Ventilation and locomotion coupling in varsity male rowers.

Ventilation and locomotion coupling (entrainment) has been observed and described in rowers during incremental exercise protocols but not during simulated race conditions. The purpose of this descriptive study was to examine ventilation and locomotion entrainment on a breath-by-breath and stroke-by-stroke basis in varsity male rowers during a maximal 2,000-m ergometer test. Eight of eleven rowers entrained ventilation at integral multiples of stroke rate (1:1, 2:1, or 3:1) for at least 120 consecutive seconds, with a 2:1 entrainment pattern being most common. In all 2:1-entrained subjects, inspiration occurred at catch and finish and expiration occurred during the latter portions of drive and recovery. In entrained and unentrained breaths from all rowers, peak flow rates and tidal volumes varied depending on when the breath was initiated during the stroke cycle. Entrained rowers made use of these differences and breathed in a pattern by which they avoided initiating breaths that resulted in reduced tidal volumes. The present data indicated that ventilation was impaired at stroke finish and not at catch, as hypothesized by some previous researchers. Ventilation also appeared to be subordinate to consistent locomotive patterns under race conditions.

Health education for a breast and cervical cancer screening program: using the ecological model to assess local initiatives.

This study investigates the development and implementation of health education strategies at the local level for a statewide breast and cervical cancer control program. Baseline data on these initiatives were collected from 88 local screening programs in North Carolina. Using the ecological model as a framework, health education initiatives were assessed and analyzed to determine the level of activity occurring at the local level and the comprehensiveness of programs. Types and levels of interventions used are described and initial analysis is provided of the impact these strategies are having on recruiting women from target populations into these screening programs. Specific examples illustrating the variety of interventions used at the individual, network, organizational and community levels, and the impact of certain variables, such as the use of local health education staff, on the comprehensiveness of interventions utilized, are provided. The importance to practitioners of establishing process indicators in assessing local initiatives and challenges to conducting evaluations of these strategies are also discussed.

Hitting the moving target of program choice.

The changes in what 2,927 people wanted and got for programs in 1988 were compared with what 3,934 people wanted and received in 1996 in Wyoming and South Dakota. As recommendations change, they present a "moving target" for these service-delivery systems. In 1988, 51% of those served in Wyoming and 62% of those served in South Dakota were in their preferred setting. By 1996, the Wyoming percentage rose to 84%, whereas South Dakota's percentage moved up to 72%. These increases enhanced other "quality of life" measures. Comparing 1996 with 1988, for example, fewer individuals in both states reported no social or leisure activities. Fewer reported the lack of transportation as a barrier and fewer reported having no one to accompany them to activities. More individuals reported family contact, family visits, and identified a hobby or personal leisure activity. The 8-year expansion of services and supports had increased positive social activities.

A proposed method for assessing the performance of local public health functions and practices.

OBJECTIVES: One of the objectives for the nation for the year 2000 requires that 90% of the population be served by a local health department effectively carrying out the core functions of public health. This study proposes a method whereby determinations can be made of the extent to which a local public health jurisdiction is served by core public health functions, as well as the extent to which the functions are rendered by the health department. METHODS: Fourteen health departments under longitudinal study between 1979 and 1992 were studied. Respondents in each department completed a survey protocol using 81 indicators linked to standard public health functions and practices. Results are presented in graphic form, which provides a visual profile of public health performance for a local jurisdiction. RESULTS: The graphic profiles successfully differentiate one jurisdiction from another, and within each jurisdiction they differentiate the performance levels of different public health practices. The method enables identification of the full range of public health providers. CONCLUSIONS: Current definitions of public health practice have utility for evaluating public health performance. The validity of the proposed method deserves further study.

A screening survey to assess local public health performance.

Current studies are attempting to develop a national surveillance system to measure the extent that populations are served by local departments carrying out the core functions of public health. Early phases of the study featured observations on 14 health departments that have been subjects of a longitudinal study. These departments were surveyed using a protocol with 81 different indicators. The results permitted distinctions to be made among the departments on levels of performance according to core functions and their associated practices. To simplify the survey protocol so that it might be suitable for use with a large number of local public health jurisdictions, a subset of 26 indicators was selected from the previously developed protocol. Each indicator in the subset was linked with one of the three core functions of public health and with one of the associated practices. In an effort to display correlation between scores on the simplified survey and those in the full survey, scatter plots were prepared for overall scores and for those pertaining to each function and practice. Stepwise regressions were done to determine which queries or groups of queries were most predictive of variations in the screening responses. Four questions accounted for 96 percent of the variance in responses for overall performance. Results suggest that a three-tiered approach to the evaluation of local public health performance might be feasible. For the study departments, responses to four questions could be used to screen overall public health performance; responses to 26 questions could be used to yield information about performance of each of the three core public health functions; and responses to 84 questions could be used to yield more detailed information about performance for each of 10 public health practices. Experience with a larger set of departments might revise the number and nature of the screening queries.

The impact of critical events of the 1980s on core functions for a selected group of local health departments.

Directors of 14 public health departments were surveyed for their perceptions on the impact of 20 critical events of the 1980s on public health performance. The departments were selected in 1979 from among those that were highly regarded by public health experts for exemplary performance, especially with regard to personal health services. The departments were the subjects of intensive case studies in 1979, 1983, and again in 1992. The public health functions that were most benefited in the 1980s were assessment and policy development. The assurance function was equivocally affected. Greatest positive impact was exerted by the acquired immunodeficiency syndrome-human immunodeficiency virus epidemic, by increase in fee income, and by the Institute of Medicine report, "The Future of Public Health." Negative influences, especially on the assurance function were exerted by loss of Federal grants, demographic changes, substance abuse, and economic downturn. Other critical events had equivocal or idiosyncratic effects. Analysis of public health practice according to the functions of assessment, policy development, and assurance appears to have utility for purposes of evaluation and planning.

Structure of the novel steroidal antibiotic squalamine determined by two-dimensional NMR spectroscopy.

Squalamine is a novel aminosterol recently isolated from the dogfish shark, Squalus acanthias. This water-soluble steroid exhibits potent antibacterial activity against both gram-negative and gram-positive bacteria. In addition, squalamine is fungicidal and induces osmotic lysis of protozoa. We report here the structural determination of squalamine, 3 beta-N-1-[N(3-[4-aminobutyl])-1,3 diaminopropane]-7 alpha,24 zeta-dihydroxy-5 alpha-cholestane 24-sulfate, which was deduced from the analysis of fast atom bombardment spectra and a series of two-dimensional nuclear magnetic resonance (NMR) spectra. Squalamine is a cationic steroid characterized by a condensation of an anionic bile salt intermediate with the polyamine, spermidine. This molecule is a potential host-defense agent in the shark, and provides insight into a new class of vertebrate antimicrobial molecules.

Acute fatty liver of pregnancy.

Acute fatty liver of pregnancy is a serious complication of the 3rd trimester associated with high rates of maternal-fetal morbidity and mortality. Prompt diagnosis and treatment are essential to achieve optimal maternal-fetal outcomes. Collaboration between critical-care and perinatal nursing staffs is a crucial component of managing patient care. A recent case of acute fatty liver of pregnancy is reported. A team approach resulted in the survival of the patient and the delivery of healthy twins.

Squalamine: an aminosterol antibiotic from the shark.

In recent years, a variety of low molecular weight antibiotics have been isolated from diverse animal species. These agents, which include peptides, lipids, and alkaloids, exhibit antibiotic activity against environmental microbes and are thought to play a role in innate immunity. We report here the discovery of a broad-spectrum steroidal antibiotic isolated from tissues of the dogfish shark Squalus acanthias. This water-soluble antibiotic, which we have named squalamine, exhibits potent bactericidal activity against both Gram-negative and Gram-positive bacteria. In addition, squalamine is fungicidal and induces osmotic lysis of protozoa. The chemical structure of the antibiotic 3 beta-N-1-(N-[3-(4-aminobutyl)]- 1,3-diaminopropane)-7 alpha,24 zeta-dihydroxy-5 alpha-cholestane 24-sulfate has been determined by fast atom bombardment mass spectroscopy and NMR. Squalamine is a cationic steroid characterized by a condensation of an anionic bile salt intermediate with spermidine. The discovery of squalamine in the shark implicates a steroid as a potential host-defense agent in vertebrates and provides insights into the chemical design of a family of broad-spectrum antibiotics.

Longitudinal observations on a selected group of local health departments: a preliminary report.

A study is in progress to document changes in selected public health departments over the past decade and to use those observations for proposing an assessment protocol that may be helpful in measuring progress toward achieving one of the Health Objectives for the Nation for the Year 2000. Objective no. 8.14 reads: "Increase to at least 90 percent the proportion of people served by a local health department that is effectively carrying out the core functions of public health." The study re-surveys a group of 14 departments that were the subjects of intensive case studies between 1979 and 1981. Some preliminary observations from follow-up study of these departments in 1992 include: growth in budget and staff and even larger growth in pressure for services, especially for personal health care; reorganization that splits away some programs of comprehensive ambulatory care and responsibility for public hospitals, while increasing the aggregation of human service agencies, including public health, under locally organized umbrella agencies; increase in preventive, screening, and categorical programs under public health sponsorship; drastic change in patterns of financing, featuring nearly total loss of direct federal grants, and increase in fee income; increase in the number of community and migrant health centers in the public health jurisdictions under study; diminished collaborative interaction with private practitioners; and continued close collaboration between health departments and community health centers in several communities. The implications of these changes are discussed. Subsequent reports will be based on efforts to measure the impact of specific events of the 1980s on public health performance, and will describe experience with a community-based surveillance approach for assessing public health performance.

A novel peptide-producing cell in Xenopus: multinucleated gastric mucosal cell strikingly similar to the granular gland of the skin.

We have characterized a novel peptide-containing cell within the gastric mucosa of Xenopus laevis. The cell is a spherical, multinucleated syncytial structure containing a cytoplasmic space filled with dense rice-shaped granules, and is strikingly similar in morphology to the well-studied granular gland of the amphibian skin. Immunohistochemical and immunogold methods were used to demonstrate that several peptides previously isolated from the granular glands of the skin, including the antimicrobial peptides magainin and PGLa (a peptide with amino-terminal glycine and carboxy-terminal leucinamide), are also stored in granules present in these enteric cells. These data demonstrate that this enteric peptide-producing cell is strikingly similar both morphologically and biochemically to the granular gland, previously considered a highly specialized structure of the amphibian integument. This novel gastric mucosal cell, which we have designated a "granular multinucleated cell," is distinct in its morphology and its diversity of stored peptide products from other well-characterized peptide-containing cells in the vertebrate gastrointestinal tract.

Antimicrobial peptides in the stomach of Xenopus laevis.

Antimicrobial peptides are widely distributed in nature and appear to play a role in the host defense of plants and animals. In this study we report the existence of antimicrobial peptides in the stomach of the vertebrate Xenopus laevis, an animal previously shown to store high concentrations of antimicrobial peptides in its skin. Antimicrobial activity was detected in extracts of X. laevis stomach tissue and nine antimicrobial peptides were then purified. A novel 24-amino acid peptide, designated PGQ, was isolated from these extracts, and has the following amino acid sequence: GVLSNVIGYLKKLGTGALNAVLKQ. PGQ is relatively basic and has the potential to form an amphipathic alpha-helix. The other peptides isolated are members of the magainin family of antimicrobial peptides, and include magainins I and II, PGLa, xenopsin precursor fragment, and four caerulein precursor fragments. None of these peptides had been previously identified in tissues other than the skin. The purification of the peptides from stomach extracts and subsequent protein sequence analysis reveals that the peptides have undergone the same processing as their dermal counterparts, and that they are stored in their processed forms. Northern blot analysis indicates that the magainin family of peptides are synthesized in the stomach, and immunohistochemical studies demonstrate that magainin is stored in a novel granular multinucleated cell in the gastric mucosa of Xenopus. This study demonstrates that the magainin family of antimicrobial peptides is found in the gastrointestinal system of X. laevis and offers an opportunity to further define the physiological role of these defense peptides.

Carboxyl-terminal modification of a gastrin releasing peptide derivative generates potent antagonists.

Gastrin releasing peptide (GRP) is a 27-residue peptide hormone which is analogous to the amphibian peptide bombesin. GRP serves a variety of physiological functions and has been implicated as an autocrine factor in the growth regulation of small cell lung cancer cells. We have developed a series of potent GRP antagonists by modification of the COOH terminus of N-acetyl-GRP-20-27. The most potent member of this series, N-acetyl-GRP-20-26-OCH2CH3, exhibits an IC50 of 4 nM in a competitive binding inhibition assay. This compound blocks GRP-stimulated mitogenesis in Swiss 3T3 mouse fibroblasts, inhibits GRP-dependent release of gastrin in vitro, and blocks GRP-induced elevation of [Ca2+]i in H345 small cell lung cancer cells. These results demonstrate that while residues 20-27 of GRP influence binding of the parent peptide to its receptor, the COOH-terminal amino acid is primarily responsible for triggering the subsequent biological response.

Proliferating cell nuclear antigen/cyclin is an interleukin 2-responsive gene.

Previously, we have shown that a protein designated p36 is synthesized at a high rate during interleukin 2-driven proliferation of a cloned T lymphocyte, L2. Biosynthesis of p36 increases 1000-fold during the initial mid-G1 phase of the cell cycle and remains high while the cells proliferate. In this report, we show that p36 has the same migration pattern by two-dimensional gel electrophoresis as proliferating cell nuclear antigen (PCNA)/cyclin and that antiserum to PCNA/cyclin selectively immunoprecipitates p36. In addition, by indirect immunofluorescence, PCNA/cyclin accumulates in the nucleus of interleukin 2-stimulated L2 cells during proliferation and is not detectable prior to the initial S phase or after proliferation ceases. These data indicate that PCNA/cyclin expression is induced by interleukin 2 and that PCNA/cyclin accumulation is closely associated with T lymphocyte proliferation.