Increased radiosensitivity in cells of two human cell lines treated with bystander medium from irradiated repair-deficient cells.

Radiation-induced bystander factors have been shown to be more toxic if they are from medium harvested from irradiated repair-deficient cells. The aim of this study was to test the hypothesis that the radiosensitivity of repair-proficient cells can be increased by exposing them to medium-borne factors harvested from sensitive cells and vice versa. Cells from a mismatch repair (MMR)-deficient cell line (Raji 10) with a sensitive response to radiation or the wild-type parent cell line were irradiated to 0.5 Gy gamma rays and then monitored for growth rate in their own medium or in the alternative conditioned medium. In other experiments, cells or conditioned medium were added to reporter cells (HPV-G, which are relatively sensitive keratinocytes, or highly radioresistant HT29 cells). The subsequent responses of the two cell lines to a 0.5-Gy dose of (60)Co gamma rays were measured. The results show that prior exposure of resistant cells to medium from irradiated sensitive cells reduced the clonogenic survival of the subsequently irradiated resistant cells. The reverse is also true. Measurement of the apoptosis index and BCL2 expression confirmed that the harvested medium was capable of modulating apoptosis after irradiation. This may have important applications in tumor therapy and also in the understanding of mechanisms involved in induction of adaptive responses.

Allelotyping defines minimal imbalance at chromosomal region 17q25 in non-serous epithelial ovarian cancers.

Allelic deletions of multiple chromosome 17q loci in sporadic ovarian cancer of epithelial origin suggest that inactivation of tumor suppressor gene(s) in these regions may be important for ovarian tumorigenesis. To further define the pattern of allelic imbalance in epithelial ovarian tumors of different histologies, a PCR-based assay was used to assess loss of heterozygosity (LOH) of polymorphic markers representative of TP53, BRCA1, NME1 and GH1, and region 17q23-25. LOH was observed for at least one marker in 68% of malignant tumors (n=60) and in 18% tumors of borderline malignancy (n=11), but not in benign tumors (n=5). The highest frequency of LOH in malignant tumors (64%) was observed with D17S801 on 17q25. Ten of 39 malignant ovarian tumors displaying LOH of at least one 17q marker, displayed a LOH pattern enabling the determination of a minimal region of overlapping deletion defined by D17S795 and D17S801. One borderline tumor also displayed an interstitial LOH pattern that overlapped this 17q25 minimal region of deletion. The histologies of malignant tumors displaying a pattern indicative of interstitial 17q deletions were of the endometrioid, clear cell and mucinous epithelial types. As the minimal region of overlap defined by these tumors overlap regions deleted in malignant tumors of all histologic types, and in a tumor of borderline malignancy, the 17q25-tumor suppressor may be implicated in the development of all types of epithelial ovarian tumors.

Expression of FHIT in primary cultures of human epithelial ovarian tumors and malignant ovarian ascites.

Abnormal FHIT gene expression has been reported in a variety of epithelial tumors shown to harbor deletions of chromosome 3p14, the chromosomal assignment of this gene. Recently, we described loss of heterozygosity of 3p in a subset of epithelial ovarian cancers. To investigate a potential role of the FHIT gene in ovarian cancer, we examined primary cell cultures derived from normal ovarian surface epithelium, ovarian tumors, and the cellular fraction of malignant ascites to determine the expression of FHIT by using reverse transcription-polymerase chain reaction. Included in this analysis were four spontaneously immortalized cell lines: three derived from malignant epithelial ovarian tumors (TOV21G, TOV112D, and TOV81D) and one from malignant ovarian ascites (OV90). OV90 was previously shown to harbor a deletion of the whole p arm of chromosome 3. The FHIT transcript was not detectable in two of 11 primary cultures derived from normal ovarian surface epithelium or in a primary culture derived from malignant ovarian ascites, whereas the remaining samples (34 malignant, eight borderline, and three benign specimens), exhibited identical expression patterns. In each case, this pattern was consistent with the co-expression of a normal FHIT transcript and a smaller transcript. DNA sequencing revealed that the abnormal-sized message lacked exons 4-7 (inclusive), which were deleted at their exact intron-exon splice sites. The aberrant-sized transcript was detectable by Northern blot analysis. There was no concordance between FHIT expression and loss of heterozygosity at the FHIT locus. Northern blot analysis also revealed that FHIT was differentially expressed, and the spontaneously immortalized cell lines TOV21G and TOV112D showed the highest level of expression. Because the same reverse transcription-polymerase chain reaction expression pattern was observed in both normal and tumor-derived primary cell cultures, these results argue against a significant role for FHIT in epithelial ovarian tumorigenesis.

Cervical flexion, extension, protrusion, and retraction. A radiographic segmental analysis.

STUDY DESIGN: A lateral radiographic analysis of the cervical spine was performed on 20 asymptomatic volunteers. OBJECTIVES: To quantify the contribution of each cervical segment to each of four sagittal cervical end-range positions: full-length flexion, full-length extension, protrusion, and retraction. SUMMARY OF BACKGROUND DATA: Recent clinical research supports the relevance of cervical protrusion and retraction in symptomatic patients. Currently, few quantitative studies are available regarding cervical protrusion and retraction. METHODS: Lateral cervical radiographs of 20 asymptomatic volunteers for four test positions and a neutral position were collected. Mean angular measurements and available ranges of motion were calculated from the occiput to C7. RESULTS: Retraction consists of lower cervical extension and upper cervical flexion, whereas protrusion consists of lower cervical flexion and upper cervical extension. Full-length cervical flexion produced more flexion at lower segments than did protrusion, and full-length cervical extension produced more extension at lower segments than did retraction. With both full-length flexion and retraction, upper cervical segments are positioned in the flexion portion of their total range, but only retraction takes Occ-C1 and C1-C2 to their full end-range of flexion. Similarly, with both full-length extension and protrusion, upper cervical segments are positioned in the extension portion of their total range, but only protrusion takes Occ-C1 and C1-C2 to their end-range of extension. CONCLUSION: A greater range of motion at Occ-C1 and C1-C2 was found for the protruded and retracted positions compared with the full-length flexion and full-length extension positions. Effects on cervical symptoms reported to occur in response to flexion, extension, protrusion, and retraction test movements may correspond with the position of lower cervical segments.

Effectiveness of exercise versus normal activity on acute low back pain: an integrative synthesis and meta-analysis.

There are a variety of protocols used to treat acute low back pain in adults. Therapies currently prescribed include bed rest, normal activity, and exercise therapy. The effectiveness of each of these treatments is controversial. The purpose of this study is to compare the effectiveness of exercise therapy with normal activity in the treatment of employed adults with acute low back pain through an integrative synthesis and meta-analysis of published research. The integrative synthesis and meta-analytical results support the hypothesis that employed adults diagnosed with acute low back pain will have fewer number of days absent from work after exercise therapy when compared to number of days absent from work after normal activity. This study's weighted P is 0.0000003109. The weighted effect size D is 0.4785 and this is a strong effect of exercise on number of days absent from work. This study concluded that exercise therapy should be prescribed for the treatment of adults with acute low back pain to expedite recovery. The results of this study allow the health care provider to confidently prescribe exercise therapy for acute low back pain. This study can be used to support exercise therapy as an evidence based care protocol for health care providers.

Mapping of chromosome 3p deletions in human epithelial ovarian tumors.

Epithelial ovarian tumors frequently display deletions on the short arm of chromosome 3 suggesting the existence of tumor suppressor genes within the deleted regions. We have recently established a primary tissue culture system as a model to investigate the genetic events associated with ovarian cancer. The frequencies of loss of heterozygosity (LOH) at 16 loci representative of chromosome 3p in 33 tumor biopsies and 47 ovarian primary cultures derived from unselected ovarian cancers were examined. This repertoire also included benign and borderline tumors as well as malignant ovarian ascites. LOH was observed in 25 (31%) samples for at least one marker: 21 of 58 malignant, two of 12 borderline and two of 10 benign specimens. Chromosome 3p loss was not restricted to ovarian tumors of high grade and stage. LOH was observed in both cultured and non cultured tumors and ascites. A spontaneously immortalized cell line derived from a malignant ovarian ascites, OV-90, displayed LOH of the majority of markers suggesting loss of one homolog of chromosome 3p. The pattern of deletion displayed by these 25 samples enabled the determination of at least two distinct regions of overlapping deletions on chromosome 3p extending from D3S1270 to D3S1597 and from D3S1293 to D3S1283. In addition, a region proximal to D3S1300 was deleted in a subset of samples. Although loss of loci overlapping these three regions (Regions I, II and III) were observed in malignant and benign tumors, in borderline tumors loss was observed of markers representative of Region III only. While RARbeta is presently included in Region II, the minimal regions of deletion exclude VHL, TGFBR2, PTPase(gamma) and FHIT as candidate tumor suppressors in ovarian tumorigenesis.

A comparison of the effectiveness of pharmacologic treatment of otitis media with effusion in children: integrative and meta-analysis.

The treatment of otitis media with effusion is controversial and has inconsistent variations of pharmacotherapeutic practices. Current pharmacologic practices include use of antibiotics, antihistamine and/or decongestants, or a combination of antibiotics with antihistamine and/or decongestants. The effectiveness of these treatment protocols was examined through an integrative and meta-analysis of published research. Data was collected from research published over a 17 year period from 1980 to 1997. The hypothesis is that children, ages three months to 12 years, with otitis media with effusion who are untreated will demonstrate successful resolution of effusion equal to those treated with pharmacologic agents (P < 0.05). The integrative and meta-analytic results reject this hypothesis, as pharmacologic treatment is statistically significant in its resolution when compared to no treatment (P=0.0017). However, there is a weak effect size (R=0.07).

Pelvic fluid collections by sonography and febrile morbidity after abdominal hysterectomy.

OBJECTIVE: To assess the range of normal findings at endovaginal sonography after abdominal hysterectomy and to assess the relationship these findings and febrile morbidity. METHODS: Fifty-eight women had endovaginal ultrasound at a median of 4 days after abdominal hysterectomy. The volume of fluid in the cul-de-sac and its sonographic characteristics were assessed. Ultrasound findings, which were not released to the patients' physicians, were correlated with febrile morbidity and clinical outcomes. RESULTS: The median pelvic fluid volume was 3.4 mL (interquartile range 0-16.8 mL). No pelvic fluid was detected in 22 of 58 women (37.9%). In the other 36 women, fluid volumes ranged between 0.2 and 76.3 mL. Febrile morbidity was present in 15 of 58 women (26%) overall: eight of 36 (25%) with and seven of 22 (32%) without pelvic fluid. There was no association between the presence of pelvic fluid collections and febrile morbidity (P = .54) or prolonged fever (P = 1.00). There was no difference in the median or mean fluid volumes between women with and without febrile morbidity. The study had a power of 90% with alpha = .05 to detect a difference of 20 mL. Even women with fixed, markedly echoic fluid collections larger than 35 mL did not have significantly more febrile morbidity than women with no pelvic fluid (P = .33). CONCLUSION: The volume of pelvic fluid 3-5 days after hysterectomy does not predict febrile morbidity or the need for drainage. Large or complex fluid collections may be present without adverse clinical consequences, and discovering such a collection in a patient with febrile morbidity after hysterectomy does not necessitate antibiotic therapy or surgical drainage of the fluid collection.

Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation.

PURPOSE: To compare the accuracy of endovaginal ultrasound (US) and magnetic resonance (MR) imaging in the diagnosis of adenomyosis. MATERIALS AND METHODS: The authors prospectively studied 119 consecutive patients undergoing hysterectomy. The endovaginal US scans and MR images were interpreted independently in a double-blind fashion. Imaging findings were compared with those at histopathologic examination. RESULTS: At histopathologic examination, adenomyosis was found in 28 of the 119 patients (24%). Sensitivity and specificity was 89% for endovaginal US and 89% for MR imaging. The positive predictive value was 71% for US and 65% for MR imaging. The negative predictive value was 96% for US and 95% for MR imaging. There was no statistically significant difference between the sensitivities (P = .65) and specificities (P = .75) of endovaginal US and MR imaging. The mean junctional zone (JZ) thickness on MR images in patients with and without proved adenomyosis was 15.0 mm +/- 4.9 and 7.7 mm +/- 3.3, respectively (P < .0001). When receiver operating characteristic curves were applied retrospectively, the optimal JZ value for the diagnosis of adenomyosis with MR imaging was > or = 12 mm. CONCLUSION: Endovaginal US was as accurate as MR imaging in the diagnosis of uterine adenomyosis. Use of a JZ thickness of > or= 12 mm should further optimize the diagnostic accuracy of MR imaging.

Thiodicarb.

Dimethyl N,N'-[thiobis(methyliminocarbonyloxy)] bis-(ethanimidothiolate), C10H18N4O4S3, is an example of a sulfenylated biscarbamate insecticide. The molecule has an approximate twofold axis through the central S atom which joins the two methyliminocarbonyloxyethanimidothiolate units. One of the two arms is planar in the crystal. Semi-empirical geometry optimization for an isolated molecule favors a model with both arms planar and, thus, crystal packing may be responsible for the observed non-planarity in one arm. Bond lengths and angles have similar values to those of the 'monomeric' carbamate insecticide methomyl.

Creating a collage: a meaningful interactive classroom strategy.

How can students be helped to make personal meaning of their nursing knowledge? The author describes one strategy, that of creating a collage, that promoted interactive learning and the making of meaning.

Transvaginal US-guided aspiration of ovarian cysts and solid pelvic masses.

Sixty-eight transvaginal ultrasound (US)-guided aspirations or biopsies were performed in 61 patients, of whom 48 had ovarian cysts and 13 had solid pelvic masses. In one patient with an ovarian cyst, aspiration revealed malignancy. Thirty-six of the 48 cysts were drained transvaginally in 23 premenopausal and 13 postmenopausal women, with recurrence rates of 48% and 80%, respectively. In seven cases a cyst was aspirated twice. In the 13 patients with solid pelvic lesions, 11 lesions proved to be malignant, with positive biopsy results in nine (sensitivity, 82%). Two benign lesions were correctly identified. No major complication was observed. The authors conclude that the transvaginal route offers simple access to pelvic lesions in pre- and postmenopausal patients. For women with a solid pelvic lesion, transvaginal aspiration biopsy with endovaginal US guidance is a safe and effective alternative to surgery, especially for patients with previously diagnosed malignant disease.

Ovarian cysts in postmenopausal women: preliminary results with transvaginal alcohol sclerosis. Work in progress.

Seven patients with a recurrent ovarian cyst after transvaginal needle aspiration underwent alcohol sclerosis of the cyst. The cysts had the appearance of simple cysts at ultrasound (US). Sclerosis, an outpatient procedure, was performed with a transvaginal approach under continuous endovaginal US guidance. After aspiration of the cyst contents, approximately two-thirds of the aspirated fluid was replaced with 100% alcohol that was left in place for 20 minutes and then aspirated. No complication was observed. Four cysts had not recurred at follow-up examinations performed 2, 5, 7, and 12 months, respectively, after sclerosis. One patient underwent surgery because mucinous material was found on analysis of the specimen, which was proved to be a benign cystadenoma. The two other cysts recurred, and one patient underwent surgery. Alcohol sclerosis of ovarian cysts may have a role in the treatment of postmenopausal women with ovarian cysts with a low risk of malignancy.

Standardized assessment of personality disorders in obsessive-compulsive disorder.

We assessed 96 patients with obsessive-compulsive disorder for DSM-III personality disorder diagnoses with a standardized interview instrument (Structured Interview for the DSM-III Personality Disorders). Fifty patients (52%) met criteria for at least one personality disorder, with mixed, dependent, and histrionic personality disorders most frequently diagnosed. Compulsive personality disorder was diagnosed in only 6 patients (6%), 5 of whom had had onset of obsessive-compulsive symptoms before the age of 10 years, indicating that DSM-III compulsive personality disorder is not invariably a premorbid condition for the development of obsessive-compulsive disorder. Schizotypal personality disorder, at 5%, was found to be less common than in past samples, reflecting differences in either assessment methods or sampling.

The effect of position and speed on ankle plantarflexion in females.

This study was undertaken to determine isokinetic plantarflexion strength at various speeds and positions on a Cybex II+ dynamometer. A second purpose of this study was to identify any relationship between calf circumference and strength. Speeds used were 0, 30, and 180 degrees /sec. Positions used were supine with 0 degrees knee extension, supine with 90 degrees knee flexion, and prone with 0 degrees knee extension. Speeds and positions are randomly ordered. Nineteen female subjects were classified as either trained (N = 9) or untrained (N = 10). Plantarflexion strength was greatest in the supine position with 0 degrees knee extension in each of the three speeds tested. The results of a two-way repeated measures analysis of variance test were significant across all speeds occurring only with the trained group at a speed of 0 degrees /sec. Further comparisons of position with other speeds were not significant. Since plantarflexion torques were higher in the supine position with 0 degrees knee extension with a speed of 30 degrees /sec, clinicians might want to use this position and speed to test ankle plantarflexion torque. The relationship between calf circumference and torque was not significant. J Orthop Sports Phys Ther 1990;12(4):153-156.

Bowel obstruction in patients with ovarian cancer: a search for prognostic factors.

Patients with concomitant ovarian cancer and bowel obstruction were studied in an effort to find objective prognostic factors predictive of patient outcome. A total of 62 patients were followed from 31 to 354 weeks, and a total of 20 variables were considered in the analyses. At the end of the study 49 patients were dead of their disease, and 13 were alive (six disease free and seven with persistent disease). Survival probabilities of the sample were 79% at 6 weeks, 48% at 20 weeks, and 24% at 104 weeks. Univariate analyses revealed no significant difference in the survival times of medically versus surgically treated patients; age greater than 60 years at diagnosis of cancer, presence of ascites, low serum albumin levels, elevated blood urea nitrogen levels, elevated alkaline phosphatase levels, lack of previous radiotherapy (p less than 0.002 for all), advanced tumor stage, normal/ileus x-ray results, and a short diagnosis to obstruction interval (p less than 0.04 for all) resulted in lower survival probabilities.