Sublethal effects of the flame retardant intermediate hexachlorocyclopentadiene (HCCPD) on the gene transcription and protein activity of Daphnia magna.

Hexachlorocyclopentadiene (HCCPD) is a chlorinated chemical of high production volume used as an intermediate in the production of flame retardants. HCCPD may be released to the environment during production, use, and as a result of product degradation. The objectives of this study were to evaluate sublethal effects of HCCPD exposure to Daphnia magna at environmentally relevant concentrations (0.0138-13.8 µg/L) using genomic tools (microarray and qPCR), enzyme activities, and life-history endpoints (survival, reproduction, and growth). In chronic exposures, no differences were observed in life-history endpoints (survival, time of first brood, time of first molt, molt frequency, number of neonates, and body length) between exposed organisms and controls. Microarray analyses indicated significant differential genomic transcription for 46 genes (p-value ≤ 0.05 and fold-change>2). Five identified genes were related to metabolic functions. Enzyme activities of α-amylase and trypsin, selected based on transcriptional responses, were evaluated in D. magna. Although trypsin activity was similar between treatments and controls, the activity of α-amylase significantly decreased with increasing HCCPD concentrations. On the chemical level, instability of HCCPD was observed in spiked culture media, most probably due to photolysis and biodegradation. HCCPD was not detected in surface water samples collected upstream and at the point of discharge of a major wastewater treatment plant effluent. Environmentally, rapid degradation of HCCPD could be outdone by its continuous release into aquatic ecosystems in specific areas of concern (e.g., vicinity of industries and hazardous sites). Toxicity results from this study highlight the use of genomics in the identification of biomarkers and help advance the science, and potential use, of multi-level biological approaches for environmental risk assessment.

Thyroid hemiagenesis: a case series and review of the literature.

PURPOSE: The purpose of this study is to present a case series and review recommendations within the literature concerning thyroid hemiagenesis. MATERIALS AND METHODS: This is a (1) retrospective case series review of 5 patients and (2) literature review (using Medline) on thyroid hemiagenesis. RESULTS: Most reported cases are female with the left thyroid lobe absent. Compensatory hypertrophy occurs in most thyroid remnants. Associated diagnoses in the remaining lobe include hyperthyroidism, hypothyroidism, simple and multinodular goiter, and carcinoma. There is no increased risk for the subsequent development of cancer in the remaining lobe, and empiric thyroidectomy is not justified. CONCLUSIONS: Thyroid hemiagenesis is an uncommon presentation that is frequently asymptomatic and detected incidentally when imaging for another condition. Awareness of its existence can help prevent unnecessary interventions associated with incorrect assumptions in patient care.

Taking microarrays to the field: differential hepatic gene expression of caged fathead minnows from Nebraska watersheds.

This study aimed to evaluate the utility of microarrays as a biomonitoring tool in field studies. A 15,000-oligonucleotide microarray was used to measure the hepatic gene expression of fathead minnows (Pimephales promelas) caged in four Nebraska, USA watersheds - the Niobrara and Dismal Rivers (low-impact agricultural sites) and the Platte and Elkhorn Rivers (high-impact agricultural sites). Gene expression profiles were site specific and fish from the low- and high-impact sites aggregated into distinct groups. Over 1500 genes were differentially regulated between fish from the low- and high-impact sites. Many gene expression differences (1218) were also noted when the Platte and Elkhorn minnows were compared to one another and Platte fish experienced a higher degree of transcript alterations than Elkhorn fish. These findings indicate that there are differences between the low-impact and high-impact sites, as well as between the two high-impact sites. Historical water quality data support these results as only trace levels of agrichemicals have been detected at the low-impact sites, while substantial levels of agrichemicals have been reported at the high-impact sites with agrichemical loads at the Platte generally exceeding those at the Elkhorn. Overall, this study demonstrates that microarrays can be utilized to discriminate sites with different contaminant loads from one another.

Gene set enrichment analysis of microarray data from Pimephales promelas (Rafinesque), a non-mammalian model organism.

BACKGROUND: Methods for gene-class testing, such as Gene Set Enrichment Analysis (GSEA), incorporate biological knowledge into the analysis and interpretation of microarray data by comparing gene expression patterns to pathways, systems and emergent phenotypes. However, to use GSEA to its full capability with non-mammalian model organisms, a microarray platform must be annotated with human gene symbols. Doing so enables the ability to relate a model organism's gene expression, in response to a given treatment, to potential human health consequences of that treatment. We enhanced the annotation of a microarray platform from a non-mammalian model organism, and then used the GSEA approach in a reanalysis of a study examining the biological significance of acute and chronic methylmercury exposure on liver tissue of fathead minnow (Pimephales promelas). Using GSEA, we tested the hypothesis that fathead livers, in response to methylmercury exposure, would exhibit gene expression patterns similar to diseased human livers. RESULTS: We describe an enhanced annotation of the fathead minnow microarray platform with human gene symbols. This resource is now compatible with the GSEA approach for gene-class testing. We confirmed that GSEA, using this enhanced microarray platform, is able to recover results consistent with a previous analysis of fathead minnow exposure to methylmercury using standard analytical approaches. Using GSEA to compare fathead gene expression profiles to human phenotypes, we also found that fathead methylmercury-treated livers exhibited expression profiles that are homologous to human systems & pathways and results in damage that is similar to those of human liver damage associated with hepatocellular carcinoma and hepatitis B. CONCLUSIONS: This study describes a powerful resource for enabling the use of non-mammalian model organisms in the study of human health significance. Results of microarray gene expression studies involving fathead minnow, typically used for aquatic ecological toxicology studies, can now be used to generate hypotheses regarding consequences of contaminants and other stressors on humans. The same approach can be used with other model organisms with microarray platforms annotated in a similar manner.

Transcriptional response of hepatic largemouth bass (Micropterus salmoides) mRNA upon exposure to environmental contaminants.

Microarrays enable gene transcript expression changes in near-whole genomes to be assessed in response to environmental stimuli. We utilized oligonucleotide microarrays and subsequent gene set enrichment analysis (GSEA) to assess patterns of gene expression changes in male largemouth bass (Micropterus salmoides) hepatic tissues after a 96 h exposure to common environmental contaminants. Fish were exposed to atrazine, cadmium chloride, PCB 126, phenanthrene and toxaphene via intraperitoneal injection with target body burdens of 3.0, 0.00067, 2.5, 50 and 100 µg g(-1), respectively. This was conducted in an effort to identify potential biomarkers of exposure. The expressions of 4, 126, 118, 137 and 58 mRNA transcripts were significantly (P ≤ 0.001, fold change ≥2×) affected by exposure to atrazine, cadmium chloride, PCB 126, phenanthrene and toxaphene exposures, respectively. GSEA revealed that none, four, five, five and three biological function gene ontology categories were significantly influenced by exposure to these chemicals, respectively. We observed that cadmium chloride elicited ethanol metabolism responses, and along with PCB 126 and phenanthrene affected transcripts associated with protein biosynthesis. PCB 126, phenanthrene and toxaphene also influenced one-carbon compound metabolism while PCB 126 and phenanthrene affected mRNA transcription and mRNA export from the nucleus and may have induced an antiestrogenic response. Atrazine was found to alter the expression of few hepatic transcripts. This work has highlighted several biological processes of interest that may be helpful in the development of gene transcript biomarkers of chemical exposure in fish.

Minnesota's Prescription Monitoring Program: how to identify patients who may be abusing controlled substances.

The Minnesota Prescription Monitoring Program, which was launched by the Minnesota Board of Pharmacy last year, is collecting data on prescriptionsof controlled substances. Reporting is required from in-state pharmacies and others including physicians who dispense medications as well as from out-of-state pharmacies that ship controlled substances to Minnesota residents. This article describes the program, how it works, and how it can benefit physicians.

Adult guardianship: human rights or social justice?

Adult guardianship in English-speaking countries has its roots firmly planted in the protective parens patriae principle. In the last 20 years, in response to societal changes and international developments, concerns about human rights have fundamentally challenged the historic basis of guardianship. This article argues that social justice offers a better framework than human rights for adult guardianship legislation.

Effects of brevetoxin exposure on the immune system of loggerhead sea turtles.

Blooms of the toxic dinoflagellate, Karenia brevis, occur almost annually off the Florida coast. These blooms, commonly called "red tides", produce a group of neurotoxins collectively termed brevetoxins. Many species of sealife, including sea turtles, are severely impacted by brevetoxin exposure. Effects of brevetoxins on immune cells were investigated in rescued loggerhead sea turtles, Caretta caretta, as well as through in vitro experiments using peripheral blood leukocytes (PBL) collected from captive sea turtles. In rescued animals, plasma brevetoxin concentrations were measured using a competitive ELISA. Plasma lysozyme activity was measured using a turbidity assay. Lysozyme activity correlated positively with plasma brevetoxin concentrations. Differential expression of genes affected by brevetoxin exposure was determined using two separate suppression subtractive hybridization experiments. In one experiment, genes from PBL collected from sea turtles rescued from red tide toxin exposure were compared to genes from PBL collected from healthy captive loggerhead sea turtles. In the second experiment, PBL from healthy captive loggerhead sea turtles were exposed to brevetoxin (500 ng PbTx-2/ml) in vitro for 18 h and compared to unexposed PBL. Results from the subtraction hybridization experiment conducted with red tide rescued sea turtle PBL indicated that genes involved in oxidative stress or xenobiotic metabolism were up-regulated. Using quantitative real-time PCR, a greater than 2-fold increase in superoxide dismutase and thioredoxin and greater than 10-fold increase in expression of thiopurine S-methyltransferase were observed. Results from the in vitro subtraction hybridization experiment indicated that genes coding for cytochrome c oxidases were the major up-regulated genes. Using quantitative real-time PCR, a greater than 8-fold increase in expression of beta-tubulin and greater than 3-fold increase in expression of ubiquinol were observed. Brevetoxin exposure may have significant implications for immune function in loggerhead sea turtles.

Agrichemicals in Nebraska, USA, watersheds: occurrence and endocrine effects.

The objective of the present study was to determine the occurrence and endocrine effects of agrichemicals in four Nebraska, USA, watersheds--the Elkhorn, Platte, Niobrara, and Dismal rivers. Land use in the Elkhorn River and Platte River watersheds is characterized by intense agriculture, including row crop and beef cattle production. In contrast, land within the Niobrara River and Dismal River watersheds consists primarily of grasslands. Polar organic chemical integrative samplers (POCIS) and caged fathead minnows were deployed at a site within each watershed for 7 d. The POCIS were analyzed for pesticides and hormones, while the caged minnows were analyzed for the expression of estrogen- and androgen-responsive genes. Amounts of pesticides recovered in POCIS extracts from the Elkhorn and Platte rivers were higher than those recovered from the Niobrara and Dismal rivers. Furthermore, female minnows deployed in the Elkhorn River experienced significant reductions in expression of two estrogen-responsive genes (vitellogenin and estrogen receptor α) relative to females deployed at the other sites, indicating alterations in endocrine function. However, the defeminization of these females could not be definitely linked to any of the agrichemicals detected in the POCIS recovered from the Elkhorn River.

Gene expression changes in bottlenose dolphin, Tursiops truncatus, skin cells following exposure to methylmercury (MeHg) or perfluorooctane sulfonate (PFOS).

Methylmercury (MeHg) and perfluorooctane sulfonate (PFOS) bioaccumulate and biomagnify in the environment and increasing concentrations of these pollutants have been found in wildlife and humans. Both chemicals are worldwide contaminants with wide ranging biological effects and have been identified in relatively high concentrations in apex level marine mammals such as bottlenose dolphins. The primary objective of this study was to determine if exposure to MeHg or PFOS would alter the gene expression in primary bottlenose dolphin epidermal cell cultures. Primary skin cells were isolated and cultured from skin samples collected from wild bottlenose dolphins. The cells were subsequently exposed to 13ppm PFOS or 1ppm MeHg and changes in gene expression were analyzed by suppressive subtractive hybridization (SSH) and quantitative real-time PCR (QPCR). 116 genes were positively identified in the dolphin skin cells by SSH. Of these, 16 total genes were analyzed by QPCR (9 and 11 genes following PFOS or MeHg exposure, respectively, with four overlapping genes). Results indicate MeHg significantly alters gene expression patterns following 24h exposure, but has no measurable effect after only 1h. PFOS exposure, however, caused significant alterations following both 1 and 25h. Overall, the changes in gene expression observed indicate these concentrations of MeHg and PFOS significantly alter normal gene expression patterns. The changes in gene expression following exposure to these contaminants not only indicate a cellular stress response, but also decreased cell cycle progression and cellular proliferation and reduced protein translation. Alterations in normal cellular biology, like those observed, may lead to changes in health in marine mammals exposed to contaminants; however, this warrants further investigation.

The genomic transcriptional response of female fathead minnows (Pimephales promelas) to an acute exposure to the androgen, 17beta-trenbolone.

We investigated the genomic transcriptional response of female fathead minnows (Pimephales promelas) to an acute (4 days) exposure to 0.1 or 1.0microg/L of 17beta-trenbolone (TB), the active metabolite of an anabolic androgenic steroid used as a growth promoter in cattle and a contaminant of concern in aquatic systems. Our objectives were to investigate the gene expression profile induced by TB, define biomarkers of exposure to TB, and increase our understanding of the mechanisms of adverse effects of TB on fish reproduction. In female gonad tissue, microarray analysis using a 22K oligonucleotide microarray (EcoArray Inc., Gainesville, FL) showed 99 significantly upregulated genes and 741 significantly downregulated genes in response to 1microg TB/L. In particular, hydroxysteroid (17beta) dehydrogenase 12a (hsd17b12a), zona pellucida glycoprotein 2.2 (zp2.2), and protein inhibitor of activated STAT, 2 (pias2) were all downregulated in gonad. Q-PCR measurements in a larger sample set were consistent with the microarray results in the direction and magnitude of these changes in gene expression. However, several novel potential biomarkers were verified by Q-PCR in the same samples, but could not be validated in independent samples. In liver, Q-PCR measurements showed a significant decrease in vitellogenin 1 (vtg1) mRNA expression. In brain, cytochrome P450, family 19, subfamily A, polypeptide 1b (cyp19a1b, previously known as aromatase B) transcript levels were significantly reduced following TB exposure. Our study provides a candidate gene involved in mediating the action of TB, hsd17b12a, and two potential biomarkers sensitive to acute TB exposure, hepatic vtg1 and brain cyp19a1b.

Adherence in patients on dialysis: strategies for success.

Adherence is a major problem in patients with chronic kidney disease. Patients can be nonadherent with different aspects of their treatment, which includes medications, treatment regimens, and dietary and fluid restrictions. Although many lessons have been learned from adherence research, the evidence of how to modify adherence is somewhat mixed. To minimize nonadherence, interventions need to focus on both patient factors and the extent to which relationships and system problems compromise the patient's ability to adhere to medication and treatment plans. There continues to be a tendency to focus on the patient as the reason for problems with adherence, ignoring other factors such as the patient-health care provider relationships and the health care system that surrounds the patient. These latter factors can have a considerable effect on adherence. The nurse can develop a strong relationship of support with the patient, identify barriers, and offer strategies to help patients improve adherence.

Development and validation of a 2,000-gene microarray for the fathead minnow (Pimephales promelas).

Gene microarrays provide the field of ecotoxicology new tools to identify mechanisms of action of chemicals and chemical mixtures. Herein we describe the development and application of a 2,000-gene oligonucleotide microarray for the fathead minnow Pimephales promelas, a species commonly used in ecological risk assessments in North America. The microarrays were developed from various cDNA and subtraction libraries that we constructed. Consistency and reproducibility of the microarrays were documented by examining multiple technical replicates. To test application of the fathead minnow microarrays, gene expression profiles of fish exposed to 17beta-estradiol, a well-characterized estrogen receptor (ER) agonist, were examined. For these experiments, adult male fathead minnows were exposed for 24 h to waterborne 17beta-estradiol (40 or 100 ng/L) in a flow-through system, and gene expression in liver samples was characterized. Seventy-one genes were identified as differentially regulated by estradiol exposure. Examination of the gene ontology designations of these genes revealed patterns consistent with estradiol's expected mechanisms of action and also provided novel insights as to molecular effects of the estrogen. Our studies indicate the feasibility and utility of microarrays as a basis for understanding biological responses to chemical exposure in a model ecotoxicology test species.

Safety of erythropoiesis stimulating agents in patients on dialysis: current issues for nephrology nurses.

Clinical data have repeatedly shown that the erythropoiesis stimulating agents (ESAs) Epoetin alfa and darbepoetin alfa are safe and efficacious to treat anemia in patients on dialysis when used in accordance with the product label The safety profile of ESAs has recently been updated based on reports from clinical investigations that studied off-label uses of ESAs at doses designed to raise the Hb to above 13.0 g/dL. This article reviews the recent safety data and the current prescribing recommendations, with an emphasis on the need to follow the guidelines found in the products' package inserts to ensure the safe and efficacious use of these agents.

A graphical systems model to facilitate hypothesis-driven ecotoxicogenomics research on the teleost brain-pituitary-gonadal axis.

Graphical systems models are powerful tools that can help facilitate hypothesis-driven ecotoxicogenomic research and aid in mechanistic interpretation of results. This paper describes a novel graphical model of the teleost brain-pituitary-gonadal (BPG) axis designed for ecotoxicogenomics research on endocrine-disrupting chemicals using small fish models. The model incorporates six compartments representing the major organs involved in the fish reproductive axis and depicts the interactions of over 105 proteins and 40 simple molecules, transcriptional regulation of 25 genes, and over 300 different reactions/ processes. Application of the model is illustrated in the context of a study examining effects of the competitive aromatase inhibitor, fadrozole, on gene expression in gonad, brain, and liver tissue of fathead minnows. Changes in mRNA transcript abundance were measured using a fathead minnow oligonucleotide microarray and quantitative real-time polymerase chain reaction. Gene expression changes observed in the ovaries of females exposed to 6.3 microg fadrozole/L for7 d were functionally consistent with fadrozole's mechanism of action, and expected compensatory responses of the BPG axis to fadrozole's effects. Furthermore, microarray results helped identify additional elements (genes/ proteins) that could be included in the model to potentially increase its predictive capacity. With proper recognition of

Documentation of surgical specimens using digital video technology.

CONTEXT: Digital technology is commonly used for documentation of specimens in anatomic pathology and has been mainly limited to still photographs. Technologic innovations, such as digital video, provide additional, in some cases better, options for documentation. OBJECTIVE: To demonstrate the applicability of digital video to the documentation of surgical specimens. DESIGN: A Canon Elura MC40 digital camcorder was used, and the unedited movies were transferred to a Macintosh PowerBook G4 computer. Both the camcorder and specimens were hand-held during filming. The movies were edited using the software iMovie. Annotations and histologic photographs may be easily incorporated into movies when editing, if desired. RESULTS: The finished movies are best viewed in computers which contain the free program QuickTime Player. Movies may also be incorporated onto DVDs, for viewing in standard DVD players or appropriately equipped computers. The final movies are on average 2 minutes in duration, with a file size between 2 and 400 megabytes, depending on the intended use. Because of file size, distribution is more practical via CD or DVD, but movies may be compressed for distribution through the Internet (e-mail, Web sites) or through internal hospital networks. CONCLUSIONS: Digital video is a practical, easy, and affordable methodology for specimen documentation, permitting a better 3-dimensional understanding of the specimens. Discussions with colleagues, student education, presentation at conferences, and other educational activities can be enhanced with the implementation of digital video technology.

Single and multiple congenic strains for hydrocephalus in the H-Tx rat.

The H-Tx rat has fetal-onset hydrocephalus with a complex mode of inheritance. Previously, quantitative trait locus mapping using a backcross with Fischer F344 rats demonstrated genetic loci significantly linked to hydrocephalus on Chromosomes 10, 11, and 17. Hydrocephalus was preferentially associated with heterozygous alleles on Chrs 10 and 11 and with homozygous alleles on Chr 17. This study aimed to determine the phenotypic contribution of each locus by constructing single and multiple congenic strains. Single congenic rats were constructed using Fischer F344 as the recipient strain and a marker-assisted protocol. The homozygous strains were maintained for eight generations and the brains examined for dilated ventricles indicative for hydrocephalus. No congenic rats had severe (overt) hydrocephalus. A few pups and a significant number of adults had mild disease. The incidence was significantly higher in the C10 and C17 congenic strains than in the nonhydrocephalic F344 strain. Breeding to F344 to make F.H-Tx C10 or C11 rats heterozygous for the hydrocephalus locus failed to produce progeny with severe disease. Both bicongenic and tricongenic rats of different genotype combinations were constructed by crossing congenic rats. None had severe disease but the frequency of mild hydrocephalus in adults was similar to congenic rats and significantly higher than in the F344 strain. Rats with severe hydrocephalus were recovered in low numbers when single congenic or bicongenic rats were crossed with the parental H-Tx strain. It is concluded that the genetic and epigenetic factors contributing to severe hydrocephalus in the H-Tx strain are more complex than originally anticipated.

Genetic loci for ventricular dilatation in the LEW/Jms rat with fetal-onset hydrocephalus are influenced by gender and genetic background.

BACKGROUND: The LEW/Jms rat strain has inherited hydrocephalus, with more males affected than females and an overall expression rate of 28%. This study aimed to determine chromosomal positions for genetic loci causing the hydrocephalus. METHODS: An F1 backcross was made to the parental LEW/Jms strain from a cross with non-hydrocephalic Fischer 344 rats. BC1 rats were generated for two specific crosses: the first with a male LEW/Jms rat as parent and grandparent, [(F x L) x L], designated B group, and the second with a female LEW/Jms rat as the parent and grandparent [L x (L x F)], designated C group. All hydrocephalic and a similar number of non-hydrocephalic rats from these two groups were genotyped with microsatellite markers and the data was analyzed separately for each sex by MAPMAKER. RESULTS: The frequency of hydrocephalus was not significantly different between the two groups (18.2 and 19.9 %), but there was a significant excess of males in the B group. The mean severity of hydrocephalus, measured as the ventricle-to-brain width ratio, was ranked as B group < C group < LEW/Jms. For the both rat groups, there were several chromosomes that showed possible regions with association between phenotype and genotype significant at the 5% or 1.0% level, but none of these had significant LOD scores. For the C group with a female LEW/Jms parent, there was a fully significant locus on Chr2 with a LOD score of 3.81 that was associated almost exclusively with male rats. Both groups showed possible linkage on Chr17 and the data combined produced a LOD score of 2.71, between suggestive and full significance. This locus was largely associated with male rats with a LEW/Jms male parent. CONCLUSION: Phenotypic expression of hydrocephalus in Lew/Jms, although not X-linked, has a strong male bias. One, and possibly two chromosomal regions are associated with the hydrocephalus.

Genetic analysis of inherited hydrocephalus in a rat model.

Congenital hydrocephalus is a serious neurological disorder with a diverse etiology. Although there is strong evidence for genetic causes, few genes have been identified in humans. The rodent model, the H-Tx rat, has hydrocephalus with an onset in late gestation and a complex mode of inheritance. Ventricular dilatation is associated with abnormalities in the cerebral aqueduct and subcommissural organ. Quantitative trait locus (QTL) mapping was performed on DNA from the progeny of a backcross with the non-hydrocephalic Fischer F344 strain, using DNA microsatellite markers. The hydrocephalus trait was quantified by measuring the severity of the ventricular dilatation. Four chromosomes, each with a locus for hydrocephalus (Chrs 9, 10, 11, and 17), were mapped using additional markers and DNA from four subsets of backcross progeny with allelic recombination at or near each locus. The genetic positions for the markers and the loci were located using the Ensemble Rat Genome Browser. For each chromosome studied, the interval containing the locus was examined for known rat genes and for human genes identified from human-rat homology. Genes expressed in brain and with a function associated with known causes of hydrocephalus were identified as possible candidate genes. Future studies to characterize the causative genes in this animal model will improve the understanding of genetic causes in humans.