A tool-kit for cDNA microarray and promoter analysis.

We describe two sets of programs for expediting routine tasks in analysis of cDNA microarray data and promoter sequences. The first set permits bad data points to be flagged with respect to a number of parameters and performs normalization in three different ways. It allows combining of result files into comprehensive data sets, evaluation of the quality of both technical and biological replicates and row and/or column standardization of data matrices. The second set supports mapping ESTs in the genome, identifying the corresponding genes and recovering their promoters, analyzing promoters for transcription factor binding sites, and visual representation of the results. The programs are designed primarily for Arabidopsis thaliana researchers, but can be adapted readily for other model systems. Availability and Supplementary information: http://www.personal.psu.edu/nhs109/Programs/

Managing geriatric syndromes: what geriatric assessment teams recommend, what primary care physicians implement, what patients adhere to.

OBJECTIVES: To evaluate the responses of primary care physicians and patients to recommendations from a community-based comprehensive geriatric assessment (CGA) program for management of four target conditions: falls, depression, urinary incontinence, and functional impairment. DESIGN: Case series. SETTING: Senior centers, meal sites, senior housing, and other community sites as screening locations; and a community-bases academic practice as the location for CGA. PARTICIPANTS: A total of 150 older patients living in the community who have one or more of the four target conditions and who received CGA. MEASUREMENTS: Physician implementation and patient adherence rates were ascertained during a face-to-face structured interview with the patient 3 months after CGA. RESULTS: Two hundred twelve of 528 (40%) CGA recommendations were clearly or possible related to the target or target-related conditions. Of these 212 recommendations, 59% required a physician's order for implementation. The remaining 41% were patient self-care recommendations. Overall physician implementation across conditions was 70%; implementation rates were highest for falls and lowest for functional impairment. Overall patient adherence rate was 85% for physician-implemented recommendations and 46% for self-care recommendations. Patient adherence to recommendations for counseling or support groups and exercise programs was particularly low. CONCLUSIONS: When examining the process of care of community-based CGA, patient as well as physician adherence must be considered. Although patient adherence to physician-initiated recommendations was high for all conditions, it varied substantially across target conditions and types of recommendations for self-care recommendations.

Gynaecological disorders and human immunodeficiency virus infection.

It is increasingly apparent that the differences in the prevalence and severity of various gynaecological conditions are a function of immunosuppression and differences in behavioural factors, rather than a direct effect of HIV itself. Women infected with HIV will present with their gynaecological disorders initially to their carers in both primary care and genitourinary medicine clinic settings. It is therefore essential that all those involved in the management of these women are aware of the interactions between HIV infection, immunosuppression and various gynaecological conditions so that they may be appropriately managed.

Menstrual symptoms in women infected by the human immunodeficiency virus.

OBJECTIVE: To determine whether there is a higher prevalence of menstrual symptoms in women seropositive for the human immunodeficiency virus (HIV) compared to a matched control group and to examine the relation between menstrual symptomatology and immunosuppression. METHODS: In a cross-sectional study, 55 HIV-seropositive women and a matched control group underwent detailed gynecologic assessment. The prevalence of regular cycles, oligomenorrhea, amenorrhea, menorrhagia, dysmenorrhea, and dyspareunia was assessed in the two groups. Any association with clinical disease or CD4 lymphocyte count was sought. RESULTS: There were no significant differences in the prevalence of oligomenorrhea, amenorrhea, menorrhagia, dysmenorrhea, or dyspareunia between the groups. Furthermore, no differences were demonstrated between symptomatic and asymptomatic women infected by HIV, nor was any correlation found between CD4 lymphocyte count and menstrual loss or dysmenorrhea. CONCLUSION: Infection with HIV and related immunosuppression do not seem to have a clinically significant effect on menstruation.

HIV infection and the gynaecologist.

PIP: As women infected with human immunodeficiency virus (HIV) will soon account for 1 in 500 gynecological patients in Great Britain, gynecologists have an obligation to become informed about the transmission, clinical manifestations, and management of HIV. Women with HIV infection are at increased risk of lower genital tract neoplasia with extensive cervical, vaginal, and vulvar lesions. There is also a strong association between HIV infection and sexually transmitted diseases involving genital ulcerations. In fact, herpes, warts, and candidiasis may be the initial clinical presentation of HIV infection. Estradiol levels may fall in seropositive women, but, in general, menstruation and ovulation are maintained. Latex condoms remain the only contraceptive choice for HIV-infected women. Sufficient data have not been accumulated on the effectiveness of the female condom, but it has the potential of giving women in developing countries in particular greater control over HIV prevention. Condom use is essential even if both partners are HIV-positive since the acquisition of different HIV strains can accelerate disease progression. Given their higher risk of percutaneous in injury compared to other surgeons, gynecologists should use double gloving and blunt tipped needles and staples.^ieng

Women with HIV presenting at three London clinics between 1985-1992.

OBJECTIVE: To determine the changing patterns of HIV infection in women in three units in London. SUBJECTS: Three hundred and fifty seven HIV seropositive women who have attended outpatient clinics between 1984 and 1992. METHODS: A retrospective review of data obtained from a computerised database and supplemented by direct inspection of the notes. RESULTS: The number of newly identified women with HIV has risen steadily over the period of study with a significant shift towards a heterosexual mode of transmission. This is a reflection of increasing numbers of women from Sub-Saharan Africa rather than a rise in the incidence of HIV in women born in the UK. CONCLUSIONS: The increase in women infected by HIV remains predominantly restricted to women in "high risk" groups. Although encouraging, our data should be interpreted with caution since it suffers from the inherent bias of selective testing. Safer sex education and epidemiological surveillance should continue despite the apparent low risk to women born in the UK.

Steroid receptors in breast cancer in Indian women.

The distribution of receptors for estradiol (ER), progesterone (PgR) and androgens (DHTR) in 104 primary and 49 metastatic breast tumours from Indian women is herein being reported for the first time. When compared to reports in the literature, a lower percentage (47%) of ER (+) tumours and a higher percentage (49%) of DHTR (+) tumours were observed. There were more ER (-) tumours in premenopausal as compared to postmenopausal women, and more ER (-) tumours had lymph node metastases at the time of surgery. Both these correlations were statistically significant.

Effect of melatonin on mammary carcinogenesis in intact and pinealectomized rats in varying photoperiods.

Exposure of female Holtzman rats to constant light (24 hr/day) immediately after birth significantly increased 9, 10-dimethyl-1,2-benzanthracene-induced mammary cancer. Such "functionally pinealectomized" animals also revealed significant increase in the circulating level of prolactin and exaggerated development and proliferative activity of mammary epithelium, as measured by quantitation of terminal end buds and alveolar buds from the whole mounts and by DNA synthesis, respectively. Administration of melatonin (500 micrograms/day/rat i.p. given from 52 to 145 days of age) completely abolished the effect of functional pinealectomy by sharply reducing 9, 10-dimethyl-1,2-benzanthracene-induced cancer incidence from 95% to 25% during the post-9, 10-dimethyl-1,2-benzanthracene observation period which lasted up to 180 days. On the other hand, administration of melatonin to surgically pinealectomized animals exposed to constant light reversed the effect only partially by reducing the cancer incidence from 83% to 53%. Further, melatonin treatment in intact and surgically pinealectomized animals exposed to a short photoperiod revealed qualitatively similar differences in suppression of the cancer incidence. From these results, it is concluded that, to have an impressive antitumor effect, presence of the pineal gland is essential, and the probable site of melatonin action appears to be at both the pineal gland and the hypothalamus.

Effect of varying photoperiods on mammary morphology, DNA synthesis, and hormone profile in female rats.

A clear positive correlation between circulating levels of prolactin (Prl) and morphologic development as well as DNA synthetic index in the mammary gland was established in young virgin Holtzman rats exposed to constant light from birth. The observed elevated level of circulating Prl by virtue of its morphogenic and mitogenic properties induced changes in mammary epithelium [numerous actively differentiating terminal end buds into alveolar buds (AB)] highly susceptible for the action of 7,12-dimethylbenz[a]anthracene [(DMBA) CAS: 57-97-6]. Conversely, substitution treatment with melatonin in such a model caused a significant decrease in both Prl and 17 beta-estradiol (E2) levels as well as in the morphologic and DNA synthetic pattern of the mammary gland. Administration of 2-bromo-alpha- ergocryptin in these animals caused a significant decrease in the plasma level of Prl (without affecting the level of E2) and a decrease in the density of AB and in DNA synthesis. These changes impaired the mammary gland responsiveness to DMBA as seen from the significant decrease in the incidence of mammary carcinoma.

Pineal ablation in varying photoperiods and the incidence of 9,10-dimethyl-1,2-benzanthracene induced mammary cancer in rats.

Our earlier observation of increased incidence of 9,10-dimethyl-1,2-benzanthracene (DMBA) induced mammary carcinoma in young, virgin 'functionally' pinealectomized Holtzman rats poses the question whether or not a comparable incidence would occur in surgically pinealectomized rats reared in varying photoperiods (e.g. light/dark (LD) 24/0 or LD 10/14 schedules). Results show that functionally or surgically pinealectomized rats in LD 24/0 schedule have comparable mammary tumor incidence (95% and 83%, respectively) and latency period of tumor appearance (60 +/- 3.1 and 69.2 +/- 6.6 days, respectively). However, when surgically pinealectomized rats were kept in short photoperiods (LD 10/14), a significant difference was observed in both tumor incidence (60.9%) and latency period (91.8 +/- 11.0 days). Our data suggest that the susceptibility of the mammary gland to carcinogenic insult may be modulated by the concentration of the pineal hormone, melatonin, in the CNS.

Barr body frequency in esophageal cancer in Indian women.

In a retrospective study, Barr body frequency was analyzed in 50 consecutive cases of esophageal cancer in females. The majority (95%) of the tumors had less than 20% Barr body frequency (of which 80% showed less than 10%), while normal controls showed 30% to 45% Barr body frequency. The mechanism(s) involved in lowering the frequency is not known at present.