in the first report, the task force recommends that institutions should develop policies establishing a rebuttable presumption against the conduct of research at or under the auspices of an institution where potential conflicts in human subjects research are identified. This presumption against engaging in the research is to be balanced against compelling circumstances in favor of the conduct of the proposed research activity. C1 Assoc Amer Med Coll, DBHSR, Washington, DC 20037 USA. Washington Univ, Board Trustees, St Louis, MO USA. Columbia Univ, New York, NY 10027 USA. Univ N Carolina, Chapel Hill, NC 27515 USA. Guidant Corp, Indianapolis, IN 46244 USA. Genentech Inc, San Francisco, CA 94080 USA. Univ Minnesota, Ctr Bioeth, Minneapolis, MN 55455 USA. John F Kennedy Sch Govt, Joan Shorenstein Ctr Press Polit & Publ Policy, Washington, DC USA. Duke Univ, Sch Med, Durham, NC 27706 USA. Univ Iowa, Coll Med, Iowa City, IA 52242 USA. Univ Calif San Francisco, Med Ctr, San Francisco, CA 94143 USA. Howard Hughes Med Inst, Coconut Grove, FL 33133 USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. Harvard Univ, Sch Med, Fac Med, Cambridge, MA 02138 USA. Hastings Ctr, Garrison, NY USA. Univ Penn, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Hogan & Hartson LLP, Washington, DC 20004 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Yale Univ, New Haven, CT 06520 USA. Mt Sinai Sch Med, Inst Gene Therapy, New York, NY 10029 USA. Assoc Amer Univ, Washington, DC 20005 USA. Assoc Amer Med Coll, Div Biomed & Hlth Sci Res, Washington, DC 20037 USA. RP Korn, D (reprint author), Assoc Amer Med Coll, DBHSR, 2450 N St NW, Washington, DC 20037 USA. NR 3 TC 21 Z9 22 U1 0 U2 1 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD FEB PY 2003 VL 78 IS 2 BP 237 EP 245 PG 9 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 647CG UT WOS:000181073900019 ER PT J AU Massie, BM Ansari, MN AF Massie, BM Ansari, MN TI Specialty care for heart failure: Does it improve outcomes? SO AMERICAN HEART JOURNAL LA English DT Editorial Material ID ACUTE MYOCARDIAL-INFARCTION; CONVERTING ENZYME-INHIBITORS; PHYSICIAN SPECIALTY; PRACTICE GUIDELINES; FAMILY PHYSICIANS; CARDIOLOGISTS; GENERALIST; MANAGEMENT; KNOWLEDGE; PATTERNS C1 San Francisco VA Med Ctr, Div Cardiol, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94143 USA. RP Massie, BM (reprint author), San Francisco VA Med Ctr, Div Cardiol, San Francisco, CA USA. NR 22 TC 6 Z9 6 U1 1 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 FEB PY 2003 VL 145 IS 2 BP 209 EP 213 DI 10.1067/mhj.2003.55 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 647MU UT WOS:000181097500008 PM 12595835 ER PT J AU Gheorghiade, M Adams, KF Gattis, WA Teerlink, JR Orlandi, C O'Connor, CM AF Gheorghiade, M Adams, KF Gattis, WA Teerlink, JR Orlandi, C O'Connor, CM TI Surrogate end points in heart failure trials SO AMERICAN HEART JOURNAL LA English DT Article; Proceedings Paper CT Meeting on the Management of Decompensated Heart Failure Resulting in Hospitalization CY APR 20-22, 2001 CL SPRINGFIELD, VIRGINIA ID MORTALITY; FLOSEQUINAN; ENALAPRIL; SURVIVAL; THERAPY C1 Northwestern Univ, Feinberg Sch Med, Div Cardiol, Chicago, IL 60611 USA. Univ N Carolina, Chapel Hill, NC USA. Duke Clin Res Inst, Durham, NC USA. Univ Calif San Francisco, Sch Med, San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Otsuka Maryland Res Inst, Rockville, MD USA. RP Gheorghiade, M (reprint author), Northwestern Univ, Feinberg Sch Med, Div Cardiol, Galter 10-240,201 E Huron St, Chicago, IL 60611 USA. RI Teerlink, John/D-2986-2012; Stough, Wendy/R-4287-2016 OI Stough, Wendy/0000-0001-8290-1205 NR 22 TC 12 Z9 12 U1 0 U2 0 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 2003 VL 145 IS 2 SU S BP S67 EP S70 DI 10.1067/mhj.2003.159 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 648TE UT WOS:000181166000012 PM 12594457 ER PT J AU Jain, P Massie, BM Gattis, WA Klein, L Gheorghiade, M AF Jain, P Massie, BM Gattis, WA Klein, L Gheorghiade, M TI Current medical treatment for the exacerbation of chronic heart failure resulting in hospitalization SO AMERICAN HEART JOURNAL LA English DT Article; Proceedings Paper CT Meeting on the Management of Decompensated Heart Failure Resulting in Hospitalization CY APR 20-22, 2001 CL SPRINGFIELD, VIRGINIA ID LEFT-VENTRICULAR DYSFUNCTION; ACUTE MYOCARDIAL-INFARCTION; RANDOMIZED CONTROLLED TRIAL; HIGH-DOSE FUROSEMIDE; INTRAVENOUS NESIRITIDE; INOTROPIC STIMULATION; PULMONARY-EDEMA; INCREASED RISK; THERAPY; DOBUTAMINE C1 Northwestern Univ, Feinberg Sch MEd, Div Cardiol, Chicago, IL 60611 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Duke Clin Res Inst, Durham, NC USA. Advocate Illinois Masonic Med Ctr, Chicago, IL USA. RP Gheorghiade, M (reprint author), Northwestern Univ, Feinberg Sch MEd, Div Cardiol, Galter 10-240 E Huron St, Chicago, IL 60611 USA. RI Stough, Wendy/R-4287-2016 OI Stough, Wendy/0000-0001-8290-1205 NR 68 TC 41 Z9 51 U1 1 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 2003 VL 145 IS 2 SU S BP S3 EP S17 DI 10.1067/mhj.2003.149 PG 15 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 648TE UT WOS:000181166000002 PM 12594447 ER PT J AU O'Connor, CM Gattis, WA Teerlink, JR Adarns, KF Gheorghiade, M AF O'Connor, CM Gattis, WA Teerlink, JR Adarns, KF Gheorghiade, M TI Design considerations and proposed template for clinical trials in hospitalized patients with decompensated chronic heart failure SO AMERICAN HEART JOURNAL LA English DT Article; Proceedings Paper CT Meeting on the Management of Decompensated Heart Failure Resulting in Hospitalization CY APR 20-22, 2001 CL SPRINGFIELD, VIRGINIA C1 Duke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC 27705 USA. Univ Calif San Francisco, San Francisco Sch Med, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. Univ N Carolina, Chapel Hill, NC USA. Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. RP Gattis, WA (reprint author), Duke Univ, Med Ctr, Duke Clin Res Inst, 2400 N Pratt St, Durham, NC 27705 USA. RI Teerlink, John/D-2986-2012; Stough, Wendy/R-4287-2016 OI Stough, Wendy/0000-0001-8290-1205 NR 1 TC 3 Z9 3 U1 0 U2 0 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 2003 VL 145 IS 2 SU S BP S47 EP S50 DI 10.1067/mhj.2003.153 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 648TE UT WOS:000181166000006 PM 12594451 ER PT J AU Teerlink, JR AF Teerlink, JR TI Dyspnea as an end point in clinical trials of therapies for acute decompensated heart failure SO AMERICAN HEART JOURNAL LA English DT Article; Proceedings Paper CT Meeting on the Management of Decompensated Heart Failure Resulting in Hospitalization CY APR 20-22, 2001 CL SPRINGFIELD, VIRGINIA ID OBSTRUCTIVE AIRWAY DISEASE; VISUAL ANALOG SCALES; INTRAVENOUS MILRINONE; SCIENTIFIC SESSIONS; OF-CARDIOLOGY; UPDATE; DESCRIPTORS; HIGHLIGHTS; EXERCISE; AMERICAN C1 San Francisco Vet Affairs Med Ctr, Heart Failure Clin, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, San Francisco, CA USA. RP Teerlink, JR (reprint author), San Francisco Vet Affairs Med Ctr, Heart Failure Clin, 111C,4150 Clement St, San Francisco, CA 94121 USA. RI Teerlink, John/D-2986-2012 NR 31 TC 43 Z9 43 U1 0 U2 0 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 2003 VL 145 IS 2 SU S BP S26 EP S33 DI 10.1067/mhj.2003.151 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 648TE UT WOS:000181166000004 PM 12594449 ER PT J AU Metz, DC Soffer, E Forsmark, CE Cryer, B Chey, W Bochenek, W Pisegna, JR AF Metz, DC Soffer, E Forsmark, CE Cryer, B Chey, W Bochenek, W Pisegna, JR TI Maintenance oral pantoprazole therapy is effective for patients with Zollinger-Ellison syndrome and idiopathic hypersecretion SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID GASTRIC-ACID HYPERSECRETION; OMEPRAZOLE; SAFETY; EFFICACY; LANSOPRAZOLE; DEFINITION; SECRETION; SURGERY AB OBJECTIVE: (1)Maintenance proton pump inhibitor (PPI) therapy is effective for gastric acid hypersecretory states, although data with pantoprazole are limited. The aim of this study was to evaluate the safety and efficacy of long term p.o. pantoprazole in individuals with hypersecretion. METHODS: All subjects had Zollinger-Ellison syndrome or idiopathic hypersecretion. Baseline acid output was measured in the presence of prior maintenance antisecretory therapy before pantoprazole exposure. The starting dose was 40 mg b.i.d. in most cases, and the dose was adjusted to document control within the first 2 wk of therapy. The maximal allowable dose was 240 mg daily. Acid output was measured on day 28 and then quarterly from month 3. The primary efficacy endpoint was documented control of acid secretion at 6 months, i.e., acid output in the last I h before the next dose of therapy of <10 mEq/h (<5 mEq/h in subjects with prior acid-reducing surgery). RESULTS: A total of 26 subjects had Zollinger-Ellison syndrome (six with multiple endocrine neoplasia syndrome type 1) and nine had idiopathic hypersecretion. Pre-enrollment therapy included omeprazole in 27 subjects and lansoprazole in eight, and 82.4% of subjects were controlled on their prior regimens. With upward dose titration, acid output was controlled in all subjects by day 10 and in all but two (6%) at the 6-month time point. Median acid secretion on therapy at 6 months was <2 mEq/h (mean 2.2 mEq/h; range 0-10.5 mEq/h) at a dose of 40 mg b.i.d for 24 subjects, 80 mg b.i.d. for seven subjects, and 120 mg b.i.d. for two subjects. During the course of the study, five subjects required doses of 240 mg daily. Pantoprazole was generally well tolerated. No cases of anterior optic ischemic neuropathy occurred. Five subjects died during follow-up, all because of events unrelated to the study drug. CONCLUSIONS: Maintenance p.o. pantoprazole therapy at a dose of 80-240 mg/day in divided doses was both effective and generally well tolerated for patients with Zollinger-Ellison syndrome and idiopathic hypersecretion. (Am J Gastroenterol 2003;98:301-307. (C) 2003 by Am. Coll. of Gastroenterology). C1 Univ Penn, Hlth Syst, Div Gastroenterol, Med Ctr, Philadelphia, PA 19104 USA. Wyeth Ayerst Res, Collegeville, PA USA. Univ Florida, Div Gastroenterol, Gainesville, FL USA. Vet Affairs Med Ctr, Div Gastroenterol, Dallas, TX USA. Rochester Inst Digest Dis & Sci, Rochester, NY USA. Univ Calif Los Angeles, Sch Med, Dept Med, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. RP Metz, DC (reprint author), Univ Penn, Hlth Syst, Div Gastroenterol, Med Ctr, Ravdin Bldg 3rd Floor,3400 Spruce St, Philadelphia, PA 19104 USA. NR 25 TC 16 Z9 17 U1 0 U2 2 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 FEB PY 2003 VL 98 IS 2 BP 301 EP 307 DI 10.1016/S0002-9270(02)05930-0 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 645RR UT WOS:000180992700018 PM 12591045 ER PT J AU Ashton, CM Septimus, J Petersen, NJ Souchek, J Menke, TJ Collins, TC Wray, NP AF Ashton, CM Septimus, J Petersen, NJ Souchek, J Menke, TJ Collins, TC Wray, NP TI Healthcare use by veterans treated for diabetes mellitus in the Veterans Affairs medical care system SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID POPULATION; HOSPITALS; MORTALITY; OUTCOMES; ADULTS AB Objectives: To estimate the burden of comorbid conditions and to describe patterns of inpatient and outpatient service use by veterans with diabetes mellitus. Study Design: Retrospective cohort study of 33 481 veterans conducted by means of secondary analysis of Department of Veterans Affairs (VA) healthcare utilization databases. Patients and Methods: The cohort was constructed enrolling,all veterans treated in the VA medical care syste who had their initial VA hospitalization for diabetes mellitus between 1992 and 1997. To estimate the typical annual pattern of service use for diabetes mellitus, 1497 utilization rates per person-year were analyzed based on cohort members surviving into 1997. Data on comorbid conditions were obtained from outpatient and inpatient contacts. Results: The 3 most prevalent coexisting conditions were hypertension (73.4%), ischemic heart disease (35.2%), and alcohol or drug abuse disorders (29.5%). In 1997, the typical cohort member followed for 12 months had 6 primary care visits, 16 other visits for tests or consultations, and 1.3 unscheduled visits for emergency- or urgent care and spent approximately 8 days in the hospital. One-year survival was 94.0%. Conclusions: In the VA medical care system, beneficiaries with diabetes mellitus have an extremely heavy burden of comorbidities, face a significant risk of dying in a given year (approximately 6% in this population), and are heavy users of hospital and outpatient services. C1 VA Med Ctr, Houston, TX 77030 USA. Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Affiliated Hosp, Dept Internal Med, Houston, TX USA. RP Ashton, CM (reprint author), VA Med Ctr, 152,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 22 TC 20 Z9 21 U1 2 U2 4 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 2003 VL 9 IS 2 BP 145 EP 150 PG 6 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 644NA UT WOS:000180923200003 PM 12597602 ER PT J AU Ramonas, KM Freilich, BD AF Ramonas, KM Freilich, BD TI Iris abscess as an unusual presentation of endogenous Endophthalmitis in a patient with bacterial endocarditis SO AMERICAN JOURNAL OF OPHTHALMOLOGY LA English DT Article AB PURPOSE: To report the clinical findings and management of a case of endogenous endophthalmitis in a patient with bacterial endocarditis presenting with a septic metastasis to the iris. DESIGN: Observational case report. METHODS: Review of clinical findings and treatment. RESULTS: A 37-year-old intravenous drug user hospitalized with bacterial endocarditis secondary to methicillin-sensitive Staphylococcus aureus bacteremia presented with a painful red left eye, hypopyon, and iris abscess. Roth spots were noted in the fundus of the right eye. Aqueous culture was positive for methicillin-sensitive S aureus. The patient was treated with intravitreal, topical, and intravenous antibiotics. The hypopyon and iris abscess resolved within 2 weeks, and the patient achieved a final visual acuity of 20/25 in the left eye. CONCLUSIONS: Septic metastasis to the iris is a rare occurrence. To our knowledge this is the first reported case of an iris abscess secondary to bacterial endocarditis. (C) 2003 by Elsevier Science Inc. All rights reserved. C1 Bronx Vet Adm Med Ctr, Bronx, NY USA. RP Ramonas, KM (reprint author), CUNY Mt Sinai Sch Med, Dept Ophthalmol, 1 Gustave Levy Pl,Box 1183,Annenberg Bldg,22nd Fl, New York, NY 10029 USA. NR 5 TC 4 Z9 4 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9394 J9 AM J OPHTHALMOL JI Am. J. Ophthalmol. PD FEB PY 2003 VL 135 IS 2 BP 228 EP 229 DI 10.1016/S0002-9394(02)01935-9 PG 2 WC Ophthalmology SC Ophthalmology GA 640VV UT WOS:000180709400018 PM 12566031 ER PT J AU Black, BJ McMahan, CA Masoro, EJ Ikeno, Y Katz, MS AF Black, BJ McMahan, CA Masoro, EJ Ikeno, Y Katz, MS TI Senescent terminal weight loss in the male F344 rat SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE caloric restriction; food intake; hypothalamic function ID FED AD-LIBITUM; FISCHER-344 RATS; NUTRITIONAL INFLUENCES; LONGEVITY; PROTEIN; DISEASE; GROWTH; MASS; LIFE AB Loss of weight, often of unknown cause and culminating in death, commonly occurs in humans at advanced ages. Rats that live to old ages, such as the Fischer 344 (F344) strain, also exhibit a terminal loss in body weight. A presently held hypothesis is that the terminal weight loss in the F344 rat model is due to reduced food intake because of an alteration in hypothalamic function resulting in early satiation. We report findings on terminal weight loss and food intake in male F344 rats fed ad libitum (AL group) or a life-prolonging dietary regimen in which caloric intake was restricted (DR group). Rats in both dietary groups that did not exhibit a terminal weight loss died at younger ages than those exhibiting the loss. Terminal weight loss in the AL group was not associated with decreased food intake; indeed, half of the rats in this group had an increased food intake during the period of terminal weight loss. This finding is not in accord with the presently held hypothesis. In the DR group, terminal weight loss was associated with reduced food intake. Pathology (renal disease and neoplasms) did not explain the presence or absence of the association between reduced food intake and weight loss in either dietary group. The duration of the period of terminal weight loss was similar for the AL and DR groups. Apparently, restricting calories delays the occurrence but does not affect the duration of senescent terminal weight loss. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Geriatr & Gerontol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Res Serv, Audie L Murphy Div, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Audie L Murphy Div, San Antonio, TX 78229 USA. RP Katz, MS (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Geriatr & Gerontol, Mail Code 7875,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIA NIH HHS [AG-01188, AG-13319] NR 33 TC 15 Z9 15 U1 1 U2 3 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 FEB PY 2003 VL 284 IS 2 BP R336 EP R342 DI 10.1152/ajpregu.00640.2001 PG 7 WC Physiology SC Physiology GA 635LP UT WOS:000180400700009 PM 12388451 ER PT J AU Sultzer, DL Brown, CV Mandelkern, MA Mahler, ME Chen, ST Cummings, JL AF Sultzer, DL Brown, CV Mandelkern, MA Mahler, ME Chen, ST Cummings, JL TI Delusional thoughts and regional frontal/temporal cortex metabolism in Alzheimer's disease SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID POSITRON-EMISSION-TOMOGRAPHY; NEUROBEHAVIORAL RATING-SCALE; CEREBRAL GLUCOSE-UTILIZATION; PSYCHIATRIC-SYMPTOMS; PSYCHOSIS; DEMENTIA; SPECT; MISIDENTIFICATION; PATHOGENESIS; RELIABILITY AB Objective: Delusional thoughts are common in patients with Alzheimer's disease and contribute prominently to morbidity. The pathophysiologic underpinnings for delusions in Alzheimer's disease are not well understood. in this study the authors examined the relationship between delusional thoughts and regional cortical metabolism in patients with Alzheimer's disease. Method: Twenty-five patients with probable Alzheimer's disease were include. None was taking psychotropic medication. Severity of delusions and other neuropsychiatric symptoms was assessed by using a semistructured interview and the Neurobehavioral Rating Scale just before the imaging procedure. [F-18]Fluorodeoxyglucose positron emission tomography was used to measure resting cerebral glucose metabolic rates in the cortical lobes and in anatomically defined subregions of the frontal and temporal cortexes. Results: A linear regression model, controlling for the effects of cognitive deficits, revealed a significant relationship between severity of delusional thought and the metabolic rates in three frontal regions: the right superior dorsolateral frontal cortex (Brodmann's area 8), the right inferior frontal pole (Brodmann's area 10), and the right lateral orbitofrontal region (Brodmann's area 47). Bivariate partial correlation analysis indicated that severity of delusions was associated with hypometabolism in additional prefrontal and anterior cingulate regions. Robust relationships with metabolism in regions of the temporal cortex were not apparent. Conclusions: Dysmetabolism in specific regions of the right prefrontal cortex may be associated with delusional thought in Alzheimer's disease. Delusions appear to reflect the pathophysiologic state of particular cortical regions. Activity across distributed neuronal networks and the specific content of delusional thoughts may modulate these relationships. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Neurol, David Geffen Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Sultzer, DL (reprint author), W Los Angeles VA Healthcare Ctr, 3 South,116AF,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIA NIH HHS [AG-16057]; NIMH NIH HHS [MH-56031] NR 56 TC 105 Z9 106 U1 3 U2 8 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD FEB PY 2003 VL 160 IS 2 BP 341 EP 349 DI 10.1176/appi.ajp.160.2.341 PG 9 WC Psychiatry SC Psychiatry GA 642DE UT WOS:000180788300020 PM 12562582 ER PT J AU Raskind, MA Peskind, ER Kanter, ED Petrie, EC Radant, A Thompson, CE Dobie, DJ Hoff, D Rein, RJ Straits-Troster, K Thomas, RG McFall, MM AF Raskind, MA Peskind, ER Kanter, ED Petrie, EC Radant, A Thompson, CE Dobie, DJ Hoff, D Rein, RJ Straits-Troster, K Thomas, RG McFall, MM TI Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: A placebo-controlled study SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER AB Objective: Prazosin is a centrally active at adrenergic antagonist. The authors' goal was to evaluate prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans. Method: Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received prazosin and placebo in a 20-week double-blind crossover protocol. Results: Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal,on the Clinician-Administered PTSD Scale also were significantly more improved in the prazosin condition, and prazosin was well tolerated. Conclusions: These data support the efficacy of prazosin for nightmares, sleep disturbance, and other PTSD symptoms. C1 VA Puget Sound Hlth Care Syst, NW Network VISN 20, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Calif San Diego, Dept Family Med & Neurosci, Div Biostat, San Diego, CA 92103 USA. RP Raskind, MA (reprint author), VA Puget Sound Hlth Care Syst, NW Network VISN 20, Mental Illness Res Educ & Clin Ctr, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 15 TC 298 Z9 303 U1 4 U2 20 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD FEB PY 2003 VL 160 IS 2 BP 371 EP 373 DI 10.1176/appi.ajp.160.2.371 PG 3 WC Psychiatry SC Psychiatry GA 642DE UT WOS:000180788300026 PM 12562588 ER PT J AU Tobin, MJ AF Tobin, MJ TI Critical care medicine in AJRCCM 2002 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review 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, Chicago, IL 60611 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. NR 92 TC 2 Z9 2 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 FEB 1 PY 2003 VL 167 IS 3 BP 294 EP 305 DI 10.1164/rccm.2212004 PG 12 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 640EZ UT WOS:000180676400004 PM 12554619 ER PT J AU Tobin, MJ AF Tobin, MJ TI Sleep-disordered breathing, control of breathing, respiratory muscles, and pulmonary function testing in AJRCCM 2002 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review 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, Chicago, IL 60611 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. NR 93 TC 2 Z9 2 U1 0 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 FEB 1 PY 2003 VL 167 IS 3 BP 306 EP 318 DI 10.1164/rccm.2212006 PG 13 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 640EZ UT WOS:000180676400005 PM 12554620 ER PT J AU Tobin, MJ AF Tobin, MJ TI Asthma, airway biology, and nasal disorders in AJRCCM 2002 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review 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, Chicago, IL 60611 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. NR 113 TC 3 Z9 3 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 FEB 1 PY 2003 VL 167 IS 3 BP 319 EP 332 DI 10.1164/rccm.2212007 PG 14 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 640EZ UT WOS:000180676400006 PM 12554621 ER PT J AU Tobin, MJ AF Tobin, MJ TI Pediatrics, surfactant, and cystic fibrosis in AJRCCM 2002 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review 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, Chicago, IL 60611 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. NR 84 TC 0 Z9 2 U1 3 U2 5 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 FEB 1 PY 2003 VL 167 IS 3 BP 333 EP 344 DI 10.1164/rccm.2212005 PG 12 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 640EZ UT WOS:000180676400007 PM 12554622 ER PT J AU Tobin, MJ AF Tobin, MJ TI Tuberculosis, lung infections, interstitial lung disease, and journalology in AJRCCM 2002 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review 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, Chicago, IL 60611 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. NR 37 TC 4 Z9 4 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 FEB 1 PY 2003 VL 167 IS 3 BP 345 EP 355 DI 10.1164/rccm.2212002 PG 11 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 640EZ UT WOS:000180676400008 PM 12554623 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 2002 SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review 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, Chicago, IL 60611 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. NR 98 TC 3 Z9 10 U1 0 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 FEB 1 PY 2003 VL 167 IS 3 BP 356 EP 370 DI 10.1164/rccm.2212003 PG 15 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 640EZ UT WOS:000180676400009 PM 12554624 ER PT J AU Xie, AL Skatrud, JB Smith, CA Dempsey, JA AF Xie, AL Skatrud, JB Smith, CA Dempsey, JA TI Measurement of the CO2 apneic threshold SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Letter ID SLEEPING HUMANS; VENTILATION C1 Univ Wisconsin, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Xie, AL (reprint author), Univ Wisconsin, Madison, WI 53706 USA. NR 8 TC 1 Z9 1 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 FEB 1 PY 2003 VL 167 IS 3 BP 472 EP 473 PG 2 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 640EZ UT WOS:000180676400036 ER PT J AU Gross, RD Mahlmann, J Grayhack, JP AF Gross, RD Mahlmann, J Grayhack, JP TI Physiologic effects of open and closed tracheostomy tubes on the pharyngeal swallow SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE aspiration; deglutition; penetration; subglottic air pressure; tracheostomy ID SPINAL STRETCH REFLEX; PASSY-MUIR VALVE; ADAPTIVE PLASTICITY; LARYNGEAL CLOSURE; SPEAKING VALVE; NECK-CANCER; ASPIRATION; COORDINATION; TRACHEOTOMY; ADULTS AB Studies linking aspiration and dysphagia to an open tracheostomy tube exemplify the possibility that the larynx may have an influence on oropharyngeal swallow function. Experiments addressing the effects of tracheostomy tube occlusion during the swallow have looked at the presence and severity of aspiration, but few have included measurements that capture the changes in swallowing physiology. Also, hypotheses for the importance of near-normal subglottic air pressure during the swallow have not been offered to date. As such, the aim of this study was to compare the depth of laryngeal penetration, bolus speed, and duration of pharyngeal muscle contraction during the swallow in individuals with tracheostomy tubes while their tubes were open and closed. The results of this series of experiments indicate that within the same tracheostomized patient, pharyngeal swallowing physiology is measurably different in the absence of subglottic air pressure (open tube) as compared to the closed tube condition. C1 VA Pittsburgh Healthcare Syst, Dept Audiol & Speech Pathol, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA USA. RP Gross, RD (reprint author), VA Pittsburgh Healthcare Syst, Dept Audiol & Speech Pathol, Univ Dr C, Pittsburgh, PA 15240 USA. NR 54 TC 23 Z9 25 U1 0 U2 2 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 FEB PY 2003 VL 112 IS 2 BP 143 EP 152 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 644VV UT WOS:000180941400007 PM 12597287 ER PT J AU Hall, P Zhou, XH AF Hall, P Zhou, XH TI Nonparametric estimation of component distributions in a multivariate mixture SO ANNALS OF STATISTICS LA English DT Article DE biased bootstrap; distribution estimation; empirical likelihood; identification; latent model; multivariate analysis; nonparametric maximum likelihood; root-n consistency ID LATENT CLASS ANALYSIS; DIAGNOSTIC-TESTS; MAXIMUM-LIKELIHOOD; PROPORTIONS; MODELS; GEOMETRY AB Suppose k-variate data are drawn from a mixture of two distributions, each having independent components. It is desired to estimate the univariate marginal distributions in each of the products, as well as the mixing proportion. This is the setting of two-class, fully parametrized latent models that has been proposed for estimating the distributions of medical test results when disease status is unavailable. The problem is one of inference in a mixture of distributions without training data, and until now it has been tackled only in a fully parametric setting. We investigate the possibility of using nonparametric methods. Of course, when k = 1 the problem is not identifiable from a nonparametric viewpoint. We show that the problem is "almost" identifiable when k = 2; there, the set of all possible representations can be expressed, in terms of any one of those representations, as a two-parameter family. Furthermore, it is proved that when k greater than or equal to 3 the problem is nonparametrically identifiable under particularly mild regularity conditions. In this case we introduce root-n consistent nonparametric estimators of the 2k univariate marginal distributions and the mixing proportion. Finite-sample and asymptotic properties of the estimators are described. C1 Australian Natl Univ, Ctr Math Applicat, Canberra, ACT 0200, Australia. Univ Washington, NW HRS&D Ctr Excellence, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Hall, P (reprint author), Australian Natl Univ, Ctr Math Applicat, Canberra, ACT 0200, Australia. NR 36 TC 73 Z9 74 U1 2 U2 7 PU INST MATHEMATICAL STATISTICS PI BEACHWOOD PA PO BOX 22718, BEACHWOOD, OH 44122 USA SN 0090-5364 J9 ANN STAT JI Ann. Stat. PD FEB PY 2003 VL 31 IS 1 BP 201 EP 224 PG 24 WC Statistics & Probability SC Mathematics GA 655VW UT WOS:000181574200007 ER PT J AU Mulsant, BH Pollock, BG Kirshner, M Shen, CY Dodge, H Ganguli, M AF Mulsant, BH Pollock, BG Kirshner, M Shen, CY Dodge, H Ganguli, M TI Serum anticholinergic activity in a community-based sample of older adults - Relationship with cognitive performance SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article; Proceedings Paper CT 15th Annual Meeting of the American-Association-for-Geriatric-Psychiatry CY FEB 24-27, 2002 CL ORLANDO, FLORIDA SP Amer Assoc Geriatr Psychiat ID ELDERLY MEDICAL PATIENTS; MOVIES PROJECT; CHRONIC-SCHIZOPHRENIA; DEPRESSED-PATIENTS; RURAL-POPULATION; ACUTE ILLNESS; DELIRIUM; DRUGS; ASSOCIATION; IMPAIRMENT AB Background: Serum anticholinergic activity (SAA), as measured by a radioreceptor assay, quantifies a person's overall anticholinergic burden caused by all drugs and their metabolites. In several small geriatric patient groups, SAA has been associated with cognitive impairment or frank delirium. To our knowledge, there has not yet been any systematic study of the prevalence of SAA and its effect on cognition in a community-based population. Methods: Serum anticholinergic activity was measured in 201 subjects who were randomly selected among the participants in an epidemiological community study, based on their age and sex. Cognitive performance was assessed with use of the Mini-Mental State Examination. The association between SAA and cognitive performance was examined using a univariate analysis and a multiple logistic regression model, adjusting for age, sex, educational level, and number of medications. Results: Serum anticholinergic activity was detectable in 180 (89.6%) participants (range, 0.50-5.70 pmol/mL). Univariate testing showed a significant association between SAA and Mini-Mental State Examination scores. Logistic regression analysis indicated that subjects with SAA at or above the sample's 90th percentile (ie, SAA greater than or equal to2.80 pmol/mL) were 13 times (odds ratio, 1.08-152.39) more likely than subjects with undetectable SAA to have a Mini-Mental State Examination score of 24 (the sample's 10th percentile) or below. Conclusions: To our knowledge, this is the largest analysis of SAA and the first to examine its extent and relationship with cognitive performance in a community sample. Its results suggest that SAA can be detected in most older persons in the community and confirm that even low SAA is associated with cognitive impairment. C1 Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15213 USA. RP Mulsant, BH (reprint author), Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, 3811 O Hara St, Pittsburgh, PA 15213 USA. RI Ganguli, Mary/A-3638-2013; MORAN, CATHERINE/C-9539-2015 FU NIA NIH HHS [AG07562]; NIMH NIH HHS [MH30915, MH01613, MH52247, MH59666, MH64173, MH65416] NR 54 TC 163 Z9 167 U1 1 U2 4 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 2003 VL 60 IS 2 BP 198 EP 203 DI 10.1001/archpsyc.60.2.198 PG 6 WC Psychiatry SC Psychiatry GA 643RA UT WOS:000180873200011 PM 12578438 ER PT J AU Luckey, A Livingston, E Tache, Y AF Luckey, A Livingston, E Tache, Y TI Mechanisms and treatment of postoperative ileus SO ARCHIVES OF SURGERY LA English DT Review ID CORTICOTROPIN-RELEASING-FACTOR; PROSPECTIVE RANDOMIZED TRIAL; GENE-RELATED PEPTIDE; PLACEBO-CONTROLLED TRIAL; MAJOR ABDOMINAL-SURGERY; KAPPA-OPIOID RECEPTORS; GASTRIC-EMPTYING RATE; POST-OPERATIVE ILEUS; PARALYTIC ILEUS; EPIDURAL ANALGESIA AB Objective: To review the pathogenesis and treatment of postoperative ileus. Data Sources: Data collected for this review were identified from a MEDLINE database search of the English-language literature. The exact indexing terms were "postoperative ileus," "treatment," "etiology," and "pathophysiology." Previous review articles and pertinent references from those articles were also used. Study Selection: All relevant studies were included. Only articles that were case presentations or that mentioned postoperative ileus in passing were excluded. Data Synthesis: The pathogenesis of postoperative ileus is complex, with multiple factors contributing either simultaneously or at various times during the development of this entity. These factors include inhibitory effects of sympathetic input; release of hormones, neurotransmitters, and other mediators; an inflammatory reaction; and the effects of anesthetics and analgesics. Numerous treatments have been used to alleviate postoperative ileus without much success. Conclusions: The etiology of postoperative ileus can best be described as multifactorial. A multimodality treatment approach should include limiting the administration of agents known to contribute to postoperative ileus (narcotics), using thoracic epidurals with local anesthetics when possible, and selectively applying nasogastric decompression. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90073 USA. Univ Calif San Francisco E Bay, Oakland, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Bariatr Surg Program, Los Angeles, CA 90073 USA. VA Greater LA Healthcare Syst, Digest Dis Res Ctr, CURE, Los Angeles, CA USA. RP Luckey, A (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, 11301 Wilshire Blvd,Bldg 115,Room 217, Los Angeles, CA 90073 USA. NR 137 TC 189 Z9 207 U1 3 U2 24 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD FEB PY 2003 VL 138 IS 2 BP 206 EP 214 DI 10.1001/archsurg.138.2.206 PG 9 WC Surgery SC Surgery GA 644AG UT WOS:000180895300022 PM 12578422 ER PT J AU Yang, L Mei, Q Zielinska-Kwiatkowska, AZE Matsui, Y Blackburn, ML Benedetti, D Krumm, AA Taborsky, GJ Chansky, HA AF Yang, L Mei, Q Zielinska-Kwiatkowska, AZE Matsui, Y Blackburn, ML Benedetti, D Krumm, AA Taborsky, GJ Chansky, HA TI An ERG (ets-related gene)-associated histone methyltransferase interacts with histone deacetylases 1/2 and transcription co-repressors mSin3A/B SO BIOCHEMICAL JOURNAL LA English DT Article DE chromatin; ERG-associated protein with a SET domain (ESET); SETDB1; trichostatin A; tudor domain ID SPINAL MUSCULAR-ATROPHY; N-COR; COMPLEX; PROTEIN; DROSOPHILA; SU(VAR)3-9; DOMAIN; TUDOR; GENE; DNA AB Covalent modifications of histone tails play important roles in gene transcription and silencing. We recently identified an ERG (ets-related gene)-associated protein with a SET (suppressor of variegation, enhancer of zest and trithorax) domain (ESET) that was found to have the activity of a histone H3-specific methyltransferase. In the present study, we investigated the interaction of ESET with other chromatin remodelling factors. We show that ESET histone methyltransferase associates with histone deacetylase I (HDAC1) and HDAC2, and that ESET also interacts with the transcription co-repressors mSin3A and mSin3B. Deletion analysis of ESET reveals that an N-terminal region containing a tudor domain is responsible for interaction with mSin3A/B and association with HDAC1/2, and that truncation of ESET enhances its binding to mSin3. When bound to a promoter, ESET represses the transcription of a downstream luciferase reporter gene. This repression by ESET is independent of its histone methyltransferase activity, but correlates with its binding to the mSin3 co-repressors. In addition, the repression can be partially reversed by treatment with the HDAC inhibitor trichostatin A. Taken together, these data suggest that ESET histone methyltransferase can form a large, multi-protein complex(es) with mSin3A/B co-repressors and HDAC1/2 that participates in multiple pathways of transcriptional repression. C1 Univ Washington, Sch Med, Dept Orthoped, Seattle, WA 98195 USA. Univ Washington, Sch Med, Div Hematol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Div Endocrinol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Div Oncol, Seattle, WA 98195 USA. RP Yang, L (reprint author), Univ Washington, Sch Med, Dept Orthoped, Seattle, WA 98195 USA. FU NCI NIH HHS [1R01CA90941] NR 44 TC 80 Z9 87 U1 0 U2 2 PU PORTLAND PRESS PI LONDON PA 59 PORTLAND PLACE, LONDON W1N 3AJ, ENGLAND SN 0264-6021 J9 BIOCHEM J JI Biochem. J. PD FEB 1 PY 2003 VL 369 BP 651 EP 657 DI 10.1042/BJ20020854 PN 3 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 645VU UT WOS:000181001300025 PM 12398767 ER PT J AU Nahas, Z Kozel, FA Li, XB Anderson, B George, MS AF Nahas, Z Kozel, FA Li, XB Anderson, B George, MS TI Left prefrontal transcranial magnetic stimulation (TMS) treatment of depression in bipolar affective disorder: a pilot study of acute safety and efficacy SO BIPOLAR DISORDERS LA English DT Article DE bipolar affective disorder, repetitive transcranial magnetic stimulation-rTMS; TMS-transcranial magnetic stimulation ID DEXAMETHASONE SUPPRESSION TEST; RTMS IMPROVES MOOD; HUMAN MOTOR CORTEX; ELECTROCONVULSIVE-THERAPY; TRIAL; LAMOTRIGINE; THRESHOLD; ILLNESS; MANIA AB Objectives: Repetitive transcranial magnetic stimulation (rTMS) has been shown to improve depressive symptoms. We designed and carried out the following left prefrontal rTMS study to determine the safety, feasibility, and potential efficacy of using TMS to treat the depressive symptoms of bipolar affective disorder (BPAD). Methods: We recruited and enrolled 23 depressed BPAD patients (12 BPI depressed state, nine BPII depressed state, two BPI mixed state). Patients were randomly assigned to receive either daily left prefrontal rTMS (5 Hz, 110% motor threshold, 8 sec on, 22 sec off, over 20 min) or placebo each weekday morning for 2 weeks. Motor threshold and subjective rating scales were obtained daily, and blinded Hamilton Rating Scale for Depression (HRSD) and Young Mania Rating Scales (YMRS) were obtained weekly. Results: Stimulation was well tolerated with no significant adverse events and with no induction of mania. We failed to find a statistically significant difference between the two groups in the number of antidepressant responders (>50% decline in HRSD or HRSD <10 - 4 active and 4 sham) or the mean HRSD change from baseline over the 2 weeks (t = -0.22, p=0.83). Active rTMS, compared with sham rTMS, produced a trend but not statistically significant greater improvement in daily subjective mood ratings post-treatment (t = 1.58, p=0.13). The motor threshold did not significantly change after 2 weeks of active treatment (t = 1.11, p=0.28). Conclusions: Daily left prefrontal rTMS appears safe in depressed BPAD subjects, and the risk of inducing mania in BPAD subjects on medications is small. We failed to find statistically significant TMS clinical antidepressant effects greater than sham. Further studies are needed to fully investigate the potential role, if any, of TMS in BPAD depression. C1 Med Univ S Carolina, Dept Psychiat, Brain Stimulat Lab, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Mental Hlth Serv, Charleston, SC USA. RP Kozel, FA (reprint author), Med Univ S Carolina, Dept Psychiat, Brain Stimulat Lab, 67 President St,POB 250861, Charleston, SC 29425 USA. RI Kozel, Frank/I-5366-2012 FU NIA NIH HHS [R01-AG40956] NR 48 TC 113 Z9 115 U1 1 U2 4 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. PD FEB PY 2003 VL 5 IS 1 BP 40 EP 47 DI 10.1034/j.1399-5618.2003.00011.x PG 8 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 645GF UT WOS:000180967300007 PM 12656937 ER PT J AU Shannon, J Cook, LS Stanford, JL AF Shannon, J Cook, LS Stanford, JL TI Dietary intake and risk of postmenopausal breast cancer (United States) SO CANCER CAUSES & CONTROL LA English DT Article DE diet; food groups; postmenopausal breast cancer ID VITAMIN-D; PROSPECTIVE COHORT; FATTY-ACIDS; MAMMARY; CAROTENOIDS; CARCINOGENESIS; MUTAGENESIS; CONSUMPTION; PRODUCTS; HEALTH AB Objectives: While there is good evidence from cell-culture and animal studies to indicate that dietary intake impacts breast cancer risk, results of epidermologic studies have been inconsistent. Additionally, while the etiology of breast cancer in premenopausal versus postmenopausal women may be quite different, most studies have not chosen to focus solely on one group or the other. In this case-control Study, we evaluate the associations between red meat, fish, dairy products, and fruits and vegetables, and risk of breast cancer in postmenopausal women. Methods: A food-frequency questionnaire was completed by 441 women with in-situ or invasive breast cancer and 370 population controls. Cases were identified from the population-based Cancer Surveillance System (CSS) of western Washington and frequency age-matched controls identified by random-digit dialing (RDD). Unconditional logistic regression was used to model the association between each food grouping and breast cancer risk adjusting for age, number of pregnancies, and education. Results: Red meat intake was significantly associated with an increased breast cancer risk (p for trend = 0.002) and fish (including fried fish) and dairy product intake was inversely associated with breast cancer risk (l) for trend = 0.04 and 0.05, respectively). No significant associations were noted betwen fruit or vegetable intake and breast cancer risk. Conclusions: The findings from this study support the results of several larger cohort studies and contribute to the evidence for the development of dietary recommendations for breast cancer risk reduction specific to postmenopausal women. C1 Portland VA Med Ctr, Portland, OR 97201 USA. Univ Calgary, Dept Community Hlth Sci, Calgary, AB T2N 4N1, Canada. Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98109 USA. RP Shannon, J (reprint author), Portland VA Med Ctr, 3710 SW US Vet Hosp Rd,P2-HSRD, Portland, OR 97201 USA. FU NCI NIH HHS [R35-CA39779, K07-CA01364, N01-CN-05230] NR 46 TC 40 Z9 40 U1 1 U2 10 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0957-5243 J9 CANCER CAUSE CONTROL JI Cancer Causes Control PD FEB PY 2003 VL 14 IS 1 BP 19 EP 27 DI 10.1023/A:1022506507984 PG 9 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 670KA UT WOS:000182405600003 PM 12708721 ER PT J AU Batra, RK Lin, A Sharma, S Dohadwala, M Luo, J Pold, M Dubinett, SM AF Batra, RK Lin, A Sharma, S Dohadwala, M Luo, J Pold, M Dubinett, SM TI Non-small cell lung cancer-derived soluble mediators enhance apoptosis in activated T lymphocytes through an I kappa B kinase-dependent mechanism SO CANCER RESEARCH LA English DT Article ID PROSTAGLANDIN E(2); IMMUNE-SYSTEM; HUMAN TUMORS; IKK-BETA; PROTEINS; ALPHA; IL-10; PHOSPHORYLATION; TRANSCRIPTION; FAMILY AB T lymphocyte survival is critical for the development and maintenance of an effective host antitumor immune response; however, the tumor environment can negatively impact T-cell survival. Lymphocytes exposed to tumor supernatants (TSNs) were evaluated for apoptosis after mitogen stimulation. TSN was observed to significantly enhance phorbol 12myristate 13-acetate/ionomycin- and anti-CD3-stimulated lymphocyte apoptosis. Enhanced lymphocyte apoptosis was associated with an impairment of nuclear factor kappaB nuclear translocation and diminished IkappaBalpha degradation. In lymphocytes stimulated after exposure to TSNs, cytoplasmic IkappaBalpha persisted as a result of alterations in IkappaB kinase (IKK) activity. Accordingly, although there were no apparent differences in IKK component concentrations, lymphocytes preexposed to TSNs exhibited markedly reduced IKK activity. We conclude that non-small cell lung cancer-derived soluble factors promote apoptosis in activated lymphocytes by an IKK-dependent pathway. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Lung Canc Res Program, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Dept Med, Los Angeles, CA 90095 USA. Vet Adm Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90095 USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm & Crit Care Med, Lung Canc Res Program, 37-131 CHS,10833 LeConte Ave, Los Angeles, CA 90095 USA. FU NCI NIH HHS [R01-CA78654, R01 CA078654-03, R01-CA71818]; PHS HHS [P50-90388] NR 45 TC 26 Z9 27 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD FEB 1 PY 2003 VL 63 IS 3 BP 642 EP 646 PG 5 WC Oncology SC Oncology GA 640PT UT WOS:000180697700015 PM 12566308 ER PT J AU Choudhury, GG Lenin, M Calhaun, C Zhang, JH Abboud, HE AF Choudhury, GG Lenin, M Calhaun, C Zhang, JH Abboud, HE TI PDGF inactivates forkhead family transcription factor by activation of Akt in glomerular mesangial cells SO CELLULAR SIGNALLING LA English DT Article DE mesangial cell; PDGF; Akt; FKHR; fas ligand ID PROTEIN-KINASE-B; GLYCOGEN-SYNTHASE KINASE-3; GROWTH-FACTOR; GENE-EXPRESSION; DNA-SYNTHESIS; FACTOR FKHR; C-FOS; PHOSPHORYLATION; INSULIN; SURVIVAL AB Regulation of the forkhead domain transcription factors by PDGF has not been studied. In this report, we investigated the role of PDGF-induced Akt in regulating forkhead domain protein FKHRL1 in glomerular mesangial cells. PDGF increased phosphorylation of FKHRL1 in a time- and PI 3 kinase-dependent manner. Expression of dominant negative Akt by adenovirus-mediated gene transfer blocked PDGF-induced FKHRL1 phosphorylation. PDGF inhibited transcription of a forkhead DNA binding element-driven reporter gene. This inhibition was mimicked by constitutively active myristoylated Akt. Moreover, FKHR1-mediated transcription of the reporter gene was completely attenuated by both PDGF and Myr-Akt. One of the targets of forkhead transcription factors is the proapoptotic Fas ligand (FasL) gene. PDGF, as well as Myr-Akt, inhibited transcription of FasL. In contrast, inhibition of PI 3 kinase and dominant negative Akt increased FasL gene transcription, suggesting that suppression of PI 3 kinase/Akt signalling may induce apoptosis in mesangial cells via upregulation of FasL expression. However, expression of dominant negative Akt by adenovirus did not induce apoptosis in mesangial cells, suggesting that Akt-independent antiapoptotic mechanisms also exist. Together, our data demonstrate for the first time that PDGF inactivates forkhead domain transcription factor by Akt-dependent phosphorylation and that suppression of Akt signalling is not sufficient to induce apoptosis in mesangial cells. (C) 2003 Elsevier Science Inc. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78229 USA. Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Choudhury, GG (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, 7703 Floyd Curl Dr,Mail Code 7882, San Antonio, TX 78229 USA. NR 56 TC 17 Z9 17 U1 0 U2 0 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 FEB PY 2003 VL 15 IS 2 BP 161 EP 170 AR PII S0898-6568(02)00057-8 PG 10 WC Cell Biology SC Cell Biology GA 643XN UT WOS:000180888700003 ER PT J AU Brown, ST Brett, I Almenoff, PL Lesser, M Terrin, M Teirstein, AS AF Brown, ST Brett, I Almenoff, PL Lesser, M Terrin, M Teirstein, AS CA ACCESS Research Group TI Recovery of cell wall-deficient organisms from blood does not distinguish between patients with sarcoidosis and control subjects SO CHEST LA English DT Article DE a case control etiologic study of sarcoidosis; cell wall-deficient forms; mycobacterium; sarcoidosis ID COMPLEX; FORMS AB Study objective: To determine if cell wall-deficient forms (CWDF) of mycobacteria can be grown in culture of blood from subjects with sarcoidosis. Design: A special multicenter study of sarcoidosis (A Case Control Etiologic Study of Sarcoidosis), supported by the National Heart, Lung, and Blood Institute. Patients and control subjects: Patients and control subjects were recruited at 10 institutions in the United States. Control subjects (controls) were of the same gender and race, and within 5 years of age as matching patients with sarcoidosis (cases). Results: Cultures were incubated from 347 blood specimens (197 cases, 150 controls). Two investigators trained to recognize CWDF mycobacteria examined material obtained from culture tubes after 3 weeks. Structures thought to be CWDF were seen with equal frequency in cases (38%) and controls (41%). Thirty-nine percent of cases and 37% of controls were read as negative for CWDF. Conclusion: This study fails to confirm earlier reports that CWDF mycobacteria can be grown from the blood of patients with sarcoidosis, but not from control subjects. C1 Bronx Vet Adm Med Ctr, Infect Dis Sect, Bronx, NY 10468 USA. Mt Sinai Med Ctr, Dept Internal Med, Bronx, NY USA. Clin Trials & Surveys Corp, Baltimore, MD USA. RP Brown, ST (reprint author), Bronx Vet Adm Med Ctr, Infect Dis Sect, 111F,130 W Kingsbridge Rd n, Bronx, NY 10468 USA. FU NHLBI NIH HHS [M01-HR-56065]; PHS HHS [56068, 56070, 56071, 56073, 56074, 56069, 56066, 56067, 56072, 56075] NR 23 TC 26 Z9 31 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD FEB PY 2003 VL 123 IS 2 BP 413 EP 417 DI 10.1378/chest.123.2.413 PG 5 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 646XK UT WOS:000181061200021 PM 12576359 ER PT J AU Albertson, TE Panacek, EA MacArthur, RD Johnson, SB Benjamin, E Matuschak, GM Zaloga, G Maki, D Silverstein, J Tobias, JK Haenftling, K Black, G Cowens, JW AF Albertson, TE Panacek, EA MacArthur, RD Johnson, SB Benjamin, E Matuschak, GM Zaloga, G Maki, D Silverstein, J Tobias, JK Haenftling, K Black, G Cowens, JW CA MAB-T88 Sepsis Study Grp TI Multicenter evaluation of a human monoclonal antibody to Enterobacteriaceae common antigen in patients with Gram-negative sepsis SO CRITICAL CARE MEDICINE LA English DT Article DE sepsis; Gram-negative sepsis; septic shock; sepsis syndrome; monoclonal antibodies; Enterobacteriaceae; endotoxin ID PLACEBO-CONTROLLED TRIAL; TUMOR-NECROSIS-FACTOR; INTERLEUKIN-1 RECEPTOR ANTAGONIST; INTENSIVE-CARE UNITS; SEPTIC SHOCK; DOUBLE-BLIND; CLINICAL-TRIALS; FUSION PROTEIN; FACTOR-ALPHA; ENDOTOXIN AB Objective: To evaluate in Gram-negative sepsis patients the human monoclonal immunoglobulin M antibody (MAB-T88) directed at the enterobacterial common antigen which is a specific surface antigen closely linked to lipopolysaccharide and shared by all members of the Enterobacteriaceae family of Gram-negative bacteria. Design: Prospective, randomized, double-blinded, placebo-controlled, multicenter trial. Setting: Thirty-three academic medical centers in the United States. Patients: Patients were entered with a clinical diagnosis of sepsis, the presence of either shock or multiple organ dysfunction, and presumptive evidence for Gram-negative infection. Interventions: Patients received a single intravenous infusion, over 30 mins, of either 300 mg of MAB-T88 formulated in albumin, or placebo (albumin). Measurements and Main Results: The primary analysis group was prospectively identified as those patients with documented evidence of an infection with bacteria of the family Enterobacteriaceae at any site. The primary end point was survival within the first 28 days. A total of 826 patients were enrolled with 55% (n = 455) in the primary analysis group. There were no significant differences between the intervention and control primary analysis group study groups for sites of infection, severity of illness, underlying medical conditions, adequacy of antibiotic or surgical treatment, or other baseline variables except for a higher frequency of chronic renal failure in the MAB-T88 group (4.4% vs. 1.3%, p = .051). The average Acute Physiology and Chronic Health Evaluation 11 scores were 26.8 +/- 8.6 (mean +/- SD) in the MAB-T88-treated group and 26.5 +/- 8.3 in the placebo-treated group (p = .72). There was no significant difference between MAB-T88- and placebo-treated groups during the first 28-day all-cause mortality in the primary analysis group (34.2% vs. 30.8%, p = .44) or in all 826 patients enrolled (37.0% vs. 34.0%, p =.36). On subset analysis, the use of MAB-T88 was not associated with significant mortality trends. More adverse events were seen with the use of MAB-T88 in the bacteremic enterobacterial common antigen group (p < .05). Conclusions: Use of the human monoclonal antibody, MAB-T88, did not improve the mortality in patients with presumed Gram-negative sepsis or in those patients with proven enterobacterial common antigen infections. No subset trends were identified that would support further investigation of this agent in sepsis. C1 Univ Calif Davis, Dept Med, Sacramento, CA 95817 USA. Med Coll Ohio, Toledo, OH 43699 USA. Univ Kentucky, Dept Surg, Lexington, KY 40506 USA. Mt Sinai Med Ctr, Dept Anesthesia, New York, NY 10029 USA. St Louis Univ Hosp, Dept Internal Med, St Louis, MO USA. Bowman Gray Sch Med, Winston Salem, NC USA. Univ Wisconsin, Dept Med, Madison, WI 53706 USA. Bronx Vet Adm Med Ctr, Dept Anesthesia, New York, NY USA. Chiron Corp, Emeryville, CA 94608 USA. Case Western Reserve Univ, Cleveland, OH 44106 USA. RP Albertson, TE (reprint author), Univ Calif Davis, Dept Med, Sacramento, CA 95817 USA. NR 44 TC 29 Z9 31 U1 0 U2 2 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 FEB PY 2003 VL 31 IS 2 BP 419 EP 427 DI 10.1097/01.CCM.0000045564.51812.3F PG 9 WC Critical Care Medicine SC General & Internal Medicine GA 644LQ UT WOS:000180919700011 PM 12576946 ER PT J AU Hull, RL Andrikopoulos, S Verchere, CB Vidal, J Wang, F Cnop, M Prigeon, RL Kahn, SE AF Hull, RL Andrikopoulos, S Verchere, CB Vidal, J Wang, F Cnop, M Prigeon, RL Kahn, SE TI Increased dietary fat promotes islet amyloid formation and beta-cell secretory dysfunction in a transgenic mouse model of islet amyloid SO DIABETES LA English DT Article ID TYPE-2 DIABETES-MELLITUS; POLYPEPTIDE AMYLIN; INSULIN-RESISTANCE; GLUCOSE-TOLERANCE; PANCREATIC-ISLETS; PERFUSED PANCREAS; C57BL/6J MICE; OBESITY; EXPRESSION; ACIDS AB Transgenic mice expressing the amyloidogenic human islet amyloid polypeptide (MAPP) in their islet R-cells are a model of islet amyloid formation as it occurs in type 2 diabetes. Our hIAPP transgenic mice developed islet amyloid when fed a breeder chow but not regular chow. Because the breeder chow contained increased amounts of fat, we hypothesized that increased dietary fat enhances islet amyloid formation. To test this hypothesis, we fed male MAPP transgenic and nontransgenic control mice diets containing 15% (low fat), 30% (medium fat), or 45% (high fat) of calories derived from fat for 12 months, and we measured islet amyloid, islet endocrine cell composition, and beta-cell function. Increased dietary fat in hLAPP transgenic mice was associated with a dose-dependent increase in both the prevalence (percentage of islets containing amyloid deposits; 34 +/- 8, 45 +/- 8, and 58 +/- 10%, P < 0.05) and severity (percentage of islet area occupied by amyloid; 0.8 +/- 0.5, 1.0 +/- 0.5, and 4.6 +/- 2.5%, P = 0.05) of islet amyloid. In addition, in these hLAPP transgenic mice, there was a dose-dependent decrease in the proportion of islet area comprising beta-cells, with no significant change in islet size. In contrast, nontransgenic mice adapted to diet-induced obesity by increasing their islet size more than twofold. Increased dietary fat was associated with impaired insulin secretion in hLAPP transgenic (P = 0.05) but not nontransgenic mice. In summary, dietary fat enhances both the prevalence and severity of islet amyloid and leads to beta-cell loss and impaired insulin secretion. Because both morphologic and functional defects are present in hIAPP transgenic mice, this would suggest that the effect of dietary fat to enhance islet amyloid formation might play a role in the pathogenesis of the islet lesion of type 2 diabetes in humans. C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Hull, RL (reprint author), VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 151,1660 S Columbian Way, Seattle, WA 98108 USA. OI Hull, Rebecca/0000-0001-9690-4087 FU NIDDK NIH HHS [DK-17047, DK-50703] NR 60 TC 68 Z9 70 U1 1 U2 5 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0012-1797 J9 DIABETES JI Diabetes PD FEB PY 2003 VL 52 IS 2 BP 372 EP 379 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 643YT UT WOS:000180891700021 PM 12540610 ER PT J AU Garvey, WT Kwon, S Zheng, D Shaughnessy, S Wallace, P Hutto, A Pugh, K Jenkins, AJ Klein, RL Liao, YL AF Garvey, WT Kwon, S Zheng, D Shaughnessy, S Wallace, P Hutto, A Pugh, K Jenkins, AJ Klein, RL Liao, YL TI Effects of insulin resistance and type 2 diabetes on lipoprotein subclass particle size and concentration determined by nuclear magnetic resonance SO DIABETES LA English DT Article ID CORONARY-ARTERY DISEASE; LOW-DENSITY LIPOPROTEINS; HEART-DISEASE; RISK-FACTORS; TRIGLYCERIDE-METABOLISM; NONDIABETIC SUBJECTS; LDL; NIDDM; HYPERINSULINEMIA; ATHEROSCLEROSIS AB The insulin resistance syndrome (IRS) is associated with dyslipidemia and increased cardiovascular disease risk. A novel method for detailed analyses of lipoprotein subclass sizes and particle concentrations that uses nuclear magnetic resonance (NMR) of whole sera has become available. To define the effects of insulin resistance, we measured dyslipidemia using both NMR lipoprotein subclass analysis and conventional lipid panel, and insulin sensitivity as the maximal glucose disposal rate (GDR) during hyperinsulinemic clamps in 56 insulin sensitive (IS; mean +/- SD: GDR 15.8 +/- 2.0 mg. kg(-1). min(-1), fasting blood glucose [FBG] 4.7 +/- 0.3 mmol/l, BMI 26 +/- 5), 46 insulin resistant (IR; GDR 10.2 +/- 1.9, FBG 4.9 +/- 0.5, BMI 29 +/- 5), and 46 untreated subjects with type 2 diabetes (GDR 7.4 +/- 2.8, FBG 10.8 +/- 3.7, BMI 30 +/- 5). In the group as a whole, regression analyses with GDR showed that progressive insulin resistance was associated with an increase in VLDL size (r = -0.40) and an increase in large VLDL particle concentrations (r = -0.42), a decrease in LDL size (r = 0.42) as a result of a marked increase in small LDL particles (r = -0.34) and reduced large LDL (r = 0.34), an overall increase in the number of LDL particles (r = -0.44), and a decrease in HDL size (r = 0.41) as a result of depletion of large HDL particles (r = 0.38) and a modest increase in small HDL (r = -0.21; all P < 0.01). These correlations were also evident when only normoglycemic individuals were included in the analyses (i.e., IS + IR but no diabetes), and persisted in multiple regression analyses adjusting for age, BMI, sex, and race. Discontinuous analyses were also performed. When compared with IS, the IR and diabetes subgroups exhibited a two- to threefold increase in large VLDL particle concentrations (no change in medium or small VLDL), which produced an increase in serum triglycerides; a decrease in LDL size as a result of an increase in small and a reduction in large LDL subclasses, plus an increase in overall LDL particle concentration, which together led to no difference (IS versus IR) or a minimal difference (IS-versus diabetes) in LDL cholesterol; and a decrease in large cardioprotective HDL combined with an increase in the small HDL subclass such that there was no net significant difference in HDL cholesterol. We conclude that 1) insulin resistance had profound effects on lipoprotein size and subclass particle concentrations for VLDL, LDL, and HDL when measured by NMR; 2) in type 2 diabetes, the lipoprotein subclass alterations are moderately exacerbated but can be attributed primarily to the underlying insulin resistance; and 3) these insulin resistance-induced changes in the NMR lipoprotein subclass profile predictably increase risk of cardiovascular disease but were not fully apparent in the conventional lipid panel. It will be important to study whether NAIR lipoprotein subclass parameters can be used to manage risk more effectively and prevent cardiovascular disease in patients with the IRS. C1 Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. Med Univ S Carolina, Div Endocrinol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Garvey, WT (reprint author), Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Dept Biometry & Epidemiol, SB323,96 Jonathon Lucas St, Charleston, SC 29425 USA. FU NCRR NIH HHS [M01-RR-1070]; NHLBI NIH HHS [P01 HL-55782]; NIDDK NIH HHS [DK-38764] NR 50 TC 311 Z9 326 U1 1 U2 6 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0012-1797 J9 DIABETES JI Diabetes PD FEB PY 2003 VL 52 IS 2 BP 453 EP 462 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 643YT UT WOS:000180891700032 PM 12540621 ER PT J AU Young, BA Maynard, C Reiber, G Boyko, EJ AF Young, BA Maynard, C Reiber, G Boyko, EJ TI Effects of ethnicity and nephropathy on lower-extremity amputation risk among diabetic veterans SO DIABETES CARE LA English DT Article ID PERIPHERAL VASCULAR-DISEASE; LOWER-LIMB AMPUTATION; FOOT ULCER; POPULATION; MELLITUS; HEALTH; EPIDEMIOLOGY; MORTALITY; COMPLICATIONS; MINORITIES AB OBJECTIVE - To describe ethnic differences in the risk of amputation in diabetic patients with diabetic nephropathy. RESEARCH DESIGN AND METHODS - A retrospective cohort study was conducted on a national cohort of diabetic patients who received primary care within the Veterans Affairs (VA) Health Care System. Hospitalizations for lower-limb amputations were established by ICD-9-CM procedure codes. Relative risk of amputation in diabetic patients with and without diabetic nephropathy was determined using Cox proportional hazard modeling for unadjusted and adjusted models. RESULTS - Of the 429,918 subjects identified with diabetes (mean age 64 +/- 11 years, 97.4% Male), 3,289 individuals were determined to have had a lower-limb amputation during the study period. Compared with diabetic patients without amputations, amputees were on average older, more likely to belong to a minority group, and were more likely to have received treatment for more comorbid conditions. Asians were more likely to have toe amputations compared with whites or other ethnicities, while Native Americans were more likely to have below-the-knee amputations. Native Americans had the highest risk of amputation (RR 1.74, 95% Cl 1.39-2.18), followed by African Americans (RR 1.41,95% Cl 1.34-1.48) and Hispanics (RR 1.28, 95% Cl 1.20-1.38) compared with whites. The presence of diabetic nephropathy increased the risk of amputation threefold in all groups. Asian subjects with diabetes had the lowest adjusted relative risk of amputation (RR 0.31, 95% CI 0.19-0.50). CONCLUSIONS - Among diabetic patients, certain ethnic minority individuals have an increased risk of lower-extremity amputation compared with whites. Presence of diabetic nephropathy further increases this risk. C1 VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Dept Vet Affairs, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Sci, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Young, BA (reprint author), VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Dept Vet Affairs, 152-E,1660 S Columbian Way, Seattle, WA 98108 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814; Boyko, Edward/0000-0002-3695-192X NR 38 TC 89 Z9 91 U1 0 U2 1 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 FEB PY 2003 VL 26 IS 2 BP 495 EP 501 DI 10.2337/diacare.26.2.495 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 724UL UT WOS:000185505000043 PM 12547888 ER PT J AU Palmer, JP Hirsch, IB AF Palmer, JP Hirsch, IB TI What's in a name: LAtent autoimmune diabetes of adults, type 1.5, adult-onset, and type 1 diabetes SO DIABETES CARE LA English DT Editorial Material ID ISLET-CELL ANTIBODIES C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. RP Palmer, JP (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 14 TC 48 Z9 54 U1 0 U2 1 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 FEB PY 2003 VL 26 IS 2 BP 536 EP 538 DI 10.2337/diacare.26.2.536 PG 3 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 724UL UT WOS:000185505000050 PM 12547896 ER PT J AU McGregor, DK Krishnan, B Green, L AF McGregor, DK Krishnan, B Green, L TI Fine-needle aspiration of adult rhabdomyoma: A case report with review of the literature SO DIAGNOSTIC CYTOPATHOLOGY LA English DT Review DE rhabdomyoma; fine-needle aspiration; cytology ID CYTOLOGY AB The cytologic features of adult rhabdomyoma, a rare benign tumor of skeletal muscle origin, have been infrequently reported in the literature. We present here a case of a rhabdomyoma involving the floor of the mouth of a 78-year-old man initially diagnosed by v fine-needle aspiration cytology. Cytologic features seen on Papanicolaou-stained smear preparation included cohesive clusters of skeletal muscle cells having abundant eosinophilic cytoplasm and often peripherally located nuclei. Although cross-striations and elongated intracytoplasmic inclusions were not identified in the smears, they were noted in the cell block preparation of the aspirated specimen and in the touch preparation and histologic sections of the surgically resected specimen. The cytologic differential diagnosis of this tumor is discussed. (C) 2003 Wiley-Liss, Inc. C1 VA Med Ctr, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. RP Green, L (reprint author), VA Med Ctr, Dept Pathol, 3A-220,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 9 TC 10 Z9 10 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 8755-1039 J9 DIAGN CYTOPATHOL JI Diagn. Cytopathol. PD FEB PY 2003 VL 28 IS 2 BP 92 EP 95 DI 10.1002/dc.10241 PG 4 WC Medical Laboratory Technology; Pathology SC Medical Laboratory Technology; Pathology GA 641WL UT WOS:000180770000009 PM 12561029 ER PT J AU Cooper, RA Boninger, ML Cooper, R Robertson, RN Baldini, FD AF Cooper, RA Boninger, ML Cooper, R Robertson, RN Baldini, FD TI Wheelchair racing efficiency SO DISABILITY AND REHABILITATION LA English DT Article ID PROPULSION TECHNIQUES; KINEMATIC ANALYSIS; PUSHING ECONOMY; EXERCISE; RACERS; RESPONSES; CAPACITY AB Purpose: For individuals with disabilities exercise, such as wheelchair racing, can be an important modality for community reintegration, as well as health promotion. The purpose of this study was to examine selected parameters during racing wheelchair propulsion among a sample of elite wheelchair racers. It was hypothesized that blood lactate accumulation and wheeling economy (i.e. oxygen consumed per minute) would increase with speed and that gross mechanical efficiency would reach an optimum for each athlete. Method: Twelve elite wheelchair racers with paraplegia participated in this study. Nine of the subjects were males and three were females. Each subject used his or her personal wheelchair during the experiments. A computer monitored wheelchair dynamometer was used during all testing. The method used was essentially a discontinuous economy protocol. Mixed model analysis of variance (ANOVA) was used to compare blood lactate concentration, economy (minute oxygen consumption), and gross mechanical efficiency across the stages. Results: The results of this study show that both economy and blood lactate concentration increase linearly with speed if resistance is held constant. The subjects in this study had gross mechanical efficiencies (gme) of about 18%, with the range going from 15.2-22.7%. The results indicate that at the higher speeds of propulsion, for example near race speeds, analysis of respiratory gases may not give a complete energy profile. Conclusion: While there is a good understanding of training methods to improve cardiovascular fitness for wheelchair racers, little is known about improving efficiency (e.g. technique, equipment), therefore methods need to be developed to determine efficiency while training or in race situations. C1 Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs, Pittsburgh, PA USA. Calif State Univ Sacramento, Dept Kinesiol & Hlth Sci, Sacramento, CA 95819 USA. RP Cooper, RA (reprint author), Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. OI Boninger, Michael/0000-0001-6966-919X NR 25 TC 4 Z9 4 U1 1 U2 9 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1464-5165 J9 DISABIL REHABIL JI Disabil. Rehabil. PD FEB-MAR PY 2003 VL 25 IS 4-5 BP 207 EP 212 DI 10.1080/0963828021000030918 PG 6 WC Rehabilitation SC Rehabilitation GA 674VF UT WOS:000182657000006 PM 12623628 ER PT J AU Chattopadhyay, M Goss, J Lacomis, D Goins, WC Glorioso, JC Mata, M Fink, DJ AF Chattopadhyay, M Goss, J Lacomis, D Goins, WC Glorioso, JC Mata, M Fink, DJ TI Protective effect of HSV-mediated gene transfer of nerve growth factor in pyridoxine neuropathy demonstrates functional activity of trkA receptors in large sensory neurons of adult animals SO EUROPEAN JOURNAL OF NEUROSCIENCE LA English DT Article DE gene transfer; herpes simplex virus; nerve growth factors; polyneuropathies; receptor; trkA ID DORSAL-ROOT GANGLION; MESSENGER-RNA EXPRESSION; SIMPLEX VIRUS TYPE-1; NEUROTROPHIN RECEPTORS; SPINAL-CORD; DISTINCT PATTERNS; AXONAL-TRANSPORT; NGF BINDING; RAT; SYSTEM AB The distinct distribution of trkA receptors on small neurons and trkC receptors on large neurons in the dorsal root ganglion correlates with the dependence of these two classes of neurons on nerve growth factor and neurotrophin-3, respectively, for survival during development. In adult animals, the distribution of high affinity neurotrophin (trk) is complex and overlapping; neurotrophins are not required for cell survival, but may influence cell phenotype and the response to injury. In order to test the functional activity of trkA receptors in the sensory ganglia of adult animals in vivo , we examined the ability of a nerve growth factor-expressing recombinant replication-defective herpes simplex virus-based vector to prevent the selective degeneration of large sensory fibres caused by intoxication with pyridoxine. Transduction of dorsal root ganglion neurons in vivo by subcutaneous inoculation of the nerve growth factor-expressing vector prevented the development of pyridoxine-induced neuropathy measured by electrophysiological, morphological and behavioural measures. These results demonstrate a functional activity of trkA receptors expressed on large neurons in the dorsal root ganglion in mature animals; this observation has important implications for the choice of neurotrophic factors for treatment of peripheral nerve disease. C1 Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA 15213 USA. RP Fink, DJ (reprint author), S-520 BST,200 Lothrop St, Pittsburgh, PA 15213 USA. NR 42 TC 28 Z9 31 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 FEB PY 2003 VL 17 IS 4 BP 732 EP 740 DI 10.1046/j.1460-9568.2003.02500.x PG 9 WC Neurosciences SC Neurosciences & Neurology GA 649VY UT WOS:000181229700007 PM 12603263 ER PT J AU Pollock, AS Turck, J Lovett, DH AF Pollock, AS Turck, J Lovett, DH TI The prodomain of interleukin 1 alpha interacts with elements of the RNA processing apparatus and induces apoptosis in malignant cells SO FASEB JOURNAL LA English DT Article DE IL-1 alpha; nuclear localization signal; RNA processing; Bcl-X ID PRE-MESSENGER-RNA; SPLICING FACTORS; SR PROTEINS; BCL-X; NUCLEAR SPECKLES; 2-HYBRID SYSTEM; PRECURSOR; SEQUENCE; GENE; TRANSCRIPTION AB Interleukin 1alpha (IL-1alpha), a 33 kDa precursor, is cleaved releasing the 17 kDa carboxyl-terminal cytokine IL-1alpha to which all of the biological properties of IL-1alpha have been attributed. We investigated the potential independent properties of the remaining 16 kDa IL-1alpha amino-terminal propiece by expression in human tumor and primary human cell lines. The IL-1alpha propiece produced apoptosis in malignant but not normal cell lines. A minimal fragment comprised of amino acids 55-108 was required for apoptosis. Deletion and mutation studies identified an extended nuclear localization sequence required for nuclear localization, induction of apoptosis and concentration of the IL-1alpha propiece in interchromatin granule clusters, concentrations of proteins in the RNA splicing and processing pathways. The IL-1alpha propiece interacted with five known components of the RNA splicing/processing pathway, suggesting that the mechanism of action may involve changes in RNA splicing or processing. Expression of the IL-1alpha propiece caused a shift in the ratio of Bcl-X-1/Bcl-X-s toward the apoptotic direction. Our findings indicate that the IL-1alpha propiece induces apoptosis in a range of tumor cells and likely operates through a mechanism involving the RNA processing apparatus and the alternate splicing of apoptosis regulatory proteins. C1 Univ Calif San Francisco, Vet Adm Med Ctr, No Calif Inst Res & Educ, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Ctr Comprehens Canc, San Francisco, CA 94143 USA. RP Pollock, AS (reprint author), San Francisco VAMC, Dept Med 111J, 4150 Clement St, San Francisco, CA 94121 USA. EM pollock.allan@maelstrom.ucsf.edu FU NCI NIH HHS [R55 CA91038]; NIDDK NIH HHS [R01DK39776, R01DK31398] NR 62 TC 39 Z9 40 U1 0 U2 1 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 FEB PY 2003 VL 17 IS 2 BP 203 EP 213 DI 10.1096/fj.02-0602com PG 11 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 653VC UT WOS:000181456900045 PM 12554699 ER PT J AU Boulis, A AF Boulis, A TI Medical careers and feminist agendas. SO GENDER & SOCIETY LA English DT Book Review C1 Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Boulis, A (reprint author), Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0891-2432 J9 GENDER SOC JI Gend. Soc. PD FEB PY 2003 VL 17 IS 1 BP 143 EP 145 DI 10.1177/0891243202238992 PG 3 WC Sociology; Women's Studies SC Sociology; Women's Studies GA 637DZ UT WOS:000180497500013 ER PT J AU Ford, ME Havstad, SL Tilley, BC AF Ford, ME Havstad, SL Tilley, BC TI Recruiting older African American men to a cancer screening trial (the AAMEN Project) SO GERONTOLOGIST LA English DT Article DE recruitment; cancer screening; African American men; older adults ID PROSTATE-CANCER; CLINICAL-TRIALS; RACIAL-DIFFERENCES; COLORECTAL-CANCER; INFORMAL SUPPORT; ELDERLY BLACKS; WHITE MEN; PARTICIPATION; PREVENTION; RETENTION AB Purpose: This article describes the demographic characteristics of participants in a randomized trial (the AAMEN Project) designed to recruit older (aged 55+ years) African American men to a cancer screening trial. Design and Methods: The AAMEN Project is a recruitment trial developed for African American men aged 55+ years living in southeastern Michigan. Results: Of the 34,376 African American men in the study, 37.6% had low incomes and 62.4% had moderate-to-high incomes. The average age of the men was 63.3 years (SD = 5.9 years). Among men who were eligible and interested in participating, the proportion of men with low incomes was significantly greater than, the proportion of men with moderate-to-high incomes (p < .001). Implications: The AAMEN Project demonstrated success in recruiting a substantial proportion of men with low incomes as well as men with mode rate-to-high incomes. These findings may facilitate the development of future recruitment efforts involving older African American men. C1 Henry Ford Hlth Sci Ctr, Ctr Res Diverse Populat, Detroit, MI USA. Henry Ford Hlth Sci Ctr, Dept Biostat & Res Epidemiol, Detroit, MI USA. Med Univ S Carolina, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. RP Ford, ME (reprint author), Baylor Coll Med, Vet Affairs Med Ctr 152, Dept Med, 2002 Holcombe Blvd, Houston, TX 77030 USA. FU NCI NIH HHS [N01-CN-25512]; NIA NIH HHS [P 30 AG 5286] NR 62 TC 30 Z9 30 U1 2 U2 3 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 2003 VL 43 IS 1 BP 27 EP 35 PG 9 WC Gerontology SC Geriatrics & Gerontology GA 644WP UT WOS:000180943600004 PM 12604743 ER PT J AU Kunik, ME Snow, AL Molinari, VA Menke, TJ Souchek, J Sullivan, G Ashton, CM AF Kunik, ME Snow, AL Molinari, VA Menke, TJ Souchek, J Sullivan, G Ashton, CM TI Health care utilization in dementia patients with psychiatric comorbidity SO GERONTOLOGIST LA English DT Article DE mental disorders; hospitalization; ambulatory care ID ALZHEIMERS-DISEASE; BEHAVIORAL DISTURBANCES; PSYCHOTIC SYMPTOMS; DEPRESSION; PREVALENCE; PREDICTORS; INPATIENTS; MORTALITY; DELUSIONS; SERVICES AB Purpose: The purpose of this research was to determine if differences in service use exist between dementia patients with and without psychiatric comorbidity. Design and Methods: A retrospective cohort study was conducted on all Veterans Affairs (VA) beneficiaries seen at the Houston Veterans Affairs Medical Center with a VA Outpatient Clinic File diagnosis of dementia in 1997. The primary dependent measure was amount of Houston VA health service use from study entry until the end of fiscal year 1999 or until death. Results: Of the 864 dementia patients in the identified cohort, two thirds had a comorbid psychiatric diagnosis. Examination of 2-year health service use revealed that, after adjusting for demographic and medical comorbidity differences, dementia patients with psychiatric comorbidity had increased medical and psychiatric inpatient days of care and more psychiatric outpatient visits compared with patients without psychiatric comorbidity. Implications: Further understanding of the current health service use of dementia patients with psychiatric comorbidity may help to establish a framework for considering change in the current system of care. A coordinated system of care with interdisciplinary teamwork may provide both cost-effective and optimal treatment for dementia patients. C1 Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Vet Affairs South Cent Mental Illness Res Educ &, Houston, TX USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ Arkansas Med Sci, Dept Psychiat & Behav Sci, Little Rock, AR 72205 USA. Cent Arkansas Vet Healthcare Syst, Ctr Mental Hlth & Outcomes Res, Little Rock, AR USA. RP Kunik, ME (reprint author), VAMC, 2002 Holcombe HSR& D152, Houston, TX 77030 USA. NR 30 TC 24 Z9 24 U1 0 U2 1 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 2003 VL 43 IS 1 BP 86 EP 91 PG 6 WC Gerontology SC Geriatrics & Gerontology GA 644WP UT WOS:000180943600010 PM 12604749 ER PT J AU Petersen, LA Normand, SLT Druss, BG Rosenheck, RA AF Petersen, LA Normand, SLT Druss, BG Rosenheck, RA TI Process of care and outcome after acute myocardial infarction for patients with mental illness in the VA health care system: Are there disparities? SO HEALTH SERVICES RESEARCH LA English DT Article DE acute myocardial infarction; mental disorders; outcome assessment (health care); health services accessibility; physicians' practice patterns ID COOPERATIVE CARDIOVASCULAR PROJECT; OF-VETERANS-AFFAIRS; CORONARY-ARTERY DISEASE; NEW-YORK-STATE; ELDERLY PATIENTS; RACIAL-DIFFERENCES; REVASCULARIZATION PROCEDURES; MEDICARE PATIENTS; CARDIAC-CATHETERIZATION; PSYCHIATRIC-PATIENTS AB Objective. To compare process of care and outcome after acute myocardial infarction, for patients with and without mental illness, cared for in die Veterans Health Administration (VA) health care system. Data Sources/Setting. Primary clinical data from 81 VA hospitals. Study Design. This was a retrospective cohort study of 4,340 veterans discharged with clinically confirmed acute myocardial infarction. Of these, 859 (19.8 percent) met the definition of mental illness. Measures were age-adjusted in-hospital and 90-day cardiac procedure use; age-adjusted relative risks (RR) of use of thrombolytic therapy, beta-blockers, angiotensin converting enzyme (ACE) inhibitors, or aspirin at discharge; risk-adjusted 30-day and one-year mortality. Results. Patients with mental illness were marginally less likely than those without mental illness to undergo in-hospital angiography (age-adjusted RR 0.90 [95 percent confidence interval: 0.83, 0.98]), but there was no significant difference in the. age-adjusted RR of coronary artery bypass graft surgery in the 90 days after admission (0.85 [0.69,1.05]), or in the receipt of medications of known benefit. For example, ideal candidates with and without mental illness were equally likely to receive beta-blockers at the time of discharge (age-adjusted RR 0.92 [0.82, 1.02]). The risk-adjusted odds ratio (OR) for death in patients with mental illness versus those without mental illness within 30 days was 1.00 (0.75,1.32), and for death within one year was 1.25 (1.00,1.53). Conclusions. Veterans Health Administration patients with mental illness were marginally less likely than those without mental illness to receive diagnostic angiography, and no less likely to receive revascularization or medications of known benefit after acute myocardial infarction. Mortality at one year may have been higher, although this finding did not reach statistical significance. These findings are consistent with other studies showing reduced health care disparities in the VA for other vulnerable groups, and suggest that an integrated health care system with few financial barriers to health care access may attenuate some health care disparities. Further work should address how health care organizational features might narrow disparities in health care for vulnerable groups. C1 Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. Yale Univ, Dept Psychiat, New Haven, CT 06520 USA. Yale Univ, Dept Publ Hlth, New Haven, CT 06520 USA. RP Petersen, LA (reprint author), Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 72 TC 52 Z9 54 U1 3 U2 12 PU BLACKWELL PUBL LTD PI OXFORD PA 108 COWLEY RD, OXFORD OX4 1JF, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 2003 VL 38 IS 1 BP 41 EP 63 DI 10.1111/1475-6773.00104 PN 1 PG 23 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 647RY UT WOS:000181108900003 PM 12650380 ER PT J AU Berlowitz, DR Young, GJ Hickey, EC Saliba, D Mittman, BS Czarnowski, E Simon, B Anderson, JJ Ash, AS Rubenstein, LV Moskowitz, MA AF Berlowitz, DR Young, GJ Hickey, EC Saliba, D Mittman, BS Czarnowski, E Simon, B Anderson, JJ Ash, AS Rubenstein, LV Moskowitz, MA TI Quality improvement implementation in the nursing home SO HEALTH SERVICES RESEARCH LA English DT Article DE quality improvement; quality of care; nursing homes; decubitus ulcers ID CLINICAL INDICATORS; CARE; MANAGEMENT; ADOPTION; CULTURE; TRIALS; IMPACT; TQM; VA AB Objective. To examine quality improvement (QI) implementation in nursing homes, its association with organizational culture, and its effects on-pressure ulcer care. Data Sources/Study Settings. Primary data were collected from staff at 35 nursing homes maintained by the Department of Veterans Affairs (VA) on measures related to QI implementation and organizational culture. These data were combined with information obtained from abstractions of medical records and analyses of an existing database., Study Design. A cross-sectional analysis of the association among the different measures was performed. Data Collection/Extraction Methods. Completed surveys containing information on QI implementation, organizational culture, employee satisfaction, and perceived adoption of guidelines were obtained from 1,065 nursing home staff. Adherence to best practices related to pressure ulcer prevention was abstracted from medical records. Risk-adjusted rates of pressure ulcer development were calculated from an administrative database. Principal Findings. Nursing homes differed significantly (p<.001) in their extent of QI implementation with scores on this I to 5 scale ranging from 2.98 to 4.08. Quality improvement implementation was greater in those nursing homes with an organizational culture that emphasizes innovation and teamwork. Employees of nursing homes with a greater degree of QI implementation were more satisfied with their jobs (a 1-point increase in QI score was associated with a 0.83 increase on the 5-point satisfaction scale, p <.001) and were more likely to report adoption of pressure ulcer clinical guidelines (a 1-point increase in QI score was associated with a 28 percent increase in number of staff reporting adoption, p<.001). No significant association was found, though, between QI implementation and either adherence to guideline recommendations as abstracted from records or the rate of pressure ulcer development. Conclusions. Quality improvement implementation is most likely to be successful in those VA nursing homes with an underlying culture that promotes innovation. While QI implementation may result in staff who are more satisfied with their jobs and who believe they are providing better; care, associations with improved care are uncertain. C1 Bedford VA Hosp, CHQOER, Bedford, MA 01730 USA. Edith Nourse Rogers Mem Vet Adm Hosp, CHQOER, Bedford, MA USA. Greater Boston VAMC, Management Decis & Res Ctr, Boston, MA USA. Boston Med Ctr, Gen Internal Med Sect, Boston, MA USA. Boston Univ, Sch Med, Boston, MA 02215 USA. Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. VA Greater Los Angeles Healthcare Syst, Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. RAND Corp, Santa Monica, CA USA. RP Berlowitz, DR (reprint author), Bedford VA Hosp, CHQOER, 200 Springs Rd, Bedford, MA 01730 USA. NR 31 TC 65 Z9 66 U1 2 U2 9 PU BLACKWELL PUBL LTD PI OXFORD PA 108 COWLEY RD, OXFORD OX4 1JF, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 2003 VL 38 IS 1 BP 65 EP 83 DI 10.1111/1475-6773.00105 PN 1 PG 19 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 647RY UT WOS:000181108900004 PM 12650381 ER PT J AU Spiegel, BMR Targownik, L Dulai, GS Karsan, HA Gralnek, IM AF Spiegel, BMR Targownik, L Dulai, GS Karsan, HA Gralnek, IM TI Endoscopic screening for esophageal varices in cirrhosis: Is it ever cost effective? SO HEPATOLOGY LA English DT Article ID RANDOMIZED CONTROLLED TRIAL; TERM FOLLOW-UP; PROPHYLACTIC SCLEROTHERAPY; GASTROINTESTINAL ENDOSCOPY; PORTAL-HYPERTENSION; NATURAL-HISTORY; LIVER-CIRRHOSIS; UNITED-STATES; PREVENTION; HEMORRHAGE AB Current guidelines for the management of patients with compensated cirrhosis recommend universal screening endoscopy followed by prophylactic beta-blocker therapy to prevent initial hemorrhage in those found to have esophageal varices. However, the cost-effectiveness of this recommendation has not been established. Our objective was to determine whether screening endoscopy is cost-effective compared with empiric medical management in patients with compensated cirrhosis. Decision analysis with Markov modeling was used to calculate the cost-effectiveness of 6 competing strategies: (1) universal screening endoscopy (EGD) followed by beta-blocker (BB) therapy (EGD-->BB) if varices are present, (2) EGD followed by endoscopic band ligation (EBL) (EGD-->EBL) if varices are present, (3) selective screening endoscopy (sEGD) in high risk patients followed by BB therapy if varices are present (sEGD-->BB), (4) selective screening endoscopy followed by EBL (sEGD-->EBL) if varices are present, (5) empiric beta-blocker therapy in all patients, and (6) no prophylactic therapy ("Do Nothing"). Cost estimates were from a third-party payer perspective. The main outcome measure was the cost per initial variceal hemorrhage prevented. The "Do Nothing" strategy was the least expensive yet least effective approach. Compared with the "Do Nothing" strategy, the empiric beta-blocker strategy cost an incremental $12,408 per additional variceal bleed prevented. Compared with the empiric beta-blocker strategy, in turn, both the EGD-->BB and the EGD-->EBL strategies cost over $175,000 more per additional bleed prevented. The sEGD-->BB and sEGD-->EBL strategies were more expensive and less effective than the empiric beta-blocker strategy. In conclusion, empiric beta-blocker therapy for the primary prophylaxis of variceal hemorrhage is a cost-effective measure, as the use of screening endoscopy to guide therapy adds significant cost with only marginal increase in effectiveness. C1 Univ Calif Los Angeles, Sch Med,CURE Digest Dis Res Ctr, Div Gastroenterol,Ctr Study Digest Healthcare, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Gralnek, IM (reprint author), Univ Calif Los Angeles, Sch Med,CURE Digest Dis Res Ctr, Div Gastroenterol,Ctr Study Digest Healthcare, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 115 Rm 215B, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-07180]; PHS HHS [K23] NR 52 TC 84 Z9 87 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 0270-9139 J9 HEPATOLOGY JI Hepatology PD FEB PY 2003 VL 37 IS 2 BP 366 EP 377 DI 10.1053/jhep.2003.50050 PG 12 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 640FQ UT WOS:000180678000018 PM 12540787 ER PT J AU Griffin, KA Abu-Amarah, I Picken, M Bidani, AK AF Griffin, KA Abu-Amarah, I Picken, M Bidani, AK TI Renoprotection by ACE inhibition or aldosterone blockade is blood pressure-dependent SO HYPERTENSION LA English DT Article DE hypertension, renal; rats, stroke-prone SHR; nephrosclerosis; autoregulation ID SPONTANEOUSLY HYPERTENSIVE RATS; REMNANT KIDNEY MODEL; RENIN-ANGIOTENSIN SYSTEM; CALCIUM-CHANNEL BLOCKERS; HEMORRHAGIC STROKE; GLOMERULAR INJURY; VASCULAR INJURY; RENAL ABLATION; ORGAN DAMAGE; SALT AB Renin-angiotensin-aldosterone system blockade has been shown to protect against renal damage in salt-supplemented, stroke-prone spontaneously hypertensive rats (SHRsp). Based on intermittent tail-cuff blood pressure (BP) measurements, it has been claimed that such protection is BP-independent and mediated by a blockade of the direct tissue-damaging effects of angiotensin and/or aldosterone. BP radiotelemetry was performed for 8 weeks in approximate to10-week-old male SHRsp who received a standard diet and either tap water (n=10) or 1% NaCl to drink. Saline-drinking SHRsp were either left untreated (n = 12), received enalapril (50 mg/L) in drinking fluid (n = 9), or had subcutaneous implantation of time-release 200-mg pellets of aldactone (n = 10). The average systolic BP (mean +/- SEM) during the final 3 weeks was significantly higher (P<0.05) in untreated saline-drinking (215 +/- 6 mm Hg) SHRsp but not aldactone-treated (198 +/- 4 mmHg) or enalapril-treated treated SHRsp (173 +/- 1 mmHg), as compared with tap water-drinking SHRsp (197 +/- 3 mm Hg). Histological renal damage scores at 8 weeks paralleled the BP in all groups, with an excellent correlation (r=0.8, P<0.001, n=41). Moreover, a renal damage score of >5 was only observed in SHRsp whose average systolic BP during the final 3 weeks exceeded 200 mm Hg, indicating a threshold relation with BP. These data show that protection by renin-angiotensin-aldosterone system blockade in this model is BP-dependent and mediated by preventing the severe increases in BP seen in untreated salt-supplemented SHRsp and further underscore the limitations of interpretations based on conventional tail-cuff BP measurements. C1 Loyola Univ, Med Ctr, Dept Internal Med, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Pathol, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. RP Griffin, KA (reprint author), Loyola Univ, Med Ctr, Dept Internal Med, 2160 S 1st Ave, Maywood, IL 60153 USA. FU NHLBI NIH HHS [HL64807]; NIDDK NIH HHS [DK-40426] NR 49 TC 78 Z9 82 U1 0 U2 0 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 2003 VL 41 IS 2 BP 201 EP 206 DI 10.1161/01.HYP.0000049881.25304.73 PG 6 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 645WQ UT WOS:000181003700004 PM 12574082 ER PT J AU Lavretsky, H Mistry, R Bastani, R Gould, R Gokhman, I Huang, D Maxwell, A McDermott, C Rosansky, J Jarvik, L AF Lavretsky, H Mistry, R Bastani, R Gould, R Gokhman, I Huang, D Maxwell, A McDermott, C Rosansky, J Jarvik, L CA UPBEAT Collaborative Grp TI Symptoms of depression and anxiety predict mortality in elderly veterans enrolled in the UPBEAT program SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Ctr Program Evaluat, Los Angeles, CA USA. Univ Calif Los Angeles, Str Comp Ctr, Los Angeles, CA USA. RP Lavretsky, H (reprint author), Univ Calif Los Angeles, Neuropsychiat Inst & Hosp, 760 Westwood Pl,Room 37-425, Los Angeles, CA 90095 USA. RI Lavretsky, Helen/M-5711-2015 OI Lavretsky, Helen/0000-0001-9990-5085 FU NIMH NIH HHS [K23 MH 01948] NR 9 TC 9 Z9 9 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD FEB PY 2003 VL 18 IS 2 BP 183 EP 184 DI 10.1002/gps.706 PG 2 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 648WT UT WOS:000181174500014 PM 12571829 ER PT J AU Balshi, TJ Wolfinger, GJ AF Balshi, TJ Wolfinger, GJ TI Immediate loading of dental implants in the edentulous maxilla: Case study of a unique protocol SO INTERNATIONAL JOURNAL OF PERIODONTICS & RESTORATIVE DENTISTRY LA English DT Article ID RETAINED MANDIBULAR OVERDENTURES AB Although immediate loading of dental implants is increasingly gaining recognition as an important option for certain categories of implant patients, the maxillary arch has historically posed difficulties that have limited the number of immediate loading applications. To address the needs of patients who cannot tolerate maxillary removable complete dentures, an immediate loading protocol we call "Teeth in a Day" uses a conversion prosthesis that has been expanded to include complete-arch maxillary reconstruction. Use of a large number of implants to prevent micromotion at the bone-to-implant interface is a critical element in this protocol. A patient treatment is reported. C1 Inst Facial Esthet, Ft Washington, PA 19034 USA. Harvard Univ, Sch Dent Med, Dept Prosthodont, Boston, MA 02115 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Balshi, TJ (reprint author), 467 Penn Ave 210, Ft Washington, PA 19034 USA. NR 18 TC 16 Z9 17 U1 0 U2 0 PU QUINTESSENCE PUBL CO INC PI CAROL STREAM PA 551 NORTH KIMBERLY DR, CAROL STREAM, IL 60188-1881 USA SN 0198-7569 J9 INT J PERIODONT REST JI Int. J. Periodontics Restor. Dent. PD FEB PY 2003 VL 23 IS 1 BP 37 EP 45 PG 9 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 653FE UT WOS:000181423900005 PM 12617367 ER PT J AU Walss-Bass, C Kreisberg, JI Luduena, RF AF Walss-Bass, C Kreisberg, JI Luduena, RF TI Effect of the antitumor drug vinblastine on nuclear beta(II)-tubulin in cultured rat kidney mesangial cells SO INVESTIGATIONAL NEW DRUGS LA English DT Article DE tubulin isotypes; micrombules; vinblastine; nuclear localization; DNA fragmentation ID MONOCLONAL-ANTIBODY; MITOTIC BLOCK; BETA-TUBULIN; MECHANISM; TAXOL; ISOTYPE; DEATH; PROLIFERATION; INHIBITION; DYNAMICS AB Tubulin, the main component of microtubules, is a major target for antitumor drugs such as vinblastine. We have recently discovered that the beta(II) isotype of tubulin is present in the nuclei of cultured rat kidney mesangial cells, smooth-muscle-like cells present in the renal glomerular mesangium (Walss C, Kreisberg JI, Luduena RF: Cell Motil Cytoskeleton 42: 274-284, 199). Here, we have investigated the effect of vinblastine on nuclear beta(II)-tubulin in these cells. We have found that, at concentrations of 15 nM and higher, vinblastine caused a reversible loss of beta(II)-tubulin from the nucleus. Our results raise the possibility that nuclear beta(II)-tubulin constitutes a population of tubulin that could be a novel target for antitumor drugs such as vinblastine. C1 Univ Texas, Hlth Sci Ctr, Dept Biochem, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Surg, San Antonio, TX 78229 USA. Dept Vet Affairs, Res & Dev Serv, San Antonio, TX 78229 USA. RP Luduena, RF (reprint author), Univ Texas, Hlth Sci Ctr, Dept Biochem, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NCI NIH HHS [CA26376] NR 25 TC 5 Z9 6 U1 0 U2 3 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0167-6997 J9 INVEST NEW DRUG JI Invest. New Drugs PD FEB PY 2003 VL 21 IS 1 BP 15 EP 20 PG 6 WC Oncology; Pharmacology & Pharmacy SC Oncology; Pharmacology & Pharmacy GA 660FJ UT WOS:000181822900002 PM 12795526 ER PT J AU Yerevanian, BI Koek, RJ Mintz, J AF Yerevanian, BI Koek, RJ Mintz, J TI Lithium, anticonvulsants and suicidal behavior in bipolar disorder SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE bipolar disorder; suicide; lithium; carbamazepine; valproic acid; longitudinal studies ID RISK; METAANALYSIS; MORTALITY AB Background: Lithium has been found to be effective in reducing suicide rates during long term treatment of patients with bipolar disorders. Data on the efficacy of anticonvulsant mood stabilizers in reducing suicide risk are sparse. Method: Charts of 140 bipolar patients treated continuously for a minimum of 6 months during a 23-year period of private practice by the senior author were extracted from nearly 4000 patient records. Data extracted from the charts were incidence of completed suicide, number of suicide attempts, and number of hospitalizations for suicidal ideation or behavior per 100 patient-years of either 'on' or 'off' lithium or anticonvulsant mood stabilizer monotherapy. Results: Only one completed suicide (during a period off of lithium) occurred in the patients studied. Incidence of non-lethal suicidal behavior was not different during treatment with lithium, compared with anticonvulsants. Being on a mood stabilizer significantly protected against suicidal behavior. The relative protective effect was more modest than in reports from other treatment settings. Limitations: This was a retrospective chart review study of naturalistically treated patients. Conclusions: Treatment of patients with bipolar disorder with either lithium or anticonvulsant mood stabilizers was associated with reduced risk of suicidal behavior. This study did not find evidence for a difference in the protective effect of the two types of mood stabilizing medications against non-lethal suicidal behavior in the naturalistic setting of private practice. (C) 2002 Published by Elsevier Science B.V. C1 VA Greater Los Angeles Healthcare Syst, Ctr Ambulatory Care, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. W Los Angeles VAMC, Biostat Consultat Unit, Los Angeles, CA USA. RP Yerevanian, BI (reprint author), 16111 Plummer St,116A, Sepulveda, CA 91343 USA. NR 20 TC 49 Z9 51 U1 1 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD FEB PY 2003 VL 73 IS 3 BP 223 EP 228 AR PII S0165-0327(02)00302-6 DI 10.1016/S0165-0327(02)00302-6 PG 6 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 645QN UT WOS:000180990000002 PM 12547290 ER PT J AU Krupnick, AS Zhu, JL Nguyen, T Kreisel, D Balsara, KR Lankford, EB Clark, CC Levine, S Stedman, HH Shrager, JB AF Krupnick, AS Zhu, JL Nguyen, T Kreisel, D Balsara, KR Lankford, EB Clark, CC Levine, S Stedman, HH Shrager, JB TI Inspiratory loading does not accelerate dystrophy in mdx mouse diaphragm: implications for regenerative therapy SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE airway resistance; airway obstruction; regeneration; muscular dystrophies; dystrophin ID CONTRACTION-INDUCED INJURY; SKELETAL-MUSCLES; MUSCULAR-DYSTROPHY; MICE; SUSCEPTIBILITY; ADAPTATIONS; MYOFIBERS; DUCHENNE; FAILURE; FIBERS AB Since the finding that the mdx mouse diaphragm, in contrast to limb muscles, undergoes progressive degeneration analogous to that seen in Duchenne muscular dystrophy, the relationship between the workload on a muscle and the pathogenesis of dystrophy has remained controversial. We increased the work performed by the mdx mouse diaphragm in vivo by tracheal banding and evaluated the progression of dystrophic changes in that muscle. Despite the establishment of dramatically increased respiratory workload and accelerated myofiber damage documented by Evans blue dye, no change in the pace of progression of dystrophy was seen in banded animals vs. unbanded, sham-operated controls. At the completion of the study, more centrally nucleated fibers were evident in the diaphragms of banded mdx mice than in sham-operated mdx controls, indicating that myofiber regeneration increases to meet the demands of the work-induced damage. These data suggest that there is untapped regenerative capacity in dystrophin-deficient muscle and validates experimental efforts aimed at augmenting regeneration within skeletal muscle as a therapeutic strategy in the treatment of dystrophinopathies. C1 Univ Penn, Med Ctr, Sch Med, Dept Surg, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Dept Surg, Philadelphia, PA USA. Vet Affairs Med Ctr, Dept Med, Philadelphia, PA USA. Thomas Jefferson Univ, Dept Med, Div Cardiovasc Med, Philadelphia, PA 19107 USA. Univ Penn, Sch Med, Dept Orthopaed Surg, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biochem, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biophys, Philadelphia, PA 19104 USA. RP Shrager, JB (reprint author), Univ Penn, Med Ctr, Sch Med, Dept Surg, 4 Silverstein Bldg,3400 Spruce St, Philadelphia, PA 19104 USA. FU NHLBI NIH HHS [HL-10251-ASK] NR 34 TC 6 Z9 6 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 PY 2003 VL 94 IS 2 BP 411 EP 419 DI 10.1152/japplphysiol.00689.2002 PG 9 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 636CU UT WOS:000180437600001 PM 12531909 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 Perfusion heterogeneity in rat lungs assessed from the distribution of 4-mu m-diameter latex particles SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE alveolar perfusion; fluorescent microspheres; fractal analysis; pulmonary blood flow ID PULMONARY BLOOD-FLOW AB Pulmonary vascular perfusion has been shown to follow a fractal distribution down to a resolution of 0.5 cm 3 (5E11 mum(3)). We wanted to know whether this distribution continued down to tissue volumes equivalent to that of an alveolus (2E5 mum(3)). To investigate this, we used confocal microscopy to analyze the spatial distribution of 4-mum-diameter fluorescent latex particles trapped within rat lung microvessels. Particle distributions were analyzed in tissue volumes that ranged from 1.7E2 to 2.8E8 mum(3). The analysis resulted in fractal plots that consisted of two slopes. The left slope, encompassing tissue volumes less than 7E5 mum(3), had a fractal dimension of 1.50 +/- 0.03 (random distribution). The right slope, encompassing tissue volumes greater than 7E5 mum(3), had a fractal dimension of 1.29 +/- 0.04 (nonrandom distribution). The break point at 7E5 mum(3) corresponds closely to a tissue volume equivalent to that of one alveolus. We conclude that perfusion distribution is random at tissue volumes less than that of an alveolus and nonrandom at tissue volumes greater than that of an alveolus. C1 Univ Wisconsin, Sch Med, Dept Surg, Clin Sci Ctr H5 301, 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, Clin Sci Ctr H5 301, 600 Highland Ave, Madison, WI 53792 USA. NR 16 TC 15 Z9 15 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 PY 2003 VL 94 IS 2 BP 420 EP 428 DI 10.1152/japplphysiol.00700.2002 PG 9 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 636CU UT WOS:000180437600002 PM 12391079 ER PT J AU Slice, LW Han, SK Simon, MI AF Slice, LW Han, SK Simon, MI TI G alpha(q) signaling is required for Rho-dependent transcriptional activation of the cyclooxygenase-2 promoter in fibroblasts SO JOURNAL OF CELLULAR PHYSIOLOGY LA English DT Article ID PROSTAGLANDIN ENDOPEROXIDE SYNTHASE; NUCLEOTIDE EXCHANGE FACTOR; STRESS FIBER FORMATION; PROTEIN-KINASE-C; SWISS 3T3 CELLS; GENE-EXPRESSION; DIFFERENTIAL REGULATION; COLORECTAL ADENOMAS; RESPONSE ELEMENT; EPITHELIAL-CELLS AB Previously, we demonstrated that the gastrin releasing peptide (GRP) induces cyclooxygenase-2 (COX-2) expression through a Rho-dependent, protein kinase C (PKC)-independent signaling pathway in fibroblasts (Slice et al., 1999, J Biol Chem 274:27562-27566). However, the specific role of heterotrimeric guanine nucleotide binding regulatory proteins (G-proteins) that are coupled to the GRP receptor in Rho-dependent COX-2 expression has not been elucidated. In this report, we utilize embryonic fibroblasts from transgenic mice containing double gene knock-outs (DKO) for Galpha(q/11) and Galpha(12/13) to demonstrate that COX-2 promoter activation by GRP requires Galpha(q), Furthermore, we show that GRP-dependent COX-2 gene expression, as assessed by a COX-2 reporter luciferase assay, was induced in cells lacking Galpha(12/13) but was blocked in cells that did not express Galpha(q/11). GRP-dependent COX-2 promoter induction in Galpha(q/11) deficient cells was rescued by expression of wild type Gaq but blocked by inhibition of calcium signaling in calcium-free media or in cells treated with 2-aminoethoxydiphenylborate (2-APB). Co-stimulation of transfected Galpha(q/11) deficient cells with GRP and thapsigargin (TG) induced the COX-2 promoter. Activation of endogenous Rho by expression of Onco-lbc or expression of Rho A Q63L resulted in COX-2 promoter activation in Galpha(q/11) deficient cells. Inhibition of Rho by Clostridium botulinum C3 toxin blocked COX-2 promoter induction. Expression of Galpha(q) Q209L in the well-characterized fibroblast cell line, NIH3T3, induced the COX-2 promoter which was blocked by expression of C3 toxin. These results demonstrate that calcium signaling mediated by Gaq and Rho play critical roles in GRP-dependent COX-2 expression in fibroblasts. (C) 2002 Wiley-Liss, Inc. C1 Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, CURE Digest Dis Res Ctr, Div Digest Dis,Dept Med, Los Angeles, CA 90095 USA. CALTECH, Div Biol, Pasadena, CA 91125 USA. RP Slice, LW (reprint author), Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, CURE Digest Dis Res Ctr, Div Digest Dis,Dept Med, 900 Vet Ave, Los Angeles, CA 90095 USA. FU NIDDK NIH HHS [DK35740]; NIGMS NIH HHS [GM-34236] NR 71 TC 9 Z9 10 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 0021-9541 J9 J CELL PHYSIOL JI J. Cell. Physiol. PD FEB PY 2003 VL 194 IS 2 BP 127 EP 138 DI 10.1002/jcp.10195 PG 12 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 631WF UT WOS:000180189500004 PM 12494451 ER PT J AU Lieber, CS AF Lieber, CS TI Hepatitis C and alcohol SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Editorial Material ID LIVER FIBROSIS PROGRESSION; HEPATOCELLULAR-CARCINOMA; VIRUS-INFECTION; OXIDATIVE STRESS; CIRRHOSIS; RISK; CONSUMPTION; DISEASES C1 Bronx Vet Adm Med Ctr, Alcohol Res Ctr, Sect Liver Dis & Nutr, New York, NY USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. RP Lieber, CS (reprint author), Bronx Vet Adm Med Ctr, Alcohol Res Ctr, Sect Liver Dis & Nutr, New York, NY USA. NR 24 TC 7 Z9 8 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 2003 VL 36 IS 2 BP 100 EP 102 DI 10.1097/00004836-200302000-00003 PG 3 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 639JL UT WOS:000180624900003 PM 12544190 ER PT J AU Garvey, WT AF Garvey, WT TI The role of uncoupling protein 3 in human physiology SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Editorial Material ID MITOCHONDRIAL PROTON LEAK; SKELETAL-MUSCLE; EXPRESSION; MICE; OBESITY; HOMOLOG; TISSUE; UCP3 C1 Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Garvey, WT (reprint author), Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Clin Sci Bldg 816,96 Jonathan Lucas St, Charleston, SC 29425 USA. NR 21 TC 8 Z9 10 U1 0 U2 0 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 FEB PY 2003 VL 111 IS 4 BP 438 EP 441 DI 10.1172/JC1200317835 PG 4 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 646TK UT WOS:000181050200004 PM 12588880 ER PT J AU Mishra, N Reilly, CM Brown, DR Ruiz, P Gilkeson, GS AF Mishra, N Reilly, CM Brown, DR Ruiz, P Gilkeson, GS TI Histone deacetylase inhibitors modulate renal disease in the MRL-lpr/lpr mouse SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; CYTOKINE GENE-EXPRESSION; KAPPA-B-BETA; INTERFERON-GAMMA; TRICHOSTATIN-A; AUTOIMMUNE-DISEASE; LPR MICE; IN-VIVO; CELL DIFFERENTIATION; T-LYMPHOCYTES AB Studies in human systemic lupus erythematosus (SLE) suggest a possible role for histone deacetylases (HDACs) in skewed gene expression and disease pathogenesis. We used the MRL-lpr/lpr murine model of lupus to demonstrate that HDACs play a key role in the heightened levels of both Th1 and Th2 cytokine expression that contribute to disease. The availability of specific HDAC inhibitors (HDIs) such as trichostatin A (TSA) and suberonylanilide hydroxamic acid (SAHA) permits the study of the role of HDACs in gene regulation. Our results indicate that HDIs downregulate IL-12, IFN-gamma, IL-6, and IL-10 mRNA and protein levels in MRL-lpr/lpr splenocytes. This effect on gene transcription is associated with an increased accumulation of acetylated histories H3 and H4 in total cellular chromatin. To elucidate the in vivo effects of TSA on lupuslike disease, we treated MRL-lpr/lpr mice with TSA (0.5 mg/kg/d) for 5 weeks. Compared with vehicle-treated control mice, TSA-treated mice exhibited a significant reduction in proteinuria, glomerulonephritis, and spleen weight. Taken together, these findings suggest that increased expression of HDACs leading to an altered state of histone acetylation may be of pathologic significance in MRL-lpr/lpr mice. In addition, TSA or other HDIs may have therapeutic benefit in the treatment of SLE. C1 Wake Forest Univ, Sch Med, Sect Rheumatol & Clin Immunol, Dept Internal Med, Winston Salem, NC 27157 USA. Ralph H Johnson Vet Adm Med Ctr, Med Res Serv, Charleston, SC USA. Med Univ S Carolina, Dept Med, Div Rheumatol, Charleston, SC 29425 USA. Univ Miami, Med Ctr, Dept Immunopathol, Miami, FL 33152 USA. RP Mishra, N (reprint author), Wake Forest Univ, Sch Med, Sect Rheumatol & Clin Immunol, Dept Internal Med, Med Ctr Blvd, Winston Salem, NC 27157 USA. OI Brown, Doris/0000-0001-8515-3759 FU NIAID NIH HHS [F32 AI10582, F32 AI010582]; NIAMS NIH HHS [AR 49153, R21 AR049153] NR 68 TC 229 Z9 242 U1 1 U2 8 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 FEB PY 2003 VL 111 IS 4 BP 539 EP 552 DI 10.1172/JC1200316153 PG 14 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 646TK UT WOS:000181050200016 PM 12588892 ER PT J AU Redding, SW Kirkpatrick, WR Saville, S Coco, BJ White, W Fothergill, A Rinaldi, M Eng, T Patterson, TF Lopez-Ribot, J AF Redding, SW Kirkpatrick, WR Saville, S Coco, BJ White, W Fothergill, A Rinaldi, M Eng, T Patterson, TF Lopez-Ribot, J TI Multiple patterns of resistance to fluconazole in Candida glabrata isolates from a patient with oropharyngeal candidiasis receiving head and neck radiation SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID AZOLE ANTIFUNGAL AGENTS; INFECTED PATIENTS; TRANSPORTER GENE; ALBICANS; COLONIZATION; SUSCEPTIBILITY; EPIDEMIOLOGY; STRAINS AB Candida glabrata has emerged in recent years as a significant cause of systemic fungal infection. We have previously reported on the first three patients receiving radiation for head and neck cancer to develop oropharyngeal candidiasis due to C. glabrata. The goal of this study was to track the development of increased fluconazole resistance in C. glabrata isolates and to evaluate previously described genetic mechanisms associated with this resistance from one of these three patients. The patient was a 52-year-old man with squamous cell carcinoma treated with radiation. At week 7 of his radiation, he developed oropharyngeal candidiasis, which was treated with 200 mg of fluconazole daily for 2 weeks. Serial cultures from this and three subsequent time points yielded C. glabrata. Isolates from these cultures were subjected to antifungal susceptibility testing, DNA karyotyping, and evaluation of the expression of genes previously associated with C. glabrata resistance to fluconazole, CgCDR1, CgCDR2, and CgERG11. Two strains (A and B) of C. glabrata were identified and found to display different patterns of resistance development and gene expression. Strain A developed resistance over a 2-week period and showed no overexpression of these genes. In contrast, strain B first showed resistance 6 weeks after fluconazole therapy was discontinued but showed overexpression of all three genes. In conclusion, development of resistance to fluconazole by C. glabrata is a highly varied process involving multiple molecular mechanisms. C1 Univ Texas, Hlth Sci Ctr, Dept Gen Dent, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Radiat Oncol, San Antonio, TX 78229 USA. S Texas Vet Healthcare Syst, San Antonio, TX 78229 USA. RP Redding, SW (reprint author), Univ Texas, Hlth Sci Ctr, Dept Gen Dent, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. RI Saville, Stephen/F-7668-2010; Lopez-Ribot, Jose/D-2048-2010 FU NIDCR NIH HHS [5-R01-DE11381-6, R01 DE011381] NR 23 TC 49 Z9 57 U1 0 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD FEB PY 2003 VL 41 IS 2 BP 619 EP 622 DI 10.1128/JCM.41.2.619-622.2003 PG 4 WC Microbiology SC Microbiology GA 643YM UT WOS:000180891200016 PM 12574256 ER PT J AU Hamner, MB Deitsch, SE Brodrick, PS Ulmer, HG Lorberbaum, JP AF Hamner, MB Deitsch, SE Brodrick, PS Ulmer, HG Lorberbaum, JP TI Quetiapine treatment in patients with posttraumatic stress disorder: An open trial of adjunctive therapy SO JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY LA English DT Article ID ATYPICAL ANTIPSYCHOTIC-DRUGS; DOUBLE-BLIND; PSYCHOTIC FEATURES; PLACEBO; SCHIZOPHRENIA; RISPERIDONE; PTSD; MULTICENTER; SERTRALINE; OLANZAPINE AB In this 6-week, open-label trial, combat veterans meeting DSM-IV criteria for posttraurnatic stress disorder (PTSD) were treated with the atypical antipsychotic quetiapine. The starting dose was 25 mg at bedtime with subsequent titration based on tolerability and clinical response. Primary outcome was measured using the Clinician Administered PT-SD Scale (CAPS). Secondary assessments of efficacy included the Positive and Negative Symptom Scale (PANSS), the Hamilton Rating Scale for Depression, and the Clinical Global Impression Scale. Safety and tolerability evaluations included neurologic ratings, vital signs, and assessment of treatment-emergent side effects. Eighteen of 20 patients enrolled in the study completed 6 weeks of open-label treatment. The dose range of quetiapine was 25 to 300 mg daily, with an average of 100 +/- 70 mg/d. There was significant improvement in CAPS scores, from 89.8 +/- 15.7 to 67.5 +/- 21.0 (t=4.863, df= 18, P<0.005), and composite PANSS ratings from baseline to endpoint. General psychopathology (PANSS) and depressive symptoms (HRSD) were also reduced at the 6-week end point. There were no serious adverse events and no clinically significant changes in vital signs or neurologic ratings. This preliminary open trial suggests that quetiapine is well tolerated and may have efficacy in reducing PTSD symptoms in patients who have not had an adequate response other medications. Studies utilizing a randomized, controlled trial design and larger sample sizes are needed to better define the potential role of quetiapine and other atypical antipsychotics in the treatment of PTSD. C1 Ralph H Johnson VA Med Ctr, Mental Hlth Serv, Charleston, SC 29401 USA. RP Hamner, MB (reprint author), Ralph H Johnson VA Med Ctr, Mental Hlth Serv, 109 Bee St, Charleston, SC 29401 USA. EM hamnermb@musc.edu NR 37 TC 90 Z9 93 U1 1 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-0749 J9 J CLIN PSYCHOPHARM JI J. Clin. Psychopharmacol. PD FEB PY 2003 VL 23 IS 1 BP 15 EP 20 DI 10.1097/00004714-200302000-00003 PG 6 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 641UJ UT WOS:000180765000003 PM 12544370 ER PT J AU Stewart, L Oesterle, AL Grifiss, JM Jarvis, GA Way, LW AF Stewart, L Oesterle, AL Grifiss, JM Jarvis, GA Way, LW TI Cholangitis: Bacterial virulence factors that facilitate cholangiovenous reflux and tumor necrosis factor-alpha production SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Article; Proceedings Paper CT 43rd Annual Meeting of the Society-for-Surgery-of-the-Alimentary-Tract CY MAY 19-22, 2002 CL SAN FRANCISCO, CALIFORNIA SP Soc Surg Alimentary Tract DE cholangitis; cytokines; TNF; slime; biliary infections; gallstones ID SYSTEMIC INFLAMMATORY RESPONSE; CIRCULATING COMPLEMENT PROTEINS; TISSUE-INJURY; SEPSIS; BACTEREMIA; SHOCK; PATHOGENESIS; RESISTANCE; ACTIVATION; BILE AB In previous studies we noted that biliary bacteria produce slime and possess P1-fimbriae. The presence of gram-negative bacteria killed by complement correlated with serious biliary infections and induced more tumor necrosis factor-alpha (TNF-alpha) production in sera, suggesting a role for cytokine production and complement activation in biliary sepsis. This study examined bacterial virulence factors that facilitate cholangiovenous reflux (CVR) and TNT-alpha production in a rat model. Twenty-one biliary bacteria and two stool isolates were tested for slime production, sensitivity to complement killing, and hemolysin production. 10(7) Bacterial colony-forming units/ml (or saline control) were injected retrograde into the common bile ducts of Sprague-Dawley rat's at a pressure of 30 cm. H2O. Blood was obtained at 5 and 60 minutes after infusion for bacterial culture and TNF-alpha assay, respectively. The magnitude of slime production correlated inversely with the magnitude of bacterial CVR. Average bacterial colony-forming units were 1.4 X 10(5), 6.8 X 10(4), or 2.1 X 10(3) for bacteria with slime production 0 to 10 ! 11 to 99, or more than 100, respectively (P < 0.0001, analysis of variance). CVR was greater for serum-resistant bacteria (1.2 X 10(5) vs. 5.5 X 10(4) [P = 0.007, resistant vs. sensitive]), but TNF-alpha production was greater in serum-sensitive bacteria. TNF-alpha-production as a function of bacterial reflux followed a logarithmic curve (R-2 = 0.75) for serum-sensitive bacteria but was linear (R-2 = 0.60) for serum-resistant bacteria. These data show how specific virulence factors explain why some bacterial species colonize without causing illness, whereas others colonize and cause sepsis. Although slime production was necessary for colonization, too much slime inhibited CVR. Although complement killing cleared bacteria from the circulation, it was also associated with increased TNF-alpha production, which can lead to septic manifestations. The most virulent bacterial species (from patients with sepsis) were killed by complement, but they still had significant CVR and were associated with increased TNF-alpha production. (C) 2003 The Society for Surgery of the Alimentary Tract, Inc. C1 Univ Calif San Francisco, Dept Surg 112, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Lab Med, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, Surg Serv, San Francisco, CA USA. San Francisco VA Med Ctr, Ctr Immunochem, San Francisco, CA USA. RP Stewart, L (reprint author), Univ Calif San Francisco, Dept Surg 112, 4150 Clement St, San Francisco, CA 94121 USA. NR 32 TC 6 Z9 7 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 FEB PY 2003 VL 7 IS 2 BP 191 EP 198 AR PII S1091-255X(02)00133-6 DI 10.1016/S1091-255X(02)00133-6 PG 8 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 649GA UT WOS:000181197800009 PM 12600443 ER PT J AU Stamm, K Williams, JW Noel, PH Rubin, R AF Stamm, K Williams, JW Noel, PH Rubin, R TI Helping journalists get it right - A physician's guide to improving health care reporting SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE journalism; medical; mass media; physician; communication; health education ID PREPUBLICATION RELEASE; INGELFINGER RULE; MEDIA COVERAGE; NEWS MEDIA; SCIENTISTS; EMBARGOES; ARTICLES; SMOKING; POLICY; PRESS AB News reports are the way that most people, including many physicians and scientists, first learn about new developments in medicine. Because these reports can raise awareness, influence behavior, and confer credibility, physicians should share responsibility with the media for accurate reporting. Physicians can work with reporters to avoid sensationalizing tentative findings, overstating benefits, and making inappropriate generalizations. This article includes pragmatic suggestions for crafting effective news releases and explaining numerical data. It details "rules of the road" for interviews. Working collaboratively with news reporters to improve the quality of medical stories in the lay press benefits patients and physicians alike. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Gen Med, San Antonio, TX 78229 USA. Dept Vet Affairs Med Ctr, HSR&D, Ctr Hlth Serv Res Primary Care, Durham, NC USA. Duke Univ, Med Ctr, Durham, NC USA. S Texas Vet Hlth Care Syst, HSR&D Ctr Excellence, San Antonio, TX USA. S Texas Vet Hlth Care Syst, HSR&D Ctr Excellence, VERDICT, San Antonio, TX USA. USA TODAY, Arlington, VA 22229 USA. RP Stamm, K (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Gen Med, 7400 Merton Minter Blvd 11C6, San Antonio, TX 78229 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 NR 32 TC 12 Z9 14 U1 1 U2 5 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 2003 VL 18 IS 2 BP 138 EP 145 DI 10.1046/j.1525-1497.2003.20220.x PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 639AH UT WOS:000180605100009 PM 12542589 ER PT J AU Ricono, JM Xu, YC Arar, M Jin, DC Barnes, JL Abboud, HE AF Ricono, JM Xu, YC Arar, M Jin, DC Barnes, JL Abboud, HE TI Morphological insights into the origin of glomerular endothelial and mesangial cells and their precursors SO JOURNAL OF HISTOCHEMISTRY & CYTOCHEMISTRY LA English DT Article DE glomerulogenesis; development; kidney; microvasculature ID GROWTH-FACTOR; KIDNEY DEVELOPMENT; ADHESION MOLECULE; EMBRYONIC KIDNEY; PDGF-RECEPTOR; BETA-RECEPTOR; EXPRESSION; GLOMERULOGENESIS; DIFFERENTIATION; NEPHROGENESIS AB Glomerular endothelial and mesangial cells may originate from the metanephric mesenchyme. We used the MAb Thy1.1, a mesangial cell marker in the adult rat kidney, and rat endothelial cell markers MAb RECA-1, MAb PECAM-1 (CD31), and MAb Flk-1 as potential markers to characterize the spatial and temporal distribution of mesangial and endothelial cell precursors during nephrogenesis in the rat. At early stages of glomerulo-genesis, RECA-1- and Thy1.1-positive cells were detected in the metanephric blastema at 14 days post conception (dpc) embryos and 15 dpc, respectively, with Thy1.1 expression in cells surrounding the ureteric bud. At 17 and 18 dpc, both RECA-1- and Thy1.1-positive cells were found in the cleft of the S-shaped bodies and in the capillary loops of maturing glomeruli. Double staining for BrdU, a marker of proliferation, and for RECA-1 or BrdU and Thy1.1 also localize in the cleft of S-shaped bodies and in glomerular capillary loops at later stages of development. PDGFRbeta co-localizes in cells expressing endothelial or mesangial markers. The data suggest that endothelial and mesangial cell precursors share common markers during the course of glomerulogenesis and that full differentiation of these cells occurs at late stages of glomerular maturation. Thy1.1- and RECA-1-positive cells may be derived from the metanephric blastemal cells at early stages of kidney development. A subpopulation of these Thy1.1- or RECA-1-positive cells may be precursors that can migrate into the cleft of comma and S-shaped bodies and proliferate in situ to form glomerular capillary tufts. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Mol Med, Inst Biotechnol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pediat, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Abboud, HE (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr,MC 7882, San Antonio, TX 78229 USA. FU NIDDK NIH HHS [DK-33665] NR 38 TC 32 Z9 34 U1 0 U2 0 PU HISTOCHEMICAL SOC INC PI SEATTLE PA UNIV WASHINGTON, DEPT BIOSTRUCTURE, BOX 357420, SEATTLE, WA 98195 USA SN 0022-1554 J9 J HISTOCHEM CYTOCHEM JI J. Histochem. Cytochem. PD FEB PY 2003 VL 51 IS 2 BP 141 EP 150 PG 10 WC Cell Biology SC Cell Biology GA 639LT UT WOS:000180631000002 PM 12533522 ER PT J AU Lee, JS Frevert, CW Thorning, DR Segerer, S Alpers, CE Cartron, JP Colin, Y Wong, VA Martin, TR Goodman, RB AF Lee, JS Frevert, CW Thorning, DR Segerer, S Alpers, CE Cartron, JP Colin, Y Wong, VA Martin, TR Goodman, RB TI Enhanced expression of Duffy antigen in the lungs during suppurative pneumonia SO JOURNAL OF HISTOCHEMISTRY & CYTOCHEMISTRY LA English DT Article DE Duffy antigen; endothelial; chemokines; lungs; pneumonia ID ERYTHROCYTE CHEMOKINE RECEPTOR; RENAL-TRANSPLANT REJECTION; RED-BLOOD-CELLS; ENDOTHELIAL-CELLS; NEGATIVE INDIVIDUALS; GENE; ANTIGEN/RECEPTOR; PHENOTYPE; MUTATION; ARG89CYS AB Duffy antigen is a chemokine binding protein expressed on the surface of erythrocytes and postcapillary venular endothelial cells. It binds selective CXC and CC chemokines with high affinity. Although Duffy antigen is present in the normal pulmonary vascular bed, it is not known whether its expression is altered by innate inflammatory responses in the lungs. We studied Duffy antigen expression by immunohistochemistry in autopsy lung specimens from 16 cases of suppurative pneumonia, 11 cases of acute lung injury, and seven normal lungs. In lungs with suppurative pneumonia, Duffy antigen was expressed in higher numbers of pre- and postcapillary parenchymal vessels compared to normal specimens or specimens with acute lung injury (p<0.03 and p<0.02, respectively). Lungs with suppurative pneumonia also showed Duffy antigen expression on the alveolar septa, whereas this was a rare finding in normal specimens or in acute lung injury (p<0.02). Furthermore, Duffy antigen labeling of the alveolar septa localized to regions with airspace accumulation of neutrophil-rich exudates. In summary, Duffy antigen expression is increased in the vascular beds and alveolar septa of the lung parenchyma during suppurative pneumonia, suggesting that Duffy antigen may have a functional role in the lung parenchyma during inflammation. C1 VA Puget Sound Hlth Care Syst, Dept Med, Div Pulm & Crit Care Med, Seattle, WA 98108 USA. Inst Natl Transfus Sanguine, INSERM U76, F-75015 Paris, France. Univ Washington, Sch Med, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Dept Pathol, Seattle, WA 98108 USA. RP Goodman, RB (reprint author), VA Puget Sound Hlth Care Syst, Dept Med, Div Pulm & Crit Care Med, 111B,1660 S Columbian Way, Seattle, WA 98108 USA. FU NHLBI NIH HHS [HL10470, HL030542, HL69955, HL63652, HL70178]; NIDDK NIH HHS [DK47659] NR 25 TC 27 Z9 30 U1 0 U2 0 PU HISTOCHEMICAL SOC INC PI SEATTLE PA UNIV WASHINGTON, DEPT BIOSTRUCTURE, BOX 357420, SEATTLE, WA 98195 USA SN 0022-1554 J9 J HISTOCHEM CYTOCHEM JI J. Histochem. Cytochem. PD FEB PY 2003 VL 51 IS 2 BP 159 EP 166 PG 8 WC Cell Biology SC Cell Biology GA 639LT UT WOS:000180631000004 PM 12533524 ER PT J AU Thurman, JM Ljubanovic, D Edelstein, CL Gilkeson, GS Holers, VM AF Thurman, JM Ljubanovic, D Edelstein, CL Gilkeson, GS Holers, VM TI Lack of a functional alternative complement pathway ameliorates ischemic acute renal failure in mice SO JOURNAL OF IMMUNOLOGY LA English DT Article ID FACTOR-B; REPERFUSION INJURY; ENDOTHELIAL-CELLS; ANTIBODY; INHIBITOR; EXPRESSION; SELECTIN; NECROSIS; FRAGMENT; DISEASE AB Ischemia/reperfusion (I/R) injury of the kidney is a common cause of acute renal failure (ARF) and is associated with high morbidity and mortality in the intensive care unit. The mechanisms underlying I/R injury are complex. Studies have shown that complement activation contributes to the pathogenesis of I/R injury in the kidney, but the exact mechanisms of complement activation have not been defined. We hypothesized that complement activation in this setting occurs via the alternative pathway and that mice deficient in complement factor B, an essential component of the alternative pathway, would be protected from ischemic ARE Wild-type mice suffered from a decline in renal function and had significant tubular injury, particularly in the outer medulla, after I/R. We found that factor B-deficient mice (fB(-/-)) developed substantially less functional and morphologic renal injury after I/R. Furthermore, control wild-type mice had an increase in tubulointerstitial complement C3 deposition and neutrophil infiltration in the outer medulla after I/R, whereas fB(-/-) mice demonstrated virtually no C3 deposition or neutrophil infiltration. Our results demonstrate that complement activation in the kidney after I/R occurs exclusively via the alternative pathway, and that selective inhibition of this pathway provides protection to the kidneys from ischemic ARF. C1 Univ Colorado, Hlth Sci Ctr, Div Rheumatol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Div Nephrol & Hypertens, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pathol, Denver, CO 80262 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Med Res Serv, Charleston, SC 29425 USA. RP Holers, VM (reprint author), Univ Colorado, Hlth Sci Ctr, Div Rheumatol, 4200 E 9th Ave,B-115, Denver, CO 80262 USA. FU NIAID NIH HHS [R0-1 AI31105, R0-1 AI47469]; NIDDK NIH HHS [5T32DK 07135] NR 34 TC 150 Z9 154 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 FEB 1 PY 2003 VL 170 IS 3 BP 1517 EP 1523 PG 7 WC Immunology SC Immunology GA 639XM UT WOS:000180655500050 PM 12538716 ER PT J AU Subramanian, S Matejuk, A Zamora, A Vandenbark, AA Offner, H AF Subramanian, S Matejuk, A Zamora, A Vandenbark, AA Offner, H TI Oral feeding with ethinyl estradiol. suppresses and treats experimental autoimmune encephalomyelitis in SJL mice and inhibits the recruitment of inflammatory cells into the central nervous system SO JOURNAL OF IMMUNOLOGY LA English DT Article ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; COLLAGEN-INDUCED ARTHRITIS; MULTIPLE-SCLEROSIS; T-CELLS; IL-6-DEFICIENT MICE; IMMUNE-RESPONSE; GAMMA PROTECTS; INDUCTION; CHEMOKINE; MYELIN AB There is much interest in the possible ameliorating effects of estrogen on various autoimmunc diseases. We previously established the protective effects of 17beta-estradiol (E2) on experimental autoimmune encephalomyelitis (EAE). In the current study we investigated the effectiveness of oral treatment with ethinyl estradiol (EE) on EAE and the mechanisms involved. Ethinyl estradiol is a semisynthetic estrogen compound found in birth control pills, and its chemical structure allows this compound to retain activity when given orally. We found that oral EE, like E2, drastically suppressed EAE induced by proteolipid protein 139-151 peptide when given at initiation of EAE. However, unlike E2, EE reduced clinical severity when given after the onset of clinical signs. Treatment with EE significantly decreased the secretion of proinflammatory cytokines (IFN-gamma, TNF-alpha, and IL-6) by activated T cells as well as the expression of a key matrix metalloproteinase, disease-mediating chemokines/receptors, and IgG2a levels, but increased the expression of TGF-beta3 in the CNS. The absence of infiltrating lymphocytes together with the suppression of cytokines, matrix metalloproteinase, and chemokines/receptors suggests that EE, like E2, protects mice from EAE by inhibiting the recruitment of T cells and macrophages into the CNS. These results suggest that oral ethinyl estradiol might be a successful candidate as therapy for multiple sclerosis. The Journal of Immunology, 2003, 170: 1548-1555. C1 Portland Vet Affairs Med Ctr, Neuroimmunol Res R&D 31, 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 Vet Affairs Med Ctr, Neuroimmunol Res R&D 31, 3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. FU NIAID NIH HHS [AI42376]; NINDS NIH HHS [NS23221, NS23444] NR 51 TC 79 Z9 82 U1 0 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 FEB 1 PY 2003 VL 170 IS 3 BP 1548 EP 1555 PG 8 WC Immunology SC Immunology GA 639XM UT WOS:000180655500054 PM 12538720 ER PT J AU Coviello, AD Herbst, KL Amory, JK Anawalt, BD Jarow, JP Brown, T Wright, W Bremner, WJ Matsumoto, AM AF Coviello, AD Herbst, KL Amory, JK Anawalt, BD Jarow, JP Brown, T Wright, W Bremner, WJ Matsumoto, AM TI Intratesticular testosterone concentrations comparable to serum levels are not sufficient to maintain normal sperm production in men. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound HCS, Seattle, WA USA. Johns Hopkins Univ, Baltimore, MD 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 FEB PY 2003 VL 51 SU 1 MA 365 BP S155 EP S155 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600371 ER PT J AU Cummings, DE Kletk, ML Frayo, DS Weigle, DS Purnell, JQ Chapelot, D Merriam, GR AF Cummings, DE Kletk, ML Frayo, DS Weigle, DS Purnell, JQ Chapelot, D Merriam, GR TI Evidence against an obligatory role for ghrelin in physiological growth hormone (GH) regulation. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Univ Washington, Sch Med, Seattle, WA 98195 USA. VA Puget Sound HCS, Tacoma, WA USA. Univ Paris, Fac Xavier Bichat, F-75252 Paris, France. 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 FEB PY 2003 VL 51 SU 1 MA 147 BP S116 EP S117 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600153 ER PT J AU Cummings, DE Kletke, ML Frayo, RS Weigle, DS Purnell, JQ Chapelot, D Merriam, GR AF Cummings, DE Kletke, ML Frayo, RS Weigle, DS Purnell, JQ Chapelot, D Merriam, GR TI Evidence against an obligatory role for ghrelin in physiological growth hormone (GH) regulation SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Univ Washington, Sch Med, Seattle, WA 98195 USA. VA Puget Sound HCS, Tacoma, WA USA. Univ Paris, Fac Xavier Bichat, F-75252 Paris, France. 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 FEB PY 2003 VL 51 SU 1 MA 36 BP S97 EP S97 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600042 ER PT J AU Elias, FN Ledoux, WR Yuen, TJ Olson, SL Ching, RP Sangeorzan, BJ AF Elias, FN Ledoux, WR Yuen, TJ Olson, SL Ching, RP Sangeorzan, BJ TI Surgical intervention for the clawed hallux deformity. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 VA Puget Sound, RR&D Ctr Excellence, Seattle, WA USA. RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 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 FEB PY 2003 VL 51 SU 1 MA 246 BP S133 EP S133 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600252 ER PT J AU Furmanczyk, PS Quinn, LS AF Furmanczyk, PS Quinn, LS TI Interleukin-15 increases myosin heavy chain accumulation in primary human skeletal myogenic cultures SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Univ Washington, Dept Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Tacoma, WA 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 FEB PY 2003 VL 51 SU 1 MA 71 BP S103 EP S104 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600077 ER PT J AU Jensen, CC Shofer, JB Boyko, EJ Fujimoto, WY Kahn, SE AF Jensen, CC Shofer, JB Boyko, EJ Fujimoto, WY Kahn, SE CA ADA GENNID Study Grp TI Relationship of ethnicity and glucose tolerance to features of the metabolic syndrome. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Univ Washington, Seattle, WA 98195 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 FEB PY 2003 VL 51 SU 1 MA 195 BP S125 EP S125 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600201 ER PT J AU Jensen, CC Shofer, JB Boyko, EJ Fujimoto, WY Kahn, SE AF Jensen, CC Shofer, JB Boyko, EJ Fujimoto, WY Kahn, SE CA ADA GENNID Study Grp TI Relationship of ethnicity and glucose tolerance to features of the metabolic syndrome SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Dept Med, 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 FEB PY 2003 VL 51 SU 1 MA 41 BP S98 EP S98 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600047 ER PT J AU Kiser, KM Prigeon, RL Kahn, SE AF Kiser, KM Prigeon, RL Kahn, SE TI Insulin sensitivity quantified with the minimal model is lower with the insulin-modified than the tolbutamide-modified frequently sampled intravenous glucose tolerance test SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Univ Washington, Seattle, WA 98195 USA. 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 FEB PY 2003 VL 51 SU 1 MA 15 BP S94 EP S94 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600021 ER PT J AU Li, L Watson, L Merrell, M Selander, K Harris, KW AF Li, L Watson, L Merrell, M Selander, K Harris, KW TI Inhibition of cytokine receptor gp130 signaling in breast cancer cells results in decreased constitutive stat3 activation via inhibition of EGF receptor family members. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Univ Alabama, Birmingham, AL USA. Birmingham VAMC, Birmingham, AL 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 FEB PY 2003 VL 51 SU 1 MA 175 BP S286 EP S286 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600703 ER PT J AU Nadeau, KI Draznin, B AF Nadeau, KI Draznin, B TI Insulin stimulates SREBP-1 expression in L6 muscle cells via the map kinase signaling pathway SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, 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 FEB PY 2003 VL 51 SU 1 MA 189 BP S124 EP S124 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600195 ER PT J AU Phan, I Peterfy, M Reue, K AF Phan, I Peterfy, M Reue, K TI Lipin deficiency attenuates obesity and exacerbates diabetes in leptin deficient ob/ob mice. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed 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 FEB PY 2003 VL 51 SU 1 MA 320 BP S147 EP S147 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600326 ER PT J AU Phan, J Peterfy, M Reue, K AF Phan, J Peterfy, M Reue, K TI Lipin deficiency attenuates obesity and exacerbates diabetes in leptin deficient ob/ob mice SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed 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 FEB PY 2003 VL 51 SU 1 MA 84 BP S106 EP S106 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600090 ER PT J AU Senthil, D Choudhury, GG Kasinath, BS AF Senthil, D Choudhury, GG Kasinath, BS TI Vascular endothelial growth factor (VEGF) induces protein synthesis in mouse renal proximal tubular epithelial (MCT) cells: A potential role in diabetic nephropathy. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX 78285 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 FEB PY 2003 VL 51 SU 1 MA 223 BP S295 EP S295 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600751 ER PT J AU Utzschneider, K Carr, DB Barsness, SL Kahn, SE Schwartz, RS AF Utzschneider, K Carr, DB Barsness, SL Kahn, SE Schwartz, RS TI Weight loss is associated with improvements in insulin sensitivity and B-cell function in older subjects. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 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 FEB PY 2003 VL 51 SU 1 MA 198 BP S125 EP S125 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600204 ER PT J AU Wang, CCL Golovchenko, I Draznin, B AF Wang, CCL Golovchenko, I Draznin, B TI Vascular smooth muscle cell quiescence and migration are mediated differentially via phosphatidylinositol 3-kinase- and mitogen-activated kinase-dependent pathways SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 29-FEB 01, 2003 CL CARMEL, CALIFORNIA SP American Fed Med Res C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 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 FEB PY 2003 VL 51 SU 1 MA 403 BP S162 EP S162 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 638KF UT WOS:000180569600409 ER PT J AU Seidberg, NA Clark, RSB Zhang, XP Lai, YC Chen, MZ Graham, SH Kochanek, PM Watkins, SC Marion, DW AF Seidberg, NA Clark, RSB Zhang, XP Lai, YC Chen, MZ Graham, SH Kochanek, PM Watkins, SC Marion, DW TI Alterations in inducible 72-kDa heat shock protein and the chaperone cofactor BAG-1 in human brain after head injury SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE apoptosis; Bcl-2; head injury; Hsc70; Hsp70; trauma ID OXIDE SYNTHASE EXPRESSION; CELL-DEATH; RAT-BRAIN; CULTURED NEURONS; STRESS-RESPONSE; HSP70; INDUCTION; GENE; HEAT-SHOCK-PROTEIN-70; FIBROBLASTS AB The stress response in injured brain is well characterized after experimental ischemic and traumatic brain injury (TBI); however, the induction and regulation of the stress response in humans after TBI remains largely undefined. Accordingly, we examined injured brain tissue from adult patients (n=8) that underwent emergent surgical decompression after TBI, for alterations in the inducible 72-kDa heat shock protein (Hsp70), the constitutive 73-kDa heat shock protein (Hsc70), and isoforms of the chaperone cofactor BAG-1. Control samples (n=6) were obtained postmortem from patients dying of causes unrelated to CNS trauma. Western blot analysis showed that Hsp70, but not Hsc70, was increased in patients after TBI versus controls. Both Hsp70 and Hsc70 coimmunoprecipitated with the cofactor BAG-1. The 33 and 46, but not the 50-kDa BAG-1 isoforms were increased in patients after TBI versus controls. The ratio of the 46/33-kDa isoforms was increased in TBI versus controls, suggesting negative modulation of Hsp70/Hsc70 protein refolding activity in injured brain. These data implicate induction of the stress response and its modulation by the chaperone cofactor and Bcl-2 family member BAG-1, after TBI in humans. C1 Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Crit Care Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Pediat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Anesthesiol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Neurol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Cell Biol & Physiol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Neurol Surg, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Brain Trauma Res Ctr, Pittsburgh, PA 15260 USA. VA Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Clark, RSB (reprint author), Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Crit Care Med, 3434 5th Ave, Pittsburgh, PA 15260 USA. RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X FU NINDS NIH HHS [KO8 NS01946, P50 NS30318, R01 NS38620] NR 52 TC 23 Z9 23 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 2003 VL 84 IS 3 BP 514 EP 521 DI 10.1046/j.1471-4159.2003.01547.x PG 8 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 635UF UT WOS:000180417200011 PM 12558971 ER PT J AU Casarett, DJ Crowley, R Hirschman, KB AF Casarett, DJ Crowley, R Hirschman, KB TI Surveys to assess satisfaction with end-of-life care: Does timing matter? SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article DE hospice; satisfaction; surveys; grief; bereavement; research ethics ID ACCURACY AB The goals of this study were to determine whether post-death surveys of family members cause more distress if they are administered closer in time to the patient's death, and whether family members are less likely to respond to earlier surveys. Caregivers of hospice patients were randomly assigned to receive a survey at 2 weeks (n = 107) or at 6 weeks (n = 100) after the patient's death. Response rates and self-reported distress experienced in completing the survey were recorded. There were no differences in self-ratings of distress between 2- and 6-week surveys, and response rates were identical (2-week: 54 %; 6-week: 54 %). Distress and response rate do not appear to be influenced by the timing of data collection, even when surveys are administered very soon after death. J Pain Symptom Manage 2003;25:128-132. (C) 2003 U.S.Cancer Pain. Relief Committee. Published by Elsevier Allrights reserved. C1 Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. Div Geriatr, Philadelphia, PA USA. Leonard Davis Inst Hlth Econ, Philadelphia, PA USA. Univ Penn, Sch Social Work, Philadelphia, PA 19104 USA. RP Casarett, DJ (reprint author), Inst Aging, 3615 St, Philadelphia, PA 19104 USA. NR 17 TC 31 Z9 31 U1 1 U2 3 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 FEB PY 2003 VL 25 IS 2 BP 128 EP 132 AR PII S0885-3924(02)00636-X DI 10.1016/S0885-3924(02)00636-X PG 5 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 649QW UT WOS:000181220300007 PM 12590028 ER PT J AU Mytilineou, C Walker, RH Jnobaptiste, R Olanow, CW AF Mytilineou, C Walker, RH Jnobaptiste, R Olanow, CW TI Levodopa is toxic to dopamine neurons in an in vitro but not an in vivo model of oxidative stress SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID PARKINSONS-DISEASE; MESENCEPHALIC CULTURES; NIGROSTRIATAL LESIONS; ASCORBIC-ACID; RAT-BRAIN; GLUTATHIONE; CELLS; MECHANISMS; 6-HYDROXYDOPAMINE; CATECHOLAMINES AB Levodopa is the "gold standard" for the symptomatic treatment of Parkinson's disease (PD). There is a theoretical concern, however, that levodopa might accelerate the rate of nigral degeneration, because it undergoes oxidative metabolism and is toxic to cultured dopaminergic neurons. Most in vivo studies do not show evidence of levodopa toxicity; levodopa is not toxic to normal rodents, nonhuman primates, or humans and is not toxic to dopamine neurons in dopamine-lesioned rodents or nonhuman primates in most studies. However, the potential for levodopa to be toxic in vivo has not been tested under conditions of oxidative stress such as exist in PD. To assess whether levodopa is toxic under these circumstances, we have examined the effects of levodopa on dopamine neurons in mesencephalic cultures and rat pups in which glutathione synthesis has been inhibited by L-buthionine sulfoximine. Levodopa toxicity to cultured dopaminergic neurons was enhanced by glutathione depletion and diminished by antioxidants. In contrast, treatment of neonatal rats with levodopa, administered either alone or in combination with glutathione depletion, did not cause damage to the dopamine neurons of the substantia nigra or changes in striatal levels of dopamine and its metabolites. This study provides further evidence to support the notion that although levodopa can be toxic to dopamine neurons in vitro, it is not likely to be toxic to dopamine neurons in vivo and specifically in conditions such as PD. C1 Mt Sinai Sch Med, Dept Neurol, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Dept Neurol, Bronx, NY USA. RP Olanow, CW (reprint author), Mt Sinai Sch Med, Dept Neurol, Box 1137, New York, NY 10029 USA. EM warren.olanow@mssm.edu NR 41 TC 66 Z9 73 U1 0 U2 2 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3995 USA SN 0022-3565 J9 J PHARMACOL EXP THER JI J. Pharmacol. Exp. Ther. PD FEB PY 2003 VL 304 IS 2 BP 792 EP 800 DI 10.1124/jpet.102.042267 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 637RL UT WOS:000180526600038 PM 12538835 ER PT J AU Livingston, EH Liu, CY Glantz, G Li, ZP AF Livingston, EH Liu, CY Glantz, G Li, ZP TI Characteristics of bariatric surgery in an integrated VA health care system: Follow-up and outcomes SO JOURNAL OF SURGICAL RESEARCH LA English DT Article ID SURGICAL VOLUME; MORTALITY; OPERATIONS AB Background. Since the 1991 NIH consensus conference, obesity surgery has been increasingly accepted as a form of therapy for morbid obesity. Approximately 40% of Veteran patients are obese and would potentially benefit from the operations. Methods. Records were reviewed for all obesity operations performed at the Veterans Administration Greater Los Angeles Health Care System between January 1997 and April 2002. Morbidity, mortality, weight loss, and extent of follow-up were the outcomes measures assessed. Results. Forty-six [11 Female (24%), 35 Male (76%)] patients underwent Roux-Y gastric bypass during the 63-month period we reviewed. There was one death from pulmonary hypertension unexpectedly encountered in the operating room. There was a single major complication: an anastomotic leak successfully treated with intravenous antibiotics. The Computerized Patient Record System contained extensive weight loss information, with dozens of weight measurements for these patients before and after surgery. Weight loss was sustained in all but 2 patients during the follow-up period. The only patients lost to follow-up were those referred from medical centers outside the boundaries of our integrated health care system. Conclusion. (1) The VA population has the opposite male/female ratio of populations reported in most weight loss studies. Because the health risks attributable to obesity are greater in males, the VA represents an important population to study that may benefit significantly from weight loss surgery. (2) Extensive clinical information available in the computerized medical record combined with frequent accession of health care resources by our patients resulted in a database rich in follow-up data for a population where long-term outcomes are traditionally difficult to obtain. (3) There was very low surgical morbidity and mortality in a high-risk population. This contrasts with the results of most volume-outcome studies and occurred in a low-volume hospital by a high-volume surgical and medical team. (4) Distinct patterns of weight loss were observed. (C) 2003 Elsevier Science (USA). C1 Univ Calif Los Angeles, Sch Med, Bariatr Surg Program, Los Angeles, CA 90073 USA. Greater Los Angeles VA Hlth Care Syst, Surg & Res Serv, Los Angeles, CA 90073 USA. RP Livingston, EH (reprint author), Univ Calif Los Angeles, Sch Med, Div Gen Surg, 10833 Le Conte Ave 72-215 CHS, Los Angeles, CA 90095 USA. NR 11 TC 16 Z9 16 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 0022-4804 J9 J SURG RES JI J. Surg. Res. PD FEB PY 2003 VL 109 IS 2 BP 138 EP 143 DI 10.1006/jsre.2003.6589 PG 6 WC Surgery SC Surgery GA 658CA UT WOS:000181703000010 PM 12643855 ER PT J AU Da Silva, MS Sobel, M AF Da Silva, MS Sobel, M CA Surg S Assoc Vasc Surg TI Popliteal vascular injury during total knee arthroplasty SO JOURNAL OF SURGICAL RESEARCH LA English DT Article DE popliteal vascular injury; total knee arthroplasty; etiology; management; outcome ID ARTERIAL COMPLICATIONS; REPLACEMENT AB Background. Popliteal vascular injury during total knee arthroplasty (TKA) is rare. Although the etiology, management, and outcome of this injury have not been systematically studied, several anecdotal reviews and small case series have suggested a high morbidity, with tourniquet injury as a predominant etiology. Methods. We surveyed 190 members of a major regional vascular society concerning their experiences with popliteal vascular injuries sustained during TKA, specifically regarding the presentation, mechanisms of injury, diagnostic studies, surgical exposure and methods of repair, and outcomes. Results. Thirteen surgeons provided data (6.8% response rate) on 19 patients with TKA-related popliteal artery injuries. In contrast to the historical literature, sharp, direct trauma was the predominant etiology of vascular injury. Vascular reconstructive techniques varied, with arterial bypass being the most common. There was no mortality in this series. Eighty-four percent (16/19) of the patients had full recoveries. Limb loss occurred in 2 of the 19 patients (10.5%). Conclusion. Popliteal vascular injuries during TKA are primarily the result of direct trauma to the vessel. Prompt diagnosis, extensile vascular exposure through a medial knee surgical incision, and standard reconstructive techniques offer a good prognosis for this limb-threatening complication. (C) 2003 Elsevier Science (USA). C1 SUNY Upstate Med Univ, Dept Surg, Syracuse, NY 13210 USA. Vet Affairs Med Ctr, Syracuse, NY 13210 USA. Univ Washington, Sch Med, Dept Surg, Div Vasc Surg, Seattle, WA 98195 USA. VA Puget Sound Healthcare Syst, Seattle, WA 98195 USA. RP Da Silva, MS (reprint author), SUNY Upstate Med Univ, Dept Surg, 750 E Adams St, Syracuse, NY 13210 USA. EM dasilvam@upstate.edu OI Hertzer, Norman/0000-0002-9698-1776 NR 13 TC 17 Z9 17 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 0022-4804 J9 J SURG RES JI J. Surg. Res. PD FEB PY 2003 VL 109 IS 2 BP 170 EP 174 DI 10.1006/jsre.2003.6592 PG 5 WC Surgery SC Surgery GA 658CA UT WOS:000181703000015 PM 12643860 ER PT J AU Alessi, CA Josephson, KR Harker, JO Pietruszka, FM Hoyl, MT Rubenstein, LZ AF Alessi, CA Josephson, KR Harker, JO Pietruszka, FM Hoyl, MT Rubenstein, LZ TI The yield, reliability, and validity of a postal survey for screening community-dwelling older people SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE geriatric assessment; postal survey; screening ID RANDOMIZED CLINICAL-TRIAL; FUNCTIONAL DECLINE; ELDERLY PEOPLE; COGNITIVE IMPAIRMENT; URINARY-INCONTINENCE; GERIATRIC EVALUATION; PREDICTIVE-VALIDITY; GENERAL-PRACTICE; PRIMARY-CARE; QUESTIONNAIRE AB OBJECTIVES: To assess the yield, reliability, and validity of a postal survey developed to identify older persons in need of outpatient geriatric assessment and follow-up services. DESIGN: A longitudinal cohort study. SETTING: Outpatient primary care clinic at a Department of Veterans Affairs teaching ambulatory care center. PARTICIPANTS: Patients (N = 2,382) aged 65 and older who returned a Geriatric Postal Screening Survey (GPSS) that screened for common geriatric conditions (depression, cognitive impairment, urinary incontinence, falls, and functional status impairment). Validity and reliability testing was performed with subsamples of patients classified as high or lower risk based on responses to the GPSS. MEASUREMENTS: Test-retest reliability was measured by percentage agreement and kappa statistic. The diagnostic validity of the 10-item GPSS was tested by comparing single GPSS items to standardized geriatric assessment instruments for depression, mental status and functional status, as well as direct questions regarding falls, urinary incontinence, and use of medications. Validity was also tested against clinician evaluation of the specific geriatric conditions. Predictive validity was tested by comparing GPSS score with 1-year follow-up data on functional status, survival, and healthcare use. RESULTS: Respondents identified as high risk by the GPSS had scores that indicated significantly greater impairment on structured assessment instruments than those identified as lower risk by GPSS. The overall mean percentage agreement between the test and retest surveys was 88.3%, with a mean weighted kappa of 0.70. In comparison with a structured telephone interview and with a clinical assessment, individual items of the GPSS showed good accuracy (range 0.71-0.78) for identifying symptoms of depression, falls, and urinary incontinence. Over a 1-year follow-up period, the GPSS-identified high-risk group had significantly (P < .05) more hospital admissions, hospital days and nursing home admissions than the lower-risk group. CONCLUSION: A brief postal screening survey can successfully target patients for geriatric assessment services. In screening for symptoms of common geriatric conditions, the GPSS identified a subgroup of older outpatients with multiple geriatric syndromes who were at increased risk for hospital use and nursing home admission and who could potentially benefit from geriatric intervention. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Pontificia Univ Catolica Chile, Santiago, Chile. RP Alessi, CA (reprint author), VA Sepulveda Ambulatory Care Ctr, GRECC, 11E,16111 Plummer St, Sepulveda, CA 91343 USA. EM Cathy.Alessi@med.va.gov NR 33 TC 20 Z9 20 U1 1 U2 7 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 2003 VL 51 IS 2 BP 194 EP 202 DI 10.1046/j.1532-5415.2003.51058.x PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 639AL UT WOS:000180605400008 PM 12558716 ER PT J AU Carnes, M Howell, T Rosenberg, M Francis, J Hildebrand, C Knuppel, J AF Carnes, M Howell, T Rosenberg, M Francis, J Hildebrand, C Knuppel, J TI Physicians vary in approaches to the clinical management of delirium SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE benzodiazepine; delirium; haloperidol; hip fracture; restraint ID HOSPITALIZED OLDER PATIENTS; DOUBLE-BLIND; PSYCHOGERIATRIC PATIENTS; OPTIMIZING MANAGEMENT; ELDERLY PATIENTS; AIDS PATIENTS; HIP FRACTURE; HALOPERIDOL; CONFUSION; OUTCOMES AB OBJECTIVES: To ascertain the variation in strategies for managing delirium of physicians with expertise in geriatrics. DESIGN: Cross-sectional mail survey. SETTING: United States. PARTICIPANTS: A probability sample of physician members of the American Geriatrics Society. MEASUREMENTS: Management choices presented in a two-part case vignette of an older woman hospitalized with a hip fracture who develops mild and then severe delirium. RESULTS: One hundred twenty-two respondents (43%) selected the three answers constituting current "best practice," 50 (18%) selected an unnecessary diagnostic test (brain imaging, lumbar puncture, or electroencephalogram), and 47 (17%) selected unnecessary pharmacologic therapy for mild delirium. For severe delirium, 270 (96%) selected pharmacological therapy, of whom 180 chose haloperidol alone, 55 chose lorazepam alone, 23 chose lorazepam in combination with haloperidol, and 12 wrote in another drug. Thirty percent of the respondents made any selection of lorazepam, alone or in combination with haloperidol, for mild or severe delirium. Sixty-one percent of those selecting haloperidol for severe delirium chose a dose greater than that recommended for geriatric patients. Sex, date of graduation from medical school, clinical specialty, completion of a geriatric fellowship, or certification in geriatrics had no significant effect on responses. CONCLUSIONS: The common selection of lorazepam to treat delirium is troubling because benzodiazepines themselves are implicated in delirium. Selection of an initial dose of haloperidol higher than that recommended for geriatric patients by more than half of the respondents is also of concern. There is a paucity of sound clinical evidence to guide the choice of pharmacological agents for treating delirium in older hospitalized patients. C1 Univ Wisconsin, Dept Med, Madison, WI 53715 USA. Univ Wisconsin, Dept Psychiat, Madison, WI 53715 USA. Univ Wisconsin, Dept Biostat, Madison, WI 53715 USA. Univ Wisconsin, Ctr Womens Hlth & Womens Hlth Res, Madison, WI 53715 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI USA. St Vincent Hosp & Hlth Syst, Indianapolis, IN USA. RP Carnes, M (reprint author), Univ Wisconsin, Dept Med, Ctr Womens Hlth & Womens Hlth Res, Meriter Hosp, 202 S Pk St, Madison, WI 53715 USA. FU NIA NIH HHS [K07AG00744] NR 44 TC 32 Z9 32 U1 0 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 2003 VL 51 IS 2 BP 234 EP 239 DI 10.1046/j.1532-5415.2003.51063.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 639AL UT WOS:000180605400013 PM 12558721 ER PT J AU Tan, EJ Lui, LY Eng, C Jha, AK Covinsky, KE AF Tan, EJ Lui, LY Eng, C Jha, AK Covinsky, KE TI Differences in mortality of black and white patients enrolled in the program of all-inclusive care for the elderly SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY, 2001 CL CHICAGO, ILLINOIS SP Amer Geriatr Soc DE blacks; frail older people; health services research; long-term care; whites ID CONGESTIVE-HEART-FAILURE; ACUTE MYOCARDIAL-INFARCTION; OF-VETERANS-AFFAIRS; RACIAL-DIFFERENCES; OLDER BLACKS; RACE; SURVIVAL; GENDER; HOSPITALIZATION; EPIDEMIOLOGY AB OBJECTIVES: To examine the relationship between race and mortality in frail community-dwelling older people with access to a program providing comprehensive access and coordination of services. DESIGN: A longitudinal cohort study. SETTING: Twelve nationwide demonstration sites of the Program of All-Inclusive Care for the Elderly (PACE) from 1990 to 1996. PACE provides comprehensive medical and long-term care services for nursing home-eligible older people who live in the community. PARTICIPANTS: Two thousand two white patients and 859 black patients. MEASUREMENTS: Patients were followed after enrollment until death or the end of the follow-up period. Time from enrollment to death was measured with adjustment of the Cox proportional hazards model for comorbid conditions, functional status, site, and other demographic characteristics. RESULTS: Black patients were younger than white patients (mean age 77 vs 80, P < .001) but had worse functional status (mean activity of daily living (ADL) score 6.5 vs 7.2, P < .001) on enrollment. Survival for black and white patients was 88% and 86% at 1 year, 67% and 61% at 3 years, and 51% and 42% at 5 years, respectively (unadjusted hazard ratio (HR) for black patients = 0.77; 95% confidence interval (CI) = 0.67-0.89). After adjustment for baseline comorbid conditions, functional status, site, and demographic characteristics, black patients still had a lower mortality rate (HR = 0.77; 95% CI = .65-0.93). The survival advantage for black patients did not emerge until about 1 year after PACE enrollment (HR for first year after enrollment = 0.97; 95% CI = 0.72-1.31; HR after first year = 0.67; 95% CI = 0.54-0.85, P -value for time interaction < .001). During the first year of enrollment, black patients were more likely to improve and less likely to decline in ADL function than white patients (P < .001). CONCLUSION: In PACE, a system providing access to and coordination of comprehensive medical and long-term care services for frail older people, black patients have a lower mortality rate than white patients. This survival advantage, which emerges approximately 1 year after PACE enrollment, may be related to the comprehensive access and coordination of services provided by the PACE program. C1 Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. VA Natl Qual Scholars Program, San Francisco, CA USA. On Lok Senior Hlth Serv, San Francisco, CA USA. RP Tan, EJ (reprint author), San Francisco Gen Hosp, 1001 Potrero Ave,5 H 22, San Francisco, CA 94110 USA. FU AHRQ HHS [K02HS00006-01] NR 39 TC 11 Z9 11 U1 7 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 FEB PY 2003 VL 51 IS 2 BP 246 EP 251 DI 10.1046/j.1532-5415.2003.51065.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 639AL UT WOS:000180605400015 PM 12558723 ER PT J AU Cheah, PY Liong, ML Yuen, KH Teh, CL Khor, T Yang, JR Yap, HW Krieger, JN AF Cheah, PY Liong, ML Yuen, KH Teh, CL Khor, T Yang, JR Yap, HW Krieger, JN TI Terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome: A randomized, placebo controlled trial SO JOURNAL OF UROLOGY LA English DT Article DE prostate; chronic disease; pelvic pain; prostatitis; drug therapy ID BLADDER OUTLET OBSTRUCTION; SYMPTOM INDEX; PROSTATODYNIA; MICTURITION; VALIDATION AB Purpose: We evaluate terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome. Materials and Methods: The study included 100, 20 to-50-year-old subjects who met the consensus criteria for chronic prostatitis/chronic pelvic pain syndrome and had not received previous alpha-blockers. Subjects were randomized to receive terazosin with dose escalation from I to 5 mg. daily or placebo for 14 weeks. The primary criterion for response was scoring 2 or less ("delighted-to-mostly satisfied") on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) quality of life item. The secondary criterion for response was greater than 50% reduction in NIH-CPSI pain score at 14 weeks. Other outcomes included total and NIH-CPSI domain scores, International Prostate Symptom Score, peak urinary flow rate, post-void residual urine and adverse effects. Results: Using the primary criterion 24 of 43 evaluable subjects (56%) responded in the terazosin group compared to 14 of 43 (36%) in the placebo group (p = 0.03). Using the secondary criterion 26 of 43 subjects (60%) responded in the terazosin group compared to 16 of 43 (37%) in the placebo group (p = 0.03). The terazosin group had greater reductions (p < 0.05) in NIH-CPSI total score, individual domain scores and International Prostate Symptom Score than the placebo group. There was no difference in peak urinary flow rate or post-void residual. In the terazosin group IS patients (42%) had side effects compared to 9 (21%) in the placebo group (p = 0.04). Conclusions: Terazosin proved superior to placebo for patients with chronic prostatitis/chronic pelvic pain syndrome who had not received a-blockers previously. C1 Univ Washington, Sch Med, Dept Urol Surg, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Sci Malaysia, Sch Pharmaceut Sci, George Town, Malaysia. Lam Wah Ee Hosp, Dept Urol, George Town, Malaysia. Penang Adventist Hosp, Dept Urol, George Town, Malaysia. Penang Hosp, Dept Urol, George Town, Malaysia. Isl Hosp, Dept Urol, George Town, Malaysia. RP Krieger, JN (reprint author), Univ Washington, Sch Med, Dept Urol Surg, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Yuen, Kah Hay /F-9059-2010 NR 20 TC 78 Z9 97 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD FEB PY 2003 VL 169 IS 2 BP 592 EP 596 DI 10.1097/01.ju0000042927.45683.6c PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 636LY UT WOS:000180458500034 PM 12544314 ER PT J AU Streblow, DN Kreklywich, C Yin, Q De La Melena, VT Corless, CL Smith, PA Brakebill, C Cook, JW Vink, C Bruggeman, CA Nelson, JA Orloff, SL AF Streblow, DN Kreklywich, C Yin, Q De La Melena, VT Corless, CL Smith, PA Brakebill, C Cook, JW Vink, C Bruggeman, CA Nelson, JA Orloff, SL TI Cytomegalovirus-mediated upregulation of chemokine expression correlates with the acceleration of chronic rejection in rat heart transplants SO JOURNAL OF VIROLOGY LA English DT Article ID GRANULOCYTE-MACROPHAGE PROGENITORS; CARDIAC ALLOGRAFT VASCULOPATHY; ENDOTHELIAL-CELLS; VIRUS INFECTION; MARROW TRANSPLANTATION; AORTIC ALLOGRAFTS; DHPG PROPHYLAXIS; DIRECT INDUCTION; RECEPTOR CXCR3; CLASS-II AB Cytomegalovirus (CMV) infections have been shown to dramatically affect solid organ transplant graft survival in both human and animal models. Recently, it was demonstrated that rat CMV (RCMV) infection accelerates the development of transplant vascular sclerosis (TVS) in both rat heart and small bowel graft transplants. However, the mechanisms involved in this process are still unclear. In the present study, we determined the kinetics of RCMV-accelerated TVS in a rat heart transplant model. Acute RCMV infection enhances the development of TVS in rat heart allografts, and this process is initiated between 21 and 24 days posttransplantation. The virus is consistently detected in the heart grafts from day 7 until day 35 posttransplantation but is rarely found at the time of graft rejection (day 45 posttransplantation). Grafts from RCMV-infected recipients had upregulation of chemokine expression compared to uninfected controls, and the timing of this increased expression paralleled that of RCMV-accelerated neointimal formation. In addition, graft vessels from RCMV-infected grafts demonstrate the increased infiltration of T cells and macrophages during periods of highest chemokine expression. These results suggest that CMV-induced acceleration of TVS involves the increased graft vascular infiltration of inflammatory cells through enhanced chemokine expression. C1 Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Mol Microbiol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Pathol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Gene Therapy Inst, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Univ Maastricht, Dept Microbiol, Maastricht, Netherlands. RP Orloff, SL (reprint author), Oregon Hlth Sci Univ, Dept Surg, Mc L590,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. FU NHLBI NIH HHS [HL 66238-01, HL 65754, R01 HL065754, R01 HL066238]; NIAID NIH HHS [AI 21640, R01 AI021640] NR 57 TC 65 Z9 68 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD FEB PY 2003 VL 77 IS 3 BP 2182 EP 2194 DI 10.1128/JVI.77.3.2182-2194.2003 PG 13 WC Virology SC Virology GA 637AD UT WOS:000180488700055 PM 12525653 ER PT J AU Chen, XL Mele, J Giese, H Van Remmen, H Dolle, MET Steinhelper, M Richardson, A Vijg, J AF Chen, XL Mele, J Giese, H Van Remmen, H Dolle, MET Steinhelper, M Richardson, A Vijg, J TI A strategy for the ubiquitous overexpression of human catalase and CuZn superoxide dismutase genes in transgenic mice SO MECHANISMS OF AGEING AND DEVELOPMENT LA English DT Article DE catalase; CuZnSOD; transgenic mice ID LONG-LIVED STRAIN; HUMAN RENIN GENE; LIFE-SPAN; DROSOPHILA-MELANOGASTER; CAENORHABDITIS-ELEGANS; OXIDATIVE DAMAGE; EXPRESSION; LONGEVITY; RESISTANCE; MOUSE AB In the present study, we generated transgenic mice that overexpress catalase or CuZn superoxide dismutase (CuZnSOD) in all tissues using large genomic DNA fragments. An 80 kb human genomic DNA, containing the 33 kb human CAT gene as well as the 41 kb of 5' and the 6 kb of 3' flanking regions, was obtained by screening a human PI library and was used to produce transgenic mice Tg(CAT). Transgenic mice Tg(SOD1) were produced by a similar strategy using a 64 kb human genomic DNA containing the 10 kb human SOD1 gene and the 27 kb of both 5' and 3' flanking regions. Catalase mRNA levels were 2-6- fold higher and catalase activity levels were 2-4- fold higher in the various tissues of the hemizygous Tg(CAT) mice compared with wild type mice. The mRNA levels for CuZnSOD were 2-12- fold higher and the CuZnSOD activity levels were 2-5- fold higher in the hemizygous Tg(SOD1) mice compared with wild type mice. In summary, our study demonstrates that a strategy of using large genomic DNA containing either the entire human CAT or SOD1 gene with large flanking regions gives ubiquitous increased expression of CuZnSOD and catalase. In addition, the expression of catalase closely reflects the tissue specific pattern found in the endogenous gene. These transgenic mice will be useful in studying the role of oxidative stress/damage in aging and age-related pathologies. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Geriatr Res Educ & Clin Ctr 182, San Antonio, TX 78229 USA. Sam & Ann Barshop Ctr Longev & Aging Studies, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. RP Richardson, A (reprint author), Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. FU NIA NIH HHS [P01AG14674, P03 AG13319, P01AG17242] NR 37 TC 33 Z9 34 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0047-6374 J9 MECH AGEING DEV JI Mech. Ageing Dev. PD FEB PY 2003 VL 124 IS 2 BP 219 EP 227 AR PII S0047-6374(02)00161-6 DI 10.1016/S0047-6374(02)00161-6 PG 9 WC Cell Biology; Geriatrics & Gerontology SC Cell Biology; Geriatrics & Gerontology GA 665BM UT WOS:000182099800010 PM 12633942 ER PT J AU Moore, ME Butler, PF Hendee, WR AF Moore, ME Butler, PF Hendee, WR TI Reference values are de facto regulatory limits for patient exposures SO MEDICAL PHYSICS LA English DT Editorial Material C1 Philadelphia VA Med Ctr, Radiat Safety Off, Philadelphia, PA 19104 USA. Amer Coll Radiol, Breast Imaging Accreditat Programs, Reston, VA 20191 USA. RP Moore, ME (reprint author), Philadelphia VA Med Ctr, Radiat Safety Off, Philadelphia, PA 19104 USA. NR 8 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC PHYSICISTS MEDICINE AMER INST PHYSICS PI MELVILLE PA STE 1 NO 1, 2 HUNTINGTON QUADRANGLE, MELVILLE, NY 11747-4502 USA SN 0094-2405 J9 MED PHYS JI Med. Phys. PD FEB PY 2003 VL 30 IS 2 BP 273 EP 275 DI 10.1118/1.1538613 PG 3 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 645NH UT WOS:000180984100020 PM 12607845 ER PT J AU Liu, CD Glantz, GJ Livingston, EH AF Liu, CD Glantz, GJ Livingston, EH TI Fibrin glue as a sealant for high-risk anastomosis in surgery for morbid obesity SO OBESITY SURGERY LA English DT Article; Proceedings Paper CT 19th Annual Meeting of the American-Society-of-Bariatric-Surgery CY JUN 24-29, 2002 CL LAS VEGAS, NEVADA SP Amer Soc Bariatr Surg DE fibrin sealant; gastric bypass; enteric leaks; bariatric surgery; morbid obesity ID BOWEL ANASTOMOSES; COMPLICATIONS AB Background: Fibrin sealants promote hemostasis and wound healing. Complex revisional surgery is performed for morbid obesity, and high-risk patients undergo weight loss surgery routinely. Fibrin sealant, Tisseel(TM), Was used by one surgeon on 120 consecutive patients at the gastrojejunal anastomosis in Roux-en-Y gastric bypass (RYGBP). We hypothesized that the application of fibrin sealant would decrease anastomotic leaks. Methods: One surgeon (Surgeon A) used fibrin sealant for 120 consecutive patients, while two other surgeons (Surgeons B & C) served as controls and did not use fibrin glue for their last 120 patients. Surgeon A did not use fibrin glue in 120 patients to serve as an internal control. All 480 patients underwent a RYGBP. Fibrin glue was applied at the gastrojejunal anastomosis. Results: The fibrin sealant group did not have any documented leaks on the previous 120 patients, while 5 patients with Surgeon B, 2 patients with Surgeon C and 1 patient with Surgeon A without fibrin sealant experienced enteric leaks requiring re-operation, drainage, or long-term total parenteral nutrition (N=480 total patients). Conclusions: Fibrin sealant may be useful in preventing leaks and promoting healing, of the "high risk" anastomosis during complex gastrointestinal surgery. While the cost of fibrin glue is to be considered, re-operation and management of subsequent enterocutanous fistulas or anastomotic strictures may be more costly than routine use for high-risk morbidly obese patients. C1 Univ Calif Los Angeles, Sch Med, Dept Surg, Los Angeles, CA 90024 USA. Greater Los Angeles VA Med Ctr, Dept Surg, Los Angeles, CA USA. RP Liu, CD (reprint author), Univ Calif Los Angeles, Sch Med, Dept Surg, 10833 LeConte Ave,72-215CHS, Los Angeles, CA 90024 USA. NR 10 TC 62 Z9 66 U1 0 U2 1 PU F D-COMMUNICATIONS INC PI TORONTO PA 3100 BAYVIEW AVE, UNIT 4, TORONTO, ONTARIO M2N 5L3, CANADA SN 0960-8923 J9 OBES SURG JI Obes. Surg. PD FEB PY 2003 VL 13 IS 1 BP 45 EP 48 DI 10.1381/096089203321136575 PG 4 WC Surgery SC Surgery GA 651ZX UT WOS:000181355100007 PM 12630612 ER PT J AU Furukawa, O Hirokawa, M Guth, PH Engel, E Kaunitz, JD AF Furukawa, O Hirokawa, M Guth, PH Engel, E Kaunitz, JD TI Role of protein kinases on acid-induced duodenal bicarbonate secretion in rats SO PHARMACOLOGY LA English DT Article DE bicarbonate; duodenum; epithelial cells; protein kinase A; protein kinase C; tyrosine kinase; PMA; acid ID GASTRODUODENAL HCO3 TRANSPORT; GUINEA-PIG; CHOLINERGIC REGULATION; MUCOSAL PROTECTION; ALKALINE RESPONSE; RECEPTOR; CELLS; PROSTAGLANDINS; COTRANSPORTER; STIMULATION AB We examined the effect of several protein kinase inhibitors, such as staurosporine for protein kinase C (PKC), H-89 for protein kinase A (PKA) and genistein for tyrosine kinase (TK) on acid-induced duodenal bicarbonate secretion (DBS) in rats. HCO3- secretion was measured using the pH-stat method. Mucosal acidification was performed by perfusing the duodenal loop for 10 min with pH 2.2 HCl. Indomethacin, staurosporine and genistein were added to acidified saline and then perfused, respectively. In some cases, genistein and phorbol 12-myristate 13-acetate (PMA) were added to the luminal solution to examine the effect on basal duodenal HCO3- secretion. PGE(2) (PKA pathway) and PMA (PKC pathway) stimulate basal DBS. Indomethacin, H-89, staurosporine and genistein inhibit acid-induced DBS, indicating involvement of the cyclooxygenase, PKA, PKC and TK pathways. Copyright (C) 2003 S. Karger AG, Basel. C1 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 USA. CURE Digest Dis Res Ctr, Los Angeles, CA USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 114,Room 217,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 33 TC 3 Z9 3 U1 1 U2 1 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0031-7012 J9 PHARMACOLOGY JI Pharmacology PD FEB PY 2003 VL 67 IS 2 BP 99 EP 105 DI 10.1159/000067740 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 641KN UT WOS:000180744100007 PM 12566854 ER PT J AU Rudkin, GH Carlsen, BT Miller, TA AF Rudkin, GH Carlsen, BT Miller, TA TI Nasolabial flap reconstruction of large defects of the lower lip SO PLASTIC AND RECONSTRUCTIVE SURGERY LA English DT Editorial Material ID LONGUS FREE-FLAP; ADVANCEMENT FLAP; CHIN C1 Univ Calif Los Angeles, Sch Med, Div Plast & Reconstruct Surg, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Miller, TA (reprint author), Univ Calif Los Angeles, Sch Med, Div Plast & Reconstruct Surg, 200 Med Plaza,Suite 465, Los Angeles, CA 90024 USA. NR 28 TC 13 Z9 14 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 FEB PY 2003 VL 111 IS 2 BP 810 EP 817 DI 10.1097/01.PRS.0000040468.61171.30 PG 8 WC Surgery SC Surgery GA 642HR UT WOS:000180798600049 PM 12560704 ER PT J AU Dobscha, SK Anderson, TA Hoffman, WF Winterbottom, SM Turner, EH Snodgrass, LS Hauser, P AF Dobscha, SK Anderson, TA Hoffman, WF Winterbottom, SM Turner, EH Snodgrass, LS Hauser, P TI Strategies to decrease costs of prescribing selective serotonin reuptake inhibitors at a VA medical center SO PSYCHIATRIC SERVICES LA English DT Article ID OF-VETERANS-AFFAIRS; HEALTH-CARE COSTS; DEPRESSION; ANTIDEPRESSANTS; DISORDERS; SAVINGS AB Objective: The authors examined the efficacy of a multifaceted intervention designed to contain the cost of prescribing selective serotonin reuptake inhibitors (SSRIs) to inpatients and outpatients served by a Veterans Affairs (VA) medical center. Methods: Elements of the intervention included identification of a preferred agent, tablet splitting, education and feedback for prescribers, and an electronic record and ordering system to facilitate changes in prescriber behaviors. VA databases were searched for information on use and costs of antidepressants. Results: Over 35 months the number of patients treated with SSRIs and the amount spent on SSRIs increased. However, the mean monthly cost per patient decreased from $57.12 to $42.19. The projected cost savings over the 35 months was approximately $700,000; one-fourth of the savings was due to tablet splitting and three-fourths to changes in the proportions of the various SSRIs prescribed. A survey of the top 75 antidepressant prescribers showed that after the educational interventions, 91 percent were aware that citalopram was the medical center's preferred antidepressant, and 59 percent identified it as their own preferred first-line treatment. Discussion and conclusions: The results suggest that multifaceted interventions can influence antidepressant costs through provider education and changes in pharmacy and computerized information processes, resulting in substantial cost savings for institutions. C1 Portland VA Med Ctr, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Behav Hlth & Clin Neurosci Div, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Hosp & Specialty Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland Ctr Evaluat Clin Serv, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. RP Dobscha, SK (reprint author), Portland VA Med Ctr, POB 1034,P3MHDC, Portland, OR 97207 USA. EM dobschas@ohsu.edu OI Turner, Erick/0000-0002-3522-3357 NR 25 TC 10 Z9 10 U1 1 U2 1 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD FEB PY 2003 VL 54 IS 2 BP 195 EP 200 DI 10.1176/appi.ps.54.2.195 PG 6 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 839BH UT WOS:000222757800011 PM 12556600 ER PT J AU Davis, TM Bush, KR Kivlahan, DR Dobie, DJ Bradley, KA AF Davis, TM Bush, KR Kivlahan, DR Dobie, DJ Bradley, KA TI Screening for substance abuse and psychiatric disorders among women patients in a VA health care system SO PSYCHIATRIC SERVICES LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; ALCOHOL-USE DISORDERS; PROBLEM DRINKING; FEMALE VETERANS; HEAVY DRINKING; PREVALENCE; POPULATION; SYMPTOMS; SMOKING; IDENTIFICATION AB Objective: This study of women Veterans Affairs (VA) health care patients screened for the prevalence of past-year smoking, hazardous and problem drinking, other drug abuse, and psychiatric disorders. Methods. A survey was mailed to women veterans who had received care from VA Puget Sound Health Care System between October 1, 19965 and January 1, 1998. Screening measures included questions about cigarettes; questions from the Alcohol Use Disorders Identification Test about consumption (hazardous drinking); the TWEAK test (problem drinking); a drug abuse screen; the Patient Health Questionnaire (psychiatric conditions); and the PTSD (posttramnatic stress disorder) Checklist. Results: Of eligible patients, 1,257 (65 percent) returned surveys with complete substance use data. Patients reported a relatively high rate of past-year smoking (29.1 percent) and hazardous drinking, problem drinking, or both (31.1 percent). The rate of past-year drug use was much lower (4.9 percent). Younger age was strongly associated with greater substance abuse: 59 percent of women under age 35 screened positive for smoking, hazardous or problem drinking, or drug abuse. Screening positive for a psychiatric condition (N=504) was also associated with substance abuse: The rate of past-year drug abuse among women screening positive for a psychiatric condition (9.7 percent) was double the rate for the entire sample; Of the women who screened positive for depression, PTSD, eating disorders, or panic disorders, 57 percent screened positive for substance abuse (including smoking). Conclusions: Substance abuse is common among women VA patients and is associated with younger age and with screening positive for other psychiatric conditions. Providers are expected to follow up on positive screening tests, and these data indicate, substantial provider burden. C1 Univ Washington, Ctr Excellence Subst Abuse Treatment, Seattle, WA 98195 USA. Univ Washington, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98195 USA. Univ Washington, Hlth Serv Res & Dev Serv, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Davis, TM (reprint author), VA Puget Sound Hlth Care Syst, Seattle Div, S116ATC,1660 S Columbian Way, Seattle, WA 98108 USA. EM tania.davis@med.va.gov FU NIAAA NIH HHS [K23AA00313] NR 43 TC 45 Z9 45 U1 6 U2 10 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD FEB PY 2003 VL 54 IS 2 BP 214 EP 218 DI 10.1176/appi.ps.54.2.214 PG 5 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 839BH UT WOS:000222757800014 PM 12556603 ER PT J AU Fierre, JM Wirshing, DA Wirshing, WC AF Fierre, JM Wirshing, DA Wirshing, WC TI "Iatrogenic malingering" in VA substance abuse treatment SO PSYCHIATRIC SERVICES LA English DT Letter C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Ctr, Dept Psychiat, Los Angeles, CA USA. RP Fierre, JM (reprint author), Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD FEB PY 2003 VL 54 IS 2 BP 253 EP 254 PG 2 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 839BH UT WOS:000222757800023 ER PT J AU Hershey, JC Asch, DA Jepson, C Baron, J Ubel, PA AF Hershey, JC Asch, DA Jepson, C Baron, J Ubel, PA TI Incremental and average cost-effectiveness ratios: Will physicians make a distinction? SO RISK ANALYSIS LA English DT Article DE cost-effectiveness analysis; incremental cost effectiveness; average cost effectiveness; medical screening; medical decision making ID MAIL SURVEYS; CANCER AB Physicians are increasingly asked to use cost-effectiveness information when evaluating alternative health care interventions. Little is known about how the way such information is presented can influence medical decision making. We presented physicians with hypothetical screening scenarios with multiple options, varying the type of cost-effectiveness ratios provided as well as whether the scenarios described cancer screening settings that were familiar or unfamiliar. Half the scenarios used average cost-effectiveness ratios, as commonly reported, calculating benefits and costs relative to a no-screening option. The other half used the preferred incremental cost-effectiveness ratios, with each option's benefits and costs calculated relative to the next best alternative. Relative to average cost-effectiveness ratios, incremental cost-effectiveness information significantly reduced preference for the most expensive screening strategies in two of three unfamiliar scenarios. No such difference was found for familiar scenarios, for which physicians likely have established practice patterns. These results suggest that, in unfamiliar settings, average cost-effectiveness ratios as reported in many analyses reported in the literature can hide the often high price for achieving incremental health care goals, potentially causing physicians to choose interventions with poor cost effectiveness. C1 Univ Penn, Wharton Sch, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychol, Philadelphia, PA 19104 USA. Univ Penn, Div Gen Internal Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Vet Affairs Med Ctr, Ann Arbor, MI USA. Univ Michigan, Div Gen Internal Med, Ann Arbor, MI 48109 USA. Univ Michigan, Ann Arbor, MI 48109 USA. VAMC, Program Improving Hlth Care Decis, Ann Arbor, MI USA. RP Hershey, JC (reprint author), Univ Penn, Wharton Sch, Philadelphia, PA 19104 USA. FU NCI NIH HHS [R01-CA78052-01] NR 19 TC 8 Z9 8 U1 0 U2 0 PU BLACKWELL PUBLISHERS PI MALDEN PA 350 MAIN STREET, STE 6, MALDEN, MA 02148 USA SN 0272-4332 J9 RISK ANAL JI Risk Anal. PD FEB PY 2003 VL 23 IS 1 BP 81 EP 89 DI 10.1111/1539-6924.00291 PG 9 WC Public, Environmental & Occupational Health; Mathematics, Interdisciplinary Applications; Social Sciences, Mathematical Methods SC Public, Environmental & Occupational Health; Mathematics; Mathematical Methods In Social Sciences GA 679AN UT WOS:000182899000007 PM 12635724 ER PT J AU Hajduk, IA Strollo, PJ Jasani, RR Atwood, CW Houck, PR Sanders, MH AF Hajduk, IA Strollo, PJ Jasani, RR Atwood, CW Houck, PR Sanders, MH TI Prevalence and predictors of nocturia in obstructive sleep apnea-hypopnea syndrome - a retrospective study SO SLEEP LA English DT Article DE nocturia; obstructive sleep apnea-hypopnea syndrome; sleep disorders ID POSITIVE AIRWAY PRESSURE; ATRIAL-NATRIURETIC-PEPTIDE; POPULATION-BASED SURVEY; URINARY-INCONTINENCE; MEN; SYMPTOMS; AGE; COMMUNITY; HYPERTENSION; ASSOCIATION AB Objective: To determine the prevalence and predictors of pathological nocturia (PN) in patients with OSAHS. Methods: Retrospective review of clinical and polysomnographic data obtained from patients evaluated at the Pulmonary Sleep Evaluation Center of the University of Pittsburgh Medical Center between November 1998 and September 1999. PN was defined as two or more urination events per night. OSAHS was defined as Apnea-Hypopnea Index (AHI)greater than or equal to5. Group t-tests and Chi-square test were used to examine differences in subjects with and without PN. A multivariate approach utilizing logistic regression was performed to examine the relationships between polysomnographic variables [Arousal Index (ARI), AHI, Apnea-Hypopnea Time/Total Sleep Time x 100(%) (AHT/TST), % Total Sleep Time (TST)<90% Oxyhemoglobin Saturation (SpO(2)), nadir SpO(2), Desaturation Event Frequency (average number of desaturations > 4% per hour sleep) (DEF)] and the presence of PN, while controlling for medical co-morbidities. Data are expressed as mean + SD unless otherwise specified. Statistical significance was assessed at p < 0.05. Results: Study population: n = 138 (50 females, 88 males), age: 49.7 +/- 12.3 years, BMI [Body Mass Index (kg/m(2))]: 37.7 +/- 11.3. The overall prevalence of PN was 47.8%. The prevalence of PN was greater in females (60% vs. 40.9% in males). OSAHS patients with PN had a higher prevalence of peripheral edema, higher BMI, a greater %TST <90% SpO(2), lower nadir SpO(2) and greater DEF. The logistic regression model indicated that age, ARI, AHI, AHT/TST, %TST <90%, DEF were significant predictors of PN independent of BMI, neck circumference and medical co-morbidities. Conclusions: Our data confirm that PN is common in OSAHS patients. The strongest predictors are age and selected polysomnographic variables reflecting OSAHS severity. C1 Univ Pittsburgh, Med Ctr, Pulm Sleep Evaluat Ctr, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, Sleep & Chronobiol Ctr, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, Pulm Sleep Disorders Program, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pulm Sect, Pittsburgh, PA USA. RP Sanders, MH (reprint author), Montefiore Univ Hosp, Div Pulm Allergy & Crit Care Med, NW 628,3459 5th Ave, Pittsburgh, PA 15213 USA. EM sandersmh@msx.upmc.edu NR 43 TC 32 Z9 32 U1 0 U2 0 PU AMER ACAD SLEEP MEDICINE PI ROCHESTER PA 6301 BANDEL RD, STE 101, ROCHESTER, MN 55901 USA SN 0161-8105 J9 SLEEP JI Sleep PD FEB 1 PY 2003 VL 26 IS 1 BP 61 EP 64 PG 4 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 658MM UT WOS:000181724800013 PM 12627734 ER PT J AU Freedland, SJ Sutter, ME Dorey, F Aronson, WJ AF Freedland, SJ Sutter, ME Dorey, F Aronson, WJ TI Defining the ideal cutpoint for determining PSA recurrence after radical prostatectomy SO UROLOGY LA English DT Article ID BIOCHEMICAL RECURRENCE; RADIATION-THERAPY; CANCER RECURRENCE; RADIOTHERAPY; RISK; PROGRESSION; BIOPSY; RACE AB Objectives. To determine the ideal cutpoint for defining prostate-specific antigen (PSA) recurrence after radical prostatectomy (RP). Although various cutpoints have been used, a recent study suggested that 0.4 ng/mL may be the most appropriate. Methods. A retrospective survey of 358 men undergoing RP at the West Los Angeles Veterans Affairs Medical Center between 1991 and 2001 was undertaken. The 3-year and 5-year risk of PSA recurrence was estimated by Kaplan-Meier analyses using various cutpoints of postoperative PSA to define recurrence: greater than 0.1, greater than 0.2, greater than 0.3, greater than 0.4, and greater than 0.5 ng/mL. The 1 and 3-year risk of PSA progression after a detectable PSA level (PSA rising to a higher cutpoint) was evaluated for each definition of PSA recurrence using Kaplan-Meier analyses. Multivariate analysis using a Cox proportional hazards model was used to determine the clinical variables that were significant independent predictors of PSA recurrence at each cutpoint. Results. For patients with a detectable postoperative PSA value from 0.11 to 0.2 ng/mL, the 1 and 3-year risk of PSA progression was 64% (95% confidence interval [CI] 46% to 82%) and 93% (95% CI 74% to 99%), respectively. For patients with a PSA value from 0.21 to 0.3 ng/mL, the I and 3-year risk of PSA progression was 86% (95% CI 69% to 97%) and 100% (95% CI 87% to 100%), respectively. The use of higher PSA cutpoints to define recurrence resulted in a lower 5-year risk of PSA recurrence. The 5-year risk of PSA recurrence using a greater than 0.1 ng/mL cutpoint resulted in a 43% (95% Cl 36% to 50%) risk of recurrence compared with only 23% (95% CI 18% to 30%) for a greater than 0.5 ng/mL cutpoint. In multivariate analysis, PSA and biopsy Gleason score were significant independent predictors of biochemical recurrence, regardless of the definition of PSA recurrence used (P less than or equal to 0.002). Conclusions. PSA and biopsy Gleason score were significant predictors of biochemical failure, regardless of the definition of failure used. However, the definition of PSA recurrence dramatically affected the perceived success of therapy. Patients with a postoperative PSA value greater than 0.2 ng/mL are at very high risk of developing an additional rise in PSA. On the basis of this finding, a PSA value greater than 0.2 ng/mL is an appropriate cutpoint to define PSA recurrence after RP. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA USA. Univ Calif Davis, Sch Med, Dept Emergency Med, Davis, CA 95616 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Aronson, WJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Box 951738, Los Angeles, CA 90095 USA. NR 19 TC 152 Z9 160 U1 0 U2 1 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 FEB PY 2003 VL 61 IS 2 BP 365 EP 369 DI 10.1016/S0090-4295(02)02268-9 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 648NN UT WOS:000181157600023 PM 12597949 ER PT J AU Gerling, IC Solomon, SS Bryer-Ash, M AF Gerling, IC Solomon, SS Bryer-Ash, M TI Genomes, transcriptomes, and proteomes - Molecular medicine and its impact on medical practice SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID DEPENDENT DIABETES-MELLITUS; GENE-EXPRESSION; OLD DISEASE; INSULIN; OBESITY; PHARMACOGENETICS; COMPLICATIONS; PATHOGENESIS; DEFICIENCY; TOLERANCE AB The human genome project and the technological breakthroughs it has produced have moved the field of molecular medicine forward with breathtaking speed. This will impact not only the advance of scientific discoveries and the way science is conducted but also the clinical practice of medicine. In this review we explain the basic principles of these new technologies. Their potential use and impact are demonstrated by using diabetes mellitus as an example of a common and serious medical disorder. Finally, several potentially adverse consequences of "excessive" knowledge are discussed. C1 Univ Tennessee, Hlth Sci Ctr, VAMC Res 151, Div Endocrinol,Dept Med, Memphis, TN 38104 USA. Univ Tennessee, Hlth Sci Ctr, Dept Pharmacol, Memphis, TN 38104 USA. Vet Affairs Med Ctr, Res Serv, Memphis, TN USA. Vet Affairs Med Ctr, Med Serv, Memphis, TN USA. Univ Calif Los Angeles, Gonda Diabet Ctr, Dept Med, Los Angeles, CA 90095 USA. W Los Angeles Vet Adm Med Ctr, Los Angeles, CA USA. RP Gerling, IC (reprint author), Univ Tennessee, Hlth Sci Ctr, VAMC Res 151, Div Endocrinol,Dept Med, 1030 Jefferson Ave, Memphis, TN 38104 USA. EM igerling@utmem.edu NR 60 TC 13 Z9 17 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0003-9926 EI 1538-3679 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JAN 27 PY 2003 VL 163 IS 2 BP 190 EP 198 DI 10.1001/archinte.163.2.190 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 638YZ UT WOS:000180601900006 PM 12546609 ER PT J AU Metlay, JP Fine, MJ AF Metlay, JP Fine, MJ TI Testing strategies in the initial management of patients with community-acquired pneumonia SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID INTENSIVE-CARE TREATMENT; C-REACTIVE PROTEIN; PROGNOSTIC FACTORS; PNEUMOCOCCAL PNEUMONIA; ELDERLY PATIENTS; PREDICTION RULE; REQUIRING HOSPITALIZATION; LEGIONNAIRES-DISEASE; DIAGNOSING PNEUMONIA; PHYSICAL-EXAMINATION AB The initial management of patients suspected of having community-acquired pneumonia is challenging because of the broad range of clinical presentations, potential life-threatening nature of the illness, and associated high costs of care. The initial testing strategies should accurately establish a diagnosis and prognosis in order to determine the optimal treatment strategy. The diagnosis is important in determining the need for antibiotic therapy, and the prognosis is important in determining the site of care. This paper reviews the test characteristics of the history, physical examination, and laboratory findings, individually and in combination, in diagnosing community-acquired pneumonia and predicting short-term risk for death from the infection. In addition, we consider the implications of these test characteristics from the perspective of decision thresholds. The history and physical examination cannot provide a high level of certainty in the diagnosis of community-acquired pneumonia, but the absence of vital sign abnormalities substantially reduces the probability of the infection. Chest radiography is considered the gold standard for pneumonia diagnosis; however, we do not know its sensitivity and specificity, and we have limited data on the costs of false-positive and false-negative results. In the absence of empirical evidence, the decision to order a chest radiograph needs to rely on expert opinion in seeking strategies to optimize the balance between harms and benefits. Once community-acquired pneumonia is diagnosed, a combination of history, physical examination, and laboratory items can help estimate the short-term risk for death and, along with the patient's psychosocial characteristics, determine the appropriate site of treatment. C1 Dept Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA USA. RP Metlay, JP (reprint author), Dept Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, 9th Floor,Univ & Woodland Ave, Philadelphia, PA 19104 USA. FU AHRQ HHS [R01 HS06468] NR 104 TC 118 Z9 125 U1 2 U2 7 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 JAN 21 PY 2003 VL 138 IS 2 BP 109 EP 118 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 646CY UT WOS:000181018300005 PM 12529093 ER PT J AU Haverkamp, S Ghosh, KK Hirano, AA Wassle, H AF Haverkamp, S Ghosh, KK Hirano, AA Wassle, H TI Immunocytochemical description of five bipolar cell types of the mouse retina SO JOURNAL OF COMPARATIVE NEUROLOGY LA English DT Article DE mouse retina; bipolar cells; CaB5; NK3R; CaB1; recoverin; glutamate receptors ID MACAQUE MONKEY RETINA; GLUTAMATE-RECEPTOR SUBUNITS; PROTEIN-KINASE-C; CALCIUM-BINDING PROTEIN; RAT RETINA; MAMMALIAN RETINA; PRIMATE RETINA; CAT RETINA; ROD PHOTORECEPTORS; KAINATE RECEPTORS AB With the ever-growing number of transgenic mice being used in vision research, a precise knowledge of the cellular organization of the mouse retina is required. As with the cat, rabbit, rat, and primate retinae, as many as 10 cone bipolar types and one rod bipolar type can be expected to exist in the mouse retina; however, they still have to be defined. In the current study, several immunocytochemical markers were applied to sections of mouse retina, and the labeling of bipolar cells was studied using confocal microscopy and electron microscopy. By using antibodies against the neurokinin-3 receptor NK3R; the plasma membrane calcium ATPase1 (PMCA1); and the calcium (Ca)-binding proteins CaB1, CaB5, caldendrin, and recoverin, three different OFF-cone bipolar cells could be identified. One type of ON-cone bipolar cell was identified through its immunoreactivity for CaB5 and PMCA1. Rod bipolar cells, comparable in morphology to those of other mammalian retinae, expressed protein kinase Ca and CaB5. It was also shown that putative OFF-cone bipolar cells receive light signals through flat contacts at the cone pedicle base, whereas ON-cone bipolar signaling involves invaginating contacts. The distribution of the kainate receptor subunit GluR5 was studied by confocal and electron microscopy. GluR5 was expressed at flat bipolar cell contacts; however, it appears to be involved with only certain types of OFF-cone bipolar cells. This suggests that different bipolar cell types receive their light signals through different sets of glutamate receptors. C1 Max Planck Inst Hirnforsch, D-60528 Frankfurt, Germany. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. RP Wassle, H (reprint author), Max Planck Inst Hirnforsch, Deutschordenstr 46, D-60528 Frankfurt, Germany. FU NEI NIH HHS [R01 EY015573, EY 07026, R01 EY004067, R01 EY004067-23, T32 EY007026] NR 68 TC 142 Z9 142 U1 0 U2 4 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0021-9967 J9 J COMP NEUROL JI J. Comp. Neurol. PD JAN 20 PY 2003 VL 455 IS 4 BP 463 EP 476 DI 10.1002/cne.10491 PG 14 WC Neurosciences; Zoology SC Neurosciences & Neurology; Zoology GA 630QD UT WOS:000180118800004 PM 12508320 ER PT J AU Bozkurt, B Agoston, I Knowlton, AA AF Bozkurt, B Agoston, I Knowlton, AA TI Complications of inappropriate use of spiroholactone in heart failure: When an old medicine spirals out of new guidelines SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID CONVERTING ENZYME-INHIBITORS; SPIRONOLACTONE; OUTCOMES AB Objectives This study was designed to investigate the appropriateness and complications of the use of spironolactone for heart failure (HF) in clinical practice. Background Spironolactone was reported by one prospective randomized trial to decrease morbidity and mortality in patients with New York Heart Association (NYHA) class III and IV HF. With this report (Randomized Spironolactone Evaluation Study [RALES] trial), we noted a marked increase in widespread use of spironolactone in patients with HF. Long-term outcome data with respect to safety and utilization of this medication in HF are not available. Methods To investigate the use of spironolactone for HF in a clinical setting, we analyzed the application of the RALES trial protocol to the care of 104 patients, whom we identified as being started on spironolactone for HF after prerelease of the RALES trial. Results We found broader use, less intensive follow-up, and increased complications with spironolactone treatment compared with the RALES trial. Cardiologists provided more appropriate care than did primary care providers. Conclusions These data suggest that spironolactone is being used widely in HF without consideration of the NYHA class and ejection fraction, and without optimization of background treatment with angiotensin-converting enzyme inhibitors and beta-blockers. Clinical follow-up does not adhere to the RALES trial guidelines, resulting in higher complications. We conclude that long-term studies with further safety and efficacy data are needed. C1 Baylor Coll Med, Winters Ctr Heart Failure Res, Houston, TX 77030 USA. Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. RP Knowlton, AA (reprint author), Univ Calif Davis, Div Cardiovasc, TB172,1 Shields Ave, Davis, CA 95616 USA. NR 13 TC 131 Z9 135 U1 0 U2 1 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 JAN 15 PY 2003 VL 41 IS 2 BP 211 EP 214 AR PII S0735-1097(02)02694-3 DI 10.1016/S0735-1097(02)02694-3 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 634VQ UT WOS:000180362800007 PM 12535810 ER PT J AU Bronikowski, AM Carter, PA Morgan, TJ Garland, T Ung, N Pugh, TD Weindruch, R Prolla, TA AF Bronikowski, AM Carter, PA Morgan, TJ Garland, T Ung, N Pugh, TD Weindruch, R Prolla, TA TI Lifelong voluntary exercise in the mouse prevents age-related alterations in gene expression in the heart SO PHYSIOLOGICAL GENOMICS LA English DT Article DE aging; artificial selection; exercise; microarray; Mus domesticus; stress/inflammation response ID DIETARY RESTRICTION; STRESS RESISTANCE; PHYSICAL-ACTIVITY; APOLIPOPROTEIN-D; DEFICIENT MICE; HOUSE MICE; LONGEVITY; SPAN; RATS; PROTEIN AB We present the first quantitative gene expression analysis of cardiac aging under conditions of sedentary and active lifestyles using high-density oligonucleotide arrays representing 11,904 cDNAs and expressed sequence tags (ESTs). With these data, we test the hypothesis that exercise attenuates the gene expression changes that normally occur in the aging heart. Male mice (Mus domesticus) were sampled from the 16th generation of selective breeding for high voluntary exercise. For the selective breeding protocol, breeders were chosen based on the maximum number of wheel revolutions run on days 5 and 6 of a test at 8 wk of age. For the colony sampled herein, mice were housed individually over their entire lifetimes (from weaning) either with or without access to running wheels. The hearts of these two treatment groups (active and sedentary) were assayed at middle age (20 mo) and old age (33 mo). Genes significantly affected by age in the hearts of the sedentary population by at least a 50% expression change (n = 137) were distributed across several major categories, including inflammatory response, stress response, signal transduction, and energy metabolism. Genes significantly affected by age in the active population were fewer (n = 62). Of the 42 changes in gene expression that were common to both treatment groups, 32 (72%) displayed smaller fold changes as a result of exercise. Thus exercise offset many age-related gene expression changes observed in the hearts of the sedentary animals. These results suggest that adaptive physiological mechanisms that are induced by exercise can retard many effects of aging on heart muscle at the transcriptional level. C1 Iowa State Univ Sci & Technol, Dept Zool & Genet, Ames, IA 50011 USA. Washington State Univ, Sch Biol Sci, Pullman, WA 99164 USA. Univ Calif Riverside, Dept Biol, Riverside, CA 92521 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53706 USA. Univ Wisconsin, Dept Genet & Med Genet, Madison, WI 53706 USA. Univ Wisconsin, Dept Med, Madison, WI 53706 USA. Univ Wisconsin, Dept Zool, Madison, WI 53706 USA. RP Bronikowski, AM (reprint author), Iowa State Univ Sci & Technol, Dept Zool & Genet, Ames, IA 50011 USA. OI Bronikowski, Anne/0000-0001-6432-298X FU NIA NIH HHS [AG-05784, AG-18922] NR 50 TC 48 Z9 50 U1 1 U2 6 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1094-8341 J9 PHYSIOL GENOMICS JI Physiol. Genomics PD JAN 15 PY 2003 VL 12 IS 2 BP 129 EP 138 DI 10.1152/physiolgenomics.00082.2002 PG 10 WC Cell Biology; Genetics & Heredity; Physiology SC Cell Biology; Genetics & Heredity; Physiology GA 635LJ UT WOS:000180400100007 PM 12429864 ER PT J AU Street, VA Bennett, CL Goldy, JD Shirk, AJ Kleopa, KA Tempel, BL Lipe, HP Scherer, SS Bird, TD Chance, PF AF Street, VA Bennett, CL Goldy, JD Shirk, AJ Kleopa, KA Tempel, BL Lipe, HP Scherer, SS Bird, TD Chance, PF TI Mutation of a putative protein degradation gene LITAF/SIMPLE in Charcot-Marie-Tooth disease 1C SO NEUROLOGY LA English DT Article ID PERIPHERAL MYELIN PROTEIN-22; TYPE-1A; DUPLICATION; LIPOPOLYSACCHARIDE; PMP-22; IDENTIFICATION; EXPRESSION; APOPTOSIS; MOUSE; 1A AB Background: Charcot-Marie-Tooth (CMT) neuropathy is a heterogeneous group of inherited disorders of the peripheral nervous system. The authors recently mapped an autosomal dominant demyelinating form of CMT type I (CMT1C) to chromosome 16p13.1-p12.3. Objective: To find the gene mutations underlying CMT1C. Methods: The authors used a combination of standard positional cloning and candidate gene approaches to identify the causal gene for CMT1C. Western blot analysis was used to determine relative protein levels in patient and control lymphocyte extracts. Northern blotting was used to characterize gene expression in 1) multiple tissues; 2) developing sciatic nerve; and 3) nerve-crush and nerve-transection experiments. Results: The authors identified missense mutations (G112S, T115N, W116G) in the LITAF gene (lipopolysaccharide-induced tumor necrosis factor-ut factor) in three CMT1C pedigrees. LITAF, which is also referred to as SIMPLE, is a widely expressed gene encoding a 161-amino acid protein that may play a role in protein degradation pathways. The mutations associated with CMT1C were found to cluster, defining a domain of the LITAF protein having a critical role in peripheral nerve function. Western blot analysis suggested that the T115N and W116G mutations do not alter the level of LITAF protein in peripheral blood lymphocytes. The LITAF transcript is expressed in sciatic nerve, but its level of expression is not altered during development or in response to nerve injury. This finding is in stark contrast to that seen for other known genes that cause CMT1. Conclusions: Mutations in LITAF may account for a significant proportion of CMT1 patients with previously unknown molecular diagnosis and may define a new mechanism of peripheral nerve perturbation leading to demyelinating neuropathy. C1 Univ Washington, Dept Pediat, Seattle, WA 98195 USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, VM Bloedel Hearing Res Ctr, Seattle, WA 98195 USA. Univ Penn, Sch Med, Dept Neurol, Philadelphia, PA 19104 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Childrens Hosp & Reg Med Ctr, Seattle, WA USA. RP Chance, PF (reprint author), Univ Washington, Dept Pediat, Box 356320, Seattle, WA 98195 USA. FU NIA NIH HHS [AG00057]; NICHD NIH HHS [HD02274]; NIDCD NIH HHS [DC02739]; NINDS NIH HHS [NS2878, NS38181] NR 31 TC 117 Z9 129 U1 1 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD JAN 14 PY 2003 VL 60 IS 1 BP 22 EP 26 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 633ZU UT WOS:000180316000006 PM 12525712 ER PT J AU Shlipak, MG Fried, LF Crump, C Bleyer, AJ Manolio, TA Tracy, RP Furberg, CD Psaty, BM AF Shlipak, MG Fried, LF Crump, C Bleyer, AJ Manolio, TA Tracy, RP Furberg, CD Psaty, BM TI Elevations of inflammatory and procoagulant biomarkers in elderly persons with renal insufficiency SO CIRCULATION LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Heart-Associations-Epidemiology-Council CY APR 24, 2002 CL HONOLULU, HAWAII SP Amer Heart Assoc Epidemiol Council DE inflammation; coagulation; kidney; coronary disease ID C-REACTIVE PROTEIN; CORONARY HEART-DISEASE; CARDIOVASCULAR-DISEASE; HEMODIALYSIS-PATIENTS; CREATININE CLEARANCE; SERUM CREATININE; FACTOR-VII; D-DIMER; FIBRINOGEN; RISK AB Background-Renal insufficiency has been associated with cardiovascular disease events and mortality in several prospective studies, but the mechanisms for the elevated risk are not clear. Little is known about the association of renal insufficiency with inflammatory and procoagulant markers, which are potential mediators for the cardiovascular risk of kidney disease. Methods and Results-The cross-sectional association of renal insufficiency with 8 inflammatory and procoagulant factors was evaluated using baseline data from the Cardiovascular Health Study, a population-based cohort study of 5888 subjects aged greater than or equal to65 years. C-reactive protein. fibrinogen, factor VIII, and factor VIIIc levels were treasured in nearly all participants; interleukin-6, intercellular adhesion molecule-1, plasmin-antiplasmin complex, and D-dither levels were measured in nearly half of participants. Renal insufficiency was defined as a serum creatinine level greater than or equal to1.3 mg/dL in women and greater than or equal to1.5 mg/dL in men. Multivariate linear regression was used to compare adjusted mean levels of each biomarker in persons with and without renal insufficiency after adjustment for other baseline characteristics. Renal insufficiency was present in 617 (11%) of Cardiovascular Health Study participants. After adjustment for baseline differences, levels of C-reactive protein, fibrinogen, interleukin-6, factor VIII, factor VIIIc, plasmin-antiplasmin complex, and D-dieter were significantly greater among persons with renal insufficiency (P<0.001). In participants with clinical, subclinical, and no cardiovascular disease at baseline, the positive associations of renal insufficiency with these inflammatory and procoagulant markers were similar. Conclusion-Renal insufficiency was independently associated with elevations in inflammatory and procoagulant biomarkers. These pathways may be important mediators leading to the increased cardiovascular risk of persons with kidney disease. C1 Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Biostat, San Francisco, CA 94143 USA. Univ Pittsburgh, Sch Med, Renal Electrolyte Div, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Wake Forest Univ, Bowman Gray Sch Med, Nephrol Sect, Winston Salem, NC USA. Wake Forest Univ, Bowman Gray Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27103 USA. NHLBI, Div Epidemiol & Clin Applicat, Bethesda, MD 20892 USA. Univ Vermont, Coll Med, Dept Pathol, Burlington, VT 05405 USA. Univ Vermont, Coll Med, Dept Biochem, Burlington, VT 05405 USA. RP Shlipak, MG (reprint author), Vet Affairs Med Ctr, 111A1,4150 Clement St, San Francisco, CA 94121 USA. FU NHLBI NIH HHS [R03 HL68099-01] NR 30 TC 442 Z9 464 U1 1 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD JAN 7 PY 2003 VL 107 IS 1 BP 87 EP 92 DI 10.1161/01.CIR.0000042700.48769.59 PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 634WZ UT WOS:000180366600030 PM 12515748 ER PT J AU Cook, DL Schwindt, PC Grande, LA Spain, WJ AF Cook, DL Schwindt, PC Grande, LA Spain, WJ TI Synaptic depression in the localization of sound SO NATURE LA English DT Article ID INTERAURAL TIME DIFFERENCES; NUCLEUS LAMINARIS NEURONS; STEM AUDITORY NUCLEI; COINCIDENCE DETECTION; COCHLEAR NUCLEUS; BRAIN-STEM; RELEASE PROBABILITY; PHASE-LOCKING; BARN OWL; CHICK AB Short-term synaptic plasticity, which is common in the central nervous system, may contribute to the signal processing functions of both temporal integration and coincidence detection(1-3). For temporal integrators, whose output firng rate depends on a running average of recent synaptic inputs, plasticity modulates input synaptic strength and thus may directly control signalling gain(2) and the function of neural networks(1-4). But the firing probability of an ideal coincidence detector would depend on the temporal coincidence of events rather than on the average frequency of synaptic events. Here we have examined a specific case of how synaptic plasticity can affect temporal coincidence detection, by experimentally characterizing synaptic depression at the synapse between neurons in the nucleus magnocellularis and coincidence detection neurons in the nucleus laminaris in the chick auditory brainstem(5). We combine an empirical description of this depression with a biophysical model of signalling in the nucleus laminaris. The resulting model predicts that synaptic depression provides an adaptive mechanism for preserving interaural time-delay information (a proxy for the location of sound in space) despite the confounding effects of sound-intensity-related information. This mechanism may help nucleus laminaris neurons to pass specific sound localization information to higher processing centres. C1 Univ Washington, Dept Physiol & Biophys, Seattle, WA 98105 USA. Univ Washington, Dept Neurol, Seattle, WA 98105 USA. Univ Washington, Virginia Merrill Bloedel Hearing Res Ctr, Seattle, WA 98105 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Spain, WJ (reprint author), Univ Washington, Dept Physiol & Biophys, Seattle, WA 98105 USA. FU BLRD VA [I01 BX000386] NR 30 TC 107 Z9 107 U1 1 U2 9 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0028-0836 J9 NATURE JI Nature PD JAN 2 PY 2003 VL 421 IS 6918 BP 66 EP 70 DI 10.1038/nature01248 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 631JY UT WOS:000180165500038 PM 12511955 ER PT J AU Langdale, LA Schaad, D Wipf, J Marshall, S Vontver, L Scott, CS AF Langdale, LA Schaad, D Wipf, J Marshall, S Vontver, L Scott, CS TI Preparing graduates for the first year of residency: Are medical schools meeting the need? SO ACADEMIC MEDICINE LA English DT Article ID CLERKSHIP AB Purpose. Changes in graduate medical education associated with full implementation of the Balanced Budget Act of 1997 have required medical schools to review and revise their curricula. As limited funding increases pressures to streamline training, residencies will potentially expect an entry level of skill and competence that is greater than that which schools are currently providing. To determine whether medical school curricular requirements correlate with residency needs, this multidisciplinary pilot study investigated expectations and prerequisites for postgraduate specialty training, Method. A questionnaire about 100 skills and competencies expected of new first-year residents was sent to 50 U.S. residency directors from surgery, internal medicine, family medicine, pediatrics, and obstetrics-gynecology programs. Each director was asked to state expectations of a first-year resident's competence in each skill at entry to residency and after three months of training. Skills deemed most appropriately acquired in residency were also identified. Competencies included diagnosis, management, triage, interpretation of data, informatics and technology, record keeping, interpersonal communications, and manual skills. Results. A total of 39 residency directors responded, including seven surgery, nine medicine, seven family medicine, eight pediatrics, and eight obstetrics -gynecology. In addition to physical examination skills, 13 competencies achieved more than 70% agreement as being entry, level skills. There was wide variability as to the relative importance of the remaining skills, with residency directors expecting to devote significant resources and time in early training to ensure competence. Conclusions. Medical schools should consider the expectations of their students' future residency directors when developing new curricula. Assuring students' competencies through focused curricular change should save both time and resources during residency. C1 Univ Washington, Sch Med, Dept Surg, VA Puget Sound Hlth Care, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med Educ, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Obstet & Gynecol, Seattle, WA 98108 USA. RP Langdale, LA (reprint author), Univ Washington, Sch Med, Dept Surg, VA Puget Sound Hlth Care, Bldg 1,Room 314,1660 S Columbian Way, Seattle, WA 98108 USA. NR 8 TC 54 Z9 54 U1 0 U2 5 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JAN PY 2003 VL 78 IS 1 BP 39 EP 44 DI 10.1097/00001888-200301000-00009 PG 6 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 636CD UT WOS:000180436200009 PM 12525408 ER PT B AU Monga, T AF Monga, T BE Sorkoker, N Ring, H TI Sexuality and disability SO ADVANCES IN PHYSICAL AND REHABILITATION MEDICINE LA English DT Proceedings Paper CT 2nd World Congress of the International-Society-of-Physical-and-Rehabilitation-Medicine (ISPRM) CY MAY 18-23, 2003 CL Prague, CZECH REPUBLIC SP Int Soc Phys & Rehabilitat Med ID SPINAL-CORD-INJURY; TRAUMATIC BRAIN INJURY; IN-VITRO FERTILIZATION; ERECTILE DYSFUNCTION; SILDENAFIL CITRATE; MALE-INFERTILITY; STROKE PATIENTS; CHRONIC PAIN; WOMEN; ELECTROEJACULATION AB Although the philosophy and practice of rehabilitation medicine has been well defined, little emphasis has been placed on dealing with problems related to sexual functioning in people with disabilities. While the problems with sexual functioning are reported to be common, the question of sexual functioning is often not discussed during rehabilitation and the sexual needs of physically challenged people arc still being ignored. The exact magnitude of the problem is not known as the information gathered is based upon self-reports. Many patients experience arousal and orgasmic problems. Sexual function and sexual adjustment within the functional limitations of a disability have not been studied systematically. Cultural differences and personal preferences have not been incorporated in study designs. Treatment interventions have not been systematically investigated. Future research should address the fundamental questions of intimate relationships, pregnancy, labor, parenting, ethical and legal issues regarding sexuality in people with physical disabilities. C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Dept Phys Med & Rehabil, Rehabil Care Line, Houston, TX 77030 USA. RP Monga, T (reprint author), Baylor Coll Med, Houston Vet Affairs Med Ctr, Dept Phys Med & Rehabil, Rehabil Care Line, Houston, TX 77030 USA. NR 81 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND S R L PI 40128 BOLOGNA PA VIA MASERATI 5, 40128 BOLOGNA, 00000, ITALY BN 88-323-3122-5 PY 2003 BP 345 EP 354 PG 10 WC Clinical Neurology; Orthopedics; Rehabilitation SC Neurosciences & Neurology; Orthopedics; Rehabilitation GA BX05W UT WOS:000184146600042 ER PT J AU Shulman, DG AF Shulman, DG TI Two mast cell stabilizers, pemirolast potassium 0.1% and nedocromil sodium 2%, in the treatment of seasonal allergic conjunctivitis: A comparative study SO ADVANCES IN THERAPY LA English DT Article DE seasonal allergic conjunctivitis; allergen challenge; pemirolast; nedocromil; comfort ID CHALLENGE; TILAVIST AB This randomized, double-masked, active-control, parallel-group trial compared the mast cell stabilizers pemirolast potassium 0.1% and nedocromil sodium 2% in the treatment of seasonal allergic conjunctivitis. Pemirolast is currently indicated for four-times-daily-administration, nedocromil, for twice-daily dosing. Both ophthalmic solutions were instilled bilaterally twice a day for 8 weeks. The study involved four office visits and two telephone contacts. Participants evaluated their symptoms daily in take-home diaries (itching was the primary efficacy variable) and completed questionnaires to assess comfort. Of a total enrollment of 80, 78 patients completed the study. No significant differences were found between pemirolast and nedocromil on any signs or symptoms of allergic conjunctivitis (redness, chemosis, itching, eyelid swelling). At each visit, pemirolast was rated significantly more comfortable than nedocromil. A significantly higher percentage of the pemirolast group experienced no signs or symptoms at work or school (58% vs 28%; P=.005). The number of adverse events did not differ significantly between groups. Twice-daily administration of pemirolast potassium was as efficacious and safe as twice-daily nedocromil sodium in the 8-week treatment of ragweed allergic conjunctivitis and was superior to nedocromil in comfort. Increased comfort with pemirolast may increase patient satisfaction and compliance with therapy. C1 Univ Texas Hlth Ctr, Audie L Murphy Vet Adm Hosp, Dept Ophthalmol, San Antonio, TX USA. RP Shulman, DG (reprint author), 999 E Basse Rd,Suite 127, San Antonio, TX 78209 USA. NR 16 TC 2 Z9 3 U1 1 U2 1 PU HEALTH COMMUNICATIONS INC PI EDISON PA 292 FERNWOOD AVE, EDISON, NJ 08837 USA SN 0741-238X J9 ADV THER JI Adv. Ther. PD JAN-FEB PY 2003 VL 20 IS 1 BP 31 EP 40 DI 10.1007/BF02850117 PG 10 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 676VL UT WOS:000182773200004 PM 12772816 ER PT J AU Graf, LL Welsh, CH Qamar, Z Marlar, RA AF Graf, LL Welsh, CH Qamar, Z Marlar, RA TI Activated protein C resistance assay detects thrombotic risk factors other than factor V Leiden SO AMERICAN JOURNAL OF CLINICAL PATHOLOGY LA English DT Article DE activated protein C resistance; case-control study; factor V Leiden; factor VIII; HR2 haplotype; venous thromboembolism ID POOR ANTICOAGULANT RESPONSE; VENOUS THROMBOSIS; HR2 HAPLOTYPE; MUTATION; THROMBOEMBOLISM; THROMBOPHILIA; SENSITIVITY; R506Q; GENE; DNA AB Activated protein C (APC) resistance is a common risk factor for venous thromboembolism (VTE) attributed to various mechanisms, including factor V Leiden (FVL) polymorphism. FVL is considered responsible for up to 95% of APC resistance; however, other factor V polymorphisms and elevated factor VIII levels also have been implicated. We assessed whether additional mechanisms contribute to APC resistance in a blinded case-control study of 65 subjects by measuring APC resistance using 3 methods: 2 activated partial thromboplastin time-based methods with and without dilution in factor V-deficient plasma and I Russell viper venom-based assay (RVV). Without factor V-deficient plasma, 24 subjects were APC resistant; with factor V-deficient plasma, the assay identified fewer APC-resistant subjects, as did RVV All assays detected the 7 heterozygous FVL subjects. Thirteen subjects had factor VIII levels above 150% (1.50). After excluding subjects with FVL or elevated factor VIII levels, 4 subjects still had APC resistance. VTE risk trended higher for subjects with APC resistance in the absence of FVL. Measurement of APC resistance without dilution in factor V-deficient plasma is needed to assess for potentially important, thrombotic risk factors other than FVL. C1 Denver Vet Affairs Med Ctr, Pathol Res Lab, Res Serv, Denver, CO USA. Denver Vet Affairs Med Ctr, Div Pulm & Crit Care Med, Med Serv, Denver, CO USA. Denver Vet Affairs Med Ctr, Pathol Res Lab, Pathol & Lab Med Serv, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Div Pulm Sci & Crit Care Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pathol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Biochem, Denver, CO 80262 USA. Aga Khan Univ, Sch Med, Karachi, Pakistan. RP Marlar, RA (reprint author), Denver Vet Affairs Med Ctr, Lab Serv 113, 1055 Clermont St, Denver, CO 80220 USA. NR 39 TC 23 Z9 24 U1 0 U2 0 PU AMER SOC CLINICAL PATHOLOGY PI CHICAGO PA 2100 W HARRISON ST, CHICAGO, IL 60612 USA SN 0002-9173 J9 AM J CLIN PATHOL JI Am. J. Clin. Pathol. PD JAN PY 2003 VL 119 IS 1 BP 52 EP 60 DI 10.1092/LX9E6Y043P58YVCL PG 9 WC Pathology SC Pathology GA 630VN UT WOS:000180131000007 PM 12520697 ER PT J AU Hu, Y Shahidi, A Park, S Guilfoyle, D Hirshfield, I AF Hu, Y Shahidi, A Park, S Guilfoyle, D Hirshfield, I TI Detection of extrahepatic hepatitis C virus replication by a novel, highly sensitive, single-tube nested polymerase chain reaction SO AMERICAN JOURNAL OF CLINICAL PATHOLOGY LA English DT Article DE hepatitis C virus; lymphocyte; complementary DNA; PCR; polymerase chain reaction; nested PCR; DNA sequencing ID BLOOD MONONUCLEAR-CELLS; FOLLOW-UP; RNA; INFECTION; STRAND; LINE; PCR; ASSAY; LIVER AB We established a cell culture system for the replication of hepatitis C virus (HCV) by using human T and B leukemia cell lines. These 2 cell lines were infected in vitro by using HCV-positive pooled patient serum samples. HCV RNA was extracted from infected cell lines at different times after infection, and a sequence of the virus 5' untranslated region was analyzed. Hepatitis C minus-strand RNA was detected in the infected cell lines by highly strand-specific rTth (recombinant Thermus thermophilus DNA polymerase)based reverse transcription followed by a novel, highly sensitive, single-tube nested polymerase chain reaction (PCR) method. PCR products were analyzed by direct DNA sequencing. These results indicate that the HCV can replicate in T and B lymphocytes. This model should represent a valuable tool for the detailed study of the initial steps of the HCV replication cycle and for the evaluation of antiviral molecules. C1 US FDA, Microbiol Sci Branch, NE Reg Lab, Jamaica, NY 11433 USA. US Dept Vet Affairs, Med Ctr, Clin Microbiol Lab, Bronx, NY USA. St Johns Univ, Dept Biol Sci, Jamaica, NY 11439 USA. RP Hu, Y (reprint author), US FDA, Microbiol Sci Branch, NE Reg Lab, 158-15 Liberty Ave, Jamaica, NY 11433 USA. NR 33 TC 30 Z9 31 U1 0 U2 1 PU AMER SOC CLINICAL PATHOLOGY PI CHICAGO PA 2100 W HARRISON ST, CHICAGO, IL 60612 USA SN 0002-9173 J9 AM J CLIN PATHOL JI Am. J. Clin. Pathol. PD JAN PY 2003 VL 119 IS 1 BP 95 EP 100 DI 10.1092/MG0L7NK6P9WE37RJ PG 6 WC Pathology SC Pathology GA 630VN UT WOS:000180131000013 PM 12520703 ER PT J AU Provenzale, D Ofman, J Gralnek, I Rabeneck, L Koff, R McCrory, D AF Provenzale, D Ofman, J Gralnek, I Rabeneck, L Koff, R McCrory, D TI Gastroenterologist specialist care and care provided by generalists - An evaluation of effectiveness and efficiency SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Review ID HELICOBACTER-PYLORI; PHYSICIAN SPECIALTY; COLORECTAL-CANCER; MANAGEMENT; OUTCOMES; KNOWLEDGE; INFECTION; PATTERNS; THERAPY; FAILURE AB OBJECTIVE In this era of cost containment, gastroenterologists must demonstrate that they provide effective and efficient care. The aim of this study was to evaluate the process and outcomes of care provided by gastroenterologists and generalist physicians (internists, family physicians, general surgeons) for GI conditions. METHODS: We conducted a systematic literature review using a MEDLINE search of English language articles (January 1980 to September 1998). A total of 2157 articles were identified; 10 met inclusion criteria for systematic review. In addition, there were nine articles that described the results of physician surveys, and examined the process of care among gastroenterologists and generalist physicians. RESULTS: Care provided by gastroenterologists for GI bleeding and diverticulitis resulted in significantly shorter length of hospital stay. Gastroenterologists diagnosed celiac disease more accurately than generalists, and more adequately diagnosed colorectal cancer and prescribed antimicrobials for peptic ulcer disease. There was no difference between gastroenterologists and generalists in terms of colonoscopy procedure time, and family physicians detected a greater number of cancers. Furthermore, there was no difference in the outcomes of gastroesophageal reflux disease therapy in patients seen by gastroenterologists, versus those educated by nurses. The survey articles suggested that gastroenterologists were more likely to test and treat for Helicobacter pylori in patients with peptic ulcer disease, and were more likely recommended for medical versus surgical therapy. Gastroenterologists had a lower threshold for ordering ERCP before cholecystectomy than surgeons, but had similar responses regarding indications for surgery in inflammatory bowel disease. Finally, primary care physicians were less likely to associate symptoms of profuse watery diarrhea with cryptosporidium infection compared with gastroenterologists and infectious disease specialists. CONCLUSIONS: We reached the following conclusions: 1) The results suggest that gastroenterologists deliver effective and efficient care for GI bleeding and diverticulitis and provide more effective diagnosis in certain disorders. 2) Studies are limited by retrospective design, small sample size, and lack of control groups. 3) To fully evaluate care by gastroenterologists, prospective comparisons with greater attention to methodology are needed. (C) 2003 by Am. Coll. of Gastroenterology. C1 Duke Univ, Med Ctr, Div Gastroenterol, GI Outcomes Res Grp, Durham, NC 27710 USA. Durham VA Med Ctr, Div Gastroenterol, Durham, NC USA. Cedars Sinai Hlth Syst, Beverly Hills, CA USA. VA Greater Los Angeles Healthcare Syst, Div Gastroenterol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Div Digest Dis, Los Angeles, CA 90024 USA. CURE, Digest Dis Res Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Ctr Study Disgest Healthcare Qual & Outcomes, CURE, Los Angeles, CA USA. VA Med Ctr, Houston, TX USA. Univ Massachusetts, Worcester, MA 01605 USA. Duke Univ, Evidence Based Med Ctr, Durham, NC USA. Ctr Hlth Policy Res, Durham, NC USA. RP Provenzale, D (reprint author), Duke Univ, Med Ctr, Div Gastroenterol, GI Outcomes Res Grp, Box 3515, Durham, NC 27710 USA. FU NCI NIH HHS [1 K24 CA83885-01] NR 33 TC 22 Z9 22 U1 0 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 2003 VL 98 IS 1 BP 21 EP 28 AR PII S0002-9270(02)05876-8 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 639NQ UT WOS:000180636400006 PM 12526931 ER PT J AU Spiegel, BMR Ofman, JJ Woods, K Vakil, NB AF Spiegel, BMR Ofman, JJ Woods, K Vakil, NB TI Minimizing recurrent peptic ulcer hemorrhage after endoscopic hemostasis: The cost-effectiveness of competing strategies SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT Digestive Disease Week Meeting/Annual Meeting of the American-Gastroenterology-Association CY MAY 19-23, 2002 CL SAN FRANCISCO, CALIFORNIA SP Amer Gastroenterol Assoc ID PROSPECTIVE RANDOMIZED TRIAL; HEATER PROBE THERMOCOAGULATION; HYPERTONIC SALINE-EPINEPHRINE; NONBLEEDING VISIBLE VESSEL; ACTIVELY BLEEDING ULCERS; INJECTION THERAPY; ADRENALINE INJECTION; FIBRIN GLUE; LASER PHOTOCOAGULATION; ETHANOLAMINE OLEATE AB OBJECTIVES: Controversy exists regarding the optimal strategy to minimize recurrent ulcer hemorrhage after successful endoscopic hemostasis. Our objective was to evaluate the cost-effectiveness of competing strategies for the posthemostasis management of patients with high risk ulcer stigmata. METHODS: Through decision analysis, we calculated the cost-effectiveness of four strategies: 1) follow patients clinically after hemostasis and repeat endoscopy only in patients with evidence of rebleeding (usual care); 2) administer intravenous proton pump inhibitors (i.v. PPIs) after hemostasis and repeat endoscopy only in patients with clinical signs of rebleeding; 3) perform second look endoscopy at 24 h in all patients with successful endoscopic hemostasis; and 4) perform selective second look endoscopy at 24 h only in patients at high risk for rebleeding as identified by the prospectively validated Baylor Bleeding Score. Probability estimates were derived from a systematic review of the medical literature. Cost estimates were based on Medicare reimbursement. Effectiveness was defined as the proportion of patients with rebleeding, surgery, or death prevented. RESULTS: The selective second look endoscopy strategy was the most effective and least expensive of the four competing strategies, and therefore dominated the analysis. The i.v. PPI strategy required 50% fewer endoscopies than the competing strategies, and became the dominant strategy when the rebleed rate with i.v. PPIs fell below 9% and when the cost of i.v. PPIs fell below $10/day. CONCLUSIONS: Compared with the usual practice of "watchful waiting," performing selective second look endoscopy in high risk patients may prevent more cases of rebleeding, surgery, or death at a lower overall cost. However, i.v. PPIs are likely to reduce the need for second look endoscopy and may be preferred overall if the rebleed rate and cost of i.v. PPIs remains low. (C) 2003 by Am. Coll. of Gastroenterology. C1 Univ Wisconsin, Sch Med, Aurora Sinai Med Ctr, Dept Gastroenterol, Milwaukee, WI 53233 USA. Univ Calif Los Angeles, Sch Med, Dept Digest Dis, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Div Gastroenterol, Los Angeles, CA USA. Ctr Study Digest Healthcare Qual & Outcomes, Los Angeles, CA USA. Cedars Sinai Med Ctr, Div Gastroenterol & Hlth Serv Res, Los Angeles, CA 90048 USA. Zynx Hlth Inc, Los Angeles, CA USA. Baylor Coll Med, Div Gastroenterol, Houston, TX 77030 USA. RP Vakil, NB (reprint author), Univ Wisconsin, Sch Med, Aurora Sinai Med Ctr, Dept Gastroenterol, 945 N 12th St,Room 4040, Milwaukee, WI 53233 USA. NR 52 TC 62 Z9 64 U1 0 U2 0 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 2003 VL 98 IS 1 BP 86 EP 97 AR PII S0002-9270(02)05831-8 PG 12 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 639NQ UT WOS:000180636400017 PM 12526942 ER PT J AU El-Serag, HB Anand, B Richardson, P Rabeneck, L AF El-Serag, HB Anand, B Richardson, P Rabeneck, L TI Association between hepatitis C infection and other infectious diseases: A case for targeted screening? SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID OF-VETERANS-AFFAIRS; VIRUS-INFECTION; BACTERIAL-INFECTIONS; MONONUCLEAR-CELLS; LIVER-DISEASE; CIRRHOSIS; SYSTEM; HIV; RECIPIENTS; RECORDS AB OBJECTIVE: Hepatitis C virus (HCV) shares risk factors and routes of transmission with several other infectious agents. However, the prevalence of comorbid infectious disorders among HCV-infected patients remains unknown. To analyze the association between HCV and several categories of infectious disorders, we carried out a case-control study using information from 172 hospitals contained in the computerized databases of the Department of Veterans Affairs. METHODS: We identified all HCV-infected patients who were hospitalized during 1992-1999. For each case, four control subjects without HCV were randomly chosen from hospitalized patients and were matched with cases on the year of admission. The frequencies of several predefined infectious disease diagnoses were compared between cases and control subjects, and the strength of these associations were assessed in multivariable logistic regression analyses. RESULTS: We identified 34,204 HCV-infected patients (cases) and 136,816 control subjects without HCV. Patients in the case group were younger (48.4 yr vs 59.8 yr), were more frequently nonwhite (38.5% vs 26.5%), and were more likely to have served in Vietnam (68.1% vs 33.0%); all p < 0.0001. Compared with control subjects, patients with HCV had a significantly higher prevalence of other blood-borne virus infections, including HIV (14.1% vs 3.0%) and hepatitis B (22.4% vs 0.7%); immunodeficiency-related infections, including cytomegalovirus (0.6% vs 0.2%), toxoplasmosis (0.3% vs 0.1%), cryptococcosis (0.4% vs 0.1%), and tuberculosis (3.3% vs 1.3%); sexually transmitted diseases, including gonococcus (0.5% vs 0.1%), chlamydia (1.6% vs 0.7%), syphilis (2.0% vs 0.6%), and genital herpes (1.0% vs 0.3%); and bacterial infection, including peritonitis, sepsis, endocarditis, cellulitis, and carbuncles (all p < 0.0001). After excluding potentially immunocompromised patients, including those with HIV, organ transplant, and cirrhosis, HCV remained significantly associated with CMV, cryptococcus, tuberculosis, and sexually transmitted diseases. Similar results were obtained when the analyses were restricted to Vietnam-era veterans. CONCLUSIONS: Several infectious diseases are more common among HCV-infected patients compared with those without HCV infection. These findings support an approach of targeted screening for HCV among patients with these infectious diseases. (Am J Gastroenterol 2003;98:167-174. (C) 2003 by Am. Coll. of Gastroenterology). C1 Houston Vet Affairs Med Ctr, HSR&D 152, Gastroenterol Sect, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr, HSR&D 152, Gastroenterol Sect, 2002 Holcombe Blvd, Houston, TX 77030 USA. FU NIDDK NIH HHS [1 K24 DK 59318-01] NR 25 TC 50 Z9 52 U1 1 U2 4 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 2003 VL 98 IS 1 BP 167 EP 174 AR PII S0002-9270(02)05844-6 DI 10.1016/S0002-9270(02)05844-6 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 639NQ UT WOS:000180636400028 PM 12526953 ER PT J AU Yang, H Shi, MJ VanRemmen, H Chen, XL Vijg, J Richardson, A Guo, ZM AF Yang, H Shi, MJ VanRemmen, H Chen, XL Vijg, J Richardson, A Guo, ZM TI Reduction of pressor response to vasoconstrictor agents by overexpression of catalase in mice SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Article DE catalase; hydrogen peroxide; transgenic mouse; blood pressure ID MUSCLE CELL-PROLIFERATION; ARTERIAL SMOOTH-MUSCLE; HYDROGEN-PEROXIDE; ANGIOTENSIN-II; OXIDATIVE STRESS; RAT AORTA; ESSENTIAL-HYPERTENSION; SUPEROXIDE PRODUCTION; BLOOD-PRESSURE; CONTRACTION AB Background: Hydrogen peroxide (H2O2) has been shown to induce vascular smooth muscle cell contraction in vitro. In this study, the effect of endogenously produced H2O2 on blood pressure (BP) was examined using a transgenic mouse model (hCatTg(+/0)) in which catalase is overexpressed. Methods: The hCatTg(+/0) and wild-type mice received a bolus injection of norepinephrine (NE; 1 mug/g) or angiotensin II (Ang II 0.5 mug/g), or an osmotic minipump infusion of NE (2.5 mug/g/day) or Ang II (0.5 mug/g/day) for 7 days. Systolic BP (SBP) was measured using a tail-cuff apparatus. H2O2 release from mouse aortas was measured using an H2O2 assay kit. Results: The hCatTg(+/0) and wild-type mice showed similar basal levels of systolic BP (SBP) and H2O2 release from the aorta. A bolus injection of NE or Ang II increased SBP 31 +/- 5 and 37 +/- 6 mm Hg, respectively, in wild-type mice. In contrast, same doses of NE and Ang II increased SBP only 15 +/- 3 and 17 +/- 4 min Hg, respectively, in hCatTg(+/0) mice. Osmotic minipump infusion of NE or Ang II increased SBP by approximately 30 mm Hg in wild-type mice, but only by about 10 mm Hg in hCatTg(+/0) mice. The addition of NE or Ang II to the incubation media significantly increased H2O2 release from the aortic segment of wild-type mice but did not alter H2O2 release from the aortic segment of hCatTg(+/0) mice. Conclusion: Overexpression of catalase diminishes the pressor response to NE and Ang II by reducing H2O2 production in the arterial wall. C1 Meharry Med Coll, Dept Physiol & Anat, Nashville, TN 37208 USA. Meharry Med Coll, Dept Internal Med, Nashville, TN 37208 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Guo, ZM (reprint author), Meharry Med Coll, Dept Physiol & Anat, Nashville, TN 37208 USA. FU NIA NIH HHS [P30 AG013319, P01 AG13319, P01 AG020591, AG 16998, P03 AG13319] NR 30 TC 17 Z9 19 U1 0 U2 1 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 2003 VL 16 IS 1 BP 1 EP 5 AR PII S0895-7061(02)03086-8 DI 10.1016/S0895-7061(02)03086-8 PG 5 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 634EE UT WOS:000180326400001 PM 12517675 ER PT J AU Watnick, S Kirwin, P Mahnensmith, R Concato, J AF Watnick, S Kirwin, P Mahnensmith, R Concato, J TI The prevalence and treatment of depression among patients starting dialysis SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE depression; end-stage renal disease (ESRD); dialysis; prevalence; Beck Depression Inventory (BDI) ID STAGE RENAL-DISEASE; QUALITY-OF-LIFE; HEMODIALYSIS-PATIENTS; PERITONEAL-DIALYSIS; BEHAVIORAL COMPLIANCE; MAJOR DEPRESSION; ILLNESS; EVENTS; PERCEPTION; MORTALITY AB Background: Depression is common in patients with end-stage renal disease (ESRD) and is associated with increased mortality, but little is known about depression in patients just after they start dialysis therapy. We sought to assess the prevalence of depressive symptoms in patients with ESRD starting dialysis therapy, identify patient characteristics associated with depression, and determine whether patients with serious depressive symptoms were receiving treatment. Methods: We implemented a multicenter prospective cohort study at 14 dialysis centers in Connecticut. Patients with ESRD who were 18 years and older were interviewed within 10 days of initiating dialysis therapy between November 2000 and July 2001. The Beck Depression Inventory (BDI) was used to assess depressive symptoms. Chi-square tests were used to evaluate associations between several patient characteristics and depression, and multivariable logistic regression models were used to determine odds ratios (ORs) for depression, with adjustment for baseline variables. Results: Among 123 patients, 44% (54 of 123 patients) had scores above the validated cutoff value in the BDI for depression. In logistic regression analysis, depression was statistically significantly associated with Caucasian race (OR, 3.4; P = 0.02), lower self-rated quality of life (OR, 2.2; P = 0.003), and no previous acquaintances on dialysis therapy (OR, 10.2; P = 0.03). Only 16% (9 of 54 patients) of depressed patients were being treated at enrollment; 13% (5 of 38 patients) of those with mild symptoms and 25% (4 of 16 patients) with more severe symptoms were being treated. Conclusion: Our results show that depressive symptoms are very common at the start of dialysis therapy, and specific characteristics are associated with a greater burden of depressive symptoms. Despite a high prevalence, treatment rates are low, even among patients with moderate to severe symptoms of depression. C1 Yale Univ, Sch Med, Dept Med, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. Vet Affairs Connecticut Healthcare Syst, Dept Psychiat, West Haven, CT USA. Vet Affairs Connecticut Healthcare Syst, Clin Epidemiol Unit, West Haven, CT USA. RP Watnick, S (reprint author), Portland VA Med Ctr, 3710 SW US Vet Hosp Rd,P3NEPH, Portland, OR 97207 USA. NR 33 TC 185 Z9 192 U1 3 U2 8 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 JAN PY 2003 VL 41 IS 1 BP 105 EP 110 DI 10.1053/ajkd.2003.50029 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 631HB UT WOS:000180161100012 PM 12500227 ER PT J AU O'Hare, AM Bacchetti, P Segal, M Hsu, CY Johansen, KL AF O'Hare, AM Bacchetti, P Segal, M Hsu, CY Johansen, KL TI Factors associated with future amputation among patients undergoing hemodialysis: Results from the dialysis morbidity and mortality study waves 3 and 4 SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE amputation; dialysis; risk factors; phosphorus; peripheral vascular disease (PVD); diabetes; prevention; screening ID LOWER-EXTREMITY AMPUTATIONS; STAGE RENAL-DISEASE; RISK-FACTORS; POPULATION AB Background: Amputation is more common in hemodialysis patients than in the general population, but risk factors for amputation in this population have not been studied extensively. Methods: We used the US Renal Data System Dialysis Morbidity and Mortality Study Waves 3 and 4 in combination with Medicare discharge data to identify factors associated with lower-extremity amputation (excluding toe amputations) in hemodialysis patients. We used stepwise multivariable logistic regression analysis to identify variables most strongly associated with amputation within 2 years of the study start date. Results: Male sex, diabetes, previous diagnosis of peripheral vascular disease (PVD), mean systolic blood pressure, and elevated serum phosphorus level were associated with the outcome of amputation within 2 years of the study start date. Among patients without diabetes, a previous diagnosis of cardiac disease, longer time from initiation of dialysis therapy (vintage), and previous hospitalization for limb ischemia were associated with increased risk for future amputation. Conclusion: The importance of preventing amputation in this population cannot be overemphasized. The strength of the association of amputation with PVD makes a strong case for screening all dialysis patients for this disease. The association of amputation with serum phosphorus level reported here should be explored further because this may offer an avenue for future intervention to reduce amputation rates. C1 Univ Calif San Francisco, Div Nephrol, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, Dept Med, San Francisco, CA USA. RP O'Hare, AM (reprint author), Univ Calif San Francisco, Div Nephrol, Dept Med, 400 Parnassus Ave,672 HSE,Box 532, San Francisco, CA 94143 USA. NR 24 TC 32 Z9 32 U1 0 U2 1 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 JAN PY 2003 VL 41 IS 1 BP 162 EP 170 DI 10.1053/ajkd.2003.50000 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 631HB UT WOS:000180161100018 PM 12500233 ER PT J AU Johansen, KL Sakkas, GK Doyle, J Shubert, T Dudley, RA AF Johansen, KL Sakkas, GK Doyle, J Shubert, T Dudley, RA TI Exercise counseling practices among nephrologists caring for patients on dialysis SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE exercise; counseling; preventive services; physical activity ID PHYSICAL-ACTIVITY; PRIMARY-CARE; INTERNISTS; PRACTITIONERS; HEMODIALYSIS; PROMOTION; DELIVERY AB Background: Patients on dialysis therapy are inactive, are at high risk for conditions that can be prevented or ameliorated by exercise, and often receive most of their care from their nephrologist. Exercise counseling by physicians can increase patients' levels of physical activity. The aim of the study is to determine the frequency of exercise assessment and counseling among practicing nephrologists, characteristics of nephrologists who provide exercise counseling to their dialysis patients, and barriers to exercise counseling perceived by nephrologists. Methods: A 25-item survey regarding exercise counseling was administered to nephrologists attending the World Congress of Nephrology meeting in 2001. Results: Five hundred five nephrologists completed the survey. Overall, 38% reported "almost always" or "often" assessing patient level of physical activity and counseling inactive patients to increase activity. Older (P < 0.0001), more active (P = 0.033), and women (P = 0.018) nephrologists, as well as those who provided primary care to more of their patients (P = 0.007), were more likely to provide exercise counseling. Nephrologists who do not provide routine counseling were more likely to endorse lack of time (P < 0.0001), lack of confidence in their ability to counsel patients (P < 0.0001), and lack of conviction that patients will respond as barriers to counseling (P = 0.01). In addition, noncounseling nephrologists were more likely to believe that other medical issues were more important than exercise (P = 0.01). Conclusion: Rates of exercise counseling among nephrologists are low, although dialysis patients are a high-risk group unlikely to receive advice about exercise from other health care providers. The low rates of counseling, particularly among younger nephrologists, could be addressed by including information about counseling in fellowship training and/or practice guidelines for the care of patients on dialysis therapy. C1 San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Inst Hlth Policy Studies, San Francisco, CA 94143 USA. No Calif Inst Res & Educ, San Francisco, CA USA. RP Johansen, KL (reprint author), San Francisco VA Med Ctr, Dept Med, Nephrol Sect 111J,4150 Clement St, San Francisco, CA 94121 USA. OI Sakkas, Giorgos/0000-0002-2462-995X FU NIDDK NIH HHS [R01-DK-56182] NR 31 TC 61 Z9 63 U1 0 U2 1 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 JAN PY 2003 VL 41 IS 1 BP 171 EP 178 DI 10.1053/ajkd.2003.50001 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 631HB UT WOS:000180161100019 PM 12500234 ER PT J AU Zimmerman, RK Santibanez, TA Janosky, JE Fine, MJ Raymund, M Wilson, SA Bardella, IJ Medsger, AR Nowalk, MP AF Zimmerman, RK Santibanez, TA Janosky, JE Fine, MJ Raymund, M Wilson, SA Bardella, IJ Medsger, AR Nowalk, MP TI What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID RISK; BEHAVIOR; PREVENTION; MODEL; QUESTIONNAIRE; OUTPATIENTS; VALIDATION; ADULTS; COST AB BACKGROUND: Despite strong evidence of the effectiveness of influenza vaccination, immunization rates have reached a plateau that is below the 20 10 national goals. Our objective was to identify facilitators of, and barriers to, vaccination in diverse groups of older patients. METHODS: A survey was conducted in 2000 by computer-assisted telephone interviewing of patients from inner-city health centers, Veterans Affairs (VA) outpatient clinics, rural practices, and suburban practices. The inclusion criteria were age greater than or equal to66 years and an office visit after September 30, 1998. RESULTS: Overall, 1007 (73%) interviews were completed among 1383 patients. Influenza vaccination rates were 91% at VA clinics, 79% at rural practices, 79% at suburban practices, and 67% at inner-city.health centers. There was substantial variability in vaccination rates among practices, except at the VA. Nearly all persons who were vaccinated reported that their physician recommended influenza vaccinations, compared with 63% of unvaccinated patients (P <0.001). Thirty-eight percent of unvaccinated patients were concerned that they would get influenza from the vaccine, compared with only 6% of vaccinated persons (P <0.001). Sixty-three percent of those vaccinated, in contrast with 22% of unvaccinated persons, thought that an unvaccinated person would probably contract influenza (P <0.001). CONCLUSION: Older patients need intentional messages from physicians that recommend vaccination. Furthermore, more patient education is needed to counter myths about adverse reactions. (C) 2003 by Excerpta Medica Inc. C1 Univ Pittsburgh, Sch Med, Dept Clin Epidemiol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Hlth Serv Adm, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, St Margaret Family Practice Residency, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Div Gen Internal Med, Pittsburgh, PA USA. Vet Affairs Ctr Study Hlth Dispar, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Family Med, Pittsburgh, PA USA. RP Zimmerman, RK (reprint author), Univ Pittsburgh, Sch Med, Dept Family Med & Clin Epidemiol, 3518 5th Ave, Pittsburgh, PA 15261 USA. OI Zimmerman, Richard/0000-0001-5941-6092 FU AHRQ HHS [HS09874] NR 40 TC 125 Z9 129 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 PY 2003 VL 114 IS 1 BP 31 EP 38 DI 10.1016/S0002-9343(02)01421-3 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 638PL UT WOS:000180579400007 PM 12543287 ER PT J AU Selinger, RRE Norman, S Dominitz, JA AF Selinger, RRE Norman, S Dominitz, JA TI Failure of health care professionals to interpret fecal occult blood tests accurately SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID COLORECTAL-CANCER C1 VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. Univ Washington, Sch Med, Div Gastroenterol, Dept Med, Seattle, WA USA. Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. Univ Washington, Sch Med, Dept Pathol & Lab Med, Seattle, WA USA. Univ Washington, Sch Med, Gastroenterol Sect, Seattle, WA USA. RP Dominitz, JA (reprint author), VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, 111-S Gastro,1660 S Columbian Way, Seattle, WA 98108 USA. OI Dominitz, Jason/0000-0002-8070-7086 NR 14 TC 23 Z9 23 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 JAN PY 2003 VL 114 IS 1 BP 64 EP 67 DI 10.1016/S0002-9343(02)01350-5 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 638PL UT WOS:000180579400014 PM 12543293 ER PT J AU Gee, MS Procopio, WN Makonnen, S Feldman, MD Yeilding, NM Lee, WMF AF Gee, MS Procopio, WN Makonnen, S Feldman, MD Yeilding, NM Lee, WMF TI Tumor vessel development and maturation impose limits on the effectiveness of anti-vascular therapy SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID ENDOTHELIAL-CELL SURVIVAL; MALIGNANT-MELANOMA; PDGF-B; ANGIOGENESIS; INHIBITION; PERICYTE; RESISTANCE; CANCER; VEGF; MICE AB The effect of anti-vascular agents on the growth of experimental tumors is well studied. Their impact on tumor vasculature, the primary therapeutic target of these agents, is not as well characterized, even though this primarily determines treatment outcome. Hypothesizing that the response of vessels to therapy is influenced by their stage of maturation, we studied vascular development and the vascular effects of therapy in several transplanted murine tumor models. Based on size, perfusion, endothelial cell (EC) proliferation, and the presence of pericytes, tumor vessels segregated into three categories. Least mature were highly proliferative, nonperfused EC sprouts emanating from functional vessels. intermediate were small, perfused vessels which, like the angiogenic sprouts, were not covered by pericytes. Most mature were larger vessels, which were predominantly pericyte-covered with quiescent ECs and few associated sprouts. Thus, a developmental order, similar to that described during physiological neovascularization, was evident among vessels in growing rumors. This order markedly influenced tumor vessel response to anti-vascular therapy with recombinant interleukin-12. Therapy reduced tumor vessel density, which was attributable to a decrease in angiogenic sprouts and induction of EC apoptosis in pericyte-negative vessels. Although the great majority of vessels in growing tumors lacked pericyte coverage, selective loss of less mature vessels with therapy significantly increased the fraction of pericyte-positive vessels after therapy. These data indicate that the therapeutic susceptibility of tumor vasculature to recombinant murine IL-12 and, potentially, other anti-vascular agents is limited by its level of maturation. An implication is that tumor susceptibility is similarly limited, making pericyte coverage of tumor vasculature a potential indicator of tumor responsiveness. C1 Univ Penn, Biomed Grad Program, Dept Med, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. Univ Penn, Ctr Canc, Sch Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Lee, WMF (reprint author), BRB 2-3,Room 312,421 Curie Blvd, Philadelphia, PA 19104 USA. FU NCI NIH HHS [R01 CA077851, CA 83042, R01 CA 77851]; NIDDK NIH HHS [P30 DK050306] NR 30 TC 143 Z9 156 U1 0 U2 3 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 2003 VL 162 IS 1 BP 183 EP 193 DI 10.1016/S0002-9440(10)63809-6 PG 11 WC Pathology SC Pathology GA 628RG UT WOS:000180009800019 PM 12507901 ER PT J AU Cook, DG Leverenz, JB McMillan, PJ Kulstad, JJ Ericksen, S Roth, RA Schellenberg, GD Jin, LW Kovacina, KS Craft, S AF Cook, DG Leverenz, JB McMillan, PJ Kulstad, JJ Ericksen, S Roth, RA Schellenberg, GD Jin, LW Kovacina, KS Craft, S TI Reduced hippocampal insulin-degrading enzyme in late-onset Alzheimer's disease is associated with the apolipoprotein E-epsilon 4 allele SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID AMYLOID PRECURSOR PROTEIN; BETA-PROTEIN; EXTRACELLULAR LEVELS; DIABETES-MELLITUS; E GENOTYPE; DEGRADATION; BRAIN; NEPRILYSIN; DEMENTIA; CHROMOSOME-10 AB A,6 is the major component of amyloid plaques characterizing Alzheimer's disease (AD). Abeta accumulation can be affected by numerous factors including increased rates of production and/or impaired clearance. Insulin-degrading enzyme (IDE) has been implicated as a candidate enzyme responsible for the degradation and clearance of Abeta in the brain. We have previously shown that AD patients exhibit abnormalities in insulin metabolism that are associated with apoliprotein E (APOE) status. The possible association of IDE with AD, as well as the link between APOE status and insulin metabolism, led us to examine the expression of IDE in AD. We report that hippocampal IDE protein is reduced by approximately 50% in epsilon4+ AD patients compared to epsilon4- patients and controls. The allele-specific decrease of IDE in epsilon4+ AD patients is not associated with neuronal loss since neuronspecific enolase levels were comparable between the AD groups, regardless of APOE status. Hippocampal IDE mRNA levels were also reduced in AD patients with the epsilon4 allele compared to AD and normal subjects without the epsilon4 allele. These findings show that reduced IDE expression is associated with a significant risk factor for AD and suggest that IDE may interact with APOE status to affect Abeta metabolism. C1 Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Pharmacol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. Univ Washington, Sch Med, Dept Pathol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Psychol, Seattle, WA USA. Stanford Univ, Sch Med, Dept Mol Pharmacol, Stanford, CA 94305 USA. RP Craft, S (reprint author), VA Puget Sound Hlth Care Syst, GRECC S-182,1660 S Columbian Way, Seattle, WA 98108 USA. FU NIA NIH HHS [AG05136, P50 AG005136] NR 36 TC 202 Z9 215 U1 0 U2 6 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 2003 VL 162 IS 1 BP 313 EP 319 DI 10.1016/S0002-9440(10)63822-9 PG 7 WC Pathology SC Pathology GA 628RG UT WOS:000180009800032 PM 12507914 ER PT J AU Voland, P Weeks, DL Marcus, EA Prinz, C Sachs, G Scott, D AF Voland, P Weeks, DL Marcus, EA Prinz, C Sachs, G Scott, D TI Interactions among the seven Helicobacter pylori proteins encoded by the urease gene cluster SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE yeast two-hybrid; urease assembly; protein interactions ID KLEBSIELLA-AEROGENES UREASE; IN-VIVO; APOPROTEIN COMPLEXES; GNOTOBIOTIC PIGLETS; FUNCTIONAL-ANALYSIS; ACID RESISTANCE; 2-HYBRID; PH; ACTIVATION; GASTRITIS AB Survival of Helicobacter pylori in acid depends on intrabacterial urease. This urease is a Ni2+-containing oligomeric heterodimer. Regulation of its activity and assembly is important for gastric habitation by this neutralophile. The gene complex encodes catalytic subunits (ureA/B), an acid-gated urea channel (ureI), and accessory assembly proteins (ureE-H). With the use of yeast two-hybrid analysis for determining protein-protein interactions, UreF as bait identified four interacting sequences encoding UreH, whereas UreG as bait detected five UreE sequences. These results were confirmed by coimmunoprecipitation and beta-galactosidase assays. Native PAGE immunoblotting of H. pylori inner membranes showed interaction of UreA/B with UreI, whereas UreI deletion mutants lacked this protein interaction. Deletion of ureE-H did not affect this interaction with UreI. Hence, the accessory proteins UreE/G and UreF/H form dimeric complexes and UreA/B form a membrane complex with UreI, perhaps enabling assembly of the urease apoenzyme at the membrane surface and immediate urea access to intrabacterial urease to allow rapid periplasmic neutralization. C1 Tech Univ Munich, Dept Med 2, D-81675 Munich, Germany. Univ Calif Los Angeles, Dept Physiol, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Hlth Syst, Los Angeles, CA 90073 USA. RP Voland, P (reprint author), Tech Univ Munich, Dept Med 2, Ismaningerstr 22,Bau 520,Rm 20-01-12, D-81675 Munich, Germany. FU NIDDK NIH HHS [DK-46917, DK-41301, DK-53462] NR 39 TC 63 Z9 66 U1 1 U2 8 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 PY 2003 VL 284 IS 1 BP G96 EP G106 DI 10.1152/ajpgi.00160.2002 PG 11 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 626JU UT WOS:000179868800011 PM 12388207 ER PT J AU Baicu, CF Stroud, JD Livesay, VA Hapke, E Holder, J Spinale, FG Zile, MR AF Baicu, CF Stroud, JD Livesay, VA Hapke, E Holder, J Spinale, FG Zile, MR TI Changes in extracellular collagen matrix alter myocardial systolic performance SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE hypertrophy; matrix metalloproteinases; heart failure; muscle; plasmin ID LEFT-VENTRICULAR DILATATION; HYPERTENSIVE HEART-DISEASE; AORTIC-VALVE DISEASE; PERFUSED RAT HEARTS; METALLOPROTEINASE INHIBITION; HYPERTROPHIED MYOCARDIUM; CONTRACTILE DYSFUNCTION; DILATED CARDIOMYOPATHY; FIBRILLAR COLLAGEN; FAILURE AB The purpose of this study was to test the hypothesis that acute disruption of fibrillar collagen will decrease myocardial systolic performance without changing cardiomyocyte contractility. Isolated papillary muscles were treated either with plasmin (0.64 U/ml, 240 min) or untreated and served as same animal control. Plasmin treatment caused matrix metalloproteinase activation and collagen degradation as measured by gelatin zymography, hydroxyproline assays, and scanning electron microscopy. Plasmin caused a significant decrease in myocardial systolic performance. Isotonic shortening extent and isometric developed tension decreased from 0.17 +/- 0.01 muscle length (ML) and 45 +/- 4 mN/mm(2) in untreated muscles to 0.09 +/- 0.01 ML and 36 +/- 3 mN/mm(2) in treated muscles (P < 0.05). However, plasmin treatment (0.64 U/ml, 240 min) did not alter shortening extent or velocity in isolated cardiomyocytes. Acute disruption of the fibrillar collagen network caused a decrease in myocardial systolic performance without changing cardiomyocyte contractility. These data support the hypothesis that fibrillar collagen facilitates transduction of cardiomyocyte contraction into myocardial force development and helps to maintain normal myocardial systolic performance. C1 Med Univ S Carolina, Dept Med, Div Cardiol, Gazes Cardiac Res Inst, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Surg, Div Cardiothorac Surg, Charleston, SC 29425 USA. RP Zile, MR (reprint author), Med Univ S Carolina, Dept Med, Div Cardiol, Gazes Cardiac Res Inst, 96 Jonathan Lucas St,Suite 816,POB 250623, Charleston, SC 29425 USA. FU NHLBI NIH HHS [R01-HL-59165-05, P01-HL-48788, R01-HL-55444-03] NR 41 TC 62 Z9 62 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD JAN PY 2003 VL 284 IS 1 BP H122 EP H132 DI 10.1152/ajpheart.00233.2002 PG 11 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 626DW UT WOS:000179857900016 PM 12485818 ER PT J AU Evans, SB Wilkinson, CW Gronbeck, P Bennett, JL Taborsky, GJ Figlewicz, DP AF Evans, SB Wilkinson, CW Gronbeck, P Bennett, JL Taborsky, GJ Figlewicz, DP TI Inactivation of the PVN during hypoglycemia partially simulates hypoglycemia-associated autonomic failure SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE paraventricular nucleus; hypothalamus; stress; rat; lidocaine ID HYPOTHALAMIC PARAVENTRICULAR NUCLEUS; SYMPATHETIC PREGANGLIONIC NEURONS; CORTICOTROPIN-RELEASING FACTOR; INCREASED GLUCAGON-SECRETION; INSULIN-INDUCED HYPOGLYCEMIA; ANTECEDENT HYPOGLYCEMIA; NERVE ACTIVITY; ADRENAL RESPONSES; EFFECTIVE SPREAD; CONSCIOUS RATS AB The anatomic connections of the paraventricular nucleus of the hypothalamus (PVN) are such that it is ideally situated to modulate and/or control autonomic responses to a variety of stressors, including hypoglycemia. In our experimental model of hypoglycemia-associated autonomic failure (HAAF), a syndrome in which the counterregulatory response to hypoglycemia is partially compromised via unknown mechanisms, activation of the PVN is blunted (15). We hypothesized that this blunted PVN activation during HAAF may be sufficient to cause the impaired counterregulatory response. To test this hypothesis, we anesthetized the PVN with lidocaine during insulin-induced hypoglycemia in rats and measured counterregulatory hormone levels. PVN inactivation decreased indexes of the sympathoadrenal response (plasma epinephrine and norepinephrine) and the hypothalamic-pituitary axis response (ACTH). Inactivation decreased the peak epinephrine response to hypoglycemia by almost half (-42 +/- 6% from control; P = 0.04) and the peak norepinephrine response by 34 +/- 5% (P = 0.01). The peak plasma ACTH levels attained were suppressed by 35 +/- 6% (P = 0.02). Adrenal corticosterone and pancreatic glucagon responses were not impaired. This pattern of neuroendocrine response is unlike that previously seen with our HAAF model. Control infusions of lidocaine greater than or equal to1 mm anterior or posterior to the PVN did not simulate this neuroendocrine pattern. Thus it appears that decreased PVN activation, as occurs with HAAF, may be involved in specific components of HAAF (i.e., blunting the sympathoadrenal and hypothalamic-pituitary-adrenocortical axis response), but not in others (i.e., blunting the glucagon response). C1 Univ Washington, Dept Psychol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Puget Sound Hlth Care Syst, Dept Vet Affairs, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Puget Sound Hlth Care Syst, Dept Vet Affairs, Ctr Geriatr Res Educ & Clin, Seattle, WA 98195 USA. RP Evans, SB (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM ngevans@u.washington.edu FU NIDDK NIH HHS [R01-DK-40,963, R01-DK-50,154] NR 59 TC 21 Z9 21 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 EI 1522-1490 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD JAN PY 2003 VL 284 IS 1 BP R57 EP R65 DI 10.1152/ajpregu.00439.2002 PG 9 WC Physiology SC Physiology GA 625YF UT WOS:000179842600007 PM 12388440 ER PT J AU Gooch, JL Barnes, JL Garcia, S Abboud, HE AF Gooch, JL Barnes, JL Garcia, S Abboud, HE TI Calcineurin is activated in diabetes and is required for glomerular hypertrophy and ECM accumulation SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE extracellular matrix; kidney; cyclosporin A; mesangial cells ID GROWTH-FACTOR-I; CARDIAC-HYPERTROPHY; MESANGIAL CELLS; MESSENGER-RNAS; CYCLOSPORINE-A; HEART-FAILURE; FACTOR-BETA; EXPRESSION; INHIBITION; PATHWAY AB Diabetic nephropathy is characterized by the rapid onset of hypertrophy and ECM expansion. Previously, we showed that calcineurin phosphatase is required for hypertrophy and ECM synthesis in cultured mesangial cells. Therefore, we examined the effect of calcineurin inhibition on renal hypertrophy and ECM accumulation in streptozotocin-induced diabetic rats. After 2 wk of diabetes, calcineurin protein was increased in whole cortex and glomeruli in conjunction with increased phosphatase activity. Daily administration of cyclosporin A blocked accumulation of both calcineurin protein and calcineurin activity. Also associated with calcineurin upregulation was nuclear localization of the calcineurin substrate NFATc1. Inhibition of calcineurin reduced whole kidney hypertrophy and abolished glomerular hypertrophy in diabetic rats. Furthermore, calcineurin inhibition substantially reduced ECM accumulation in diabetic glomeruli but not in cortical tissue, suggesting a differential effect of calcineurin inhibition in glomerular vs. extraglomerular tissue. Corresponding increases in fibronectin mRNA and transforming growth factor-beta mRNA were observed in tubulointerstitium but not in glomeruli. In summary, calcineurin plays an important role in glomerular hypertrophy and ECM accumulation in diabetic nephropathy. C1 Univ Texas, Hlth Sci Ctr, Div Renal, San Antonio, TX 78284 USA. Audie Murphy Mem Hosp, S Texas Vet Hlth Care Adm, San Antonio, TX 78284 USA. RP Gooch, JL (reprint author), Univ Texas, Hlth Sci Ctr, Div Renal, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. EM Gooch@UTHSCSA.edu NR 39 TC 45 Z9 50 U1 0 U2 2 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 JAN PY 2003 VL 284 IS 1 BP F144 EP F154 DI 10.1152/ajprenal.00158.2002 PG 11 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 623NK UT WOS:000179709600016 PM 12388427 ER PT J AU Woody, GE AF Woody, GE TI Research findings on psychotherapy of addictive disorders SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article; Proceedings Paper CT Conference on Whats New in Addiction Psychiatry CY APR, 2002 CL SILVER HILL HOSP, NEW CANAAN, CONNECTICUT HO SILVER HILL HOSP ID SUBSTANCE-ABUSE TREATMENT; COCAINE DEPENDENCE AB Psychoanalytically trained physicians working in methadone programs in the 1980s theorized that adding psychotherapy to addiction treatment would improve outcomes. Since then, a number of clinical studies have evaluated the effect of psychotherapy, drug counseling, and twelve-step intervention on treatment outcomes in methadone maintenance or cocaine and alcohol addiction programs. These studies have shown consistently that psychosocial treatments are helpful for patients with addictive disorders, with an effect size that ranges from mild to moderate. Major studies of psychotherapy in the treatment of addictive disorders are reviewed, and background information on psychotherapy and drug counseling is presented. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. RP Woody, GE (reprint author), Vet Affairs Med Ctr, Addict Treatment & Res Ctr, Dept Psychiat, 600 Publ Ledger Bldg,150 S Independence Mall W, Philadelphia, PA 19106 USA. NR 12 TC 11 Z9 11 U1 4 U2 9 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. PY 2003 VL 12 SU 2 BP S19 EP S26 DI 10.1080/10550490390210236 PG 8 WC Substance Abuse SC Substance Abuse GA 710LT UT WOS:000184682200003 PM 12857660 ER PT J AU Maggard, MA Thompson, JE Ko, CY AF Maggard, MA Thompson, JE Ko, CY TI Why do breast cancer mortality rates vary across states? SO AMERICAN SURGEON LA English DT Article; Proceedings Paper CT Annual Meeting of the Southern California Chapter of the American-College-of-Surgeons CY JAN 18-20, 2002 CL SANTA BARBARA, CALIFORNIA SP Amer Coll Surgeons, SO Calif Chapter ID OLDER WOMEN; MAMMOGRAPHY; SURVIVAL; OUTCOMES; PROJECT AB In 2001 approximately 40,000 deaths from breast cancer will occur in the United States. Although some estimates suggest possible state-to-state variations in breast cancer mortality rates the reasons for such differences remain unknown. Our objective was to confirm whether breast cancer mortality rates are significantly different by state and to identify predictors for such variation. Administrative data from the National Center for Health Statistics (NCHS) report were used to determine statewide death rates. Analyses were similarly performed with the Surveillance, Epidemiology, and End Results (SEER) cancer database to determine predictors of high versus low mortality rates. State-level variation in breast cancer mortality rates was demonstrated in the NCHS database. A subsequent analysis of high versus low mortality states in the SEER cancer registry demonstrates that stage at presentation was a significant predictor of mortality, as "high" mortality states had more patients presenting with later-stage disease. We conclude that variations in the breast cancer mortality rates exist between states. A nearly 50 per cent increase is observed between the states with the highest and lowest mortality rates. Adjusted analyses demonstrate that stage at presentation is a more important predictor of mortality variation than treatment differences. As such breast cancer mortality rates may be best improved by targeting screening and access-to-care issues rather than treatment. C1 Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. W Los Angeles VA, Los Angeles, CA USA. Olive View UCLA Med Ctr, Dept Surg, Sylmar, CA 91342 USA. RP Maggard, MA (reprint author), Univ Calif Los Angeles, Med Ctr, Dept Gen Surg, CHS,Room 72-228,10833 Le Conte Ave, Los Angeles, CA 90024 USA. NR 13 TC 8 Z9 9 U1 0 U2 0 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 JAN PY 2003 VL 69 IS 1 BP 59 EP 62 PG 4 WC Surgery SC Surgery GA 639UC UT WOS:000180646900013 PM 12575783 ER PT S AU Siegle, GJ Konecky, RO Thase, ME Carter, CS AF Siegle, GJ Konecky, RO Thase, ME Carter, CS BE ShinnickGallagher, P Pitkanen, A Shekhar, A Cahill, L TI Relationships between amygdala volume and activity during emotional information processing tasks in depressed and never-depressed individuals - An fMRI investigation SO AMYGDALA IN BRAIN FUNCTION: BACIC AND CLINICAL APPROACHES SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on the Amygdala in Brain Function CY JUN 24-26, 2002 CL GALVESTON, TEXAS SP Univ Texas Med Branch, NY Acad Sci, NIH, RW Johnson Pharmaceut Inst, NIA, Natl Inst Neurol Dis & Stroke DE fMRI; amygdala; depression; emotion; information processing C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. RP Siegle, GJ (reprint author), UPMC Hlth Syst, Western Psychiat Inst & Clin, 3811 OHara St, Pittsburgh, PA 15213 USA. FU NIMH NIH HHS [MH60473, MH30915, MH01306, MH16804] NR 3 TC 52 Z9 52 U1 0 U2 5 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-404-8 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2003 VL 985 BP 481 EP 484 PG 4 WC Multidisciplinary Sciences; Neurosciences; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BW71H UT WOS:000182918800039 PM 12724182 ER PT J AU Lambe, S Washington, DL Fink, A Laouri, M Liu, HH Fosse, JS Brook, RH Asch, SM AF Lambe, S Washington, DL Fink, A Laouri, M Liu, HH Fosse, JS Brook, RH Asch, SM TI Waiting times in California's emergency departments SO ANNALS OF EMERGENCY MEDICINE LA English DT Article; Proceedings Paper CT Annual Meeting of the Robert-Wood-Johnson-Foundation-Clinical-Scholars CY NOV, 2001 CL FT LAUDERDALE, FLORIDA SP Robert Wood Johnson Fdn Clin Scholars ID HEALTH AB Study objective: Many perceive emergency department crowding as a significant problem that is getting worse. A national survey of ED directors defined crowding, in part, as waiting more than 1 hour to see a physician, a wait considered likely to result in adverse outcomes. Yet few data are available on ED waiting times among a heterogeneous group of hospitals serving a distinct geographic region. Methods: We observed a random sample of 1,798 patients visiting 30 California EDs between December 15, 2000, and May 15, 2001. We defined waiting time as the interval from ED arrival to first contact with a physician or midlevel provider. Results: Patients waited an average of 56 minutes (95% confidence interval [CI] 52 to 61 minutes; median 38 minutes); 42% waited longer than 60 minutes. Ordinary least squares regression analysis revealed that waiting times were significantly longer at hospitals in poorer neighborhoods; for every $10,000 decline in per capita income, patients waited 10.1 minutes longer (95% CI 1.8 to 18.4 minutes; P=.02) after adjusting for hospital ownership, teaching status, trauma status, proximity to a recently closed ED, ED volume, patient severity, and age. Lower ratios of physicians and triage nurses to waiting room patient were also associated with longer waits. Conclusion: Waiting times often exceeded the threshold set by a survey of ED directors. Further study is required to examine factors that lead to longer waiting times at hospitals in low-income areas. Physician and nurse staffing should be investigated as a means of reducing waiting times. C1 Univ Calif Los Angeles, Robert Wood Johnson Clin Scholars Program, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med & Publ Hlth, Los Angeles, CA 90024 USA. Calif HealtCare Fdn, Oakland, CA USA. Univ Calif Los Angeles, Div Gen Internal Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med & Hlth Serv, Los Angeles, CA 90024 USA. RAND Hlth, Santa Monica, CA USA. RP Lambe, S (reprint author), Univ Calif San Francisco, Div Emergency Med, Box 0208,505 Parnassus St, San Francisco, CA 94143 USA. NR 27 TC 50 Z9 50 U1 0 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD JAN PY 2003 VL 41 IS 1 BP 35 EP 44 DI 10.1067/mem.2003.2 PG 10 WC Emergency Medicine SC Emergency Medicine GA 634YC UT WOS:000180369200006 PM 12514681 ER PT J AU Cummings, DE Merriam, GR AF Cummings, DE Merriam, GR TI Growth hormone therapy in adults SO ANNUAL REVIEW OF MEDICINE LA English DT Review DE aging; ghrelin; growth hormone deficiency; insulin-like growth factor-I; somatotropin ID PLACEBO-CONTROLLED TRIAL; GH-DEFICIENT ADULTS; HEALTHY AGED WOMEN; QUALITY-OF-LIFE; FACTOR-I; BODY-COMPOSITION; HYPOPITUITARY ADULTS; REPLACEMENT THERAPY; ELDERLY-MEN; OLDER MEN AB Growth hormone (GH) is classically linked with linear growth in childhood but continues to have important metabolic actions throughout life. GH deficiency in adulthood causes a distinct syndrome with significant morbidities. These include increased total and visceral fat, decreased muscle mass and aerobic capacity, affective disturbances, abnormal lipids, and increased vascular mortality, all of which are ameliorated with GH replacement. The possibility of adult GH deficiency (AGHD) should always be considered in individuals with a history of childhood GH deficiency or significant hypothalamic-pituitary damage, and the diagnosis should then be confirmed by biochemical testing. Adult GH dosing is much lower than that in pediatric practice, as appropriate for physiologic reconstitution. Hormonal side effects are minimized by stepwise dose titration. Lingering concerns remain regarding the possibility of increased cancer risk with long-term treatment, but this hazard has not been unequivocally demonstrated. Compared with AGHD, there is much less information about GH replacement in other diseases or in normal aging, or about the use of supraphysiologic GH doses to treat catabolic states. In critical illness, high-dose GH therapy has proven clearly harmful, and the balance of risks and benefits of GH administration in most adult contexts other than AGHD has not been defined. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Cummings, DE (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. EM davidec@u.washington.edu; merriam@u.washington.edu NR 93 TC 56 Z9 57 U1 2 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 2003 VL 54 BP 513 EP 533 DI 10.1146/annurev.med.54.101601.152147 PG 21 WC Medicine, General & Internal SC General & Internal Medicine GA 670WV UT WOS:000182433600030 PM 12471175 ER PT J AU Cummings, DE Schwartz, MW AF Cummings, DE Schwartz, MW TI Genetics and pathophysiology of human obesity SO ANNUAL REVIEW OF MEDICINE-SELECTED TOPICS IN THE CLINICAL SCIENCES LA English DT Review DE energy homeostasis; leptin; melanocortins; ghrelin; body-weight regulation ID PLASMA GHRELIN LEVELS; CENTRAL MELANOCORTIN RECEPTORS; MELANIN-CONCENTRATING HORMONE; REVERSES INSULIN-RESISTANCE; BODY-MASS INDEX; FOOD-INTAKE; NEUROPEPTIDE-Y; FEEDING-BEHAVIOR; MICE LACKING; DIABETIC HYPERPHAGIA AB Obesity has become a leading public health concern. Over 1 billion people are now overweight or obese, and the prevalence of these conditions is rising rapidly. Remarkable new insights into the mechanisms that control body weight are providing an increasingly detailed framework for a better understanding of obesity pathogenesis. Key peripheral signals, such as leptin, insulin, and ghrelin, have been linked to hypothalamic neuropeptide systems, and the anatomic and functional networks that integrate these systems have begun to be elucidated. This article highlights some of these recent findings and their implications for the future of obesity treatment. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Harborview Med Ctr, Seattle, WA 98195 USA. RP Cummings, DE (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. RI Schwartz, Michael/H-9950-2012 NR 110 TC 214 Z9 224 U1 1 U2 17 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 2003 VL 54 BP 453 EP 471 DI 10.1146/annurev.med.54.101601.152403 PG 23 WC Medicine, General & Internal SC General & Internal Medicine GA 670WV UT WOS:000182433600027 PM 12414915 ER PT J AU Mann, DL AF Mann, DL TI Stress-activated cytokines and the heart: From adaptation to maladaptation SO ANNUAL REVIEW OF PHYSIOLOGY LA English DT Review DE TNF; IL-6; IL-1; contractility; stress; homeostasis ID TUMOR-NECROSIS-FACTOR; ACUTE MYOCARDIAL-INFARCTION; RAT CARDIAC MYOCYTES; NF-KAPPA-B; LEFT-VENTRICULAR DYSFUNCTION; ISCHEMIA-REPERFUSION INJURY; ADULT FELINE MYOCARDIUM; GROWTH-FACTOR-BETA; FACTOR-ALPHA GENE; NITRIC-OXIDE AB The ability of the myocardium to successfully compensate for and adapt to environmental stress ultimately determines whether the heart will decompensate and fail or 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. In the present review we summarize recent experimental material suggesting that the cytokines expressed within the myocardium in response to environmental injury, namely tumor necrosis factor (TNF), interleukin-1 (IL-1), and the interleukin-6 (IL-6) family, play an important role in initiating and integrating homeostatic responses. However, these stress-activated cytokines all have the potential to produce cardiac decompensation when expressed at sufficiently high concentrations. Accordingly, the theme to emerge from this review is that the short-term expression of stress-activated cytokines within the heart may be an adaptive response to stress, whereas long-term expression of these molecules may be frankly maladaptive by producing cardiac decompensation. C1 Baylor Coll Med, Winters Ctr Heart Failure Res, Dept Med, Houston, TX 77030 USA. Houston Vet Adm Med Ctr, Houston, TX 77030 USA. RP Mann, DL (reprint author), Baylor Coll Med, Winters Ctr Heart Failure Res, Dept Med, Houston, TX 77030 USA. EM dmann@bcm.tmc.edu OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [P50 HL-O6H, HL-42250-10/10, R01 HL58081, R01 HL61543] NR 101 TC 170 Z9 187 U1 2 U2 7 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0066-4278 J9 ANNU REV PHYSIOL JI Annu. Rev. Physiol. PY 2003 VL 65 BP 81 EP 101 DI 10.1146/annurev.physiol.65.092101.142249 PG 23 WC Physiology SC Physiology GA 672MD UT WOS:000182523700005 PM 12500970 ER PT J AU Mays, VM Ponce, NA Washington, DL Cochran, SD AF Mays, VM Ponce, NA Washington, DL Cochran, SD TI Classification of race and ethnicity: Implications for public health SO ANNUAL REVIEW OF PUBLIC HEALTH LA English DT Review DE classification bias; public health statistics; cultural competence ID BLACK-AND-WHITE; UNITED-STATES; MANAGED CARE; 2000 CENSUS; RESIDENTIAL SEGREGATION; MEDICAID BENEFICIARIES; MINORITY POPULATIONS; INTERRACIAL MARRIAGE; DIABETES EDUCATION; RACIAL DISPARITIES AB Emerging methods in the measurement of race and ethnicity have important implications for the field of public health. Traditionally, information on race and/or ethnicity has been integral to our understanding of the health issues affecting the U.S. population. We review some of the complexities created by new classification approaches made possible by the inclusion of multiple-race assessment in the U.S. Census and large health surveys. We discuss the importance of these classification decisions in understanding racial/ethnic health and health care access disparities. The trend toward increasing racial and ethnic diversity in the United States will put further pressure on the public health industry to develop consistent and useful approaches to racial/ethnic classifications. C1 Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Epidemiol, Los Angeles, CA 90095 USA. RP Mays, VM (reprint author), Univ Calif Los Angeles, Dept Psychol, Box 951563, Los Angeles, CA 90095 USA. EM mays@ucla.edu; nponce@ucla.edu; donna.washington@med.va.gov; cochran@ucla.edu OI Ponce, Ninez/0000-0001-5151-6718 FU NIDA NIH HHS [DA 045539, R01 DA015539]; NIMH NIH HHS [MH 61774, R01 MH044345, R01 MH061774] NR 133 TC 120 Z9 121 U1 5 U2 20 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0163-7525 J9 ANNU REV PUBL HEALTH JI Annu. Rev. Public Health PY 2003 VL 24 BP 83 EP 110 DI 10.1146/annurev.publhealth.24.100901.140927 PG 28 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 717MX UT WOS:000185094600006 PM 12668755 ER PT J AU Yueh, B Weaver, EM Bradley, EH Krumholz, HM Heagerty, P Conley, A Sasaki, CT AF Yueh, B Weaver, EM Bradley, EH Krumholz, HM Heagerty, P Conley, A Sasaki, CT TI A critical evaluation of critical pathways in head and neck cancer SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Head-and-Neck-Society CY MAY 11, 2002 CL BOCA RATON, FLORIDA SP Amer Head Neck Surg ID ACUTE MYOCARDIAL-INFARCTION; CONTROLLED TRIAL; HOSPITAL STAY; CARE; MANAGEMENT; QUALITY; IMPLEMENTATION; LARYNGECTOMY; PROTOCOLS; EFFICACY AB Background: Critical pathways have been purported to decrease resource utilization in the management of head and neck cancer. Prior reports have documented shorter lengths of stay (LOS) for pathway patients than for historical cohorts. Objective: To critically evaluate the impact of critical pathways on LOS after laryngectomy. Design: Length-of-stay trends of 2 concurrent observational cohorts of laryngectomy patients (September 1992 to February 1999) were compared, I at each of 2 medical centers. One center instituted a critical pathway for laryngectomy patients in February 1997; the other never used such pathways. In addition, we examined the independent impact of the critical path way at the pathway institution after controlling for date of laryngectomy (which reflected temporal trends) and other confounding variables. Results: Both centers experienced reductions in LOS after February 1997, but there was no statistically significant difference between the reductions (1.9 days at the pathway center vs 1.5 days at the nonpathway center; P>.05). Multivariable linear and linear spline regression models demonstrated that the use of critical pathways at the pathway institution had no statistically significant impact on LOS after controlling for the date of laryngectomy. Conclusions: Pathway implementation has a limited direct impact on LOS in relatively low-volume procedures such as laryngectomy. Although pathways may influence utilization trends, their impact is likely mediated by the development and educational process that accompanies pathway adoption rather than implementation of the pathway itself. The inclusion of temporal trends and contemporary cohorts provides substantial insight into the effectiveness of critical pathways. C1 Vet Affairs Puget Sound Hlth Care Syst, Surg & Perioperat Care Serv, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA 98108 USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Ctr Cost & Outcomes Res, Seattle, WA 98195 USA. Yale Univ, Div Hlth Policy & Adm, Dept Epidemiol, New Haven, CT USA. Yale Univ, Div Hlth Policy & Adm, Dept Publ Hlth, New Haven, CT USA. Yale Univ, Med Sect Cardiol, New Haven, CT USA. Yale Univ, Dept Surg, Otolaryngol Sect, New Haven, CT USA. Yale Univ, Ctr Outcomes Res & Evaluat, New Haven, CT USA. RP Yueh, B (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Surg & Perioperat Care Serv, 112OTO,1660 S Columbian Way, Seattle, WA 98108 USA. OI Yueh, Bevan/0000-0003-1380-1053 NR 28 TC 7 Z9 8 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 JAN PY 2003 VL 129 IS 1 BP 89 EP 95 PG 7 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 634DU UT WOS:000180325400014 PM 12525201 ER PT J AU Doctor, JN Wolfson, AM McKnight, P Burns, SP AF Doctor, JN Wolfson, AM McKnight, P Burns, SP TI The effect of inaccurate FIM instrument ratings on prospective payment: A study of clinician expertise and FIM rating difficulty as contributing to inaccuracy SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE outcome assessment (health care); prospective payment system; rehabilitation ID FUNCTIONAL INDEPENDENCE MEASURE; JUDGMENTS; SYSTEM AB Objective: To test whether clinician expertise and FIM(TM) instrument rating difficulty explain clinician overconfidence in FIM rating accuracy. Design: Participants answered 60 true/false FIM questions and, for each question. completed a 6-category scale to assess confidence in the accuracy of their responses. Experts and novices, as well as hard and easy items, Were identified through a Rasch analysis, The relation between confidence and accuracy was examined for these different groups. Setting: Three urban medical centers. Participants: Fifty medical rehabilitation professionals, including physical therapists, occupational therapists, rehabilitation psychologists, speech pathologists, and rehabilitation nurses. Interventions: Not applicable. Main Outcome Measures: Observed proportion of correct responses to 60 true/false questions and responses from the 6-category confidence scale. Results: The amount of overconfidence was mediated by the difficulty of the FIM task and the level of expertise of the clinical,judge. Conclusions: Decreasing the level of overconfidence in FIM scoring is a promising avenue for improving the accuracy of functional assessment. Accurate assessment of functional status for case-mix group classification will be of even greater importance under the recently initiated Medicare prospective payment system. C1 Univ Washington, Dept Med Educ, Div Biomed & Hlth Informat, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Hlth Serv, Seattle, WA 98195 USA. Rehabil Psychol Associates LLC, New Orleans, LA USA. Univ Arizona, Dept Psychol, Evaluat Grp Anal Data, Tucson, AZ 85721 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Doctor, JN (reprint author), Univ Washington, Dept Med Educ, Div Biomed & Hlth Informat, Box 357240, Seattle, WA 98195 USA. FU NICHD NIH HHS [K01HD01221] NR 17 TC 3 Z9 3 U1 0 U2 1 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 2003 VL 84 IS 1 BP 46 EP 50 DI 10.1053/apmr.2003.50063 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 634YM UT WOS:000180370100007 PM 12589619 ER PT J AU Cooper, RA Wolf, E Fitzgerald, SG Boninger, ML Ulerich, R Ammer, WA AF Cooper, RA Wolf, E Fitzgerald, SG Boninger, ML Ulerich, R Ammer, WA TI Seat and footrest shocks and vibrations in manual wheelchairs with and without suspension SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE cumulative trauma disorders; rehabilitation; vibration; wheelchairs ID WHOLE-BODY VIBRATION; APPARENT MASS; BIOMECHANICS; SUBJECT; POSTURE; IMPACT; DESIGN; MODEL; PAIN AB Objective: To examine differences in the shock and vibration transmitted to an occupant of a manual wheelchair with and Without suspension caster forks and with and without rear-suspension systems. Design: Repeated-measures engineering testing, Setting: Rehabilitation engineering center With a wheelchair standards test laboratory. Specimens: Six manual wheelchairs. Interventions: An American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America wheelchair test dummy and a Hybrid III test dummy were used to test shock and vibration transmission in wheelchairs equipped with original equipment manufacturer (OEM) caster forks and suspension caster forks. Ultralight wheelchairs, half of which had factory-equipped rear-suspension systems, were tested. Testing was conducted on a double-drum wheelchair test machine. Main Outcome Measures: Shocks were examined by using peak acceleration and the frequency at which peak acceleration occurs for the seat and footrest. Vibration was characterized by the acceleration power per octave for the seat and footrest, Results: Significant differences were found in the peak accelerations at the seat (P=.0004) and footrest (P=.0007) between the Wheelchairs with the OEM caster forks and those with the suspension casters, The wheelchairs with suspension had significantly different frequencies at which the peak accelerations occurred for both the seat (P=.01) and footrest (P=.0001). The wheelchairs with suspension caster forks had a lower total power per octave than the wheelchairs with the OEM caster forks. For the footrest vibrations, significant differences Were found between the types of caster forks for all octaves except those associated with frequencies more than 78.75Hz. There were significant differences for wheelchairs with and without rear suspension for total power per octave of seat vibrations in the octaves between 7,81 and 9.84Hz (P=.01) and 12.40 and 15,63Hz (P=.008). Conclusions: Suspension caster forks reduce the shock and vibration exposure to the user of a manual wheelchair, Rear-suspension systems reduce some of the factors related to shock and vibration exposure, but they are not clearly superior to traditional designs. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Lab, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Lab, 151 R1,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper+@pitt.edu OI Wolf, Erik/0000-0002-6353-7978; Boninger, Michael/0000-0001-6966-919X NR 31 TC 21 Z9 21 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 2003 VL 84 IS 1 BP 96 EP 102 DI 10.1053/apmr.2003.50069 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 634YM UT WOS:000180370100016 PM 12589628 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 17 beta-estradiol treatment profoundly down-regulates gene expression in spinal cord tissue in mice protected from experimental autoimmune encephalomyelitis SO ARCHIVUM IMMUNOLOGIAE ET THERAPIAE EXPERIMENTALIS LA English DT Article DE 17 beta estradiol; EAE; microarray; spinal cord ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; MULTIPLE-SCLEROSIS LESIONS; INTERFERON-GAMMA; BINDING-PROTEIN; NERVOUS-SYSTEM; RECEPTOR; CYTOKINE; CELLS; RATS; IDENTIFICATION AB It is now well documented that experimental autoimmune encephalomyeltitis (EAE) can be effectively prevented by estrogen therapy. Previously, we identified a limited set of genes that were altered in spleens of mice protected from EAE by 17beta-estradiol (E2) treatment. As a continuation of these studies, we present here transcriptional changes in genes expressed in spinal cord tissue. The Affymetrix microarray system was used to screen more than 12,000 genes from E2-treated double transgenic (BV8S2 and AV4) female mice protected from EAE vs. control mice with severe EAE. We found that estrogen therapy had a profound inhibitory effect on the expressions of many immune-related genes in spinal cords. Estrogen significantly affected the transcription of 315 genes, 302 of which were down-regulated and only 13 that were up-regulated by greater than or equal to2.4 fold. A number of genes encoding the histocompatibility complex, cytokines/receptors, chemokines, adhesion molecules, and signal transduction proteins were strongly down-regulated (>20 fold) in estrogen-treated mice to levels similar to those of the spinal cord tissue from unmanipulated mice. The identification of genes with altered expression patterns in the spinal cords of estrogen-treated mice provides unique insight into the process that ultimately results in protection against EAE. C1 Portland VA Med Ctr, Neuroimmunol Res R&D 31, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Polish Acad Sci, L Hirszfeld Inst Immunol & Expt Therapy, Wroclaw, Poland. Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97201 USA. RP Offner, H (reprint author), Portland VA Med Ctr, Neuroimmunol Res R&D 31, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. NR 36 TC 15 Z9 18 U1 0 U2 2 PU INST IMMUNOLOGY & EXPERIMENTAL THERAPY PI WROCLAW PA POLISH ACADEMY OF SCIENCES CZERSKA 12, 53-114 WROCLAW, POLAND SN 0004-069X J9 ARCH IMMUNOL THER EX JI Arch. Immunol. Ther. Exp. PY 2003 VL 51 IS 3 BP 185 EP 193 PG 9 WC Immunology SC Immunology GA 693RZ UT WOS:000183733300006 PM 12894873 ER PT J AU Peters, JH Carsons, S Yoshida, M Ko, F McDougall, S Loredo, GA Hahn, TJ AF Peters, JH Carsons, S Yoshida, M Ko, F McDougall, S Loredo, GA Hahn, TJ TI Electrophoretic characterization of species of fibronectin bearing sequences from the N-terminal heparin-binding domain in synovial fluid samples from patients with osteoarthritis and rheumatoid arthritis SO ARTHRITIS RESEARCH & THERAPY LA English DT Article DE chondrocytes; fibronectin; osteoarthritis; rheumatoid arthritis; synovial fluid ID HUMAN ARTICULAR CHONDROCYTES; CARTILAGE CHONDROLYSIS; INCREASED EXPRESSION; INTEGRIN EXPRESSION; FRAGMENTS; MATRIX; PROTEINS; SURVIVAL; RECEPTOR; CULTURE AB Fragments of fibronectin (FN) corresponding to the N-terminal heparin-binding domain have been observed to promote catabolic chondrocytic gene expression and chondrolysis. We therefore characterized FN species that include sequences from this domain in samples of arthritic synovial fluid using one- and two-dimensional (1D and 2D) Western blot analysis. We detected similar assortments of species, ranging from similar to 47 to greater than 200 kDa, in samples obtained from patients with osteoarthritis (n= 9) versus rheumatoid arthritis (n= 10). One of the predominant forms, with an apparent molecular weight of similar to 170 kDa, typically resolved in 2D electrophoresis into a cluster of subspecies. These exhibited reduced binding to gelatin in comparison with a more prevalent species of similar to200+ kDa and were also recognized by a monoclonal antibody to the central cell-binding domain (CBD). When considered together with our previous analyses of synovial fluid FN species containing the alternatively spliced EIIIA segment, these observations indicate that the similar to 170-kDa species includes sequences from four FN domains that have previously, in isolation, been observed to promote catabolic responses by chondrocytes in vitro: the N-terminal heparin-binding domain, the gelatin-binding domain, the central CBD, and the EIIIA segment. The similar to 170-kDa N-terminal species of FN may therefore be both a participant in joint destructive processes and a biomarker with which to gauge activity of the arthritic process. C1 Sacramento VA Med Ctr, VA No Calif Hlth Care Syst, Mather, CA 95655 USA. Univ Calif Davis, Sch Med, Dept Internal Med, Davis, CA 95616 USA. Winthrop Univ Hosp, Mineola, NY 11501 USA. W Los Angeles VA Med Ctr, VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. RP Peters, JH (reprint author), Sacramento VA Med Ctr, VA No Calif Hlth Care Syst, 151-SMC,10535 Hosp Way, Mather, CA 95655 USA. EM John.Peters3@med.va.gov FU NIA NIH HHS [P60 AG010415, P60 AG10415] NR 36 TC 14 Z9 14 U1 0 U2 1 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 2003 VL 5 IS 6 BP R329 EP R339 DI 10.1186/ar1001 PG 11 WC Rheumatology SC Rheumatology GA 736BT UT WOS:000186151000009 PM 14680507 ER PT S AU Singh, BN Sarma, JSM AF Singh, BN Sarma, JSM BE Papp, JG Straub, M Ziegler, D TI Mechanisms of antiarrhythmic actions in the maintenance of sinus rhythm in patients with atrial fibrillation: Clinical and experimental correlations SO ATRIAL FIBRILLATION: NEW THERAPEUTIC CONCEPTS SE SOLVAY PHARMACEUTICALS CONFERENCES LA English DT Proceedings Paper CT 2nd Solvay-Pharmaceuticals Conference CY NOV 28-30, 2001 CL Budapest, HUNGARY SP Solvay Pharmaceut DE class III antiarrhythmic actions; rate-dependent property; atrial-specific antifibrillatory effects; pure class III antiarrhythmic agents ID CONGESTIVE-HEART-FAILURE; LEFT-VENTRICULAR DYSFUNCTION; LOW-DOSE AMIODARONE; TORSADE-DE-POINTES; ELECTRICAL CARDIOVERSION; QUINIDINE; CONVERSION; TEDISAMIL; THERAPY; FLUTTER AB Atrial fibrillation (AF) is now the commonest arrhythmia in clinical practice. It is associated with an increased mortality by a factor of two-fold, with significant morbidity, and impaired quality of life. It has not yielded uniformly well to the use of implantable atrial defibrillators or ablative techniques. Restoration and maintenance of sinus rhythm long-term by the use of antifibrillatory drugs therefore remain a desirable therapeutic goal. The ideal antiarrhythmic compound is a compound that is at least in part atrial-specific and blocks AV nodal conduction. AF occurs more frequently in patients with shorter atrial action potentials (APDs) and effective refractory periods (ERPs) than in those with longer ones. This has formed the basis for the use of class III drug actions in the control of AF. Studies of a range of class III compounds from the simplest (pure class IIIs such as dofetilide and azimilide) to the most complex ones (amiodarone and dronedarone), and those with an intermediate degree of complexity (such as dl-sotalol and tedisamil) have provided insights into the actions of antiarrhythmic drugs for use in AF. The electrophysiological property that appears to be of major clinical interest is the rate-dependent effect of the compounds on the APD and ERP. Drugs that exert the classical reverse rate dependency (dofetilide, quinidine, and dl-sotalol) appear to exhibit a similar ceiling of efficacy and a similar propensity for inducing torsades de pointes (TDP). In contrast, the actions of amiodarone and those of dronedarone are similar, as under the action of these drugs, the ERP increases in a parallel fashion over a wide range of frequencies, a phenomenon also noted in the case of azimilide. The efficacy for maintaining stability of sinus rhythm appears to be the highest in the case of amiodarone and is associated with the lowest incidence of TDP. Of much importance also is the fact that in the case of flecainide (presumably also propafenone) the atrial ER-P and APD both prolong APD and ERP (a class III action) as the cardiac frequency increases. In such a setting the drug is more effective in AF than in flutter. Such an atrial-specific action is of much theoretical and clinical importance for the synthesis and characterization of future compounds. C1 W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90073 USA. RP Singh, BN (reprint author), W Los Angeles Vet Affairs Med Ctr, Dept Med, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 67 TC 13 Z9 13 U1 1 U2 1 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1566-7685 BN 1-58603-387-5 J9 SOLVAY PHARMACEUT PY 2003 VL 2 BP 41 EP 55 PG 15 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA BY95G UT WOS:000189503200004 ER PT J AU Sanford, LD Tang, XD Ross, RJ Morrison, AR AF Sanford, LD Tang, XD Ross, RJ Morrison, AR TI Influence of shock training and explicit fear-conditioned cues on sleep architecture in mice: Strain comparison SO BEHAVIOR GENETICS LA English DT Article DE anxiety; conditioning; fear; mouse strains; rapid eye movement sleep; sleep ID INBRED MOUSE STRAINS; EYE-MOVEMENT SLEEP; CONTEXTUAL FEAR; POTENTIATED STARTLE; ANXIETY DISORDERS; C57BL/6 MICE; AMYGDALA; STATES; WAKEFULNESS; INHIBITION AB Fear conditioning is thought to model anticipatory anxiety. Inbred mouse strains exhibit different levels of reactivity to aversive environmental stimuli, which may reflect anxiety. We examined the effects of fear conditioning on sleep in mouse strains that differ on behavioral measures of anxiety. Mice (BALB/cJ [C], C57BL/6J [B6], CB6F1/J [CB6], n = 7-10 per strain) were implanted with transmitters for recording sleep by telemetry. Baseline sleep was recorded, and the mice were trained to associate a cue (tone) with footshock (15 cue-shock pairings on 4 consecutive days). Sleep was recorded after shock training and again 4 to 5 days later after presentation of the cue alone. Shock training produced a relatively selective suppression of rapid eye movement sleep (REM) that was greater in the C strain compared to the B6 and CB6 mice. Post-training exposure to the cue alone suppressed REM in all strains. The C strain exhibited a relatively greater immediate suppression of REM, and the CB6 hybrid mice showed the greatest overall suppression of REM. These data demonstrate that stimuli associated with an aversive event can alter sleep and suppress REM in much the same way as exposure to the event itself. Fear conditioning may provide a model for examining genetic and neural mechanisms underlying the influence of anxiety on sleep. C1 Eastern Virginia Med Sch, Dept Anat & Pathol, Sleep Res Lab, Norfolk, VA 23501 USA. Univ Penn, Sch Vet Med, Dept Anim Biol, Lab Study Brain Sleep, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Sanford, LD (reprint author), Eastern Virginia Med Sch, Dept Anat & Pathol, Sleep Res Lab, POB 1980, Norfolk, VA 23501 USA. FU NIMH NIH HHS [MH61716, MH64827]; NINDS NIH HHS [NS36694] NR 36 TC 66 Z9 69 U1 2 U2 8 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0001-8244 J9 BEHAV GENET JI Behav. Genet. PD JAN PY 2003 VL 33 IS 1 BP 43 EP 58 DI 10.1023/A:1021051516829 PG 16 WC Behavioral Sciences; Genetics & Heredity; Psychology, Multidisciplinary SC Behavioral Sciences; Genetics & Heredity; Psychology GA 614QR UT WOS:000179201400006 PM 12645821 ER PT S AU Whitcomb, DC AF Whitcomb, DC BE Ogawa, M Yamamoto, T Hirota, M TI Molecular and genetic mechanisms of acute and chronic pancreatitis SO BIOLOGICAL RESPONSE TO PLANNED AND UNPLANNED INJURIES: CELLULAR, MOLECULAR AND GENETIC ASPECTS SE INTERNATIONAL CONGRESS SERIES LA English DT Proceedings Paper CT 19th Kumamoto Medical Bioscience Symposium CY NOV 07-08, 2002 CL KUMAMOTO, JAPAN DE pancreatitis; trypsin; CFTR; pancreatic secretory trypsin inhibitor; SPINK1 ID CATIONIC TRYPSINOGEN GENE; HEREDITARY PANCREATITIS; STELLATE CELLS; CALCIUM-CARBONATE; RAT PANCREAS; MUTATIONS; ACTIVATION; CLASSIFICATION; PROTEIN; IDENTIFICATION AB Hereditary pancreatitis is a rare, autosomal dominant disorder characterized by acute pancreatitis, chronic pancreatitis and a very high risk for pancreatic cancer. Over 300 families have been identified, with the majority originating in Europe. The cause of most of the cases is from mutations in the cationic trypsinogen gene, or PRSS1. The three most common mutations are R122H, N291 and R122C. The mutations are thought to cause gain-of-function mutations so that typsinogen is either more easily activated, or active trypsin has delayed degradation. Research focused on the amino acids mutated in hereditary pancreatitis teach us about the central role of trypsin in the initiation of acute pancreatitis, and how the pancreas is normally protected from trypsin. The link between SPINK1 and trypsin activation further supports these concepts. Hereditary pancreatitis also teaches us about chronic pancreatitis. In this case, chronic pancreatitis develops in patients with recurrent acute pancreatitis. The unifying sentinel acute pancreatitis event (SAPE) model is reviewed. There are several major unanswered questions. First, how are 20% of the individuals who inherit the hereditary pancreatitis gene protected from ever getting an attack of pancreatitis? Secondly, what is the cause of the pancreatitis in the 35-40% of patients who do not have trypsinogen mutations? Third, what determines the severity of pancreatitis in those who develop pancreatitis? Finally, with knowledge of the mechanisms leading to pancreatitis, what can be done to limit or prevent damage from this disease? (C) 2003 Published by Elsevier B.V. C1 Univ Pittsburgh, VA Pittsburgh Hlth Care Syst, Dept Med Cell Biol & Physiol, Pittsburgh, PA 15213 USA. RP Whitcomb, DC (reprint author), UPMC Presbyterian, M2,C Wing,200 Lothrop St, Pittsburgh, PA 15213 USA. NR 56 TC 3 Z9 3 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA SARA BURGERHARTSTRAAT 25, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0531-5131 BN 0-444-51259-4 J9 INT CONGR SER PY 2003 VL 1255 BP 49 EP 60 DI 10.1016/S0531-5131(03)00674-5 PG 12 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA BX83V UT WOS:000186622700008 ER PT J AU Feinstein, LC Sandmaier, BM Hegenbart, U McSweeney, PA Maloney, DG Gooley, TA Maris, MB Chauncey, TR Bruno, B Appelbaum, FR Niederwieser, DW Storb, RF AF Feinstein, LC Sandmaier, BM Hegenbart, U McSweeney, PA Maloney, DG Gooley, TA Maris, MB Chauncey, TR Bruno, B Appelbaum, FR Niederwieser, DW Storb, RF TI Non-myeloablative allografting from human leucocyte antigen-identical sibling donors for treatment of acute myeloid leukaemia in first complete remission SO BRITISH JOURNAL OF HAEMATOLOGY LA English DT Article DE AML; first remission; non-myeloablative; transplant ID BONE-MARROW TRANSPLANTATION; ACUTE MYELOGENOUS LEUKEMIA; COLONY-STIMULATING FACTOR; SOUTHWEST-ONCOLOGY-GROUP; COUNCIL AML11 TRIAL; VERSUS-HOST DISEASE; ELDERLY PATIENTS; DOUBLE-BLIND; INTENSIVE CHEMOTHERAPY; POSTREMISSION THERAPY AB Many patients with acute myeloid leukaemia (AML) in first complete remission (CR1) are ineligible for allogeneic transplantation as a result of age or medical problems other than leukaemia. Eighteen patients (median age 59 years, range 36-73 years) with de novo (n = 13) and secondary (n = 5) AML in morphological CR1, who were not candidates for conventional allografting, received non-myeloablative peripheral blood stem cell transplants from human leucocyte antigen identical sibling donors after conditioning with 2 Gy total body irradiation (TBI; n = 10) or 2 Gy TBI and 90 mg/m(2) of fludarabine (n = 8). Postgrafting immunosuppression was with cyclosporine and mycophenolate mofetil. Two rejections were observed in patients not given fludarabine and one died with relapse. Overall, 10 patients died between 77 and 841 d, seven from relapse and three from non-relapse mortality (NRM). Day +100 NRM was 0% with a 1-year estimated NRM of 17%[95% confidence interval (CI) 0-35%]. The median follow-up among the eight survivors was 766 d (range, 188-1141 d). Seven of these eight survivors remain in complete remission (CR). One-year estimates of overall and progression-free survivals were 54% (95% CI 31-78%) and 42% (95% CI 19-66%) respectively. While follow-up is short, this analysis demonstrates that the procedure is sufficiently safe to be studied in a wider group of patients. C1 Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA. Univ Washington, Seattle, WA 98195 USA. Univ Leipzig, Leipzig, Germany. Univ Colorado, Denver, CO 80202 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Turin, Turin, Italy. RP Storb, RF (reprint author), Fred Hutchinson Canc Res Ctr, 1100 Fairview Ave N,D1-100,POB 19024, Seattle, WA 98109 USA. EM rstorb@fhcrc.org FU NCI NIH HHS [P01 CA078902, CA15704, CA18221, CA78902, K23CA92058]; NHLBI NIH HHS [HL36444] NR 37 TC 75 Z9 77 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0007-1048 J9 BRIT J HAEMATOL JI Br. J. Haematol. PD JAN PY 2003 VL 120 IS 2 BP 281 EP 288 DI 10.1046/j.1365-2141.2003.04057.x PG 8 WC Hematology SC Hematology GA 638XW UT WOS:000180598900017 PM 12542488 ER PT J AU Walsh, NE Walsh, WS AF Walsh, NE Walsh, WS TI Rehabilitation of landmine victims - the ultimate challenge SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article DE blast injuries/rehabilitation/complications; artifical limbs; health services accessibilty; health care costs; costs of illness; socioeconomic factors ID MINES; MOZAMBIQUE; INJURIES AB Antipersonnel landmines are often used indiscriminately and frequently result in injury or death of non-combatants. In the last 65 years, over 110 million mines have been spread throughout the world into an estimated 70 countries. Landmine victims use a disproportionately high amount of medical resoures; the vast majority of incidents occur in regions and countries without a sophisticated medical infrastructure and with limited resources, where rehabilitation is difficult in the best of circumstances. It is suggested that only a quarter of the patients with amputation secondary to landmines receive appropriate care. C1 Univ Texas, Hlth Sci Ctr, Dept Rehabil Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Syst, Phys Med & Rehabil Serv, San Antonio, TX USA. Univ Hlth Syst, San Antonio, TX USA. RP Walsh, NE (reprint author), Univ Texas, Hlth Sci Ctr, Dept Rehabil Med, 7703 Floyd Curl Dr,Mail Code 7872, San Antonio, TX 78229 USA. NR 29 TC 25 Z9 26 U1 0 U2 5 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA MARKETING AND DISSEMINATION, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 2003 VL 81 IS 9 BP 665 EP 670 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 731GQ UT WOS:000185876300008 PM 14710508 ER PT J AU Lin, PH Martin, L Matsuura, JH Wellons, E Bush, RL Terramani, TT Chen, CY Lumsden, AB AF Lin, PH Martin, L Matsuura, JH Wellons, E Bush, RL Terramani, TT Chen, CY Lumsden, AB TI Intraaortic stabilization of the AneuRx stent-graft system: A useful adjunct to minimize device migration SO CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY LA English DT Article DE stent-grafts-abdominal aortic aneurysm; interventional procedure ID ABDOMINAL AORTIC-ANEURYSMS; ENDOVASCULAR REPAIR AB The deployment of a Medtronic AneuRx stent-graft system for endovascular abdominal aortic aneurysm repair requires a series of precise maneuvers that include positioning the primary delivery catheter in the infrarenal aorta, retracting the graft-covering sheath, and withdrawing the stainless steel runners. The last step allows the stent-graft to fully expand and attach to the non-aneurysmal aorta and iliac arteries. Such maneuvers may cause the stent-graft to move caudally if the device is placed in a severely angulated aortic neck. We describe a simple, coaxial, stabilization technique utilizing the contralateral introducer sheath which minimizes potential caudal migration of the stent-graft in angulated aortic necks during runner withdrawal. C1 Baylor Coll Med, Houston VAMC, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. Emory Univ, Sch Med, Dept Radiol, Atlanta, GA 30322 USA. Med Coll Georgia, Atlanta Med Ctr, Dept Surg, Atlanta, GA USA. RP Lin, PH (reprint author), Baylor Coll Med, Houston VAMC, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, 2002 Holcomb Blvd 112, Houston, TX 77030 USA. NR 5 TC 1 Z9 3 U1 0 U2 0 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0174-1551 J9 CARDIOVASC INTER RAD JI Cardiovasc. Interv. Radiol. PD JAN-FEB PY 2003 VL 26 IS 1 BP 73 EP 75 DI 10.1007/s00270-002-2624-3 PG 3 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA 649DV UT WOS:000181192400012 PM 12491021 ER PT J AU Furmanczyk, PS Quinn, LS AF Furmanczyk, PS Quinn, LS TI Interleukin-15 increases myosin accretion in human skeletal myogenic cultures SO CELL BIOLOGY INTERNATIONAL LA English DT Article DE Interleukin-15; insulin-like growth factor-I; skeletal muscle; cytokines; anabolism; hypertrophy; atrophy; myoblasts; myotubes; muscle fibers ID GROWTH-FACTOR-I; SATELLITE CELL-ACTIVITY; MUSCLE HYPERTROPHY; BODY-COMPOSITION; DIFFERENTIATION; EXPRESSION; HORMONE; OVEREXPRESSION; PROLIFERATION; CACHEXIA AB Interleukin-15 (IL-15) has been shown to have anabolic effects on skeletal muscle in rodent studies conducted in vitro and in vivo. The mechanism of IL-15 action on muscle appears to be distinct from that of the well-characterized muscle anabolic factor insulin-like growth factor-I (IGF-I). IL-15 action has not been investigated in a human culture system nor in detail in primary skeletal myogenic cells. The purpose of this study was to compare the effects of IL-15 and IGF-I in primary human skeletal myogenic cells. Accretion of a major myofibrillar protein, myosin heavy chain (MHC), was used as a measure of muscle anabolism. We found that both growth factors induced increases in MHC accretion in primary human skeletal myogenic cultures; however, IL-15 and IGF-I actions were temporally distinct. IL-15 was more effective at stimulating MHC accretion when added to cultures after differentiation of myoblasts had occurred. In contrast, IGF-I was more effective at stimulating MHC accretion when added to cultures prior to differentiation of myoblasts. These results using a human system support recent findings from rodent models which indicate that the primary mode of IGF-I action on skeletal muscle anabolism is through stimulation of myogenic precursor cells, whereas the primary target of IL-15 action is the differentiated muscle fiber. Further, since clinical and experimental studies have shown IGF-I is not effective in preventing skeletal muscle wasting, the distinct mode of action of IL-15 suggests it may be of potential usefulness in the treatment of muscle wasting disorders. (C) 2003 Elsevier Ltd. All rights reserved. C1 Univ Washington, Dept Med, Div Gerontol & Geriat Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Amer Lake Div 151, Tacoma, WA 98493 USA. RP Quinn, LS (reprint author), Univ Washington, Dept Med, Div Gerontol & Geriat Med, Seattle, WA 98195 USA. NR 27 TC 41 Z9 42 U1 0 U2 4 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1065-6995 J9 CELL BIOL INT JI Cell Biol. Int. PY 2003 VL 27 IS 10 BP 845 EP 851 DI 10.1016/S1065-6995(03)00172-0 PG 7 WC Cell Biology SC Cell Biology GA 737JC UT WOS:000186225800007 PM 14499665 ER PT J AU Siegel, RE AF Siegel, RE TI Linezolid to decrease length of stay in the hospital for patients with methicillin-resistant Staphylococcus aureus infection SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID COMMUNITY-ACQUIRED PNEUMONIA C1 Bronx Vet Affairs Med Ctr, Crit Care Ctr, New York, NY 10468 USA. Mt Sinai Sch Med, New York, NY USA. RP Siegel, RE (reprint author), Bronx Vet Affairs Med Ctr, Crit Care Ctr, New York, NY 10468 USA. NR 6 TC 1 Z9 1 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 JAN 1 PY 2003 VL 36 IS 1 BP 124 EP 124 DI 10.1086/345300 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 627DM UT WOS:000179916500025 PM 12491215 ER PT J AU Kilzieh, N Wood, AE Erdmann, J Raskind, M Tapp, A AF Kilzieh, N Wood, AE Erdmann, J Raskind, M Tapp, A TI Depression in Kraepelinian schizophrenia SO COMPREHENSIVE PSYCHIATRY LA English DT Article ID POST-PSYCHOTIC DEPRESSION; SYMPTOMS; REPLICATION; DISORDERS; EXTENSION; RELAPSE AB In order to improve our understanding of depression in chronic schizophrenia, depressive symptoms were assessed in institutionalized, so called Kraepelinian, patients with schizophrenia (N = 43). The patients had been ill and dependent on others for at least 5 years. Depressive symptoms as measured by the Hamilton Depression (HAM-D) scale were less prevalent in this population compared to published data on non-Kraepelinian patients. Only 5% of our Kraepelinian patients had a HAM-D score greater than or equal to 16. There was also a low prevalence of core depressive symptoms (depressed mood, suicidal ideation, and guilt). The relationship of depression to other dimensions of schizophrenia was explored. Depression had a modest positive correlation (r = 0.44) with general psychopathology as measured by the Brief Psychiatric Rating Scale (BPRS), but not with positive symptoms as measured by BPRS positive subscale or negative symptoms as measured by the Scale for the Assessment of Negative Symptoms (SANS). Depression also showed a modest positive correlation (r =.48) using the Simpson-Angus Rating Scale (SAS) for extrapyramidal symptoms (EPS). These results indicate that in Kraepelinian schizophrenia, depression is not prevalent, even though patients are severely ill both in symptom and functioning domains. The results of our analysis support that Kraepelinian schizophrenia is a distinct subtype, and raise questions regarding the boundary between schizoaffective disorder and non-Kraepelinian schizophrenia. Finally, the low rate of depression observed revives the notion that preservation of core functional abilities is important for a depressive reaction to evolve in schizophrenia. Copyright 2003, Elsevier Science (USA). All rights reserved. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Kilzieh, N (reprint author), VA Puget Sound Hlth Care Syst, Mental Hlth Serv 116M, Amer Lake Div, Tacoma, WA 98493 USA. NR 27 TC 11 Z9 12 U1 1 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0010-440X J9 COMPR PSYCHIAT JI Compr. Psychiat. PD JAN-FEB PY 2003 VL 44 IS 1 BP 1 EP 6 DI 10.1053/comp.2003.50002 PG 6 WC Psychiatry SC Psychiatry GA 632TN UT WOS:000180239100001 PM 12524629 ER PT J AU Nieves, DJ Cnop, M Retzlaff, B Walden, CE Brunzell, JD Knopp, RH Kahn, SE AF Nieves, DJ Cnop, M Retzlaff, B Walden, CE Brunzell, JD Knopp, RH Kahn, SE TI The atherogenic lipoprotein profile associated with obesity and insulin resistance is largely attributable to intra-abdominal fat SO DIABETES LA English DT Article ID CORONARY-ARTERY-DISEASE; ADIPOSE-TISSUE DISTRIBUTION; IMPAIRED GLUCOSE-TOLERANCE; HEPATIC LIPASE ACTIVITY; WEIGHT-LOSS; OLDER MEN; REGIONAL ADIPOSITY; INTRAABDOMINAL FAT; LIPID-METABOLISM; VISCERAL FAT AB Obesity and insulin resistance are both associated with an atherogenic lipoprotein profile. We examined the effect of insulin sensitivity and central adiposity on lipoproteins in 196 individuals (75 men and 121 women) with an average age of 52.7 years. Subjects were subdivided into three groups based on BMI and their insulin sensitivity index (S-I): lean insulin sensitive (n = 65), lean insulin resistant (n = 73), and obese insulin resistant (n = 58). This categorization revealed that both obesity and insulin resistance determined the lipoprotein profile. In addition, the insulin-resistant groups had increased central adiposity. Increasing intra-abdominal fat (IAF) area, quantified by computed tomography scan and decreasing SI, were important determinants of an atherogenic profile, marked by increased triglycerides, LDL cholesterol, and apolipoprotein B and decreased HDL cholesterol and LDL buoyancy (Rf). Density gradient ultracentrifugation (DGUC) revealed that in subjects who had more IAF and were more insulin resistant, the cholesterol content was increased in VLDL, intermediate-density lipoprotein (IDL), and dense LDL fractions whereas it was reduced in HDL fractions. Multiple linear regression analysis of the relation between the cholesterol content of each DGUC fraction as the dependent variable and IAF and S, as independent variables revealed that the cholesterol concentration in the fractions corresponding to VLDL, IDL, dense LDL, and HDL was associated with IAF, and that S, additionally contributed independently to VLDL, but not to IDL, LDL, or HDL. Thus an atherogenic lipoprotein profile appears to be the result primarily of an increase in IAF, perhaps via insulin resistance. C1 VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA 98108 USA. Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. RP Kahn, SE (reprint author), VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, 151,1660 S Columbian Way, Seattle, WA 98108 USA. OI Kahn, Steven/0000-0001-7307-9002 FU NCRR NIH HHS [RR-37]; NHLBI NIH HHS [HL-30086]; NIDDK NIH HHS [DK-02456, DK-02654, DK-17047, DK-35816] NR 65 TC 147 Z9 160 U1 0 U2 3 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0012-1797 J9 DIABETES JI Diabetes PD JAN PY 2003 VL 52 IS 1 BP 172 EP 179 DI 10.2337/diabetes.52.1.172 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 631FK UT WOS:000180157300024 PM 12502509 ER PT J AU Parchman, ML Arambula-Solomon, TG Noel, PH Larme, AC Pugh, JA AF Parchman, ML Arambula-Solomon, TG Noel, PH Larme, AC Pugh, JA TI Stage of change advancement for diabetes self-management behaviors and glucose control SO DIABETES EDUCATOR LA English DT Article ID PATIENT EDUCATION RESEARCH; REGULAR EXERCISE; IMPACT; NIDDM AB PURPOSE this study was conducted to evaluate whether patients with type 2 diabetes who participated in diabetes education advanced through stages of change for self-management behaviors and to determine if movement was related to glucose control. METHODS A cohort of 428 patients with type 2 diabetes participated in a traditional diabetes education program in a large urban center in the Southwest. The sample was predominantly female with less than a high school education, a mean age of 52 years, and a mean duration of diabetes of 7 years. Two interviews were conducted approximately 9 months apart, at 1 to 4 weeks before the educational program and at 6 months after completing it. Blood specimens were collected at each interview to measure hemoglobin A1C (A1C) levels. RESULTS Most of the patients advanced 1 or more stages of change for at least 1 self-management behavior. Those with diabetes for less than 2 years were significantly more likely to advance at least 1 stage of change for diet and exercise than those with diabetes for more than 2 years. Such advancement was significantly associated with a decline in A1C. CONCLUSIONS Patients with type 2 diabetes who participated in diabetes education advanced through stages of change for self-care behaviors. The intervention was more effective for those with a shorter duration of diabetes. C1 Univ Texas, Hlth Sci Ctr, Dept Family & Community Med, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, Sch Publ Hlth, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, VERDICT Ctr, S Texas Vet Hlth Care Syst,Audie L Murphy Div, San Antonio, TX 78285 USA. RP Parchman, ML (reprint author), Diabet Educator, 367 W Chicago Ave, Chicago, IL 60610 USA. OI Pugh, Jacqueline/0000-0003-4933-141X; Parchman, Michael/0000-0001-7129-2889 FU PHS HHS [3015941485] NR 18 TC 18 Z9 19 U1 1 U2 4 PU AMER ASSOC DIABETES EDUCATORS PI CHICAGO PA STE 1240, 444 NORTH MICHIGAN AVE, CHICAGO, IL 60611-3901 USA SN 0145-7217 J9 DIABETES EDUCATOR JI Diabetes Educ. PD JAN-FEB PY 2003 VL 29 IS 1 BP 128 EP 134 DI 10.1177/014572170302900117 PG 7 WC Endocrinology & Metabolism; Public, Environmental & Occupational Health SC Endocrinology & Metabolism; Public, Environmental & Occupational Health GA 643UZ UT WOS:000180880400011 PM 12632691 ER PT J AU Vidal, J Verchere, CB Andrikopoulos, S Wang, F Hull, RL Cnop, M Olin, KL LeBoeuf, RC O'Brien, KD Chait, A Kahn, SE AF Vidal, J Verchere, CB Andrikopoulos, S Wang, F Hull, RL Cnop, M Olin, KL LeBoeuf, RC O'Brien, KD Chait, A Kahn, SE TI The effect of apolipoprotein E deficiency on islet amyloid deposition in human islet amyloid polypeptide transgenic mice SO DIABETOLOGIA LA English DT Article DE islet amyloid; islet amyloid polypeptide; amylin; apolipoprotein E; diabetes; Alzheimer's disease ID BETA-PEPTIDE DEPOSITION; DEPENDENT DIABETES-MELLITUS; ONSET ALZHEIMER-DISEASE; MOUSE MODEL; CYNOMOLGUS MONKEYS; PRECURSOR PROTEIN; E GENOTYPE; HYPERCHOLESTEROLEMIA; ATHEROSCLEROSIS; HYPERGLYCEMIA AB Aims/hypothesis. Islet amyloid deposits are present in over 85% of Type 2 diabetic patients and have been suggested to be pathogenic. The mechanism that converts islet amyloid polypeptide (IAPP), the unique component of these deposits, into amyloid fibrils in vivo is not known. The amino acid sequence of IAPP is critical but insufficient for beta-pleated sheet formation. As apolipoprotein E (apoE), another component of islet amyloid deposits, plays a critical role in amyloid formation in Alzheimer's disease, we hypothesised that apoE could play an important role in islet amyloid formation. Methods. Transgenic mice expressing the human form of IAPP (hIAPP(+/0)) were crossbred with apoE deficient (apoE(-/-)) mice and followed for 12 months, at which time the prevalence and severity of islet amyloid, as well as plasma glucose, hIAPP, immunoreactive insulin (IRI) and lipid concentrations were measured. Results. The prevalence and severity of islet amyloid after one year of follow up were comparable among hIAPP(+/0) mice that were apoE(+/+), apoE(+/-) or apoE(-/-). Differences in glucose tolerance, lipid abnormalities or changes in pancreatic content or plasma concentrations of hIAPP and/or IRI did not account for these findings. Conclusion/interpretation. Our data shows that, unlike in the localized amyloidosis in the brain characteristic of Alzheimer's disease, apoE is not critical for islet amyloid formation in a transgenic mouse model of Type 2 diabetes mellitus. These results indicate that the mechanisms of localised amyloid formation probably vary among different amyloid-associated disorders. Therefore, therapeutic strategies targeting apoE might not apply equally to patients with different amyloid associated diseases. C1 Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Pathobiol, Seattle, WA 98195 USA. Univ Washington, Dept Nutr Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Cardiol, Seattle, WA USA. RP Kahn, SE (reprint author), Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. OI Kahn, Steven/0000-0001-7307-9002; Hull, Rebecca/0000-0001-9690-4087 FU NHLBI NIH HHS [HL-30086, HL-52848]; NIA NIH HHS [AG10917]; NIDDK NIH HHS [DK-02456, DK-17047, DK-50703] NR 43 TC 20 Z9 21 U1 0 U2 1 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD JAN PY 2003 VL 46 IS 1 BP 71 EP 79 DI 10.1007/s00125-002-0984-5 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 654PX UT WOS:000181506200010 PM 12637985 ER PT B AU Garber, AM AF Garber, AM GP OECD OECD TI Comparing health care systems from the disease-specific perspective SO DISEASE-BASED COMPARISON OF HEALTH SYSTEMS: WHAT IS BEST AND AT WHAT COST? LA English DT Proceedings Paper CT Workshop on Disease Based Comparison of Health Systems CY JUN 20-21, 2002 CL PARIS, FRANCE SP Natl Inst Aging U S, Natl Board Hlth & Welfare Japan AB The McKinsey Health Care Productivity study sought to learn about system factors that might influence health care productivity by comparing the costs and outcomes of care in Germany, the United Kingdom, and the United States in the management of four specific conditions: breast cancer, lung cancer, cholelithiasis, and diabetes mellitus. The study assessed productivity in the management of these conditions by measuring the levels of inputs used, rather than expenditures on inputs. The US health care system, despite its much greater expenditures, tended to be more productive than Germany and the UK, except in diabetes care, where the UK experienced better outcomes at lower Costs than in the US Several system features may have been responsible for these performance findings. The OECD Ageing-Related Diseases project is leading to similar insights in a range of conditions. C1 Stanford Univ, US Dept Vet Affairs, Stanford, CA 94305 USA. NR 4 TC 1 Z9 1 U1 0 U2 0 PU ORGANIZATION ECONOMIC COOPERATION & DEVELOPMENT PI PARIS PA 2, RUE ANDRE PASCAL, CEDEX 16, 75775 PARIS, FRANCE BN 92-64-09981-6 PY 2003 BP 95 EP 103 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA BX11X UT WOS:000184328200005 ER PT J AU Etminan, M Gill, S Samii, A AF Etminan, M Gill, S Samii, A TI Comparison of the risk of adverse events with pramipexole and ropinirole in patients with Parkinson's disease - A meta-analysis SO DRUG SAFETY LA English DT Article ID DOUBLE-BLIND; DOPAMINE AGONIST; MOTOR FLUCTUATIONS; D-2 AGONIST; PLACEBO; MULTICENTER; SAFETY; LEVODOPA; EFFICACY; TRIALS AB Background: Pramipexole and ropinirole are relatively new dopamine agonists, both of which have proven efficacy in the treatment of Parkinson's disease. There is, however, uncertainty regarding differences in the adverse event profiles associated with each drug. Objective: To compare the adverse events of pramipexole and ropinirole as. reported in the peer-reviewed medical literature. Methods: We systematically reviewed the medical literature to identify randomised controlled trials of pramipexole and ropinirole used in the management of Parkinson's disease. Computerised databases (including Medline, Embase, the Cochrane Library, and the International Pharmaceutical Abstracts) were used to identify pertinent articles for inclusion in this study. Trials that compared the dopamine agonists to either levodopa or placebo were included. Analysis: Adverse events with these drugs included dizziness, nausea, hypotension, hallucinations, and somnolence. We made two separate analyses. In the first analysis, we estimated the pooled relative risk (RR) of adverse events with either pramipexole or ropinirole as compared with levodopa. In the second analysis, the pooled RRs of adverse events with pramipexole and ropinirole were compared with placebo. We used the random-effects model of DerSimonian and Laird to estimate the RRs and their corresponding 95% CIs. We tested for study heterogeneity using Q statistics. Results: There was no significant difference in the risk of dizziness, nausea, or hypotension with either drug individually or in combination when compared with levodopa. The risk of hypotension was approximately four times higher with ropinirole than pramipexole when each drug was individually compared with placebo (6.46 [95% CI 1.47-28.28] for ropinirole, and 1.65 [0.88-3.08] for pramipexole). The pooled RR (for pramipexole and ropinirole combined) of hallucinations was 1.92 (95% CI 1.08-3.43) when compared with levodopa. Relative to placebo, pramipexole had a significantly higher risk of hallucinations than ropinirole (pramipexole 5.2 [95% CI 1.97-13.72] vs ropinirole 2.75 [95% CI 0.55-13.73]). There was no significant difference in the risk of somnolence between the two drugs when each was individually compared with levodopa. When compared with placebo, the pooled RR (pramipexole and ropinirole combined) of somnolence was 3.16 (95% CI 1.62-6.13). Relative to placebo, the risk of somnolence was 2.01 (95% CI 2.17-3.16) with pramipexole and 5.73 (95% CI 2.34-14.01) with ropinirole. Conclusions: Use of ropinirole seems to be associated with a higher risk of hypotension and somnolence than use of pramipexole when compared with placebo. Use of pramipexole seems to be associated with a higher risk of hallucinations than use of ropinirole when compared with placebo. C1 Univ Toronto, Baycrest Ctr Geriatr Care, Kunin Lunenfeld Appl Res Unit, Dept Clin Epidemiol, Toronto, ON, Canada. Washington Univ, Dept Neurol, Seattle, WA USA. RP Samii, A (reprint author), VA Puget Sound Hlth Care Syst, Dept Neurol, Mailstop 127,1660 S Columbian Way, Seattle, WA 98108 USA. NR 25 TC 48 Z9 51 U1 0 U2 8 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 0114-5916 J9 DRUG SAFETY JI Drug Saf. PY 2003 VL 26 IS 6 BP 439 EP 444 DI 10.2165/00002018-200326060-00005 PG 6 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy; Toxicology SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy; Toxicology GA 679BF UT WOS:000182900600005 PM 12688834 ER PT J AU Messmore, HL Jeske, WP Wehrmacher, WH Walenga, JM AF Messmore, HL Jeske, WP Wehrmacher, WH Walenga, JM TI Benefit-risk assessment of treatments for heparin-induced thrombocytopenia SO DRUG SAFETY LA English DT Review ID SYNTHETIC THROMBIN INHIBITOR; PLATELET-AGGREGATION TEST; MOLECULAR-WEIGHT HEPARIN; CARDIOPULMONARY BYPASS; RECOMBINANT HIRUDIN; R-HIRUDIN; ARGATROBAN ANTICOAGULATION; ANTITHROMBOTIC AGENTS; CLINICAL USEFULNESS; ARTERIAL-OCCLUSION AB Patients with heparin-induced thrombocytopenia (HIT) are at high risk of thrombosis and should be treated with alternative anticoagulant therapy to reduce complications. The current treatment of choice is one of the approved direct thrombin inhibitors, argatroban or lepirudin. These drugs have been proven to be safe and effective in multicentre clinical trials where dosage regimens have been established for prophylaxis and treatment of thrombosis. Argatroban has also been tested and approved for use in invasive cardiology procedures in the HIT patient. Dosage regimens for other clinical uses, such as cardiac surgery, have not yet been established for either drug. The safety and effectiveness of the thrombin inhibitors is dependent on their use according to established guidelines. Other treatment options that may be effective for the patient with HIT include dextran, plasmapheresis, intravenous gammaglobulin and aspirin (acetylsalicylic acid). Although used historically, these options have not been tested in rigorous clinical trials. For life- and limb-threatening thrombosis, thrombolytic agents and/or surgery may provide benefit. Because the risk of bleeding is high from these procedures, they should be performed only by an experienced practitioner. Several studies have shown that patients with HIT requiring continued anticoagulation are best managed with a warfarin derivative initiated while under full anticoagulation with a thrombin inhibitor. There is a risk of skin necrosis and bleeding if guidelines for dose administration and monitoring of warfarin are not followed. Subsequent use of heparin or a low molecular weight heparin after resolution of the clinical episode of HIT can be hazardous, particularly within the first 3 months. If laboratory testing is negative, heparin may be cautiously reinstituted for short-term use (1-2 hours) with monitoring for platelet count decrease and thromboembolism. The pregnant patient with HIT requiring anticoagulation represents a particular challenge, where there is no drug of choice at present. Although today there are realistic treatment options for the patient with HIT, the morbidity and mortality associated with this disease have not been eliminated. Awareness and early treatment of HIT remain important components of the clinical care for patients exposed to heparins. Future therapeutic developments based on a better understanding of the pathophysiology of HIT may further improve clinical outcomes. Despite some limitations, the current treatment options for patients with HIT provide unparalleled benefit compared with the treatment options available only a few years ago. C1 Loyola Univ, Med Ctr, Cardiovasc Inst, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Med, Hines, IL 60141 USA. Loyola Univ, Med Ctr, Dept Cardiovasc Thorac Surg, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Pathol, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Physiol, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Med, Maywood, IL 60153 USA. RP Walenga, JM (reprint author), Loyola Univ, Med Ctr, Cardiovasc Inst, Bldg 110,Room 5226, Maywood, IL 60153 USA. NR 112 TC 24 Z9 24 U1 0 U2 1 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 0114-5916 J9 DRUG SAFETY JI Drug Saf. PY 2003 VL 26 IS 9 BP 625 EP 641 DI 10.2165/00002018-200326090-00003 PG 17 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy; Toxicology SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy; Toxicology GA 702YZ UT WOS:000184253800003 PM 12814331 ER PT J AU Basile, JN AF Basile, JN TI Systolic blood pressure elevation - It's where the action is SO DRUGS & AGING LA English DT Editorial Material ID HYPERTENSION C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Primary Care Program, Charleston, SC 29403 USA. Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Div Gen Internal Med Geriatr, Charleston, SC 29403 USA. RP Basile, JN (reprint author), Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Primary Care Program, 1090 Bee St, Charleston, SC 29403 USA. NR 17 TC 0 Z9 0 U1 0 U2 0 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 1170-229X J9 DRUG AGING JI Drugs Aging PY 2003 VL 20 IS 4 BP 287 EP 288 DI 10.2165/00002512-200320040-00007 PG 2 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 665XJ UT WOS:000182146300005 PM 12641484 ER PT J AU Mendez, MF Lim, GTH AF Mendez, MF Lim, GTH TI Seizures in elderly patients with dementia - Epidemiology and management SO DRUGS & AGING LA English DT Review ID ONSET ALZHEIMERS-DISEASE; UNITED-STATES POPULATION; NEWLY-DIAGNOSED EPILEPSY; UNPROVOKED SEIZURES; ANTIEPILEPTIC DRUGS; COGNITIVE FUNCTION; CLINICAL-FEATURES; PRESENILIN-1 MUTATION; STATUS EPILEPTICUS; PREDICTIVE MODEL AB Epileptic seizures occur in patients with dementia at a higher prevalence than among healthy elderly individuals. The incidence of seizures among patients with dementia varies with the aetiology of the dementing illness. In patients with Alzheimer's disease (the most common form of dementia), approximately 10-22% have at least one unprovoked seizure. Seizures usually occur in later stages of Alzheimer's disease, on average, greater than or equal to6 years into the course of the disease. Seizures in Alzheimer's disease are more likely to occur with early-onset disease, particularly if there is a familial presenilin I mutation. The incidence of seizures in other dementing diseases is less clear. There are special considerations regarding the management of seizures in the elderly with dementia. First, the presence of cognitive impairment may impede an accurate diagnosis of seizures. Clinicians may also mistake seizure manifestations for symptoms of the underlying dementia. Second, since most dementia patients are elderly, there are pharmacokinetic changes with aging that affect the use of antiepileptic drugs. Third, antiepileptic drugs have potential cognitive adverse effects that may worsen dementia. Although few studies are available, extrapolations from research in young people and elderly patients without dementia provide several recommendations for the management of seizures in patients with dementia: exclude symptomatic causes of seizures before committing to antiepileptic drug therapy; treat after a first seizure if there is evidence of focal neurological involvement or a risk of recurrent seizures; use antiepileptic drugs with minimal cognitive adverse effects, such as carbamazepine, valproic acid, gabapentin and lamotrigine; and use the lowest possible dosage and monitor antiepileptic drug levels, where possible. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA 90073 USA. RP Mendez, MF (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Neurol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 100 TC 89 Z9 91 U1 1 U2 7 PU ADIS INT LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 1170-229X J9 DRUG AGING JI Drugs Aging PY 2003 VL 20 IS 11 BP 791 EP 803 DI 10.2165/00002512-200320110-00001 PG 13 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 725JE UT WOS:000185539700001 PM 12964886 ER PT J AU Sachs, G Shin, JM Pratha, V Hogan, D AF Sachs, G Shin, JM Pratha, V Hogan, D TI Synthesis or rupture: Duration of acid inhibition by proton pump inhibitors SO DRUGS OF TODAY LA English DT Article; Proceedings Paper CT Symposium on Acid-Related Disease CY OCT, 2002 CL GENEVA, SWITZERLAND ID SECRETION; OMEPRAZOLE; LANSOPRAZOLE; REVERSAL; E3810 AB Insight has been gained into the relationship between the structure of proton pump inhibitors (PPIs), their binding, and their suppression of acid secretion. PPIs accumulate in the acidic space of the secreting parietal cell, where then their active forms create disulfide bonds with key cysteines of the H+, K+-ATPase. Studies in humans on the half-lives of recovery of acid secretion have found that while lansoprazole showed a half-life of less than 15 h, and both omeprazole and rabeprazole showed one of less than 30 h, for pantoprazole the half-life was approximately 46 h. This difference in duration of inhibition with PPIs may be related to variations in proton pump inhibitor dwell time. A study in rats suggests that the recovery of gastric pump activity after treatment with omeprazole, esomeprazole, lansoprazole and rabeprazole is likely due to both reversal of binding by disulfide-reducing agents and to pump synthesis. However, for pantoprazole, reversal of acid inhibition is probably due mainly to de novo pump synthesis and not loss of binding. This profile is likely related to the unique binding of pantoprazole to cysteine 822, a binding site which is buried deep within the membrane domain of the pump and may therefore be inaccessible to reducing agents. Although clinical data supporting these findings are limited, prolonged binding of pantoprazole may confer a longer duration of action in comparison with other PPIS. (C) 2003 Prous Science. Ail rights reserved. C1 Univ Calif Los Angeles, Membrane Biol Lab, W Los Angeles VA Med Ctr, Los Angeles, CA 90073 USA. Univ Calif San Diego, San Diego, CA 92103 USA. RP Sachs, G (reprint author), Univ Calif Los Angeles, Membrane Biol Lab, W Los Angeles VA Med Ctr, 11301 Wilshire Blvd,Bldg 113,Rm 324, Los Angeles, CA 90073 USA. NR 9 TC 13 Z9 13 U1 1 U2 2 PU PROUS SCIENCE, SA PI BARCELONA PA PO BOX 540, PROVENZA 388, 08025 BARCELONA, SPAIN SN 0025-7656 J9 DRUGS TODAY JI Drugs Today PY 2003 VL 39 SU A BP 11 EP 14 PG 4 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 663RT UT WOS:000182019900003 PM 12712216 ER PT J AU Royall, DR Roman, GC Delacourte, A AF Royall, DR Roman, GC Delacourte, A TI Untitled SO EXPERIMENTAL AGING RESEARCH LA English DT Letter ID ASTROCYTES C1 Audie L Murphy Mem Vet Adm Med Ctr, Audie L Murphy VA Geriatr Res Educ Clin Ctr, Dept Psychiat, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, Dept Med, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, Dept Pharmacol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. Audie L Murphy VA, Dept Med Neurol, San Antonio, TX USA. Unite INSERM, Serv Neurol, Lille, France. RP Royall, DR (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, Audie L Murphy VA Geriatr Res Educ Clin Ctr, Dept Psychiat, San Antonio, TX 78229 USA. NR 10 TC 3 Z9 3 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0361-073X J9 EXP AGING RES JI Exp. Aging Res. PD JAN-MAR PY 2003 VL 29 IS 1 BP 107 EP 110 DI 10.1080/03610730390168102 PG 4 WC Geriatrics & Gerontology; Psychology SC Geriatrics & Gerontology; Psychology GA 614ZX UT WOS:000179222300008 PM 12735084 ER PT J AU Hunt, GC Smith, PP Faigel, DO AF Hunt, GC Smith, PP Faigel, DO TI Yield of tissue sampling for submucosal lesions evaluated by EUS SO GASTROINTESTINAL ENDOSCOPY LA English DT Article; Proceedings Paper CT Digestive Disease Week/102nd Annual Meeting of the American-Gastroenterological-Association CY MAY 20-23, 2001 CL ATLANTA, GEORGIA SP Amer Gastroenterol Assoc ID ENDOSCOPIC MUCOSAL RESECTION; COLORECTAL TUMORS; ULTRASOUND PROBE; DIAGNOSIS; INVASION AB Background: Evaluation of submucosal nodules or large gastric folds is a common indication for EUS. Establishing a tissue diagnosis is challenging because the yield of forceps biopsies is low. The aim of this study was to determine the diagnostic yield of EUS-guided endoscopic submucosal-mucosal resection and forceps biopsy for submucosal nodules and large gastric folds. Methods: Patients who underwent EUS from March 1997 through January 2002 for evaluation of submucosal nodules or large gastric folds were identified, and the procedure and pathology reports reviewed. Patients were included who underwent endoscopic submucosal-mucosal resection (n = 45) or large-capacity ("jumbo") biopsy (n = 36) of submucosal lesions (arising from third endosonographic layer) or large gastric folds. Endoscopic submucosal-mucosal resection was performed with an electrosurgical snare or with a cap-fitted endoscopic mucosal resection device. Results: Sixty-six patients (62% men; mean age, 61 years; range 27-80 years) underwent 69 EUS procedures to obtain tissue samples of subepithelial lesions. Diagnostic yields were as follows: endoscopic submucosal-mucosal resection 40/45 (89%; 95% CI [80%, 98%]), jumbo biopsy 15/36 (42%; 95% CI [26%, 58%]) (p < 0.001 by two-tailed Fisher exact test). There were 9 complications: 7 instances of bleeding (6 endoscopic submucosal-mucosal resection, 1 jumbo biopsy), 3 requiring hospitalization (2 endoscopic submucosal-mucosal resection, 1 jumbo biopsy) and 2 requiring transfusion; 1 chest pain and odynophagia (esophageal endoscopic submucosal-mucosal resection); and 1 oversedation (requiring administration of reversal agents). Conclusions: For submucosal lesions and large gastric folds, endoscopic submucosal-mucosal resection has a better diagnostic yield than the jumbo biopsy, but may have a higher complication rate. C1 Oregon Hlth Sci Univ, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Faigel, DO (reprint author), Oregon Hlth Sci Univ, Phys Pavil,Suite 310,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. NR 20 TC 66 Z9 71 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 JAN PY 2003 VL 57 IS 1 BP 68 EP 72 DI 10.1067/mge.2003.34 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 634JQ UT WOS:000180336600012 PM 12518134 ER PT S AU Sattin, A Pekary, AE Lloyd, RL Paulson, M Meyerhoff, JA Hinkle, PM Faull, K AF Sattin, A Pekary, AE Lloyd, RL Paulson, M Meyerhoff, JA Hinkle, PM Faull, K BE Moghaddam, B Wolf, M TI TRH and related peptides - Homeostatic regulators of glutamate transmission? SO GLUTAMATE AND DISORDERS OF COGNITION AND MOTIVATION SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Glutamate and Disorders of Cognition and Motivation CY APR 13-15, 2003 CL NEW HAVEN, CONNECTICUT SP Acad Sci, Natl Inst Ment Mental, Eli Lilly & Co DE TRH; glutamate transmission; colocalization ID RAT-BRAIN; MECHANISM; RECEPTORS C1 Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Calif State Univ Los Angeles, Dept Psychiat, Los Angeles, CA USA. Calif State Univ Los Angeles, Dept Med, Los Angeles, CA USA. Calif State Univ Los Angeles, Brain Res Inst, Los Angeles, CA USA. Univ Minnesota, Dept Psychol, Duluth, MN USA. Walter Reed Army Inst Res, Silver Spring, MD USA. Univ Rochester, Dept Pharmacol, Rochester, NY USA. RP Sattin, A (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, POB 84122, Los Angeles, CA 90073 USA. EM asattin@ucla.edu NR 10 TC 2 Z9 2 U1 0 U2 1 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-476-5 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2003 VL 1003 BP 458 EP 460 DI 10.1196/annals.1300.053 PG 3 WC Multidisciplinary Sciences; Clinical Neurology; Neurosciences; Pharmacology & Pharmacy SC Science & Technology - Other Topics; Neurosciences & Neurology; Pharmacology & Pharmacy GA BY31Q UT WOS:000188893500058 PM 14684488 ER PT B AU El-Zimaity, H AF El-Zimaity, H BE Hunt, RH Tytgat, GNJ TI Multifocal Atrophic Gastritis (MAG) does not exist: new finding based on sectioning the entire stomach SO HELICOBACTER PYLORI: BASIC MECHANISMS TO CLINICAL CURE 2002 LA English DT Proceedings Paper CT 5th Symposium on Helicobacter Pylori - Basic Mechanisms to Clinical Care CY NOV 10-13, 2002 CL Maui, HI SP AXCAN PHARMA ID HELICOBACTER-PYLORI INFECTION; DUODENAL-ULCER DISEASE; INTESTINAL METAPLASIA; PEPTIC-ULCER; CANCER; CARCINOMA; MUCOSA; OMEPRAZOLE; RISK; ACQUISITION C1 VA Med Ctr, Gastrointestinal Mucosa Pathol Lab, Houston, TX 77030 USA. RP El-Zimaity, H (reprint author), VA Med Ctr, Gastrointestinal Mucosa Pathol Lab, GI 111D,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 51 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA PO BOX 17, 3300 AA DORDRECHT, NETHERLANDS BN 0-7923-8790-2 PY 2003 BP 133 EP 142 PG 10 WC Gastroenterology & Hepatology; Microbiology SC Gastroenterology & Hepatology; Microbiology GA BAN62 UT WOS:000222982900013 ER PT S AU Ishikawa, F Drake, CJ Yang, S Fleming, PA Minamiguchi, H Visconti, RP Crosby, CV Argraves, WS Harada, M Key, LL Livingston, AG Wingard, JR Ogawa, M AF Ishikawa, F Drake, CJ Yang, S Fleming, PA Minamiguchi, H Visconti, RP Crosby, CV Argraves, WS Harada, M Key, LL Livingston, AG Wingard, JR Ogawa, M BE Orlic, D Brummendorf, TH Fibbe, W Sharkis, S Kanz, L TI Transplanted human cord blood cells give rise to hepatocytes in engrafted mice SO HEMATOPOIETIC STEM CELLS 2002: GENETICS AND FUNCTION SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 4th International Symposium on Hematopoietic Stem Cells CY SEP 19-21, 2002 CL UNIV TUBINGEN, TUBINGEN, GERMANY SP Amgen Europe, Kirin Japan HO UNIV TUBINGEN DE hepatocytes; cord blood; transdifferentiation; production; stem cells ID BONE-MARROW CELLS; STEM-CELL; C-KIT; LIVER; DIFFERENTIATE; ANTIBODY; FUSION; TUMORS AB Recent studies suggest-that rodent hepatocytes may be derived from hematopoietic stem cells. In the current study, the potential hematopoietic origin of hepatocytes was addressed using xenogeneic transplantation of human cord blood cells. CD34(+) or CD45(+) human cord blood cells were transplanted into "conditioned" newborn NOD/SCID/beta2-microglobulin(null) mice. At 4 to 5 months post-transplantation, livers of the recipient mice were cryosectioned and examined for evidence of human hepatocyte engraftment using RT-PCR to detect human albumin mRNA, immunohistochemistry to detect human hepatocytic proteins, and fluorescence in situ hybridization (FISH) to detect the presence of human centromeric DNA. Analysis of the bone marrow of transplanted mice revealed that 21.0-45.9% of the cells were human CD45(+) cells. FISH analysis of frozen sections of transplanted mouse liver revealed the presence of engrafted cells positive for human centromeric DNA. That engrafted human cells functioned as hepatocytes was indicated by the expression of human albumin mRNA, as judged by RT-PCR. FISH analysis with human and mouse centromeric DNA probes excluded spontaneous cell fusion as the cause for the generation of human hepatocytes. Human cord blood cells can give rise to hepatocytes in a xenogeneic transplantation model. This model will be useful to further characterize the cord blood progenitors of hepatocytes. C1 Dept Vet Affairs Med Ctr, Charleston, SC USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Kyushu Univ, Grad Sch Med, Dept Med & Biosystemat Sci, Fukuoka 812, Japan. Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Cell Biol & Anat, Charleston, SC 29425 USA. Univ Florida, Dept Hematol Oncol, Gainesville, FL USA. RP Ogawa, M (reprint author), Ralph H Johnson Vet Affairs Med Ctr, 109 Bee St, Charleston, SC 29401 USA. RI 石川, 文彦/L-4488-2014 FU NCI NIH HHS [P01-CA78582]; NHLBI NIH HHS [R01-HL52813, R01-HL57375]; NIDDK NIH HHS [R01-DK54197] NR 20 TC 99 Z9 103 U1 0 U2 2 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-466-8 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2003 VL 996 BP 174 EP 185 PG 12 WC Cell Biology; Hematology; Multidisciplinary Sciences SC Cell Biology; Hematology; Science & Technology - Other Topics GA BW93G UT WOS:000183697800020 PM 12799295 ER PT J AU Houser, CR Esclapez, M AF Houser, CR Esclapez, M TI Downregulation of the alpha 5 subunit of the GABA(A) receptor in the pilocarpine model of temporal lobe epilepsy SO HIPPOCAMPUS LA English DT Article DE GABA; hippocampus; plasticity; immunohistochemistry; in situ hybridization ID GAMMA-AMINOBUTYRIC-ACID; SPONTANEOUS RECURRENT SEIZURES; MESSENGER-RNA EXPRESSION; CEREBELLAR GRANULE CELLS; CA1 PYRAMIDAL CELLS; ADULT-RAT BRAIN; A RECEPTOR; DENTATE GYRUS; IMMUNOCYTOCHEMICAL DISTRIBUTION; PHARMACOLOGICAL PROPERTIES AB Specific subunits of gamma-aminobutyric acid (GABA)(A) receptors may be regulated differentially in animal models of temporal lobe epilepsy during the chronic stage. Although several subunits may be upregulated, other subunits may be downregulated in the hippocampal formation. The alpha5 subunit is of particular interest because of its relatively selective localization in the hippocampus and its potential role in tonic inhibition. In normal rats, immunolabeling of the alpha5 subunit was high in the dendritic layers of CA1 and CA2 and moderate in these regions of CA3. in chronic pilocarpine-treated rats displaying recurrent seizures, alpha5 subunit-labeling was substantially decreased in CA1 and nearly absent in CA2. Only slight decreases in immunolabeling were evident in CA3. In situ hybridization studies demonstrated that the alpha5 subunit mRNA was also strongly decreased in stratum pyramidale of CA1 and CA2. Thus, the alterations in localization of the alpha5 subunit peptide and its mRNA were highly correlated. The large decreases in labeling of the alpha5 subunit did not appear to be related to loss of pyramidal neurons in CA1 or CA2 since these neurons were generally preserved in pilocarpine-treated animals. No comparable decreases in labeling of the alpha2 subunit of the GABA(A) receptor were detected. These findings indicate that the alpha5 subunit of the GABA(A) receptor is capable of substantial and prolonged downregulation in remaining pyramidal neurons in a model of temporal lobe epilepsy. The results raise the possibility that presumptive extrasynaptic GABA(A) receptor subunits, such as the alpha5 subunit, may be regulated differently than synaptically located subunits, such as the alpha2 subunit, within the same brain regions in some pathological conditions. (C) 2003 Wiley-Liss, Inc. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Inst Brain Res, Los Angeles, CA 90095 USA. Fac Sci Luminy, INSERM, INMED, U29, Marseille, France. VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. RP Houser, CR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, 73-235 CHS, Los Angeles, CA 90095 USA. RI Esclapez, Monique/O-6509-2016 OI Esclapez, Monique/0000-0002-8558-1363 FU BLRD VA [I01 BX000404]; NINDS NIH HHS [NS35985] NR 66 TC 74 Z9 78 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 1050-9631 J9 HIPPOCAMPUS JI Hippocampus PY 2003 VL 13 IS 5 BP 633 EP 645 DI 10.1002/hipo.10108 PG 13 WC Neurosciences SC Neurosciences & Neurology GA 706FZ UT WOS:000184444100008 PM 12921352 ER PT J AU Johnson, FK Durante, W Peyton, KJ Johnson, RA AF Johnson, FK Durante, W Peyton, KJ Johnson, RA TI Heme oxygenase inhibitor restores arteriolar nitric oxide function in Dahl rats SO HYPERTENSION LA English DT Article DE acetylcholine; nitric oxide; hypertension, sodium-dependent; rats, Dahl; endothelium ID SALT-SENSITIVE HYPERTENSION; CARBON-MONOXIDE; ANGIOTENSIN-II; L-ARGININE; VASODILATION; HEMOPROTEIN; EXPRESSION; SYNTHASE AB Vascular tissues express heme oxygenase (HO), which metabolizes heme to form carbon monoxide (CO). CO relaxes vascular smooth muscle but inhibits nitric oxide (NO) formation. Decreased NO synthesis may contribute to salt-induced hypertension in Dahl salt-sensitive (DS) rats. The current study examines the hypothesis that elevated levels of endogenous CO contribute to NO dysfunction in salt-induced hypertensive DS rats. Male DS rats were placed on high-salt (8% NaCl, HS) or low-salt (0.3% NaCl, LS) diets for 4 weeks. With respect to the LS group, the HS group's blood pressure and carboxyhemoglobin levels were elevated, and abdominal aortas showed 6-fold higher HO-1 protein levels. Experiments used isolated pressurized first-order gracilis muscle arterioles superfused with oxygenated modified Krebs buffer. An inhibitor of NO synthase, Nomega-nitro-L-arginine methyl ester (L-NAME), caused concentration-dependent vasoconstriction in both groups, with attenuated responses in HS arterioles. HS arterioles also showed attenuated vasodilatory responses to an endothelium-dependent vasodilator, acetylcholine. Acute pretreatment with an inhibitor of HO, chromium mesoporphyrin, enhanced vascular responses to L-NAME and acetylcholine in both groups but abolished the differences between HS and LS arterioles. These data show that HO-1 protein levels and CO production are increased in HS rats. Arteriolar responses to L-NAME and acetylcholine are impaired in HS rats compared with LS animals, and this difference can be abolished by an inhibitor of endogenous CO production. These results suggest that elevated levels of endogenous CO contribute to arteriolar NO dysfunction in DS rats with salt-induced hypertension. C1 Tulane Univ, Hlth Sci Ctr, Dept Physiol, New Orleans, LA 70112 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pharmacol, Houston, TX 77030 USA. Baylor Coll Med, Houston VA Med Ctr, Houston, TX 77030 USA. RP Johnson, FK (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 [1R01HL64577, R01 HL59976] NR 38 TC 40 Z9 40 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD JAN PY 2003 VL 41 IS 1 BP 149 EP 155 DI 10.1161/01.HYP.0000046923.52222.58 PG 7 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 634XD UT WOS:000180367000025 PM 12511545 ER PT J AU Bush, RK Stave, GM AF Bush, RK Stave, GM TI Laboratory animal allergy: An update SO ILAR JOURNAL LA English DT Article DE allergens; allergy; animal allergy; asthma; laboratory animal allergy; laboratory animals; occupational health ID GUINEA-PIG; OCCUPATIONAL ALLERGY; UNIVERSITY EMPLOYEES; LIPOCALIN PROTEINS; RABBIT ALLERGENS; MOUSE ALLERGENS; IMMUNE-RESPONSE; DOG ALLERGENS; RAT FUR; SENSITIZATION AB Allergic reactions are among the most common conditions affecting the health of workers involved in the care and use of research animals. Between 11 and 44% of the individuals working with laboratory animals report work-related allergic symptoms. Of those who become symptomatic, 4 to 22% may eventually develop occupational asthma that can persist even after exposure ceases. Allergic symptoms consist of rashes where animals are in contact with the skin, nasal congestion and sneezing, itchy eyes, and asthma (cough, wheezing, and chest tightness). The generation of immunoglobulin E (IgE) antibodies is a prerequisite for the production of allergic symptoms. The mechanism by which IgE antibodies develop is becoming clearer. The propensity to produce IgE is genetically determined, and pre-existing allergy may be a risk factor for the development of laboratory animal allergy (LAA). However, exposure to animal allergens is the major risk factor for the development of LAA. Techniques to measure the airborne concentration of laboratory animal allergens have been developed. Research on animal allergens themselves indicates that many of the mouse and rat urinary proteins belong to a family of proteins called lipocalins, which share sequence homology with antigens of the parasitic agent that causes schistosomiasis. The fact that parasite infections also trigger I-E antibody responses may account for the development of LAA in persons who have never had any previous allergy. The prevention of LAA should be a major goal of an effective health and safety program in the animal research facility, and it can be accomplished by education and training of employees, reduction of exposure (including the use of personal protective gear), and changes in facility design. Medical surveillance programs can also play a role in improving health of individuals working with laboratory research animals. Early recognition of symptoms and evidence of sensitization can lead to interventions to reduce exposure and thereby avoid the long-term health consequences of LAA. C1 William S Middleton Mem Vet Adm Med Ctr, Allergy Sect, Madison, WI USA. Univ Wisconsin, Madison, WI 53706 USA. GlaxoSmithKline, Res Triangle Pk, NC USA. Duke Univ, Med Ctr, Div Environm & Occupat Med, Durham, NC 27706 USA. RP Bush, RK (reprint author), William S Middleton Mem Vet Adm Med Ctr, Allergy Sect, Madison, WI USA. NR 75 TC 41 Z9 44 U1 0 U2 1 PU INST LABORATORY ANIMAL RESEARCH, NATL RES COUNCIL PI WASHINGTON PA 500 FIFTH ST, N W, WASHINGTON, DC 20001 USA SN 1084-2020 J9 ILAR J JI ILAR J. PY 2003 VL 44 IS 1 BP 28 EP 51 PG 24 WC Veterinary Sciences SC Veterinary Sciences GA 752WL UT WOS:000187199100005 PM 12473829 ER PT J AU Hammer, MB Faldowski, RA Ulmer, HG Frueh, BC Huber, MG Arana, GW AF Hammer, MB Faldowski, RA Ulmer, HG Frueh, BC Huber, MG Arana, GW TI Adjunctive risperidone treatment in post-traumatic stress disorder: a preliminary controlled trial of effects on comorbid psychotic symptoms SO INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY LA English DT Article DE risperidone; post-traumatic stress disorder; psychosis ID AUDITORY HALLUCINATIONS; COMBAT VETERANS; DOUBLE-BLIND; PTSD; SCHIZOPHRENIA; OLANZAPINE; PLACEBO; MULTICENTER; SERTRALINE; SEVERITY AB Positive and negative symptoms of psychosis may be common in patients with chronic post-traumatic stress disorder (PTSD), but few studies have investigated the use of antipsychotic agents in these patients. This preliminary study examined the potential efficacy of risperidone in treating psychotic symptoms associated with chronic PTSD. In a 5-week, prospective, randomized, double-blind, placebo-controlled trial, adjunctive risperidone treatment was assessed in 40 combat veterans with chronic PTSD and comorbid psychotic features. Most patients were receiving antidepressants and some other psychotics with doses of concurrent medications held constant for at least 1 month prior to and during the study. Thirty-seven patients completed at least 1 week of treatment with risperidone or placebo. The Positive and Negative Syndrome Scale (PANSS) and the Clinician Administered PTSD Scale (CAPS) were used to assess symptoms. The PANSS was the primary outcome measure. At treatment endpoint, risperidone-treated patients showed a significantly greater decrease from baseline, albeit modest, in psychotic symptoms (PANSS total scores) than placebo-treated patients (P<0.05). CAPS ratings declined significantly in both groups but did not differ significantly between groups. However, CAPS re-experiencing subscale scores had greater improvement in the risperidone-treated patients at week 5 (P<0.05, completer analysis) with a trend towards greater improvement versus placebo a endpoint (P<0.1, LOCF). Risperidone was well tolerated with minimal extrapyramidal symptoms. These preliminary results support studying the potential efficacy of risperidone for treating global psychotic symptoms associated with chronic PTSD with a suggestion that core re-experiencing symptoms may also be responsive. Further research using randomized, controlled trial designs in larger patient groups are needed to define more adequately the role of risperidone and other atypical agents in PTSD. (C) 2003 Lippincott Williams Wilkins. C1 Ralph H Johnson VA Med Ctr 116, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. RP Hammer, MB (reprint author), Ralph H Johnson VA Med Ctr 116, 109 Bee St, Charleston, SC 29401 USA. EM hamnermb@musc.edu NR 34 TC 13 Z9 14 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0268-1315 EI 1473-5857 J9 INT CLIN PSYCHOPHARM JI Int. Clin. Psychopharmacol. PD JAN PY 2003 VL 18 IS 1 BP 1 EP 8 DI 10.1097/01.yic.0000050744.67514.6d PG 8 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 636ZZ UT WOS:000180488300001 ER PT J AU Solomon, CS Leitner, JW Goalstone, ML AF Solomon, CS Leitner, JW Goalstone, ML TI Dominant negative alpha-subunit of farnesyl- and geranylgeranyl-transferase I inhibits insulin-induced differentiation of 3T3-L1 pre-adipocytes SO INTERNATIONAL JOURNAL OF OBESITY LA English DT Article DE 3T3-L1 adipocytes; DN FTase alpha-subunit; farnesyltransferase; geranylgeranyltransferase; obesity; type 2 diabetes ID ACTIVATED PROTEIN-KINASE; SMOOTH-MUSCLE CELLS; GENE-EXPRESSION; GROWTH-FACTOR; FARNESYLTRANSFERASE; HYPERINSULINEMIA; ADIPOGENESIS; RAS; PHOSPHORYLATION; PREADIPOCYTES AB OBJECTIVE: To investigate whether the expression of a dominant negative (DN) farnesyl- and geranygeranyl-transferase I (FTase /GGTase 1) alpha-subunit in 3T3-L1 pre-adipocytes can inhibit insulin's ability to induce differentiation, DESIGN: 3T3-L1 pre-adipocytes were stably transfected with vector alone or vector expressing a mutated DN FTase/GGTase I alpha-subunit (S60A)(S62A) and incubated in serum-free medium in the absence and presence of insulin. MEASUREMENTS: Various assays were performed to determine the effect of DN FTase/GGTase I alpha-subunit expression in 3T3-L1 pre-adipocyte on insulin-induced DNA synthesis, cell count, phosphorylation of the FTase/GGTase I alpha-subunit, FTase and GGTase I activity, amounts of prenylated p21 Ras and RhoA, phosphorylation of MAP kinase and Akt, and differentiation to mature fat cells. RESULTS: Expression of DN FTase/GGTase I alpha-subunit inhibited insulin's ability to increase DNA synthesis, cell count, FTase and GGTase I activity, amounts of prenylated p21 Ras and RhoA, and magnitude of phosphorylation of MAP kinase, Expression of DN FTase/GGTase I alpha-subunit in 3T3-L1 pre-adipocytes was without effect on insulin-induced Akt phosphorylation. CONCLUSION: Expression of DN FTase/GGTase I alpha-subunit inhibits insulin-induced differentiation of 3T3-L1 pre-adipocytes to mature adipocytes, and thus could indicate potential therapeutic avenues to assuage the deleterious effects of obesity and type 2 diabetes. C1 Denver VA Med Ctr, Res Serv, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. RP Goalstone, ML (reprint author), Denver VA Med Ctr, Res Serv, 111H,1055 Clermont St, Denver, CO 80220 USA. NR 36 TC 11 Z9 11 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0307-0565 J9 INT J OBESITY JI Int. J. Obes. PD JAN PY 2003 VL 27 IS 1 BP 40 EP 47 DI 10.1038/sj.ijo.0802189 PG 8 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 636XP UT WOS:000180482800006 PM 12532152 ER PT J AU Breitner, J AF Breitner, J TI Nixon's law: for AD risk factors, "timing is everything" SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Meeting Abstract C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PUBLISHING CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10012 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PY 2003 VL 15 SU 2 BP 109 EP 109 PG 1 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 831QJ UT WOS:000222209400258 ER PT J AU Sano, M AF Sano, M TI Practical strategies for identifying minority elders: Focus on Alzheimer's disease trials SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Meeting Abstract C1 Bronx Vet Adm Med Ctr, Dept Psychiat, Mt Sinai Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PUBLISHING CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10012 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PY 2003 VL 15 SU 2 BP 154 EP 154 PG 1 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 831QJ UT WOS:000222209400376 ER PT J AU Rapp, MA Mohs, RC Sano, M Wysocki, M Kesar, R Ware, K Marin, D Haroutunian, V Grossman, HZ AF Rapp, MA Mohs, RC Sano, M Wysocki, M Kesar, R Ware, K Marin, D Haroutunian, V Grossman, HZ TI Predictors of longitudinal change in cognition in very old nursing home residents SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Meeting Abstract C1 Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PUBLISHING CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10012 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PY 2003 VL 15 SU 2 BP 281 EP 282 PG 2 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 831QJ UT WOS:000222209400652 ER PT J AU Rapp, MA Mohs, RC Sano, M Wysocki, M Ware, K Kesar, R Marin, D Grossman, HZ Haroutunian, V AF Rapp, MA Mohs, RC Sano, M Wysocki, M Ware, K Kesar, R Marin, D Grossman, HZ Haroutunian, V TI Orientation deficits precede rapid cognitive decline in nursing home residents with Alzheimer's disease SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Meeting Abstract C1 Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PUBLISHING CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10012 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PY 2003 VL 15 SU 2 BP 281 EP 281 PG 1 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 831QJ UT WOS:000222209400651 ER PT J AU Raskind, M Peskind, E Kershaw, P Mahableshwarkar, AR AF Raskind, M Peskind, E Kershaw, P Mahableshwarkar, AR TI Long-term cognitive response to galantamine in patients with mild-to-moderate Alzheimer's disease: A continuance analysis SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Meeting Abstract C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Janssen Pharmaceutica Prod LP, Titusville, NJ USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU SPRINGER PUBLISHING CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10012 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PY 2003 VL 15 SU 2 BP 282 EP 282 PG 1 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 831QJ UT WOS:000222209400653 ER PT J AU Mistry, R Gokhman, I Bastani, R Gould, R Jimenez, EE Lavretsky, H Maxwell, A McDermott, C Rosansky, J Van Stone, W Jarvik, L AF Mistry, R Gokhman, I Bastani, R Gould, R Jimenez, EE Lavretsky, H Maxwell, A McDermott, C Rosansky, J Van Stone, W Jarvik, L TI Measuring medical burden in older veterans enrolled in UPBEAT, a psychogeriatric treatment program: A pilot study SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Meeting Abstract C1 Univ Calif Los Angeles, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RI Lavretsky, Helen/M-5711-2015 OI Lavretsky, Helen/0000-0001-9990-5085 NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PUBLISHING CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10012 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PY 2003 VL 15 SU 2 BP 310 EP 310 PG 1 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 831QJ UT WOS:000222209400709 ER PT J AU Stempel, D Sandusky, H Lampi, K Cilluffo, M Horwitz, J Braun, J Goodglick, L Gordon, LK AF Stempel, D Sandusky, H Lampi, K Cilluffo, M Horwitz, J Braun, J Goodglick, L Gordon, LK TI Beta B1-crystallin: Identification of a candidate ciliary body uveitis antigen SO INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE LA English DT Article ID ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES; EXPERIMENTAL AUTOIMMUNE UVEORETINITIS; ALPHA-B-CRYSTALLIN; ULCERATIVE-COLITIS; ANTERIOR UVEITIS; EPITHELIAL-CELLS; CROHNS-DISEASE; EXTRALENTICULAR EXPRESSION; DIFFERENTIAL EXPRESSION; PANCA ANTIBODIES AB PURPOSE. Perineuclear anti-neutrophil cytoplasmic antibody (pANCA), a marker antibody present in 12% of patients with anterior uveitis, recognizes cytoplasmic antigens in the nonpigmented ciliary body epithelium, a probable site of immunologic reactivity in this inflammatory disease. In this study, a recombinantly isolated pANCA monoclonal antibody was used to identify the corresponding antigenic target(s) in the ciliary body. METHODS. Proteins from microdissected eye bank ocular ciliary body tissue were used to identify the corresponding ANCA antigen. Parallel two-dimensional protein gels were used for simultaneous identification of candidate antigenic protein spots by Western blot analysis and as a source of material for proteomic analysis. Multiple independent methods including Western blot analysis, confocal microscopy, and RT-PCR were used to provide additional characterization of the candidate protein. RESULTS. Proteomic analysis suggested that beta B1 (betaB1)-crystallin is the primary ciliary body antigen. The presence of betaB1-crystallin in the human ciliary body was confirmed by Western blot with a betaB1 specific anti-peptide antibody. Confocal microscopy revealed colocalization of the antigenic reactivity of both anti-betaB1 antibody and monoclonal pANCA. RTPCR confirmed the presence of betaB1-crystallin RNA in the ciliary body tissues. CONCLUSIONS. This study identified betaB1-crystallin as a new cytoplasmic ciliary body antigenic target of a marker autoantibody associated with uveitis. This characterization of betaB1-crystallin outside the lens raises questions about its extralenticular expression, intracellular role, and potential target of inflammation in uveitis. C1 Univ Calif Los Angeles, Dept Ophthalmol, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Physiol Sci, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Pathol & Lab Med, Los Angeles, CA USA. Oregon Hlth Sci Univ, Dept Oral Mol Biol, Portland, OR USA. W Los Angeles Vet Affairs Med Ctr, Dept Surg, Los Angeles, CA USA. RP Gordon, LK (reprint author), Jules Stein Eye Inst, 100 Stein Plaza, Los Angeles, CA 90095 USA. OI Braun, Jonathan/0000-0003-1646-2974 FU NEI NIH HHS [R29 EY012239-05, EY 00360, EY 12239, EY 13708, R03 EY013708, R29 EY012239] NR 53 TC 15 Z9 16 U1 0 U2 1 PU ASSOC RESEARCH VISION OPHTHALMOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0146-0404 J9 INVEST OPHTH VIS SCI JI Invest. Ophthalmol. Vis. Sci. PD JAN PY 2003 VL 44 IS 1 BP 203 EP 209 DI 10.1167/iovs.01-1261 PG 7 WC Ophthalmology SC Ophthalmology GA 631EZ UT WOS:000180156300031 PM 12506076 ER PT J AU Schellhase, KG Koepsell, TD Weiss, NS Wagner, EH Reiber, GE AF Schellhase, KG Koepsell, TD Weiss, NS Wagner, EH Reiber, GE TI Glucose screening and the risk of complications in Type 2 diabetes mellitus SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE mass screening; diabetes mellitus; outcome assessment; case-control studies; diabetes mellitus/complications; diabetes mellitus/epidemiology ID COLORECTAL-CANCER; NIDDM; MORTALITY; BENEFITS; ADULTS AB It is unknown whether glucose screening for Type 2 diabetes mellitus (DM2) reduces the risk of diabetic complications. We conducted a case-control study using 303 cases with DM2 and at least one symptomatic microvascular diabetic complication, matched 1:1 to control subjects. All subjects' blood glucose tests for the decade before the first clinical suspicion of DM2 were categorized as screening or not based on the presence of symptoms suggestive of DM2. Approximately 90% of case subjects and control subjects had been screened for diabetes. After adjusting for multiple covariates in a logistic regression model, the odds ratio of developing a complication associated with screening was 0.87 (95% confidence interval 0.38-1.98), suggesting that screening may be associated with a modest reduction in the risk of certain diabetic complications. However, the confidence limits were wide and consistent with no true benefit. Further studies are needed to establish whether the small reduction we observed is genuine. (C) 2003 Elsevier Science Inc. All rights reserved. C1 Univ Washington, Dept Family Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Sci, Seattle, WA 98195 USA. Univ Washington, Robert Wood Johnson Clin Scholars Program, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. Sandy MacColl Inst Healthcare Innovat, Seattle, WA 98101 USA. Grp Hlth Cooperat Puget Sound, Seattle, WA 98101 USA. Vet Affairs Puget Sound Hlth Syst, Hlth Sci Res & Dev, Seattle, WA 98108 USA. RP Schellhase, KG (reprint author), Med Coll Wisconsin, Dept Family & Community Med, 8701 Watertown Plank Rd, Milwaukee, WI 53226 USA. NR 25 TC 11 Z9 11 U1 0 U2 1 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 JAN PY 2003 VL 56 IS 1 BP 75 EP 80 AR PII S0895-4356(02)00533-4 DI 10.1016/S0895-4356(02)00533-4 PG 6 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 646ZW UT WOS:000181067600010 PM 12589873 ER PT J AU Marder, SR AF Marder, SR TI Overview of partial compliance SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Teleconference on Partial Compliance: Need for Long Acting Atypical Antipsychotics CY MAR 27, 2002 CL ELECTR NETWORK ID SCHIZOPHRENIC-PATIENTS; MEDICATION ADHERENCE; ANTIPSYCHOTIC MEDICATION; PSYCHOTIC DISORDERS; RELAPSE; INPATIENTS; THERAPY; DRUG; NONCOMPLIANCE AB A substantial proportion of patients with psychiatric and nonpsychiatric chronic illnesses fail to take their medications as prescribed. A number of studies suggest that 50% or more of individuals with schizophrenia are noncompliant with medications at some time during their illness. In most cases, patients are partially compliant, taking only a portion of their prescribed medications. Noncompliance is probably the most important element contributing to relapse in schizophrenia. Factors contributing to the rate of noncompliance include medication side effects, the severity of psychotic symptoms, impaired cognition, and an inadequate understanding of the role of medication for preventing relapse. In addition, both patients and clinicians overestimate patients' compliance. Strategies for managing partial compliance include the treatment of medication side effects, the education of patients about their illness, and the use of long-acting antipsychotic formulations. C1 W LA VA Hlth Care Ctr, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90024 USA. RP Marder, SR (reprint author), W LA VA Hlth Care Ctr, VA Greater Los Angeles Hlth Care Syst, MIRECC-210A,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 41 TC 61 Z9 62 U1 2 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 2003 VL 64 SU 16 BP 3 EP 9 PG 7 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 753YW UT WOS:000187276800001 PM 14680412 ER PT J AU Mintzer, JE AF Mintzer, JE TI The search for better noncholinergic treatment options for Alzheimer's disease SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Teleconference on Noncholinergic Treatments for Alzheimers Disease CY NOV 25, 2002 CL ELECTR NETWORK ID PLACEBO-CONTROLLED-TRIAL; DOUBLE-BLIND; BEHAVIORAL DISTURBANCES; DEMENTIA; GINKGO; PSYCHOSIS; MEMANTINE; EFFICACY; MEMORY AB Alzheimer's disease is a biological process that involves the disruption of multiple neurochemical pathways. Current treatments for Alzheimer's disease focus on deficits in the cholinergic neurochemical pathway. While newer generation cholinergic agents have a more favorable side effect profile, only a limited, but consistent, degree of efficacy is seen. Treatments are emerging that focus on other areas of neurochemical activity such as oxidative damage, inflammation, glutamatergic neurotransmissions, and serotonergic and dopaminergic pathways. These treatments, supplemented with current cholinergic therapies, may help to ease patients' suffering and caregiver distress. C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Mintzer, JE (reprint author), Med Univ S Carolina, 5900 Core Rd,Ste 203, Charleston, SC 29425 USA. NR 15 TC 4 Z9 5 U1 1 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 2003 VL 64 SU 9 BP 18 EP 22 PG 5 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 715ZQ UT WOS:000185004700004 PM 12934970 ER PT J AU Marder, SR Conley, R Ereshefsky, L Kane, JM Turner, MS AF Marder, SR Conley, R Ereshefsky, L Kane, JM Turner, MS TI Clinical guidelines - Dosing and switching strategies for long-acting risperidone SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Teleconference on Partial Compliance: Need for Long Acting Atypical Antipsychotics CY MAR 27, 2002 CL ELECTR NETWORK C1 W Los Angeles Hlth Ctr, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Stobhill Gen Hosp, Glasgow G21 3UW, Lanark, Scotland. Zucker Hillside Hosp, N Shore Long Isl Jewish Hlth Syst, Dept Psychiat, Glen Oaks, NY USA. Albert Einstein Coll Med, Bronx, NY 10467 USA. Calif Clin Trials, Los Angeles, CA USA. San Antonio State Hosp, Clin Res Unit, Los Angeles, CA USA. Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. Maryland Psychiat Res Ctr, Baltimore, MD 21228 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Marder, SR (reprint author), W Los Angeles Hlth Ctr, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. NR 4 TC 15 Z9 16 U1 0 U2 0 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 2003 VL 64 SU 16 BP 41 EP 46 PG 6 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 753YW UT WOS:000187276800007 PM 14680418 ER PT J AU Pandol, SJ Gukovsky, I Satoh, A Lugea, A Gukovskaya, AS AF Pandol, SJ Gukovsky, I Satoh, A Lugea, A Gukovskaya, AS TI Emerging concepts for the mechanism of alcoholic pancreatitis from experimental models SO JOURNAL OF GASTROENTEROLOGY LA English DT Review DE alcohol; pancreatitis; cholecytokinin; fatty acid ethyl esters; nuclear factor-kappa B ID NF-KAPPA-B; ACID ETHYL-ESTERS; ACINAR-CELLS; STELLATE CELLS; NONOXIDATIVE METABOLITES; ETHANOL-METABOLISM; INHIBITORY FACTOR; GENE-EXPRESSION; ACTIVATION; RAT AB The pathophysiologic mechanisms that underlie acute and chronic pancreatitis arising from alcohol abuse are poorly understood. The reasons for this state of knowledge result historically from a lack of models for experimental investigation. Ethanol feeding alone, even at high doses, has minimal and inconsistent effects on morphologic findings in the pancreas in experimental animals. This experience, plus the fact that alcohol abuse causes pancreatic pathology in only a minority of patients, suggest that ethanol acts to sensitize the pancreas to the deleterious effects of other stimuli. In this article, we discuss findings to support this concept of ethanol as a sensitizing agent and experimental models developed that can be used to investigate the effects of ethanol on the pathologic processes of pancreatitis. These pathologic processes include inflammation, cell death, intrapancreatic digestive enzyme activation, and fibrosis. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, W Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. USC UCLA, Res Ctr Alcohol Liver & Pancreat Dis, Los Angeles, CA USA. RP Pandol, SJ (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, W Los Angeles Healthcare Ctr, Bldg 258,Room 340,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIAAA NIH HHS [P50 AA 11999]; NIDDK NIH HHS [DK 59936, DK 59508] NR 63 TC 21 Z9 24 U1 0 U2 0 PU SPRINGER-VERLAG TOKYO PI TOKYO PA 3-3-13, HONGO, BUNKYO-KU, TOKYO, 113-0033, JAPAN SN 0944-1174 J9 J GASTROENTEROL JI J. Gastroenterol. PY 2003 VL 38 IS 7 BP 623 EP 628 DI 10.1007/s00535-003-1134-7 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 706KH UT WOS:000184452500001 PM 12898353 ER PT J AU Hedrick, SC Chaney, EF Felker, B Liu, CF Hasenberg, N Heagerty, P Buchanan, J Bagala, R Greenberg, D Paden, G Fihn, SD Katon, W AF Hedrick, SC Chaney, EF Felker, B Liu, CF Hasenberg, N Heagerty, P Buchanan, J Bagala, R Greenberg, D Paden, G Fihn, SD Katon, W TI Effectiveness of collaborative care depression treatment in veterans' affairs primary care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE depressive disorder; primary health care; veterans ID RANDOMIZED CONTROLLED TRIAL; HEALTH-CARE; ANTIDEPRESSANT TREATMENT; IMPROVE TREATMENT; MAJOR DEPRESSION; MANAGEMENT; GUIDELINES; POPULATION; DISORDERS; SYMPTOMS AB OBJECTIVE: To compare collaborative care for treatment of depression in primary care with consult-liaison (CL) care. In collaborative care, a mental health team provided a treatment plan to the primary care provider, telephoned patients to support adherence to the plan, reviewed treatment results, and suggested modifications to the provider. In CL care, study clinicians informed the primary care provider of the diagnosis and facilitated referrals to psychiatry residents practicing in the primary care clinic. DESIGN: Patients were randomly assigned to treatment model by clinic firm. SETTING: VA primary care clinic. PARTICIPANTS: One hundred sixty-eight collaborative care and 186 CL patients who met criteria for major depression and/or dysthymia. MEASUREMENTS: Hopkins Symptom Checklist (SCL-20), Short Form (SF)-36, Sheehan Disability Scale. MAIN RESULTS: Collaborative care produced greater improvement than CL in depressive symptomatology from baseline to 3 months (SCL-20 change scores), but at 9 months there was no significant difference. The intervention increased the proportion of patients receiving prescriptions and cognitive behavioral therapy. Collaborative care produced significantly greater improvement on the Sheehan at 3 months. A greater proportion of collaborative care patients exhibited an improvement in SF-36 Mental Component Score of 5 points or more from baseline to 9 months. CONCLUSIONS: Collaborative care resulted in more rapid improvement in depression symptomatology, and a more rapid and sustained improvement in mental health status compared to the more standard model. Mounting evidence indicates that collaboration between primary care providers and mental health specialists can improve depression treatment and supports the necessary changes in clinic structure and incentives. C1 VA Puget Sound Hlth Care Syst, HSR&D 152, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Mental Hlth Serv, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. VA Puget Sound, Med Serv, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Sch Social Work, Seattle, WA 98195 USA. RP Hedrick, SC (reprint author), VA Puget Sound Hlth Care Syst, HSR&D 152, Hlth Serv Res & Dev Ctr Excellence, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 49 TC 120 Z9 120 U1 0 U2 5 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 2003 VL 18 IS 1 BP 9 EP 16 DI 10.1046/j.1525-1497.2003.11109.x PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 634QU UT WOS:000180352600002 PM 12534758 ER PT J AU Thomas, EJ Petersen, LA AF Thomas, EJ Petersen, LA TI Measuring errors and adverse events in health care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE medical error; adverse events; patient safety; measurement ID COMPLICATIONS SCREENING-PROGRAM; OF-MEDICINE REPORT; ADMINISTRATIVE DATA; DRUG EVENTS; QUALITY; CRITERIA; ANESTHESIA; VALIDATION; EXPLICIT; SYSTEMS AB In this paper, we identify 8 methods used to measure errors and adverse events in health care and discuss their strengths and weaknesses. We focus on the reliability and validity of each, as well as the ability to detect latent errors (or system errors) versus active errors and adverse events. We propose a general framework to help health care providers, researchers, and administrators choose the most appropriate methods to meet their patient safety measurement goals. C1 Univ Texas, Sch Med, Ctr Clin Res & Evidence Based Med, Div Gen Med, Houston, TX 77030 USA. Univ Texas, Sch Med, Dept Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Ctr Excellence, Houston, TX USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. RP Thomas, EJ (reprint author), Univ Texas, Sch Med, Ctr Clin Res & Evidence Based Med, Div Gen Med, 6431 Fannin MSB 1-122, Houston, TX 77030 USA. NR 54 TC 172 Z9 178 U1 5 U2 14 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 2003 VL 18 IS 1 BP 61 EP 67 DI 10.1046/j.1525-1497.2003.20147.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 634QU UT WOS:000180352600010 PM 12534766 ER PT J AU Carpenter, KM Watson, JM Raffety, B Chabal, C AF Carpenter, KM Watson, JM Raffety, B Chabal, C TI Teaching brief interventions for smoking cessation via an interactive computer-based tutorial SO JOURNAL OF HEALTH PSYCHOLOGY LA English DT Article DE e-learning; motivational interviewing; smoking cessation ID PRIMARY-CARE; PHYSICIANS; PRACTITIONERS; PREVENTION; STRATEGIES; DENTISTS; SKILLS; ADVICE; STAGE AB Many current smokers do not plan on quitting any time soon. For these smokers, the immediate treatment goal is not a quit attempt, but an increase in readiness to stop smoking. In the present study we developed an interactive multimedia simulation and tutoring environment that teaches healthcare professionals to provide brief motivational interviewing-based smoking cessation interventions tailored to the patient's current readiness to change. This tutorial utilizes a cognitive science-derived learning approach that provides tailored feedback and lessons based on learners pre-existing knowledge, is highly interactive and allows learners to practice skills in simulated clinical situations. Results from two pilot studies indicate that healthcare professionals and students found the software easy and enjoyable to use and successfully learned MI-based strategies for smoking cessation. C1 Talaria Inc, Seattle, WA 98104 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA USA. RP Carpenter, KM (reprint author), Talaria Inc, 821 2nd Ave,Suite 1150, Seattle, WA 98104 USA. FU NCI NIH HHS [R43 CA088569] NR 44 TC 8 Z9 8 U1 0 U2 2 PU SAGE PUBLICATIONS LTD PI LONDON PA 6 BONHILL STREET, LONDON EC2A 4PU, ENGLAND SN 1359-1053 J9 J HEALTH PSYCHOL JI J. Health Psychol. PD JAN PY 2003 VL 8 IS 1 BP 149 EP 160 DI 10.1177/1359105303008001450 PG 12 WC Psychology, Clinical SC Psychology GA 640GZ UT WOS:000180681500012 PM 22113907 ER PT J AU Mar, CM Chabal, C Anderson, RA Vore, AE AF Mar, CM Chabal, C Anderson, RA Vore, AE TI An interactive computer tutorial to teach pain assessment SO JOURNAL OF HEALTH PSYCHOLOGY LA English DT Article DE communication skills; computer-assisted learning; nurse education; pain assessment; role-play ID ELDERLY PATIENTS; MANAGEMENT; LIFE; PHYSICS; CANCER; SKILLS; CARE; END AB Under-treated pain is a significant problem. Health care institutions are under increasing pressure from patients and accreditation bodies to improve staff training in pain management. Pain assessment, a necessary pre-cursor to good pain management, is a complex multi-step process requiring sophisticated understanding and superior communication skills. This article describes the development and usability testing of an interactive, Internet-deliverable, multimedia tutorial to teach best practice pain assessment. The software platform allowed non-programmers to create multimedia tutorials and included the capability to simulate role-plays. The tutorial was designed to actively engage and respond to the learner and to include skills practice. Twenty-five nurses took the tutorial and rated it positively on a usability questionnaire in terms of ease-of-use and learning method. C1 Talaria Inc, Seattle, WA 98104 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Talaria Inc, Seattle, WA USA. RP Mar, CM (reprint author), Talaria Inc, 821 2nd Ave,Suite 1150, Seattle, WA 98104 USA. NR 30 TC 1 Z9 1 U1 0 U2 4 PU SAGE PUBLICATIONS LTD PI LONDON PA 6 BONHILL STREET, LONDON EC2A 4PU, ENGLAND SN 1359-1053 J9 J HEALTH PSYCHOL JI J. Health Psychol. PD JAN PY 2003 VL 8 IS 1 BP 161 EP 173 DI 10.1177/1359105303008001454 PG 13 WC Psychology, Clinical SC Psychology GA 640GZ UT WOS:000180681500013 PM 22113908 ER PT J AU Erikson, JM Freeman, GL Chandrasekar, B AF Erikson, JM Freeman, GL Chandrasekar, B TI Ultrasound-targeted antisense oligonucleotide attenuates ischemia/reperfusion-induced myocardial tumor necrosis factor-alpha SO JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY LA English DT Article DE antisense oligonucleotides; contrast; ultrasound; ischemia/reperfusion injury ID SONICATED DEXTROSE ALBUMIN; CONSCIOUS DOGS; INFARCTION; MICROBUBBLES; DESTRUCTION; INTERLEUKIN-6; EXPRESSION; CYTOKINE; ISCHEMIA; DELIVERY AB Ultrasound contrast agents are now emerging as effective vehicles for delivering therapeutic agents to target tissues. In the present study, we used ultrasound-targeted, contrast-bound antisense oligonucleotides to inhibit the expression of tumor necrosis factor-alpha (TNF-alpha), a proinflammatory cytokine with negative inotropic effects. We compared the efficacy of left ventricular vs. intravenous administration and determined the optimal time for delivery. WKY rats were treated with perfluorocarbon-exposed sonicated dextrose albumin (PESDA) microspheres incubated with 100 mug of antisense oligonucleotide directed against TNF-alpha. Contrast was infused into either the superior vena cava or the left ventricular cavity along with simultaneous application of ultrasound. Twenty-four hours later, the animals underwent 15 min of ischemia and 2 h reperfusion. Control animals underwent sham operation only, ischemia/reperfusion only, or received PESDA only. A second group received treatment just prior to, or immediately after the onset of ischemia. At the end of the experimental period, hearts were removed and analyzed for TNF-alpha by northern and western blotting. While no TNF-alpha expression was detected in sham-operated animals, robust expression of TNF-alpha mRNA and protein was seen in controls treated with ultrasound and PESDA alone. In contrast, intravenous or left ventricular administration of antisense oligonucleotides significantly inhibited ischemia/reperfusion-induced TNF-alpha expression. Direct delivery into the left ventricular cavity was more effective than intravenous administration, and delivery just prior to ischemia was most effective in attenuating TNF-alpha expression. Furthermore, attenuation of TNF-alpha expression also significantly inhibited other post-ischemic inflammatory mediators including IL-1beta and intercellular adhesion molecule-1 (ICAM-1). Thus, ultrasound-targeted antisense oligonucleotides can effectively attenuate post-ischemic cytokine expression when delivered in a clinically relevant time frame, obviating the need for pretreatment. (C) 2003 Elsevier Science Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Cardiol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Erikson, JM (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Cardiol, 7703 Floyd Curl Dr,MC 7872, San Antonio, TX 78229 USA. EM erikson@uthscsa.edu FU NHLBI NIH HHS [HL68020] NR 32 TC 21 Z9 21 U1 0 U2 0 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0022-2828 EI 1095-8584 J9 J MOL CELL CARDIOL JI J. Mol. Cell. Cardiol. PD JAN PY 2003 VL 35 IS 1 BP 119 EP 130 AR PII S0022-2828(02)00289-4 DI 10.1016/S0022-2828(02)00289-4 PG 12 WC Cardiac & Cardiovascular Systems; Cell Biology SC Cardiovascular System & Cardiology; Cell Biology GA 650YZ UT WOS:000181293500012 PM 12623306 ER PT J AU Matejuk, A Buenafe, AC Dwyer, J Ito, A Silverman, M Zamora, A Subramanian, S Vandenbark, AA Offner, H AF Matejuk, A Buenafe, AC Dwyer, J Ito, A Silverman, M Zamora, A Subramanian, S Vandenbark, AA Offner, H TI Endogenous CD4+BV8S2-T cells from TG BV8S2+donors confer complete protection against spontaneous experimental encephalomyelitis (Sp-EAE) in TCR transgenic, RAG(-/-) mice SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE EAE; regulatory T cells; CD4+T cells; TCR transgenic mice ID EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; V-BETA-GENES; CHEMOKINE RECEPTORS; DIFFERENTIAL EXPRESSION; NOD MICE; DISEASE; DEFINES; REGION; RAT AB To investigate regulatory mechanisms which naturally prevent autoimmune diseases, we adopted the genetically restricted immunodeficient (RAG-1 (-/-)) myelin basic protein (MBP)-specific T cell receptor (TCR) double transgenic (T/R-) mouse model of spontaneous experimental autoimmune encephalomyelitis (Sp-EAE). Sp-EAE can be prevented after transfer of CD4+splenocytes from naive immunocompetent mice. RAG-1+ double transgenic (T/R+) mice do not develop Sp-EAE due to the presence of a very small population (about 2%) of non-Tg TCR specificities. In this study, CD4+BV8S2+ T cells that predominate in T/R+ mice, and three additional populations, CD4+BV8S2-, CD4-CD8-BV8S2+, and CD4-CD8+BV8S2+ T cells that expanded in T/R+ mice after immunization with MBP-Ac1-11 peptide, were studied for their ability to prevent Sp-EAE in T/R- mice. Only the CD4+BV8S2- T cell population conferred complete protection against Sp-EAE, similar to unfractionated splenocytes from non-Tg donors, whereas CD4-CD8-BV8S2+ and CD4+BV8S2+ T cells conferred partial protection. In contrast, CD4-CD8+BV8S2+ T cells had no significant protective effects. The highly protective CD4+BV8S2- subpopulation was CD25+, contained non-clonotypic T cells, and uniquely expressed the CCR4 chemokine receptor. Protected recipient T/R- mice had marked increases in CD4+CD25+ Treg-like cells, retention of the pathogenic T cell phenotype in the spleen, and markedly reduced inflammation in CNS tissue. Partially protective CD4+BV8S2+ and CD4- CD8-BV8S2+ subpopulations appeared to be mainly clonotypic T cells with altered functional properties. These three Sp-EAE protective T cell subpopulations possessed distinctive properties and induced a variety of effects in T/R- recipients, thus implicating differing mechanisms of protection. (C) 2002 Wiley-Liss, Inc. C1 Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Vet Affairs Med Ctr, Portland, OR USA. Polish Acad Sci, L Hirszfeld Inst Immunol & Expt Therapy, PL-53114 Wroclaw, Poland. Oregon Hlth Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR USA. RP Offner, H (reprint author), Portland VA Med Ctr, R&D 31, 3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. FU NIAID NIH HHS [AI42376]; NINDS NIH HHS [NS23444, NS23221] NR 30 TC 9 Z9 9 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 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD JAN 1 PY 2003 VL 71 IS 1 BP 89 EP 103 DI 10.1002/jnr.10450 PG 15 WC Neurosciences SC Neurosciences & Neurology GA 628TW UT WOS:000180013500009 PM 12478617 ER PT J AU Schildhauer, TA Ledoux, WR Chapman, JR Henley, MB Tencer, AF Routt, MLC AF Schildhauer, TA Ledoux, WR Chapman, JR Henley, MB Tencer, AF Routt, MLC TI Triangular osteosynthesis and iliosacral screw fixation for unstable sacral fractures: A cadaveric and biomechanical evaluation under cyclic loads SO JOURNAL OF ORTHOPAEDIC TRAUMA LA English DT Article DE pelvis; Sacrum; fracture fixation; internal; biomechanics; iliosacral screw; triangular osteosynthesis ID POSTERIOR INTERNAL-FIXATION; PELVIC RING DISRUPTIONS; OPEN REDUCTION; STABILITY; INJURIES AB Objective: To conduct a biomechanical comparison of a new triangular osteosynthesis and the standard iliosacral screw osteosynthesis for unstable transforaminal sacral fractures in the immediate postoperative situation as well as in the early postoperative weight-bearing period. Design: Twelve preserved human cadaveric lumbopelvic specimens were cyclicly tested in a single-limb-stance model. A transforaminal sacral fracture combined with ipsilateral superior and inferior pubic rami fractures were created and stabilized. Loads simulating muscle forces and body Weight were applied. Fracture site displacement in three dimensions was evaluated using an electromagnetic motion sensor system. Intervention: Specimens were randomly assigned to either an iliosacral and superior pubic ramus screw fixation or to a triangular osteosynthesis consisting of lumbopelvic stabilization (between L5 pedicle and posterior ilium) combined with iliosacral and superior pubic ramus screw fixation. Main Outcome Measures: Peak loaded displacement at the fracture site was measured for assessment of initial stability. Macroscopic fracture behavior through 10,000 cycles of loading, simulating the early postoperative weight-bearing period, was classified into type I with minimal motion at the fracture site, type 2 with complete displacement of the inferior pubic ramus, or type 3 with catastrophic failure. Results: The triangular osteosynthesis had a statistically significantly smaller displacement under initial peak loads (mean +/- standard deviation [SD], 0.163 +/- 0.073 cm) and therefore greater initial stability than specimens with (lie standard iliosacral screw fixation (mean +/- SD, 0.611 +/- 0.453 cm) (p = 0.0104), independent of specimen age or sex. All specimens With the triangular osteosynthesis demonstrated type I fracture behavior, whereas iliosacral screw fixation resulted in one type 1, two type 2, and three type 3 fracture behaviors before or at 10,000 cycles, of loading. Conclusion: Triangular osteosynthesis for unstable transforaminal sacral fractures provides significantly greater stability than iliosacral screw fixation under in vitro cyclic loading conditions. In vitro cyclic loading, as a limited simulation of early stages of patient mobilization in the postoperative period, allows for a time-dependent evaluation of any fracture fixation system. C1 Univ Washington, Harborview Med Ctr, Dept Orthopaed & Sports Med, Seattle, WA 98104 USA. Univ Washington, Harborview Med Ctr, Orthopaed Sci Lab, Seattle, WA 98104 USA. VA Puget Sound, RR&D Ctr Excellence, Seattle, WA USA. RP Schildhauer, TA (reprint author), Ruhr Univ Bochum, Chirurg Klin & Poliklin, BG Kliniken Bergmannsheil, Burkle Camp Pl 1, D-44789 Bochum, Germany. RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 NR 48 TC 75 Z9 96 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0890-5339 J9 J ORTHOP TRAUMA JI J. Orthop. Trauma PD JAN PY 2003 VL 17 IS 1 BP 22 EP 31 DI 10.1097/00005131-200301000-00004 PG 10 WC Orthopedics; Sport Sciences SC Orthopedics; Sport Sciences GA 630PP UT WOS:000180117400004 PM 12499964 ER PT J AU da Cunha, IT Henson, H Wankadia, S Protas, EJ AF da Cunha, IT Henson, H Wankadia, S Protas, EJ TI Reliability of measures of gait performance and oxygen consumption with stroke survivors SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE gait performance; oxygen consumption; reliability; stroke ID ENERGY-EXPENDITURE; WALKING; GENERALIZABILITY; CLASSIFICATION; REHABILITATION AB This study assessed the reliability of gait performance with concurrent measures of oxygen consumption (VO2) in stroke survivors (SS). Nine male SS (60.00 +/- 15.08 yr) had a recent history of stroke (44.56 +/- 51.35 days since the stroke) and were receiving rehabilitation. Four had a right cerebrovascular accident (CVA), and five had a left CVA. Subjects walked without assistance, although three used a single cane to complete the test. Within 30 minutes, subjects completed two trials of a 5 min walk while walking back and forth on a 5 m walkway wearing a portable gas analyzer to collect samples of gases. The intraclass correlation coefficient (ICC) was used to assess reliability. The ICC for gait energy expenditure, walk distance, gait speed, and gait energy cost were 0.64, 0.97, 0.95, and 0.97, respectively. Assessment of gait performance with concurrent measures of VO2 is a reliable procedure with SS. C1 Univ Texas, Med Branch, Dept Phys Therapy, Sch Allied Hlth Sci, Galveston, TX 77555 USA. Texas Womans Univ, Sch Phys Therapy, Houston, TX USA. Houston Vet Affiars Med Ctr, Dept Phys Med & Rehabil, Houston, TX USA. Houston Vet Affairs Med Ctr, Rehabil Res & Dev Ctr Excellence Hralthy Aging Di, Houston, TX USA. RP Protas, EJ (reprint author), Univ Texas, Med Branch, Dept Phys Therapy, Sch Allied Hlth Sci, 301 Univ Blvd, Galveston, TX 77555 USA. FU NIA NIH HHS [P30 AG024832] NR 25 TC 18 Z9 18 U1 0 U2 2 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 2003 VL 40 IS 1 BP 19 EP 25 PG 7 WC Rehabilitation SC Rehabilitation GA 661WQ UT WOS:000181913200005 PM 15150717 ER PT J AU Oates, JC Levesque, MC Hobbs, MR Smith, EG Molano, ID Page, GP Hill, BS Weinberg, JB Cooper, GS Gilkeson, GS AF Oates, JC Levesque, MC Hobbs, MR Smith, EG Molano, ID Page, GP Hill, BS Weinberg, JB Cooper, GS Gilkeson, GS TI Nitric oxide synthase 2 promoter Polymorphisms and systemic lupus erythematosus in African-Americans SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE blacks; polymorphism (genetics); microsatellite repeats; promoter regions (genetics); genetic predisposition to disease ID FUNCTIONAL-ANALYSIS; TANZANIAN CHILDREN; DISEASE-ACTIVITY; GENE; MALARIA; SERUM; PEROXYNITRITE; REGION; 3-NITROTYROSINE; DISEQUILIBRIUM AB Objective. Systemic lupus erythematosus (SLE) is an autoimmune disease in which morbidity and-mortality are higher in African-Americans. The etiology of this racial disparity is unknown. A genetic predisposition to enhanced nitric oxide (NO) production may predispose African-Americans to develop SLE and may increase disease severity. We have demonstrated a correlation between NO production and disease activity in SLE. Two polymorphisms in the inducible NO synthasie (NOS2) promoter region (G-954C and CCTTT microsatellite repeat polymorphisms) are associated with improved outcome in some African patients with malaria. This study was designed to determine if these polymorphisms are. associated with SLE. Methods. We assessed the frequency of both the G-954C and CCTTT microsatellite repeat NOS2 promoter polymorphisms in a cohort of patients with SLE and age, sex, and race matched controls in North Carolina and South Carolina. Results. Both polymorphisms were more frequent among African-American female SLE patients when compared with controls (p=0.04 for the,G-954C polymorphism and p=0.03 for the CCTTT-8 repeat polymorphism). Further, the G-954C and CCTTT-8 repeat polymorphisms were in,linkage disequilibriurn (D'=0.89, p=0.0001) among African-American female SLE patients. Conclusion. Altered genetic control of NOS2 transcription may be a risk factor for SLE among African-American females. The extent of linkage disequilibrium between the G-954C and CCTTT-8 repeat NOS2 promoter polymorphisms suggests that they were co-inherited. C1 Med Univ S Carolina, Dept Med, Div Rheumatol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Dept Med, Charleston, SC USA. Durham VAMC, Dept Med, Durham, NC USA. Duke Univ, Med Ctr, Durham, NC USA. Univ Utah, Sch Med, Dept Internal Med, Salt Lake City, UT USA. Univ Alabama, Dept Biostat, Birmingham, AL 35294 USA. Ctr Arthrit & Rheumat Dis, Concord, NC USA. NIEHS, Res Triangle Pk, NC 27709 USA. RP Oates, JC (reprint author), Med Univ S Carolina, Dept Med, Div Rheumatol, 96 Jonathan Lucas St,Suite 912,POB 250623, Charleston, SC 29425 USA. FU NIAID NIH HHS [AI41764]; NIAMS NIH HHS [AR39162, R01 AR045476, AR45476] NR 48 TC 29 Z9 30 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 2003 VL 30 IS 1 BP 60 EP 67 PG 8 WC Rheumatology SC Rheumatology GA 633LW UT WOS:000180285600011 PM 12508391 ER PT J AU Sreenivasan, S Weinberger, LE Garrick, T AF Sreenivasan, S Weinberger, LE Garrick, T TI Expert testimony in sexually violent predator commitments: Conceptualizing legal standards of "mental disorder" and "likely to reoffend" SO JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW LA English DT Article ID OFFENDER RECIDIVISM RISK; SEX OFFENDERS; ACTUARIAL; ASSESSMENTS; METAANALYSIS; PREDICTION AB The most recent type of civil commitment for dangerous sex offenders is found under the sexually violent predator laws. Forensic psychiatrists or psychologists must render an opinion as to whether the sex offender has a diagnosed mental disorder and, as such, represents a risk to public safety if released from custody into the community. Thus, expert testimony provided by these professionals has taken a central role in the commitment determinations. There is considerable debate as to what disorders predispose individuals to sexual recidivism and what the term "likely" signifies. In this article, the authors explore the debate in terms of whether Antisocial Personality Disorder is a qualifying diagnosed mental disorder for classification as a sexually violent predator and how a likely threshold of risk of sexual recidivism can be conceptualized. C1 Greater Los Angeles VA Med Ctr, Gen Hosp Psychiat, Los Angeles, CA 90073 USA. Univ So Calif, Keck Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. RP Sreenivasan, S (reprint author), Greater Los Angeles VA Med Ctr, Gen Hosp Psychiat, 11301 Wilshire Blvd,691-B116, Los Angeles, CA 90073 USA. EM shoba.sreenivasan@med.va.gov NR 38 TC 20 Z9 20 U1 0 U2 0 PU AMER ACAD PSYCHIATRY LAW PI BLOOMFIELD PA ONE REGENCY DR, PO BOX 30, BLOOMFIELD, CT 06002 USA SN 1093-6793 J9 J AM ACAD PSYCHIATRY JI J. Am. Acad. Psychiatry Law PY 2003 VL 31 IS 4 BP 471 EP 485 PG 15 WC Law; Psychiatry SC Government & Law; Psychiatry GA 829OJ UT WOS:000222058300011 PM 14974803 ER PT J AU Lui, LY Stone, K Cauley, JA Hillier, T Yaffe, K AF Lui, LY Stone, K Cauley, JA Hillier, T Yaffe, K TI Bone loss predicts subsequent cognitive decline in older women: The study of osteoporotic fractures SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE bone loss; cognitive decline; older women ID APOLIPOPROTEIN-E POLYMORPHISM; ESTROGEN REPLACEMENT THERAPY; MINERAL DENSITY; ALZHEIMERS-DISEASE; HIP FRACTURE; RISK-FACTORS; COMMUNITY WOMEN; ELDERLY WOMEN; WEIGHT CHANGE; E PHENOTYPE AB OBJECTIVES: To determine whether the rate of bone loss predicts subsequent cognitive decline independently of baseline bone mass and whether apolipoprotein E (ApoE) genotype explains the association. DESIGN: A prospective cohort study. SETTING: Clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Pittsburgh, Pennsylvania; and Portland, Oregon. PARTICIPANTS: Four thousand four hundred sixty-two women aged 70 and older (mean = 75.8) participating in the Study of Osteoporotic Fractures. MEASUREMENTS: Total hipbone mineral density (BMD) was measured 2 and 6 years after enrollment (mean follow-up = 3.5 years), and expressed as annualized percentage rate of bone change. A modified Mini-Mental State Examination (mMMSE) was administered at 6 and 10 years (mean follow-up = 4.5 years) and defined cognitive decline as a decline of three or more points on repeat mMMSE score. ApoE genotype information was available on 883 women. RESULTS: Cognitive decline occurred in 12% of the women with the least bone loss (by quartile), 14% in the second, 16% in the third, and 20% in those with the greatest bone loss. After adjustment for age, education, stroke, functional status, estrogen use, body mass index, and smoking, the results were similar. Those who lost the most BMD were almost 40% more likely than women in the lowest quartile to develop cognitive decline in the multivariate model (odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.1-1.8). A similar association between hipbone loss and cognitive decline was observed in the multivariate model further adjusting for ApoE e4 (OR = 1.5, 95% CI = 0.8-2.7). CONCLUSIONS: Women with more rapid hipbone loss were more likely to develop cognitive decline than those who had lower rate of loss (or who gained bone mass). Differences in functional status, estrogen use, and ApoE did not explain this association. Further investigation is needed to determine the mechanisms that link osteoporosis and cognitive decline. C1 Univ Calif San Francisco, Dept Med, San Francisco, CA 94105 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94105 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94105 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94105 USA. Univ Calif San Francisco, Dept Biostat, San Francisco, CA 94105 USA. Univ Pittsburgh, Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA. Kaiser Permanente Ctr Hlth Res, Portland, OR USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Lui, LY (reprint author), Univ Calif San Francisco, Dept Med, 74 New Montgomery St,Suite 600, San Francisco, CA 94105 USA. RI Cauley, Jane/N-4836-2015 OI Cauley, Jane/0000-0003-0752-4408 FU NIA NIH HHS [AG05407, AG05394, K23-AG00888]; NIAMS NIH HHS [AR35582, AR35583, AR35584] NR 28 TC 26 Z9 26 U1 0 U2 3 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 2003 VL 51 IS 1 BP 38 EP 43 DI 10.1034/j.1601-5215.2002.51007.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 635ML UT WOS:000180403200006 PM 12534843 ER PT J AU Walter, LC Lui, LY Eng, C Covinsky, KE AF Walter, LC Lui, LY Eng, C Covinsky, KE TI Risk of hip fracture in disabled community-living older adults SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE hip fracture; frail; older ID NURSING-HOME RESIDENTS; BONE-MINERAL DENSITY; OSTEOPOROTIC FRACTURES; COGNITIVE IMPAIRMENT; PHYSICAL-ACTIVITY; ELDERLY MEN; FALLS; CARE AB OBJECTIVES: To determine the rate of hip fracture and risk factors associated with hip fractures in disabled older persons who enroll in the Program of All-Inclusive Care for the Elderly (PACE), a program providing comprehensive care to community-living nursing-home-eligible persons. DESIGN: Prospective cohort study between January 1990 and December 1997. SETTING: The twelve PACE demonstration sites: San Francisco, California; Columbia, South Carolina; Detroit, Michigan; Denver, Colorado; East Boston, Massachusetts; El Paso, Texas; Milwaukee, Wisconsin; Oakland, California; Portland, Oregon; Rochester, New York; Sacramento, California; and the Bronx, New York. PARTICIPANTS: Five thousand one hundred eighty-seven individuals in PACE; mean age 79, 71% female, 49% white, 47% with dementia. MEASUREMENTS: Functional status, cognitive status, demographics, and comorbid conditions were recorded on all the participants, who were tracked for occurrence of a hip fracture. The goals were to determine the rate of hip fracture and identify risk factors. RESULTS: Two hundred thirty-eight hip fractures (4.6%) occurred during follow-up. The rate of hip fracture was 2.2% per person-year. Four independent predictors of hip fracture were identified using Cox proportional hazard analysis: age of 75 and older (adjusted hazard ratio (HR) = 2.0, 95% confidence interval (CI) = 1.4-2.8); white ethnicity (HR = 2.1, 95% CI = 1.6-2.8); ability to transfer independently to and from bed, chair, and toilet (HR = 3.0, 95% Cl = 1.2-7.2); and five or more Short Portable Mental Status Questionnaire errors (HR = 1.6, 95% CI = 1.3-2.1). The incidence of hip fracture ranged from 0.5% per person-year in persons with zero to one independent risk factors to 4.7% per person-year in those with all four independent risk factors. CONCLUSIONS: The rate of hip fracture in this cohort of disabled community-living older adults was similar to that reported in nursing home cohorts. Older age, white race, ability to transfer independently, and cognitive impairment were independent predictors of hip fracture. Persons with these risk factors should be targeted for preventive interventions, which should include strategies for making transferring safer. C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. On Lok Senior Hlth Serv, San Francisco, CA USA. RP Walter, LC (reprint author), San Francisco VA Med Ctr, Div Geriatr, 181G,4150 Clement St, San Francisco, CA 94121 USA. FU NIA NIH HHS [5 T32 AG00212-09]; PHS HHS [K02H500006-01] NR 23 TC 25 Z9 27 U1 8 U2 16 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 2003 VL 51 IS 1 BP 50 EP 55 DI 10.1034/j.1601-5215.2002.51009.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 635ML UT WOS:000180403200008 PM 12534845 ER PT J AU Simmons, SF Lam, HY Rao, G Schnelle, JF AF Simmons, SF Lam, HY Rao, G Schnelle, JF TI Family members' preferences for nutrition interventions to improve nursing home residents' oral food and fluid intake SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE nutrition interventions; preferences; nursing homes ID LONG-TERM-CARE; DECISION-MAKING; WEIGHT-LOSS; DEMENTIA; QUALITY AB OBJECTIVES: To measure family members' preferences for nutrition interventions to improve the oral food and fluid intake of their relatives in a nursing home. DESIGN: Cross-sectional descriptive. SETTING: Three skilled nursing facilities in Southern California. PARTICIPANTS: One hundred five residents from the three skilled nursing facilities and their respective family members. MEASUREMENTS: A mailed questionnaire to family members that consisted of 15 forced-choice comparisons between six nutrition interventions. An assessment of oral food and fluid intake during mealtime for 3 days (nine meals) for each participant using direct observations and estimations of percentage consumed (0% to 100%) by trained research staff. RESULTS: In order of most to least desirable, the family members preferred the following interventions to improve their relative's oral food and fluid intake: (1) improve quality of food; (2) improve quality and quantity of feeding assistance; (3) provide multiple small meals and snacks throughout the day; (4) place resident in preferred dining location; (5) provide an oral liquid nutritional supplement between meals; and (6) provide a medication to stimulate appetite. The average +/- standard deviation total percentage intake for residents whose family members reported that they thought their relative had a problem with their intake was 50% +/- 16%. CONCLUSIONS: Family members prefer that other nutrition interventions be attempted before the use of oral supplements or pharmacological approaches. Family members perceive a need for interventions when residents consume, on average, only half of the food and fluid items provided during mealtime. C1 Univ Calif Los Angeles, Borun Ctr Gerontol Res, Los Angeles Jewish Home Aging, Sch Med,Dept Geriatr, Reseda, CA 91335 USA. Univ Pittsburgh, Div Geriatr Med, Pittsburgh, PA USA. Vet Adm Greater Los Angeles Healthcare Syst, Sepulveda Geriatr Res Educ & Clin Ctr, Sepulveda, CA USA. RP Simmons, SF (reprint author), Univ Calif Los Angeles, Borun Ctr Gerontol Res, Los Angeles Jewish Home Aging, Sch Med,Dept Geriatr, 7150 Tampa Ave, Reseda, CA 91335 USA. FU NIA NIH HHS [AG10415] NR 29 TC 16 Z9 17 U1 3 U2 4 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 2003 VL 51 IS 1 BP 69 EP 74 DI 10.1034/j.1601-5215.2002.51012.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 635ML UT WOS:000180403200011 PM 12534848 ER PT J AU Gruenewald, DA Matsumoto, AM AF Gruenewald, DA Matsumoto, AM TI Testosterone supplementation therapy for older men: Potential benefits and risks SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE testosterone; aging; hormone replacement therapy; androgens; hypogonadism ID CORONARY-ARTERY DISEASE; BONE-MINERAL DENSITY; NURSING-HOME MEN; MIDDLE-AGED MEN; HYPOGONADAL MEN; TRANSDERMAL TESTOSTERONE; ANDROGEN DEFICIENCY; REPLACEMENT THERAPY; ELDERLY MEN; BIOAVAILABLE TESTOSTERONE AB Serum testosterone levels decline gradually and progressively with aging in men. Many manifestations associated with aging in men, including muscle atrophy and weakness, osteoporosis, reduced sexual functioning, and increased fat mass, are similar to changes associated with testosterone deficiency in young men. These similarities suggest that testosterone supplementation may prevent or reverse the effects of aging. A MEDLINE search was performed to identify studies of testosterone supplementation therapy in older men. A structured, qualitative review was performed of placebo-controlled trials that included men aged 60 and older and evaluated one or more physical, cognitive, affective, functional, or quality-of-life outcomes. Studies focusing on patients with severe systemic diseases and hormone deficiencies related to specific diseases were excluded. In healthy older men with low-normal to mildly decreased testosterone levels, testosterone supplementation increased lean body mass and decreased fat mass. Upper and lower body strength, functional performance, sexual functioning, and mood were improved or unchanged with testosterone replacement. Variable effects on cognitive function were reported, with improvements in some cognitive domains (e.g., spatial, working, and verbal memory). Testosterone supplementation improved exercise-induced coronary ischemia in men with coronary heart disease, whereas angina pectoris was improved or unchanged. In a few studies, men with low testosterone levels were more likely to experience improvements in lumbar bone mineral density, self-perceived functional status, libido, erectile function, and exercise-induced coronary ischemia with testosterone replacement than men with less marked testosterone deficiency. No major unfavorable effects on lipids were reported, but hematocrit and prostate specific antigen levels often increased. Based on these results, testosterone supplementation cannot be recommended at this time for older men with normal or low-normal testosterone levels and no clinical manifestations of hypogonadism. However, testosterone replacement may be warranted in older men with markedly decreased testosterone levels, regardless of symptoms, and in men with mildly decreased testosterone levels and symptoms or signs suggesting hypogonadism. The long-term safety and efficacy of testosterone supplementation remain uncertain. Establishment of evidence-based indications will depend on further demonstrations of favorable clinical outcomes and symptomatic, functional, and quality-of-life benefits in carefully performed, long-term, randomized, placebo-controlled clinical trials. 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. Univ Washington, Sch Med, Populat Ctr Res Reprod, Seattle, WA 98195 USA. 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. NR 98 TC 146 Z9 156 U1 1 U2 12 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 2003 VL 51 IS 1 BP 101 EP 115 DI 10.1034/j.1601-5215.2002.51018.x PG 15 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 635ML UT WOS:000180403200017 PM 12534854 ER PT J AU Steinman, MA Covinsky, KE AF Steinman, MA Covinsky, KE TI Donepezil for nursing home patients with dementia: A reinterpretation of the evidence SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Letter C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. RP Steinman, MA (reprint author), San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. NR 1 TC 4 Z9 4 U1 0 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 JAN PY 2003 VL 51 IS 1 BP 132 EP 132 DI 10.1034/j.1601-5215.2002.51022.x PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 635ML UT WOS:000180403200022 PM 12534859 ER PT J AU Allen, DN Goldstein, G Warnick, E AF Allen, DN Goldstein, G Warnick, E TI A consideration of neuropsychologically normal schizophrenia SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article DE schizophrenia; abstract reasoning; cluster analysis; premorbid ability ID COGNITIVE HETEROGENEITY AB Neuropsychological deficits are considered by many to be core features of schizophrenia. However, about 20% of patients with schizophrenia appear to have normal neuropsychological function. This study investigates this subgroup by comparing a "neuropsychologically normal" schizophrenia group to a non-schizophrenic, non-brain damaged patient comparison (PC) sample, and to patients with definitive brain damage who performed normally on neuropsychological testing. All patients completed the Halstead-Reitan Neuropsychological Test Battery and were classified as neuropsychologically normal or impaired using the Average Impairment Rating (AIR). In a sample of 113 patients with schizophrenia, 19.5% were classified as neuropsychologically normal. The brain damaged neuropsychologically normal group (BD-NN) consisted of 14.3% of 124 subjects. These groups were compared with a patient non-schizophrenic. non-brain damaged group who were selected on the basis of having an Average Impairment Rating in the neuropsychologically normal range. The neuropsychologically normal schizophrenic group performed less well than the non-brain damaged, non-schizophrenic patient comparison group on a number of tests, indicating that patients in this group may not be completely neuropsychologically normal, and would be better characterized as "high-functioning," or near normal. The results are discussed in regard to possible neurobiological differences between neuropsychologically impaired and intact schizophrenic patients, and implications for course and outcome. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Nevada, Dept Psychol, Las Vegas, NV 89154 USA. Univ Pittsburgh, Pittsburgh, PA 15213 USA. RP Goldstein, G (reprint author), VA Pittsburgh Healthcare Syst, 7180 Highland Dr 151R, Pittsburgh, PA 15206 USA. NR 31 TC 46 Z9 46 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD JAN PY 2003 VL 9 IS 1 BP 56 EP 63 DI 10.1017/S135561770391006X PG 8 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 661HL UT WOS:000181885100006 PM 12570358 ER PT J AU Saha, S Saint, S Christakis, DA AF Saha, S Saint, S Christakis, DA TI Impact factor: a valid measure of journal quality? SO JOURNAL OF THE MEDICAL LIBRARY ASSOCIATION LA English DT Article AB Objectives: Impact factor, an index based on the frequency with which a journal's articles are cited in scientific publications, is a putative marker of journal quality. However, empiric studies on impact factor's validity as an indicator of quality are lacking. The authors assessed the validity of impact factor as a measure of quality for general medical journals by testing its association with journal quality as rated by clinical practitioners and researchers. Methods: We surveyed physicians specializing in internal medicine in the United States, randomly sampled from the American Medical Associations Physician Masterfile (practitioner group, n = 113) and from a list of graduates from a national postdoctoral training program in clinical and health services research (research group, n = 151). Respondents rated the quality of nine general medical journals, and we assessed the correlation between these ratings and the journals' impact factors. Results: The correlation between impact factor and physicians' ratings of journal quality was strong (r(2) = 0.82, P = 0.001). The correlation was higher for the research group (r(2) = 0.83, P = 0.001) than for the practitioner group (r(2) = 0.62, P = 0.01). Conclusions: Impact factor may be a reasonable indicator of quality for general medical journals. C1 Portland VA Med Ctr, Div Gen Internal Med & Geriatr, Portland, OR 97207 USA. Portland VA Med Ctr, Dept Med Informat & Outcomes Res, Portland, OR 97207 USA. Portland VA Med Ctr P3MED, Portland, OR 97207 USA. Univ Michigan, Div Gen Med, Taubman Ctr 3116, Ann Arbor, MI 48109 USA. Univ Washington, Dept Pediat, Seattle, WA 98103 USA. Univ Washington, Inst Child Hlth, Seattle, WA 98103 USA. RP Saha, S (reprint author), Portland VA Med Ctr, Div Gen Internal Med & Geriatr, 3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. NR 11 TC 229 Z9 239 U1 6 U2 32 PU MEDICAL LIBRARY ASSOC PI CHICAGO PA 65 EAST WACKER PLACE, STE 1900, CHICAGO, IL 60601-7298 USA SN 1536-5050 J9 J MED LIBR ASSOC JI J. Med. Libr. Assoc. PD JAN PY 2003 VL 91 IS 1 BP 42 EP 46 PG 5 WC Information Science & Library Science SC Information Science & Library Science GA 642BN UT WOS:000180784300008 PM 12572533 ER PT J AU Quarterman, RL McMillan, A Ratcliffe, MB Block, MI AF Quarterman, RL McMillan, A Ratcliffe, MB Block, MI TI Effect of preoperative delay on prognosis for patients with early stage non-small cell lung cancer SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article; Proceedings Paper CT 27th Annual Meeting of the Western-Thoracic-Surgical-Association CY JUN 20-23, 2001 CL SAN DIEGO, CALIFORNIA SP Western Thorac Surg Assoc ID MICROMETASTASES; CARCINOMA; SURVIVAL; PROJECT; IMPACT AB Objective: Screening for lung cancer will discover many nodules of indeterminate pathology. Observation has the theoretic risk of permitting dissemination of a localized cancer and worsening prognosis, whereas immediate evaluation of benign conditions generates morbidity and cost. This study was conducted to assess the effect of delay in surgical intervention on survival for patients with early stage non-small cell lung cancer. Methods: Records for patients with resected pathologic stage I and II non-small cell lung cancer (1989-1999) were abstracted for patient age, race, sex, medical history, date of presentation, date and type of surgical treatment, pathologic stage, and date of death or last follow-up. Kaplan-Meier survival analysis was performed to test for the effect of delay (time from presentation to surgical intervention) on survival. Results: Eighty-four patients were identified. Median age was 66 years, median preoperative interval was 82 days (range, 1-641 days), and median follow-up was 3.3 years (range, 5 days-11.9 years). Median survival was 3.7 years. Overall 5-year survival was 40%; disease-specific 5-year survival was 63%. Log-rank analysis of the effect of delay on overall survival generated a P value of .54, with an estimated hazard ratio for a 90-day delay of 1.06 (95% confidence interval, 0.87-1.30). Conclusions: For this population, we were unable to detect a significant effect of delay on prognosis. Although these results suggest that the risk of judicious observation of indeterminate pulmonary nodules might be low, the 95% confidence interval is broad. Larger sample sizes are needed to reach definitive conclusions. C1 Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. San Francisco Vet Affairs Med Ctr, Dept Surg, Div Cardiothorac Surg, San Francisco, CA USA. Univ Calif San Francisco, Div Biostat, Ctr Canc, San Francisco, CA 94143 USA. RP Block, MI (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, 96 Jonathan Lucas St,409 CSB, Charleston, SC 29425 USA. NR 20 TC 48 Z9 49 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0022-5223 J9 J THORAC CARDIOV SUR JI J. Thorac. Cardiovasc. Surg. PD JAN PY 2003 VL 125 IS 1 BP 108 EP 114 DI 10.1067/mtc.2003.93 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 638PK UT WOS:000180579300021 PM 12538992 ER PT J AU Musicant, SE Giswold, ME Olson, CJ Landry, GJ Taylor, LM Yeager, RA Edwards, JM Moneta, GL AF Musicant, SE Giswold, ME Olson, CJ Landry, GJ Taylor, LM Yeager, RA Edwards, JM Moneta, GL TI Postoperative duplex scan surveillance of axillofemoral bypass grafts SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 50th Annual Meeting of the American-Association-for-Vascular-Surgery CY JUN 09-12, 2002 CL BOSTON, MASSACHUSETTS SP Amer Assoc Vascular Surg ID SUPPORTED POLYTETRAFLUOROETHYLENE; FEMOROPOPLITEAL BYPASS; AXILLOBIFEMORAL BYPASS; INFRAINGUINAL BYPASS; PATENCY; VEIN; ULTRASONOGRAPHY; PROGRAM AB Objective: Duplex scan surveillance (DS) for axillofemoral bypass grafts (AxFBGs) has not been extensively studied. The intent of this study was twofold: 1, to characterize the flow velocities within AxFBGs; and 2, to determine whether postoperative DS is useful in assessment of future patency of AxFBGs. Methods. We identified all patients who underwent AxFBG procedures between January 1996 and January 2001 at our combined university and Veterans Affairs hospital vascular surgical service. All grafts were performed with ringed 8-mm polytetrafluoroethylene with the distal limb of the axillofemoral component anastomosed to the hood of the femoral-femoral graft. DS was every 3 months for 1 year and every 6 months thereafter. Duplex scan results were compared in primarily patent grafts with grafts that thrombosed. Graft failures from infection were excluded. Influences of ankle-brachial index, blood pressure, outflow patency, operative indication, and comorbidities on graft patency were analyzed. Results. One hundred twenty patients underwent AxFBG procedures. Twenty-eight were excluded because of infection or death before surveillance examination. Fourteen were lost to follow-up, 23 had failed grafts from occlusion, and 55 had grafts that remained patent. In the 78 patients evaluated during long-term follow-up period, the mean peak systolic velocities (PSVs) at the proximal (axillary) anastomosis during the first postoperative year ranged from 153 to 194 cm/s. Mean PSVs at the mid portion of the axillofemoral graft during the first postoperative year ranged from 100 to 125 cm/s, whereas those for the distal axillofemoral anastomosis ranged from 93 to 129 cm/s. Mean midgraft and distal anastomotic velocities obtained before thrombosis were significantly lower in the thrombosed grafts compared with the last recorded velocities at the same sites in the patent grafts (mean PSV, 84 versus 112 cm/s; P = .015; mean PSV, 89 versus 127 cm/s; P = .024, respectively). Forty-eight percent of occluded grafts had a mean midgraft PSV at last observation of less than 80 cm/s. Blood pressure correlated with midgraft velocity (r = 0.415; P < .05). With multivariate logistic regression analysis, a mean midgraft velocity less than 80 cm/s was the sole independent factor associated with graft failure (P < .01). No patients with midgraft velocities greater than 155 cm/s had occlusion. Conclusion: Flow velocity varies widely within and among AxFBGs. Patency of AxFBGs is associated with higher midgraft PSV, and thrombosis with midgraft velocities less than 80 cm/s. C1 Oregon Hlth Sci Univ, Div Vasc Surg, Dept Surg, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Moneta, GL (reprint author), Oregon Hlth Sci Univ, Div Vasc Surg, Dept Surg, OP-11,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. NR 27 TC 12 Z9 12 U1 0 U2 0 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 JAN PY 2003 VL 37 IS 1 BP 54 EP 60 DI 10.1067/mva.2003.43 PG 7 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 636PN UT WOS:000180465200014 PM 12514578 ER PT J AU Ibrahim, SA Burant, CJ Kwoh, CK AF Ibrahim, SA Burant, CJ Kwoh, CK TI Elderly hospitalized patients with diastolic heart failure: Lack of gender and ethnic differences in 18-month mortality rates SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID VENTRICULAR EJECTION FRACTION; CONVERTING ENZYME-INHIBITORS; PRIOR MYOCARDIAL-INFARCTION; CLINICAL-FEATURES; SYSTOLIC FUNCTION; COMMUNITY; DYSFUNCTION; PROGNOSIS; DIURETICS; OUTCOMES AB Background. Racial and gender differences in mortality rates have been reported for patients with systolic heart failure. Relatively little is known regarding diastolic heart failure prognosis. Methods. Our sample consisted of 1058 patients 65 years of age or older who were admitted to 30 hospitals in Northeastern Ohio with a principal diagnosis of heart failure and a left ventricular ejection fraction of greater than or equal to 50% by echocardiogram. Results. Of the 1058 patients with diastolic heart failure (13% African American and 87% white), African Americans and whites were comparable with respect to history of angina, stroke, being on dialysis, and alcohol use; the proportion of male patients was also comparable. The African American to white adjusted odds ratio for 18-month mortality (all cause) was 1.03 (0.66-1.59). For men versus women (30% vs 70%), the above-mentioned comorbidities were comparable, except women were More likely to have a do not resuscitate status (16% vs 7.3%; p = .000) and to be older (79.5 +/- 8 vs 77 +/- 7; p = .000). Men were more likely to have a history of tobacco use (30% vs 14%: p = .000) and alcohol use (36% vs 15%; p = .000), and a higher serum creatinine level (1.7 +/- 1.2 vs 1.4 +/- 1.1: p = .001). The men to women adjusted odds ratio for 18-month mortality (all cause) was 1.06 (0.76-1.46). Conclusion. In this cohort of elderly patients admitted with diastolic heart failure. there were no ethnic or gender differences in 18-month mortality rates. C1 VA Pittsburgh HealthCare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Case Western Reserve Univ, Sch Med, Dept Bioeth, Cleveland, OH 44106 USA. RP Ibrahim, SA (reprint author), VA Pittsburgh HealthCare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C,11 East,130 A-U, Pittsburgh, PA 15240 USA. NR 20 TC 14 Z9 14 U1 0 U2 0 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD JAN PY 2003 VL 58 IS 1 BP 56 EP 59 PG 4 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 636GB UT WOS:000180445300008 PM 12560412 ER PT J AU Ullian, ME Gantt, BJ Ford, AK Tholanikunnel, BG Spicer, EK Fitzgibbon, WR AF Ullian, ME Gantt, BJ Ford, AK Tholanikunnel, BG Spicer, EK Fitzgibbon, WR TI Potential importance of glomerular citrate synthase activity in remnant nephropathy SO KIDNEY INTERNATIONAL LA English DT Article DE Wistar-Furth rats; mineralocorticoid receptors; aldosterone; radioligand binding; citrate synthase; remnant nephropathy; glomeruli; progressive renal injury ID RATS RESISTANT; ALDOSTERONE; HYPERTENSION; RECEPTOR; PSEUDOHYPOALDOSTERONISM; DISEASE; KIDNEY AB Background. Aldosterone fosters progressive renal injury, but the mechanism is unknown. Both Wistar-Furth rats, which are resistant to aldosterone actions, and adrenalectomized Sprague-Dawley rats, which lack aldosterone, are characterized by resistance to remnant nephropathy and by reduced whole kidney citrate synthase activity. Increase in citrate synthase activity is a well-characterized, specific renal response to aldosterone. Therefore, we performed experiments to test the hypothesis that enhanced citrate synthase activity contributes to remnant nephropathy. Methods. Rat models included Wistar (control for Wistar-Furth), Wistar-Furth (resistant to aldosterone), Sprague-Dawley (normal), adrenalectomy (lacking aldosterone), and 5/6 nephrectomy (renal injury). Glomeruli were obtained by differential sieving. Citrate synthase activity was determined spectrophotometrically. Binding characteristics of cytosolic mineralocorticoid receptors were determined by equilibrium competition binding between tritiated and unlabeled aldosterone. Gene sequencing was performed with reverse transcription-polymerase chain reaction (RT-PCR) and fluorescent dye terminators. Results. In glomeruli isolated from adrenalectomized Wistar rats with intact renal mass, aldosterone stimulated a threefold increase in citrate synthase activity; this stimulation was not observed in glomeruli from Wistar-Furth rats. Similarly, citrate synthase activity in glomeruli isolated from adrenally intact Sprague-Dawley rats was 65% greater than that from adrenalectomized Sprague-Dawley rats. Compared to sham surgery, subtotal nephrectomy resulted in 100% greater glomerular citrate synthase activity in Sprague-Dawley rats. In Wistar-Furth rats, mineralocorticoid receptor binding was not reduced, and mutations in the mineralocorticoid receptor DNA binding segment were not found. Conclusion. Citrate synthase activity is elevated in remnant glomeruli, and experimental models characterized by reduced glomerular citrate synthase activity (Wistar-Furth rats, adrenalectomized Sprague-Dawley rats) are protected from remnant nephropathy. C1 Med Univ S Carolina, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Ullian, ME (reprint author), Med Univ S Carolina, Div Nephrol, Clin Sci bldg 829,171 Ashley Ave, Charleston, SC 29425 USA. NR 22 TC 5 Z9 5 U1 0 U2 0 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 2003 VL 63 IS 1 BP 156 EP 164 DI 10.1046/j.1523-1755.2003.00731.x PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 624NU UT WOS:000179766600016 PM 12472778 ER PT J AU Johansen, KL Shubert, T Doyle, J Soher, B Sakkas, GK Kent-Braun, JA AF Johansen, KL Shubert, T Doyle, J Soher, B Sakkas, GK Kent-Braun, JA TI Muscle atrophy in patients receiving hemodialysis: Effects on muscle strength, muscle quality, and physical function SO KIDNEY INTERNATIONAL LA English DT Article DE end-stage renal disease; hemodialysis; magnetic resonance imaging; muscle; strength; physical performance ID CHRONIC-RENAL-FAILURE; SKELETAL-MUSCLE; BODY-COMPOSITION; PARATHYROID-HORMONE; EXERCISE CAPACITY; MAINTENANCE DIALYSIS; SUBMAXIMAL EXERCISE; DISEASE; ACTIVATION; IMPEDANCE AB Background. Dialysis patients are less active and have reduced functional capacity compared to individuals with normal renal function. Muscle atrophy and weakness may contribute to these problems. This investigation was undertaken to quantify the extent of atrophy in the lower extremity muscles, to determine whether defects in muscle specific strength (force per unit mass) or central nervous system (CNS) activation are present, and to assess the relationship between muscle size and physical performance in a group of patients on hemodialysis. Methods. Thirty-eight dialysis subjects (aged 55 +/- 15 years) and nineteen healthy sedentary controls (aged 55 +/- 13 years) were enrolled. Magnetic resonance imaging of the lower leg was used to determine the total cross-sectional area (CSA) and the area of contractile and non-contractile tissue of the ankle dorsiflexor muscles. Isometric dorsiflexor strength was measured during a maximal voluntary contraction with and without superimposed tetanic stimulation (N = 22 for dialysis subjects, N = 12 for controls). Physical activity was measured by accelerometry, and gait speed was recorded as a measure of physical performance. Results. Dialysis subjects were weaker, less active, and walked more slowly than controls. Total muscle compartment CSA was not significantly different between dialysis subjects and controls, but the contractile CSA was smaller in the dialysis patients even after adjustment for age, gender, and physical activity. Central activation and specific strength were normal. Gait speed was correlated with contractile CSA. Conclusions. Significant atrophy and increased non-contractile tissue are present in the muscle of patients on hemodialysis. The relationship between contractile area and strength is intact in this population. Muscle atrophy is associated with poor physical performance. Thus, interventions to increase physical activity or otherwise address atrophy may improve performance and quality of life. C1 Univ Calif San Francisco, Nephrol Sect, Dept Med, San Francisco VA Med Ctr, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, No Calif Inst Res & Educ, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, Dept Radiol, San Francisco, CA 94121 USA. Univ Massachusetts, Dept Exercise Sci, Amherst, MA 01003 USA. RP Johansen, KL (reprint author), Univ Calif San Francisco, Nephrol Sect, Dept Med, San Francisco VA Med Ctr, 111J San Francisco,4150 Clement St, San Francisco, CA 94121 USA. FU NCRR NIH HHS [RR-00083]; NIDDK NIH HHS [1R01-DK56182] NR 46 TC 138 Z9 151 U1 1 U2 10 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 2003 VL 63 IS 1 BP 291 EP 297 DI 10.1046/j.1523-1755.2003.00704.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 624NU UT WOS:000179766600033 PM 12472795 ER PT J AU Lewis, KG Schmidt, A Nahm, WK Moy, RL AF Lewis, KG Schmidt, A Nahm, WK Moy, RL TI Lack of difference between rates of leukoderma after skin resurfacing with 90 mu s pulsed and 900 mu s dwell time carbon dioxide lasers SO LASERS IN SURGERY AND MEDICINE LA English DT Meeting Abstract CT 23rd Annual Meeting of the American-Society-for-Laser-Medicine-and-Surgery CY APR 09-13, 2003 CL ANAHEIM, CALIFORNIA SP American Soc Laser Med Surg C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. NR 0 TC 0 Z9 0 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 0196-8092 J9 LASER SURG MED JI Lasers Surg. Med. PY 2003 SU 15 MA 70 BP 22 EP 22 PG 1 WC Dermatology; Surgery SC Dermatology; Surgery GA 661FK UT WOS:000181880400070 ER PT J AU Higuchi, Y Zeng, H Ogawa, M AF Higuchi, Y Zeng, H Ogawa, M TI CD38 expression by hematopoietic stem cells of newborn and juvenile mice SO LEUKEMIA LA English DT Article DE CD38; hematopoietic stem cells; transplantation; developmental changes ID MURINE CD38; TRANSPLANTATION AB While investigators in a number of laboratories have documented that the hematopoietic stem cells (HSCs) of fetal and adult mice are CD38(+), no information is available about CD38 expression by HSCs of newborn and juvenile mice. We used a murine, transplantation model to examine HSC CD38 expression. First, we observed that all HSCs from newborn bone marrow are CD38(-). Next, it was determined that the majority of HSCs in the bone marrow of 5-week-old mice are CD38(-), with a minority being CD38(+). These observations indicated that the CD38(+) subpopulation of HSC appears before the age of 5 weeks and expands during adolescence. However, the majority of HSCs of 5-week-old mice became CD38(+) following injection of 5-fluorouracil, indicating that activation of juvenile stem cells enhances CD38 expression. These observations may have implications for CD38 expression by HSCs from human umbilical cord blood and bone marrow of young children in steady state and under pathological conditions. C1 Med Univ S Carolina, Dept Vet Affairs Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Ogawa, M (reprint author), Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. FU NCI NIH HHS [P01-CA78582]; NIDDK NIH HHS [R01-DK54197] NR 16 TC 9 Z9 10 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0887-6924 J9 LEUKEMIA JI Leukemia PD JAN PY 2003 VL 17 IS 1 BP 171 EP 174 DI 10.1038/sj.leu.2402785 PG 4 WC Oncology; Hematology SC Oncology; Hematology GA 638ZG UT WOS:000180602700023 PM 12529675 ER PT J AU Arbuckle, MR James, JA Dennis, GJ Rubertone, MV McClain, MT Kim, XR Harley, JB AF Arbuckle, MR James, JA Dennis, GJ Rubertone, MV McClain, MT Kim, XR Harley, JB TI Rapid clinical progression to diagnosis among African-American men with systemic lupus erythematosus SO LUPUS LA English DT Article DE African-American; autoantibodies; ethnicity; gender; lupus; SLE ID 3 ETHNIC-GROUPS; DESCRIPTIVE ANALYSIS; GENDER DIFFERENCES; REVISED CRITERIA; GENOME SCAN; DISEASE; FEATURES; AUTOANTIBODIES; MANIFESTATIONS; CLASSIFICATION AB The initial clinical course of systemic lupus erythematosus (SLE) is variable, ranging from relatively minor manifestations progressing over years to rapid onset of fulminate disease. We sought to identify factors associated with the rapid manifestation of SLE. Chart review of military medical records was used to identify 130 patients who met the American College of Rheumatology classification criteria for SLE. Demographics, clinical criteria date of occurrence, and the date of SLE classification (at least four clinical criteria) met were documented. Prospectively stored serum samples prior to the diagnosis were evaluated for SLE autoantibodies. Median time from the first recorded criteria to diagnosis was significantly shorter in African-American (AA) males compared with AA females and European American (EA) females and males combined. AA males were more likely to have nephritis as their first clinical symptom. Also, less time transpired between the first clinical criterion and SLE diagnosis in AA males with nephritis than in other groups presenting with nephritis. Even when cases presenting with nephritis were excluded, a diagnosis of SLE was made more rapidly in AA males. African-American men progress from initial clinical manifestations to SLE diagnosis more rapidly than other ethnic or gender groups. C1 Oklahoma Med Res Fdn, Arthrit & Immunol Program, Oklahoma City, OK 73104 USA. Univ Oklahoma, Hlth Sci Ctr, Dept Med, Oklahoma City, OK USA. Univ Oklahoma, Hlth Sci Ctr, Dept Pathol, Oklahoma City, OK USA. Walter Reed Army Med Ctr, Dept Rheumatol, Washington, DC 20307 USA. USA, Ctr Hlth Promot & Prevent Med, Army Med Surveillance Act, Washington, DC 20310 USA. Oklahoma Med Res Fdn, Genet Epidemiol Unit, Oklahoma City, OK 73104 USA. US Dept Vet Affairs, Oklahoma City, OK USA. RP James, JA (reprint author), Oklahoma Med Res Fdn, Arthrit & Immunol Program, 825 NE 13th St, Oklahoma City, OK 73104 USA. FU NIAID NIH HHS [AI24717, AI31584]; NIAMS NIH HHS [AR45231, AR01981, AR42460, AR45084] NR 29 TC 42 Z9 46 U1 0 U2 1 PU ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PY 2003 VL 12 IS 2 BP 99 EP 106 DI 10.1191/0961203303lu334oa PG 8 WC Rheumatology SC Rheumatology GA 651EU UT WOS:000181308200004 PM 12630753 ER PT J AU Heinlen, LD McClain, MT Kim, X Del-Rio, AIQ James, JA Harley, JB Scofield, RH AF Heinlen, LD McClain, MT Kim, X Del-Rio, AIQ James, JA Harley, JB Scofield, RH TI Anti-Ro and anti-nRNP response in unaffected family members of SLE patients SO LUPUS LA English DT Letter ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; SJOGRENS-SYNDROME; REVISED CRITERIA; CLASSIFICATION; ANTIBODIES; AUTOANTIBODIES C1 Oklahoma Med Fdn, Arthrit & Immuniol Program, Oklahoma City, OK USA. Oklahoma Med Res Fdn, Genet Epidemiol Unit, Oklahoma City, OK 73104 USA. Univ Oklahoma, Hlth Sci Ctr, Dept Med, Oklahoma City, OK USA. Univ Oklahoma, Hlth Sci Ctr, Dept Pathol, Oklahoma City, OK USA. US Dept Vet Affairs, Oklahoma City, OK 73104 USA. RP Heinlen, LD (reprint author), Oklahoma Med Fdn, Arthrit & Immuniol Program, Oklahoma City, OK USA. FU NIAID NIH HHS [AI31584]; NIAMS NIH HHS [AR01981, AR45084, AR45451] NR 16 TC 8 Z9 8 U1 0 U2 0 PU ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PY 2003 VL 12 IS 4 BP 335 EP 337 DI 10.1191/0961203303lu377xx PG 3 WC Rheumatology SC Rheumatology GA 669RA UT WOS:000182363200016 PM 12729062 ER PT J AU Holliday, SL Navarrete, MG Hermosillo-Romo, D Valdez, CR Saklad, AR Escalante, A Brey, RL AF Holliday, SL Navarrete, MG Hermosillo-Romo, D Valdez, CR Saklad, AR Escalante, A Brey, RL TI Validating a computerized neuropsychological test battery for mixed ethnic lupus patients SO LUPUS LA English DT Article DE neuropsychiatric; neuropsychological testing; systemic lupus erythematosus ID COGNITIVE IMPAIRMENT; NEUROPSYCHIATRIC SYNDROMES; RATING-SCALE; ERYTHEMATOSUS; PREVALENCE; DYSFUNCTION; DEFINITIONS; DEPRESSION; INDEX AB Patients with systemic lupus erythematosus (SLE) often show cognitive impairment on traditional neuropsychological tests; however, many of these tests are unsuitable for use with mixed ethnic populations. Computer-administered cognitive tests are promising, but have not been validated against traditional tests or with predominantly Hispanic samples. We gave 67 lupus patients a computer-administered test battery (Automated Neuropsychological Assessment Metrics - ANAM) and a battery of traditional neuropsychological tests. The two batteries were compared using correlation and multiple regression analyses. All patients were fluent in English, 54% were Hispanic and 13% were bilingual. Non-Hispanic patients were predominantly European American (37%). About 80% of patients were rated as impaired on traditional tests. Hispanics were younger, had less education and more current SLE disease activity than non-Hispanics; but did not differ in lifetime SLE-related organ damage or current steroid use. Hispanics and younger patients were more impaired on many of the traditional tests, while ANAM was not affected by Hispanic ethnicity or education. ANAM tests were moderately correlated with analogous traditional tests. Age and selected ANAM scores accounted for about 60% of the variance in the traditional battery. These results replicate the high prevalence of cognitive deficits in SLE found by others and suggest that computer-administered tests like ANAM may be useful for assessment of cognitive impairment in mixed-ethnic samples. Confounding variables such as age, education, English language fluency and prior experience with tests were identified and need to be controlled statistically or with comparison groups in future studies. C1 S Texas Vet Hlth Care Syst, Psychol Serv 116B, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Div Neurol, San Antonio, TX 78229 USA. RP Holliday, SL (reprint author), S Texas Vet Hlth Care Syst, Psychol Serv 116B, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. RI Valdez, Carmen/K-6313-2012 FU NCRR NIH HHS [M01 RR01346-19]; NINDS NIH HHS [NS35477] NR 32 TC 30 Z9 31 U1 1 U2 1 PU ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PY 2003 VL 12 IS 9 BP 697 EP 703 DI 10.1191/0961203303lu442oa PG 7 WC Rheumatology SC Rheumatology GA 721MJ UT WOS:000185319900008 PM 14514133 ER PT J AU Chou, R Saha, S Helfand, M AF Chou, R Saha, S Helfand, M TI Quality of adverse event assessment in randomized controlled trials and observational studies SO MAYO CLINIC PROCEEDINGS LA English DT Letter C1 Oregon Hlth Sci Univ, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. RP Chou, R (reprint author), Oregon Hlth Sci Univ, Portland, OR 97201 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 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 JAN PY 2003 VL 78 IS 1 BP 119 EP 119 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 632VQ UT WOS:000180244500019 PM 12528888 ER PT J AU Chang, JS Van Remmen, H Cornell, J Richardson, A Ward, WF AF Chang, JS Van Remmen, H Cornell, J Richardson, A Ward, WF TI Comparative proteomics: characterization of a two-dimensional gel electrophoresis system to study the effect of aging on mitochondrial proteins SO MECHANISMS OF AGEING AND DEVELOPMENT LA English DT Article; Proceedings Paper CT International Conference on Functional Genomics of Ageing CY APR 24-27, 2002 CL SEVILLE, SPAIN DE 2-D PAGE; mitochondria proteins; aging; skeletal muscle ID IMMOBILIZED PH GRADIENTS; 2-DIMENSIONAL ELECTROPHORESIS; OXIDATIVE STRESS; IDENTIFICATION; COMPLEX; LIVER AB To study the effect of aging and anti-aging strategies on mitochondria, we have characterized a two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) system to analyze the profile of mitochondrial proteins. We have optimized the separation of proteins by 2-D PAGE and established the linearity and reproducibility of the system with mitochondria isolated from skeletal muscle of mice. Using total mitochondria protein ranging from 10 to 200 mug, we found that 74% of the proteins resolved by 2-D PAGE had coefficient of determination (R-2) values greater than 0.8, showing a linear increase in fluorescence with increasing protein concentration. The coefficient of variation (CV) was less than 50% for at least 93% of the 424 spots analyzed for both gel-to-gel variance and animal-to-animal variance. Using mitochondrial protein fractions prepared from skeletal muscle of 18-month-old mice, we show that 10 animals will be sufficient to detect a 100% difference in the 97% (i.e. 505) of the proteins resolved by 2-D PAGE. Thus, 2-D PAGE provides a sensitive and reliable technique for analysis of protein expression in mitochondria. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Vet Evidence Based Res Disseminat & Implementat C, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Div Geriatr & Gerontol, San Antonio, TX 78229 USA. RP Ward, WF (reprint author), Univ Texas, Hlth Sci Ctr, Dept Physiol, 7703 Floyd Curl Dr,MSC 7756, San Antonio, TX 78229 USA. FU NIA NIH HHS [P01 AG13319, P01 AG19316, P01 AG20591, P01AG14674] NR 32 TC 32 Z9 36 U1 0 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0047-6374 J9 MECH AGEING DEV JI Mech. Ageing Dev. PD JAN PY 2003 VL 124 IS 1 BP 33 EP 41 AR PII S0047-6374(02)00167-7 DI 10.1016/S0047-6374(02)00167-7 PG 9 WC Cell Biology; Geriatrics & Gerontology SC Cell Biology; Geriatrics & Gerontology GA 665BJ UT WOS:000182099500006 PM 12618004 ER PT J AU Smetana, GW Macpherson, DS AF Smetana, GW Macpherson, DS TI The case against routine preoperative laboratory testing SO MEDICAL CLINICS OF NORTH AMERICA LA English DT Article ID CHEST X-RAYS; CARDIAC SURGICAL-PROCEDURES; CATARACT-SURGERY; ADMISSION URINALYSIS; NONCARDIAC SURGERY; UNPROVEN UTILITY; ELDERLY PATIENTS; BLEEDING-TIME; RISK-FACTORS; RADIOGRAPHY AB Clinicians often obtain routine laboratory tests with the intent of identifying patients at risk for postoperative complications. Such tests should be performed selectively based on patient characteristics and the type of planned surgery. Most laboratory abnormalities can be predicted based on clinical evaluation and add little to the preoperative risk assessment or management. The incidence of unanticipated abnormalities that influences management for many preoperative tests is less than 1 %. In this article, we provide the evidence base to support a strategy of selective preoperative testing and to make a case against routine preoperative laboratory testing. C1 Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA. Univ Pittsburgh, Dept Med, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. RP Smetana, GW (reprint author), Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, 330 Brookline Ave, Boston, MA 02215 USA. NR 84 TC 64 Z9 71 U1 2 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0025-7125 J9 MED CLIN N AM JI Med. Clin. N. Am. PD JAN PY 2003 VL 87 IS 1 BP 7 EP + AR PII S0025-7125(02)00147-5 DI 10.1016/S0025-7125(02)00147-5 PG 35 WC Medicine, General & Internal SC General & Internal Medicine GA 640ZT UT WOS:000180719600003 PM 12575882 ER PT J AU Arozullah, AM Conde, MV Lawrence, VA AF Arozullah, AM Conde, MV Lawrence, VA TI Preoperative evaluation for postoperative pulmonary complications SO MEDICAL CLINICS OF NORTH AMERICA LA English DT Article ID POSITIVE AIRWAY PRESSURE; UPPER ABDOMINAL-SURGERY; DEEP BREATHING EXERCISES; OBSTRUCTIVE LUNG-DISEASE; INCENTIVE SPIROMETRY; RISK-FACTORS; RESPIRATORY-FAILURE; CONSERVATIVE THERAPY; CHEST PHYSIOTHERAPY; THORACIC-SURGERY AB This article reviews the morbidity and mortality associated with postoperative pulmonary complications and the risk factors associated with the development of postoperative pulmonary complications. The authors discuss indications for specific preoperative tests, including preoperative pulmonary function testing. Risk indices for predicting postoperative pulmonary complications are also presented. Finally, the authors review the evidence for various risk reduction strategies. C1 Univ Illinois, Coll Med, Gen Internal Med Sect, Chicago, IL 60612 USA. Vet Affairs Chicago Healthcare Syst, Westside Div, Chicago, IL USA. Univ Texas, Hlth Sci Ctr, Audie Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Audie Murphy Div, Gen Internal Med Sect, San Antonio, TX USA. RP Arozullah, AM (reprint author), Univ Illinois, Coll Med, Gen Internal Med Sect, M-C 718,840 S Wood St,Suite 440-M, Chicago, IL 60612 USA. NR 86 TC 33 Z9 36 U1 1 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0025-7125 J9 MED CLIN N AM JI Med. Clin. N. Am. PD JAN PY 2003 VL 87 IS 1 BP 153 EP + AR PII S0025-7125(02)00151-7 DI 10.1016/S0025-7125(02)00151-7 PG 22 WC Medicine, General & Internal SC General & Internal Medicine GA 640ZT UT WOS:000180719600009 PM 12575888 ER PT J AU Rizvon, MK Chou, CL AF Rizvon, MK Chou, CL TI Surgery in the patient with liver disease SO MEDICAL CLINICS OF NORTH AMERICA LA English DT Article ID ACUTE ACALCULOUS CHOLECYSTITIS; POSTOPERATIVE RENAL-FUNCTION; CIRRHOTIC-PATIENTS; HEPATOCELLULAR-CARCINOMA; LAPAROSCOPIC CHOLECYSTECTOMY; OBSTRUCTIVE-JAUNDICE; HEPATIC RESECTION; RISK-FACTORS; ABDOMINAL OPERATIONS; SURGICAL RISK AB Patients with liver disease scheduled for surgery need to be evaluated in a stepwise manner with careful emphasis on history and physical examination. Appropriate laboratory testing should be done in patients with clinical evidence of liver disease. Elective surgery should be postponed in patients with active hepatitis. Child's classification still remains an important prognostic factor in evaluating surgical patients with cirrhosis. Newer techniques, such as laparoscopic procedures, seem to be associated with a better postoperative course. C1 Nassau Univ, Med Ctr, Med Consultat Serv, E Meadow, NY 11554 USA. SUNY Stony Brook, Dept Med, Stony Brook, NY 11794 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. San Francisco Vet Affairs Med Ctr, Med Consultat Serv, San Francisco, CA USA. RP Rizvon, MK (reprint author), Nassau Univ, Med Ctr, Med Consultat Serv, 2201 Hempstead Turnpike, E Meadow, NY 11554 USA. NR 100 TC 18 Z9 19 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0025-7125 J9 MED CLIN N AM JI Med. Clin. N. Am. PD JAN PY 2003 VL 87 IS 1 BP 211 EP + AR PII S0025-7125(02)00153-0 DI 10.1016/S0025-7125(02)00153-0 PG 18 WC Medicine, General & Internal SC General & Internal Medicine GA 640ZT UT WOS:000180719600012 PM 12575891 ER PT J AU King, JT Justice, AC Roberts, MS Chang, CCH AF King, JT Justice, AC Roberts, MS Chang, CCH TI Long-term HIV/AIDS survival estimation in the highly active antiretroviral therapy era SO MEDICAL DECISION MAKING LA English DT Article DE AIDS; anti-infective agents/therapeutic use; CD4 lymphocyte count; life expectancy; Markov chains; models, theoretical ID IMMUNODEFICIENCY-VIRUS INFECTION; COST-EFFECTIVENESS; HIV-INFECTION; ZIDOVUDINE TREATMENT; AIDS; MORTALITY; DISEASE; REGIMEN; COHORT; COUNT AB Background. Highly active antiretroviral therapy (HAART) prolongs short-term survival in patients with HIV/AIDS. HAART has only been available since 1996; thus, no long-term survival data are available. Computer simulation models extrapolating short-term survival data can provide estimates of long-term survival. These survival estimates may assist patients and clinicians in HAART treatment planning. The authors construct a computer simulation model based on observational data to estimate long-term survival in a cohort of HIV/AIDS patients undergoing treatment with HAART Methods. The authors use data from the Collaboration in HIV Outcomes Research-US (CHORUS) observational cohort (N = 4791), the published literature, and US Life Tables to specify a computer simulation model of expected survival accounting for baseline CD4 cell count, progressive HAART treatment failure, progressive risk of HAART on-treatment mortality, and age-associated mortality. Time to treatment failure for each of three rounds of HAART and risk of mortality on-treatment were estimated using parametric survival models with censoring of follow-up fit to CHORUS data. Off-treatment survival after HAART failure was estimated from the pre-HAART literature. Age-associated mortality was taken from US Life Tables. Results. Median projected survivals stratified by baseline CD4 cell count subgroups were CD4 > 200 cells/mm(3), 15.4 years; CD4 less than or equal to 200 cells/mm(3), 8.5 years; and CD4 less than or equal to 50 cells/mm(3), 5.5 years. These values are 4 to 6 years longer than pre-HAART cohorts. The sensitivity analyses showed that the model survival predictions were most sensitive to the treatment failure rate, the on-treatment mortality rate, and the number of treatment rounds. Conclusions. Computer simulation modeling of long-term survival of patients with HIV/AIDS on HAART-accounting for differential treatment failure and death rates stratified by CD4 cell count and age-associated mortality-suggests a relatively consistent 4- to 6-year survival benefit over pre-HAAART therapies. C1 VA Pittsburgh Healthcare Syst, Surg Serv Line, Neurosurg Sect, Pittsburgh, PA USA. Univ Pittsburgh, Dept Neurol Surg, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Div Gen Internal Med, Sect Decis Sci & Clin Syst Modeling, Pittsburgh, PA USA. Univ Pittsburgh, Ctr Hlth Care, Pittsburgh, PA USA. Univ Pittsburgh, Dept Biostat, Pittsburgh, PA USA. GlaxoSmithKline Inc, N Amer Med Affairs, Res Triangle Pk, NC USA. RP Justice, AC (reprint author), Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Univ Dr C,11E-124 130-U, Pittsburgh, PA 15240 USA. NR 28 TC 43 Z9 45 U1 0 U2 3 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 JAN-FEB PY 2003 VL 23 IS 1 BP 9 EP 20 DI 10.1177/0272989X02239652 PG 12 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 640BC UT WOS:000180665300001 PM 12583451 ER PT J AU Song, MK Hwang, IK Rosenthal, MJ Harris, DM Yamaguchi, DT Yip, I Go, VLW AF Song, MK Hwang, IK Rosenthal, MJ Harris, DM Yamaguchi, DT Yip, I Go, VLW TI Antidiabetic actions of arachidonic acid and zinc in genetically diabetic Goto-Kakizaki rats SO METABOLISM-CLINICAL AND EXPERIMENTAL LA English DT Article ID INSULIN-RECEPTOR KINASE; SKELETAL-MUSCLE; IN-VITRO; HIS-PRO; MELLITUS; GLUCOSE; TRANSPORT; PROSTAGLANDIN-E2; ADIPOCYTES; DEFICIENCY AB In previous studies, we showed that feeding arachidonic acid (AA) supplemented with a fixed amount of zinc lowered blood glucose concentrations in the fed state and water intake in rats with streptozotocin-induced diabetes. The present study was designed to determine dose-dependent effects of AA supplemented with a fixed amount of zinc on fed blood glucose levels, water intake, and glucose tolerance in genetically type 2 diabetic Goto-Kakizaki (G-K) Wistar rats. In an acute study, 20 mg/kg AA plus 10 mg/kg zinc administered via gastric gavage significantly improved oral glucose tolerance in G-K rats when compared to rats given distilled water (DW) only. When rats were treated chronically (2 weeks) with increasing doses of AA in drinking water, fed blood glucose concentrations and water intake were maximally decreased with diets containing 20 or 30 mg/L AA plus 10 mg/L zinc. Three-hour average area-above-fasting glucose concentrations (TAFGC; index of oral glucose tolerance) in diabetic G-K rats treated with 10, 20, or 30 mg/L AA plus 10 mg/L zinc for 2 weeks were significantly decreased relative to DW-treated rats. The effect on TAFGC values was maintained for an additional 2 weeks after cessation of treatment. Plasma insulin levels significantly increased in rats treated with 20 mg/L AA only or 10 mg/L AA plus 10 mg/L zinc, but not in rats treated with 20 or 30 mg/L AA plus 10 mg/L zinc, which are the most effective doses for the improvement of clinical signs of diabetes in G-K rats. In in vitro assays, 0.2 mg/mL AA in the incubation media was optimal for glucose uptake in isolated soleus muscle slices. These results suggest that treatment of genetically diabetic G-K rats with AA plus zinc lowers blood glucose levels via improvement of insulin sensitivity. Copyright 2003, Elsevier Science (USA). All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Ctr Human Nutr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Pediat, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Hlthcare Syst, Los Angeles, CA USA. RP Harris, DM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Ctr Human Nutr, 900 Veteran Ave,13-145 Warren Hall, Los Angeles, CA 90095 USA. FU NIDDK NIH HHS [1 R43 DK 56546-01] NR 34 TC 23 Z9 26 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 0026-0495 J9 METABOLISM JI Metab.-Clin. Exp. PD JAN PY 2003 VL 52 IS 1 BP 7 EP 12 DI 10.1053/meta.2003.50031 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 632VU UT WOS:000180244800002 PM 12524655 ER PT J AU Green, LK AF Green, LK TI Basaloid squamous cell carcinoma of the lung: A review of 292 cases SO MODERN PATHOLOGY LA English DT Meeting Abstract CT 92nd Annual Meeting of the United-States-and-Canadian-Academy-of-Pathology CY MAR 22-28, 2003 CL WASHINGTON, D.C. SP US & Canadian Acad Pathol C1 Houston Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 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 0893-3952 J9 MODERN PATHOL JI Mod. Pathol. PD JAN PY 2003 VL 16 IS 1 MA 1404 BP 307A EP 307A PG 1 WC Pathology SC Pathology GA 640ZY UT WOS:000180720101414 ER PT J AU Rivera, OJ Song, CS Centonze, VE Lechleiter, JD Chatterjee, B Roy, AK AF Rivera, OJ Song, CS Centonze, VE Lechleiter, JD Chatterjee, B Roy, AK TI Role of the promyelocytic leukemia body in the dynamic interaction between the androgen receptor and steroid receptor coactivator-1 in living cells SO MOLECULAR ENDOCRINOLOGY LA English DT Article ID NUCLEAR-BODIES; ESTROGEN-RECEPTOR; PREMATURE SENESCENCE; BINDING-PROTEIN; ONCOGENIC RAS; CANCER CELLS; PML; SUMO-1; TRANSCRIPTION; PROTEASOME AB The dynamic interaction between the androgen receptor (AR) and steroid receptor coactivator-1 (SRC-1) was explored in living cells expressing chimeric forms of the receptor and the coactivator containing two spectral variants of jellyfish fluorescent protein. Laser scanning confocal imaging of transfected cells expressing fluorescently labeled SRC-1 revealed that in an unsynchronized cell population, the coactivator is distributed in approximately 40% cells as nuclear bodies of 0.2-1.0 gm in diameter. Immunostaining of cyan fluorescent protein-labeled SRC-1 (CFP-SRC1)-expressing cells with antibody to promyelocytic leukemia (PML) protein showed significant overlap of the CFP fluorescence with the antibody stain. Cotransfection of cells with a plasmid expressing the CFP conjugate of Sp100 (another marker protein for the PML nuclear body) also showed colocalization of the yellow fluorescent protein (YFP)-SRC1 containing nuclear foci with the PML bodies in living cells. Analysis of the three-dimensional structure revealed that the PML bodies are round to elliptical in shape with multiple satellite bodies on their surface. Some of these satellite bodies contain the SRC-1. Activation and nuclear import of CFP-AR by the agonistic ligand 5alpha-dihydrotestosterone, but not by the antagonist casodex, transferred YFP-SRC1 from the PML bodies to an interlacing filamentous structure. In a single living cell, agonist-activated AR caused a time-dependent movement of YFP-SRC1 from the PML bodies to this filamentous structure. Additionally, coexpression of a constitutively active mutant of AR (AR-Deltaligand binding domain) also displaced YFP-SRC1 from the PML bodies to this intranuclear filamentous structure. The fluorescence recovery after photobleaching approach was used to examine changes in the kinetics of movement of YFP-SRC1 during its mobilization from the PML bodies to the intranuclear filamentous structure by the agonist-activated AR. Results of the relative half-times (t1/2) of replacement of YFP-SRC1 within the photobleached region of a single PML body from its surrounding nuclear space supported the conclusion that SRC-1 is actively transported from the PML bodies to the intranuclear filamentous structure by the ligand-activated AR. This observation also suggests an interaction between AR and SRC-1 before its binding to the target gene. The PML bodies have been implicated as a cross-road for multiple regulatory pathways that control cell proliferation, cellular senescence, and apoptosis. Our present results along with other recent reports expand the role of this subnuclear structure to include the regulation of steroid hormone action. C1 Univ Texas, Ctr Hlth Sci, Inst Biotechnol, Dept Mol Med, San Antonio, TX 78245 USA. Univ Texas, Ctr Hlth Sci, Dept Cellular & Struct Biol, San Antonio, TX 78245 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Roy, AK (reprint author), Univ Texas, Ctr Hlth Sci, Inst Biotechnol, Dept Mol Med, 15355 Lambda Dr, San Antonio, TX 78245 USA. EM roy@uthscsa.edu FU NIA NIH HHS [R37AG-10486, T32-AG-00165]; NIDDK NIH HHS [R01-DK-14744] NR 46 TC 26 Z9 26 U1 1 U2 2 PU ENDOCRINE SOC PI WASHINGTON PA 2055 L ST NW, SUITE 600, WASHINGTON, DC 20036 USA SN 0888-8809 J9 MOL ENDOCRINOL JI Mol. Endocrinol. PD JAN PY 2003 VL 17 IS 1 BP 128 EP 140 DI 10.1210/me.2002-0165 PG 13 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 632VL UT WOS:000180244100011 PM 12511612 ER PT J AU Leonard, S Freedman, R AF Leonard, S Freedman, R TI Recombination in a schizophrenic proband fails to exclude CHRNA7 at chromosome 15q14 SO MOLECULAR PSYCHIATRY LA English DT Editorial Material ID RECEPTOR GENE CHRNA7; SUBUNIT GENE; DUPLICATION; LOCUS C1 Denver VA Med Ctr, Dept Psychiat, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80262 USA. RP Freedman, R (reprint author), Denver VA Med Ctr, Dept Psychiat, 4200 E 9th Ave C-268-71, Denver, CO 80262 USA. NR 5 TC 5 Z9 5 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1359-4184 J9 MOL PSYCHIATR JI Mol. Psychiatr. PY 2003 VL 8 IS 2 BP 145 EP 146 DI 10.1038/sj.mp.4001209 PG 2 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 649FG UT WOS:000181195900006 PM 12610645 ER PT J AU Troen, BR AF Troen, BR TI The biology of aging SO MOUNT SINAI JOURNAL OF MEDICINE LA English DT Article; Proceedings Paper CT Geriatric Medicine Update and Board Review Meeting CY OCT 05-08, 2001 CL MT SINAI SCH MED, NEW YORK, NEW YORK HO MT SINAI SCH MED DE aging; senescence; cellular; lifespan; mortality; antagonistic pleiotropy; cancer ID DELETED MITOCHONDRIAL-DNA; REPLICATIVE LIFE-SPAN; PROGRAMMED CELL-DEATH; IMMORTALIZED HUMAN FIBROBLASTS; AGE-ASSOCIATED ACCUMULATION; SENESCENT HUMAN FIBROBLASTS; GENE-EXPRESSION PROFILE; COMPLEX-I DEFICIENCY; CALORIC RESTRICTION; PARKINSONS-DISEASE AB In humans, aging is inexorable. The progressive decrease in physiological capacity and the reduced ability to respond to environmental stresses lead to increased susceptibility and vulnerability to disease. Consequently, mortality due to all causes increases exponentially with aging. Attempts at understanding the causes of aging are limited by the complexity of the problem. Aging changes are manifest from the molecular to the organismic level; environmental factors affect experimental observations; secondary effects complicate elucidation of primary mechanisms; and precisely defined, easily measurable "biomarkers" are lacking. No one unifying theory may exist, since the mechanisms of aging could be quite distinct in different organisms, tissues, and cells. Evolutionary pressures have selected for successful reproduction, making it likely that the post-reproductive physiology of an organism (i.e., aging) is an epigenetic and pleiotropic manifestation of the optimization for early fitness. Indeed, antagonistic pleiotropy, wherein genes that enhance early survival and function but are disadvantageous later in life, may play an overriding role in aging. Theories of aging can be divided into two general categories: stochastic and developmental-genetic. These are not mutually exclusive, particularly when considering the free radical/mitochondrial DNA theory of aging. Increasing evidence suggests that cellular senescence and organismic aging are antagonistically pleiotropic manifestations of evolutionary pressures to prevent malignant transformation. In other words, aging may be the price we pay to avoid cancer. The beneficial paradox may be that the maximum lifespan potential of humans may have been achieved, in part, due to our ability to grow old. C1 Bronx Vet Adm Med Ctr, Brookdale Dept Geriatr & Adult Dev, Bronx, NY USA. RP Troen, BR (reprint author), Miami Vet Adm Med Ctr, 11GRC,1201 NW 16th St, Miami, FL 33125 USA. NR 219 TC 172 Z9 186 U1 0 U2 16 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 2003 VL 70 IS 1 BP 3 EP 22 PG 20 WC Medicine, General & Internal SC General & Internal Medicine GA 629MT UT WOS:000180054000003 PM 12516005 ER PT J AU Mendez, MF Perryman, KM AF Mendez, MF Perryman, KM TI Disrupted facial empathy in drawings from artists with frontotemporal dementia SO NEUROCASE LA English DT Article DE frontotemporal dementia; empathy; right temporal lobe; art; faces ID FUSIFORM FACE AREA; SPECT CHARACTERISTICS; HUMAN AMYGDALA; TEMPORAL-LOBE; DEGENERATION; EXPRESSIONS; PERCEPTION; EMOTIONS; DAMAGE; PROSOPAGNOSIA AB The sense of empathy may be altered by brain disease. We report the drawing performance of four artists who developed frontotemporal dementia (FTD). The first three, but not the fourth, had a prominent decrease in empathy for others as well as alterations in their caricatures of people. Their drawings of faces became distorted, menacing, skeleton-like, or 'alien'. None of the four had facial recognition difficulties, problems in interpreting facial emotions, or a decreased appreciation of the distinction between animate and inanimate objects. Functional brain imaging in the patients revealed bilateral frontal hypometabolism or hypoperfusion, and the three with altered drawings had additional prominent involvement of the right temporal lobe. These FTD patients and the literature suggest that FTD, possibly with greater right temporal involvement, disrupts the sense of empathy from human faces. C1 VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 37 TC 15 Z9 16 U1 0 U2 4 PU SWETS ZEITLINGER PUBLISHERS PI LISSE PA P O BOX 825, 2160 SZ LISSE, NETHERLANDS SN 1355-4794 J9 NEUROCASE JI Neurocase PY 2003 VL 9 IS 1 BP 44 EP 50 DI 10.1076/neur.9.1.44.14375 PG 7 WC Clinical Neurology; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 698CL UT WOS:000183980000004 PM 16210224 ER PT J AU Mendez, MF Cherrier, MM AF Mendez, MF Cherrier, MM TI Agnosia for scenes in topographagnosia SO NEUROPSYCHOLOGIA LA English DT Article DE topographic disorientation; environmental disorientation; spatial agnosia; visual agnosia; prosopagnosia; route(s) ID TOPOGRAPHICAL DISORIENTATION; ALZHEIMERS-DISEASE; SPATIAL MEMORY; PARAHIPPOCAMPAL CORTEX; FACE RECOGNITION; LESIONS; IMPAIRMENT; DEFICITS; LOCALIZATION; PERCEPTION AB Topographagnosia is most commonly attributed to an agnosia for landmarks. In order to define the nature of this agnosia, we studied a patient with isolated topographic disorientation (TD) after a stroke in the right medial occipitotemporal region. The patient got lost in familiar environments but could readily read and draw maps, describe familiar routes, and provide correct directions. He had normal perceptual test performance and met criteria for topographagnosia rather than for other forms of topographic disorientation. Two ecologically valid route tests assessed the nature of his agnosia. On a familiar route, he could recognize major landmarks. He could not, however, recognize route configurations made up of combinations of visual features each lacking individual distinctiveness. On a test of route learning, he learned landmarks that differed in minor details and could use them to orient himself along a route. He had difficulty, however, recognizing and learning scenes lacking salient landmarks. This agnosia for scenes was worse for semantically-related environments, but improved with semantic knowledge such as street names. In addition, the patient lacked overt prosopagnosia but tended toward semantic errors in the recognition of famous faces. Together these findings suggest that this patient's inability to recognize a route resulted from an inability of intact perceptual units for scenes, composed of specific visual configurations of individually indefinite features, from accessing stored representations. (C) 2003 Elsevier Science Ltd. All rights reserved. C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. RP Mendez, MF (reprint author), W Los Angeles Vet Affairs Med Ctr, Neurobehav Unit, 116AF,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 60 TC 55 Z9 56 U1 0 U2 4 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 2003 VL 41 IS 10 BP 1387 EP 1395 DI 10.1016/S0028-3932(03)00041-1 PG 9 WC Behavioral Sciences; Neurosciences; Psychology, Experimental SC Behavioral Sciences; Neurosciences & Neurology; Psychology GA 687GN UT WOS:000183368300010 PM 12757910 ER PT J AU Casey, DE Daniel, DG Wassef, AA Tracy, KA Wozniak, P Sommerville, KW AF Casey, DE Daniel, DG Wassef, AA Tracy, KA Wozniak, P Sommerville, KW TI Effect of divalproex combined with olanzapine or risperidone in patients with an acute exacerbation of schizophrenia SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE divalproex; olanzapine; risperidone; psychosis; schizophrenia ID VALPROIC ACID; PLASMA-CONCENTRATIONS; ANTIEPILEPTIC DRUGS; SERUM-LIPIDS; CARBAMAZEPINE; HALOPERIDOL; CHILDREN; LIPOPROTEINS; AUGMENTATION; DISORDERS AB This double-blind, randomized, multicenter study investigated the use of divalproex with an antipsychotic agent in patients hospitalized for acute exacerbation of schizophrenia. Patients (n = 249) who met DSM-IV criteria for schizophrenia were randomly assigned to receive olanzapine monotherapy, risperidone monotherapy, divalproex plus olanzapine, or divalproex plus risperidone for 28 days. Dvalproex was initiated at 15 mg/kg/day and titrated over 12 days to a maximum dosage of 30 mg/kg/day. Olanzapine and risperidone, were, respectively, initiated at 5 and 2 mg/day and were titrated over the first 6 days to respective target fixed daily dosages of 15 and 6 mg/day. Improvements from baseline were observed at all evaluation points throughout the 28-day treatment period in the two combination therapy and the two antipsychotic monotherapy groups, with statistically significant treatment differences favoring combination therapy as soon as day 3 for Positive and Negative Syndrome Scale (PANSS) total score, derived Brief Psychiatric Rating Scale (BPRSd) total score, as well as PANSS and BPRSd subscales. These findings were confirmed in post hoc repeated-measures analyses of variance in which treatment differences favoring combination therapy were observed for PANSS total (p = 0.020) and PANSS positive scale scores (p=0.002). Both combination therapy and antipsychotic monotherapy were well tolerated. Treatment with divalproex in combination with an atypical antipsychotic agent resulted in earlier improvements in a range of psychotic symptoms among acutely hospitalized patients with schizophrenia. Further evaluation is warranted to confirm these findings. C1 George Washington Univ, Washington, DC USA. Bioniche Dev, Falls Church, VA USA. Univ Texas, HCPC, Houston, TX USA. Abbott Labs, Abbott Pk, IL 60064 USA. Univ Illinois, Chicago, IL USA. Portland VA Med Ctr, Mental Ilness Res Educ & Clin Ctr, Portland, OR 97201 USA. RP Casey, DE (reprint author), Portland VA Med Ctr, Mental Ilness Res Educ & Clin Ctr, P3MIRECC,VISN 20,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. NR 39 TC 145 Z9 148 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD JAN PY 2003 VL 28 IS 1 BP 182 EP 192 DI 10.1038/sj.npp.1300023 PG 11 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 642GT UT WOS:000180796400021 PM 12496955 ER PT J AU Lao, LJ Song, B Marvizon, JCG AF Lao, LJ Song, B Marvizon, JCG TI Neurokinin release produced by capsaicin acting on the central terminals and axons of primary afferents: Relationship with N-methyl-D-aspartate and GABA(B) receptors SO NEUROSCIENCE LA English DT Article DE C fiber; dorsal horn; internalization; neurokinin 1 receptor; substance P; vanilloid 1 receptor ID RAT SPINAL-CORD; GENE-RELATED PEPTIDE; SUBSTANCE-P RELEASE; POTASSIUM-STIMULATED RELEASE; GAMMA-AMINOBUTYRIC-ACID; LONG-TERM DEPRESSION; DORSAL-HORN NEURONS; GELATINOSA NEURONS; EVOKED RELEASE; IMMUNOREACTIVITY RELEASE AB Capsaicin stimulates neurokinin release in the spinal cord when applied both centrally and peripherally. To determine whether these two actions have different mechanisms, we measured neurokinin 1 receptor (NK1R) internalization in rat spinal cord slices elicited by incubating the whole slice or just the dorsal root with capsaicin. NK1R internalization produced by incubating the slices with capsaicin was abolished by the NK1R antagonist RP-67580, by the vanilloid receptor 1 (VR1) antagonist capsazepine, and by eliminating Ca2+ from the medium, but was not affected by the Na+ channel blocker lidocaine. Therefore, the internalization was due to neurokinin release mediated by Ca2+ entry through VR1 receptors, but did not require the firing of action potentials. Incubating the root with capsaicin produced NK1R internalization in the ipsilateral dorsal horn that was abolished when capsazepine or lidocaine was included in, or when Ca2+ was omitted from, the medium surrounding the root. Therefore, the internalization was mediated by Ca2+ entry in the axons through VR1, and required firing of action potentials. The efficacy of capsaicin when applied to the root (36 +/- 3%) was lower than when applied to the slice (91 +/- 3%), but its potency was the same (0.49 muM and 0.37 muM, respectively). We also investigated whether presynaptic N-methyl-D-aspartate (NMDA) and GABA(B) receptors modulate these two actions of capsaicin. Neither the NMDA receptor blocker MK-801 nor the GABA(B) agonist baclofen decreased NK1R internalization produced by 1 muM capsaicin applied to the slices, but they inhibited the internalization produced by 0.3 muM capsaicin applied to the slices or 1 muM capsaicin applied to the root. Therefore, capsaicin can produce neurokinin release from primary afferents 1) by a direct action on their central terminals and 2) by increasing the firing of action potentials on their axons. The first effect largely bypasses other modulatory mechanism, but the second does not. (C) 2003 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Digest Dis Res Ctr,Div Digest Dis,Dept Med, CURE,Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90095 USA. RP Marvizon, JCG (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 115,Room 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDA NIH HHS [R01-DA12609] NR 73 TC 30 Z9 30 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 2003 VL 121 IS 3 BP 667 EP 680 DI 10.1016/S0306-4522(03)00501-3 PG 14 WC Neurosciences SC Neurosciences & Neurology GA 743QC UT WOS:000186584200014 PM 14568027 ER PT J AU Minnis, JG Patierno, S Kohlmeier, SE Brecha, NC Tonini, M Sternini, C AF Minnis, JG Patierno, S Kohlmeier, SE Brecha, NC Tonini, M Sternini, C TI Ligand-induced mu opioid receptor endocytosis and recycling in enteric neurons SO NEUROSCIENCE LA English DT Article DE guinea-pig ileum; gastrointestinal motility; G protein-coupled receptors; receptor trafficking ID GUINEA-PIG ILEUM; GASTROINTESTINAL MOTILITY; MEDIATED ENDOCYTOSIS; MOLECULAR-BIOLOGY; MYENTERIC PLEXUS; OPIATE RECEPTOR; RAT-BRAIN; INTERNALIZATION; MORPHINE; AGONIST AB Immunohistochemistry and confocal microscopy were used to investigate endocytosis and recycling of the native mu opioid receptor (muOR) in enteric neurons. Isolated segments of the guinea-pig ileum were exposed to increasing concentrations of muOR agonists at 4 degreesC to allow ligand binding and warming to 37 degreesC for 0 min (baseline) to 6 h in ligand-free medium to allow receptor internalization and recycling. The endogenous ligand, [Met]enkephalin, and [D-Ala(2),MePhe(4),Gly-ol(5)] enkephalin (DAMGO), an opioid analog, and the alkaloids, etorphine and fentanyl, induced rapid internalization of muOR immunoreactivity in enteric neurons, whereas morphine did not. muOR internalization was prevented by muOR antagonists. Basal levels of muOR immunoreactivity in the cytoplasm were 10.52+/-2.05%. DAMGO (1 nM-100 muM) induced a concentration-dependent increase of muOR immunofluorescence density in the cytoplasm to a maximum of 84.37+/-2.26%. Translocation of muOR immunoreactivity in the cytoplasm was detected at 2 min, reached the maximum at 15-30 min, remained at similar levels for 2 h, began decreasing at 4 h, and was at baseline values at 6 h. A second exposure to DAMGO (100 nM) following recovery of internalized muOR immunoreactivity at the cell surface induced a translocation of muOR immunoreactivity in the cytoplasm comparable to the one observed following the first exposure (46.89+/-3.11% versus 43.31+/-0.80%). muOR internalization was prevented by hyperosmolar sucrose, phenylarsine oxide or potassium depletion, which inhibit clathrin-mediated endocytosis. muOR recycling was prevented by pre-treatment with bafilomycin A1, an acidotropic agent that inhibits endosomal acidification, but not by the protein synthesis inhibitor, cycloheximide. This study shows that native muOR in enteric neurons undergoes ligand-selective endocytosis, which is primarily clathrin-mediated, and recycles following endosomal acidification. Following recycling, muOR is activated and internalized by DAMGO indicating that recycled receptors are functional. (C) 2003 IBRO. Published by Elsevier Science Ltd. All rights reserved. C1 Vet Adm Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Pavia, Dept Physiol & Pharmacol Sci, I-27100 Pavia, Italy. Univ Calif Los Angeles, Opioid Res Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. RP Sternini, C (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Div Digest Dis, Bldg 115,Room 224,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDA NIH HHS [P50 DA005010, DA 05010]; NIDDK NIH HHS [DK 41301, DK54155] NR 55 TC 48 Z9 49 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 2003 VL 119 IS 1 BP 33 EP 42 DI 10.1016/S0306-4522(03)00135-0 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 688DN UT WOS:000183418000005 PM 12763066 ER PT J AU Zheng, F Johnson, SW AF Zheng, F Johnson, SW TI Dual modulation of gabaergic transmission by metabotropic glutamate receptors in rat ventral tegmental area SO NEUROSCIENCE LA English DT Article DE non-dopamine neurons; t-ACPD; neuronal excitation; synaptic inhibition; midbrain ID GABA-CONTAINING NEURONS; DOPAMINE NEURONS; NUCLEUS-ACCUMBENS; PREFRONTAL CORTEX; SYNAPTIC INPUTS; INWARD CURRENT; ACTIVATION; REWARD; NMDA; STIMULATION AB The effects of metabotropic glutamate receptor (mGluR) activation on non-dopamine (putative GABAergic) neurons and inhibitory synaptic transmission in the ventral tegmental area were examined using intracellular recordings from rat midbrain slices. Perfusion of (+/-)-1-aminocyclopentane-trans-1,3-dicarboxylic acid (t-ACPD; agonist for group I and II mGluRs), but not L-amino-4-phosphonobutyric acid (L-AP4; agonist for group III mGluRs), produced membrane depolarization (current clamp) and inward current (voltage clamp) in non-dopamine neurons. The t-ACPD-induced depolarization was concentration-dependent (concentration producing 50% maximal depolarization [EC50]=6.1+/-2.5 muM), and was blocked by the antagonist (+/-)-alpha-methyl-4-carboxyphenylglycine, but not by tetrodotoxin and ionotropic glutamate-receptor antagonists. The t-ACPD-evoked responses were mimicked comparably by selective group I mGluR agonist (RS)-3,5-dihydroxyphenylglycine (DHPG). Furthermore, the DHPG-induced depolarization in non-dopamine neurons was greatly reduced by mGluR1-specific antagonist 7(hydroxyimino)cyclopropachromen-1a-carboxylate ethyl ester. When recorded in dopamine neurons, the frequency of spontaneous GABA(A) receptor-mediated inhibitory postsynaptic potentials was increased by t-ACPD but not L-AP4. However, the amplitude of evoked inhibitory postsynaptic currents in dopamine neurons was reduced by all three group mGluR agonists. These results reveal a dual modulation of mGluR activation on inhibitory transmission in midbrain ventral tegmental area: enhancing putative GABAergic neuronal excitability and thus potentiating tonic inhibitory synaptic transmission while reducing evoked synaptic transmission at inhibitory terminals. (C) 2003 IBRO. Published by Elsevier Science Ltd. All rights reserved. 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, RD-61,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. FU NIMH NIH HHS [MH40416] NR 41 TC 15 Z9 16 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 2003 VL 119 IS 2 BP 453 EP 460 DI 10.1016/S0306-4522(03)00190-8 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 688DP UT WOS:000183418100012 PM 12770559 ER PT J AU Hohmann, JG Jureus, A Teklemichael, DN Matsumoto, AM Clifton, DK Steiner, RA AF Hohmann, JG Jureus, A Teklemichael, DN Matsumoto, AM Clifton, DK Steiner, RA TI Distribution and regulation of galanin receptor 1 messenger RNA in the forebrain of wild type and galanin-transgenic mice SO NEUROSCIENCE LA English DT Article DE galanin; receptor; transgenic; knockout; hypothalamus; mouse ID LOCUS-COERULEUS NEURONS; CENTRAL-NERVOUS-SYSTEM; RAT-BRAIN; NEUROPEPTIDE-Y; SPINAL-CORD; MAGNOCELLULAR NEURONS; HORMONE SECRETION; FEMALE RAT; EXPRESSION; HYPOTHALAMUS AB To learn more about molecular alterations in the brain that occur as a consequence of either the chronic excess or absence of peptide neurotransmitters, we examined the impact of genetically manipulating the neuropeptide galanin on the expression of one of its cognate receptors, galanin receptor 1. First, we examined the distribution of galanin receptor 1 messenger RNA in the mouse forebrain, and found it to be abundantly expressed in many brain regions, including in numerous hypothalamic and other forebrain regions associated with neuroendocrine function. The distribution of galanin receptor 1 messenger RNA in the mouse was similar to previous reports in the rat, with additional expression noted in the caudate putamen and in several midbrain regions. Next, using quantitative in situ hybridization, we measured cellular levels of galanin receptor 1 messenger RNA in the brains of mice that either overexpress galanin (galanin transgenic) or lack a functional galanin gene (galanin knockout). We report that relative to wild-type controls, the expression of galanin receptor 1 messenger RNA was increased in discrete areas of the brain in galanin-transgenic mice, but that depletion of galanin/noradrenergic innervation to the hypothalamus with the neurotoxin 6-hydroxy-dopamine did not alter levels of galanin receptor 1 messenger RNA. We also report that levels of galanin receptor 1 messenger RNA were not different between galanin-knockout and wild-type mice. These results suggest that compensatory adjustments in the expression of cognate receptors represent one mechanism by which the developing nervous system attempts to maintain homeostasis in response to overexpression of a peptidergic transmitter. However, the lack of significant changes in galanin receptor 1 messenger RNA in galanin-knockout mice suggests that developmentally programmed levels of receptor expression are maintained even in the complete absence of ligand. (C) 2003 IBRO. Published by Elsevier Science Ltd. All rights reserved. C1 Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA. Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA. Univ Washington, Neurobiol & Behav Program, Seattle, WA 98195 USA. Univ Washington, Dept Zool, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. RP Steiner, RA (reprint author), Univ Washington, Dept Physiol & Biophys, Box 357290, Seattle, WA 98195 USA. FU NIA NIH HHS [AG05136]; NICHD NIH HHS [R01 HD27142]; PHS HHS [U5412629] NR 58 TC 40 Z9 40 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 2003 VL 117 IS 1 BP 105 EP 117 DI 10.1016/S0306-4522(02)00798-4 PG 13 WC Neurosciences SC Neurosciences & Neurology GA 653AA UT WOS:000181412000012 PM 12605897 ER PT J AU Agdeppa, ED Kepe, V Petric, A Satyamurthy, N Liu, J Huang, SC Small, GW Cole, GM Barrio, JR AF Agdeppa, ED Kepe, V Petric, A Satyamurthy, N Liu, J Huang, SC Small, GW Cole, GM Barrio, JR TI In vitro detection of (S)-naproxen and ibuprofen binding to plaques in the Alzheimer's brain using the positron emission tomography molecular imaging probe 2-(1-{6-[(2[F-18]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene) malononitrile SO NEUROSCIENCE LA English DT Article DE anti-aggregation; beta-amyloid fibrils; competitive binding; digital autoradiography; fluorescence microscopy; non-steroidal anti-inflammatory drugs ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; AMYLOID-BETA-PROTEIN; CONTROLLED TRIAL; CACHE COUNTY; DOUBLE-BLIND; DISEASE; DISPOSITION; AGGREGATION; ANTAGONISTS; METABOLISM AB Epidemiological studies have suggested that the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) reduces the relative risk of Alzheimer's disease (AD). The possible neuroprotection by NSAIDs in AD is generally attributed to anti-inflammatory activity. An additional mode of drug action may involve anti-aggregation of P-amyloid (Abeta) peptides by commonly used NSAIDs. We utilized in vitro competition assays, autoradiography, and fluorescence microscopy with AD brain specimens to demonstrate concentration-dependent decreases in the binding of the in vivo molecular imaging probe, 2-(1-{6-[(2-[F-18]fluoroethyl)(methyl) amino]-2-naphthyl}ethylidene)malononitrile ([F-18]FDDNP), against (S)-naproxen and (R)- and (S)-ibuprofen (but not diclofenac) to Abeta fibrils and ex vivo Abeta senile plaques. Conversely, in vitro amyloid dyes Congo Red and Thioflavine T were demonstrated in the same experiments not to bind to the FDDNP binding site. FDDNP and the NSAIDs that share the same binding site also exhibit anti-aggregation effects on Abeta peptides, suggesting that the shared binding site on Abeta fibrils and plaques may be a site of anti-aggregation drug action. Our results indicate for the first time the binding of select NSAIDs to plaques, specifically to the binding site of the molecular imaging probe [F-18]FDDNP. Our understanding of the molecular requirements of FDDNP binding may help in the optimization of the Abeta anti-aggregation potency of experimental drugs. [F-18]FDDNP has been used to image plaques in vivo with positron emission tomography (PET), and investigations into the influence of Abeta anti-aggregation on the risk-reduction effects of NSAIDs on AD could utilize [F-18]FDDNP and PET in determining the occupancy rate of NSAIDs and experimental drugs in plaques in the living brain of AD patients. (C) 2003 IBRO. Published by Elsevier Science Ltd. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Nucl Med, Dept Mol & Med Pharmacol,Lab Struct Biol & Mol Me, Los Angeles, CA 90095 USA. Univ Ljubljana, Fac Chem & Chem Technol, Ljubljana, Slovenia. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Inst Neuropsychiat, Los Angeles, CA 90095 USA. Greater Los Angles Vet Affairs Healthcare Syst, Sepulveda Geritr Res Educ & Clin Ctr, Sepulveda, CA 91343 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 Neurol, Los Angeles, CA 90095 USA. RP Barrio, JR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Nucl Med, Dept Mol & Med Pharmacol,Lab Struct Biol & Mol Me, Box 956948, Los Angeles, CA 90095 USA. NR 46 TC 136 Z9 144 U1 2 U2 6 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 2003 VL 117 IS 3 BP 723 EP 730 DI 10.1016/S0306-4522(02)00907-7 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 656TJ UT WOS:000181624300020 PM 12617976 ER PT J AU Benedict, S AF Benedict, S TI The nadir of nursing: Nurse-perpetrators of the Ravensbruck concentration camp SO NURSING HISTORY REVIEW LA English DT Article C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. RP Benedict, S (reprint author), Med Univ S Carolina, 99 Jonathan Lucas St, Charleston, SC 29425 USA. NR 3 TC 9 Z9 9 U1 0 U2 1 PU SPRINGER PUBLISHING CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10012 USA SN 1062-8061 J9 NURS HIST REV JI Nurs. Hist. Rev. PY 2003 VL 11 BP 129 EP 146 PG 18 WC History & Philosophy Of Science; History Of Social Sciences; Nursing SC History & Philosophy of Science; Social Sciences - Other Topics; Nursing GA 607DC UT WOS:000178775200008 PM 12418154 ER PT J AU Learman, LA Gerrity, MS Field, DR van Blaricom, A Romm, J Choe, J AF Learman, LA Gerrity, MS Field, DR van Blaricom, A Romm, J Choe, J TI Effects of a depression education program on residents' knowledge, attitudes, and clinical skills SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID PRIMARY-CARE PHYSICIANS; RECOGNITION; INSTRUMENTS; MANAGEMENT; DISORDERS; PATIENT AB OBJECTIVE: To determine whether an interactive educational program would improve obstetrics and gynecology residents' knowledge, attitudes, confidence, and skills in caring for depressed patients. METHODS: We recruited 74 residents from eight residency programs to attend the Depression Education Program, which consists of a 1-hour lecture and two 2-hour workshops combining discussion, diagnosis and treatment tools, critique of a videotape, practice with feedback, and audio-tape self-assessment. Before and after the program, participants 1) completed a questionnaire measuring knowledge, attitudes, and reported actions taken with a recent depressed patient; 2) received a standardized patient visit; and 3) kept lists of patients they suspected were depressed. Clinic patients completed a depression screening questionnaire. To assess improvement, we used paired t tests, Mc-Nemar chi(2) tests, and multivariate models adjusting for training site. RESULTS: The education program led to 3-month improvements in participants' reported use of formal diagnostic criteria (38% before, 66% after; P = .004), clinical actions documented for suspected depression (P = .035), and perceived self-efficacy in depression care (P < .001). Perceived preparedness to diagnose depression, treat with medications, and comanage with a mental health practitioner improved (P < .05 for each). Small improvements in clinical behaviors with standardized patients and clinic-based depression detection rates were not statistically significant. CONCLUSION: The Depression Education Program improved residents' knowledge, confidence, and reported clinical actions with depressed patients, but did not improve most objectively assessed outcomes. (C) 2003 by The American College of Obstetricians and Gynecologists. C1 Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, San Francisco, CA 94143 USA. Portland Vet Affairs Med Ctr, Div Hosp & Specialty Med, Portland, OR USA. Kaiser Permanente Med Ctr, Dept Obstet & Gynecol, San Francisco, CA USA. Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA. Oregon Hlth & Sci Univ, Dept Obstet & Gynecol, Portland, OR USA. RP Learman, LA (reprint author), San Francisco Gen Hosp, Dept Obstet & Gynecol, 1001 Potrero St,Room 6D-9, San Francisco, CA 94110 USA. NR 23 TC 19 Z9 19 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD JAN PY 2003 VL 101 IS 1 BP 167 EP 174 AR PII S0029-7844(02)02510-3 DI 10.1016/S0029-7844(02)02510-3 PG 8 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 632UN UT WOS:000180241800029 PM 12517663 ER PT J AU Silverman, SL Crans, GG Wong, M Stock, JL Genant, HK AF Silverman, SL Crans, GG Wong, M Stock, JL Genant, HK TI Relationships between age, number and maximal severity of prevalent vertebral fractures with health-related quality of life SO OSTEOPOROSIS INTERNATIONAL LA English DT Meeting Abstract CT 4th European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ECCEO 4) CY NOV 14-17, 2003 CL NICE, FRANCE SP WHO Collaborat Ctr Public Hlth Aspects Osteoart Disorders, Int Osteoporosis Fdn C1 Univ Calif Los Angeles, Greater Los Angeles VA Hlth Syst, Cedars Sinai Med Ctr, Los Angeles, CA USA. Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA. Univ Calif San Francisco, Osteoporosis & Arthrit Res Grp, San Francisco, CA 94143 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER-VERLAG LONDON LTD PI GODALMING PA SWEETAPPLE HOUSE CATTESHALL ROAD, GODALMING GU7 3DJ, SURREY, ENGLAND SN 0937-941X J9 OSTEOPOROSIS INT JI Osteoporosis Int. PY 2003 VL 14 SU 7 BP S49 EP S50 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 756ZJ UT WOS:000187515400143 ER PT S AU Heidenreich, KA AF Heidenreich, KA BE Federoff, HJ Burke, RE Fahn, S Fiskum, G TI Molecular mechanisms of neuronal cell death SO PARKINSON'S DISEASE: THE LIFE CYCLE OF THE DOPAMINE NEURON SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Parkinsons Disease - The Life Cycle of the Dopamine Neuron CY SEP 18-20, 2002 CL PRINCETON, NEW JERSEY SP New York Acad Sci DE neuron; cell death; apoptosis ID AMYOTROPHIC-LATERAL-SCLEROSIS; CEREBELLAR GRANULE NEURONS; CYTOCHROME-C RELEASE; GROWTH-FACTOR-I; MITOCHONDRIAL PERMEABILITY TRANSITION; NECROSIS-FACTOR-ALPHA; BCL-2 FAMILY MEMBERS; ALZHEIMERS-DISEASE; PARKINSONS-DISEASE; HUNTINGTONS-DISEASE AB Chronic neurodegenerative diseases, including Parkinson's disease, are characterized by a selective loss of specific subsets of neuronal populations over a period of years or even decades. While the underlying causes of the various neurodegenerative diseases are not clear, the death of neurons and the loss of neuronal contacts are key pathological features. Pinpointing molecular events that control neuronal cell death is critical for the development of new strategies to prevent and treat neurodegenerative disorders. C1 Denver VAMC, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Program Neurosci, Denver, CO 80262 USA. RP Heidenreich, KA (reprint author), Denver VAMC, 111H,1055 Clermont St, Denver, CO 80220 USA. FU NINDS NIH HHS [NS38619-01A1] NR 64 TC 18 Z9 19 U1 0 U2 1 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-448-X J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2003 VL 991 BP 237 EP 250 PG 14 WC Biochemistry & Molecular Biology; Cell Biology; Multidisciplinary Sciences; Neurosciences SC Biochemistry & Molecular Biology; Cell Biology; Science & Technology - Other Topics; Neurosciences & Neurology GA BX10S UT WOS:000184302100023 PM 12846991 ER PT S AU Duda, JE Giasson, BI Lee, VMY Trojanowski, JQ AF Duda, JE Giasson, BI Lee, VMY Trojanowski, JQ BE Federoff, HJ Burke, RE Fahn, S Fiskum, G TI Is the initial insult in Parkinson's disease and dementia with Lewy bodies a neuritic dystrophy? SO PARKINSON'S DISEASE: THE LIFE CYCLE OF THE DOPAMINE NEURON SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Parkinsons Disease - The Life Cycle of the Dopamine Neuron CY SEP 18-20, 2002 CL PRINCETON, NEW JERSEY SP New York Acad Sci DE Parkinson's disease; dementia with Lewy bodies; neuritic dystrophy; alpha-synuclein ID ALPHA-SYNUCLEIN; PATHOLOGY C1 Univ Penn, Ctr Neurodegenerat Dis Res, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA 19104 USA. RP Trojanowski, JQ (reprint author), Univ Penn, Ctr Neurodegenerat Dis Res, 3600 Spruce St,3 Maloney, Philadelphia, PA 19104 USA. NR 7 TC 8 Z9 8 U1 0 U2 1 PU NEW YORK ACAD SCIENCES PI NEW YORK PA 2 EAST 63RD ST, NEW YORK, NY 10021 USA SN 0077-8923 BN 1-57331-448-X J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2003 VL 991 BP 295 EP 297 PG 3 WC Biochemistry & Molecular Biology; Cell Biology; Multidisciplinary Sciences; Neurosciences SC Biochemistry & Molecular Biology; Cell Biology; Science & Technology - Other Topics; Neurosciences & Neurology GA BX10S UT WOS:000184302100031 ER PT J AU Metlay, JP Hardy, C Strom, BL AF Metlay, JP Hardy, C Strom, BL TI Agreement between-patient self-report and a Veterans Affairs national pharmacy database for identifying recent exposures to antibiotics SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Article DE epidemiologic methods; recall; antibiotics; data collection ID RISK-FACTORS; BETA-LACTAM; RESISTANCE; ERYTHROMYCIN; CONSUMPTION; PENICILLIN; MACROLIDE; VALIDATION; CARE AB Purpose The dramatic rise in antibiotic drug resistance among community pathogens has stimulated interest in the epidemiological relationship between antibiotic exposure and drug resistance. In assessing the strength of this relationship, studies are hampered by the lack of data on the accuracy of subject self-report of antibiotic exposure. The authors compared self-report with pharmacy dispensing data to determine the accuracy of self-reported antibiotic exposure. Methods The study design Was a cross-sectional survey of veterans seen at the Philadelphia Veterans Affairs (VA) Medical Center in 1999 and 2000. Subjects reported exposures to antibiotics, antihypertensive drugs and nonsteroidal anti-inflammatory drugs through a structured telephone interview. The instrument included open-ended questions, condition-specific prompts and drug-specific prompts. Subject responses were linked to a national-VA pharmacy database that served as the reference standard for evaluating self-reported exposures. Results The authors found that the sensitivity of self-report of antibiotic exposure increased with increasing use of prompts. A comprehensive assessment of antibiotic exposure identified 73% of antibiotic exposures, compared to 73% of antihypertensive drug exposures and 92% of nonsteroidal anti-inflammatory drug exposures. Conclusions Assessment of antibiotic exposure appears to be comparable to assessment of other chronic and episodic drugs. Multistep assessment of exposure improves the sensitivity of assessment. Copyright (C) 2002 John Wiley Sons, Ltd. C1 Univ Penn, Sch Med, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. RP Metlay, JP (reprint author), Univ Penn, Sch Med, Philadelphia Vet Affairs Med Ctr, 712 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. NR 20 TC 16 Z9 17 U1 0 U2 1 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD JAN-FEB PY 2003 VL 12 IS 1 BP 9 EP 15 DI 10.1002/pds.772 PG 7 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 642TE UT WOS:000180819900002 PM 12622056 ER PT B AU Gukovskaya, AS Vaquero, EC Edderkaoui, M Pandol, SJ AF Gukovskaya, AS Vaquero, EC Edderkaoui, M Pandol, SJ BE Sikiric, P Seiwerth, S Mozsik, G Arakawa, T Takeuchi, K TI Survival signals in pancreatic cancer SO PROCEEDINGS OF THE 11TH INTERNATIONAL CONFERENCE ON ULCER RESEARCH LA English DT Proceedings Paper CT 11th International Conference on Ulcer Research CY SEP 15-20, 2003 CL Dubrovnik, CROATIA ID CELL-DEATH; APOPTOSIS; NECROSIS; GROWTH AB Pancreatic adenocarcinoma is one of the most malignant tumors with a very poor prognosis. This cancer is unresponsive to treatment with all forms of therapy including chemotherapy, radiotherapy and immunotherapy. One of the reasons for the poor response of this cancer to therapy is that it is resistant to apoptosis-the common form of cell death that occurs with successful treatments of cancers. We have been investigating signaling systems responsible for preventing apoptosis in this cancer so that strategies can be developed to overcome these "survival" signals for treatment. To date, we have identified both extracellular matrix and reactive oxygen species (ROS) as survival factors in this cancer. Furthermore, we have found that this cancer undergoes apoptosis when exposed to several plant-derived polyphenolic compounds. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. RP Gukovskaya, AS (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. NR 17 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND PUBLISHING CO PI BOLOGNA PA VIA RUBBIANI 6/2, 40124 BOLOGNA, ITALY BN 88-7587-021-7 PY 2003 BP 345 EP 348 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA BY68F UT WOS:000189437800060 ER PT B AU Pandol, SJ Gukovsky, I Satoh, A Fischer, L Lugea, A Gukovskaya, AS AF Pandol, SJ Gukovsky, I Satoh, A Fischer, L Lugea, A Gukovskaya, AS BE Sikiric, P Seiwerth, S Mozsik, G Arakawa, T Takeuchi, K TI Molecular mechanisms of pancreatitis SO PROCEEDINGS OF THE 11TH INTERNATIONAL CONFERENCE ON ULCER RESEARCH LA English DT Proceedings Paper CT 11th International Conference on Ulcer Research CY SEP 15-20, 2003 CL Dubrovnik, CROATIA ID KAPPA-B ACTIVATION; ACINAR-CELLS; NEUTROPHILS; CYTOKINES; ETHANOL; RATS C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. RP Pandol, SJ (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. NR 17 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND PUBLISHING CO PI BOLOGNA PA VIA RUBBIANI 6/2, 40124 BOLOGNA, ITALY BN 88-7587-021-7 PY 2003 BP 349 EP 352 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA BY68F UT WOS:000189437800061 ER PT B AU Monga, U Garber, SL Thornby, J Vallbona, C Monga, TN AF Monga, U Garber, SL Thornby, J Vallbona, C Monga, TN TI Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiation therapy SO PROCEEDINGS OF THE 2ND WORLD CONGRESS OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE - ISPRM LA English DT Proceedings Paper CT 2nd World Congress of the International-Society-of-Physical-and-Rehabilitation-Medicine (ISPRM) CY MAY 18-23, 2003 CL Prague, CZECH REPUBLIC SP Int Soc Phys & Rehabilitat Med ID AEROBIC EXERCISE; DEPRESSION; ADULTS C1 Houston VA Med Ctr, Houston, TX 77211 USA. RP Monga, U (reprint author), Houston VA Med Ctr, Houston, TX 77211 USA. NR 30 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND S R L PI 40128 BOLOGNA PA VIA MASERATI 5, 40128 BOLOGNA, 00000, ITALY BN 88-323-3124-1 PY 2003 BP 499 EP 504 PG 6 WC Rehabilitation SC Rehabilitation GA BX04U UT WOS:000184053400103 ER PT B AU El-Zaatari, FAK Hulten, K Collins, MT Huchzermeier, R Graham, DY AF El-Zaatari, FAK Hulten, K Collins, MT Huchzermeier, R Graham, DY BE Juste, RA Geijo, MV Garrido, JM TI p35-based ELISA assay for the detection of Mycobacterium avium subsp paratuberculosis infection in cattle with Johne's disease SO PROCEEDINGS OF THE SEVENTH INTERNATIONAL COLLOQUIUM ON PARATUBERCULOSIS LA English DT Proceedings Paper CT 7th International Colloquium on Paratuberculosis CY JUN 12-14, 2002 CL Bilbao, SPAIN SP Int Assoc Paratuberculos Inc DE p35; ELISA; subclinical; Johne's disease ID BOVINE PARATUBERCULOSIS; CROHNS-DISEASE; DIAGNOSIS; ETIOLOGY; COWS AB Early diagnosis of paratuberculosis (Johne's disease) in cattle is essential for controlling the spread of the disease. Available tests lack sensitivity. A purified p35-based ELISA assay was developed and optimized and its efficacy as compared to that of commercial ELISA assays was evaluated on 44 reference sera. Sera from 10 Mycobacterium avium subsp. paratuberculosis (Map)-free cattle and 3 cows artificially inoculated with multiple doses of viable Map were negative by most assays. Sera from 12 cattle with clinically advanced Johne's disease were positive by all assays. For sera from cows with subclinical infection, p35-ELISA was positive in 13/19 (68%) as compared to 42%, 47% and 53% for the most commonly used commercial ELISAs. An additional subclinical case (14/19; 73%) was positive by only p35 immunoblotting. The specificity and the positive predictive values of p35-based ELISA and the three most commonly used commercial ELISAs were 100% and the negative predictive values were 63% for p35-ELISA and 48%, 50% and 53% for the commercial ELISAs, respectively. Based on this limited initial evaluation, the p35-ELISA shows promise as a potentially more sensitive and specific test for paratuberculosis. The addition of p35-based immunoblot test further improved detection of subclinical cases. Evaluation of p35-ELISA on a larger set of well-characterized sera is warranted. C1 VA Med Ctr, Houston, TX 77030 USA. RP El-Zaatari, FAK (reprint author), VA Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 18 TC 0 Z9 0 U1 0 U2 0 PU INT ASSOC PARATUBERCULOSIS INC PI PROVIDENCE PA SWP 526, RI HOSPITAL 593 EDDY STREET, PROVIDENCE, RI 02903 USA BN 0-9633043-5-6 PY 2003 BP 136 EP 139 PG 4 WC Public, Environmental & Occupational Health; Infectious Diseases; Microbiology; Veterinary Sciences SC Public, Environmental & Occupational Health; Infectious Diseases; Microbiology; Veterinary Sciences GA BAD78 UT WOS:000221711100031 ER PT J AU Freedland, SJ Amling, CL Terris, MK Presti, JC Elashoff, D Kane, CJ AF Freedland, SJ Amling, CL Terris, MK Presti, JC Elashoff, D Kane, CJ CA SEARCH Database Study Grp TI Is there a difference in outcome after radical prostatectomy between patients with biopsy Gleason sums 4, 5, and 6? results from the SEARCH database SO PROSTATE CANCER AND PROSTATIC DISEASES LA English DT Article DE radical prostatectomy; PSA recurrence; Gleason sum; needle biopsy ID BIOCHEMICAL RECURRENCE; SEXTANT BIOPSIES; RADIATION-THERAPY; NEEDLE-BIOPSY; CANCER; ADENOCARCINOMA; DIAGNOSIS; PREDICTOR; TRENDS; GRADE AB Purpose: Fewer patients newly diagnosed with prostate cancer today have biopsy Gleason sums <6 compared to several years ago. Several tables and nomograms for predicting disease recurrence after definitive therapy provide little or no discrimination between biopsy Gleason sums 4, 5, and 6. We sought to examine the significance of biopsy Gleason sum for predicting biochemical failure following radical prostatectomy ( RP) for men with biopsy Gleason sums of 4, 5, and 6. Materials and methods: We examined data from 988 men treated with RP between 1988 and 2002 who had biopsy Gleason sums of 4 - 6. Clinical and pathological variables as well as outcome information were compared between men with biopsy Gleason sums of 4 - 6. The log-rank and Cox proportional hazards analysis were used to determine whether biopsy Gleason sum provided unique prognostic information for men with low biopsy Gleason sums undergoing RP. Results: There was statistically significant, but overall weak correlation between biopsy Gleason sum and Gleason sum of the RP specimen ( Spearman's r = 0.277, P<0.001). As biopsy Gleason sum increased from 4 to 5 to 6, there was a steady rise (HR = 1.31 for each one point increase in Gleason sum, Cox's model) in the risk of PSA failure ( P = 0.025, log-rank). On multivariate analysis comparing biopsy Gleason sum, preoperative PSA, clinical stage, year of surgery, percent of biopsy cores positive, and age for their ability to predict time to biochemical recurrence, only PSA ( HR 2.09, CI 1.56 - 2.80, P<0.001) and biopsy Gleason sum ( HR 1.33, CI 1.05 - 1.70, P = 0.019) were significant independent predictors of PSA failure. Conclusions: Despite weak correlation between biopsy and pathologic Gleason sum among men with biopsy Gleason sum 4 - 6 tumors, grade was a significant independent predictor of PSA failure following RP. In the range of 4 - 6, biopsy Gleason sum acted as a continuous variable for predicting PSA failure. The routine use of Gleason sums 4 and 5 to grade prostate needle biopsy specimens should not be abandoned. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. San Diego Naval Hosp, Dept Urol, San Diego, CA USA. Med Coll Georgia, Div Urol, Augusta, GA 30912 USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. Vet Adm Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA USA. Vet Adm Med Ctr, Dept Surg, Urol Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. RP Freedland, SJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Box 951738, Los Angeles, CA 90095 USA. OI Terris, Martha/0000-0002-3843-7270 NR 24 TC 5 Z9 5 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1365-7852 J9 PROSTATE CANCER P D JI Prostate Cancer Prostatic Dis. PY 2003 VL 6 IS 3 BP 261 EP 265 DI 10.1038/sj.pcan.4500673 PG 5 WC Oncology; Urology & Nephrology SC Oncology; Urology & Nephrology GA 724UY UT WOS:000185506100016 PM 12970733 ER PT J AU Tapp, A Wood, AE Secrest, L Erdmann, J Cubberley, L Kilzieh, N AF Tapp, A Wood, AE Secrest, L Erdmann, J Cubberley, L Kilzieh, N TI Combination antipsychotic therapy in clinical practice SO PSYCHIATRIC SERVICES LA English DT Article; Proceedings Paper CT 39th Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 09-14, 2000 CL SAN JUAN, PUERTO RICO SP Amer Coll Neuropsychopharmacol ID REFRACTORY SCHIZOPHRENIA; CLOZAPINE; RISPERIDONE; AUGMENTATION; POLYPHARMACY AB Objective: Surveys have shown that antipsychotic drug combinations are frequently prescribed, vet few clinical studies have examined this practice. Experts have generally recommended antipsychotic combinations, especially those combining an atypical and a conventional antipsychotic, as a measure of last resort. A survey of prescribers was conducted to examine why combination antipsychotic therapy is being used in outpatient clinical practice. Methods: Antipsychotic prescribing practices in the Department of Veterans Affairs Puget Sound Health System were reviewed for a six-month period during 1998-1999. Data on the use of atypical and conventional antipsychotics in combination were collected. Results: A total of 1,794 patients received prescriptions for at least one antipsychotic medication during the study period, of which 715 (40 percent) received an atypical agent. Ninety-three patients (13 percent) who were treated with an atypical antipsychotic received a prescription for combination antipsychotic therapy for at least 30 days. In cases in which both a conventional and an atypical agent were prescribed, the primary reason given for adding a conventional antipsychotic medication was to treat persistent positive symptoms. The primary, reason an atypical agent was added to a conventional agent was to switch medications to the atypical agent; however, a significant number of patients became "stuck" on the combination. Conclusions: The results of this study support previous reports of the frequent use of combination antipsychotic therapy in clinical practice. Prospective controlled trials are needed to substantiate perceptions that combination antipsychotic therapy is clinically beneficial and to provide guidelines on when and for whom antipsychotic polypharmacy should be considered. C1 VA Puget Sound Hlth Care Syst, Amer Lake Div, Tacoma, WA 98493 USA. Univ Washington, Dept Psychiat, Seattle, WA USA. Dept Vet Affairs Puget Sound Hlth Care Syst, Tacoma, WA USA. RP Tapp, A (reprint author), VA Puget Sound Hlth Care Syst, Amer Lake Div, Tacoma, WA 98493 USA. NR 23 TC 111 Z9 112 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1075-2730 J9 PSYCHIATR SERV JI Psychiatr. Serv. PD JAN PY 2003 VL 54 IS 1 BP 55 EP 59 DI 10.1176/appi.ps.54.1.55 PG 5 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 631XL UT WOS:000180193300010 PM 12509667 ER PT J AU Aisen, PS Berg, JD Craft, S Peskind, ER Sano, M Teri, L Mulnard, RA Thomas, RG Thal, LJ AF Aisen, PS Berg, JD Craft, S Peskind, ER Sano, M Teri, L Mulnard, RA Thomas, RG Thal, LJ TI Steroid-induced elevation of glucose in Alzheimer's disease: relationship to gender, apolipoprotein E genotype and cognition SO PSYCHONEUROENDOCRINOLOGY LA English DT Article DE Alzheimer's disease; prednisone; hyperglycemia; apolipoprotein E; gender; cognition ID RANDOMIZED CONTROLLED-TRIAL; INSULIN-RESISTANCE; MEMORY; ENHANCEMENT; METABOLISM; DEMENTIA AB Glucose and insulin may play an important role in the pathophysiology and symptomatology of Alzheimer s disease (AD), and prior studies suggest interactions among glucose, insulin, gender and apolipoprotein E genotype. We analyzed the relationship between steroid-induced glucose elevation and gender, presence of the apolipoprotein E epsilon4 (APOE-4) allele and cognition using data from a multicenter trial of prednisone therapy in AD. The low-dose prednisone regimen (initial dose: 20 mg/day. maintenance dose: 10 mg/day) caused a moderate increase in random blood. glucose (mean post-baseline glucose 115 mg/dl). There was a significant interaction between rise in glucose, gender and presence of the APOE-4 allele. There was no important relationship between glucose and cognitive function at baseline or with prednisone treatment. Meta-analysis including data from three other AD trial,, showed a small influence of random blood glucose oil cognitive scores. These results support a relationship between gender, apolipoprotein F. genotype and glucose metabolism, but do not indicate that mild changes in glucose have an important impact on cognitive function. (C) 2002 Elsevier Science Ltd. All rights reserved. C1 Georgetown Univ, Med Ctr, Dept Neurol, Washington, DC 20007 USA. Univ Calif San Diego, Alzheimers Dis Cooperat Study, San Diego, CA 92103 USA. Univ Washington, Sch Med, Geriatr Res Educ & Clin Ctr, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, Mental Illness Res Educ & Clin Ctr, Vet Affairs Puget Sound Hlth Care, Seattle, WA USA. Columbia Univ Coll Phys & Surg, Dept Neurol, Gertrude H Sergievsky Ctr, New York, NY 10032 USA. Univ Washington, Sch Med, Dept Psychosocial & Community Hlth, Seattle, WA USA. Univ Calif Irvine, Inst Brain Aging & Dementia, Irvine, CA USA. Univ Calif San Diego, Dept Family & Prevent Med, San Diego, CA 92103 USA. Univ Calif San Diego, Dept Neurosci, San Diego, CA 92103 USA. RP Aisen, PS (reprint author), Georgetown Univ, Med Ctr, Dept Neurol, 1 Bles Bldg,3800 Reservoir Rd NW, Washington, DC 20007 USA. EM psa@georgetown.edu FU NIA NIH HHS [U01-AG10483, U19 AG010483] NR 18 TC 7 Z9 9 U1 2 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4530 J9 PSYCHONEUROENDOCRINO JI Psychoneuroendocrinology PD JAN PY 2003 VL 28 IS 1 BP 113 EP 120 AR PII S0306-4530(02)00015-X DI 10.1016/S0306-4530(02)00015-X PG 8 WC Endocrinology & Metabolism; Neurosciences; Psychiatry SC Endocrinology & Metabolism; Neurosciences & Neurology; Psychiatry GA 634RK UT WOS:000180354300008 PM 12445840 ER PT J AU Kisley, MA Olincy, A Robbins, E Polk, SD Adler, LE Waldo, MC Freedman, R AF Kisley, MA Olincy, A Robbins, E Polk, SD Adler, LE Waldo, MC Freedman, R TI Sensory gating impairment associated with schizophrenia persists into REM sleep SO PSYCHOPHYSIOLOGY LA English DT Article DE sensory gating; REM sleep; schizophrenia; auditory event-related potentials; P50; N100 ID AUDITORY-EVOKED-RESPONSES; P50 SUPPRESSION; MISMATCH NEGATIVITY; PARADOXICAL SLEEP; NATURAL SLEEP; POTENTIALS; DEFICITS; STRESS; INTENSITY; DISORDER AB Physiological measures of sensory gating are increasingly used to study biological factors associated with attentional dysfunction in psychiatric and neurologic patient populations, The present study as designed to assess sensory gating during rapid eye movement (REM) sleep in patients with schizophrenia, a population bearing a genetic load for gating impairment. Auditory event-related potentials (ERPs) were recorded in response to paired clicks during separate waking and overnight sleep recording sessions in controls and schizophrenia patients. Suppression of ERP component P50 was significantly impaired in the patient group during both waking and REM sleep. whereas the difference between groups for N100 gating was dependent on state. These results suggest that REM sleep is an appropriate state during,which to assess P50 gating in order to disentangle the effects of state and trait on sensors gating impairment in other clinical populations. C1 Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Boulder, CO 80309 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Kisley, MA (reprint author), Univ Colorado, Dept Psychol, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80933 USA. FU NIMH NIH HHS [MH38321, MH64466] NR 70 TC 33 Z9 34 U1 4 U2 4 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 2003 VL 40 IS 1 BP 29 EP 38 DI 10.1111/1469-8986.00004 PG 10 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 636KT UT WOS:000180455300004 PM 12751801 ER PT J AU Page, KR Karakousis, PC Maslow, JN AF Page, KR Karakousis, PC Maslow, JN TI Postoperative pneumococcal cellulitis in systemic lupus erythematosus SO SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES LA English DT Editorial Material ID SOFT-TISSUE INFECTIONS; STREPTOCOCCUS-PNEUMONIAE; NEISSERIAL AB This paper reports a case of nosocomial pneumococcal cellulitis that developed following a lymph-node biopsy in a woman being treated with high-dose intravenous corticosteroids for systemic lupus erythematosis (SLE). Her rapid and severe clinical deterioration was similar to that caused by group A streptococcus. The risk factors for the development of nosocomial pneumococcal cellulitis as a complication of SLE are reviewed and preventive measures discussed. C1 Hosp Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Dept Med, Philadelphia, PA USA. RP Maslow, JN (reprint author), V A Med Ctr, ACOS Res, 151,Univ & Woodland Ave, Philadelphia, PA 19104 USA. NR 19 TC 4 Z9 4 U1 0 U2 0 PU TAYLOR & FRANCIS AS PI OSLO PA CORT ADELERSGT 17, PO BOX 2562, SOLLI, 0202 OSLO, NORWAY SN 0036-5548 J9 SCAND J INFECT DIS JI Scand. J. Infect. Dis. PY 2003 VL 35 IS 2 BP 141 EP 143 DI 10.1080/0036554021000027002 PG 3 WC Infectious Diseases SC Infectious Diseases GA 664UE UT WOS:000182079500015 PM 12693569 ER PT J AU Kee, KS Green, MF Mintz, J Brekke, JS AF Kee, KS Green, MF Mintz, J Brekke, JS TI Is emotion processing a predictor of functional outcome in schizophrenia? SO SCHIZOPHRENIA BULLETIN LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-for-Research-in-Psychopathology CY NOV 18-21, 1999 CL MONTREAL, CANADA SP Soc Res Psychopathol DE schizophrenia; emotion perception; affect recognition; social cognition; functional outcome; psychosocial functioning ID FACIAL-AFFECT RECOGNITION; CHRONICALLY MENTALLY-ILL; SUBJECTIVE EXPERIENCE; AFFECTIVE-DISORDERS; AFFECT PERCEPTION; DEFICIT; REHABILITATION; COGNITION; BEHAVIOR; SERVICES AB Deficits in the ability to perceive facial and vocal emotion expression are common in schizophrenia. However, relatively little is known about how such deficits might affect functional outcomes. This prospective study examined cross-sectional and longitudinal relationships between perception of emotion and aspects of psychosocial functioning, including family relationships, social relationships, work functioning, and independent living/self-care in 94 clinically stabilized schizophrenia outpatients from five community-based rehabilitation programs. Emotion perception (facial emotion, voice emotion, and affect perception) and psychosocial outcome (Strauss and Carpenter Outcome Scale and Role Functioning Scale) were assessed at baseline and after 12 months of psychosocial rehabilitation. Significant associations were found between perception of emotion and work functioning/independent living both cross-sectionally and prospectively over the 12 months. Causal explanatory models suggested that perception of emotion might cause work functioning/independent living outcome over 1 year. The results remained significant when conceptual disorganization was statistically controlled. We did not find differences between men and women in the correlations between emotion perception and work functioning/independent living. Associations between social functioning/family relationships and perception of emotion were not significant. These findings suggest that emotion processing is a key determinant of work functioning/independent living for individuals with serious mental illness. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. MIRECC, VA VISN 22, Los Angeles, CA USA. Univ So Calif, Sch Social Work, Los Angeles, CA 90089 USA. RP Kee, KS (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Dept Psychiat & Biobehav Sci, 11301 Wilshire Blvd,MIRECC 210A,Bldg 210, Los Angeles, CA 90073 USA. FU NIMH NIH HHS [MH53282] NR 43 TC 205 Z9 210 U1 1 U2 6 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 2003 VL 29 IS 3 BP 487 EP 497 PG 11 WC Psychiatry SC Psychiatry GA 742NJ UT WOS:000186523700007 PM 14609242 ER PT J AU Siegel, JM AF Siegel, JM TI The narcoleptic borderland SO SLEEP MEDICINE LA English DT Editorial Material ID PLASMA OREXIN-A; HYPOCRETIN OREXIN; RELEASE C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat, VA GLAHS Sepulveda, North Hills, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, VA GLAHS Sepulveda, North Hills, CA 91343 USA. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Sch Med, Dept Psychiat, VA GLAHS Sepulveda, North Hills, CA 91343 USA. EM jsiegel@ucla.edu NR 13 TC 4 Z9 4 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1389-9457 J9 SLEEP MED JI Sleep Med. PD JAN PY 2003 VL 4 IS 1 BP 3 EP 4 DI 10.1016/S1389-9457(02)00192-2 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 772JM UT WOS:000188838900002 PM 14592352 ER PT J AU Binder, DK Rau, G Starr, PA AF Binder, DK Rau, G Starr, PA TI Hemorrhagic complications of microelectrode-guided deep brain stimulation SO STEREOTACTIC AND FUNCTIONAL NEUROSURGERY LA English DT Article; Proceedings Paper CT Meeting of the American-Society-for-Stereotactic-and-Functional-Neurosurgery CY MAY 18-21, 2003 CL NEW YORK, NEW YORK SP Amer Soc Stereotact & Funct Neurosurg DE hemorrhage; deep brain stimulation; microelectrode; movement disorders AB Background: The incidence of intracranial hemorrhage occurring during microelectrode-guided implantation of deep brain stimulators (DBS) for movement disorders has not been well defined. We report the incidence of hemorrhage in a large series of DBS implants into the subthalamic nucleus (STN), thalamus (VIM) and internal globus pallidus (GPi). Methods: All DBS procedures performed by a single surgeon ( P. A. S.) between June 1998 and April 2003 were included in this study. Patients had postoperative imaging (MRI or CT) 4 - 24 h following surgery, and all hematomas >0.2 cm(3) in volume were noted and scored as symptomatic ( associated with any new neurologic deficit lasting 124 h) or asymptomatic. Results: The total number of lead implants was 357. There were 5 symptomatic hematomas and 6 asymptomatic hematomas. The relative risk of hematoma ( any type) per lead implant was 3.1%. The incidence of hematoma by target site was 2.5% per lead for STN-DBS, 6.7% for GPi-DBS and 0% for VIM-DBS. Conclusion: The overall risk of intraoperative or early postoperative symptomatic hemorrhage with microelectrode-guided DBS, over all targets, was 1.4% per lead implant. The brain target had a significant effect on the risk of hemorrhage. Copyright (C) 2003 S. Karger AG, Basel. C1 Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, San Francisco, CA USA. RP Binder, DK (reprint author), Univ Calif San Francisco, Moffitt Hosp M779, Dept Neurol Surg, Box 0112, San Francisco, CA 94143 USA. EM dbinder@itsa.ucsf.edu NR 4 TC 69 Z9 70 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1011-6125 J9 STEREOT FUNCT NEUROS JI Stereotact. Funct. Neurosurg. PY 2003 VL 80 IS 1-4 BP 28 EP 31 DI 10.1159/000075156 PG 4 WC Neurosciences; Neuroimaging; Surgery SC Neurosciences & Neurology; Surgery GA 766PZ UT WOS:000188385900005 PM 14745205 ER PT J AU Simpson, TL AF Simpson, TL TI Childhood sexual abuse, PTSD, and the functional roles of alcohol use among women drinkers SO SUBSTANCE USE & MISUSE LA English DT Article DE human females; drinking behavior; sexual abuse; posttraumatic stress disorder; alcohol-related expectancies ID POSTTRAUMATIC-STRESS-DISORDER; SUBSTANCE USE DISORDERS; PERSONALITY-VARIABLES; SELF-MEDICATION; DRUG-ABUSE; VICTIMIZATION; COMORBIDITY; ADOLESCENT; DEPENDENCE; DRINKING AB The present study investigated whether a history of childhood sexual abuse (CSA) or current post traumatic stress disorder (PTSD) was associated with alcohol-related expectancies and recalled effects of drinking reported by women in substance user treatment. The results indicate that CSA status was not associated with the alcohol-related expectancies or effects of drinking reported by women in substance user treatment. However, those currently manifesting PTSD were more likely than their peers without PTSD to report greater alcohol-related expectancies of tension reduction and having experienced greater positive enhancement from drinking. Theoretical and clinical implications of these findings are considered. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Washington, DC USA. RP Simpson, TL (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,116-MHC, Seattle, WA 98108 USA. FU NIAAA NIH HHS [5 R01 AA09774, T32 AA07460-10, T32 AA07455-17] NR 70 TC 29 Z9 29 U1 7 U2 18 PU MARCEL DEKKER INC PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 USA SN 1082-6084 J9 SUBST USE MISUSE JI Subst. Use Misuse PD JAN PY 2003 VL 38 IS 2 BP 249 EP 270 DI 10.1081/JA-120017248 PG 22 WC Substance Abuse; Psychiatry; Psychology SC Substance Abuse; Psychiatry; Psychology GA 645AR UT WOS:000180954500005 PM 12625430 ER PT J AU Gordon, AJ Conigliaro, J Maisto, SA McNeil, M Kraemer, KL Kelley, ME AF Gordon, AJ Conigliaro, J Maisto, SA McNeil, M Kraemer, KL Kelley, ME TI Comparison of consumption effects of brief interventions for hazardous drinking elderly SO SUBSTANCE USE & MISUSE LA English DT Article DE alcohol drinking; counseling; aged; randomized controlled trial; early interventions; hazardous drinking ID PRIMARY-CARE PATIENTS; ALCOHOLISM SCREENING QUESTIONNAIRES; RANDOMIZED CONTROLLED TRIAL; BRIEF PHYSICIAN ADVICE; OLDER ADULTS; USE DISORDERS; FOLLOW-UP; DRINKERS; IDENTIFICATION; POPULATION AB We sought to determine if Brief Interventions [BIs, Motivational Enhancement (ME), and Brief Advice (BA)] reduced alcohol consumption among hazardous alcohol drinking elderly (65 years or older) and whether the elderly responded similarly to younger populations. In 12 primary care offices from October 1995 to December 1997, we screened 13,438 patients of whom 2702 were elderly (180 were hazardous drinkers). Forty-five elderly enrollees were randomized to receive ME (n = 18), BA (n = 12), and Standard Care (SC, n = 12). At baseline, the elderly drank more alcohol and abstained fewer days than the younger cohort (p < 0.05). During the year, the elderly in ME, BA, and SC intervention arms increased the number of days abstained, decreased the number of drinks per day, and reduced the number of total days per month drinking. There were trends toward decreases in the alcohol consumption measures in the ME and BA treatment arms compared to SC. The elderly's response to all interventions was similar to that of the younger cohort. This study suggests that hazardous alcohol consumption in the elderly is common and that BIs reduce alcohol consumption in the elderly similar to younger populations. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Gen Internal Med Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Ctr Res Hlth Care, Div Gen Internal Med, Pittsburgh, PA USA. Syracuse Univ, Ctr Hlth & Behav, Dept Psychol, Syracuse, NY USA. RP Gordon, AJ (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Gen Internal Med Sect, 130-U,Room 11E-118-U,Univ Dr C, Pittsburgh, PA 15240 USA. FU NIAAA NIH HHS [AA00235, AA10291] NR 45 TC 29 Z9 30 U1 5 U2 6 PU MARCEL DEKKER INC PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 USA SN 1082-6084 J9 SUBST USE MISUSE JI Subst. Use Misuse PY 2003 VL 38 IS 8 BP 1017 EP 1035 DI 10.1081/JA-120017649 PG 19 WC Substance Abuse; Psychiatry; Psychology SC Substance Abuse; Psychiatry; Psychology GA 705EY UT WOS:000184383800001 PM 12901447 ER PT J AU Saw, J Kereiakes, DJ Mahaffey, KW Applegate, RJ Braden, GA Brent, BN Brodie, BR Groce, JB Levine, GN Leya, F Moliterno, DJ AF Saw, J Kereiakes, DJ Mahaffey, KW Applegate, RJ Braden, GA Brent, BN Brodie, BR Groce, JB Levine, GN Leya, F Moliterno, DJ TI Evaluation of a novel point-of-care enoxaparin monitor with central laboratory anti-Xa levels SO THROMBOSIS RESEARCH LA English DT Article DE anti-Xa activity; clotting time; enoxaparin ID PERCUTANEOUS CORONARY INTERVENTION; MOLECULAR-WEIGHT HEPARIN; UNFRACTIONATED HEPARIN; SUBCUTANEOUS ENOXAPARIN; UNSTABLE ANGINA; COMBINATION; ABCIXIMAB; TRIAL; EFFICACY; SAFETY AB Background: Measurement of enoxaparin's anticoagulant activity has been limited to specialized coagulation laboratories and has been impractical for areas needing rapid results, such as during coronary angioplasty. A new point-of-care device, Rapidpoint(R) ENOX(R), was recently developed to measure clotting times with enoxaparin use. Objectives: To correlate ENOX times with anti-Xa levels among patients receiving enoxaparin. Methods: A total of 166 patients receiving enoxaparin for the prevention of deep venous thrombosis or as treatment during acute coronary syndromes or angioplasty were prospectively studied. Ciliated and non-citrated whole-blood (CWB and NCWB) samples were obtained at baseline and peak enoxaparin activity. ENOX times were measured with whole-blood, and the Stachrom(R) anti-Xa assay was performed on the plasma from the remainder of the samples. The Pearson correlation coefficient was used to assess the relationship between these two assays. Results: There was a strong linear correlation between the ENOX times and the anti-Xa activities for both CWB (r = 0.89, p<0.001) and NCWB (r=0.82, p<0.001) when considering all 332 samples (baseline and peak). When baseline samples were excluded, the correlation remained strong for CWB ENOX times and anti-Xa levels (r = 0.84, p<0.001), but was only moderate for NCWB (r = 0.73, p<0.001). A CWB ENOX time of less than or equal to 160 s corresponded to anti-Xa level of less than or equal to 0.5 IU/ml in 95% (188/197) of patients. A CWB ENOX time greater than or equal to 200 s corresponded to anti-Xa levels greater than or equal to 0.8 IU/ml in 96% (93/96) of patients. Conclusions: Rapidpoint(R) ENOX times correlate strongly to anti-Xa activities measured by the Stachrom(R) Heparin Assays for citrated whole-blood samples. This novel test can be used for rapid bedside measurements of enoxaparin anticoagulant activity. (C) 2004 Elsevier Ltd. All rights reserved. C1 Cleveland Clin Fdn, Dept Cardiovasc Med, Cleveland, OH 44195 USA. Ohio Heart Hlth Ctr, Linder Ctr, Cleveland, OH 44195 USA. Duke Clin Res Inst, Div Cardiovasc Med, Durham, NC USA. Wake Forest Univ, Med Ctr, Div Cardiovasc Med, Winston Salem, NC 27109 USA. Forsythe Med Ctr, Winston Salem, NC USA. Calif Pacific Med Ctr, Geraldine Brush Canc Res Inst, San Francisco, CA USA. Moses Cone Hosp, Greensboro, NC USA. Houston VAMC, Div Cardiovasc Med, Houston, TX USA. Loyola Univ, Med Ctr, Div Cardiovasc Med, Maywood, IL 60153 USA. Univ Kentucky, Gill Heart Inst, Lexington, KY 40536 USA. Univ Kentucky, Div Cardiovasc Med, Lexington, KY 40536 USA. RP Moliterno, DJ (reprint author), Cleveland Clin Fdn, Dept Cardiovasc Med, 9500 Euclid Ave, Cleveland, OH 44195 USA. EM moliterno@uky.edu NR 21 TC 8 Z9 8 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 2003 VL 112 IS 5-6 BP 301 EP 306 DI 10.1016/j.thromres.2004.01.006 PG 6 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 808VD UT WOS:000220595700008 PM 15041274 ER PT J AU Obeid, LA Okamoto, Y Mao, CG AF Obeid, LA Okamoto, Y Mao, CG TI Yeast sphingolipids: metabolism and biology SO BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR AND CELL BIOLOGY OF LIPIDS LA English DT Review DE yeast; sphingolipid; cell regulation ID LONG-CHAIN BASES; GLYCOSYLPHOSPHATIDYLINOSITOL-ANCHORED PROTEINS; SPHINGANINE N-ACYLTRANSFERASE; FATTY-ACID ELONGATION; SACCHAROMYCES-CEREVISIAE; SERINE PALMITOYLTRANSFERASE; HEAT-STRESS; ALKALINE CERAMIDASE; ENDOPLASMIC-RETICULUM; GROWTH-INHIBITION AB Sphingolipids have recently emerged as important bioactive molecules in addition to being critical structural components of cellular membranes. These molecules have been implicated in regulating cell growth, differentiation, angiogenesis, apoptosis, and senescene. To study sphingolipid mediated biology, it is necessary to investigate sphingolipid metabolism and its regulation. The yeast Saccharomyces cerevisiae has allowed such studies to take place as the sphingolipid metabolic and regulatory pathways appear conserved across species. Using yeast genetic approaches most enzymes of sphingolipid metabolism have been identified and cloned which has led to identification of their mammalian homologues. Many of the yeast enzymes are targets of fungal toxins thus underscoring the importance of this pathway in yeast cell regulation. This review focuses on the yeast sphingolipid metabolic pathway and its role in regulation of yeast biology. Implication of the insights gained from yeast to mammalian cell regulation are discussed. (C) 2002 Elsevier Science B.V. All rights reserved. C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Med Univ S Carolina, Dept Biochem, Charleston, SC 29425 USA. RP Obeid, LA (reprint author), Med Univ S Carolina, Dept Med, POB 250779,114 Doughty St, Charleston, SC 29425 USA. OI obeid, lina/0000-0002-0734-0847 FU NIA NIH HHS [AG16583]; NIGMS NIH HHS [GM62887] NR 71 TC 89 Z9 91 U1 0 U2 7 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1388-1981 J9 BBA-MOL CELL BIOL L JI Biochim. Biophys. Acta Mol. Cell Biol. Lipids PD DEC 30 PY 2002 VL 1585 IS 2-3 BP 163 EP 171 AR PII S1388-1981(02)00337-2 DI 10.1016/S1388-1981(02)00337-2 PG 9 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 640NL UT WOS:000180694800015 PM 12531550 ER PT J AU Dohadwala, M Batra, RK Luo, J Lin, Y Krysan, K Pold, M Sharma, S Dubinett, SM AF Dohadwala, M Batra, RK Luo, J Lin, Y Krysan, K Pold, M Sharma, S Dubinett, SM TI Autocrine/paracrine prostaglandin E2 production by non-small cell lung cancer cells regulates matrix metalloproteinase-2 and CD44 in cyclooxygenase-2-dependent invasion SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; HUMAN PROSTATE; INCREASED EXPRESSION; PANCREATIC-CANCER; CARCINOMA CELLS; TUMOR INVASION; UP-REGULATION; INHIBITION; APOPTOSIS; GROWTH AB Tumor cyclooxygenase-2 (COX-2) expression is known to be associated with enhanced tumor invasiveness. In the present study, we evaluated the importance of the COX-2 product prostaglandin E2 (PGE2) and its signaling through the EP4 receptor in mediating non-small cell lung cancer (NSCLC) invasiveness. Genetic inhibition of tumor COX-2 led to diminished matrix metalloproteinase (MMP)-2, CD44, and EP4 receptor expression and invasion. Treatment of NSCLC cells with exogenous 16,16-dimethylprostaglandin E2 significantly increased EP4 receptor, CD44, and MMP-2 expression and matrigel invasion. In contrast, anti-PGE2 decreased EP4 receptor, CD44, and MMP-2 expression in NSCLC cells. EP4 receptor signaling was found to be central to this process, because antisense oligonucleotide-mediated inhibition of tumor cell EP4 receptors significantly decreased CD44 expression. In addition, agents that increased intracellular cAMP, as is typical of EP4 receptor signaling, markedly increased CD44 expression. Moreover, MMP-2-AS treatment decreased PGE2-mediated CD44 expression, and CD44-AS treatment decreased MMP-2 expression. Thus, PGE2-mediated effects through EP4 required the parallel induction of both CD44 and MMP-2 expression because genetic inhibition of either MMP-2 or CD44 expression effectively blocked PGE2-mediated invasion in NSCLC. These findings indicate that PGE2 regulates COX-2-dependent, CD44- and MMP-2-mediated invasion in NSCLC in an autocrine/paracrine manner via EP receptor signaling. Thus, blocking PGE2 production or activity by genetic or pharmacological interventions may prove to be beneficial in chemoprevention or treatment of NSCLC. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Pulm & Crit Care Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Hlth Care Ctr, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Lung Canc Res Program, Los Angeles, CA 90095 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. OI Batra, Raj K./0000-0002-1126-543X FU NCI NIH HHS [P50 CA090388, P50 CA90388, R01 CA078654, R01CA71818] NR 60 TC 195 Z9 211 U1 0 U2 5 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 DEC 27 PY 2002 VL 277 IS 52 BP 50828 EP 50833 DI 10.1074/jbc.M210707200 PG 6 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 631QD UT WOS:000180177700083 PM 12393872 ER PT J AU Hinkin, CH Castellon, SA Durvasula, RS Hardy, DJ Lam, MN Mason, KI Thrasher, D Goetz, MB Stefaniak, M AF Hinkin, CH Castellon, SA Durvasula, RS Hardy, DJ Lam, MN Mason, KI Thrasher, D Goetz, MB Stefaniak, M TI Medication adherence among HIV+ adults - Effects of cognitive dysfunction and regimen complexity SO NEUROLOGY LA English DT Article ID ACTIVE ANTIRETROVIRAL THERAPY; HUMAN-IMMUNODEFICIENCY-VIRUS; SELF-REPORTED ADHERENCE; NEUROPSYCHOLOGICAL PERFORMANCE; DRUG-RESISTANCE; INFECTION; PATIENT; AIDS; INDIVIDUALS; TRIAL AB Background: Although the use of highly active antiretroviral therapy in the treatment of HIV infection has led to considerable improvement in morbidity and mortality, unless patients are adherent to their drug regimen (i.e., at least 90 to 95% of doses taken), viral replication may ensue and drug-resistant strains of the virus may emerge. Methods: The authors studied the extent to which neuropsychological compromise and medication regimen complexity are predictive of poor adherence in a convenience sample of 137 HIV-infected adults. Medication adherence was tracked through the use of electronic monitoring technology (MEMS caps). Results: Two-way analysis of variance revealed that neurocognitive compromise as well as complex medication regimens were associated with significantly lower adherence rates. Cognitively compromised participants on more complex regimens had the greatest difficulty with adherence. Deficits in executive function, memory, and attention were associated with poor adherence. Logistic regression analysis demonstrated that neuropsychological compromise was associated with a 2.3 times greater risk of adherence failure. Older age (>50 years) was also found to be associated with significantly better adherence. Conclusions: HIV-infected adults with significant neurocognitive compromise are at risk for poor medication adherence, particularly if they have been prescribed a complex dosing regimen. As such, simpler dosing schedules for more cognitively impaired patients might improve adherence. C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA 90024 USA. Calif State Univ Los Angeles, Dept Psychol, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90032 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. RP Hinkin, CH (reprint author), Univ Calif Los Angeles, Sch Med, Dept Psychiat & Behav Sci, 760 Westwood Plaza,Room C8-747, Los Angeles, CA 90024 USA. OI Goetz, Matthew/0000-0003-4542-992X FU NIMH NIH HHS [T32 MH019535, R01 MH058552, R01 MH058552-05, R01 MH58552] NR 52 TC 231 Z9 237 U1 1 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD DEC 24 PY 2002 VL 59 IS 12 BP 1944 EP 1950 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 627JY UT WOS:000179931100021 PM 12499488 ER PT J AU Hallen, S Bjorquist, A Ostlund-Lindqvist, AM Sachs, G AF Hallen, S Bjorquist, A Ostlund-Lindqvist, AM Sachs, G TI Identification of a region of the ileal-type sodium/bile acid cotransporter interacting with a competitive bile acid transport inhibitor SO BIOCHEMISTRY LA English DT Article ID CORONARY HEART-DISEASE; SUBSTRATE-SPECIFICITY; HYPERLIPIDEMIAS POSCH; FUNCTIONAL EXPRESSION; SURGICAL CONTROL; CLONING; RABBIT; BYPASS; GENE; HYPERCHOLESTEROLEMIA AB Drug intervention that prevents reabsorption of circulating bile acids by the apical (ileal) sodium/bile acid cotransporter (ASBT) may be a promising new therapy for lowering of plasma cholesterol. 2164U90 is a benzothiazepine-based competitive inhibitor of bile acid transport with K-i values of similar to10 and 0.068 muM for the homologous human and mouse apical transporters, respectively. Hybrid human-mouse and mouse-human transporters were engineered to identify regions involved in this 150-fold difference in the inhibition constant for 2164U90. A mouse-human chimera with only the most C-terminal hydrophobic domain and the C-terminus of the transporter originating from the human variant was found to have a sensitivity to 2164U90 inhibition similar to that of the human transporter. Conversely, a human-mouse hybrid transporter encompassing the same C-terminal region from the mouse sequence but now inserted into the human sequence demonstrated the greater inhibition seen with the mouse wild type ASBT. Amino acid substitutions, individually or in combinations, of six candidate nonconserved residues between mouse and human transporters in this C-terminal domain showed replacements of Thr294 by Ser and Val295 by Ile to be responsible for the difference in the sensitivity toward 2164U90 seen between the species. The hamster apical SBAT encompassing Ser/Ile in these positions shared the lower sensitivity to 2164U90, as seen with the human ASBT, even though it is identical to the mouse SBAT in the remaining four positions of this region. In addition, the rat ASBT which is identical to the mouse ASBT in this domain also had the high sensitivity to 2164U90 inhibition found for the mouse ASBT. Methanethio-sulfonates (MTS) are known to inactivate the sodium/bile acid transporters through alkylation of a cysteine in the most C-terminal hydrophobic domain (1). Inactivation of the human ASBT due to MTS modification of cysteine 270 was shown to be largely abolished when the transporter was preincubated with 2164U90, suggesting that the binding of this benzothiazepine is in the vicinity of position 270. Thus, the domain containing the two most C-terminal putative transmembrane regions of the SBATs, H8-H9, previously shown to constitute part of the binding pocket for bile acids, interacts also with the bile acid transport competitive inhibitor, 2164U90. C1 Univ Calif Los Angeles, Los Angeles, CA 90073 USA. Wadsworth Vet Adm Hosp, Los Angeles, CA 90073 USA. AstraZeneca, R&D, Molndal, Sweden. RP Sachs, G (reprint author), W Los Angeles Vet Affairs Med Ctr, Membrane Biol Lab, 11301 Wilshire Blvd,Bldg 113,Rm 324, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK17294, DK46917, DK53462, DK41301] NR 31 TC 24 Z9 26 U1 0 U2 1 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0006-2960 J9 BIOCHEMISTRY-US JI Biochemistry PD DEC 17 PY 2002 VL 41 IS 50 BP 14916 EP 14924 DI 10.1021/bi0205404 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 625LD UT WOS:000179817200030 PM 12475240 ER PT J AU Kramer, BJ Harker, JO Wong, AL AF Kramer, BJ Harker, JO Wong, AL TI Arthritis beliefs and self-care in an urban American Indian population SO ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH LA English DT Article DE Native Americans; joint pain; self-care; education; health beliefs; coping ID SYSTEMIC LUPUS-ERYTHEMATOSUS; RHEUMATOID-ARTHRITIS; COPING STRATEGIES; HIGH PREVALENCE; PAIN PATIENTS; DISEASE; DISABILITY; ALCOHOL; HEALTH AB Objective. To describe beliefs and self-care strategies of American Indians with chronic arthritis joint pain. Method. In-depth interviews were conducted with a convenience sample of urban-dwelling American Indians (n = 56) concerning self-care and beliefs about arthritis; objective measures of arthritis disease activity were obtained through standardized interview protocols. Results. Joint pain was not generally assumed to be arthritis nor directly related to aging. Belief that chronic pain affecting multiple joints was a serious and unexpected condition oriented American Indians' decisions to seek medical attention. However, verbal communications about pain may be subtle or under emphasized. Few coping strategies were used to control either chronic or episodic pain. Conclusions. Chronic arthritis pain may not be optimally managed in this population. Cultural assessment should recognize that American Indian patients may understate serious symptoms. Community educational interventions should target this population to enhance self-care, pain management, and communication of arthritis symptoms to physicians. C1 Dept Vet Affairs Greater Los Angeles Healthcare S, Ctr Geriatr Res Educ & Clin, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. Olive View UCLA Med Ctr, Sylmar, CA 91342 USA. RP Kramer, BJ (reprint author), VA Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr 11E, Sepulveda Ambulatory Care Ctr & Nursing Home, 16111 Plummer St, Sepulveda, CA 91343 USA. NR 28 TC 18 Z9 18 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 0004-3591 J9 ARTHRIT RHEUM-ARTHR JI Arthritis Rheum-Arthritis Care Res. PD DEC 15 PY 2002 VL 47 IS 6 BP 588 EP 594 DI 10.1002/art.10795 PG 7 WC Rheumatology SC Rheumatology GA 624ZG UT WOS:000179791700004 PM 12522831 ER PT J AU Mitropoulou, V Harvey, PD Maldari, LA Moriarty, PJ New, AS Silverman, JM Siever, LJ AF Mitropoulou, V Harvey, PD Maldari, LA Moriarty, PJ New, AS Silverman, JM Siever, LJ TI Neuropsychological performance in schizotypal personality disorder: Evidence regarding diagnostic specificity SO BIOLOGICAL PSYCHIATRY LA English DT Article DE information processing; cognition; memory; learning; schizophrenia spectrum ID VISUOSPATIAL WORKING-MEMORY; SCHIZOPHRENIC-PATIENTS; NONPSYCHOTIC RELATIVES; SEX-DIFFERENCES; PERSPECTIVE; INHIBITION; DEFICITS; TASK; PEN AB Background: Individuals with schizotypal personality disorder (SPD) share cognitive deficits with schizophrenic patients, suggesting that these deficits represent a core feature of the schizophrenia spectrum. We investigated the neuropsychological profile in SPD patients compared with two comparison groups: healthy volunteers (HV) and patients who met criteria for another non-schizophrenia spectrum personality disorder (NSS). Methods: We tested 48 DSM-III-R SPD patients, 22 NSS and 32 HV on a neuropsychologic battery that included the California Verbal Learning Test (CVLT), Trail Making A and B, the DOT test of working memory, the Stroop Color-Word Interference, the Paced Auditory Serial Addition Test (PASAT), the Wechsler Memory Scale Visual Reproduction Test (WMSV-R), and the Wechsler Adult Intelligence Scale vocabulary and block design. Results: Normative standards for performance were created using the HV group. SPD patients performed significantly worse compared with HVs; specifically, SPD patients demonstrated impaired performance on the PASAT and the WMSV-R immediate and delayed recall compared to HV. Moreover, SPD patients were impaired in the PASAT and the WMSV-R immediate condition compared with the NSS group. The NSS patients did not differ from HV on any of the cognitive tasks. The interpersonal factor of the schizotypal symptoms inversely correlated with the PASAT score (r = -.32, p < .006). Conclusions: Compared with HVs, SPD patients demonstrate modest cognitive impairment. These differences reached statistical significance for the PASAT (an auditory working memory task), and the WMSV-R immediate and delayed recall (a learning-recall test). In contrast, performance of NSS patients did not differ from that of HVs. The types of deficits observed in SPD patients are qualitatively similar to but milder than those seen in patients with schizophrenia. (C) 2002 Society of Biological Psychiatry. C1 CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, New York, NY USA. VA VISN 3 MIRECC, New York, NY USA. RP Mitropoulou, V (reprint author), CUNY Mt Sinai Sch Med, Dept Psychiat, Box 1027,1 Gustave Levy Pl, New York, NY 10029 USA. FU NCRR NIH HHS [NCRR-MO1-RR00071]; NIMH NIH HHS [R01-MH 5606] NR 44 TC 47 Z9 47 U1 3 U2 6 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 15 PY 2002 VL 52 IS 12 BP 1175 EP 1182 AR PII S0006-3223(02)01426-9 DI 10.1016/S0006-3223(02)01426-9 PG 8 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 634QW UT WOS:000180352800007 PM 12488063 ER PT J AU Mileykovskiy, BY Kiyashchenko, LI Siegel, JM AF Mileykovskiy, BY Kiyashchenko, LI Siegel, JM TI Cessation of activity in red nucleus neurons during stimulation of the medial medulla in decerebrate rats SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID PONTINE RETICULAR-FORMATION; LOCUS-COERULEUS NEURONS; MUSCLE TONE SUPPRESSION; C-FOS EXPRESSION; BRAIN-STEM; RETICULOSPINAL NEURONS; RUBROSPINAL NEURONS; INHIBITORY REGIONS; LOCOMOTOR REGION; ANESTHETIZED RAT AB The Pontine oral reticular nucleus, gigantocellular reticular nucleus (Gi) and dorsal paragigantocellular nucleus (DPGi) of the medulla are key elements of a brainstem-reticulospinal inhibitory system that participates in rapid eye movement (REM) sleep atonia. Our recent study has shown that excitation of these brainstem nuclei in decerebrate rats inhibits locus coeruleus cells and the midbrain locomotor region neurons related to muscle tone facilitation. In the present study we have examined the influences of electrical and chemical stimulation of Gi and DPGi inhibitory sites on the activity of neurons located in the magnocellular part of the red nucleus (RMC), a cell group that participates in both the tonic and phasic regulation of motor output. A total of 192 RMC neurons were recorded in precollicular-premammillary decerebrate rats with muscle rigidity and induced locomotion. Thirty-three RMC neurons were identified antidromically as rubrospinal (RMC-spinal) cells by stimulation of the contralateral dorsolateral funiculus at the L2 level. A total of 141 RMC neurons (88.7%) and all RMC-spinal neurons were inhibited during electrical stimulation of Gi and DPGi inhibitory sites. This cessation of activity was correlated with bilateral muscle atonia or blockage of locomotion. Six RMC cells (3.8%) were excited (224 +/- 50%, n = 6, minimum = 98, maximum = 410, P < 0.05) and 11 cells (7%) gave no response to Gi and DPGi stimulation. Microinjections of kainic acid (100 muM, 0.2 mu1) into Gi and DPGi inhibitory sites, previously identified by electrical stimulation, produced a short-latency (35 +/- 3.5 s, n = 11) decrease of rigid hindlimb muscle tone and inhibition of all tested RMC (n = 7) and RMC-spinal (n = 5) neurons. These results, combined with our recent published data, suggest that inhibition of motor function during activation of the brainstem inhibitory system is related to both the descending inhibition of spinal motoneurons and suppression of activity in supraspinal motor facilitatory systems. These two mechanisms acting synergistically may cause generalized motor inhibition during REM sleep and cataplexy. C1 Univ Calif Los Angeles, Dept Psychiat, Sch Med, North Hills, CA 91343 USA. Univ Calif Los Angeles, Biobehav Sci & Brain Res Inst, Sch Med, North Hills, CA 91343 USA. Vet Adm Greater Los Angeles Hlth Syst Sepulveda, Sepulveda, CA USA. Russian Acad Sci, Inst Evolut Physiol & Biochem, St Petersburg 194223, Russia. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Dept Psychiat, Sch Med, Neurobiol Res 151A3,VA GLAHS,16111 Plummer St, North Hills, CA 91343 USA. FU NHLBI NIH HHS [R01 HL041370, R37 HL041370, P50 HL060296, HL 60296, HL 41370] NR 82 TC 14 Z9 14 U1 0 U2 1 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD DEC 15 PY 2002 VL 545 IS 3 BP 997 EP 1006 DI 10.1113/jphysiol.2002.028985 PG 10 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 631QK UT WOS:000180178300022 PM 12482902 ER PT J AU Zhang, BX Ma, XY Yeh, CK Lifschitz, MD Zhu, MX Katz, MS AF Zhang, BX Ma, XY Yeh, CK Lifschitz, MD Zhu, MX Katz, MS TI Epidermal growth factor-induced depletion of the intracellular Ca2+ store fails to activate capacitative Ca2+ ntry in a human salivary cell line SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID BASOPHILIC LEUKEMIA-CELLS; MEDIATED CALCIUM-ENTRY; CURRENT I-CRAC; PHOSPHOLIPASE-C; INOSITOL TRISPHOSPHATE; HUMAN-PLATELETS; PROTEIN-KINASE; RECEPTOR; INFLUX; CHANNELS AB Epidermal growth factor (EGF) is a multifunctional factor known to influence proliferation and function of a variety of cells. The actions of EGF are mediated by EGF receptor tyrosine kinase pathways, including stimulation of phospholipase Cgamma and mobilization of intracellular Ca2+ ([Ca2+](i)). Generally, agonist-mediated Ca2+ mobilization involves both Ca2+ release from internal stores and Ca2+ influx activated by store depletion (i.e. capacitative or store-operated Ca2+ influx). However, the role of capacitative Ca2+ entry in EGF-mediated Ca2+ mobilization is still largely unknown. In this study, we compared [Ca2+], signals elicited by EGF with those induced by agents (the muscarinic receptor agonist carbachol and thapsigargin (Tg)) known to activate capacitative Ca2+ entry. Unlike carbachol and Tg, EGF (5 nM) elicited a transient [Ca2+](i) signal without a plateau phase in the presence of extracellular Ca2+ and also failed to accelerate Mn2+ entry. Repletion of extracellular Ca2+ to cells stimulated with EGF in the absence of Ca2+ elicited an increase in [Ca2+](i), indicating that EGF indeed stimulates Ca2+ influx. However, the influx was activated at lower EGF concentrations than those required to stimulate Ca2+ release. Interestingly, the phospholipase C inhibitor U73122 completely inhibited Ca2+ release induced by both EGF and carbachol and also reduced Ca2+ influx responsive to carbachol but had no effect on Ca2+ influx induced by EGF. EGF-induced Ca2+ influx was potentiated by low concentrations (<5 ng/ml) of oligomycm, a mitochondrial inhibitor that blocks capacitative Ca2+ influx in other systems. Transient expression of the hTRPC3 protein enhanced Ca2+ influx responsive to carbachol but did not increase EGF-activated Ca2+ influx. Both EGF and carbachol depleted internal Ca2+ stores. Our results demonstrate that EGF-induced Ca2+ release from internal stores does not activate capacitative Ca2+ influx. Rather, EGF stimulates Ca2+ influx via a mechanism distinct from capacitative Ca2+ influx induced by carbachol and Tg. C1 Audie L Murphy Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Audie L Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, Med Res Serv, Audie L Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Biochem, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, San Antonio, TX 78229 USA. Ohio State Univ, Dept Neurosci, Columbus, OH 43210 USA. Ohio State Univ, Neurobiotechnol Ctr, Columbus, OH 43210 USA. RP Katz, MS (reprint author), 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. FU NIDCR NIH HHS [DE10756]; NINDS NIH HHS [NS42183] NR 42 TC 14 Z9 16 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 DEC 13 PY 2002 VL 277 IS 50 BP 48165 EP 48171 DI 10.1074/jbc.M208077200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 624YK UT WOS:000179789600027 PM 12368284 ER PT J AU Sambrano, GR Chandy, G Choi, S Decamp, D Hsueh, R Lin, KM Mock, D O'Rourke, N Roach, T Shu, HJ Sinkovits, B Verghese, M Bourne, H AF Sambrano, GR Chandy, G Choi, S Decamp, D Hsueh, R Lin, KM Mock, D O'Rourke, N Roach, T Shu, HJ Sinkovits, B Verghese, M Bourne, H TI Unravelling the signal-transduction network in B lymphocytes SO NATURE LA English DT Article ID LYMPHOMA-CELLS; WEHI-231; ACTIVATION; CHEMOKINES; EXPRESSION AB The Alliance for Cellular Signaling has chosen the mouse B lymphocyte as a model system to understand basic principles that govern cellular signalling. Progress to that end has focused initially on establishing a reproducible experimental cell system and characterizing essential signalling responses. Although unravelling this complex network will take years, findings revealed in the interim will prove immensely useful to the scientific community at large. C1 Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USA. Stanford Univ, Sch Med, Dept Mol Pharmacol, Stanford, CA 94305 USA. CALTECH, Div Biol, Pasadena, CA 91125 USA. Univ Texas, SW Med Ctr, Dept Pharmacol, Dallas, TX 75390 USA. Univ Calif San Diego, San Diego Supercomp Ctr, La Jolla, CA 92093 USA. San Francisco Vet Adm Med Ctr, Dept Rheumatol, San Francisco, CA 94121 USA. RP Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, 513 Parnassus Ave, San Francisco, CA 94143 USA. EM sambrano@cmp.ucsf.edu NR 22 TC 20 Z9 20 U1 1 U2 4 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0028-0836 EI 1476-4687 J9 NATURE JI Nature PD DEC 12 PY 2002 VL 420 IS 6916 BP 708 EP 710 DI 10.1038/nature01305 PG 3 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 624GK UT WOS:000179751800055 PM 12478302 ER PT J AU Sambrano, GR Fraser, I Han, HP Ni, Y O'Connell, T Yan, Z Stull, JT AF Sambrano, GR Fraser, I Han, HP Ni, Y O'Connell, T Yan, Z Stull, JT TI Navigating the signalling network in mouse cardiac myocytes SO NATURE LA English DT Article ID SIGNALING PATHWAYS; CULTURE; HEART AB Cardiac myocytes have a complex network of signals that regulates their essential role in the rhythmic pumping of the heart. This network is an appealing model system in which to study the basic principles underlying cellular signalling mechanisms. Progress in this effort has come through the establishment of standardized myocyte isolation and culture procedures and characterization of important signalling responses. C1 Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, San Francisco, CA 94143 USA. CALTECH, Div Biol, Pasadena, CA 91125 USA. Univ Texas, SW Med Ctr, Dept Pharmacol, Dallas, TX 75390 USA. Univ Texas, SW Med Ctr, Dept Physiol, Dallas, TX 75390 USA. San Francisco Vet Adm Med Ctr, Dept Cardiol, San Francisco, CA 94121 USA. RP Sambrano, GR (reprint author), Univ Calif San Francisco, Dept Mol & Cellular Pharmacol, 513 Parnassus Ave, San Francisco, CA 94143 USA. RI O'Connell, Timothy/D-5048-2013 NR 25 TC 67 Z9 67 U1 0 U2 4 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0028-0836 J9 NATURE JI Nature PD DEC 12 PY 2002 VL 420 IS 6916 BP 712 EP 714 DI 10.1038/nature01306 PG 3 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 624GK UT WOS:000179751800056 PM 12478303 ER PT J AU Unutzer, J Katon, W Callahan, CM Williams, JW Hunkeler, E Harpole, L Hoffing, M Della Penna, RD Noel, PH Lin, EHB Arean, PA Hegel, MT Tang, LQ Belin, TR Oishi, S Langston, C AF Unutzer, J Katon, W Callahan, CM Williams, JW Hunkeler, E Harpole, L Hoffing, M Della Penna, RD Noel, PH Lin, EHB Arean, PA Hegel, MT Tang, LQ Belin, TR Oishi, S Langston, C CA IMPACT Investigators TI Collaborative care management of late-life depression in the primary care setting - A randomized controlled trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID MENTAL-HEALTH-SERVICES; EPIDEMIOLOGIC CATCHMENT-AREA; PATIENTS AGED 65; MAJOR DEPRESSION; OLDER ADULTS; QUALITY IMPROVEMENT; COST-EFFECTIVENESS; MINOR DEPRESSION; DISORDERS; SYMPTOMS AB Context Few depressed older adults receive effective treatment in primary care settings. Objective To determine the effectiveness of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) collaborative care management program for late-life depression. Design Randomized controlled trial with recruitment from July 1999 to August 2001. Setting Eighteen primary care clinics from 8 health care organizations in 5 states. Participants A total of 1801 patients aged 60 years or older with major depression (17%), dysthymic disorder (30%), or both (53%). Intervention Patients were randomly assigned to the IMPACT intervention (n=906) or to usual care (n=895). Intervention patients had access for up to 12 months to a depression care manager who was supervised by a psychiatrist and a primary care expert and who offered education, care management, and support of antidepressant management by the patient's primary care physician or a brief psychotherapy for depresssion, Problem Solving Treatment in Primary Care. Main Outcome Measures Assessments at baseline and at 3, 6, and 12 months for depression, depression treatments, satisfaction with care, functional impairment, and quality of life. Results At 12 months, 45% of intervention patients had a 50% or greater reduction in depressive symptoms from baseline compared with 19% of usual care participants (odds ratio [OR], 3.45; 95% confidence interval [CI], 2.71-4.38; P<.001). Intervention patients also experienced greater rates of depression treatment (OR, 2.98; 95% CI, 2.34-3.79; P<.001), more satisfaction with depression care (OR, 3.38; 95% CI, 2.66-4.30; P<.001), lower depression severity (range, 0-4; between-group difference, -0.4; 95% CI, -0.46 to -0.33; P<.001), less functional impairment (range, 0-10; between-group difference, -0.91; 95% CI, -1.19 to -0.64; P<.001), and greater quality of life (range, 0-10; between-group difference, 0.56; 95% CI, 0.32-0.79; P<.001) than participants assigned to the usual care group. Conclusion The IMPACT collaborative care model appears to be feasible and significantly more effective than usual care for depression in a wide range of primary care practices. C1 Univ Calif Los Angeles, Inst Neuropsychiat, Ctr Hlth Serv Res, Los Angeles, CA 90024 USA. Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Indiana Univ, Ctr Aging Res, Regenstrief Inst Hlth Care, Indianapolis, IN 46204 USA. Durham Vet Affairs Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. Kaiser Permanente No Calif, Div Res, Oakland, CA USA. Desert Med Grp, Palm Springs, CA USA. Kaiser Permanente So Calif, San Diego, CA USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Dartmouth Coll Sch Med, Dept Psychiat, Hanover, NH USA. John A Hartford Fdn, New York, NY USA. RP Unutzer, J (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, Ctr Hlth Serv Res, 10920 Wilshire Blvd,Suite 300, Los Angeles, CA 90024 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558; Penna, Maria Pietronilla/0000-0002-0982-3893 NR 81 TC 1208 Z9 1216 U1 6 U2 74 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 11 PY 2002 VL 288 IS 22 BP 2836 EP 2845 DI 10.1001/jama.288.22.2836 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 623YM UT WOS:000179732600028 PM 12472325 ER PT J AU Small, GW AF Small, GW TI Use of neuroimaging to detect early brain changes in people at genetic risk for Alzheimer's disease SO ADVANCED DRUG DELIVERY REVIEWS LA English DT Review DE neuroimaging; Alzheimer's disease; apolipoprotein E; positron emission tomography; functional magnetic resonance imaging; genetic risk ID CEREBRAL BLOOD-FLOW; APOLIPOPROTEIN-E; SENSORY STIMULATION; ALLELE; EPSILON-4; ACTIVATION; DEMENTIA; ABILITY AB The neuropathological and cognitive changes. preceding Alzheimer's disease appear to begin subtly decades before symptoms. of the disease make the clinical diagnosis obvious. Clinical trials have begun to focus on preventive treatments designed to slow age-related cognitive decline and delay the onset of Alzheimer's disease in people with only mild memory complaints. Because people with few cognitive deficits represent a heterogeneous population, prevention studies require large samples in order to detect active drug effects. To address such challenges, recent neuroimaging studies have focused on middle-aged and older adults with only mild memory complaints and evaluated results according to the major known genetic risk for Alzheimer's disease, the apolipoprotein E-4 (APOE-4) allele. In studies using positron emission tomography during mental rest and functional magnetic resonance imaging during memory task performance, brain patterns differ according to genetic risk and are useful in predicting future decline measures and following disease progression in clinical trials. (C) 2002 Elsevier Science B.V. All rights reserved. C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Inst Neuropsychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Ctr Aging, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Small, GW (reprint author), Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Inst Neuropsychiat, 760 Westwood Plaza, Los Angeles, CA 90024 USA. FU NIA NIH HHS [AG10123, AG13308]; NIMH NIH HHS [MH52453] NR 31 TC 19 Z9 19 U1 1 U2 9 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0169-409X J9 ADV DRUG DELIVER REV JI Adv. Drug Deliv. Rev. PD DEC 7 PY 2002 VL 54 IS 12 BP 1561 EP 1566 AR PII S0169-409X(02)00151-5 DI 10.1016/S0169-409X(02)00151-5 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 632AN UT WOS:000180200900004 PM 12453673 ER PT J AU Dolgilevich, S Zaidi, N Song, JB Abe, E Moonga, BS Sun, L AF Dolgilevich, S Zaidi, N Song, JB Abe, E Moonga, BS Sun, L TI Transduction of TAT fusion proteins into osteoclasts and osteoblasts SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article ID MAMMALIAN-CELLS; CALCINEURIN AB It has been difficult to transduce primary cultures of bone cells with proteins of interest. Here, we report the development and validation of a new technology for transduction of osteoblasts and osteoclasts with peptides and moderately sized proteins. Fusion proteins between TAT, an 11 amino acid Arg-rich sequence derived from the HIV protein, and either hemagglutinin or calcineurin Aalpha were synthesized and purified. Exposure of osteoblasts and osteoclasts in primary culture to either TAT-HA or TAT-calcineurin Aalpha resulted in a rapid (within 10 min) intracellular movement of the fusion protein evident on co-immunostaining. Almost 99% of cells were transduced and the fusion protein was retained in similar to50% of the cells for up to 5 days. TAT did not abolish the functionality of calcineurin Aalpha; the fusion protein stimulated osteoblast differentiation and inhibited osteoclastic resorption. We expect that our studies will provide a firm basis for the future development of TAT fusion proteins for critical molecules involved in bone cell differentiation and function. (C) 2002 Elsevier Science (USA). All rights reserved. C1 CUNY Mt Sinai Sch Med, Mt Sinai Bone Program, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Med, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, GRECC, New York, NY 10029 USA. RP Sun, L (reprint author), CUNY Mt Sinai Sch Med, Mt Sinai Bone Program, 1 Gustave L Levy Pl,PO 1055, New York, NY 10029 USA. NR 12 TC 18 Z9 18 U1 1 U2 1 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 DEC 6 PY 2002 VL 299 IS 3 BP 505 EP 509 AR PII S0006-291X(02)02664-5 DI 10.1016/S0006-291X(02)02664-5 PG 5 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 625LM UT WOS:000179818000028 PM 12445831 ER PT J AU Morrison, DA Sethi, G Sacks, J Henderson, WG Grover, F Sedlis, S Esposito, R AF Morrison, DA Sethi, G Sacks, J Henderson, WG Grover, F Sedlis, S Esposito, R CA Inv Dep Veterans Affairs Cooperat TI Percutaneous coronary intervention versus repeat bypass surgery for patients with medically refractory myocardial ischemia - AWESOME randomized trial and registry experience with post-CABG patients SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID GRAFT-SURGERY; RISK-FACTORS; MORTALITY; ANGIOPLASTY AB OBJECTIVES This report compares long-term percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) survival among post-CABG patients included in the Angina With Extremely Serious Operative Mortality Evaluation (AWESOME) randomized trial and prospective registry. BACKGROUND Repeat CABG surgery is associated with a higher risk of mortality than first-time CABG. The AWESOME is the first randomized trial comparing CABG with PCI to include post-CABG patients. METHODS Over a five-year period (1995 to 2000), patients at 16 hospitals were screened to identify a cohort of 2,431 individuals who had medically refractory myocardial ischemia and at least one of five high-risk factors. There were 454 patients in the randomized trial, of whom 142 had prior CABG. In the physician-directed registry of 1,650 patients, 719 had prior CABG. Of the 327 patient-choice registry patients, 119 had at least one prior CABG. The CABG and PCI survivals for the three groups were compared using Kaplan-Meier curves and log-rank tests. RESULTS The CABG and PCI three-year survival rates were 73% and 76% respectively for the 142 randomized patients (75 and 67 patients) (log-rank = NS). In the physician-directed registry, 155 patients were assigned to reoperation and 357 to PCI (207 received medical therapy); 36-month survivals were 71% and 77% respectively (log-rank = NS). In the patient-choice registry, 32 patients chose reoperation and 74 chose PCI (13 received medical therapy); 36-month survivals were 65% and 86% respectively (log-rank test p = 0.01). CONCLUSION Percutaneous coronary intervention is preferable to CABG for many post-CABG patients. (C) 2002 by the American College of Cardiology Foundation. C1 Tucson VA Med Ctr, Tucson, AZ USA. Univ Arizona, Tucson, AZ 85724 USA. Hines VA Cooperat Studies, Hines, IL USA. Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Denver, CO 80202 USA. New York VA Med Ctr, New York, NY USA. NYU, New York, NY 10016 USA. RP Morrison, DA (reprint author), So Arizona Vet Affairs Healthcare Syst, 3601 S 6th St, Tucson, AZ 85723 USA. NR 14 TC 60 Z9 63 U1 0 U2 3 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 DEC 4 PY 2002 VL 40 IS 11 BP 1951 EP 1954 AR PII S0735-1097(02)02560-3 DI 10.1016/S0735-1097(02)02560-3 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 621WE UT WOS:000179613400008 PM 12475454 ER PT J AU Luck, J Peabody, JW AF Luck, J Peabody, JW TI When do developing countries adopt managed care policies and technologies? Part II: Infrastructure, techniques, and reform strategies SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID HEALTH SYSTEM REFORM; TRANSITION; BRAZIL; SECTOR; MARKET; CHINA; COSTS AB Objectives: To specify the essential infrastructure elements required to-implement managed care techniques successfully in a developing country, once the necessary macroeconomic preconditions for managed care have been met. Also, to describe how managed care techniques can be integrated into health system reform strategies. Study Design and Methods: Analysis of available developing country health system and healthcare spending data, review of the available literature, and authors' experience evaluating healthcare reform in developing countries. Results: Successful managed care relationships among payers, providers, and patients rely on several essential infrastructure elements: enabling legislation; regulatory mechanisms to administratively, correct health and insurance market failures; enforceable contracts; and formal groups or associations of providers. Once these infrastructure elements are in place, a developing country government can consider implementing 1 or more managed care techniques, including payment strategies, demand-side techniques, and utilization management. Conclusions: Governments in many developing countries can take deliberate steps to accelerate the evolution of certain macroeconomic preconditions-human capital and information systems-and essential infrastructure elements necessary to support managed care techniques. They may then choose to experiment carefully with implementing specific managed care techniques, with consideration given to how the managed care techniques can promote primary care. C1 Univ Calif San Francisco, Sch Med, San Francisco Vet Affairs Med Ctr, Inst Global Hlth, San Francisco, CA 94105 USA. Univ Calif Los Angeles, Sch Publ Hlth, W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA 90407 USA. RP Peabody, JW (reprint author), Univ Calif San Francisco, Sch Med, San Francisco Vet Affairs Med Ctr, Inst Global Hlth, 74 New Montgomery St,Suite 508, San Francisco, CA 94105 USA. NR 43 TC 3 Z9 3 U1 1 U2 2 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 DEC PY 2002 VL 8 IS 12 BP 1093 EP 1103 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 626LE UT WOS:000179873100006 PM 12500885 ER PT J AU Martinez, V Barrachina, MD Ohning, G Tache, Y AF Martinez, V Barrachina, MD Ohning, G Tache, Y TI Cephalic phase of acid secretion involves activation of medullary TRH receptor subtype 1 in rats SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE gastrin; atropine; nitro-L-arginine methyl ester; indomethacin; glycine-gastrin antibody; antisense oligodeoxynucleotides; 2-deoxy-D-glucose; histamine ID THYROTROPIN-RELEASING-HORMONE; DORSAL MOTOR NUCLEUS; CENTRAL-NERVOUS-SYSTEM; GASTRIC-ACID; VAGAL COMPLEX; NUTRITIONAL IMPLICATIONS; INTRACISTERNAL TRH; RESPONSES; VAGUS; STIMULATION AB Mechanisms involved in the cephalic phase of gastric acid secretion were studied in awake fasted rats with chronic gastric fistula and exposed to the sight and smell of chow for 30 min. Acid secretion was monitored using constant intragastric perfusion and automatic titration. Sham feeding induced a peak acid response reaching 82 +/- 7 mumol/10 min within 20 min compared with the average 22 +/- 2 mumol/10 min in controls. The sham-feeding response was abolished by intracisternal pretreatment with the TRH1-receptor antisense oligodeoxynucleotides or subcutaneous injection of atropine, whereas TRH1 mismatch oligodeoxynucleotides had no effect. Serum gastrin was not altered by the sham feeding and increased by refeeding. Gastrin antibody did not block the rise in acid during sham feeding, although the net acid response was reduced by 47% compared with the control group. Glycine-gastrin antibody, indomethacin and nitro-L-arginine methyl ester had no effect. Atropine and gastrin antibody decreased basal acid secretion by 98 and 75%, respectively, whereas all other pretreatments did not. These results indicate that the cholinergic-dependent acid response to sham feeding is mediated by brain medullary TRH1 receptors in rats. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Div Digest Dis, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90073 USA. RP Tache, Y (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Div Digest Dis, CURE Digest Dis Res Ctr, Bldg 115,Rm 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [DK-30110, DK-41301] NR 56 TC 18 Z9 19 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 DEC PY 2002 VL 283 IS 6 BP G1310 EP G1319 DI 10.1152/ajpgi.00222.2002 PG 10 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 615KM UT WOS:000179244400012 PM 12388176 ER PT J AU Nemoto, S Defreitas, G Mann, DL Carabello, BA AF Nemoto, S Defreitas, G Mann, DL Carabello, BA TI Effects of changes in left ventricular contractility on indexes of contractility in mice SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE contractile indexes; echocardiography; catheterization; mouse heart ID PRESSURE-VOLUME RELATION; FORCE-FREQUENCY RELATION; CONDUCTANCE CATHETER; ECHOCARDIOGRAPHY; MODULATION; MOUSE AB Measurement of left ventricular (LV) function is often overlooked in murine studies, which have been used to analyze the effects of genetic manipulation on cardiac phenotype. The goal of this study was to address the effects of changes in LV contractility on indexes of contractility in mice. LV function was assessed in vivo in closed-chest mice by echocardiography and by LV catheterization using a conductance pressure-volume (P-V) catheter with three different interventions that alter contractility by 1) atrial pacing to increase inotropy by augmentation of the force-frequency relation (modest increment of inotropy), 2) dobutamine to maximize inotropy, and 3) esmolol infusion to decrease contractility. Load-independent parameters derived from P-V relations, such as slope of end-systolic P-V relations (ESPVR) and slope of the first maximal pressure derivative over time (dP/dt(max))-end-diastolic volume relation (dP/dt-EDV), and standard echocardiographic parameters were measured. The dP/dt-EDV changed the most among parameters after atrial pacing and dobutamine infusion (percent change, 162.8 +/- 95.9% and 271.0 +/- 44.0%, respectively). ESPVR was the most affected by a decrease in LV contractility during esmolol infusion (percent change, -49.8 +/- 8.3%). However, fractional shortening failed to detect changes in contractility during atrial pacing and esmolol infusion and its percent change was <20%. This study demonstrated that contractile parameters derived from P-V relations change the most during a change in LV contractility and should therefore best detect a small change in contractility in mice. Heart rate has a modest but significant effect on P-V relationship-derived indexes and must be considered in the evaluation of murine cardiac physiology. C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Winters Ctr Heart Failure Res, Houston, TX 77030 USA. RP Nemoto, S (reprint author), 2002 Holcombe Blvd,Bldg 110,Rm 151C, Houston, TX 77030 USA. NR 21 TC 45 Z9 45 U1 1 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD DEC PY 2002 VL 283 IS 6 BP H2504 EP H2510 DI 10.1152/ajpheart.00765.2001 PG 7 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 613XD UT WOS:000179156000043 PM 12427596 ER PT J AU Richardson, RD Omachi, K Kermani, R Woods, SC AF Richardson, RD Omachi, K Kermani, R Woods, SC TI Intraventricular insulin potentiates the anorexic effect of corticotropin releasing hormone in rats SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE food intake; body weight; obesity; satiety ID HYPOTHALAMOPITUITARY-ADRENAL AXIS; MESSENGER-RNA EXPRESSION; CENTRAL-NERVOUS-SYSTEM; Y GENE-EXPRESSION; BODY-WEIGHT GAIN; FA FA RATS; FOOD-INTAKE; ARCUATE NUCLEUS; CEREBROSPINAL-FLUID; LEPTIN RECEPTOR AB Intraventricular corticotropin releasing hormone (CRH) suppresses food intake and body weight as a stress response. Insulin, acting within the brain, also suppresses food intake and body weight, and this suppression is related to caloric homeostasis. We determined if increased insulin within the brain potentiates the anorexic effects of intraventricular CRH. Rats were food deprived for 17 h each day and then given 30-min access to Ensure. One-half received continuous third ventricular infusion of synthetic cerebrospinal fluid via osmotic minipumps, and one-half received insulin (0.6 mU/day). During the infusion, rats also received 0, 0.1, 1.0, or 5.0 mug of CRH into the lateral ventricle just before access to Ensure. Insulin alone had no effect on Ensure intake or body weight. CRH dose dependently reduced Ensure intake in both groups, and the reduction was greater in the insulin group. Hence, central insulin potentiated the ability of centrally administered CRH to suppress food intake. These findings suggest that stress-related influences over food intake, particularly those mediated via CRH, interact with relative adiposity as signaled to the brain by central insulin. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Dent, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Tehran, Tehran, Iran. Univ Cincinnati, Med Ctr, Dept Psychiat, Cincinnati, OH 45267 USA. RP Woods, SC (reprint author), Univ Cincinnati, Med Ctr, Dept Psychiat, Box 670559, Cincinnati, OH 45267 USA. FU NIDDK NIH HHS [DK-17844] NR 78 TC 11 Z9 12 U1 0 U2 0 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 PY 2002 VL 283 IS 6 BP R1321 EP R1326 DI 10.1152/ajpregu.00521.2001 PG 6 WC Physiology SC Physiology GA 614BW UT WOS:000179169300005 PM 12429558 ER PT J AU Senthil, D Choudhury, GG Abboud, HE Sonenberg, N Kasinath, BS AF Senthil, D Choudhury, GG Abboud, HE Sonenberg, N Kasinath, BS TI Regulation of protein synthesis by IGF-I in proximal tubular epithelial cells SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE phosphatidylinositol 3-kinase; mitogen-activated protein kinase; protein translation; eukaryotic initiation factor 4E; eIF4E binding protein ID GROWTH-FACTOR-I; INITIATION-FACTOR EIF-4E; FACTOR 4E-BINDING PROTEIN-1; SMOOTH-MUSCLE CELLS; TRANSLATION INITIATION; PHAS-I; MESSENGER-RNA; RENAL GROWTH; FACTOR 4E; UNINEPHRECTOMIZED RATS AB Protein synthesis is required for renal hypertrophy, and proximal tubular epithelial cells are an important cell type involved in this process. We examined IGF-I regulation of protein synthesis in murine proximal tubular epithelial (MCT) cells. We focused on initial events in protein translation and the signaling events involved. Translation of capped mRNAs is under the control of eukaryotic initiation factor 4E (eIF4E). In the resting cell, eIF4E is normally kept in an inactive state by binding to 4E-BP1, its binding protein. Phosphorylation of 4E-BP1 results in dissociation of the eIF4E-4E-BP1 complex allowing eIF4E to initiate peptide synthesis. IGF-I stimulated protein synthesis, augmented phosphorylation of 4E-BP1 and promoted the dissociation of eIF4E from 4E-BP1. IGF-I stimulated the activities of phosphatidylinositol (PI) 3-kinase, Akt, and ERK1/2-type MAPK in MCT cells. IGF-I-induced phosphorylation of 4E-BP1, dissociation of the 4E-BP1-eIF4E complex, and increase in protein synthesis required activation of both PI 3-kinase and ERK pathways. Furthermore, ERK activation by IGF-I was also PI 3-kinase dependent. Transfection with the Thr(37,46)-->Ala(37,46) mutant of 4E-BP1 showed that phosphorylation of Thr(37,46) residues was required for IGF-I induction of protein synthesis in MCT cells. Our observations reveal the importance of initial events in protein translation in IGF-I-induced protein synthesis in MCT cells and identify the regulatory signaling pathways involved. C1 Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med,S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. McGill Univ, Dept Biochem, Montreal, PQ H3Z 2Z3, Canada. RP Kasinath, BS (reprint author), Univ Texas, Hlth Sci Ctr, Div Nephrol, Dept Med,S Texas Vet Hlth Care Syst, MC 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM kasinath@uthscsa.edu FU NIDDK NIH HHS [DK-55815] NR 54 TC 30 Z9 30 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 2002 VL 283 IS 6 BP F1226 EP F1236 DI 10.1152/ajprenal.00109.2002 PG 11 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 613AA UT WOS:000179106600007 PM 12388420 ER PT J AU Levine, S Nguyen, T Kaiser, LR Shrager, JB AF Levine, S Nguyen, T Kaiser, LR Shrager, JB TI Evaluating respiratory muscle adaptations - A new approach SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Editorial Material ID OBSTRUCTIVE PULMONARY-DISEASE; DIAPHRAGM C1 Univ Penn, Med Ctr, Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Levine, S (reprint author), Univ Penn, Med Ctr, Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NR 9 TC 5 Z9 6 U1 0 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 1 PY 2002 VL 166 IS 11 BP 1418 EP 1419 DI 10.1164/rccm.2209001 PG 2 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 621LT UT WOS:000179590900002 PM 12450930 ER PT J AU Awad, SS Fagan, S Abudayyeh, S Karim, N Berger, DH Ayub, K AF Awad, SS Fagan, S Abudayyeh, S Karim, N Berger, DH Ayub, K TI Preoperative evaluation of hepatic lesions for the staging of hepatocellular and metastatic liver carcinoma using endoscopic ultrasonography SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 54th Annual Meeting of the Southwestern-Surgical-Congress CY APR 07-10, 2002 CL CORONADO, CALIFORNIA SP Southwestern Surg Congress DE endoscopic ultrasonography; hepatocellular cancer; metastatic liver carcinoma; fine needle aspiration; staging ID FINE-NEEDLE ASPIRATION; INTRAOPERATIVE ULTRASONOGRAPHY; COMPUTED-TOMOGRAPHY; COLORECTAL-CANCER; SONOGRAPHY; ULTRASOUND; DIAGNOSIS; ANGIOGRAPHY; ACCURACY; TUMORS AB Background: Noninvasive imaging techniques, such as dynamic computed tomography (CT), magnetic resonance imaging band transabdominal ultrasonography are limited in their ability to detect hepatic lesions less than one cm. Intraoperative ultrasonography (IOUS) is currently the most sensitive modality for the detection of small hepatic lesions. However, IOUS is invasive requiring laparoscopy or formal laparotomy. We sought to evaluate the feasibility of using endoscopic ultrasonograhpy (EUS) for the detection and diagnosis of hepatic masses in patients with hepatocellular cancer (HCCA) and metastatic lesions (ML). We hypothesized that EUS could detect small (< 1.0 cm) hepatic lesions undetectable by CT scan and could be used for biopsy of deep-seated hepatic lesions. Methods: Consecutive patients referred for EUS with suspected liver lesions were evaluated between July 2000 and October 2001. All patients underwent EUS using an Olympus (EM30) radial echoendoscope. If liver lesions were confirmed and fine needle aspiration (FNA) was deemed necessary, a linear array scope was used and an FNA performed with a 22-gauge needle. Two passes were made for each lesion. Results: 14 patients underwent evaluation with dynamic CT scans and EUS. In all 14 patients, EUS. successfully identified hepatic lesions ranging in size from 0.3 cm to 14 cm (right lobe: n = 3, left lobe: n = 1, bilobar: n = 8). Moreover, EUS identified new or additional lesions in 28% (4 of 14) of the patients, all less than 0.5 cm in size (HCCA: n = 2, ML n = 2), influencing the clinical management. In 2 of 14 patients EUS identified liver lesions, previously described as suspicious by CT scan, to be hemangiomas. Nine patients underwent EUS-guided FNA of hepatic lesions (deep seated: n = 3, superficial: n = 6). All FNA passes yielded adequate specimens (malignant: n 8, benign: n = 1). Conclusions: Our preliminary experience suggests that EUS is a feasible preoperative staging tool for liver masses suspected to be HCCA or metastatic lesions. EUS can detect small hepatic lesions previously undetected by dynamic CT scans. Furthermore, EUS-guided FNA can confirm additional HCCA liver lesions or liver metastases, in deep-seated locations, upstaging patients and changing clinical management. (C) 2002 Excerpta Medica Inc. All rights reserved. C1 Houston VAMC, Michael E DeBakey Dept Surg, Surg Serv 112, Houston, TX 77030 USA. Baylor Coll Med, Houston VAMC, Dept Med, Div Gastroenterol, Houston, TX 77030 USA. RP Awad, SS (reprint author), Houston VAMC, Michael E DeBakey Dept Surg, Surg Serv 112, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 17 TC 27 Z9 27 U1 0 U2 1 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 DEC PY 2002 VL 184 IS 6 BP 601 EP 604 AR PII S0002-9610(02)01092-9 DI 10.1016/S0002-9610(02)01092-9 PG 4 WC Surgery SC Surgery GA 626LL UT WOS:000179873800043 PM 12488184 ER PT J AU Arteaga, JR Huerta, S Livingston, EH AF Arteaga, JR Huerta, S Livingston, EH TI Management of gastrojejunal anastomotic leaks after Roux-en-Y gastric bypass SO AMERICAN SURGEON LA English DT Article; Proceedings Paper CT Annual Meeting of the Southern California Chapter of the American-College-of-Surgeons CY JAN 18-20, 2002 CL SANTA BARBARA, CALIFORNIA SP Amer Coll Surgeons, SO Calif Chapter ID VERTICAL BANDED GASTROPLASTY; MORBID-OBESITY; COMPLICATIONS; SURGERY; TRIAL AB Anastomotic leaks after Roux-en-Y gastric bypass (RYGB) potentially result in considerable morbidity and mortality. In the present report we describe our experience with the management of gastrojejunal anastomotic leaks. Tachycardia and fever are considered early signs of anastomotic disruption. Patients weighing less than 350 pounds underwent radiographic testing to diagnose gastrojejunal disruption. Those with severe leaks or patients too large for radiographic evaluation underwent exploratory laparotomy. For severe anastomotic disruptions a retrograde transanastomotic jejunal sump drain was placed. Twenty-four (1.3%) anastomotic leaks occurred in 1789 RYGBs. Five of the leaks were classified as severe and required retrograde sump tube placement. There was one mortality and all of the other patients completely recovered. Aggressive and early intervention for anastomotic disruption after RYGB is necessary to ensure the best possible outcomes for patients with this complication. A high index of suspicion for leaks in postoperative RYGB patients with tachycardia is required if patients are to have good outcomes when complications develop. C1 Univ Calif Los Angeles, Ctr Human Nutr, Los Angeles, CA 90095 USA. VA Greater Los Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA 90095 USA. RP Arteaga, JR (reprint author), Univ Calif Los Angeles, Ctr Human Nutr, 900 Vet Ave,Warren Hall,Room 12-217, Los Angeles, CA 90095 USA. NR 18 TC 22 Z9 22 U1 0 U2 0 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 DEC PY 2002 VL 68 IS 12 BP 1061 EP 1065 PG 5 WC Surgery SC Surgery GA 629WE UT WOS:000180074100007 PM 12516809 ER PT J AU Schwid, HA Rooke, GA Carline, J Steadman, RH Murray, WB Olympio, M Tarver, S Steckner, K Wetstone, S AF Schwid, HA Rooke, GA Carline, J Steadman, RH Murray, WB Olympio, M Tarver, S Steckner, K Wetstone, S CA Anesthesia Simulator Res Consortiu TI Evaluation of anesthesia residents using mannequin-based simulation - A multiinstitutional study SO ANESTHESIOLOGY LA English DT Article; Proceedings Paper CT Annual Spring Meeting of the Society-for-Eduction-in-Anesthesia CY JUN 03, 2001 CL CLEVELAND, OHIO SP Soc Educ Anesthesia ID CRITICAL INCIDENTS; INTERRATER RELIABILITY; PERFORMANCE; VALIDITY; CONSISTENCY; EXPERIENCE AB Background: Anesthesia simulators can generate reproducible, standardized clinical scenarios for instruction and evaluation purposes. Valid and reliable simulated scenarios and grading systems must be developed to use simulation for evaluation of anesthesia residents. Methods: After obtaining Human Subjects approval at each of the 10 participating institutions, 99 anesthesia residents consented to be videotaped during their management of four simulated scenarios on MedSim or METI mannequin-based anesthesia simulators. Using two different grading forms, two evaluators at each department independently reviewed the videotapes of the subjects from their institution to score the residents' performance. A third evaluator, at an outside institution, reviewed the videotape again. Statistical analysis was performed for construct- and criterion-related validity, internal consistency, interrater reliability, and intersimulator reliability. A single evaluator reviewed all videotapes a fourth time to determine the frequency of certain management errors. Results: Even advanced anesthesia residents nearing completion of their training made numerous management errors; however, construct-related validity of mannequin-based simulator assessment was supported by an overall improvement in simulator scores from CB and CA-1 to CA-2 and CA-3 levels of training. Subjects rated the simulator scenarios as realistic (3.47 out of possible 4), further supporting construct-related validity. Criterion-related validity was supported by moderate correlation of simulator scores with departmental faculty evaluations (0.37-0.41, P < 0.01), ABA written in-training scores (0.44-0.49, P < 0.01), and departmental mock oral board scores (0.44-0.47, P < 0.01). Reliability of the simulator assessment was demonstrated by very good internal consistency (alpha = 0.71-0.76) and excellent interrater reliability (correlation = 0.94-0.96; P < 0.01; kappa = 0.81-0.90). There was no significant difference in METI versus MedSim scores for residents in the same year of training. Conclusions: Numerous management errors were identified in this study of anesthesia residents from 10 institutions. Further attention to these problems may benefit residency training since advanced residents continued to make these errors. Evaluation of anesthesia residents using mannequin-based simulators shows promise, adding a new dimension to current assessment methods. Further improvements are necessary in the simulation scenarios and grading criteria before mannequin-based simulation is used for accreditation purposes. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Anesthesiol, Seattle, WA 98195 USA. RP Schwid, HA (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Rooke, Alec/F-8909-2013 NR 17 TC 106 Z9 111 U1 3 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-3022 J9 ANESTHESIOLOGY JI Anesthesiology PD DEC PY 2002 VL 97 IS 6 BP 1434 EP 1444 DI 10.1097/00000542-200212000-00015 PG 11 WC Anesthesiology SC Anesthesiology GA 621LN UT WOS:000179590500014 PM 12459669 ER PT J AU Higuchi, M Manna, SK Sasaki, R Aggarwal, BB AF Higuchi, M Manna, SK Sasaki, R Aggarwal, BB TI Regulation of the activation of nuclear factor kappa B by mitochondrial respiratory function: Evidence for the reactive oxygen species-dependent and -independent pathways SO ANTIOXIDANTS & REDOX SIGNALING LA English DT Article ID TUMOR-NECROSIS-FACTOR; FACTOR-INDUCED APOPTOSIS; TRANSCRIPTION FACTOR; OXIDATIVE STRESS; CONSTITUTIVE ACTIVATION; SUPEROXIDE-DISMUTASE; HYDROGEN-PEROXIDE; NADPH-OXIDASE; CYTOCHROME-C; CELLS AB Mitochondrial respiratory function regulates the redox status of cells, which, in turn, can control the activation of transcription factors. However, how mitochondria accomplish this modulation is not completely understood. Using the human myelogenous leukemia cells ML-1a, respiration-deficient clone 19 derived from ML-1a, and reconstituted clones, we demonstrated the role of respiratory function in the activation of nuclear factor-kappaB (NF-kappaB) and activator protein-1 (AP-1). Constitutive activation of NF-kappaB and AP-1 was observed in clone 19, but not in ML-1a, and the constitutive activation observed in clone 19 was completely inhibited in reconstituted clones that have functional mitochondria. Additionally, tumor necrosis factor (TNF)-induced activation of NF-kappaB and AP-1 observed in ML-1a was greatly reduced in clone 19. These results indicate that mitochondrial respiratory function regulates TNF-induced and constitutive activation of NF-kappaB and AP-1. We investigated the roles of reactive oxygen species in NF-kappaB activation. Generation of superoxide detected by hydroethidine, but not hydrogen peroxide detected by dehydrorhodamine 123, was transiently increased by TNF in both of the cells. The antioxidant, pyrrolidine dithiocarbamate, reduced TNF-induced, but not the constitutive, NF-kappaB activation. These results indicate that the increase in superoxide generation might be involved in TNF-induced, but not in constitutive, NF-kappaB activation. Our results thus demonstrate the involvement of mitochondrial respiratory function in the activation of reactive oxygen species-dependent and -independent pathways for NF-kappaB activation. C1 Baylor Coll Med, Dept Neurol, VA Med Ctr, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Dept Mol Therapeut, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Cytokine Res Lab, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Dept Bioimmunotherapy, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Dept Mol Pathol, Houston, TX 77030 USA. RP Baylor Coll Med, Dept Neurol, VA Med Ctr, Neurol Svc Bldg 100,Room 2B 114,2002 Holcombe Blv, Houston, TX 77030 USA. EM mhiguchi@bcm.tmc.edu RI Aggarwal, Bharat/G-3388-2013 NR 47 TC 19 Z9 20 U1 0 U2 0 PU MARY ANN LIEBERT, INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1523-0864 EI 1557-7716 J9 ANTIOXID REDOX SIGN JI Antioxid. Redox Signal. PD DEC PY 2002 VL 4 IS 6 BP 945 EP 955 DI 10.1089/152308602762197489 PG 11 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 629LX UT WOS:000180052100010 PM 12573143 ER PT J AU Willems, B Lau, G Leung, N Schiff, E Trepo, C Wright, T Watkins, K Woessner, M Brosgart, C Bourne, E Tait, D AF Willems, B Lau, G Leung, N Schiff, E Trepo, C Wright, T Watkins, K Woessner, M Brosgart, C Bourne, E Tait, D TI Safety and efficacy of adding adefovir dipivoxil to lamivudine therapy in compensated chronic hepatitis B patients with YMDD variant HBV and a reduced, response to lamivudine: 52 week results SO ANTIVIRAL THERAPY LA English DT Meeting Abstract CT Workshop on Therapies for Viral Hepatitis CY OCT 29-31, 2002 CL BOSTON, MASSACHUSETTS C1 CHU Montreal, Montreal, PQ, Canada. Queen Mary Hosp, Hong Kong, Hong Kong, Peoples R China. Prince Wales Hosp, Hong Kong, Hong Kong, Peoples R China. Univ Miami, Ctr Liver Dis, Miami, FL 33152 USA. Hop Hotel Dieu, F-69288 Lyon, France. San Francisco VA Med Ctr, San Francisco, CA USA. GlaxoSmithKline, Greenford, Middx, England. GlaxoSmithKline, Res Triangle Pk, NC USA. Gilead Sci Inc, Foster City, CA 94404 USA. NR 0 TC 2 Z9 2 U1 1 U2 1 PU INT MEDICAL PRESS LTD PI LONDON PA 2-4 IDOL LANE, LONDON EC3R 5DD, ENGLAND SN 1359-6535 J9 ANTIVIR THER JI Antivir. Ther. PD DEC PY 2002 VL 7 IS 4 MA 45 BP L111 EP L112 PG 2 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA 662VP UT WOS:000181969800058 ER PT J AU Leonard, S Gault, J Hopkins, J Logel, J Vianzon, R Short, M Drebing, C Berger, R Venn, D Sirota, P Zerbe, G Olincy, A Ross, RG Adler, LE Freedman, R AF Leonard, S Gault, J Hopkins, J Logel, J Vianzon, R Short, M Drebing, C Berger, R Venn, D Sirota, P Zerbe, G Olincy, A Ross, RG Adler, LE Freedman, R TI Association of promoter variants in the alpha 7 nicotinic acetylcholine receptor subunit gene with an inhibitory deficit found in schizophrenia SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID MAJOR SUSCEPTIBILITY LOCUS; P50 SUPPRESSION; LINKAGE ANALYSIS; CHROMOSOME-15 LOCUS; SUGGESTIVE EVIDENCE; RELATIVES; PEDIGREES; FAMILIES; SMOKING; REGION AB Background: The alpha7 neuronal nicotinic acetylcholine receptor subunit gene (CHRNA7) has been implicated as a candidate gene for schizophrenia, and for an auditory sensory processing deficit found in the disease, by both genetic linkage at 15q14 and biochemical data. The expression of CHRNA7 is reduced in several brain regions in schizophrenic subjects compared with control subjects. This study presents DNA sequence analysis of the core promoter region for CHRNA7 in schizophrenic and control subjects. Methods: Single-strand conformation polymorphism analysis and DNA sequencing were used for mutation screening of the core promoter in the CHRNA7 gene. The sample included subjects from 166 schizophrenic families and 165 controls. Controls had no evidence of current or past psychosis and had auditory evoked potentials recorded. Results: Multiple polymorphic patterns were identified in the CHRNA7 core promoter in both schizophrenic and control subjects. Functional analysis of polymorphisms indicated that transcription was reduced. The prevalence of functional promoter variants was statistically greater in schizophrenic subjects than in the controls. Presence of an alpha7 promoter polymorphism in controls was associated with failure to inhibit the P50 auditory evoked potential response. Conclusions: Although linkage disequilibrium with other genetic alterations cannot be excluded, the CHRNA7 core promoter variants, found in this study, may contribute to a common pathophysiologic feature of schizophrenia. C1 Univ Colorado, Hlth Sci Ctr, Dept Psychiat, 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. Denver Vet Affairs Med Ctr, Denver, CO USA. Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel. RP Leonard, S (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Campus Box C-268-71,4200 E 9th Ave, Denver, CO 80262 USA. FU NIDA NIH HHS [DA 09457, DA 12231]; NIMH NIH HHS [MH 38321, MH 42212] NR 71 TC 319 Z9 329 U1 5 U2 12 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 DEC PY 2002 VL 59 IS 12 BP 1085 EP 1096 DI 10.1001/archpsyc.59.12.1085 PG 12 WC Psychiatry SC Psychiatry GA 623NW UT WOS:000179710600002 PM 12470124 ER PT J AU Brody, AL Mandelkern, MA London, ED Childress, AR Lee, GS Bota, RG Ho, ML Saxena, S Baxter, LR Madsen, D Jarvik, ME AF Brody, AL Mandelkern, MA London, ED Childress, AR Lee, GS Bota, RG Ho, ML Saxena, S Baxter, LR Madsen, D Jarvik, ME TI Brain metabolic changes during cigarette craving SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article; Proceedings Paper CT 39th Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 09-14, 2000 CL SAN JUAN, PUERTO RICO SP Amer Coll Neuropsychopharmacol ID POSITRON-EMISSION-TOMOGRAPHY; OBSESSIVE-COMPULSIVE DISORDER; SUSTAINED-RELEASE BUPROPION; ANTERIOR CINGULATE CORTEX; ORBITOFRONTAL CORTEX; FUNCTIONAL-ANATOMY; SMOKING CESSATION; PREFRONTAL CORTEX; NICOTINE PATCH; SOMATOSENSORY AREAS AB Background: In functional brain imaging studies, exposure to cues related to cocaine, opiates, and alcohol in dependent individuals is associated with activation of the anterior cingulate gyrus, amygdala, orbitofrontal cortex, and dorsolateral prefrontal cortex. Craving for these substances positively correlates with activity in the orbitofrontal cortex, dorsolateral prefrontal cortex, and anterior insula. The objective of this study was to determine changes in regional cerebral glucose metabolism and correlations between craving and regional metabolism in heavy cigarette smokers exposed to cigarette-related cues. Methods: Twenty heavy smokers (who smoked greater than or equal to20 cigarettes per day) and 20 nonsmoking control subjects underwent 2 fluorine 18-fluorodeoxyglucose positron emission tomography scans 10 days apart in randomized order: one while watching a videotape that presented cigarette-related cues and handling a cigarette, and the other while watching an educational (nature) videotape and handling a neutral object (pen). Results: From the neutral to the cigarette cue scan, heavy smokers had greater increases than nonsmoking controls in relative glucose metabolism in the perigenual anterior cingulate gyrus spanning the midline. Significant positive correlations were found between intensity of craving and metabolism in the orbitofrontal cortex, dorsolateral prefrontal cortex, and anterior insula bilaterally. An unexpected positive association was found between craving and metabolism in the right sensorimotor cortex. Conclusions: Brain regions associated with arousal, compulsive repetitive behaviors, sensory integration, and episodic memory are activated during exposure to cigarette-related cues and cigarette craving. These regional brain activations and associations with craving are similar to findings with other addictive substances. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Positron Emiss Tomog Ctr, Los Angeles, CA USA. Univ Calif Irvine, Dept Phys, Irvine, CA 92717 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Alabama, Dept Psychiat & Behav Neurobiol, Birmingham, AL 35294 USA. RP Brody, AL (reprint author), Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, 300 UCLA Med Plaza,Suite 2200, Los Angeles, CA 90095 USA. FU NIDA NIH HHS [R01 DA015059] NR 103 TC 264 Z9 274 U1 6 U2 15 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 DEC PY 2002 VL 59 IS 12 BP 1162 EP 1172 DI 10.1001/archpsyc.59.12.1162 PG 11 WC Psychiatry SC Psychiatry GA 623NW UT WOS:000179710600011 PM 12470133 ER PT J AU Boulis, AK Long, J AF Boulis, AK Long, J TI Variation in the treatment of children by primary care physician specialty SO ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE LA English DT Article ID FAMILY PRACTITIONERS; GENERAL INTERNISTS; OTITIS-MEDIA; PEDIATRICIANS; PATTERNS; OUTCOMES; MEDICINE; SERVICES AB Objective: To investigate specialty differences in the treatment of a diverse array of routine childhood problems. Study Design: Analysis of the first round of the Community Tracking Study Physician Survey, a survey designed to assess the effect of corporatization of medicine on physician practice patterns. Participants: A cohort of 1735 pediatricians and 1267 family practitioners interviewed between 1996 and 1997 for round 1 of the Community Tracking Study. Physicians practicing more than 20 hours per week in the United States, whose primary specialty is either general pediatrics or family practice were included. Main Outcome Measure: Physicians' responses to 6 vignettes describing model patients with clinical presentations contrived to have multiple appropriate treatment plans. Results: Relative to general pediatricians, family practitioners are more likely to: (1) recommend desmopressin acetate for primary enuresis (58.9% vs 37.4%); (2) request an office visit for a child with nasal stuffiness, fever, and no other symptoms (69.8% vs 63.3%); (3) recommend a chest x-ray for a child with productive cough, tachypnea, and rales at the right base (51.3% vs 47.7%); (4) refer a 4-year-old child with eczema and seasonal asthma to an allergist (64.3% vs; 59.2%,); and (5) refer a child with recurring suppurative otitis media to an otolaryngologist (49.7% vs; 33.9%). However, family practitioners are significantly less likely than pediatricians to order a sepsis workup on a 6-week-old infant with a temperature of 38.3degreesC (66.4% vs 81.1%). Physician attributes, practice characteristics, referral patterns, and geographical traits explain little of these differences in practice style. Conclusions: On average, there are significant differences between the approaches of pediatricians and family practitioners to the treatment of children, which may relate to the relative experience that each profession has in treating children. C1 Univ Penn, Dept Sociol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Boulis, AK (reprint author), Univ Penn, Dept Sociol, 3718 Locust Walk, Philadelphia, PA 19104 USA. NR 34 TC 9 Z9 11 U1 2 U2 6 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 1072-4710 J9 ARCH PEDIAT ADOL MED JI Arch. Pediatr. Adolesc. Med. PD DEC PY 2002 VL 156 IS 12 BP 1210 EP 1215 PG 6 WC Pediatrics SC Pediatrics GA 622RU UT WOS:000179661400011 PM 12444832 ER PT J AU Doyle, PJ AF Doyle, PJ TI Measuring health outcomes in stroke survivors SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE health status; rehabilitation; stroke ID QUALITY-OF-LIFE; VALIDITY; TRIALS; SCALE AB Stroke frequently results in psychologic distress and activity limitations across multiple domains of functioning. However, most stroke outcome measurement tools and clinical trial endpoints are narrowly focused on neurologic symptom status and physical aspects of functioning, and rarely assess other important components of health. In this article, I discuss the limitations in the measurement of nonfatal stroke outcomes; propose a minimum set of fundamental assessment domains comprising a comprehensive assessment of health status in stroke survivors; and describe the conceptual development of the Burden of Stroke Scale, a comprehensive, patient-reported measure of functioning and well-being for stroke survivors. C1 VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA USA. RP Doyle, PJ (reprint author), VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, 132A-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 36 TC 35 Z9 37 U1 1 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 2002 VL 83 IS 12 SU 2 BP S39 EP S43 DI 10.1053/apmr.2002.36838 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 624CR UT WOS:000179743200006 PM 12474170 ER PT J AU Fu, YC Luo, NL Lopes-Virella, MF Garvey, WT AF Fu, YC Luo, NL Lopes-Virella, MF Garvey, WT TI The adipocyte lipid binding protein (ALBP/aP2) gene facilitates foam cell formation in human THP-1 macrophages SO ATHEROSCLEROSIS LA English DT Article DE lipid binding protein; oxLDL; macrophage; foam cell; atherosclerosis ID LOW-DENSITY-LIPOPROTEIN; FATTY-ACID-BINDING; PPAR-GAMMA; OXIDIZED LDL; SIGNALING PATHWAY; EXPRESSION; ATHEROSCLEROSIS; DIFFERENTIATION; OXIDATION; AP2 AB The critical initiating event in atherogenesis involves the invasion of monocytes through the endothelial wall of arteries, and their transformation from macrophages into foam cells. Human THP-1 monocytic cells can be induced to differentiate into macrophages by phorbol myristate acetate (PMA) treatment, and can then be converted into foam cells by exposure to oxidized low-density lipoprotein (oxLDL). To define genes that are specifically expressed during the transformation of macrophages into foam cells, we have performed a subtractive library screening utilizing mRNA isolated from THP-1 macrophages and foam cells. From this analysis, we have identified adipocyte lipid binding protein (ALBP/aP2) as a gene that is highly upregulated in foam cells in response to oxLDL. Furthermore, overexpression the ALBP gene using an adenovirus construct enhanced the accumulation of cholesterol ester in macrophage foam cells, probably due to an increase in transcription since oxLDL enhanced ALBP promoter activity in experiments using a promoter-luciferase reporter gene construct. The induction of ALBP by oxLDL probably involved activation of peroxisome proliferator-activated receptor gamma (PPARgamma) transcription factors, since four different endogenous PPARgamma ligands, including 9-hydroxyoctadecadienoic acid (9-HODE) and 13-hydroxyoctadecadienoic acid (13-HODE), two oxidized lipid components of oxLDL, as well as 15-deoxy-delta 12,14 prostaglandin J2 (15d-PGJ2) and retinoic acid (RA), all induced ALBP expression in macrophage/foam cells. Finally, ALBP was found to be highly expressed in vivo in macrophage/foam cells of human atherosclerotic plaques. These observations suggest that oxLDL-mediated increase in ALBP gene expression accelerate cholesterol ester accumulation, and that this is an important component of the genetic program regulating conversion of macrophages to foam cells. The observation that ALBP is readily detected in foam cells in active atherosclerotic lesions implicates a role for ALBP in human vascular disease. The induction of ALPB expression by oxLDL likely involves activation of PPARgamma by components of oxLDL (9-HODE and 13-HODE) that also function as PPARgamma ligands. Our results add to the concern that the clinical use of insulin-sensitizing PPARgamma agonists (i.e. thiazolidinediones) to treat Type 2 Diabetes could exacerbate atherosclerosis, and highlight the need for clinical trials that address this issue. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved. C1 Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29403 USA. Ralph H Johnson Vet Adm Med Ctr, Charleston, SC 29401 USA. RP Fu, YC (reprint author), Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, STB-514,114 Doughty St, Charleston, SC 29403 USA. FU NCRR NIH HHS [P20 RR16434]; NHLBI NIH HHS [P01-HL55782]; NIDDK NIH HHS [DK38764] NR 39 TC 96 Z9 110 U1 2 U2 6 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0021-9150 J9 ATHEROSCLEROSIS JI Atherosclerosis PD DEC PY 2002 VL 165 IS 2 BP 259 EP 269 AR PII S0021-9150(02)00305-2 DI 10.1016/S0021-9150(02)00305-2 PG 11 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 617FR UT WOS:000179351700009 PM 12417276 ER PT J AU Deegan, NI Carsten, CJ Dorman, JP Bovio, SG Thomas, CR AF Deegan, NI Carsten, CJ Dorman, JP Bovio, SG Thomas, CR TI Cancer care providers appropriately offer breast conservation therapy (BCT): pilot data from the South Texas Veterans Health Care System (STVHCS). SO BREAST CANCER RESEARCH AND TREATMENT LA English DT Meeting Abstract CT 25th San Antonio Breast Cancer Symposium CY DEC 11-14, 2002 CL SAN ANTONIO, TEXAS C1 S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0167-6806 J9 BREAST CANCER RES TR JI Breast Cancer Res. Treat. PD DEC PY 2002 VL 76 SU 1 MA 456 BP S117 EP S117 PG 1 WC Oncology SC Oncology GA 624QA UT WOS:000179770100352 ER PT J AU McGee, G Spanogle, JP Caplan, AL Penny, D Asch, DA AF McGee, G Spanogle, JP Caplan, AL Penny, D Asch, DA TI Successes and failures of hospital ethics committees: A national survey of ethics committee chairs SO CAMBRIDGE QUARTERLY OF HEALTHCARE ETHICS LA English DT Article ID MAIL SURVEYS; CONSULTATION C1 Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. Columbia Univ, New York, NY USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP McGee, G (reprint author), Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. NR 14 TC 12 Z9 12 U1 1 U2 3 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4221 USA SN 0963-1801 J9 CAMB Q HEALTHC ETHIC JI Camb. Q. Healthc. Ethics PD WIN PY 2002 VL 11 IS 1 BP 87 EP 93 DI 10.1017/S0963180102001147 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Social Sciences, Biomedical SC Health Care Sciences & Services; Biomedical Social Sciences GA 512ZP UT WOS:000173353700012 PM 11868423 ER PT J AU Singleton, PA Bourguignon, LYW AF Singleton, PA Bourguignon, LYW TI CD44v10 interaction with Rho-Kinase (ROK) activates inositol 1,4,5-triphosphate (IP3) receptor-mediated Ca2+ signaling during hyaluronan (HA)-induced endothelial cell migration SO CELL MOTILITY AND THE CYTOSKELETON LA English DT Article DE CD44; Rho-Kinase; IP3 receptors; Ca2+ signaling; hyaluronan; endothelial cell migration ID RECONSTITUTED LIPID VESICLES; ANKYRIN-BINDING DOMAIN; 1,4,5-TRISPHOSPHATE RECEPTOR; PROTEIN-KINASE; TYROSINE KINASES; BREAST-CANCER; TRANSMEMBRANE GLYCOPROTEIN; TRISPHOSPHATE RECEPTOR; ADP-RIBOSYLATION; FOCAL ADHESIONS AB Aortic endothelial cells (GM7372A) express a major cell adhesion molecule, CD44v10, which binds the extracellular matrix component, hyaluronan (HA), at its external domain and interacts with various signaling molecules at its cytoplasmic domain. In this study, we have determined that CD44v10 and Rho-Kinase (ROK) are physically associated as a complex in vivo. Using a recombinant fragment of ROK (in particular, the pleckstrin homology [PH] domain) and in vitro binding assays, we have detected a specific binding interaction between the PH domain of ROK and the cytoplasmic domain of CD44. Scatchard plot analysis indicates that there is a single high-affinity CD44 binding site in the PH domain of ROK with an apparent dissociation constant (Kd) of 1.76 nM, which is comparable to CD44 binding (Kd similar to 1.56 nM) to intact ROK. These findings suggest that the PH domain is the primary ROK binding region for CD44. Furthermore, HA binding to GM7372A cells promotes RhoA-mediated ROK activity, which, in turn, increases phosphorylation of three different inositol 1, 4, 5-trisphosphate receptors (IP(3)Rs) [in particular, subtype 1 (IP(3)R1), and to a lesser extent subtype 2 (IP(3)R2) and subtype 3 (IP(3)R3)] all known as Ip(3)-gated Ca2+ channels. The phosphorylated IP(3)R1 (but not IP(3)R2 or IP(3)R3) is enhanced in its binding to IP3 which subsequently stimulates IP3-mediated Ca2+ flux. Transfection of the endothelial cells with ROK's PH cDNA significantly reduces ROK association with CD44v10, and effectively inhibits ROK-mediated phosphorylation of IP(3)Rs and IP3R-mediated Ca2+ flux in vitro. The PH domain of ROK also functions as a dominant-negative mutant in vivo to block HA-dependent, CD44v10-specific intracellular Ca2+ mobilization and endothelial cell migration. Taken together, we believe that CD44v10 interaction with ROK plays a pivotal role in IP3R-mediated Ca2+ signaling during HA-mediated endothelial cell migration. (C) 2002 Wiley-Liss, Inc. C1 Univ Calif San Francisco, Dept Med, Endocrine Unit 111N, San Francisco VA Med Ctr, San Francisco, CA 94121 USA. RP Bourguignon, LYW (reprint author), Univ Calif San Francisco, Dept Med, Endocrine Unit 111N, San Francisco VA Med Ctr, 4150 Clement St, San Francisco, CA 94121 USA. FU NCI NIH HHS [CA66163, CA78633] NR 85 TC 56 Z9 56 U1 0 U2 6 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0886-1544 J9 CELL MOTIL CYTOSKEL JI Cell Motil. Cytoskeleton PD DEC PY 2002 VL 53 IS 4 BP 293 EP 316 DI 10.1002/cm.10078 PG 24 WC Cell Biology SC Cell Biology GA 616QG UT WOS:000179314000006 PM 12378540 ER PT J AU Swenson, ER Deem, S Kerr, ME Bidani, A AF Swenson, ER Deem, S Kerr, ME Bidani, A TI Inhibition of aquaporin-mediated CO2 diffusion and voltage-gated H+ channels by zinc does not alter rabbit lung CO2 and NO excretion SO CLINICAL SCIENCE LA English DT Article DE aquaporin; carbon dioxide; carbonic anhydrase; gas exchange; lungs; nitric oxide; rabbit; voltage-gated H+ channels ID CARBONIC-ANHYDRASE; WATER CHANNELS; PERMEABILITY; EXCHANGE; TRANSPORT; O2 AB Aquaporins (AQs) increase cell membrane CO2 diffusivity, and it has been proposed that they may serve as transmembrane channels for CO2 and other small gas molecules. In addition, it has been hypothesized that voltage-gated H+ channels located on the apical membrane of the alveolar epithelium contribute to CO2 elimination by the lung. To test whether these membrane proteins contribute to CO2 elimination in vivo, we measured CO2 exchange in buffer- and blood-perfused rabbit lungs before and after addition of 0.5 mM ZnCl2, an inhibitor of both AQ-mediated CO2 diffusion and voltage-gated H+ channels. For comparison, red cell and lung carbonic anhydrases (CAs) were inhibited by 0.1 mM methazolamide. ZnCl2 had no effect on CO2 exchange when inspired CO2 was altered between 2% and 5% in 5-min intervals. Pulmonary vascular and airway resistances were not altered by ZnCl2. In contrast, methazolamide inhibited CO2 exchange by 30% in buffer-perfused lungs and by 65% in blood-perfused lungs. Exhaled NO concentrations were unaffected by ZnCl2 or by CA inhibition. Lung capillary gas exchange modelling shows that under normal resting conditions it would be necessary to reduce the alveolar-capillary membrane CO2 diffusion capacity by > 90% to lower CO2 elimination by 10%. Therefore we conclude that red cell and lung AQs and voltage-gated H+ channels in the alveolar epithelium contribute minimally to normal physiological CO2 elimination. C1 Univ Washington, Dept Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Anesthesiol, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Texas, Hlth Sci Ctr, Div Pulm Crit Care Med & Sleep Med, Houston, TX 77550 USA. RP Swenson, ER (reprint author), Univ Washington, Dept Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. FU NHLBI NIH HHS [HL 03796-01, HL 51421, HL 45571] NR 36 TC 15 Z9 16 U1 0 U2 0 PU PORTLAND PRESS PI LONDON PA 59 PORTLAND PLACE, LONDON W1N 3AJ, ENGLAND SN 0143-5221 J9 CLIN SCI JI Clin. Sci. PD DEC PY 2002 VL 103 IS 6 BP 567 EP 575 PG 9 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 625TW UT WOS:000179832500005 PM 12444909 ER PT J AU Mares, AS Young, AS McGuire, JF Rosenheck, RA AF Mares, AS Young, AS McGuire, JF Rosenheck, RA TI Residential environment and quality of life among seriously mentally ill residents of board and care homes SO COMMUNITY MENTAL HEALTH JOURNAL LA English DT Article; Proceedings Paper CT 5th Conference of the Society-for-Social-Work-and-Research CY JAN, 2001 CL ATLANTA, GEORGIA SP Soc Social Work & Res DE residential environment; board and care; social climate; quality of life ID OF-LIFE; SCHIZOPHRENIA; SYMPTOMS; SCALE AB This study examined the relationship between residential environment of seriously mentally ill patients living in board and care homes and quality of life. Participants included 162 seriously mentally ill veteran patients living in 26 board and care-homes in Los Angeles. Data from structured interviews were used to assess subjective quality of life (satisfaction with living situation and general well-being) and objective quality of life (social functioning and daily activities). Independent variables examined in multivariate analyses included individual socio-demographic and clinical characteristics, objective characteristics of the home, and subjective resident assessments of social climate within the home. Adjusting for individual characteristics, social climate was significantly and positively associated with both satisfaction with current living situation and with general well-being. Interpersonal conflict was negatively associated with general well-being. Number of beds within the home and median income in the neighborhood were significantly associated (positively and negatively, respectively) with social functioning outside the home. Living environment characteristics explained between 3 and 9% of the total variation in three of four quality of life measures, and 27% of the variation in the fourth, satisfaction with living situation. Satisfaction with living sittiation among seriously mentally ill residents of board and care homes may be enhanced by making the social climate more positive, and reducing conflict within the home. Social functioning outside of the home may be enhanced by placing patients into a home with more beds, and/or a home located in a lower income neighborhood. C1 VA CT Healthcare Syst, NE Program, Evaluat Ctr, NEPEC, West Haven, CT 06156 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Heathcare Syst, Los Angeles, CA USA. Yale Univ, Dept Psychiat, New Haven, CT 06520 USA. Yale Univ, Dept Publ Hlth, New Haven, CT 06520 USA. RP Mares, AS (reprint author), VA CT Healthcare Syst, NE Program, Evaluat Ctr, NEPEC, 182,950 Campbell Ave, West Haven, CT 06156 USA. RI Mares, Alvin/I-8186-2012; Young, Alexander/A-1523-2009 OI Young, Alexander/0000-0002-9367-9213 NR 23 TC 15 Z9 15 U1 1 U2 2 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0010-3853 J9 COMMUNITY MENT HLT J JI Community Ment. Health J. PD DEC PY 2002 VL 38 IS 6 BP 447 EP 458 DI 10.1023/A:1020876000860 PG 12 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 618QY UT WOS:000179429800002 PM 12474933 ER PT J AU Walter, RB Li, HY Intano, GW Kazianis, S Walter, CA AF Walter, RB Li, HY Intano, GW Kazianis, S Walter, CA TI Absence of global genomic cytosine methylation pattern erasure during medaka (Oryzias latipes) early embryo development SO COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY B-BIOCHEMISTRY & MOLECULAR BIOLOGY LA English DT Article DE medaka; fish; methylcytosine; genomic DNA; methylation patterns; microinjection; embryogenesis; restriction analyses ID DNA METHYLATION; EXCISION-REPAIR; MOUSE EMBRYO; GENE; DEMETHYLATION; CELLS; 5-METHYLDEOXYCYTIDINE; EXPRESSION; ZEBRAFISH; ISLANDS AB Two techniques were used to analyze global genomic 5-methyl cytosine methylation at CCGG sites of medaka embryo DNA. DNA was labeled by incorporation of microinjected radiolabeled deoxynucleotide into one-cell embryos. After Hpa 11 or Msp I digestion the radiolabeled DNA was fractionated in agarose gels and the distribution of label quantified throughout each sample lane to detect differences in fragment distribution. Alternately isolated DNA was digested with Hpa 11 or Msp I and the resulting generated termini end-labeled. The end-labeled digestion products were then analyzed for fragment distribution after gel fractionation. These techniques proved to be extremely sensitive, allowing comparison of genomic DNA methylation values from as few as 640 fish cells. The data suggest that in medaka embryos the vast majority (> 90%) of genomic DNA is methylated at CCGG sites. Furthermore, these data support the conclusion that the extent of methylation at these sites does not change or changes very little during embryogenesis (from 16 cells to the hatchling). These data argue against active demethylation, or loss of methylation patterns by dilution, during the developmental stages between the one cell zygote and gastrulation. From a comparative viewpoint, these data may indicate that mammals and fishes methylate and demethylate their genomes in very different manners during development. (C) 2002 Elsevier Science Inc. All rights reserved. C1 SW Texas State Univ, Dept Biochem & Chem, San Marcos, TX 78666 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Walter, RB (reprint author), SW Texas State Univ, Dept Biochem & Chem, 419 Centennial Hall,601 Univ Dr, San Marcos, TX 78666 USA. FU NCI NIH HHS [CA75137]; NCRR NIH HHS [RR12253, RR17072]; NIEHS NIH HHS [ES09136] NR 31 TC 13 Z9 13 U1 3 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 1096-4959 J9 COMP BIOCHEM PHYS B JI Comp. Biochem. Physiol. B-Biochem. Mol. Biol. PD DEC PY 2002 VL 133 IS 4 BP 597 EP 607 AR PII S1096-4959(02)00144-6 DI 10.1016/S1096-4959(02)00144-6 PG 11 WC Biochemistry & Molecular Biology; Zoology SC Biochemistry & Molecular Biology; Zoology GA 629BL UT WOS:000180030500014 PM 12470822 ER EF