Cardiac therapy for men with coronary artery disease. The lived experience.

A phenomenological inquiry was conducted to uncover the lived experience of cardiac therapy for men with coronary artery disease in Northwest Ohio. Five men age 60 to 70 years were purposively selected to participate. Data obtained from individual audiotaped interviews were analyzed using Colaizzi's method. Eight major themes emerged: (a) feelings of fear and disbelief, (b) being aware of mortality, (c) losing control of self, (d) halting usual activities and future plans, (e) heightening awareness of spirituality and belief in a higher power, (f) resigning to accept external forces and required changes, (g) increasing sense of well-being, and (h) receiving a second chance and moving forward. This study makes valuable contributions to nursing by increasing awareness of actual lived experiences of cardiac therapy for men, offering direction for cardiac therapy programs to assist men with holistic lifestyle modifications that enable them to increase wellness, and serving as an impetus for further research.

Prevalence of cervical cancer and feasibility of screening in rural China: a pilot study for the Shanxi Province Cervical Cancer Screening Study.

For cervical cancer screening to be feasible in developing countries, it must be accurate, inexpensive, and easy to administer. We conducted a pilot study in rural Shanxi Province, People's Republic of China, to determine disease prevalence and study feasibility in preparation for a large-scale comparative trial of 6 screening tests. One-hundred and thirty-six nonpregnant women with no history of hysterectomy, pelvic radiation, or Papanicolaou tests were screened in a rural clinic. Ten percent of the women enrolled reported abnormal vaginal bleeding and 45% reported abnormal vaginal discharge. The tests were the Papanicolaou test (both conventional and ThinPrep), a self-administered swab test by Hybrid Capture II for high-risk human papillomavirus (HPV), a test for high-risk HPV from residual PreservCyt medium, fluorescence spectroscopy, and visual inspection of the cervix by a clinician. All women also underwent colposcopy and biopsies as the reference standard. Biopsies showed 12 of 136 women had >/= high-grade squamous intraepithelial lesions (HGSIL). Screening was completed in 5 half-day sessions, the procedures went smoothly, and local cooperation was enthusiastic. Disease prevalence in Xiangyuan and Yangcheng Counties, Shanxi Province, can be estimated at 8.8% (95% CI, 4.5% to 15.0%). Screening 1000-2000 patients would be sufficient to detect a 10% difference in accuracy between diagnostic tests. The proposed large-scale trial is feasible.

Proliferation, esterase activity, and propidium iodide exclusion in urologic tumor cells after in vitro exposure to chemotherapeutic agents.

After exposing urological tumor cells to anticancer agents in vitro, cellular esterase activity and the ability to exclude propidium iodide (PI) were examined as dual indicators of functionality or "viability." High esterase activity/PI exclusion was observed in assays in which anticancer agents failed to inhibit cellular proliferation, while low esterase activity/PI exclusion was often observed when proliferation had been significantly inhibited. In a number of instances, exposure to anticancer agents did produce significant inhibition of proliferation without lowering viability. In this setting, the recovery of proliferative capacity could be demonstrated with several transitional cell carcinoma cell lines, and this recovery was always associated with high esterase activity/PI exclusion. When the proliferation of primary urological tumor preparations was inhibited by drug exposure, estimates of elevated viability were obtained in 27 per cent of the determinations. Thus, viability estimates may be an indicator of the potential for tumor-cell recovery from exposure to anticancer agents. Moreover, the potential for recovery may explain differences between the results of chemosensitivity testing and actual clinical events by reconciling clinical failures with elevated viabilities indicative of this potential.

Growth of urinary transitional cell carcinoma cell lines in agar, agarose and methyl cellulose.

Because in vitro cell growth of transitional cell carcinoma explants and cell lines often fail to adequately proliferate in semisolid media, we have examined the effect of agents used to make media semisolid (methyl cellulose, Bacto-agar, Sea Plaque agarose and Sea Prep 15/45 agarose) on the in vitro growth of 11 transitional cell carcinoma cell lines. The growth of human transitional cell carcinoma lines was supported such that agents permissive for growth ranked as follows: Sea Plaque agarose approximately Sea Prep agarose greater than methyl cellulose greater than Bacto-agar. These observations have important implications for the in vitro study of transitional cell carcinoma cell lines and are relevant to the development of improved chemosensitivity determinations for human transitional cell carcinoma.

Esterase activity, exclusion of propidium iodide, and proliferation in tumor cells exposed to anticancer agents: phenomena relevant to chemosensitivity determinations.

Cellular esterase activity and the ability to exclude propidium iodide were examined after exposing tumor cells to anticancer agents. In general, esterase activity and the ability to exclude propidium iodide continued when cells proliferated and disappeared when proliferation was inhibited. However, with a number of preparations, drug exposure inhibited proliferation while esterase activity and propidium iodide exclusion persisted. These indications of persisting cell function or viability after drug exposure may be relevant to a potential for tumor cell recovery. When the viability of established cell lines progressively declined on days 4 and 7 following drug exposure, recovery did not occur. When proliferative recoveries occurred, viabilities remained elevated. Estimates of in vitro sensitivity by proliferation-related criteria were contrasted by persistent high viability estimates in 22% of the determinations performed with primary tumor cell preparations. The potential for recovery may explain the disappointing ability of proliferative chemosensitivity assays to predict clinical sensitivity.

Stability of doxorubicin in relation to chemosensitivity determinations: loss of lethality and retention of antiproliferative activity.

The chemical stability of doxorubicin in a variety of tissue culture media has been studied by thin layer chromatography (TLC). In all the media examined, authentic doxorubicin was converted to a chemically distinct form as evidenced by the failure of this form to migrate on TLC plates. The rates of conversion were rapid enough (t 1/2 approximately equal to 3 hr) to be of consequence in chemosensitivity determinations, especially if working solutions of doxorubicin were to be routinely made and stored in tissue culture media. The addition of certain antioxidants to media did not prevent the conversion of authentic doxorubicin. However, doxorubicin was quite stable in distilled water. No single component of media was found to be responsible for the conversion of authentic doxorubicin, although arginine, histidine, tyrosine, NaHCO3, and Fe(NO3)3 could each generate a form of doxorubicin which did not migrate in TLC analysis. Purification of the nonmigrating form of doxorubicin demonstrated that in vitro conversion resulted in considerable loss of lethality while antiproliferative activity was retained. These observations provide possible explanations for the variability in chemosensitivity determinations and may explain some of the failures to predict clinical responsiveness.

The proliferation of human tumor cell lines in the presence of different agars, agaroses, and methyl cellulose.

Human tumor cell lines, derived from cancers of the colon, ovary, and cervix, were grown in liquid tissue culture media and media made semisolid with agar (Bacto + deoxycholate lactose agar), agarose [LE, ME, Sea Plaque and Sea Prep (15/45)], and methyl cellulose. The effects of each agent on overall cell proliferation and rate of overall cell proliferation were examined. The agents, used to make media semisolid, were observed to inhibit or, in some cases, enhance cell growth in a fashion that was characteristic of individual cell lines. These phenomena may be of consequence to the optimization of nutrient media for primary tumor cell preparations.

The effect of different agars, agaroses and methyl cellulose on the in vitro proliferation of a human urinary transitional cell carcinoma cell line.

The effects of different agars (Bacto-agar and deoxycholate lactose agar), agaroses (LE, ME, Sea Plaque and Sea Prep 15/45) and methyl cellulose on the growth of a human tumor cell line, derived from a transitional cell carcinoma of the urinary bladder, were examined. The overall growth in the presence of agars and agarose was generally less than in liquid medium alone. In contrast, growth in the presence of methyl cellulose was significantly enhanced. Thus, methyl cellulose may be a useful agent for optimizing the proliferation of primary tissue cultures prepared from human transitional cell carcinomas.

Properties of anticancer agents relevant to in vitro determinations of human tumor cell sensitivity.

The physical properties of 59 anticancer agents have been examined with respect to solubility in tissue culture media, binding to ultrafiltration materials, and molecular absorbance and fluorescence behavior. Methods for dissolving these agents, which are compatible with in vitro sensitivity testing of human tumor cells to anticancer agents, are reported in this paper. The potential for anticancer agent binding to cellulose nitrate/cellulose acetate and teflon membrane ultrafilters was documented, and quantitation of these anticancer agents based upon absorbance and fluorescence spectroscopy was performed. Post-filtration quantitation of anticancer agents was found to be a reliable method for determining the actual drug concentrations available in tumor cell sensitivity testing in vitro. The properties documented herein are pharmacologically relevant parameters related to in vitro determinations of human tumor cell sensitivity to anticancer agents.

Cell surface alpha 1-protease inhibitor on human peripheral mononuclear cells in culture.

We have studied expression of alpha 1-protease inhibitor (alpha 1-PI) by human mononuclear cells. alpha 1-PI was detected on 50% of freshly isolated peripheral mononuclear cells. Unless a proliferative stimulus was provided, alpha 1-PI subsequently disappeared from the cell surfaces. Plant mitogens, periodate, neuraminidase-galactose oxidase, or allogeneic cells all were effective stimuli of alpha 1-PI expression. Concanavalin A stimulated de novo synthesis of alpha 1-PI in cell cultures containing both lymphocytes and mononuclear phagocytes, and alpha 1-PI simultaneously appeared on surfaces of activated lymphocytes. Inhibition of protein synthesis by cycloheximide or monocyte depletion abolished de novo alpha 1-PI synthesis, but only monocyte depletion inhibited alpha 1-PI expression. Lymphocytes, but not monocytes, displayed saturable binding of radioiodinated alpha 1-PI. The data are consistent with the interpretation that human mononuclear phagocytes synthesize and secrete alpha 1-PI. When protein synthesis is inhibited, mitogenic stimuli may provoke release of previously synthesized alpha 1-PI from mononuclear phagocytes. Secreted alpha 1-PI then may bind to specific lymphocyte cell surface receptors. This pattern of alpha 1-PI synthesis, secretion, binding, and expression on lymphoid cell surfaces appears to be a common characteristic of many immunologic reactions in vitro.

Properties of the lysosomal apparatus during differentiation of cultured striated muscle cells.

A technique for the preparation of relatively pure myoblasts from chick primary culture is described. Cultured rat myogenic cells (L6) were plated and grown to provide three morphologically distinct cell populations: perfusion, postfusion, and nonfusion. Homogenates of L6 cells demonstrated two major peaks of proteolytic activity at pH 3.0 and 5.5. The activity could be partially inhibited by leupeptin or pepstatin. Differential centrifugation indicated significant acid hydrolase activity in the "H" fraction of prefused cells, which shifted to the "L" fraction after fusion of the cells. Two populations of lysosomes were resolved in the myoblasts and myotubes after isopycnic centrifugation in Percoll. The equilibrium densities were 1.044 and 1.060-1.068. Cells were incubated with several protease inhibitors. Only chloroquine caused a large inhibition of protein degradation.