The goal of this work was to examine the use of simplified diode detector models within a recently proposed Monte Carlo (MC) based small field dosimetry formalism and to investigate the influence of electron source parameterization has on MC calculated correction factors. BEAMnrc was used to model Varian 6 MV jaw-collimated square field sizes down to 0.5 cm. The IBA stereotactic field diode (SFD), PTW T60016 (shielded) and PTW T60017 (un-shielded) diodes were modelled in DOSRZnrc and isocentric output ratios (OR(fclin)(detMC)) calculated at depths of d = 1.5, 5.0 and 10.0 cm. Simplified detector models were then tested by evaluating the percent difference in (OR(fclin)(detMC)) between the simplified and complete detector models. The influence of active volume dimension on simulated output ratio and response factor was also investigated. The sensitivity of each MC calculated replacement correction factor (k(fclin,fmsr)(Qclin,Qmsr)), as a function of electron FWHM between 0.100 and 0.150 cm and energy between 5.5 and 6.5 MeV, was investigated for the same set of small field sizes using the simplified detector models. The SFD diode can be approximated simply as a silicon chip in water, the T60016 shielded diode can be modelled as a chip in water plus the entire shielding geometry and the T60017 unshielded diode as a chip in water plus the filter plate located upstream. The detector-specific (k(fclin,fmsr)(Qclin,Qmsr)), required to correct measured output ratios using the SFD, T60016 and T60017 diode detectors are insensitive to incident electron energy between 5.5 and 6.5 MeV and spot size variation between FWHM = 0.100 and 0.150 cm. Three general conclusions come out of this work: (1) detector models can be simplified to produce OR(fclin)(detMC) to within 1.0% of those calculated using the complete geometry, where typically not only the silicon chip, but also any high density components close to the chip, such as scattering plates or shielding material is necessary to be included in the model, (2) diode detectors of smaller active radius require less of a correction and (3) (k(fclin,fmsr)(Qclin,Qmsr)) is insensitive to the incident the electron energy and spot size variations investigated. Therefore, simplified detector models can be used with acceptable accuracy within the recently proposed small field dosimetry formalism.

This study investigated the amount of energy available to growing pigs from fermentation of dietary fiber in the hindgut. Eighteen growing barrows, fitted with a simple T-shaped cannula at the terminal ileum, were allocated to 3 experimental diets in a completely randomized design. The 3 diets were a standard-fiber diet (SFD), which contained 75.1 g NDF/kg diet; a medium-fiber diet (MFD) of 105.7 g NDF/kg diet; and a high-fiber diet (HFD), which contained 146.9 g NDF/kg diet. Each diet had 6 replicate pigs. After a 5-d period of adjustment of the pigs to the cage environment, feces were collected on d 6 and 7 and ileal digesta on d 8 and 9 and subsequently freeze-dried. Fecal slurry from a pig was used to inoculate the ileal digesta from the same pig. The amount of energy available was calculated from the amount of short-chain fatty acids (SCFA) produced from a 48-h in vitro fermentation of the ileal digesta. Increasing NDF enhanced ( < 0.01) the ileal DM flow and DM in feces. The energy available in the foregut was reduced ( < 0.05) from 3,360 to 2,974 kcal/kg feed DM and increased ( < 0.01) from 619 to 1,009 kcal/kg feed DM produced in the hindgut with increasing dietary NDF. The amount of SCFA increased ( < 0.01) with higher dietary NDF. Acetic acid was highest ( < 0.01) in the HFD whereas propionic and valeric acids were highest ( < 0.05) in the SFD. The amount of butyric acid was not affected by diet. The amount of energy contributed from SCFA fermentation to total tract digestible energy increased ( < 0.01) from 10.7 to 24.2% as dietary NDF level increased from 75 to 147 g/kg feed. The results of the study showed that increasing level of dietary NDF resulted in reduced energy digestibility in the foregut of growing pigs with a corresponding increase in the amount of energy from microbial fermentation in the hindgut.

Twenty-two small for dates (SFD) fetuses and 96 fetuses from uncomplicated pregnancies were monitored on two occasions between 27 and 32 weeks and the second time between 33 and 36 weeks of gestation by studying the development of behavioural states (coincidence 1F and 2F; no coincidence) and umbilical artery Doppler waveform patterns (UA; Resistance Index, RI). Data were related to neurological outcome at 8 months after birth. The purpose of this study was to investigate if the development of behavioural state is disturbed in SFD fetuses and if SFD fetuses who needed to be delivered early and/or had abnormal neurological outcome showed different state development and RI than SFD fetuses delivered later in pregnancy or with normal neurological outcome. Finally, we studied if there was a relationship between state development and RI. At 27-32 weeks of gestation the percentage of coincidence 2F (C2F%) was lower and the percentage of coincidence 1F (C1F%) and no coincidence (NOC%) were higher in the SFD fetuses than in the control group. At 33-36 weeks C2F% was lower and NOC% was higher but not statistically different (P = 0.2 and P = 0.07, respectively). SFD fetuses who needed to be delivered early had poorer state development than SFD fetuses at lower risk and infants who were abnormal at 8 months of life showed a higher C1F% and lower C2F% at 27-32 weeks. There were significant correlations between RI on the one hand and NOC% (r = 0.62) and C2F% (r = -0.48) on the other hand at 27-32 weeks in the subgroup with abnormal neurological outcome. In conclusion, in SFD fetuses there are disturbances in the development of behavioural states as well in the distribution of the periods of coincidence (with a decrease in C2F% and an increase in C1F%). Poorest state development is present in SFD fetuses at highest risk and in this group there appears to be a significant relationship between the degree of utero-placental insufficiency (RI) and disturbances in behavioural development.

Insulin-like growth factor-I (IGF-I) is one of growth factors that circulates bound to specific, high affinity binding proteins (IGFBPs). Physiological significance of IGF-I and IGFBPs on fetal growth is investigated in this study. In mother, circulating levels of IGF-I are increased during pregnancy in which placental hormones take the place of pituitary GH to regulate IGF-I during pregnancy and correlates with fetal birth weight. IGFBPs except IGFBP-1 in the maternal circulation are markedly reduced compared to those of non pregnant women due to increased activity of protease(s) while IGFBP-1 gradually increased throughout pregnancy and negatively correlates with fetal weight. IGF-I stimulated 3H-AIB uptake and release by cultured trophoblast cells in a dose dependent manner. Furthermore, fetal growth and the transfer of 3H-AIB to fetus is inhibited when IGF-I is neutralized by polyclonal antibody. These results indicate that maternal IGF-I stimulates fetal growth by activating placental transport of nutrients to fetus. In contrast, IGFBP-1 inhibits both 125I-IGF-I binding to placental membrane and 3H-glycine uptake of trophoblast cells by IGF-I in a dose dependent manner. Moreover, fetal growth and the transfer of 3H-AIB to fetus are accelerated when IGFBP-1 is neutralized by polyclonal antibody, suggesting that maternal IGFBP-1 inhibits fetal growth by inhibiting IGF-I action on the placenta. IGF-I and four IGFBPs including IGFBP-1, -2, -3, and -4 are localized in cytotrophoblast of term placenta. Similarly IGFBP-1, -2, and -4 are detected in medium conditioned by term decidua cells by Western ligand blot in which release of IGFBP-1 and -4 are diminished by IGF-I and all three IGFBPs are increased by progesterone. Thus, there is a complicated autocrine/paracrine regulation between decidua and placenta and IGF-I action on fetal growth is presumed to be modified by this local regulation. Fetal levels of IGF-I and IGFBP-1 are positively and negatively correlate with fetal weight, respectively. The isomers of phosphorylated IGFBP-1 in cord sera are separated by anion ion exchange chromatography in which one nonphosphorylated and four phosphorylated IGFBP-1 are detected. In pared blood samples from mid-term delivery, percentage of nonphosphorylated IGFBP-1 is higher in fetal blood compared to those in mother. Similarly, percentage of nonphosphorylated IGFBP-1 is elevated in AFD infants than is SFD infants from term delivery. Thus, the proportion of nonphosphorylated and phosphorylated isomers of IGFBP-1 varies corresponding to fetal growth.(ABSTRACT TRUNCATED AT 400 WORDS)

Knowledge of rice genome brings new dimensions to the management of abiotic stresses; however, gene sequences in the rice genome are yet to be assigned structure and function. Hydrogen peroxide, salicylates and jasmonates act as signal molecules in plants employing common machinery to manage abiotic stress. The present work is primarily focused to assign a structurefunction relationship by modeling of the hypothetical proteins of SA-JA signaling pathway known in Arabidopsis thaliana and compare them with corresponding proteins in rice in silico. Thirteen known gene sequences with their encoded proteins for SA/JA pathway in model plant A. thaliana were obtained and similar gene sequences from rice were retrieved at NCBI. Five rice gene sequences Os09g0392100, Os03g0233200, OsJ_33269, OsJ_23610 and Os01g0194300 resulted in hypothetical protein products with unknown structure and function. Modeling and comparison of 5 proteins from rice and Arabidopsis showed 73 - 98% identity with acceptable RMSD values of 0.6 - 1.7 upon superimposition. Results suggest conserved nature of these proteins during evolution. The hypothetical protein from rice contains similar functional protein domain as that in A. thaliana and therefore are likely to perform similar functions in rice. There is a cross talk between the genes in SA/JA pathway wherein Os09g0392100 or EDS1, Os03g0233200 or PR5, OsJ_33269 or PAD4 and OsJ_23610 or SFD-1 activates the pathway and Os01g0194300 or NPR1 inhibit the pathway. Further investigation through wet-lab experiments are in progress to look into suppression/activation of the genes of SAJA signaling in rice plants exposed to abiotic stress.

OBJECTIVE

To compare the efficiency of the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD) with venlafaxine in comparison with tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI).

METHODS

A bibliographic systematic review of the published pharmacoeconomic studies in which one of the treatments was venlafaxine (immediate or extended-release) was conducted for MDD or GAD indications.

RESULTS

Nine studies for immediate-release venlafaxine and seven with extended-release in MDD were published, two with Spanish data. In the more extended Spanish model (1 year treatment), in depressive disorder, 106, 97 and 99 depression symptom free days (SFD) were achieved by venlafaxine, TCA and SSRI respectively, with annual costs of 6,791, 7,116 and 7,029 euros. Similar results were obtained in the second Spanish 6 month study. Regarding GAD, after the treatment of elderly patients during 8 weeks, 17 and 5 SFD were obtained with venlafaxine and placebo, with a cost per SFD of 22.94 and 65.40 euros, respectively.

CONCLUSIONS

According to the available studies, venlafaxine generates lower total costs (due to the reduction of treatment failure costs) than SSRI and TCA for the treatment of MDD. Venlafaxine is cost-effective in comparison with no treatment for GAD.

Retrospective examinations of 8,139 placentae were performed to clarify the relationship between placental disorders with massive intervillous fibrin deposition (MIFD) and intrauterine growth retardation (IUGR). Although the incidence of MIFD was low (0.4%), the small-for-date (SFD) birth rate in the MIFD group was significantly higher than that in the control group (62.9 vs. 8.3%; p < 0.001). Seventeen of 35 patients in the MIFD group had no clinical complications. MIFD itself was thought to be the main cause of IUGR in these patients. 78.4% of multiparae in the MIFD group have unsuccessful obstetrical histories such as intrauterine fetal death and fetal growth retardation. Four of 6 patients with a history of MIFD and SFD delivery in a previous pregnancy repeated the same episode. These data indicate that the MIFD recurrence rate in subsequent pregnancies must be high. Patients with a history of both SFD delivery and MIFD in previous pregnancies were defined as high-risk patients and they were given orally 30 mg of aspirin and 150 mg of dipyridamole daily and/or daily intravenous injection of 10,000 IU heparin during pregnancy. As a result, MIFD did not recur in all cases of the treated group and 87.5% (7/8) of the treated group could deliver approximate-for-date infants compared with 33.3% (2/6) of the untreated group (p < 0.05). These results indicate that anticoagulant and antiplatelet therapies are extremely effective for prevention of MIFD and IUGR due to MIFD.

Serum concentrations of copper (Cu) and zinc (Zn) were determined in 20 non-pregnant healthy menstruating women and in 20 pregnant women during the 1st, 2nd and 3rd trimesters and 5 weeks postpartum as a longitudinal study. Also a cross-sectional population of 106 women was studied. Further, Cu and Zn concentrations were measured in 13 pregnant women who gave birth to small-for-date (SFD) infants; this was done during the 3rd trimester of pregnancy. The serum Cu concentration in nonpregnant women was 0.91 +/- 0.19 mg/l. During pregnancy it was significantly higher (1.48 +/- 0.31, 1.91 +/- 0.25 and 2.20 +/- 0.36 mg/l during the 1st, 2nd and 3rd trimesters, respectively) and 5 weeks postpartum it was still higher (1.09 +/- 0.17 mg/l) than in the nonpregnant women. In the cross-sectional population, serum Cu and Zn values were of the same magnitude as in the longitudinal study. When longitudinal and cross-sectional values of serum Cu during the 3rd trimester were combined, the mean level (2.23 +/- 0.40 mg/l) was significantly higher than that in the SFD group (2.06 +/- 0.25 mg/l). Serum Zn in the SFD group (0.48 +/- 0.12 mg/l) did not differ significantly from the normal pregnant values.

A retrospective study.

The aim of this study was to identify the relationships between radiological findings and the presence of stooping in lumbar degenerative kyphosis (LDK).

Many studies have addressed fixed sagittal imbalances and surgical treatments. However, information regarding the relationship between radiological findings and stooping in LDK is sparse.

The study included 73 patients with LDK and 44 with normal lumbar lordosis. Of those with LDK, 63 patients exhibited stooping (group 1) and 10 did not (group 2). Of those with 44 normal lumbar lordosis, 13 patients exhibited stooping (group 3) and 31 patients did not (group 4). Radiographic parameters such as sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), horizontal distance between C7 plumb line and the posterosuperior corner of the sacrum (C7PL), sacrofemoral distance (SFD), C7PL/SFD ratio (C7/SFD), spinosacral angle (SSA), spinopelvic angle (SPA), C2-C7 lordosis (CL), C2-C7 sagittal vertical axis (C2-C7 SVA), T1 slope, and T1 slope minus C2-C7 lordosis (TS-CL) were analyzed.

Significant differences were observed in TK, LL, C7PL, SFD, C7/SFD, PT, SS, SSA, SPA, C2-C7 SVA, and TS-CL between LDK and normal lumbar lordosis, but no significant intergroup difference was observed in PI, CL, or T1 slope. These results showed that groups 1 and 3 had higher C7PL, C7/SFD, PT, and CL values than groups 2 and 4. Logistic regression analysis revealed that C7/SFD and CL could significantly predict stooping in LDK.

C7/SFD and CL predict the presence of stooping in LDK. Furthermore, patients with LDK with compensatory mechanisms to maintain sagittal balance have low C7PL values, that is, C7/SFD < 0.5 and high PT and CL on upright whole spine lateral radiography.

3.

A total of 2288 infants were screened for hematocrit over a period of 15 months. Polycythemia was diagnosed in 27 cases (1.2%). Preterm and term babies had more or less equal risk to develop polycythemia (1.5% and 1.1% respectively) while postterm infants had at least three times increased risk (3.4%) when compared to their term counterparts. Large-for-dates (LFDs) and small-for-dates (SFDs) infants had increased risk of manifesting polycythemia which was nearly four times (2.2%) and twenty-five times (13.2%) respectively, as compared to appropriate-for-dates (AFDs) babies (0.5%). About one-third of polycythemic infants had one or more symptoms. The most common symptoms observed was jitteriness (25.9%) followed by respiratory distress (14.8%) and lethargy (11.1%). The mean (+/- SD) hematocrit of symptomatic newborns (76.0 +/- 4.04) was found to be significantly higher (p less than 0.001) as compared to asymptomatic babies (70.84 +/- 2.73). Partial exchange transfusion with plasma was performed in all the symptomatic cases within 8 hours of onset of symptoms. No such intervention was performed in asymptomatic cases. On neurodevelopment follow-up, the development indices (MDI and PDI) of both asymptomatic and symptomatic cases were found to be comparable.

The purpose of the current study is to describe the demographic and clinical characteristics and health care use of medically hospitalized patients with eating disorders (ED) and somatoform disorders (SFD) in a pediatric setting and to use the findings to explore opportunities for improved care.

Retrospective chart reviews of 125 patients with SFD and 125 patients with ED (N = 250) seen at a tertiary pediatric facility over a 12- and 19-month period, respectively.

Patients in both groups were predominantly girls, white, came from households with above average incomes, and had academic pressures, internalizing coping styles, and high rates of anxiety disorders. Compared with SFD patients, ED patients had longer medical admissions (P < .001), more depressive disorders (P < .01), higher lifetime rates of suicidal ideation and self-injurious behaviors (P < .05), and were more frequently discharged to intensive psychiatric treatment programs (P < .001). SFD patients were referred later to psychiatry (P < .001), had more emergency department visits (P < .001) and more visits to other hospitals (P < .05) and also had higher rates of learning difficulties (P < .001), bullying (P < .05), and trauma (P < .01) compared with ED patients.

Identifying overlapping features and key differences in the clinical characteristics and health care use of patients with primary psychiatric disorders like ED and SFD, who are frequent users of medical services, is the first step toward developing innovative, integrated hospital-based care approaches and clinical pathways that can reduce service utilization and improve patient outcomes.

Spray freeze drying (SFD) was used to prepare re-dispersible powders of crystalline, pure-drug nanodispersions of naproxen in lactose and stabilized with hydroxypropyl cellulose. The particle size of the rehydrated powders was determined using static light scattering/Mie analysis. The nanoparticles present in the SFD powders were aggregated but could be dispersed on re-dispersion with water and stirring either with or without additional ultrasonic treatment. The disaggregation of the SFD nanoparticles was superior to that reported in the literature for spray dried nanoparticles of the same composition. It appears that the moderately-rapid freezing of the large spray droplets in LN2 during SFD produces less aggregation than does evaporative drying of the much smaller droplets during spray drying. Re-dispersion was also found to depend strongly on the pH of the original nanodispersion. The solubility of this weak acid is greater at higher pH which resulted in formation of a dissolved fraction of drug in the nanodispersions during media milling. After SFD, the dissolved naproxen fraction formed an amorphous solid which re-dissolves on re-hydration whereas the crystalline nanoparticles disaggregate.

The gastric residual (GR) volume was measured in 50 healthy preterm babies, 38 appropriate-for-dates (AFD), and 12 small-for-dates (SFD) with gestational age of 28-36 weeks. The mean basal 4-hour gastric residual (B4 GR) volume was 2.8 +/- 0.63 ml in parenterally fed babies. There was a marked decrease in the residuals from 20.7 +/- 15.2 per cent (mean +/- SD) on day 4 to 8.6 +/- 4.3 per cent on day 7 (P < 0.001). Of the 27 infants fed with expressed breastmilk (EBM), mean GR was 24.4 +/- 10.2 per cent in supine and 12.8 +/- 4.3 per cent in prone position (P < 0.01). Twenty-one babies nursed in the prone position showed a mean GR volume of 12.8 +/- 4.3 per cent with EBM and 13.6 +/- 2.7 per cent with milk formula. No difference was noted in the gastric residuals of AFD v. SFD babies. No linear correlation was found between increase in abdominal girth and GR. However, if the increase in abdominal girth was at least 2 cm or more, a GR of 23 per cent or more was observed. This should be taken as warnings to reduce or withhold oral feeds.

This study to evaluate the performance of eight diagnostic tests for HIV/AIDS infection was conducted at the National Reference Center for HIV/AIDS/STD in Lomé, Togo. The tests were as follows: Enzymum test anti HIV Combi, Enzymum tests anti-HIV1 + 2 + subtype O, Genscreen HIV 1/2, Ice 1.0.2, Vironostika HIV Uni-Form II Plus O, Genie II HIV 1/2, SFD HIV 1/2 PA and DETERMINE HIV 1/2. A total of 238 serum specimens collected consecutively between January and April 1999 were studied. They were from 161 occasional blood donors and 77 patients. New Lav-Blot I and Ii (western blot) were used as reference tests. Test sensitivity ranged from 90 to 100%. Specificity ranged from 96 to 100%. The Enzymum test anti HIV Combi used only on serum samples from blood donors demonstrated a sensitivity and specificity of 100%. Tests based on Elisa (Emzymum Combi, Enzymum HIV 1 + 2 + subtype O, Genscreen, Ice 1.0.2 and Vironostika) allowed acceptable diagnosis of HIV/AIDS as alternatives to western blot. Two of the three rapid assays tested provided acceptable results, i.e., Genie II HIV 1/2 and SFD HIV 1/2. They are suitable for screening to prevent HIV transmission by blood transfusion in areas where Elisa is unfeasible.

The digital imaging and communications in medicine (DICOM) information model combines pixel data and its metadata in a single object. There are user scenarios that only need metadata manipulation, such as deidentification and study migration. Most picture archiving and communication system use a database to store and update the metadata rather than updating the raw DICOM files themselves. The multiseries DICOM (MSD) format separates metadata from pixel data and eliminates duplicate attributes. This work promotes storing DICOM studies in MSD format to reduce the metadata processing time. A set of experiments are performed that update the metadata of a set of DICOM studies for deidentification and migration. The studies are stored in both the traditional single frame DICOM (SFD) format and the MSD format. The results show that it is faster to update studies' metadata in MSD format than in SFD format because the bulk data is separated in MSD and is not retrieved from the storage system. In addition, it is space efficient to store the deidentified studies in MSD format as it shares the same bulk data object with the original study. In summary, separation of metadata from pixel data using the MSD format provides fast metadata access and speeds up applications that process only the metadata.

OBJECTIVE

To probe the relationship of glucocorticoid receptor and some Chinese medicinal herbs.

METHODS

The models of Qi-Yang exhaustion and Qi-Yin exhaustion were made with hemorrhagic rats and heat-stressed rats respectively. The effect of Shenfu Decoction (SFD) and Shengmai Powder (SMP) on plasma glucocorticoid (GC) and its receptor (GcR) in hepatic cytosol of the models were measured respectively.

RESULTS

The activity of GcR decreased in both models, while their blood level of GC increased markedly. SFD and SMP showed no regulating effect on blood GC, but displayed obvious up-regulation on GcR level in both models.

CONCLUSIONS

SFD and SMP could up-regulate the activity of GcR in Qi-Yang and Qi-Yin exhaustion models.

OBJECTIVE

The aim of this study was to determine whether there was a correlation between auditory steady-state responses (ASSRs) for complex toneburst stimuli and speech feature discrimination (SFD) abilities in young infants.

METHODS

Seventeen infants (mean age = 9.4 months) and 21 adults (mean age = 27 years) with normal hearing had ASSR and SFD tests.

METHODS

The ASSR test employed an eight-component complex toneburst stimulus; threshold and input-output functions were determined as level was systematically varied. The SFD test utilized an observer-based, visual-reinforcement test procedure to determine the infant's ability to detect the speech feature change from /ba/ to /da/.

RESULTS

The correlation of the group mean /ba/-/da/ discrimination performance (percent correct) with the group mean ASSR score (percent responses present) ranged from r = 0.64 for the 1500 Hz amplitude-modulated and frequency-modulated tone burst to 0.99 for ASSRs for all stimulus components; however, correlations between ASSRs and SFD scores for individual subjects were modest.

CONCLUSIONS

The ASSR and SFD results appear to reflect the audibility of the stimuli.

BACKGROUND

Schizophreniform disorder (SFD) has an unclear diagnostic and prognostic status within the psychotic spectrum.

METHODS

We studied 36 inpatients admitted to our ward between 1983 and 1993 due to SFD. The patients were contacted an average of 12 years after index hospitalization, and we noted the course of their illness, as well as their present diagnosis.

RESULTS

Of the sample, 84% had additional, mostly psychotic, episodes during the follow-up, and 70% had diagnoses in the schizophrenic spectrum (that is, schizophrenia and schizoaffective disorder). A survival analysis revealed that confusion and the presence of at least 2 good prognostic factors (GPF) at index hospitalization predicted better outcome.

CONCLUSIONS

SFD seems to be an early manifestation of schizophrenia. Only a few of those sampled did not experience additional relapses--a pessimistic finding at 12-year follow-up. The findings of this study accord with DSM-IV criteria and the literature regarding the long-term prognosis of SFD and the importance of the GPF.

The purpose of this study was to investigate cortisol levels as a function of the hypothalamic-pituitary-adrenal axis (HPA) in relation to alexithymia in patients with somatoform disorders (SFD). Diurnal salivary cortisol was sampled in 32 patients with SFD who also underwent a psychiatric examination and filled in questionnaires (Toronto Alexithymia Scale, TAS scale; Screening for Somatoform Symptoms, SOMS scale; Hamilton Depression Scale, HAMD). The mean TAS total score in the sample was 55.6+/-9.6, 32% of patients being classified as alexithymic on the basis of their TAS scores. Depression scores were moderate (HAMD=13.2, Beck Depression Inventory, BDI=16.5). The patients' alexithymia scores (TAS scale "Difficulty identifying feelings") correlated significantly positively with their somatization scale scores (Symptom Checklist-90 Revised, SCL-90-R); r=0.3438 (P<0.05) and their scores on the Global Severity Index (GSI) on the SCL-90-R; r=0.781 (P<0.01). Regression analysis was performed with cortisol variables as the dependent variables. Cortisol levels [measured by the area under the curve-ground (AUC-G), area under the curve-increase (AUC-I) and morning cortisol (MCS)] were best predicted in a multiple linear regression model by lower depressive scores (HAMD) and more psychopathological symptoms (SCL-90-R). No significant correlations were found between the patients' alexithymia scores (TAS) and cortisol levels. The healthy control group (n=25) demonstrated significantly higher cortisol levels than did the patients with SFD; in both tests P<0.001 for AUC-G and AUC-I. However, the two groups did not differ in terms of their mean morning cortisol levels (P>0.05). The results suggest that pre-existing hypocortisolism might possibly be associated with SFD.

Components of complement (protein concentrations of C1q, C3, C3-activator, C4, C5 and C9 and whole complement (hemolytic activity)) were measured in sera from full-term small-for-date (SFD) and appropriate-for-date (AFD) infants and their mothers. (1) Half the SFD infants showed lower C1q levels than the AFD infants. (2) SFD infants showed the same levels of C3 as AFD infants. (3) Although SFD infants showed slightly higher levels of C3-activator than AFD infants, there was no significant difference. (4) SFD infants and AFD infants showed the same level of C4. (5) With respect to C5, half the SFD infants showed lower levels than the AFD infants. (6) Levels of C9 in the SFD infants were essentially the same as those in the AFD infants. (7) The amount of protein in every complement component of an infant was smaller than that of the mother. In AFD infants, the infant-maternal ratios were 0.64 for C1q, 0.45 for C3, 0.29 for C3-activator, 0.43 for C4, 0.54 for C5 and 0.12 for C9. (8) The whole complement titers of umbilical cord sera from the AFD infants were approximately one half of those of the maternal sera. This is due to the smaller amount of complement protein itself in the infant sera. (9) The whole complement titers of umbilical cord serum agreeably correlate with gestational weeks and birth weight of the infants. (10) The whole complement titer in full-term SFD infants was lower than that in normal full-term AFD infants.

The recent appreciation of the energy burning capacity of brown adipose tissue turns it to an attractive target for anti-obesity therapy. We sought to evaluate the effect of L-carnosine on browning of white adipose tissue in exercised obese rats. Sixty adult male Wistar albino rats, 7-8 week-old weighing 130-150 g, were allocated into six groups; with 10 rats in each, for an experimentation period of 12 weeks: (i) normal control rats fed a standard fat diet (SFD/control), (ii) normal control rats fed a standard diet and injected with L-carnosine (250 mg/kg, i.p,) for 6 weeks (SFD/CAR), (iii) high-fat diet (HFD)-induced obese rats for 12 weeks, (iv) HFD rats subjected to exercise training (HFD/EXE) for 6 weeks, (v) HFD rats injected with L-carnosine (250 mg/kg,i.p.) for 6 weeks (HFD/CAR) and, (vi) HFD rats subjected to exercise training and L-carnosine (HFD/EXE/CAR). At the end of the 12-week-experiment, the body weights and the serum levels of lipid profile, oxidative stress, and inflammatory markers as well as circulating myokines were investigated. Gastrocnemius muscles and inguinal adipose tissues were excised for the measurement of gene expression of muscle irisin, adipose tissue uncoupling protein1 (UCP1), CD137 and the protein level of p38MAPK. In addition, histopathological examination for the studied groups was performed. Both exercise training for 6 weeks and carnosine treatment significantly decreased body weight gain, ameliorated obesity-induced dyslipidemia, reduced the thiobarbituric acid reactive species (TBARS) and TNF-α, while increased total antioxidant capacity and IL-10. Furthermore, increases in serum irisin levels and the expression of adipose uncoupling protein-1 (UCP-1), adipose CD137, p38 MAPK, and muscular fibronectin type III domain-containing protein 5(FNDC5), the precursor of irisin gene expression, were correlated with these carnosine- and exercise-induced physiological improvements. The highest improvement was evident in the combined exercise and carnosine group which indicates that their beneficial effects in obese animals were synergistic. These findings suggest that L-carnosine may induce browning of adipose tissue through irisin stimulation, a phenomenon that could be related to its antioxidant, anti-inflammatory, and anti-obesity effects.

OBJECTIVE

To describe two Japanese families with Sorsby's fundus dystrophy (SFD) with unusual clinical features.

METHODS

Two families from Kagoshima Prefecture with senile-onset macular dystrophy were examined. Three affected individuals through three successive generations of one family and three affected siblings in another family were examined and followed.

RESULTS

The initial symptom of these patients was a rapid or slow central visual loss that occurred at an average age of 67.4 years. The major ophthalmoscopic changes consisted of soft drusen and hemorrhagic or atrophic lesions in the macula, which were progressive and ultimately led to disciform scarring. They had no difficulty with night vision. All the patients had normal peripheral retina with intact peripheral fields. They maintained good ambulatory vision and could walk unguided until late in life. These patients had a novel mutation in the tissue inhibitor of the metalloproteinases-3 (TIMP3) gene.

CONCLUSIONS

This is the first report of SFD from the East. Its clinical features differ from those of SFD patients of the West, appearing closer to features of age-related macular degeneration. These two unrelated Japanese families with an identical mutation in the TIMP3 gene might be descendants of a common ancestor who carried the mutant gene.

OBJECTIVE

We aimed to determine whether S100B protein levels in cord blood and the development of fetal behavioral states were altered and interrelated in small-for-dates (SFD) fetuses.

METHODS

Umbilical cord blood samples were collected from 12 SFD fetuses with normal umbilical artery (UA) Doppler findings, from six SFD fetuses with abnormal Doppler waveform patterns and from 36 controls matched for gestational age. S100B protein levels were measured by means of a specific radioimmunoassay. Fetal behavioral state recordings were made before delivery by Cesarean section and data were expressed as percentage of quiet sleep coincidence (C1F), of activity state coincidence (C2-4F) and of no coincidence (NOC). Flow velocimetry waveforms were recorded from the uterine artery, UA and fetal middle cerebral artery (MCA).

RESULTS

Mean S100B protein levels in umbilical plasma were significantly higher in the six SFD infants with abnormal prenatal Doppler findings (3.31 +/- 0.65 microg/l) than in SFD infants with normal Doppler findings (1.56 +/- 0.35 microg/l) and in controls (1.23 +/- 0.43 microg/l). Similarly in these fetuses NOC was higher and C2F significantly lower (p < 0.05), but there was no significant difference in C1F. S100B concentrations were correlated with the UA pulsatility index (PI) (r = 0.78, p < 0.01), with the MCA PI (r = -0.78, p < 0.01) and with the UA PI/MCA PI ratio (r = 0.80, p < 0.01). Also, NOC and C2F percentages were correlated with the UA PI (r = 0.61, p < 0.01 and r = -0.61, p < 0.01, respectively), with the MCAPI (r = -0.72, p < 0.001 and r = 0.66, p < 0.01, respectively), and with the UA PI/MCA PI ratio (r = 0.60, p < 0.01 and r = -0.54, p < 0.05, respectively). NOC was also correlated with S100B protein (r = 0.48, p < 0.05); the correlation of S100B protein and C2F almost reached significance (r = -0.47, p < 0.05).

CONCLUSIONS

This study provides evidence of a relationship between a biochemical marker of brain development and/or integrity and the development of fetal behavioral states, offering additional information on brain maturation in normal and high-risk pregnancies.

BACKGROUND

The recent identification of the tissue inhibitor of metalloproteinases-3 (TIMP3) as the gene underlying SFD pathology has made it possible to address the question of genetic heterogeneity in this disorder. In addition, it now has become feasible to clarify whether SFD is directly involved in other maculopathies and, in particular, may represent a genetic model for age-related macular degeneration.

METHODS

Genetic analysis were performed in five unrelated and 18 related British SFD pedigrees as well as in 143 patients affected with age-related macular degeneration, 28 patients with adult vitelliform macular dystrophy, 21 patients with central areolar choroidal dystrophy and 25 individuals with other forms of macular dystrophies.

RESULTS

Molecular genetic analyses confirmed the autosomal dominant mode of inheritance in SFD. In all five unrelated SFD pedigrees individual TIMP3 mutations were identified introducing an additional cysteine residue into the C-terminal region of the mature protein. Affected individuals from 18 SFD families residing in Great Britain, Canada, Oregon and South Africa were found to carry a common ancestral Ser181Cys mutation. The clinical variability of this Ser181Cys mutation was reevaluated. A mutational screen in 217 patients with various maculopathies revealed no disease-causing mutations in the TIMP3 gene.

CONCLUSIONS

So far, TIMP3 mutations have exclusively been associated with SFD. Therefore, this disorder appears to be genetically homogeneous with complete penetrance but variable expressivity.