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Temple University Physicians
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Top 50%

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American College of Surgeons
American Urological Association

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Dr. White is affiliated with 4 hospitals.

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  • Saint Joseph Medical Center
    145 N 6th St, Reading, PA 19601
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    Top 25%
  • Hospital of the University of PA
    3400 Spruce St, Philadelphia, PA 19104
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    Top 25%
  • The Reading Hospital and Medical Center
    Urology
    300 S 6th Ave, Reading, PA 19611
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    Top 25%
  • Reading Hospital & Medical Center
    601 Spruce St, West Reading, PA 19611
  • Publications & Research

    Dr. White has contributed to 102 publications.
    Title Better Fear Conditioning is Associated with Reduced Symptom Severity in Autism Spectrum Disorders.
    Date May 2012
    Journal Autism Research : Official Journal of the International Society for Autism Research
    Excerpt

    Evidence from behavioral and neuroimaging studies suggest that atypical amygdala function plays a critical role in the development of autism spectrum disorders (ASD). The handful of psychophysiological studies examining amygdala function in ASD using classical fear conditioning paradigms have yielded discordant results. We recorded skin conductance response (SCR) during a simple discrimination conditioning task in 30 children and adolescents (ages 8-18) diagnosed with high-functioning ASD and 30 age- and IQ-matched, typically developing controls. SCR response in the ASD group was uniquely and positively associated with social anxiety; and negatively correlated with autism symptom severity, in particular with social functioning. Fear conditioning studies have tremendous potential to aid understanding regarding the amygdale's role in the varied symptom profile of ASD. Our data demonstrate that such studies require careful attention to task-specific factors, including task complexity; and also to contributions of dimensional, within-group factors that contribute to ASD heterogeneity.

    Title Management of the Male Urethra After Cystectomy.
    Date August 2010
    Journal The Urologic Clinics of North America
    Excerpt

    Approximately 70,000 new cases of bladder cancer are diagnosed yearly, of which 52,000 are male patients. In 2009 there were approximately 14,000 deaths attributed to bladder cancer, 10,000 of which were men. Approximately 40% to 45% of all cases are high-grade tumors with half of these being muscle-invasive tumors at the time of diagnosis. With the preponderance of men in this population, there is a need for clear management strategies regarding the retained urethra in those men undergoing radical cystectomy. This article reviews the incidence of urothelial carcinoma in the retained urethra, risk factors for the development of urethral urothelial carcinoma, surveillance strategies, treatment modalities, and outcomes following intervention.

    Title Clinical Outcomes of a Specialised Inpatient Unit for Adults with Mild to Severe Intellectual Disability and Mental Illness.
    Date April 2010
    Journal Journal of Intellectual Disability Research : Jidr
    Excerpt

    Limitations of general psychiatric services have led to the development of specialised psychiatric programmes for patients with intellectual disability (ID) and mental health needs. Few studies have examined treatment outcomes of specialised inpatient units, and no studies have explored how the effects of intervention may differ for individuals at varying levels of cognitive ability. The present study examined clinical outcomes of inpatients with mild ID in contrast to inpatients with moderate to severe ID within the same service.

    Title Prioritizing Blood Flow: Cardiovascular Performance in Response to the Competing Demands of Locomotion and Digestion for the Burmese Python, Python Molurus.
    Date February 2010
    Journal The Journal of Experimental Biology
    Excerpt

    Individually, the metabolic demands of digestion or movement can be fully supported by elevations in cardiovascular performance, but when occurring simultaneously, vascular perfusion may have to be prioritized to either the gut or skeletal muscles. Burmese pythons (Python molurus) experience similar increases in metabolic rate during the digestion of a meal as they do while crawling, hence each would have an equal demand for vascular supply when these two actions are combined. To determine, for the Burmese python, whether blood flow is prioritized when snakes are digesting and moving, we examined changes in cardiac performance and blood flow in response to digestion, movement, and the combination of digestion and movement. We used perivascular blood flow probes to measure blood flow through the left carotid artery, dorsal aorta, superior mesenteric artery and hepatic portal vein, and to calculate cardiac output, heart rate and stroke volume. Fasted pythons while crawling experienced a 2.7- and 3.3-fold increase, respectively, in heart rate and cardiac output, and a 66% decrease in superior mesenteric flow. During the digestion of a rodent meal equaling in mass to 24.7% of the snake's body mass, heart rate and cardiac output increased by 3.3- and 4.4-fold, respectively. Digestion also resulted in respective 11.6- and 14.1-fold increases in superior mesenteric and hepatic portal flow. When crawling while digesting, cardiac output and dorsal aorta flow increased by only 21% and 9%, respectively, a modest increase compared with that when they start to crawl on an empty stomach. Crawling did triggered a significant reduction in blood flow to the digesting gut, decreasing superior mesenteric and hepatic portal flow by 81% and 47%, respectively. When faced with the dual demands of digestion and crawling, Burmese pythons prioritize blood flow, apparently diverting visceral supply to the axial muscles.

    Title Debt Advice: a Missing Dimension.
    Date January 2009
    Journal Mental Health Today (brighton, England)
    Title Integrating Genetics and Genomics to Identify New Leads for the Control of Eimeria Spp.
    Date May 2008
    Journal Parasitology
    Excerpt

    Eimerian parasites display a biologically interesting range of phenotypic variation. In addition to a wide spectrum of drug-resistance phenotypes that are expressed similarly by many other parasites, the Eimeria spp. present some unique phenotypes. For example, unique lines of Eimeria spp. include those selected for growth in the chorioallantoic membrane of the embryonating hens egg or for faster growth (precocious development) in the mature host. The many laboratory-derived egg-adapted or precocious lines also share a phenotype of a marked attenuation of virulence, the basis of which is different as a consequence of the in ovo or in vivo selection procedures used. Of current interest is the fact that some wild-type populations of Eimeria maxima are characterized by an ability to induce protective immunity that is strain-specific. The molecular basis of phenotypes that define Eimeria spp. is now increasingly amenable to investigation, both through technical improvements in genetic linkage studies and the availability of a comprehensive genome sequence for the caecal parasite E. tenella. The most exciting phenotype in the context of vaccination and the development of new vaccines is the trait of strain-specific immunity associated with E. maxima. Recent work in this laboratory has shown that infection of two inbred lines of White Leghorn chickens with the W strain of E. maxima leads to complete protection to challenge with the homologous parasite, but to complete escape of the heterologous H strain, i.e. the W strain induces an exquisitely strain-specific protective immune response with respect to the H strain. This dichotomy of survival in the face of immune-mediated killing has been examined further and, notably, mating between a drug-resistant W strain and a drug-sensitive H strain leads to recombination between the genetic loci responsible for the specificity of protective immunity and resistance to the anticoccidial drug robenidine. Such a finding opens the way forward for genetic mapping of the loci responsible for the induction of protective immunity and integration with the genome sequencing efforts.

    Title Mosquito Pathogenic Viruses--the Last 20 Years.
    Date October 2007
    Journal Journal of the American Mosquito Control Association
    Excerpt

    There are several types of viral pathogens that cause disease in mosquitoes with most belonging to 4 major groups. The most common viruses of mosquitoes are the baculoviruses (NPVs) (Baculoviridae: Nucleopolyhedrovirus) and cytoplasmic polyhedrosis viruses (CPVs) (Reoviridae: Cypovirus). The other major types of viruses in mosquitoes are represented by the densoviruses (DNVs) (Parvoviridae: Brevidensovirus) and the iridoviruses (MIVs) (Iridoviridae: Chloriridovirus). Baculoviruses, densoviruses and iridoviruses are DNA viruses while cypoviruses are the main RNA viruses in mosquitoes. This chapter presents an overview of the recent advancements in the study of mosquito pathogenic viruses and discusses how this new understanding of virus-mosquito interactions can be used to develop novel research and control strategies.

    Title Review of Microsporidia-mosquito Relationships: from the Simple to the Complex.
    Date August 2005
    Journal Folia Parasitologica
    Excerpt

    Microsporidia in mosquitoes can be divided into two categories based on their life cycles and host-parasite relationships. Some species of microsporidia exhibit simple life cycles with one spore type responsible for oral (horizontal) transmission. They affect only one generation of the mosquito and are not usually host or tissue specific. Brachiola algerae and Vavraia culicis are examples of species isolated from mosquitoes with relatively straightforward life cycles (one spore type) and simple host-parasite relationships. B. algerae and a close relative of V. culicis have also been isolated from a vertebrate (human) host but sources for these infections are unknown. In contrast to B. algerae and V. culicis, polymorphic (heterosporous) microsporidia in mosquitoes are characterized by complex life cycles involving multiple spore types responsible for horizontal and vertical transmission. They affect two generations of the mosquito and some involve an obligate intermediate host. These microsporidia are generally very host and tissue specific with complex developmental sequences comprised of unique stages and events. The microsporidium Edhazardia aedis is a pathogen of Aedes aegypti and does not require an intermediate host. The developmental cycle of E. aedis is characterized by four sporulation sequences, two in the parental host and two in the filial generation. Recent speculation relative to the source of B. algerae human infection have implicated infected mosquitoes and raised concerns about the safety of mosquito microsporidia in general. The subject of this review is to compare and contrast three species of microsporidia from mosquitoes, two with broad host ranges (B. algerae and V. culicis) and one specific to mosquitoes (E. aedis). This review describes features that distinguish mosquito-parasitic microsporidia with simple life cycles and broad host ranges from truly mosquito-specific microsporidian parasites with complex life cycles.

    Title A Nucleopolyhedrovirus from Uranotaenia Sapphirina (diptera: Culicidae).
    Date September 2004
    Journal Journal of Invertebrate Pathology
    Excerpt

    In this report we present data on biology, gross pathology, ultrastructure, and host range studies of a naturally occurring nucleopolyhedrovirus from the mosquito Uranotaenia sapphirina (UrsaNPV). Development of this virus was restricted to nuclei of epithelial cells in posterior midgut and distal gastric caecum. Occlusion bodies contained numerous singly enveloped rod-shaped virions. Early occlusion bodies were irregularly shaped and seemed to subsequently coalesce to form larger polyhedra. Mature occlusion bodies had a unique dumbbell shape, and lacked a polyhedron envelope and crystalline structure. Developmental and structural features of UrsaNPV were generally similar to other mosquito NPVs, with major differences in occlusion body shape and size. Transmission tests showed that only members of Uranotaenia (Ur. sapphirina and Ur. lowii) were susceptible to this virus. Transmission was facilitated by magnesium. Field collected Ur. sapphirina larvae had a relatively high rate of dual infections with UrsaNPV and UrsaCPV (cypovirus).

    Title Anesthesiology: Perioperative Medicine or "when the Anesthetic is a Diuretic".
    Date August 2004
    Journal Journal of Clinical Anesthesia
    Excerpt

    Two patients are reported, each with heart failure, who were treated with digoxin (case 1) and furosemide (case 2). Indications for medical treatment of patients with heart failure, the role of various drugs, and exercise therapy, are reviewed. At a time when the population of people over 65 years of age is increasing, it is important for physicians to recognize the symptoms of heart failure and to know the most up-to-date treatment for this disorder. These cases demonstrate the significance of the anesthesiologist as a perioperative physician.

    Title Infectivity and Pathogenicity of a Novel Baculovirus, Cuninpv from Culex Nigripalpus (diptera: Culicidae) for Thirteen Species and Four Genera of Mosquitoes.
    Date January 2004
    Journal Journal of Medical Entomology
    Excerpt

    The infectivity and pathogenicity of newly discovered baculovirus, CuniNPV (family Baculoviridae, genus Nucleopolyhedrovirus) originally isolated from the mosquito Culex nigripalpus Theobald, was evaluated in laboratory bioassys against thirteen species and four genera of mosquitoes native to the northeastern U.S. Purified virus at a dosage rate of 1.6 x 10(7) occlusion bodies/ml with 10 mM Mg2+ added was used in exposures with second through fourth instars at temperatures ranging from 17 to 27 degrees C. High infection rates and accompanying mortality were achieved in Cx. pipiens L. (83.0-14.4%), Cx. pipiens f. molestus (80.4% infection), and Cx. salinarius Coquillett (48.0-43.1%). Cx. restuans Theobald was also susceptible but infection rates were lower (21.3-12.5%). The gross pathology associated with infection was identical to that reported in Cx. nigripalpus. Infected larvae were lethargic and were often suspended at the water surface. Development of CuniNPV was observed in the nuclei of the midgut epitheial cells in the gastric caeca and posterior region of the stomach of host larvae. One hundred percent mortality was observed in all larvae that exhibited gross symptoms of infection within 4-d p.i. Cx. territans Walker (subgenus Neoculex Dyar) was the only Culex mosquito that was not susceptible. No infections were obtained with any species of Aedes [Ae. vexans (Meigen)], Culiseta [Culiseta morsitans (Theobald)] or Ochlerotatus [Ochlerotatus canadensis (Theobald), Oc. cantator (Coquillett), Oc. communis (De Geer), Oc. excrucians (Walker), Oc. japonicus (Theobald), Ochlerotatus stimulans (Walker), and Ochlerotatus triseriatus (Coquillett)]. The host range of CuniNPV appears to be restricted to Culex mosquitoes within the subgenus Culex. An inhibitory effect on transmission of CuniNPV was observed when a liver powder/Brewer's yeast mixture was used as a source of food reinforcing the critical role of Mg2+ and sensitivity of the infection process to the presence other divalent cations (Cu2+, Fe2+, and Zn2+) in the larval medium that interfered with the infection process. The high infectivity and pathogenicity of CuniNPV for the principal vectors of West Nile virus in North America make CuniNPV an attractive candidate for future development as a biopesticide.

    Title Culex Nigripalpus Nucleopolyhedrovirus (cuninpv) Infections in Adult Mosquitoes and Possible Mechanisms for Dispersal.
    Date August 2003
    Journal Journal of Invertebrate Pathology
    Title Immatures of Anopheles Quadrimaculatus S.s. Collected from Atypical Habitats.
    Date May 2003
    Journal Journal of the American Mosquito Control Association
    Excerpt

    Two unusual habitats for the immatures of Anopheles quadrimaculatus s.s. are described: a highly polluted sewage retention pond and an artificial container.

    Title Effect of Intermittent Umbilical Cord Occlusion on Fetal Respiratory Activity and Brain Adenosine in Late-gestation Sheep.
    Date December 2002
    Journal Reproduction, Fertility, and Development
    Excerpt

    It was hypothesized that intermittent umbilical cord occlusion (UCO) would inhibit ovine fetal breathing movements (FBM) in association with increased cerebral adenosine levels. To test this hypothesis, on two successive days during late gestation (133-134 days; term = 146 days), microdialysis samples were collected from the brains of 10 chronically instrumented fetal sheep during 2-h periods of complete UCO induced every 30 min (Day 1: 2-min UCOs; Day 2: 4-min UCOs). Control fetuses (n = 10) underwent no UCO. Tracheal pressure was measured throughout. This regimen resulted in a decrease in fetal arterial PO2 (PaO2) during each UCO to 7.3 +/- 0.8 mmHg (P<0.01; Day 1) and 8.4 +/- 1.1 mmHg (P<0.01; Day 2). Throughout each UCO period, fetal arterial pH (pHa) decreased to 7.28 +/- 0.02 (P<0.01; Day 1) and 7.11 +/- 0.07 (P<0.01; Day 2). The hourly incidence of FBM decreased significantly only on Day 2, from 38.6 +/- 4.1% to 4.1 +/- 1.6% (P<0.01). The frequency of deep isolated inspiratory efforts increased from 4.7 +/- 2.0 h(-1) to 17.6 +/- 6.1 h(-1) (P<0.05; Day 1) and from 2.2 +/- 0.9 h(-1) to 33.6 +/- 4 h(-1) (P<0.01; Day 2). The amplitude of both FBM and deep isolated inspiratory efforts increased during the UCO periods on both days. The concentration of cerebral extracellular fluid (ECF) adenosine during UCO increased by 219 +/- 215% (P<0.05; Day 1) and 172 +/- 107% (P<0.05; Day 2) over the baseline periods. In conclusion, the severity of the inhibitory effect of repeated UCO on FBM depends, in part, on the length of the occlusions. The inhibition of FBM during intermittent UCO may be mediated by the increase in ECF adenosine in the fetal brain. Furthermore, FBM and deep isolated inspiratory efforts appear to be regulated by different mechanisms.

    Title In Vivo and in Vitro Development of the Protist Helicosporidium Sp.
    Date March 2002
    Journal The Journal of Eukaryotic Microbiology
    Excerpt

    We describe the discovery and developmental features of a Helicosporidium sp. isolated from the black fly Simulium jonesi. Morphologically, the helicosporidia are characterized by a distinct cyst stage that encloses three ovoid cells and a single elongate filamentous cell. Bioassays have demonstrated that the cysts of this isolate infect various insect species, including the lepidopterans, Helicoverpa zea, Galleria mellonella, and Manduca sexta, and the dipterans, Musca domestica, Aedes taeniorhynchus, Anopheles albimanus, and An. quadrimaculatus. The cysts attach to the insect peritrophic matrix prior to dehiscence, which releases the filamentous cell and the three ovoid cells. The ovoid cells are short-lived in the insect gut with infection mediated by the penetration of the filamentous cell into the host. Furthermore, these filamentous cells are covered with projections that anchor them to the midgut lining. Unlike most entomopathogenic protozoa, this Helicosporidium sp. can be propagated in simple nutritional media under defined in vitro conditions, providing a system to conduct detailed analysis of the developmental biology of this poorly known taxon. The morphology and development of the in vitro produced cells are similar to that reported for the achorophyllic algae belonging to the genus Prototheca.

    Title Sagittal Sinus Blood Flow in the Ovine Fetus As a Continuous Measure of Cerebral Blood Flow: Relationship to Behavioural State Activity.
    Date February 2002
    Journal Brain Research. Developmental Brain Research
    Excerpt

    Superior sagittal sinus blood flow (Q(ss)) was studied over a 6-h period in nine chronically catheterized fetal sheep as a continuous measure of cerebral blood flow to determine the change in blood flow values and in measures of blood flow variability in relation to behavioural state activity. Mean Q(ss) was increased during the low voltage (LV)/rapid eye movement (REM) state compared to the high voltage (HV)/NREM state by approximately 25%, and was further increased during periods of LV/REM with fetal breathing movements. The increase in Q(ss) was abrupt and began at the transition to LV/REM, with the rate of change 2-fold greater than that during transition to HV/NREM, where the decrease in Q(ss) was gradual and began prior to the evident state change. Q(ss) showed considerable fluctuation, which tended to be greater during the HV/NREM state compared to the LV/REM state when analyzed using measures of longer term variability. Q(ss) thus provides for a continuous measure of cerebral blood flow in the ovine fetus, with the approximately 25% increase with change from the HV/NREM to LV/REM state similar to that previously reported using radioactive microspheres. The abrupt increase in Q(ss) at the transition to LV/REM versus the gradual decrease in Q(ss) before transition to HV/NREM would suggest that the state-related change in brain blood flow is better linked to the presence of the LV electrocorticogram and favours its active generation.

    Title Adaptation of Cardiovascular Responses to Repetitive Umbilical Cord Occlusion in the Late Gestation Ovine Fetus.
    Date December 2001
    Journal The Journal of Physiology
    Excerpt

    1. The impact of repeated umbilical cord occlusion on the normal maturation of fetal heart rate (FHR) and mean arterial pressure (MAP) and the cardiovascular responses to successive umbilical cord occlusion was investigated over a 21 day period in the latter part of gestation. 2. Fifteen chronically instrumented sheep (control group n = 6; occlusion group n = 9) were studied for 21 days (113-133 days of gestation, term = 145 days) with umbilical cord occlusions (90 s duration) performed every 30 min for 1-4 h each day. On days 1, 9 and 18, FHR, FHR variation and MAP were monitored continuously and fetal arterial blood gases, pH and metabolites were measured at predetermined intervals. The baroreflex response to 75-100 microg phenylephrine (I.V.) was tested on days 1 and 18. 3. Basal FHR decreased (DeltaFHR: control, 34.6 +/- 3.6 beats x min(-1); occlusion, 36.9 +/- 2.7 beats x min(-1)) and MAP increased (DeltaMAP: control, 3.1 +/- 1.7 mmHg; occlusion, 5.2 +/- 2.1 mmHg) to a similar extent in control and occlusion groups between days 1 and 21 of the study. There was a small decline in FHR variation over the 21 day study in occlusion, but not control, group fetuses. 4. The magnitude of the fall in FHR decreased and the rise in MAP increased, despite similar changes in blood gases in response to umbilical cord occlusion, over the course of the 21 day study. Despite a significant decline in the ratio of DeltaFHR to DeltaMAP on days 9 and 18 compared to day 1, there was no difference between control and occlusion groups in baroreflex sensitivity. However DeltaFHR/DeltaPO2, an index of chemoreceptor sensitivity, had decreased by day 9 and 18 compared to day 1. 5. The cardiovascular responses to umbilical cord occlusion are altered with repetitive occlusions during the latter part of gestation, with a decrease in DeltaFHR/DeltaMAP, which does not involve changes in baroreflex sensitivity, but may involve changes in chemoreceptor sensitivity. However, repeated umbilical cord occlusion appears to have no impact on baseline cardiovascular control since there was no change in the normal maturational decrease in FHR and rise in MAP.

    Title Effects of Trendelenburg Position and Positive Intrathoracic Pressure on Internal Jugular Vein Cross-sectional Area in Anesthetized Children.
    Date July 2001
    Journal Journal of Clinical Anesthesia
    Excerpt

    STUDY OBJECTIVE: To compare the cross-sectional area (in cm(2)) of the left internal jugular vein (LIJV) and right internal jugular vein (RIJV) in anesthetized children, and measure the response to the Trendelenburg tilt position (TBRG) and a positive inspiratory pressure hold. DESIGN: Prospective, nonrandomized study. SETTING: University medical center. PATIENTS: 45 ASA physical status I and II children, ages 6 months to 8 years, undergoing general anesthesia and mechanical ventilation.Interventions: The cross-sectional area of both internal jugular veins was measured with a 5-MHz, two-dimensional surface transducer, at the level of the cricoid cartilage. Three measurements were obtained: 1) with the patient supine, 2) during a 10-second breath-hold with a positive inspiratory pressure (PIP) of 20 cm H(2)O, and 3) with the patient at 20 degrees TBRG. Data were analyzed with two-way analysis of variance (ANOVA) and Student-Newman-Keuls test, with a p < 0.05 considered significant. MEASUREMENTS AND MAIN RESULTS: In supine patients, the cross-sectional area of the RIJV was larger than the LIJV in 31 patients (69%), and equal or smaller in 14 patients (31%) (0.80 +/- 0.38 vs. 0.59 +/- 0.22; p = 0.002). A PIP hold, but not TBRG, significantly dilated the RIJV (0.8 +/- 0.38 at baseline vs. 0.93 +/- 0.42 with TBRG; p = not significant vs. 1.1 +/- 0.46 with PIP; p < 0.05), whereas neither maneuver was effective with the LIJV. CONCLUSION: The cross-sectional area of the RIJV is often greater than the LIJV; the TBRG was not effective to increase the cross-sectional area of the internal jugular veins, and only a PIP hold increased significantly the cross-sectional area of the RIJV. In this study, the LIJV appeared of smaller size and less compliant compared with the RIJV.

    Title The Molecular Evolution of Terminal Ear1, a Regulatory Gene in the Genus Zea.
    Date December 1999
    Journal Genetics
    Excerpt

    Nucleotide diversity in the terminal ear1 (te1) gene, a regulatory locus hypothesized to be involved in the morphological evolution of maize (Zea mays ssp. mays), was investigated for evidence of past selection. Nucleotide polymorphism in a 1.4-kb region of te1 was analyzed for a sample of 26 sequences isolated from 12 maize lines, five populations of the maize progenitor, Z. mays ssp. parviglumis, six other Zea populations, and two Tripsacum species. Although nucleotide diversity in te1 in maize is reduced relative to ssp. parviglumis, phylogenetic and statistical analyses of the pattern of polymorphism among these sequences provided no evidence of past selection, indicating that the region of the gene studied was probably not involved in maize evolution. The level of reduction in genetic diversity in te1 in maize relative to its progenitor is comparable to that found in previous reports for isozymes and other neutrally evolving maize genes and is consistent with a genome-wide reduction of genetic diversity resulting from a domestication bottleneck. An estimate of the age (1.2-1.4 million yr) of the maize gene pool based on te1 is roughly consistent with previous estimates based on other neutral genes, but may be biased by the apparently slow synonymous substitution rate at te1.

    Title The Adenosine A(1)-receptor Antagonist 8-cpt Reverses Ethanol-induced Inhibition of Fetal Breathing Movements.
    Date November 1999
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    Administration of either ethanol or adenosine inhibits fetal breathing movements (FBM), eye movements, and low-voltage electrocortical activity (LV ECoG). The concentration of adenosine in ovine fetal cerebral extracellular fluid increases during ethanol-induced inhibition of FBM. The purpose of this study was to determine the effect of a selective adenosine A(1)-receptor antagonist, 8-cyclopentyltheophylline (8-CPT) on the incidence of FBM during ethanol exposure. After a 2-h control period, seven pregnant ewes received a 1-h intravenous infusion of ethanol (1 g/kg maternal body wt), followed 1 h later by a 2-h fetal intravenous infusion of either 8-CPT (3.78 +/- 0.08 microg. kg(-1). min(-1)) or vehicle. Ethanol reduced the incidence of FBM from 44.0 +/- 10.4 to 2.7 +/- 1.3% (P < 0.05) and 51.2 +/- 7.6 to 11.9 +/- 5.0% (P < 0.05) in fetuses destined to receive 8-CPT or vehicle, respectively. In the vehicle group, FBM remained suppressed for 7 h. In contrast, during the first hour of 8-CPT infusion, FBM returned to baseline (31 +/- 11%) and was not different from control throughout the rest of the experiment. Ethanol also decreased the incidence of both low-voltage electrocortical activity and eye movements, but there were no differences in the incidences of these behavioral parameters between the 8-CPT and vehicle groups throughout the experiment. These data are consistent with the hypothesis that adenosine, acting via A(1) receptors, may play a role in the mechanism of ethanol-induced inhibition of FBM.

    Title Cardiovascular and Metabolic Responses to Intermittent Umbilical Cord Occlusion in the Preterm Ovine Fetus.
    Date June 1999
    Journal Journal of the Society for Gynecologic Investigation
    Excerpt

    OBJECTIVE: To determine the cardiovascular and metabolic responses to umbilical cord occlusion in the preterm ovine fetus and the impact of repetitive intermittent insults over a 4-day period. METHODS: Repetitive umbilical cord occlusions (experimental group, n = 7; control group, n = 7) were performed daily (112-115 days' gestation, term = 147 days). Mean arterial pressure (MAP), fetal heart rate (FHR), and FHR variation were monitored, and arterial blood was sampled at predetermined intervals. RESULTS: During umbilical cord occlusions, arterial oxygen pressure (PaO2) (approximately 17 mmHg) and glucose (approximately 0.3) millimoles per liter (mmol/L) fell and arterial carbon dioxide pressure (approximately 8 mmHg) rose (P < .01) to a similar extent on days 1 and 4. Umbilical cord occlusion produced a rise in lactate over the course of successive umbilical cord occlusions each day, the magnitude of which tended to be reduced by day 4 (0.3 +/- 0.1 versus 0.6 +/- 0.1 mmol/L). Control hour FHR and MAP were unaltered over the 4 days, but the delta (delta) FHR to delta PaO2 ratio during umbilical cord occlusions was less on day 4 than on day 1 (6.0 +/- 0.4 versus 10.9 +/- 1.5 beats per minute/mmHg; P < .01). During occlusion hours, high FHR variation episodes, as a measure of fetal activity, were reduced (14.6 +/- 1.5 versus 4.2 +/- 1.3 min/h; P < .01), whereas the reduction in short-term (7.4 +/- 0.7 to 5.8 +/- 0.6 milliseconds; P < .05) and long-term (34.9 +/- 2.7 to 30.0 +/- 0.6 milliseconds; P < .05) FHR variation reached significance only on day 4. CONCLUSION: The increase in lactate and reduced high-FHR variation episodes over successive umbilical cord occlusions may affect fetal growth and development. Furthermore, repeated umbilical cord occlusions over several days alter the preterm FHR response to subsequent stresses, suggesting an altered chemoreflex response.

    Title Increased Cerebral Extracellular Adenosine and Decreased Pge2 During Ethanol-induced Inhibition of Fbm.
    Date May 1999
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    Adenosine and PGE2 are neuromodulators, both of which inhibit fetal breathing movements (FBM). Although circulating PGE2 has been implicated as a mediator of ethanol-induced inhibition of FBM in the late-gestation ovine fetus, a role for adenosine has not been examined. The objective of this study was to determine the effect of maternal ethanol infusion on ovine fetal cerebral extracellular fluid adenosine and PGE2 concentrations by using in utero microdialysis and to relate any changes to ethanol-induced inhibition of FBM. Dialysate samples were obtained from the fetal parietal cortex over 70 h after surgery to determine steady-state extracellular fluid adenosine and PGE2 concentrations. On each of postoperative days 3 and 4, after a 2-h baseline period, ewes received a 1-h infusion of ethanol (1 g/kg maternal body wt) or an equivalent volume of saline, and the fetus was monitored for a further 11 h with 30-min dialysate samples collected throughout. Immediately after surgery, dialysate PGE2 and adenosine concentrations were 3.7 +/- 0.7 and 296 +/- 127 nM, respectively. PGE2 did not change over the 70 h, whereas adenosine decreased to 59 +/- 14 nM (P < 0.05) at 4 h and then remained unchanged. Ethanol decreased dialysate PGE2 concentration for 2 h (3.3 +/- 0.3 to 1.9 +/- 0.4 nM; P < 0.05) and increased adenosine concentration for 6 h (87 +/- 13 to a maximum of 252 +/- 59 nM, P < 0.05). Ethanol decreased FBM incidence from 47 +/- 7 to 16 +/- 5% (P < 0.01) for 8 h. Saline infusion did not change dialysate adenosine or PGE2 concentrations or FBM incidence. These data are consistent with the hypothesis that fetal cerebral adenosine, and not PGE2, is the primary mediator of ethanol-induced inhibition of FBM at 123 days of gestation in sheep.

    Title Prostaglandin E2 Inhibition of Fetal Breathing Movements is Not Sustained During Prolonged Reduced Uterine Blood Flow in Sheep.
    Date April 1999
    Journal Canadian Journal of Physiology and Pharmacology
    Excerpt

    Fetal breathing movements (FBM) are inhibited by both exogenous prostaglandin E2 (PGE2) and ethanol in sheep. Maternal ethanol exposure in late-gestation sheep also increases fetal [PGE2]. However, during prolonged reduced uterine blood flow (RUBF) when [PGE2] in fetal plasma is already elevated, FBM are not inhibited by ethanol. These experiments were designed, therefore, to test the hypothesis that the FBM response to PGE2 is also diminished during RUBF. PGE2 (594+/-19 ng.min(-1).kg(-1) fetal body weight) was infused for 6 h into the jugular vein of RUBF (PO2 = 14+/-1 mmHg (1 mmHg = 133.3 Pa); n = 7) and control (PO2 = 22+/-1 mmHg (p < 0.01); n = 7) ovine fetuses, and the effect on FBM, electrocortical (ECoG), and electroocular activities was determined. The infusion of PGE2 increased plasma [PGE2] from 881+/-162 to 1189+/-114 pg.mL(-1) in RUBF fetuses and from 334+/-72 to 616+/-118 pg.mL(-1) (p < 0.05) in control fetuses. FBM were initially inhibited by PGE2 from 22.5+/-9.4 and 17.9+/-6.5% of the time to 6.9+/-2.4 and 0.5+/-0.4% (p < 0.01) in RUBF and control fetuses, respectively. FBM remained inhibited in control fetuses throughout the infusion but returned to baseline incidence in RUBF fetuses in the last 2 h of the infusion. These results are consistent with the hypothesis that one component of the adaptative mechanisms of the fetus to prolonged RUBF is an altered response of FBM to exogenous PGE2. We speculate that the lack of a sustained inhibition in FBM during RUBF with infusion of PGE2 may be a result of an alteration in brainstem receptor function or number or local PGE2 removal.

    Title Altered Fetal Cardiovascular Responses to Prolonged Hypoxia After Sinoaortic Denervation.
    Date March 1999
    Journal The American Journal of Physiology
    Excerpt

    This study examines the role of the peripheral chemoreceptors in mediating fetal cardiovascular responses to prolonged hypoxia secondary to reduced uterine blood flow (RUBF). Fetal sheep were chronically instrumented for continuous heart rate (FHR), blood pressure (FBP), and carotid blood flow (CBF) measurements after bilateral sectioning of the carotid sinus and vagus nerves (denervated, n = 7) or sham denervation (intact, n = 7). Four days postoperatively, uterine blood flow was mechanically restricted, reducing fetal arterial oxygen saturation by 47.3% (P < 0.01). An initial bradycardia was observed in intact (184.0 +/- 10.7 to 160.5 +/- 10.7 beats/min, not significant) but not denervated fetuses, followed by a tachycardia (180.0 +/- 2.2 to 193.7 +/- 2.7 beats/min, P < 0.05). FHR increased in denervated fetuses (175.5 +/- 8.7 to 203. 0 +/- 17.9 beats/min, P < 0.05). FBP increased transiently in intact fetuses from 45.1 +/- 1.0 to 55.4 +/- 3.0 mmHg at 2 h (P < 0.01), whereas denervated fetuses demonstrated a decrease in FBP from 47.1 +/- 4.2 to 37.2 +/- 3.7 mmHg (not significant). CBF increased (P < 0. 05) in both intact and denervated fetuses from 39.3 +/- 2.8 and 29.7 +/- 3.8 ml. min-1. kg-1 to 47.7 +/- 0.4 and 39.1 +/- 0.3 ml. min-1. kg-1, respectively, whereas carotid vascular resistance decreased only in denervated fetuses (1.7 +/- 0.1 to 1.1 +/- 0.02 mmHg. ml-1. min. kg-1, P < 0.05). We conclude that the peripheral chemoreceptors play an important role in mediating fetal cardiovascular responses to prolonged RUBF.

    Title Multivariate Prediction of Skeletal Class Ii Growth.
    Date September 1998
    Journal American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics
    Excerpt

    Prediction of craniofacial growth is one of the keys to successful orthodontic treatment and stability. Despite numerous attempts at growth forecasting, our ability to accurately predict growth is limited. The present study outlines a possible new approach to prediction of craniofacial growth that differs from any previous attempt because of both the methods used and type of patients studied. The purpose of this study is to create and test prediction equations for forecasting favorable or unfavorable patterns of growth in skeletal Class II preadolescents. The subjects for this study include 19 females and 12 males from the Bolton growth center in Cleveland, Ohio. The patients were all untreated orthodontically, had lateral cephalometric headfilms taken biannually from the ages of 6 through 18 and had a Class II skeletal relationship at age 8. Twenty-six skeletal and dental landmarks were identified and digitized, and 48 linear, angular, and proportional measurements were calculated. The subjects were divided into two groups based on anterior-posterior changes in the relationship between the maxilla and mandible. Eleven patients were in the favorable growth group, with an average improvement of 4.13 degrees in the ANB angle; 20 patients were in the unfavorable growth group with an average increase of 0.16 degrees in the ANB angle. The following prediction formula was created with Bayes theorem and assuming a multivariate Gaussian distribution: P(Good¿Fn) = ke (-(0.5)) ¿Fn - mu(ng)¿sigma(g)(-1)¿Fn - mu(ng)¿T. The equation's sensitivity and specificity was calculated from serial cephalometric data from ages 6, 8, 10, and 12. The results obtained with this equation indicate 82.2% sensitivity, 95% specificity with a overall positive predictive value of 91%. This corresponds to 17.8% of patients being incorrectly identified as Poor Growers and only 5% of our patients were incorrectly identified as Good Growers. We conclude that this prediction formula improves the ability to predict favorable or unfavorable patterns of growth in this sample of skeletal Class II preadolescents.

    Title Effect of Partial Release of the Posterior Cruciate Ligament in Total Knee Arthroplasty.
    Date September 1998
    Journal Clinical Orthopaedics and Related Research
    Excerpt

    Appropriate tension of the posterior cruciate ligament, which often is tight in deep flexion, is difficult to achieve after posterior cruciate ligament retaining total knee arthroplasty. Kinematics and maximum flexion after partial release of the posterior cruciate ligament were evaluated in this study. A partial release improved the maximum flexion angle and maintained anteroposterior stability without causing undesirable changes in kinematics, whereas full resection of the posterior cruciate ligament caused unfavorable anteroposterior instability. Partial posterior cruciate ligament release eliminated excessive rollback movement caused by a tight posterior cruciate ligament and also shifted the point of articular surface contact anteriorly. These results indicate that partial release of the posterior cruciate ligament may improve knee function in patients with a tight posterior cruciate ligament after total knee arthroplasty.

    Title Fetal Endocrine Responses to Prolonged Reduced Uterine Blood Flow Are Altered Following Bilateral Sectioning of the Carotid Sinus and Vagus Nerves.
    Date June 1998
    Journal The Journal of Endocrinology
    Excerpt

    The present study examines the effect of carotid sinus/vagosympathetic denervation on fetal endocrine responses to prolonged reduced uterine blood flow (RUBF). Fetal sheep had vascular catheters inserted following bilateral sectioning of the carotid sinus and vagus nerves (denervated, n = 7) or sham denervation (intact, n = 7). Uterine blood flow was mechanically restricted at 126.1 +/- 0.7 days (mean +/- S.E.M.) for 24 h, decreasing arterial oxygen saturation by 47.3 +/- 2.6% (P < 0.01). Fetal plasma samples were obtained at -1, 3, 6, 12 and 24 h for subsequent analyses of arginine vasopressin (AVP), angiotensin II and catecholamines. The AVP response to prolonged RUBF was markedly attenuated in denervated fetuses (15.6 +/- 3.6 to 34.9 +/- 6.0 pg/ml) when compared with intact (10.0 +/- 1.4 to 127.3 +/- 28.4 pg/ml). In contrast, intact fetuses demonstrated no change in plasma angiotensin II concentrations with RUBF whereas denervated fetuses demonstrated a marked increase from 47.5 +/- 18.9 to 128.7 +/- 34.2 pg/ml. The norepinephrine and epinephrine responses to prolonged RUBF were attenuated in denervated fetuses (950.1 +/- 308.9 and 155.8 +/- 58.5 to 1268.3 +/- 474.6 and 290.6 +/- 160.2 pg/ml respectively) when compared with intact (1558.3 +/- 384.4 and 547.3 +/- 304.7 pg/ml to 3289.2 +/- 1219.8 and 896.8 +/- 467.8 pg/ml respectively). These results support a role for the peripheral chemoreceptors in mediating fetal endocrine responses to prolonged RUBF, which may in part lead to the altered cardiovascular responses observed in denervated fetuses under these conditions.

    Title Malpractice Claims. Best Defense is No Offense.
    Date December 1997
    Journal Hospitals & Health Networks / Aha
    Title School Clinics. Schooled in Primary Care.
    Date October 1997
    Journal Hospitals & Health Networks / Aha
    Title Insurance Reform. These Opposites Detract.
    Date September 1997
    Journal Hospitals & Health Networks / Aha
    Title Failure of Magnesium Sulfate Infusion to Inhibit Uterine Activity in Pregnant Sheep.
    Date August 1997
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    OBJECTIVES: Our purpose was to determine the effect of magnesium sulfate infusion on nonlabor uterine contractures and corticotropin-induced preterm uterine contractions in pregnant sheep. STUDY DESIGN: Fetal and maternal vascular catheters and uterine electromyographic electrodes were surgically placed in 15 pregnant sheep between 118 and 125 days' gestation. After 3 to 5 days of recovery, magnesium sulfate was infused into 7 ewes with a 0.11 gm/kg bolus over 20 minutes, followed by 0.08 gm/kg/hr. In 8 animals labor was induced with use of an intrafetal corticotropin infusion, after which 4 ewes received magnesium sulfate and 4 received saline solution. Continuous recordings of uterine electromyographic activity, amniotic pressure, fetal heart rate, blood pressure, and tracheal pressure were made. Maternal and fetal magnesium, calcium, albumin concentrations, and blood gases were determined before and during the infusion. RESULTS: Maternal magnesium concentrations increased from an average of 0.94 +/- 0.03 mmol/L to 2.73 +/- 0.1 mmol/L at the end of the bolus, remaining elevated (2.44 +/- 0.17 mmol/L) for 8 hours. Fetal magnesium concentrations (0.89 +/- 0.03 mmol/L before the bolus) did not change with the maternal infusion. In ewes not in labor, uterine contractures occurred 3.7 +/- 0.7 times per 2 hours before and did not change significantly with the infusion of magnesium sulfate. During corticotropin-induced preterm labor uterine contractions were present 13 +/- 3.2 times per hour before infusions and were unchanged by infusion of magnesium sulfate to the ewes. CONCLUSIONS: Magnesium sulfate infusion in pregnant sheep has no effect on either nonlabor uterine contractures or on corticotropin-induced preterm uterine contractions.

    Title Outreach. Health Care Spoken Here.
    Date July 1997
    Journal Hospitals & Health Networks / Aha
    Title Sarcoidosis in a Pregnant Woman.
    Date May 1997
    Journal Journal of Clinical Anesthesia
    Excerpt

    Sarcoidosis, a rare multisystem disease, often occurs in women of childbearing age. The disease, which may be improved or exacerbated by pregnancy, presents unique considerations to the anesthesiologist. These considerations are illustrated by the case presented here of complicated sarcoidosis in a parturient who underwent cesarean section.

    Title Egg Production by Strelkovimermis Spiculatus (nematoda:mermithidae).
    Date May 1997
    Journal Journal of the American Mosquito Control Association
    Excerpt

    Egg production by the mermithid nematode Strelkovimermis spiculatus, a parasite of mosquitoes, was examined over a period of 34 days. Oviposition did not occur in the absence of males. Egg production was best when males were continuously present (6.4 x 10(3) +/- 0.9 x 10(3) eggs/female). Fewer eggs were produced when males were removed after 7 days (2.8 x 10(3) +/- 0.2 x 10(3) eggs/female) and oviposition partially recovered after males were returned 11 days later (4.4 x 10(3) +/- 0.5 x 10(3) eggs/female). The nematodes deposited substantially more eggs in sand (6.4 x 10(3) +/- 0.9 x 10(3)/female) than in water (1.9 x 10(3) +/- 0.3 x 10(3)/(female).

    Title Fetal Breathing is Not Inhibited by Ethanol Exposure During Prolonged Reduced Uterine Blood Flow.
    Date March 1997
    Journal Canadian Journal of Physiology and Pharmacology
    Excerpt

    When prolonged hypoxemia is induced in fetal sheep by reducing uterine blood flow, fetal breathing movements (FBM) return to normal incidence after their initial decrease. Ethanol also inhibits FBM. These experiments were designed to determine the role of fetal oxygenation status in affecting ethanol-induced inhibition of FBM. A 1-h maternal infusion of 1 g ethanol/kg maternal body weight was given to animals following 20 h of reduced uterine blood flow (RUBF; n = 9), as well as to normoxemic (n = 9) fetal sheep, and the effect on FBM, electrocortical activity (ECoG), and electroocular activity (EOG) was determined. In normoxemic fetuses, the incidence of FBM decreased from 26.1 +/- 5.5% to 2.8 +/- 1.6% (p < 0.05) with ethanol, subsequently returning to baseline values over 6 h, but there was no effect of ethanol on FBM incidence in RUBF fetuses (32.8 +/- 9.1%). Ethanol increased the incidence of intermediate ECoG from 16.6 +/- 2.9% to 49.0 +/- 9.8% (p < 0.01) in normoxemic fetuses, but there was no change in RUBF fetuses. We conclude that the adaptive mechanism(s) invoked by fetal sheep during prolonged RUBF abolishes its ability to respond behaviourally to ethanol.

    Title Intramuscular Atropine Sulfate in Children: Comparison of Injection Sites.
    Date January 1997
    Journal Anesthesia and Analgesia
    Excerpt

    In children undergoing inhaled induction of anesthesia with halothane who suffer bradycardia, submental glossal injection of atropine may result in more rapid onset of vagolysis than traditional intramuscular sites. We compared the intervals between injection and onset of heart rate acceleration (tHR increases) after intramuscular injection of atropine into the deltoid, vastus lateralis, and glossa in children between 1 mo and 10 yr of age scheduled for elective surgery. The tHR increases was determined by measuring the interval between atropine injection and the time point at which the slope of the heart rate curve initially became positive. To ensure that the drug had taken effect before surgical stimulation, heart rate observation was continued until it increased at least 5% above baseline with evidence of continuing acceleration. Anesthesia was induced in all subjects by mask with nitrous oxide and halothane. After tracheal intubation, constant inspired concentrations of the anesthetics were administered for 3 min. While heart rate was monitored, atropine (0.02 mg/kg) was injected into one of the three sites. Each patient's end-tidal anesthetic concentrations were recorded, and minimum alveolar anesthetic concentrations (MAC) were subsequently calculated and adjusted for age. The tHR increases was recorded and averaged for each group. The study groups did not differ by age, weight, end-tidal anesthetic concentrations, age-adjusted MAC, or heart rate at the time atropine was administered. After submental glossal injection (n = 11), tHR increases increase was fastest (3.0 +/- 1.1 min) and was significantly faster than that found with deltoid injection (n = 16; 4.4 +/- 1.1 min) or vastus lateralis injection (n = 8; 6.4 +/- 2.4 min) (P < 0.05 compared with both). The tHR increases also differed significantly between the deltoid and the vastus lateralis (P < 0.05). We conclude that submental glossal injection of atropine results in a more rapid onset of vagolysis than injection at traditional intramuscular sites.

    Title Effect of Prolonged Catecholamine Infusion on Heart Rate, Blood Pressure, Breathing, and Growth in Fetal Sheep.
    Date December 1996
    Journal Canadian Journal of Physiology and Pharmacology
    Excerpt

    Norepinephrine and epinephrine were infused into fetal sheep for 24 h to compare the effects on fetal heart rate, blood pressure, breathing movements, and tissue growth with those of prolonged reductions in uterine blood flow. Norepinephrine concentrations increased (p < 0.01) from 871 +/- 71 to 6831 +/- 1090 pg/mL (2 h) with norepinephrine infusion, and epinephrine concentrations increased from 310 +/- 95 to 1424 +/- 288 pg/mL (2 h) with epinephrine infusion. Fetal pH decreased (p < 0.01) from 7.37 +/- 0.01 to 7.29 +/- 0.02 at 0.5 h of the norepinephrine infusion and returned to control values by 2 h, whereas fetal lactate concentrations increased (p < 0.05) from 1.6 +/- 0.2 to 4.6 +/- 1.0 mmol/L at 2 h and remained elevated for 12 h. Lactate concentrations also increased with epinephrine infusion. Fetal heart rate increased (p < 0.05) from 176 +/- 5 to 246 +/- 6 and 220 +/- 6 beats/min in the 1st h of norepinephrine and epinephrine infusions, respectively, with a subsequent decline. Fetal blood pressure increased (p < 0.05) from 43 +/- 3 and 40 +/- 2 to 53 +/- 3 and 47 +/- 2 mmHg (1 mmHg = 133.3 Pa) during the 1st h of norepinephrine and epinephrine infusions, respectively, remaining elevated for 24 h. Fetal body weights were not different between the groups of animals, although liver/body weight ratio was less (p < 0.05) in epinephrine-infused fetuses (0.030 +/- 0.001) compared with vehicle-infused animals (0.036 +/- 0.002). There was no change in DNA synthesis rate in any of the fetal organs, despite changes in organ-specific DNA and protein content. Our results indicate that the changes in fetal cardiovascular and behavioural function, as well as tissue growth, that occur with prolonged reductions in uterine blood flow are not mediated solely by elevated circulating catecholamine concentrations.

    Title Ltr-retrotransposons and Mites: Important Players in the Evolution of Plant Genomes.
    Date October 1996
    Journal Current Opinion in Genetics & Development
    Excerpt

    Retrotransposons are an abundant and ancient component of plant genomes, yet recent evidence indicates that element activity in many modern plants is restricted to times of stress. Stress activation of plant retrotransposons may be a significant factor in somaclonal variation, in addition to providing an important means to isolate new active elements. Long terminal repeat retrotransposons and a second class of elements we have called miniature inverted-repeat transposable elements (MITEs) have recently been found to be associated with the genes of diverse plants where some contribute regulatory sequences. Because of their sequence diversity and small size, MITEs may be a valuable evolutionary tool for altering patterns of gene expression.

    Title Placental and Fetal Hepatic Growth Are Selectively Inhibited by Prolonged Reductions of Uterine Blood Flow in Pregnant Sheep.
    Date May 1996
    Journal Reproduction, Fertility, and Development
    Excerpt

    Experiments were conducted in eight pregnant sheep to determine the effect on fetal growth of mechanical restriction of uterine blood flow (RUBF) between 120 days and 134 days gestation. Uterine blood flow measured in the middle uterine arteries was 40% less in RUBF animals compared with control animals at the end of the experimental period. There was no change in fetal blood gases, bodyweights, or organ weights between the two groups of animals. The rate of DNA synthesis in the right lobe of the liver was significantly less in RUBF animals (581 +/- 34 dpm micrograms-1 DNA) compared with control animals (845 +/- 44 dpm microgram-1 DNA). There was no difference in the rate of DNA synthesis in the left lobe of the liver or in any of the other organs examined. Autoradiographic examination of the placental cotyledons demonstrated that most DNA synthesis in the placenta was occurring in fetal trophoblastic cells and there was a 40% reduction in the nuclear-labelling index of placental trophoblast cells. These studies show that mild mechanical reductions in uterine blood flow in pregnant sheep results in the selective inhibition of growth in the right lobe of the fetal liver and the placental trophoblastic cells. The mechanism underlying this close association remains to be determined.

    Title Retrotransposons in the Flanking Regions of Normal Plant Genes: a Role for Copia-like Elements in the Evolution of Gene Structure and Expression.
    Date January 1995
    Journal Proceedings of the National Academy of Sciences of the United States of America
    Excerpt

    The wx-K mutation results from the insertion of a copia-like retrotransposon into exon 12 of the maize waxy gene. This retrotransposon, named Hopscotch, has one long open reading frame encoding all of the domains required for transposition. Computer-assisted database searches using Hopscotch and other plant copia-like retroelements as query sequences have revealed that ancient, degenerate retrotransposon insertions are found in close proximity to 21 previously sequenced plant genes. The data suggest that these elements may be involved in gene duplication and the regulation of gene expression. Similar searches using the Drosophila retrotransposon copia did not reveal any retrotransposon-like sequences in the flanking regions of animal genes. These results, together with the recent finding that reverse-transcriptase sequences characteristic of copia-like elements are ubiquitous and diverse in plants, suggest that copia-like retrotransposons are an ancient component of plant genomes.

    Title Transduction of a Cellular Gene by a Plant Retroelement.
    Date June 1994
    Journal Cell
    Title Basis for the Selective Reduction of Pulmonary Vascular Resistance in Humans During Infusion of Adenosine.
    Date June 1994
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    The objective of this study was to demonstrate the basis for the selective reduction of pulmonary vascular resistance by intravenous infusion of adenosine. Secondary objectives of the study were to determine the rate of central infusion of adenosine at which the nucleoside appears in the systemic circulation and to relate this to hemodynamic events. Plasma concentrations of adenosine in the right and left atria were measured during peripheral (5 patients) and central (12 patients) infusions of adenosine in adults with normal pulmonary arterial pressures undergoing coronary artery bypass surgery. The hemodynamic effects of central (right ventricle) infusion of adenosine were also examined. The extraction of adenosine across the pulmonary vascular bed was found to be 73.6 +/- 4.8%. The mean maximal decrease in pulmonary vascular resistance index, 48.8 +/- 9.6%, occurred at an adenosine infusion rate of 30 micrograms.kg-1.min-1, whereas the systemic vascular resistance index remained unchanged. Thus, adenosine, administered centrally in anesthetized patients with normal pulmonary vascular resistances, selectively lower pulmonary vascular resistance. The basis for this selective effect is the substantial extraction of adenosine during passage through the pulmonary vascular bed.

    Title Catecholamines Stimulate the Synthesis and Release of Insulin-like Growth Factor Binding Protein-1 (igfbp-1) by Fetal Sheep Liver in Vivo.
    Date April 1994
    Journal Endocrinology
    Excerpt

    In fetal sheep, prolonged hypoxia (for 24 h) induced by a reduction in maternal uterine artery blood flow, increases insulin-like growth factor binding protein-1 (IGFBP-1) levels and decreases IGFBP-2 levels in the plasma, with corresponding changes in messenger RNA (mRNA) levels in the liver. Since IGFBP-1 synthesis in liver cells in vitro is stimulated by compounds that increase intracellular cAMP concentrations, we hypothesized that the increased IGFBP-1 synthesis during prolonged hypoxemia may be induced by circulating catecholamines, that are released during hypoxia, and that elevate fetal liver cAMP levels. Our aim was to determine the effect of 24-h catecholamine infusions on the synthesis and release of IGFBP-1 and IGFBP-2 in fetal sheep. Vascular catheters were implanted into fetuses at 110-115 days gestation in 14 pregnant ewes. After a 5-day recovery period, fetuses received a 24-h infusion of either norepinephrine (1 micrograms/kg.min, n = 5), epinephrine (0.25 micrograms/kg.min, n = 5), or vehicle (normal saline, n = 4). Fetal carotid arterial samples were collected at specified intervals throughout the infusion for the determination of blood glucose concentrations, plasma catecholamine concentrations by HPLC, insulin, and glucagon concentrations by RIA, and IGFBP levels by Western ligand blotting. After 24 h, the ewe and fetus were killed and selected fetal tissues (liver and kidney) were collected, and analyzed for IGFBP mRNA levels by northern blotting followed by laser densitometric quantification. Plasma catecholamine concentrations were increased in treated fetuses to levels that may be expected in fetuses subjected to prolonged hypoxia. In epinephrine and norepinephrine infused fetuses, blood glucose and plasma glucagon concentrations were increased significantly, whereas plasma insulin concentrations were decreased significantly. Norepinephrine and epinephrine infusions increased IGFBP-1 levels significantly (2- to 5-fold) in fetal plasma within 8-12 h, and the time course pattern of elevation of plasma IGFBP-1 levels was similar to that observed in prolonged hypoxia. After 24 h of either norepinephrine or epinephrine infusion, IGFBP-1 mRNA levels in the liver of fetuses were increased significantly (5- to 7-fold) compared to those of vehicle infused fetuses. IGFBP-2, -3, and -4 levels in fetal plasma were not affected by either infusion, nor were IGFBP-2 mRNA levels in fetal liver and kidney.(ABSTRACT TRUNCATED AT 400 WORDS)

    Title Linking Environmental and Health Care Databases: Assessing the Health Effects of Environmental Pollutants.
    Date July 1993
    Journal International Journal of Bio-medical Computing
    Excerpt

    The assessment of pollutant effects on health status requires the mergence and analysis of two different databases: pollution measurements and health care information. This paper compares two subsets of these data: Ohio Environmental Protection Agency data on ambient air pollutants and Ohio Medicare data on respiratory diseases. Small area analysis was performed to assess statewide variations in hospital admission rates for respiratory diseases. The ambient air pollutant levels for each small area were compared to the variations in respiratory disease rates. Five groups of diseases correlated with pollutant levels. In addition, pollutant levels were significantly associated with medical complications. This study demonstrates the feasibility and benefit of linking environmental and health care databases and suggests the need for a more comprehensive, automated analysis of more pollutants and diseases.

    Title Comparison of Coronary Angiographic Findings in Acute and Chronic First Presentation of Ischemic Heart Disease.
    Date July 1993
    Journal Circulation
    Excerpt

    BACKGROUND. It is generally assumed that the clinical manifestations of ischemic heart disease occur randomly on the same underlying pathological process. Therefore, coronary angiographic findings should be similar whether the first presentation of ischemic heart disease is acute myocardial infarction or uncomplicated chronic stable angina. METHODS AND RESULTS. We studied 102 patients (men < or = 60 years old, women < or = 65 years old) presenting with either acute myocardial infarction as first manifestation of coronary artery disease with a concomitant coronary angiogram (55 patients; mean age, 50.2 years) or stable angina for at least 2 years with no history, ECG, or left ventriculographic evidence of any acute event and with an angiogram performed at least 2 years after initial symptoms (47 patients; mean age at symptom onset, 51.7 years). These angiograms were evaluated blindly for severity (number of vessels diseased, stenoses > or = 50%, occlusions), extent of disease (with an index derived by assigning a score of 0-3 per segment, depending on the proportion of lumen length irregularity and dividing the sum by the number of visualized segments), and pattern (discrete: three or fewer loci of disease never involving more than 50% of the length of any segment or diffuse: anything exceeding this). Patients with unheralded myocardial infarction had fewer vessels diseased, fewer stenoses and occlusion, and a lower extent index than those with uncomplicated stable angina (mean +/- SD of 1.3 +/- 0.8 versus 2.1 +/- 0.8, p < 0.001; 2.1 +/- 1.8 versus 3.9 +/- 1.8, p < 0.001; 0.6 +/- 0.6 versus 1.0 +/- 0.9, p < 0.02; and 0.6 +/- 0.5 versus 1.2 +/- 0.5, p < 0.001, respectively). A discrete pattern was present in 54.5% of patients with unheralded infarction and in only 8.5% of those with uncomplicated angina (p < 0.001). CONCLUSIONS. These very different angiographic findings suggest that unheralded acute myocardial infarction and uncomplicated chronic stable angina do not occur randomly on a common atherosclerotic background but rather that additional factors, such as a varying propensity to thrombosis, may predispose to one or the other of these two clinical syndromes.

    Title Effects of Restricting Uteroplacental Blood Flow on Concentrations of Corticotrophin-releasing Hormone, Adrenocorticotrophin, Cortisol, and Prostaglandin E2 in the Sheep Fetus During Late Pregnancy.
    Date March 1993
    Journal Canadian Journal of Physiology and Pharmacology
    Excerpt

    We have examined the effects of reduced uterine blood flow and prolonged fetal hypoxemia on the temporal relationship between changes in hormones associated with the activity of the pituitary-adrenal axis (corticotrophin-releasing hormone (CRH), adrenocorticotrophin (ACTH), cortisol, and prostaglandin E2 (PGE2) in the ovine fetus at 120-125 days of pregnancy, and we sought evidence for placental secretion of CRH and ACTH during prolonged hypoxemia. Uterine blood flow was reduced by placing an adjustable Teflon clamp around the maternal common internal iliac artery to decrease fetal arterial oxygen saturation from mean values of 59.1 +/- 3.3 to 25.7 +/- 4.6% (+/- SEM, n = 10). There was a transient peak in immunoreactive (IR-) CRH at 1-2 h after reducing uterine blood flow. IR-ACTH rose to peak values at +2 h, then gradually decreased to control level by +12 h. Fetal plasma cortisol and PGE2 concentrations were elevated significantly by +2 and +4 h, respectively, and at 20-24 h. The identity of IR-CRH in fetal plasma and in ovine placental extracts was confirmed by HPLC, but there was no consistent umbilical vein--femoral arterial concentration difference for either IR-CRH or IR-ACTH during normoxemia or hypoxemia. We conclude that a sequence of endocrine changes involving CRH, ACTH, PGE2, and cortisol occurs in the fetus during a prolonged reduction in uterine blood flow. However, we did not obtain evidence, for placental secretion of either CRH or ACTH in response to this manipulation.

    Title Unnecessary Hospitalization of Medicare Patients in Ohio. A Preliminary Profile.
    Date January 1993
    Journal American Journal of Medical Quality : the Official Journal of the American College of Medical Quality
    Excerpt

    Peer review organizations (PRO) review the health care given to Medicare beneficiaries. If a PRO determines that a hospital admission was unnecessary, the hospital is not reimbursed for the medical care and the case is "denied." The average hospital denial rate on Ohio is 2%; however, the denial rate for hospital admissions of one day or less is 7.5%. An analysis of hospitals and diagnoses for one-day hospital admission denials was performed, showing that urban hospitals and disorders of the circulatory and digestive systems predominate. The inappropriate utilization of health care resources costs millions of dollars per year in Ohio and could be costing the nation billions of dollars. There is an urgent need to research why resources are used less effectively by some hospitals and for some diseases.

    Title Health Care Quality Problems in Ohio: Analysis by Diagnosis Related Groups.
    Date January 1993
    Journal Topics in Health Information Management
    Excerpt

    Quality problems occur throughout the health care system, regardless of the disease or diagnosis. Peer review groups and health care organizations can take advantage of this finding to design quality improvement programs that will have a greater impact on health care quality than traditional quality assurance programs. Problems associated with high volume diagnoses or high risk procedures can be analyzed with the understanding that lessons learned in those examinations can be applied to many other aspects of health care. Continuous quality improvement can be implemented, using specific indicators and criteria as models for the overall factors contributing to quality in the health care system. Quality improvement experts estimate that the majority of all quality problems originate in the system, rather than in the performance of individuals. An in-depth analysis of our hospital and health care systems, complementing the performance-based quality assurance programs already in place, will facilitate the comprehensive improvement of quality throughout our health care institutions.

    Title Oxygen Consumption is Maintained in Fetal Sheep During Prolonged Hypoxaemia.
    Date November 1992
    Journal Journal of Developmental Physiology
    Excerpt

    Experiments were conducted in 12 chronically-catheterized pregnant sheep to examine the effect of prolonged hypoxaemia secondary to the restriction of uterine blood flow on fetal oxygen consumption. Surgery was performed at 115 days gestation to place a teflon vascular occluder around the maternal common internal iliac artery and for insertion of vascular catheters. Following a 5-day recovery period, uterine blood flow was reduced in 6 animals for 24 hours and in 6 animals, the occluder was not adjusted. Fetal arterial PO2 decreased from 19.9 +/- 2.0 mmHg to 12.8 +/- 2.0 mmHg and 11.0 +/- 2.0 mmHg at 1 and 24 hours respectively in the experimental group and did not change the control group. Fetal pH decreased from 7.34 +/- 0.01 to 7.25 +/- 0.03 and 7.29 +/- 0.02 at 1 and 24 hours of hypoxaemia respectively. Fetal arterial lactate concentrations remained elevated throughout the experimental period with maximum concentrations of 6.6 +/- 2.1 mmol/l being present at 4 hours compared to 1.3 +/- 0.2 mmol/l during the control period. Umbilical blood flow increased from 186 +/- 19 ml/min/kg to 251 +/- 39 ml/min/kg at 1 h of hypoxaemia and returned to 191 +/- 21 ml/min/kg at 24 h. In association with the progressive fall in oxygen delivery to the fetus, oxygen extraction increased from 0.33 +/- 0.04 to 0.43 +/- 0.04 and 0.54 +/- 0.05 at 1 and 24 hours, respectively. Overall oxygen consumption by the fetus remained unchanged from control values.(ABSTRACT TRUNCATED AT 250 WORDS)

    Title Effect of Acutely-induced Lactic Acidemia on Fetal Breathing Movements, Heart Rate, Blood Pressure, Acth and Cortisol in Sheep.
    Date March 1992
    Journal Journal of Developmental Physiology
    Excerpt

    Experiments were conducted in 8 chronically-catheterized fetal sheep at 125-135 days gestation in order to determine the effect of exogenously administered lactic acid to the fetus on fetal heart rate, blood pressure, breathing movements (FBM), electrocortical activity (ECOG), plasma immunoreactive (IR-ACTH) and cortisol concentrations. When fetal arterial pH decreased from 7.37 +/- 0.01 during the control period to 7.20 +/- 0.01, there was an initial bradycardia followed by tachycardia but no change in blood pressure. The amplitude of FBM increased 2-fold initially in association with an increase in PCO2 from 47.9 +/- 2.1 mmHg to 58.8 +/- 3.6 mmHg at 5 min into the lactate infusion. There was no change in the incidence of FBM or low-voltage ECOG and there was no change in the plasma concentrations of IR-ACTH and cortisol with the infusion of lactate. We conclude that the major effects of acutely elevating circulatory lactate concentrations in fetal sheep are to increase the amplitude of FBM and to cause an initial bradycardia followed by a tachycardia.

    Title Variation at the Apo Ai/ciii/aiv Gene Complex is Associated with Elevated Plasma Levels of Apo Ciii.
    Date August 1991
    Journal Atherosclerosis
    Excerpt

    A number of studies have reported that a variant allele (S2) of the apo AI/CIII/AIV complex is associated with high plasma lipid levels in some populations and furthermore that the frequency of this allele is 2-5-fold higher in patient groups with premature coronary heart disease compared to control groups. This study shows in the healthy "English" population that the S2 allele is associated with elevated plasma apo CIII levels but not with low apo AI levels. In addition, it shows that the allele is associated with elevated plasma levels of apo B in men. Regression analysis shows in both men and women that apo CIII levels are positively correlated with plasma triglyceride levels and moreover that they are a stronger predictor of this parameter than apo AI, B or AIV. Apo CIII levels are also an independent predictor of total plasma cholesterol and HDL-cholesterol levels in males and females, respectively. Together these data suggest that a genetic predisposition to develop elevated plasma levels of apo CIII, alone or in combination with elevated plasma apo AIV levels, is the primary defect responsible for the association of the S2 allele with hyperlipidemia and/or premature CHD.

    Title Sunshine and Skin Cancer: a School-based Skin Cancer Prevention Project.
    Date August 1990
    Journal Journal of Cancer Education : the Official Journal of the American Association for Cancer Education
    Excerpt

    Over 50 percent of the cancers diagnosed in the U.S. are skin cancers. The incidence in Arizona far exceeds the national average for all types of skin cancers, currently having the second highest incidence and prevalence in the world. Results from skin cancer prevention programs elsewhere have suggested that awareness, attitudes, and behavior could be changed by educational efforts with eventual decreases in measurable outcomes such as morbidity and mortality. Sensible sun habits develop early in life. Most health educators agree that the ideal place to begin to teach values regarding health choices is with school-aged children. We have evaluated a primary skin cancer prevention education program in a controlled situation. The target population was chosen in a formal school setting and represented pre-adolescents and early adolescents, who were just beginning to develop "sun-worshipping" tendencies as a part of their increasing preoccupation with appearance. Two unique comprehensive "Sunshine and Skin Cancer" curricula comprised of six units about the sun, its benefits and disadvantages, the skin, cancer and skin cancer, and sun damage prevention were developed. The curricula were very well received by the school system, teachers, children, and the community, and have received local, national, and international attention. This program was shown to significantly change the knowledge and the self-reported behavior (p less than .001) of the children with respect to skin cancer prevention. Steps are being taken to integrate this curriculum into all Arizona middle schools.

    Title Macroglossia Causing Airway Obstruction Following Cleft Palate Repair.
    Date January 1990
    Journal Anesthesiology
    Title Fetal and Maternal Endocrine Responses to Prolonged Reductions in Uterine Blood Flow in Pregnant Sheep.
    Date May 1989
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    To examine the effects of sustained (48-hour) hypoxemia on fetal and maternal adrenocorticotropic hormone concentrations and on maternal progesterone, uterine blood flow was reduced in eight sheep at day 128 of pregnancy by means of an adjustable Teflon clamp placed around the maternal common internal iliac artery. Control measurements were made in four animals in which the vascular clamp was not adjusted. Fetal PaO2 fell from 20.6 +/- 1.1 mm Hg (mean +/- SEM) to 16.6 +/- 0.6 mm Hg within 1 hour after application of the clamp and remained suppressed during 48 hours. There was a transient acidemia at 1 to 2 hours that had corrected by 8 hours. Fetal adrenocorticotropic hormone levels rose from 24 +/- 6 to 1320 +/- 205 pg/ml at 2 hours but decreased by 16 hours. Measured by high-pressure liquid chromatography, more than 95% of immunoreactivity corresponded to adrenocorticotropic hormone1-39. Fetal cortisol levels rose by 6 hours and remained elevated through 48 hours. Maternal adrenocorticotropic hormone, cortisol, and progesterone levels were unchanged during the study period. We conclude that fetal hypoxemia-acidemia after restriction of uterine blood flow provokes fetal adrenocorticotropic hormone release, but the elevation in adrenocorticotropic hormone is not sustained. However, the level of fetal cortisol rises progressively, consistent with fetal adrenal activation.

    Title Behavioral Activity During Prolonged Hypoxemia in Fetal Sheep.
    Date March 1989
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    Experiments were conducted in unanesthetized, chronically catheterized pregnant sheep to determine the fetal behavioral response to prolonged hypoxemia produced by restricting uterine blood flow. Uterine blood flow was reduced by adjusting a vascular occluder placed around the maternal common internal iliac artery to decrease fetal arterial O2 content from 6.1 +/- 0.3 to 4.1 +/- 0.3 ml/dl for 48 h. Associated with the decrease in fetal O2 content, there was a slight increase in fetal arterial PCO2 and decrease in pH, which were both transient. There was an initial inhibition of both fetal breathing movements and eye movements but no change in the pattern of electrocortical activity. After this initial inhibition there was a return to normal incidence of both fetal breathing movements and eye movements by 16 h of the prolonged hypoxemia. These studies indicate that the chronically catheterized sheep fetus is able to adapt behaviorally to a prolonged decrease in arterial O2 content secondary to the restriction of uterine blood flow.

    Title Circulatory Responses to Prolonged Hypoxemia in Fetal Sheep.
    Date January 1989
    Journal American Journal of Obstetrics and Gynecology
    Excerpt

    Experiments were conducted in 11 chronically catheterized pregnant sheep to determine the distribution of blood flow within the fetus during prolonged (48 hours) hypoxemia secondary to the restriction of uterine blood flow. Uterine blood flow was mechanically restricted with a polytetrafluoroethylene vascular clamp placed around the maternal common internal iliac artery such that mean (+/- SEM) fetal arterial oxygen tension decreased from 23.4 +/- 1.9 to 17.3 +/- 0.8 mm Hg at 1 hour of hypoxemia and remained low for 48 hours. There was an initial increase in fetal arterial carbon dioxide pressure from 48.5 +/- 0.9 mm Hg during the control period to 56.2 +/- 2.3 mm Hg at 1 hour; this parameter subsequently returned to control values, whereas base excess showed a transient decrease. Fetal cerebral, myocardial, and adrenal blood flows were significantly increased at 1, 24, and 48 hours of hypoxemia. In contrast, there was no change in nuchal muscle or renal blood flows with hypoxemia of this magnitude. Cotyledonary blood flow increased transiently by 38% at 1 hour of hypoxemia, but was not changed from control at 24 and 48 hours. These experiments demonstrate that the sheep fetus is able to maintain the normal protective circulatory adjustments seen with acute hypoxemia for up to 48 hours in the absence of progressive metabolic acidemia.

    Title Hypoglycemia Associated with Supraventricular Tachycardia in an Infant.
    Date January 1989
    Journal Anesthesiology
    Title Delayed Respiratory Depression After Alfentanil.
    Date November 1988
    Journal Anesthesiology
    Title Hypoglycemia Associated with Supraventricular Tachycardia in an Infant.
    Date October 1988
    Journal Anesthesiology
    Title Yersinia Enterocolitica and Transfusion-induced Septicemia.
    Date May 1988
    Journal Anesthesia and Analgesia
    Title Return Migration to Eastern Kentucky and the Stem Family Concept.
    Date December 1987
    Journal Growth and Change
    Title Sexuality in the Puerperium: a Review.
    Date July 1987
    Journal Archives of Sexual Behavior
    Excerpt

    Pregnancy and the puerperium herald dramatic and complex physiological, psychological, interpersonal, and sexual changes in a woman and in the marital process. Pregnancy tends to have an increasingly negative effect on sexual desire, expression, and satisfaction as term approaches. Clinical variables discussed include anatomic and physiological changes, puerperal sexual response patterns, marital adjustment, body image, dyspareunia related to episiotomy, lactation, and traditional taboos and cautions regarding coitus for the new mother. Most research respondents reported gradual return to prepregnancy levels of sexual desire, enjoyment, and coital frequency, with a minority in most cited studies indicating sexual interest and coitus levels below prepregnancy levels up to 1 year after delivery. The most frequently listed reasons for poor postpartum sexual adjustment include episiotomy discomfort, fatigue, vaginal bleeding or discharge, dyspareunia, insufficient lubrication, fears of awakening the infant or not hearing him/her, fear of injury, and decreased sense of attractiveness. Postpartum counseling should be offered prior to hospital discharge.

    Title One Hundred and Twenty Years of Population Change in Kansas.
    Date June 1986
    Journal Transactions of the Kansas Academy of Science. Kansas Academy of Science
    Title Departmental Structure, Locus of Control, and Job Stress: the Effect of a Moderator.
    Date March 1986
    Journal The Journal of Applied Psychology
    Title The Effects of 6-mercaptopurine Nucleotide Derivatives on the Growth and Survival of 6-mercaptopurine-sensitive and -resistant Cell Culture Lines.
    Date May 1985
    Journal British Journal of Cancer
    Excerpt

    6-Mercaptopurine (MP)-sensitive and -resistant cell culture lines were used to further characterize the apparent ability of MP nucleotide derivatives to overcome resistance to the parent drug. 6-Mercaptopurine-9-beta-D-ribofuranoside 5'-monophosphate [MPRP], bis(6-mercaptopurine-9-beta-D-ribofuranoside)-5', 5"'-monophosphate [bis(MPR)P], bis(O2',O3'-dibutyryl-6-mercaptopurine-9-beta-D-ribofuranoside)-5', 5"'-monophosphate [bis(dibut.MPR)P], and O2',O3'-dibutyryl-6-mercaptopurine-9-beta-D-ribofuranoside 5'-monophosphate [dibut.MPRP] were tested for cytotoxic and/or growth inhibitory effects against MP-resistant sublines of V79 Chinese hamster lung fibroblasts (CH/TG) and L1210 mouse leukaemia cells (L1210/MPR) in which deficiencies of hypoxanthine-guanine phosphoribosyltransferase, and hence drug nucleotide forming capacity were the basis of resistance. L1210/MPR cells were totally resistant to 1 mM 6-mercaptopurine-9-beta-D-ribofuranoside [MPR] and 2 mM MPRP, but were inhibited by high concentrations (greater than 0.25 mM) of bis(MPR)P. These results suggested that bis(MPR)P was taken up by cells as the intact molecule since MPR and MPRP were its extracellular breakdown products. L1210/MPR cells were much more sensitive to the lipophilic bis(dibut.MPR)P derivative which had a predominantly cytotoxic action as judged by trypan blue staining and the ability of treated cells to produce macroscopic colonies in soft agar medium. However, cells killed by bis(dibut.MPR)P did not disintegrate appreciably over periods of up to 10 days. The effects of bis(dibut.MPR)P were probably the result of cellular uptake of the intact molecule. Dibut.MPRP showed minimal ability to inhibit L1210/MPR cells although this compound was a possible breakdown product of bis(dibut.MPR)P and a source of the same extracellular degradation products. The median cell size decreased in L1210/MPR cultures during exposure to both bis(MPR)P and bis(dibut.MPR)P. This effect was elicited more rapidly and at lower concentration by bis(dibut.MPR)P than by bis(MPR)P. In contrast, sodium butyrate, a breakdown product of bis(dibut.MPR)P induced increases in cell size at high concentration. Bis (dibut.MPR)P was also cytotoxic to MP-resistant CH/TG cells and was approximately 300 times more effective than bis(MRP)P and MPR which exhibited similar activity against this cell line. Bis(dibut.MPR)P and dibut.MPRP were equivalent and less active than MPR in their effects on MP-sensitive L1210/0 cells where their predominant mechanism of action was via degradation to release MPR.(ABSTRACT TRUNCATED AT 400 WORDS)

    Title Sexuality in Pregnancy and the Puerperium: a Review.
    Date February 1985
    Journal Obstetrical & Gynecological Survey
    Title Sexuality and Pregnancy: a Review.
    Date February 1983
    Journal Archives of Sexual Behavior
    Excerpt

    Marital success and failure may be related to sexual satisfaction, including orgasmic capability. Pregnancy represents a life crisis to the pregnant woman and her husband. Complex psychosocial and physiological demands may produce insecurities, anxieties, and somatic complaints. The expectant mother may seek to fulfill increasing nurturant needs through increased physical contact such as cuddling or being held. A pregnant woman's interest in sexual activity may be affected by her changing physical appearance and the hormonal milieu of pregnancy. Although there are marked individual variations and methodological biases and differences among empirical studies, pregnancy appears to be usually accompanied by a decrease in sexual desire, coital frequency, and orgasm. Sexual behavior in pregnancy has been traditionally restricted and is currently poorly defined. Sexual proscriptions may precipitate sexual frustration and marital estrangement. Abortion is only rarely caused by coitus. The relationship of coitus and orgasm to prematurity and distress of the fetus and newborn has not been clearly established. Coitus can indirectly result in maternal, fetal, and neonatal morbidity and mortality through the spread of sexually transmitted diseases. Deaths from air embolism in pregnancy associated with cunnilingus and vaginal insufflation have been reported.

    Title Sexuality and Pregnancy. A Prospective Study.
    Date December 1982
    Journal The Journal of Reproductive Medicine
    Excerpt

    The normative changes in various sexual variables in pregnancy remain controversial. Much of the data available have been derived from retrospective and subjective, prospective investigations. The present prospective study indicated decreases in sexual enjoyment, coital frequency and orgasm as pregnancy progressed. A midtrimester increase in sexual desire preceding a progressive decrease was evident. Overall sexual satisfaction was correlated with feeling happy about being pregnant, feeling more attractive in late pregnancy than before pregnancy and experiencing orgasm. Anticipatory guidance and informed counsel regarding sexual changes in pregnancy should be provided to help pregnant patients and their husbands adapt to the pregnancy and enhance their marital bonds.

    Title Mental Map Variability: a Migration Modeling Problem.
    Date March 1982
    Journal The Annals of Regional Science
    Title The Effects of Group Decision-making Process and Problem-situation Complexity on Implementation Attempts.
    Date October 1980
    Journal Administrative Science Quarterly
    Excerpt

    The effects of group problem-solving method and problem-situation complexity on attempts at implementing group solutions were investigated in a laboratory-field setting. Group members were supervisory nurses from various organizations, who were randomly assigned to three groups in a balanced research design which included three group decision-making processes and three levels of problem-situation complexity in implementation. The dependent variable was the number of attempts at implementing group-derived solutions in home organizations. The results showed that structure in group decision-making processes led to increased rates of implementation attempts at all levels of problem-situation complexity. There was a significant complexity-by-process interaction effect among the decision-making processes, which supports the conclusion that the type of group decision-making process and the problem-situation complexity should be considered in order to optimize the number of implementation attempts.g

    Title Nurses' Management Problems and Their Training Implications.
    Date June 1979
    Journal The Personnel Journal
    Title Effect of Halofenate on Binding of Various Drugs to Human Plasma Proteins and on the Plasma Half-life of Antipyrine in Monkeys.
    Date November 1972
    Journal Journal of Pharmaceutical Sciences
    Title Metabolism of a New Hypolipidemic Agent, 2-acetamidoethyl(p-chlorophenyl) (m-trifluoromethylphenoxy)-acetate (halofenate) in the Rat, Dog, Rhesus Monkey and Man.
    Date March 1972
    Journal The Journal of Pharmacology and Experimental Therapeutics
    Title Failure is Not an Option: Risk-taking is Moderated by Anxiety and Also by Cognitive Ability in Children and Adolescents Diagnosed with an Autism Spectrum Disorder.
    Date
    Journal Journal of Autism and Developmental Disorders
    Excerpt

    Understanding hetereogeneity in symptom expression across the autism spectrum disorders (ASD) is a major challenge for identifying causes and effective treatments. In 40 children and adolescents diagnosed with ASD and 37 IQ-and age-matched comparison participants (the TYP group), we found no differences in summary measures on an experimental risk-taking task. However, anxiety and IQ predicted risk-taking only in the ASD group. Risk-taking was correlated with behavioral inhibition in the ASD group and behavioral activation in the TYP group. We suggest that performance on the task was motivated by fear of failure in the ASD group and by sensitivity to reward in the TYP group. Behavioral markers of anxiety and cognitive ability may improve conceptualization of heterogeneity in ASD.

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