Role of porcine P-selectin in complement-dependent adhesion of human leukocytes to porcine endothelial cells.

BACKGROUND: Rapid leukocyte adherence to donor organ vasculature is a hallmark of hyperacute xenograft rejection. However, the molecular interactions required for leukocyte binding to vascular endothelium have not been characterized. METHODS AND RESULTS: Binding assays performed between human neutrophils and porcine aortic endothelial cells (PAEC) after exposure to human complement demonstrated that adhesion was mediated by both surface-bound C3b and C5b-9 activity. C5b-9-dependent adhesion was blocked by neuraminidase treatment of the neutrophils, suggesting that this binding was mediated by porcine P-selectin. Porcine P-selectin was isolated from a PAEC cDNA library. The porcine P-selectin primary sequence contained an open reading frame encoding 646 amino acids with 82% identity to human P-selectin. Recombinant soluble porcine P-selectin specifically bound to human neutrophils and HL-60 cells. Transfection of COS cells with the full-length porcine P-selectin cDNA resulted in surface expression of the protein and markedly increased the binding of human neutrophils to these cells. The binding of both soluble and COS-expressed porcine P-selectin to human neutrophils was blocked by pretreatment of the neutrophils with neuraminidase or the addition of EDTA. Finally, treatment of PAEC with human thrombin or normal human serum but not purified human C5a- or C8-deficient human serum resulted in the rapid expression of porcine P-selectin on the cell surface. CONCLUSIONS: This report establishes that porcine P-selectin supports the binding of human neutrophils to PAEC in vitro. Further, these data suggest that sublytic deposition of C5b-9 during hyperacute rejection results in the expression of porcine P-selectin, which may contribute to the rapid adhesion of neutrophils to porcine xenografts.

Effects of general and alcohol-specific media literacy training on children's decision making about alcohol.

This article examines the immediate and delayed effects of media literacy training on third-grade children's perceptions of alcohol advertising, alcohol norms, expectancies for drinking, and behaviors toward alcohol. A Solomon four-group style experiment (N = 225) with two levels of the treatment factor assessed the effectiveness of in-school media literacy training for alcohol. The experiment compared a treatment that included the viewing of a videotape about television advertising along with the viewing of video clips of alcohol ads and discussion pertaining to alcohol advertising specifically versus one that included the viewing of the same general purpose media literacy videotape along with video clips of non-alcohol advertising and then discussion of advertising in general. The treatment had both immediate and delayed effects. Immediate effects included the children's increased understanding of persuasive intent, viewing of characters as less similar to people they knew in real life and less desirable, decreased desire to be like the characters, decreased expectation of positive consequences from drinking alcohol, and decreased likelihood to choose an alcohol-related product. Indirect effects also were found on their perceptions of television's realism and their views of social norms related to alcohol. Delayed effects were examined and confirmed on expectancies and behavior. The treatment was more effective when alcohol-specific, and it also was more effective among girls than boys.

Prognostic significance of gross myometrial invasion with endometrial cancer.

OBJECTIVE: To determine if intraoperative estimation of gross myometrial invasion is sufficiently precise to guide surgical aggressiveness in staging patients with endometrial cancer. METHODS: Between September 1987 and September 1995, 236 women with endometrial cancer had visual estimation of gross myometrial invasion during surgical staging which included pelvic and para-aortic lymphadenectomy. RESULTS: In 213 patients (90.3%), the depth of gross myometrial invasion correctly predicted the microscopic depth of invasion on permanent histopathologic sections. Statistically significant associations were found between gross depth of myometrial invasion and tumor grade (P < .001), histopathology (P = .014), cervical metastases (P < .001), adnexal metastases (P < .001), omental metastases (P < .001), malignant pelvic cytology (P < .001), pelvic lymph node metastases (P < .001), para-aortic lymph node metastases (P = .001), and surgical stage (P < .001). Patients with more than 50% gross myometrial invasion were more likely to have poorly differentiated malignancies; nonendometrial histologies; malignant pelvic cytology; higher surgical stage; and cervical, adnexal, omental, pelvic lymph node, and para-aortic lymph node metastases. Patients with more than 50% gross myometrial invasion had a 6.4-fold higher prevalence of pelvic lymph node metastases, a 6.9-fold higher prevalence of para-aortic lymph node metastases, and a 6.7-fold higher prevalence of advanced surgical stage than patients with less than 50% myometrial invasion. CONCLUSION: Patients with endometrial cancer and more than 50% myometrial invasion on gross visual intraoperative estimation are at marked risk for extrauterine metastases, including pelvic and para-aortic lymph node metastases. Such patients should be considered for more aggressive surgical staging, including pelvic and para-aortic lymphadenectomy.

High dose methotrexate infusion with leucovorin rescue for treatment of ectopic pregnancy.

The purpose of this article is to evaluate the effectiveness, side effects, and complications of high dose methotrexate infusion with leucovorin rescue in select patients with ectopic pregnancy. Between January 1991 and November 1994, 28 patients with ectopic pregnancies were prospectively treated with methotrexate (100 mg/m2 intravenous bolus followed by a 200 mg/m2 infusion over six hours) with leucovorin rescue. Twenty-seven of 28 patients (96%) were successfully treated. Only one patient (4%) required a second course of methotrexate to reach a normal hCG titer. One patient failed methotrexate infusion 45 days after treatment at a hCG titer of 12 mIU/mL. No Gynecologic Oncology Group grade 3 or 4 clinical, biochemical or hematologic toxicities occurred. Uterine bleeding and abdominal pain, not requiring transfusion or hospitalization, occurred in 71% and 56% of patients. The authors conclude that high dose methotrexate infusion with leucovorin rescue is a highly effective, well tolerated, nonsurgical treatment for select patients with ectopic pregnancy.

Comparison of D&C and office endometrial biopsy in predicting final histopathologic grade in endometrial cancer.

OBJECTIVE: To compare the accuracy of D&C and office Z-sampler endometrial biopsy in predicting hysterectomy tumor grade in women with endometrial cancer. METHODS: Between September 1987 and July 1994, 183 women with endometrial cancer had D&C or office Z-sampler endometrial biopsy before hysterectomy. RESULTS: One hundred thirty-one patients (72%) had Z-sampler biopsies and 52 (28%) had D&C. The Z-sampler correctly identified the hysterectomy tumor grade in 76 of 131 patients (58%), compared with 40 of 52 (77%) with D&C, a significant difference (P = .024). The major difference observed was an increased fraction of lesions undergraded (ie, a lower grade tumor found in the biopsy than in the hysterectomy specimen) by the Z-sampler (34 of 131, 26%) versus D&C (five of 52, 10%). CONCLUSION: Dilation and curettage was more accurate in identifying hysterectomy tumor grade and less likely to miss a higher-grade tumor than was Z-sampler biopsy. However, the inaccuracy of D&C alone necessitates further preoperative and intraoperative assessment for other risk factors to determine the aggressiveness with which an individual patient should be staged surgically.

Patch-clamp recording from identified rat ciliary ganglion neurons in primary culture.

Adult rat parasympathetic ciliary ganglion (CG) neurons were retrogradely labelled by intraocular injection of the carbocyanine fluorescent dye 1,1-dioleyl-3,3,3',3'-tetramethylindocarbocyanine methanesulfonate (DiI). Whole-cell and nystatin perforated patch recording techniques were then used to examine the electrophysiological properties of labelled CG neurons growing in primary culture. The resting membrane potential of CG neurons in dissociated cell culture was -50 +/- 8 mV, and isolated neurons fired overshooting action potentials in response to depolarizing current injection. Voltage-clamp recordings of membrane currents revealed a transient tetrodotoxin-sensitive Na+ inward current and both sustained and transient outward K+ currents. Sustained outward K+ current was reduced (55-77%) by 5 mM tetraethylammonium and to a lesser extent (42-46%) by superfusion with nominally Ca2+ free external solution. Transient outward current was blocked by 100 microns 4-aminopyridine and exhibited steady-state inactivation at potentials depolarized to -50 mV. These data demonstrate that identified adult mammalian CG neurons can be successfully maintained in culture. Cultured CG neurons retain electrical excitability, with voltage-sensitive Na+ and K+ currents giving rise to action potentials.

Molecular and functional analysis of porcine E-selectin reveals a potential role in xenograft rejection.

In this study, we report the molecular and functional characterization of porcine E-selectin. Incubation of porcine endothelial cells with human TNF alpha but not human IL-1 resulted in a marked increase in binding to human neutrophils. In order to confirm that this interaction was mediated by E-selectin, we isolated the full-length porcine E-selectin cDNA which contained an open reading frame encoding 485 amino acids with 75% identity to human E-selectin. Expression or recombinant porcine E-selectin in COS cells resulted in surface expression of the protein and increased binding to human neutrophils. Northern blot analysis showed that treatment of porcine endothelial cells with human TNF alpha but not human IL-1 resulted in high levels of porcine E-selectin mRNA. Taken together, our data establish that porcine E-selectin mediates adhesive interactions between porcine endothelial cells and human leukocytes that may contribute to xenograft rejection.

Prognostic significance of malignant cervical cytology in patients with endometrial cancer.

OBJECTIVE: To determine the prognostic importance of malignant cervical cytology before surgical stating in patients with endometrial cancer. METHODS: Between September 1987 and August 1993, 164 patients with endometrial cancer had preoperative cervical cytology examined before surgical staging, which included pelvic and para-aortic lymphadenectomy. RESULTS: Ninety-four patients (57.3%) had normal cervical cytology, 21 (12.8%) had atypical cytology suspicious for malignancy, and 49 (29.9%) had malignant cytology on preoperative cervical cytology. Statistically significant associations were found between cervical cytology and histopathology (P = .017), tumor grade (P = .001), cervical metastases (P < .001), surgical stage (P = .035), pelvic lymph node metastases (P = .016), and para-aortic lymph node metastases (P = .006). Patients with malignant cytology were more likely to have non-endometrioid histology, poorly differentiated malignancies, higher surgical stage, and cervical, pelvic lymph node, and para-aortic lymph node metastases. Patients with malignant cervical cytology had a 3.5 times higher prevalence of pelvic lymph node metastases and a five times higher prevalence of para-aortic lymph node metastases than patients with normal cytology. No association was found between preoperative cervical cytology and the depth of myometrial invasion, adnexal metastases, omental metastases, or malignant pelvic peritoneal cytology. CONCLUSIONS: Patients with endometrial cancer and malignant preoperative cervical cytology are at marked risk for extrauterine metastases, including pelvic and para-aortic lymph node metastases. Such patients should be considered for primary surgical staging, including pelvic and para-aortic lymphadenectomy.

Comparison of the Z-sampler and Novak endometrial biopsy instruments for in-office diagnosis of endometrial cancer.

The purpose of this study was to compare the diagnostic accuracy and specimen adequacy of in-office endometrial biopsies taken with the Novak curette and with a disposable flexible polypropylene biopsy device, the Z-sampler, in patients with endometrial cancer. Eighty women with endometrial cancer had in-office endometrial biopsies performed with the Z-sampler and the Novak curette prior to hysterectomy. The Z-sampler diagnosed 66 (82.5%) with endometrial cancer compared to 68 (85%) with the Novak curette (P = 0.724). The Z-sampler biopsies included 10 specimens (12.5%) pathologically inadequate for diagnosis, compared to 5 (6.3%) Novak curette biopsies inadequate for diagnosis (P = 0.074). When both endometrial biopsies were adequate for pathologic evaluation, the Z-sampler diagnosed 66 of 70 women (94.3%) with endometrial cancer, compared to 64 of 70 (91.4%) diagnosed with the Novak curette (P = 0.617). We did not demonstrate a significant difference in diagnostic accuracy or specimen adequacy between in-office biopsies taken with the Novak curette and those taken with the Z-sampler in patients with endometrial cancer.

Three-dimensional computed tomography reconstruction of tibial torsion.

The accuracy and reproducibility of computed tomography (CT) scanning techniques in assessing tibial version and torsion are measured in this study. A technique of three-dimensional CT reconstruction is introduced to assess the influence of selection and variation of landmarks on rotation measured in the tibia. The authors conclude that, within 2 cm of the articular surface, the level at which the proximal tibial axis is determined has no effect on the degree of torsion measured by CT scan. Furthermore, they conclude that the slope of the proximal tibial cut, with respect to the long tibial axis, has no effect on the measure of tibial torsion. Finally, they conclude that there is no significant difference in tibial torsion measured by reference to the posterior-condylar axis instead of the transtibial axis in cuts below the articular surface.

Effects of conformity and nonconformity to gender-role expectations for dress: teachers versus students.

Role theory predicts that a student's conformity to gender-role expectations for dress will result in favorable teacher evaluations and expectations. This conformity may be complicated by contradictory expectations from two sources: teachers and peers. This study examined the effects of conformity and nonconformity to gender-role expectations for dress on evaluations made by teachers and students. Both viewed a photograph of a young male student wearing or not wearing an earring and rated his personal traits, educational performance, parents' attitudes, social class, and interpersonal skills. Subjects were also asked to assess guilt and assign punishment after reading a behavior vignette. Results revealed that evaluations of personal traits, social class, and reactions to the behavior vignette were influenced by the presence or absence of an earring and by whether the evaluator was a teacher or a student. Results are discussed in terms of role theory.

Pelvic and para-aortic lymphadenectomy for surgical staging of high-risk endometrioid adenocarcinoma of the endometrium.

The objective of this study was to analyze the results of pelvic and para-aortic lymphadenectomy in high-risk patients with endometrioid adenocarcinoma of the endometrium and no clinical or gross surgical evidence of extrauterine metastases. From August 1987 to October 1992, 50 patients with high-risk endometrioid adenocarcinoma of the endometrium had pelvic and para-aortic lymphadenectomy performed. The median number of lymph nodes removed was 18. No preoperative radiotherapy was administered. Pelvic lymph node metastases (20.0%) and para-aortic lymph node metastases (16.0%) were the most common sites of extrauterine metastases diagnosed. Eight patients (80.0%) with pelvic lymph node metastases also had para-aortic metastases. All 8 patients with para-aortic lymph node metastases had pelvic lymph node metastases. Pelvic lymphadenopathy was diagnosed on surgical exploration in 30% of patients with pelvic lymph node metastases, and para-aortic lymphadenopathy was present in 50% with para-aortic metastases. Six of 46 patients (13.0%) without pelvic or para-aortic lymphadenopathy had microscopic lymph node metastases. Palpation of the pelvic and para-aortic lymph node areas alone is inadequate in identifying patients with lymph node metastases. The addition of routine pelvic and para-aortic lymphadenectomy to TAH/BSO will identify subclinical lymph node metastases in a significant number of patients who may benefit from individualized postoperative therapy.

US-guided automated large-core breast biopsy.

To evaluate the efficacy of ultrasound (US)-guided automated large-core percutaneous needle breast biopsy, biopsy of 181 ultrasonographically suspicious breast lesions was performed by using a long-throw biopsy gun and 14-gauge needles with continuous US guidance. A "freehand" technique with either 5.0- or 7.5-MHz linear-array transducers was used. Needle core diagnoses were compared with surgical diagnoses in the 49 lesions subsequently surgically excised. The remaining 132 cases were followed for 12-36 months. Agreement between needle-core and surgical diagnoses in the 49 lesions was 100%. This group included 34 cancers (28 infiltrating ductal, two mucinous, one mixed infiltrating ductal and lobular, and one each of intraductal, infiltrating lobular, and tubular carcinoma). To date, no cancers have been found in the other 132 cases. The procedure time averaged 20 minutes, and no complications occurred. With an accuracy approaching that of excisional biopsy, US-guided needle core biopsy provides an alternative to surgery.

Use of perfluorooctylbromide (PFOB) to detect liver abscesses with computed tomography. Safety and efficacy.

Although perfluorooctylbromide (PFOB) is known to stimulate macrophages, particulates given intravenously (IV) can inhibit the body's response to infection by blocking the reticuloendothelial system. Since PFOB enhances abscesses on computed tomography (CT), the authors evaluated its safety and efficacy by assessing the mortality and abscess volume in 104 rabbits with intrahepatic abscesses given either PFOB or lactated Ringer's (LR), and by comparing its efficacy to that of 76% meglumine sodium diatrizoate (MSD76). Abscesses were produced by injecting a virulent strain of E. coli into the liver. Two days later, five of the rabbits had died. Of the remaining rabbits, 50 were given 5 g/kg PFOB IV, and 49 were given an equal volume of LR. All rabbits had a CT scan at four and at ten days after infusion. They were killed before the second CT scan. Thirty seconds before being killed, 28 rabbits given LR were given a bolus of 2 ml/kg MSD76 IV. Following CT, rabbits were frozen, sliced, and photographed. Abscess volumes were calculated by digitizing the photographs of the anatomic sections and the CT images. MSD76 enhanced the liver by 105 Hounsfield units (HU) more than the liquefied abscess center. The abscess wall enhanced to the same degree as liver, resulting in nonvisualization of three of six abscesses less than 3 mm in size, and a 30% underestimation of true abscess volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis of synthetic vascular graft infection: comparison of CT and gallium scans.

Sixteen patients were examined with both abdominal CT and 67Ga scintigraphy for suspected synthetic vascular graft infection. Two patients were studied twice, yielding a total of 18 paired tests. A total of 25 grafts were analyzed. The results of CT and 67Ga scintigraphy were compared for grafts in specific anatomic locations including the retroperitoneum, groin, and abdominal wall, and for combined sites. When all locations were considered as a group, CT had a sensitivity of 100% and specificity of 72%; 67Ga scintigraphy had a sensitivity of 78% and specificity of 94%. 67Ga scintigraphy proved to be more specific than CT (p less than .05) for combined sites, but no significant difference in sensitivities was demonstrated, possibly because of the small number of infected grafts in our study. No differences in sensitivities or specificities were statistically significant when grafts in individual anatomic sites were analyzed. Since no significant difference between the sensitivities of CT and 67Ga scanning was demonstrated in our study, although the number of infected grafts was small, CT is recommended as the initial examination when graft infection is suspected because it can be performed immediately. 67Ga scintigraphy remains an important complementary test, adding specificity to the diagnostic workup.

Q-angle: a factor in peak torque occurrence in isokinetic knee extension*.

* This study was conducted in partial fulfillment for the requirements the U.S. Any-Baylor University Program in Physical Therapy, Academy of Health Sciences, Fort Sam Houston, TX. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the U.S. Army or the Department of the Defense. The purpose of this study was to examine the differences in peak torque occurrence during knee extension range of motion between groups of subjects with varying quadriceps-angle (Q-angle). Fifty-six female subjects, aged 18 to 35, participated in the study. The subjects were separated into three groups: low (N = 12) consisted of subjects with Q-angles <11 degrees ; moderate (N = 27), 13-17 degrees ; and high (N = 17), > 19 degrees . Three sets of subjects, grouped according to Q-angle, were evaluated using the Cybex II Isokinetic Dynamometer. Each subject was tested at three isokinetic speeds (30, 60, and 180 degrees /sec) utilizing only the right lower extremity. The results suggest that the point at which peak torque occurs within knee extension range of motion is not significantly different between the three groups of subjects tested at the three test speeds.J Orthop Sports Phys Ther 1988;9(7):250-253.

Arterial cholesterol content and collagen metabolism in cynomolgus monkeys.

The activity of prolyl hydroxylase and the rate of collagen synthesis were examined in two anatomically different arterial segments of cholesterol-fold cynomolgus monkeys. In the aortic arch vessels the activity of prolyl hydroxylase was increased after six months on a high fat and high cholesterol diet. In this tissue the enzyme activity showed positive correlation with the levels of plasma and tissue cholesterol content. By contrast in the abdominal aortas of the same animals no significant increase of arterial tissue cholesterol or prolyl hydroxylase activity was seen. Despite the elevation of prolyl hydroxylase activity in the arch vessels of hyper cholesterolemic animals, no concomitant increase of collagen synthesis was seen. Neither cholesterolemia nor arterial cholesterol showed a positive correlation with the rate of arterial collagen synthesis. No significant changes of the rate of collagen metabolism were detected at the end of an 18 months intervention phase when the cholesterol content both in plasma and in the arterial tissue was substantially reduced.

Durkheim revisited: "Why do women kill themselves?".

Durkheim divided suicide into four social types; egoistic, anomic, fatalistic, and altruistic assigning the first two to modern, western society while relegating the last two to pre-industrial social orders. However, contemporary studies of female suicidal behavior and depression show that such women exhibit personality characteristics of low self-esteem, passivity, dependence and living vicariously for others which correspond to the behavioral indices of impersonalism, submissiveness, passivity, and obedience that produce the lack of individuation characteristic of Durkheim's altruistic/fatalistic suicide categories. On this basis, the author suggests that altruistic/fatalistic suicide may even in the modern world be relevant to the explanation of female suicidal behavior, a hypothesis which, if true, would support the contention that "men and women inhibit different social worlds."