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1.
Conserv Biol ; 25(5): 965-74, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21732979

ABSTRACT

The amphibian fungal pathogen Batrachochytrium dendrobatidis (Bd) has received considerable attention due to its role in amphibian population declines worldwide. Although many amphibian species appear to be affected by Bd, there is little information on species-specific differences in susceptibility to this pathogen. We used a comparative experimental approach to examine Bd susceptibility in 6 amphibian species from the United States. We exposed postmetamorphic animals to Bd for 30 days and monitored mortality, feeding rates, and infection levels. In all species tested, Bd-exposed animals had higher rates of mortality than unexposed (control) animals. However, we found differences in mortality rates among species even though the amount of Bd detected on the different species' bodies did not differ. Of the species tested, southern toads (Anaxyrus terrestris) and wood frogs (Lithobates sylvaticus) had the highest rates of Bd-related mortality. Within species, we detected lower levels of Bd on individuals that survived longer and found that the relationship between body size and infection levels differed among species. Our results indicate that, even under identical conditions, amphibian species differ in susceptibility to Bd. This study represents a step toward identifying and understanding species variation in disease susceptibility, which can be used to optimize conservation strategies.


Subject(s)
Anura/microbiology , Chytridiomycota/pathogenicity , Dermatomycoses/veterinary , Disease Susceptibility/veterinary , Analysis of Variance , Animals , Dermatomycoses/mortality , Dermatomycoses/physiopathology , Feeding Behavior/physiology , Host-Pathogen Interactions/physiology , Models, Biological , Species Specificity , Statistics, Nonparametric , United States
2.
Dis Aquat Organ ; 72(2): 163-9, 2006 Oct 17.
Article in English | MEDLINE | ID: mdl-17140139

ABSTRACT

When exploring the possible factors contributing to population declines, it is necessary to consider multiple, interacting environmental stressors. Here, we investigate the impact of 2 factors, ultraviolet radiation and disease, on the survival of anuran amphibians. Exposure to ultraviolet-B (UV-B) radiation increases mortality and results in various sub-lethal effects for many amphibian species. Infectious diseases can also negatively impact amphibian populations. In this study, we exposed metamorphic individuals (metamorphs) to both UV-B and Batrachochytrium dendrobatidis (BD), a fungal pathogen and cause of the disease chytridiomycosis, and monitored survival for 3 wk. We tested for possible interactions between UV-B and BD in 3 species: the Cascades frog Rana cascadae; the Western toad Bufo boreas; and the Pacific treefrog Hyla regilla. We found strong interspecific differences in susceptibility to BD. For example, R. cascadae suffered a large increase in mortality when exposed to BD; B. boreas also experienced mortality, but this effect was small relative to the R. cascadae response. H. regilla did not show any decrease in survival when exposed to either factor. No synergistic interactions between UV-B and BD were found for any of the test species. A previous study investigating the impact of BD on larval amphibians showed different species responses (Blaustein et al. 2005a). Our results highlight the importance of studying multiple life history stages when determining the impact of environmental stressors. The contrast between these 2 studies emphasizes how vulnerability to a pathogen can vary between life history stages within a single species.


Subject(s)
Anura/microbiology , Anura/physiology , Chytridiomycota/pathogenicity , Mycoses/veterinary , Radiation Injuries/veterinary , Ultraviolet Rays/adverse effects , Animals , Mycoses/complications , Mycoses/mortality , Radiation Injuries/complications , Radiation Injuries/mortality , Survival Analysis , Time Factors
3.
Environ Toxicol Chem ; 20(10): 2328-35, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11596767

ABSTRACT

We examined the effects of a forest fertilizer (urea) on newly metamorphosed terrestrial amphibians (Western toads, Bufo boreas; Cascades frogs, Rana cascadae; long-toed salamanders, Ambystoma macrodactylum; and roughskin newts, Taricha granulosa). We examined avoidance behavior of Western toads and Cascades frogs on both paper towel and soil substrates dosed with urea (control and 100 kg N/ha and an additional treatment of 50 kg N/ha for Western toads on soil substrate) and avoidance behavior of long-toed salamanders on soil substrate dosed with urea. We further examined the survival and feeding behavior of all four species exposed to urea on soil substrate (100 kg N/ha) for 5 d. Juvenile Western toads and Cascades frogs avoided paper towels dosed with urea but did not avoid urea-dosed soil substrate. However, Western toads and Cascades frogs both suffered significant mortality when exposed to urea on a soil substrate for 5 d. Furthermore, after adjusting for weight, we found that urea-exposed juvenile Western toads and Cascades frogs consumed significantly fewer prey items (crickets) compared with nonexposed control animals. Long-toed salamanders did not discriminate against soil substrate dosed with urea, and neither long-toed salamanders nor roughskin newts died or reduced prey consumption as a result of urea exposure. Juvenile amphibians may not be able to detect and avoid harmful levels of urea fertilizer on a natural substrate. Furthermore, anthropogenic stressors such as urea fertilizer can significantly reduce the survival and prey consumption of juvenile amphibians. These effects are important to consider in light of possible threats to the conservation status of many amphibian species.


Subject(s)
Amphibians , Avoidance Learning , Behavior, Animal , Soil Pollutants/pharmacology , Urea/pharmacology , Agriculture , Animals , Conservation of Natural Resources , Feeding Behavior , Fertilizers/adverse effects , Larva , Perception , Soil Pollutants/adverse effects , Survival Analysis , Urea/adverse effects
4.
Cancer ; 92(8): 2158-63, 2001 Oct 15.
Article in English | MEDLINE | ID: mdl-11596033

ABSTRACT

BACKGROUND: The authors conducted a Phase II study to evaluate the activity and toxicity of weekly docetaxel in second-line therapy for nonsmall cell lung carcinoma (NSCLC). METHODS: Patients with documented recurrent or refractory NSCLC, previously treated with no more than one chemotherapy regimen, were eligible if they had a performance status (PS) of 0-2, measurable or evaluable disease, and adequate organ function. Patients were treated with docetaxel 36 mg/m(2)/week for 6 consecutive weeks, administered intravenously with dexamethasone premedication. Cycles were repeated every 8 weeks. RESULTS: Thirty-one patients were enrolled. One patient was ineligible because of uncontrolled brain metastases. Hematologic toxicity was minimal. Nonhematologic toxicities were modest except for diarrhea and cumulative fatigue. There were no treatment-related deaths. The overall response rate was 10% (95% confidence interval [CI], 1.6-29%). The median survival time (MST) was 8.0 months. and the 1-year survival rate was 31% (95% CI, 17- 58%). Patients with PS 0-1 had a MST of 11.9 months with 1-year survival of 42%. CONCLUSIONS: Weekly docetaxel is very well tolerated as second-line therapy for NSCLC. The activity of this regimen appears to be comparable to the standard 3-week schedule. This regimen offers new opportunities for combination regimens, both as first- and second-line therapy for NSCLC.


Subject(s)
Antineoplastic Agents, Phytogenic/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Neoplasm Recurrence, Local/drug therapy , Paclitaxel/analogs & derivatives , Paclitaxel/therapeutic use , Taxoids , Aged , Aged, 80 and over , Antineoplastic Agents, Phytogenic/administration & dosage , Docetaxel , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Paclitaxel/administration & dosage , Survival Analysis
5.
J Chem Ecol ; 27(8): 1667-76, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11521404

ABSTRACT

Bullfrogs (Rana catesbeiana), native to eastern North America, were introduced into Oregon in the 1930's. Bullfrogs are highly efficient predators that are known to eat a variety of prey including other amphibians. In laboratory experiments, we investigated whether juvenile Pacific treefrogs (Hyla regilla) recognize adult bullfrogs as a predatory threat. The ability of prey animals to acquire recognition of an introduced predator has important implications for survival of the prey. We found that treefrogs from a population that co-occurred with bullfrogs showed a strong avoidance of chemical cues of bullfrogs. In contrast, treefrogs from a population that did not co-occur with bullfrogs, did not respond to the bullfrog cues. Additional experiments showed that both populations of treefrogs use chemical cues to mediate predation risk. Treefrogs from both populations avoided chemical alarm cues from injured conspecifics.


Subject(s)
Anura , Avoidance Learning , Pheromones/physiology , Predatory Behavior , Animals , Rana catesbeiana , Risk Factors , Smell , Wounds and Injuries/veterinary
6.
Arch Environ Contam Toxicol ; 40(3): 406-9, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11443373

ABSTRACT

Forest fertilization with granular urea is a well-established management practice in many forested regions of the world. We hypothesize that chemical forest fertilizers may be affecting forest-dwelling wildlife. In the laboratory, we studied the effects of fertilization doses of granular urea on three species of forest-dwelling amphibians (Plethodon vehiculum, Rhyacotriton variegatus, and Taricha granulosa). In avoidance experiments, the three species avoided a substrate treated with a dose of 225 kg N/ha urea. In toxicity experiments, we exposed amphibians to urea at doses of 225 kg N/ha and 450 kg N/ha for 4 days. The observed effects increased with time and dose, and there were significant differences in sensitivity among the species. Both treatment levels had an acute effect on survival of P. vehiculum and R. variegatus. At 24 h, mortality at the highest dose was 67% for P. vehiculum, and 47% for R. variegatus. In contrast, there was no mortality for T. granulosa at these concentrations. We suggest that environmental levels of urea could be affecting behavior and survival of some amphibians species in fertilized forests.


Subject(s)
Amphibians/physiology , Fertilizers/toxicity , Urea/toxicity , Animals , Lethal Dose 50 , Population Dynamics , Survival Analysis , Trees
7.
Nature ; 410(6829): 681-4, 2001 Apr 05.
Article in English | MEDLINE | ID: mdl-11287952

ABSTRACT

Amphibian populations have suffered widespread declines and extinctions in recent decades. Although climatic changes, increased exposure to ultraviolet-B (UV-B) radiation and increased prevalence of disease have all been implicated at particular localities, the importance of global environmental change remains unclear. Here we report that pathogen outbreaks in amphibian populations in the western USA are linked to climate-induced changes in UV-B exposure. Using long-term observational data and a field experiment, we examine patterns among interannual variability in precipitation, UV-B exposure and infection by a pathogenic oomycete, Saprolegnia ferax. Our findings indicate that climate-induced reductions in water depth at oviposition sites have caused high mortality of embryos by increasing their exposure to UV-B radiation and, consequently, their vulnerability to infection. Precipitation, and thus water depth/UV-B exposure, is strongly linked to El Niño/Southern Oscillation cycles, underscoring the role of large-scale climatic patterns involving the tropical Pacific. Elevated sea-surface temperatures in this region since the mid-1970s, which have affected the climate over much of the world, could be the precursor for pathogen-mediated amphibian declines in many regions.


Subject(s)
Amphibians/physiology , Amphibians/embryology , Amphibians/microbiology , Animals , Bufonidae/embryology , Bufonidae/physiology , Climate , Embryo, Nonmammalian , Oomycetes/physiology , Population Dynamics , Ultraviolet Rays , United States
8.
J Am Coll Cardiol ; 37(1): 19-25, 2001 Jan.
Article in English | MEDLINE | ID: mdl-11153737

ABSTRACT

OBJECTIVES: We wished to determine the effect of post-infarct management strategy on event rates (death or recurrent nonfatal myocardial infarction [MI]) in patients who evolved non-Q-wave MI (NQMI) following thrombolytic therapy. BACKGROUND: Patients who evolve NQMI following thrombolytic therapy are often considered to be at high risk and are frequently managed with routine early invasive testing despite a lack of data supporting improved outcome. METHODS: The Veterans Affairs Non-Q-Wave Infarction Strategies In-Hospital (VANQWISH) study included 115 patients who evolved NQMI following thrombolytic therapy. We compared the event rates in patients randomized to routine early coronary angiography with those in patients randomized to a conservative strategy of noninvasive functional assessment, with angiography reserved for patients with spontaneous or induced ischemia. RESULTS: During an average follow-up of 23 months, 19 of 58 patients (33%) randomized to the invasive management strategy died or suffered recurrent nonfatal MI, compared with 11 of 57 patients (19%) randomized to the conservative strategy (p = 0.152). Equivalent numbers of patients were subjected to revascularization (percutaneous transluminal coronary angioplasty or coronary artery bypass graft). There were more deaths in the invasive management group than in the conservative management group (11 vs. 2). Excess deaths could not be attributed to periprocedural mortality. CONCLUSIONS: Overall event rates (death or recurrent nonfatal MI) are comparable with conservative and invasive strategies in patients who evolve NQMI following thrombolytic therapy. Mortality rate in patients managed conservatively is low (3.5%), and routine invasive management may be associated with an increased risk of death.


Subject(s)
Coronary Angiography , Electrocardiography , Myocardial Infarction/therapy , Myocardial Revascularization , Thrombolytic Therapy , Aged , Combined Modality Therapy , Female , Hospitals, Veterans , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/mortality , Outcome and Process Assessment, Health Care , Recurrence , Risk Assessment , Survival Analysis
9.
Arch Environ Contam Toxicol ; 39(4): 494-9, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11031310

ABSTRACT

We investigated interactions between low pH, high nitrate level, and ultraviolet-B (UV-B) light on the survival and activity level of larval Cascades frogs (Rana cascadae). We used a fully factorial experimental design, with pH levels of 5 and 7; initial "pulse" nitrate exposure levels of 0, 5, and 20 mg/L; and UV-B present or absent. After a 3-week laboratory exposure, we measured survival and activity level of the larvae. The experiment was repeated two times, in two separate years. Similar effects on survival and activity level were observed in both experiments. R. cascadae survival was not significantly reduced in treatments with individual factors alone (i.e., UV-B control, pH 5 control, or high nitrate level without pH or UV-B). However, in experiments from both years, survival and activity levels of larval R. cascadae were significantly reduced in the treatment with low pH, high nitrate, and UV-B together. In both years, analysis of variance (ANOVA) indicated that pH and nitrate had the greatest effect on survival and that UV-B and nitrate had the greatest effect on activity level. Additional effects were observed in the 1998 experiment on both survival and activity level. In 1998, UV radiation and the interaction term between pH and nitrate (pH x nitrate) had a significant effect on survival. Also in the 1998 experiment, activity level was significantly reduced in treatments at neutral pH with UV, at initial nitrate doses of 5 and 20 mg/L and at neutral pH without UV at an initial nitrate dose of 20 mg/L. We suggest that the adverse effects were due to the multiple stressors acting together.


Subject(s)
Larva/drug effects , Larva/radiation effects , Nitrates/toxicity , Ranidae , Ultraviolet Rays , Animals , Hydrogen-Ion Concentration , Water Pollutants/analysis
10.
Cardiol Clin ; 16(3): 551-72, x, 1998 Aug.
Article in English | MEDLINE | ID: mdl-9742330

ABSTRACT

The tricuspid and mitral valves are homologous whose function depends on coordination among components. Isolated tricuspid valve abnormalities are relatively uncommon. Rheumatic disease, chemicals, immunologic and degenerative disorders alter leaflet anatomy and may result in either stenosis, insufficiency or a combination. More often, tricuspid disorders present as a component of congenital syndromes or secondary to pulmonary vascular or let heart disease which alter geometry and function of nonleaflet components.


Subject(s)
Heart Valve Diseases , Heart Valve Prosthesis Implantation , Tricuspid Valve , Blood Flow Velocity , Diagnosis, Differential , Echocardiography, Doppler , Evaluation Studies as Topic , Heart Valve Diseases/etiology , Heart Valve Diseases/physiopathology , Heart Valve Diseases/surgery , Humans , Treatment Outcome , Tricuspid Valve/diagnostic imaging
11.
N Engl J Med ; 338(25): 1785-92, 1998 Jun 18.
Article in English | MEDLINE | ID: mdl-9632444

ABSTRACT

BACKGROUND: Non-Q-wave myocardial infarction is usually managed according to an "invasive" strategy (i.e., one of routine coronary angiography followed by myocardial revascularization). METHODS: We randomly assigned 920 patients to either "invasive" management (462 patients) or "conservative" management, defined as medical therapy and noninvasive testing, with subsequent invasive management if indicated by the development of spontaneous or inducible ischemia (458 patients), within 72 hours of the onset of a non-Q-wave infarction. Death or nonfatal infarction made up the combined primary end point. RESULTS: During an average follow-up of 23 months, 152 events (80 deaths and 72 nonfatal infarctions) occurred in 138 patients who had been randomly assigned to the invasive strategy, and 139 events (59 deaths and 80 nonfatal infarctions) in 123 patients assigned to the conservative strategy (P=0.35). Patients assigned to the invasive strategy had worse clinical outcomes during the first year of follow-up. The number of patients with one of the components of the primary end point (death or nonfatal myocardial infarction) and the number who died were significantly higher in the invasive-strategy group at hospital discharge (36 vs. 15 patients, P=0.004, for the primary end point; 21 vs. 6, P=0.007, for death), at one month (48 vs. 26, P=0.012; 23 vs. 9, P=0.021), and at one year (111 vs. 85, P=0.05; 58 vs. 36, P= 0.025). Overall mortality during follow-up did not differ significantly between patients assigned to the conservative-strategy group and those assigned to the invasive-strategy group (hazard ratio, 0.72; 95 percent confidence interval, 0.51 to 1.01). CONCLUSIONS: Most patients with non-Q-wave myocardial infarction do not benefit from routine, early invasive management consisting of coronary angiography and revascularization. A conservative, ischemia-guided initial approach is both safe and effective.


Subject(s)
Coronary Angiography , Myocardial Infarction/therapy , Myocardial Revascularization , Angioplasty, Balloon, Coronary , Coronary Artery Bypass , Exercise Test , Female , Humans , Male , Middle Aged , Myocardial Infarction/drug therapy , Myocardial Infarction/mortality , Myocardial Infarction/surgery , Prospective Studies , Radionuclide Ventriculography , Survival Analysis , Thrombolytic Therapy , Treatment Outcome
12.
J Am Coll Cardiol ; 31(2): 312-20, 1998 Feb.
Article in English | MEDLINE | ID: mdl-9462573

ABSTRACT

OBJECTIVES: The Veterans Affairs Non-Q-Wave Infarction Strategies In-Hospital (VANQWISH) trial was designed to compare outcomes of patients with a non-Q wave myocardial infarction (NQMI) who were randomized prospectively to an early "invasive" strategy versus an early "conservative" strategy. The primary objective was to compare early and late outcomes between the two strategies using a combined trial end point (all-cause mortality or nonfatal infarction) during at least 1 year of follow-up. BACKGROUND: Because of the widely held view that survivors of NQMI are at high risk for subsequent cardiac events, management of these patients has become more aggressive during the last decade. There is a paucity of data from controlled trials to support such an approach, however. METHODS: Appropriate patients with a new NQMI were randomized to an early "invasive" strategy (routine coronary angiography followed by myocardial revascularization, if feasible) versus an early "conservative" strategy (noninvasive, predischarge stress testing with planar thallium scintigraphy and radionuclide ventriculography), where the use of coronary angiography and myocardial revascularization was guided by the development of ischemia (clinical course or results of noninvasive tests, or both). RESULTS: A total of 920 patients were randomized (mean follow-up 23 months, range 12 to 44). The mean patient age was 61 +/- 10 years; 97% were male; 38% had ST segment depression at study entry; 30% had an anterior NQMI; 54% were hypertensive; 26% had diabetes requiring insulin; 43% were current smokers; 43% had a previous acute myocardial infarction; and 45% had antecedent angina within 3 weeks of the index NQMI. CONCLUSIONS: Baseline characteristics were compatible with a moderate to high risk group of patients with an NQMI.


Subject(s)
Electrocardiography , Myocardial Infarction/therapy , Angina Pectoris/complications , Cause of Death , Coronary Angiography , Diabetes Mellitus, Type 1/complications , Exercise Test , Feasibility Studies , Female , Follow-Up Studies , Humans , Hypertension/complications , Male , Middle Aged , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/physiopathology , Myocardial Ischemia/physiopathology , Myocardial Ischemia/therapy , Myocardial Revascularization , Prospective Studies , Radionuclide Ventriculography , Radiopharmaceuticals , Recurrence , Risk Factors , Smoking/adverse effects , Survival Rate , Thallium Radioisotopes , Treatment Outcome , United States , United States Department of Veterans Affairs
13.
Geriatrics ; 52(11): 62-3, 67-8, 73-4 passim; quiz 80, 1997 Nov.
Article in English | MEDLINE | ID: mdl-9371105

ABSTRACT

The typical physiologic effects of aging on the musculoskeletal system can be impeded with regular exercise and diet. Common orthopedic problems in sedentary midlife patients are shoulder impingement, low back pain, and plantar fasciitis. Although the responsibility for maintaining an exercise program rests with the individual, the primary care physician can play an important role as coach, cheerleader, and respected advisor. The key is to encourage patients to initiate a program of regular, moderate exercise 30 minutes a day, three times a week, and to eat a balanced, nutritious diet. The best exercise and diet regimen is one that is custom-designed to accommodate the individual patient's needs and objectives.


Subject(s)
Exercise Therapy/methods , Fasciitis/rehabilitation , Heel , Low Back Pain/rehabilitation , Shoulder Impingement Syndrome/rehabilitation , Age Factors , Fasciitis/diagnosis , Fasciitis/etiology , Humans , Low Back Pain/diagnosis , Low Back Pain/etiology , Male , Middle Aged , Nutritional Requirements , Patient Education as Topic , Shoulder Impingement Syndrome/diagnosis , Shoulder Impingement Syndrome/etiology
14.
J Am Coll Cardiol ; 29(5): 985-93, 1997 Apr.
Article in English | MEDLINE | ID: mdl-9120185

ABSTRACT

OBJECTIVES: We sought to evaluate the comparative accuracy of myocardial contrast echocardiography (MCE), quantitative rest-redistribution thallium-201 (Tl-201) tomography and low and high dose (up to 40 microg/kg body weight per min) dobutamine echocardiography (DE) in identifying myocardial hibernation. BACKGROUND: Myocardial contrast echocardiography can assess myocardial perfusion and may therefore be useful in predicting myocardial hibernation. However, its accuracy in comparison to myocardial perfusion scintigraphy and to that of high dose DE remains to be investigated. METHODS: Eighteen patients (aged [+/- SD] 57 +/- 10 years) with stable coronary artery disease and ventricular dysfunction underwent the above three modalities before coronary revascularization. Myocardial contrast echocardiography was achieved with intracoronary Albunex. Rest echocardiographic and Tl-201 studies were repeated > or = 6 weeks after revascularization. RESULTS: Of 109 revascularized segments with severe dysfunction, 46 (42%) improved. Left ventricular ejection fraction increased from 38 +/- 14% to 45 +/- 13% at follow-up (p = 0.003). Rest Tl-201 uptake and the ratio of peak contrast intensity of dysfunctional to normal segments with MCE were higher (p < 0.01) in segments that recovered function compared with those that did not. Myocardial contrast echocardiography, thallium scintigraphy and any contractile reserve during DE had a similar sensitivity (89% to 91%) with a lower specificity (43% to 66%) for recovery of function. A biphasic response during DE was the most specific (83%) and the least sensitive (68%) (p < 0.01). The best concordance with MCE was Tl-201 (80%, kappa 0.57). Changes in ejection fraction after revascularization related significantly to the number of viable dysfunctional segments by all modalities (r = 0.54 to 0.65). CONCLUSIONS: In myocardial hibernation, methods evaluating rest perfusion (MCE, Tl-201) or any contractile reserve have a similar high sensitivity but a low specificity for predicting recovery of function. A limited contractile reserve (biphasic response) increases the specificity of DE. Importantly, the three techniques identified all patients who had significant improvement in global ventricular function.


Subject(s)
Cardiotonic Agents , Dobutamine , Echocardiography/methods , Heart/diagnostic imaging , Myocardial Reperfusion Injury/diagnosis , Myocardium/pathology , Thallium Radioisotopes , Aged , Albumins , Contrast Media , Humans , Middle Aged , Myocardial Contraction , Myocardial Reperfusion Injury/diagnostic imaging , Myocardial Reperfusion Injury/physiopathology , Radionuclide Imaging , Sensitivity and Specificity , Stroke Volume , Ventricular Dysfunction, Left/physiopathology
15.
Circulation ; 95(3): 626-35, 1997 Feb 04.
Article in English | MEDLINE | ID: mdl-9024150

ABSTRACT

BACKGROUND: The purposes of this study were to evaluate the comparative accuracy of dobutamine echocardiography and quantitative rest-redistribution 201Tl tomography in the prediction of recovery of function after revascularization and to assess the relation of contractile reserve to thallium uptake. METHODS AND RESULTS: Thirty-four patients with stable coronary disease and regional dysfunction underwent dobutamine echocardiography (2.5 up to 40 micrograms.kg-1.min-1) and rest-redistribution 201Tl tomography 1 day before revascularization. Resting echocardiography and scintigraphy were repeated at > or = 6 weeks. Before revascularization, resting 201Tl uptake was similar in segments demonstrating biphasic or sustained improvement and was higher than in those exhibiting no change or worsening function during dobutamine. After revascularization, 201Tl uptake increased only in segments that showed a biphasic response (from 66 +/- 12% to 78 +/- 13%; P < .05). Biphasic response had a sensitivity of 74% and specificity of 89% for prediction of recovery. The use of biphasic or sustained improvement responses increased the sensitivity to 86% with a decrease in specificity to 68%. Qualitative thallium assessment provided a high sensitivity (98%) but poor specificity (27%). Quantification of thallium uptake, however, improved its accuracy: a maximal uptake (at rest or redistribution) of > or = 60% yielded a 90% sensitivity and a 56% specificity. CONCLUSIONS: In patients with myocardial hibernation, biphasic response during dobutamine is less sensitive but more specific for recovery of function, whereas indexes of 201Tl scintigraphy are in general more sensitive and less specific, the least accurate being a qualitative assessment of thallium uptake. The sensitivity and specificity of both methods, however, can be altered depending on the quantitative criteria of thallium uptake or combination of responses of the myocardium to dobutamine.


Subject(s)
Dobutamine , Echocardiography , Myocardial Contraction , Myocardial Stunning/diagnosis , Myocardial Stunning/physiopathology , Thallium Radioisotopes , Tomography, Emission-Computed, Single-Photon , Aged , Forecasting , Humans , Middle Aged , Reference Values , Rest
16.
Proc Natl Acad Sci U S A ; 94(25): 13735-7, 1997 Dec 09.
Article in English | MEDLINE | ID: mdl-9391095

ABSTRACT

There has been a great deal of recent attention on the suspected increase in amphibian deformities. However, most reports of amphibian deformities have been anecdotal, and no experiments in the field under natural conditions have been performed to investigate this phenomenon. Under laboratory conditions, a variety of agents can induce deformities in amphibians. We investigated one of these agents, UV-B radiation, in field experiments, as a cause for amphibian deformities. We monitored hatching success and development in long-toed salamanders under UV-B shields and in regimes that allowed UV-B radiation. Embryos under UV-B shields had a significantly higher hatching rate and fewer deformities, and developed more quickly than those exposed to UV-B. Deformities may contribute directly to embryo mortality, and they may affect an individual's subsequent survival after hatching.


Subject(s)
Ambystoma/abnormalities , Ultraviolet Rays/adverse effects , Ambystoma/embryology , Ambystoma/metabolism , Animals , Deoxyribodipyrimidine Photo-Lyase/metabolism , Ecosystem , Female , Fresh Water , Oregon , Ovum/enzymology , Ovum/growth & development , Ovum/radiation effects
17.
Photochem Photobiol ; 64(3): 449-56, 1996 Sep.
Article in English | MEDLINE | ID: mdl-8806225

ABSTRACT

Many amphibian species, in widely scattered locations, currently show population declines and/or reductions in range, but other amphibian species show no such declines. There is no known single cause for these declines. Differential sensitivity to UVB radiation among species might be one contributing factor. We have focused on amphibian eggs, potentially the most UVB-sensitive stage, and compared their resistance to UVB components of sunlight with their levels of photolyase, typically the most important enzyme for repair of the major UV photoproducts in DNA, cyclobutane pyrimidine dimers. Photolyase varied 100-fold among eggs/oocytes of 10 species. Among three species-Hyla regilla, Rana cascadae, and Bufo boreas-for which resistance of eggs to solar UVB irradiance in their natural locations was measured, hatching success correlated strongly with photolyase. Two additional species, Rana aurora and Ambystoma gracile, now show similar correlations. Among the low-egg-photolyase species, R. cascadae and B. boreas are showing declines, and the status of A. gracile is not known. Of the two high-photolyase species, populations of H. regilla remain robust, but populations of R. aurora are showing declines. To determine whether levels of photolyase or other repair activities are affected by solar exposures during amphibian development, we have initiated an extended study of H. regilla and R. cascadae, and of Xenopus laevis, laboratory-reared specimens of which previously showed very low photolyase levels. Hyla regilla and R. cascadae tadpoles are being reared to maturity in laboratories supplemented with modest levels of UV light or light filtered to remove UVB wavelengths. Young X. laevis females are being reared indoors and outdoors. Initial observations reveal severe effects of both UVA and UVB light on H. regilla and R. cascadae tadpoles and metamorphs, including developmental abnormalities and high mortalities. Assays of photolyase levels in the skins of young animals roughly parallel previous egg/oocyte photolyase measurements for all three species.


Subject(s)
Amphibians , Sunlight/adverse effects , Amphibians/growth & development , Amphibians/metabolism , Animals , DNA/radiation effects , DNA Repair , Deoxyribodipyrimidine Photo-Lyase/metabolism , Female , Ovum/metabolism , Ovum/radiation effects , Radiation Tolerance , Ultraviolet Rays/adverse effects
18.
Cardiol Clin ; 14(3): 393-404, 1996 Aug.
Article in English | MEDLINE | ID: mdl-8853133

ABSTRACT

Infective endocarditis, especially when it involves prosthetic valves, is a serious, often fatal illness. Although antibiotics are essential in management, surgery is required in many patients who develop even incipient heart failure and structural complications. Early identification and referral results in improved mortality and morbidity rates, and there is evidence that surgery should play a larger role in managing infective endocarditis. Patients with intracardiac pacemakers and cardioverting devices represent a growing reservoir of patients with the potential to develop endocarditis.


Subject(s)
Endocarditis, Bacterial/surgery , Endocarditis, Bacterial/diagnostic imaging , Endocarditis, Bacterial/mortality , Humans , Survival Rate , Time Factors , Ultrasonography
19.
Am J Clin Pathol ; 105(6): 727-32, 1996 Jun.
Article in English | MEDLINE | ID: mdl-8659447

ABSTRACT

Two cases are described of an unusual form of primary adenocarcinoma of the pancreas characterized histologically by their striking resemblance with a neuroendocrine neoplasm. The tumors were composed of a population of relatively small, uniform cells arranged in sheets admixed with small microglandular structures resulting in a cribriform pattern of growth. The tumor cells displayed scant cytoplasm with indistinct cell borders and round to oval nuclei with irregular clumping of chromatin and small, inconspicuous nucleoli. Immunohistochemical studies in both cases showed positivity of the neoplastic cells with CAM 5.2 antibodies and negative staining with a battery of neuroendocrine-related markers including chromogranin, NSE and synaptophysin, as well as with a variety of peptide hormones including insulin, glucagon, vasoactive intestinal polypeptide, gastrin and serotonin. Ultrastructural examination revealed a cohesive population of cells forming abortive glandular lumens lined by imperfectly formed microvilli and showing well-developed junctional complexes. No dense core neurosecretory granules or zymogen granules could be identified in any of the cells, supporting a ductal type of differentiation for these tumors. The main importance of recognizing this rare variant of pancreatic adenocarcinoma lies in avoiding misdiagnosis with other primary and metastatic neuroendocrine neoplasms of this organ. Immunohistochemical and ultrastructural examination will be of value in such cases for differential diagnosis.


Subject(s)
Adenocarcinoma/chemistry , Adenocarcinoma/ultrastructure , Neuroendocrine Tumors/chemistry , Neuroendocrine Tumors/ultrastructure , Pancreatic Neoplasms/chemistry , Pancreatic Neoplasms/ultrastructure , Adenocarcinoma/secondary , Aged , Diagnosis, Differential , Follow-Up Studies , Humans , Immunohistochemistry , Liver Neoplasms/secondary , Male , Middle Aged , Neuroendocrine Tumors/pathology , Pancreatic Neoplasms/pathology
20.
J Chem Ecol ; 22(9): 1709-16, 1996 Sep.
Article in English | MEDLINE | ID: mdl-24226482

ABSTRACT

Organisms from a wide variety of taxonomic groups possess chemical alarm cues that are important in mediating predator avoidance. However, little is known about the presence of such alarm cues in most amphibians, and in particular terrestrial salamanders. In this study we tested whether adult long-toed salamanders (Ambystoma macrodactylum) showed an avoidance response to stimuli from injured conspecifics. Avoidance of stimuli from injured conspecifics could represent avoidance of a chemical alarm cue or, alternatively, avoidance of a territorial pheromone or conspecific predator odor. Consequently, we also tested whether salamanders avoided stimuli from noninjured conspecifics. Salamanders avoided stimuli from injured but not from noninjured conspecifics. Therefore, we concluded that the response to injured conspecifics represents avoidance of a chemical alarm cue and not avoidance of a territorial pheromone or predator cue. This is the first clear demonstration of chemical alarm signaling by a terrestrial amphibian and the first report of chemical alarm signaling in an ambystomatid salamander. By avoiding an area containing stimuli from injured conspecifics, long-toed salamanders may lower their risk of predation by avoiding areas where predators are foraging.

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