Congruence and goal sharing of health-related goals among newly dating individuals explaining goal importance and commitment.

OBJECTIVES: The study aimed to determine whether perceived goal sharing (i.e., perceiving a partner as having the same health-related goal) and/or perceived goal congruence (i.e., being able to spend time together in health-related goal activities) with a romantic partner are associated with health-related goal commitment and importance. DESIGN AND MAIN OUTCOME MEASURES: 80 participants with a health-related goal in a larger study on newly dating relationships completed two self-report questionnaires 3 months apart using validated assessments of goal commitment and importance. RESULTS: Perceived goal congruence was associated with concurrent goal commitment and importance and higher goal commitment over time. However, perceived goal sharing was not associated with the health-related goal dimensions (even when interacting with goal congruence) with the exception of increased goal importance over time for those scoring lower than the average on relationship satisfaction. CONCLUSION: One way to enhance health-related goal importance and commitment is to ensure goal congruence exists within romantic relationships, and partners can spend time together engaging in goal-related activities with their partner. Moreover, the results suggest that romantic partners exert an influence even among the newly dating, who are often presumed to be less impactful on health outcomes and processes.

[Epidemiology of hemorrhagic strokes]. / Epidémiologie des accidents hémorragiques cérébraux.

Hemorrhagic stroke (HS) may be secondary to spontaneous intracerebral hemorrhage or to subarachnoid hemorrhage. There are no clinical symptoms that differentiate hemorrhagic stroke form ischemic stroke (IS) and only imaging can make the difference. But epidemiology, pathologic process and management are different in HS and IS. We will discuss the different risk factors of spontaneous intracerebral hemorrhage and subarachnoid hemorrhage.

Transfer of swine major histocompatibility complex class II genes into autologous bone marrow cells of baboons for the induction of tolerance across xenogeneic barriers.

BACKGROUND: The present study examined the potential role of gene therapy in the induction of tolerance to anti-porcine major histocompatibility complex (SLA) class II-mediated responses after porcine renal or skin xenografts. METHODS: Baboons were treated with a non-myeloablative or a myeloablative preparative regimen before bone marrow transplantation with autologous bone marrow cells retrovirally transduced to express both SLA class II DR and neomycin phosphotransferase (NeoR) genes, or the NeoR gene alone. Four months or more after bone marrow transplantation, the immunological response to a porcine kidney or skin xenograft was examined. Both the renal and skin xenografts were SLA DR-matched to the transgene, and recipients were conditioned by combinations of complement inhibitors, adsorption of natural antibodies, immunosuppressive therapy, and splenectomy. RESULTS: Although the long-term presence of the SLA transgene was detected in the peripheral blood and/or bone marrow cells of all baboons, the transcription of the transgene was transient. Autopsy tissues were available from one animal and demonstrated expression of the SLA DR transgene in lymphohematopoietic tissues. After kidney and skin transplantation, xenografts were rejected after 8-22 days. Long-term follow-up of control animals demonstrated that high levels of induced IgG antibodies to new non-alphaGal epitopes developed after organ rejection. In contrast, induced non-alphaGal IgG antibody responses were minimal in the SLA DR-transduced baboons. CONCLUSIONS: Transfer and expression of xenogeneic class II DR transgenes can be achieved in baboons. This therapy may prevent late T cell-dependent responses to porcine xenografts, which include induced non-alphaGal IgG antibody responses.

Temporal mapping of gene expression levels during the differentiation of individual primary hematopoietic cells.

A hierarchical order of gene expression has been proposed to control developmental events in hematopoiesis, but direct demonstration of the temporal relationships between regulatory gene expression and differentiation has been difficult to achieve. We modified a single-cell PCR method to detect 2-fold changes in mRNA copies per cell (dynamic range, 250-250,000 copies/cell) and used it to sequentially quantitate gene expression levels as single primitive (CD34+,CD38-) progenitor cells underwent differentiation to become erythrocytes, granulocytes, or monocyte/macrophages. Markers of differentiation such as CD34 or cytokine receptor mRNAs and transcription factors associated with their regulation were assessed. All transcription factors tested were expressed in multipotent progenitors. During lineage-specific differentiation, however, distinct patterns of expression emerged. SCL, GATA-2, and GATA-1 expression sequentially extinguished during erythroid differentiation. PU.1, AML1B, and C/EBP alpha expression profiles and their relationship to cytokine receptor expression in maturing granulocytes could be distinguished from similar profiles in monocytic cells. These data characterize the dynamics of gene expression accompanying blood cell development and define a signature gene expression pattern for specific stages of hematopoietic differentiation.

Lack of in vivo effect of granulocyte-macrophage colony-stimulating factor on human immunodeficiency virus type 1.

Neutropenia complicates HIV disease or its treatment in a large proportion of patients. Hematopoietic growth factor support has been tested in a number of clinical settings in HIV disease and has been demonstrated to be of benefit for specific parameters. One consideration regarding the use of hematopoietic growth factors in HIV disease is their potential effect on HIV viral burden, since alterations in HIV expression have been documented with certain cytokines in vitro. It has also been reported that some cytokines, notably GM-CSF, potentiate the antiviral properties of thymidine analogs such as zidovudine (AZT) in vitro. We tested these observations in vivo. Twelve HIV-positive patients with a CD4 cell count < or = 200/mm3 or HIV plasma viremia who were receiving a stable dose of zidovudine were enrolled into three dose cohorts of yeast-derived GM-CSF at 50, 125, or 250 micrograms/m2 daily by subcutaneous self-injection for 28 days. Measurements of HIV activity included serum acid-dissociated HIV p24 antigen levels, plasma and peripheral blood mononuclear cell (PBMC) limiting dilution HIV culture, and plasma HIV quantitative competitive polymerase chain reaction (PCR). Serum and intracellular zidovudine levels were measured as well as hematologic, immunologic, and toxicity parameters. Virologic measures showed neither significant upregulation nor downregulation of serum acid-dissociated HIV p24 antigen, plasma and PBMC HIV culture, or PCR in association with GM-CSF administration. A trend toward increased intracellular AZT levels was noted, but this did not achieve statistical significance (p = 0.073). CD4 and CD8 lymphocytes were essentially unaffected while absolute neutrophil counts increased with GM-CSF administration as expected. These data suggest that administration of GM-CSF does not perturb HIV activity or immunologic parameters in patients receiving AZT for advanced HIV disease. No potentiation of AZT antiviral effect was demonstrated.

In vivo effects of interleukin 3 in HIV type 1-infected patients with cytopenia.

OBJECTIVE: To determine the safety, tolerance, and hematological and virological effects of the recombinant hematopoietic growth factor interleukin 3 (IL-3) in HIV-1-infected individuals with cytopenia. DESIGN AND METHODS: A phase I single-center trial was conducted with patients in cohorts of three receiving one of four dose levels of self-administered, subcutaneously injected IL-3 (0.5, 1.0, 2.5, or 5.0 micrograms/kg/day). Toxicities, hematological effects, and virological effects were recorded. Viral studies included serum HIV p24 antigen levels, quantitative plasma and peripheral blood mononuclear cell cultures, and quantitative, competitive polymerase chain reaction of patient plasma. RESULTS: Increases in white blood cell counts (WBC) and absolute neutrophil counts (ANC) were noted at the higher dose levels while absolute eosinophil counts (AEC) increased in all patients. The percent changes in WBC from baseline ranged from 52 to 309 and in ANC from 20 to 262 in the 2.5- and 5.0-micrograms/kg/day groups. The mean AEC change was 17-fold (range, 2- to 59-fold). Hemoglobin, hematocrit, platelets, and CD4 and CD8 counts were generally unaffected although individual patients demonstrated increases in hemoglobin and platelet levels. Toxicities were generally mild, but one patient developed a transient local erythematous rash at the sites of IL-3 injection which pathologically demonstrated hypersensitivity vasculitis. Of note, viral studies did not demonstrate any consistent changes in HIV-1 activity. CONCLUSION: These data demonstrate limited hematological effects of IL-3 monotherapy in HIV-1-infected patients with cytopenia. However, should IL-3 be incorporated into combination cytokine therapies for HIV disease, these data suggest that IL-3 does not enhance in vivo HIV-1 activity.

Evaluation of a twice-a-week application of 1% niclosamide lotion in preventing Schistosoma haematobium reinfection.

A randomized double-blind trial was conducted to assess the efficacy of a twice-a-week application of 1% niclosamide lotion for prevention of Schistosoma haematobium reinfection. Six hundred farmers in Fayoum, Egypt, 18-40 years of age, were treated to cure their S. haematobium infection, then randomly assigned to self-apply niclosamide or placebo lotion to their limbs, neck, and torso. Subjects were exposed to schistosomal-infested water during routine irrigation activities from April to October 1992. Three hundred fifty subjects met the inclusion criteria and completed the trial, 169 (48.3%) in the niclosamide group and 181 (51.7%) in the placebo group. The subjects assigned to the niclosamide-treated group were comparable with those in the placebo group in age (27.2 versus 27.8 years), total water contact (101.9 versus 109.0 hr), lotion application compliance (93.5% versus 90.6%), and avoidance of whole body water contact (94.7% versus 96.7%). The reinfection rate with S. haematobium was 30.8% in the niclosamide-treated group and 28.2% in the placebo group. Niclosamide lotion applied to the limbs and trunk twice a week failed to prevent S. haematobium reinfection.

Solid phase extraction of phencyclidine from urine followed by capillary gas chromatography/mass spectrometry.

This communication describes a method for the solid phase extraction of phencyclidine (PCP) from urine, followed by GC/MS analysis. The method is linear over the range 5-1000 ng/mL and consistently produces cleaner chromatograms than can be obtained by liquid-liquid extraction. The limits of detection and quantitation are 0.47 and 1.38 ng/mL, respectively. Extraction efficiency, or recovery, was found to be 100.8 +/- 6.5%, and the between-run precision was 3.5% (25 ng/mL, n = 51). This solid phase method for extraction of PCP from urine has several advantages over liquid-liquid extraction for laboratories of any size.

Solid Phase Extraction of Abused Drugs.

The current standard for acceptable practice in forensic urine drug testing, as reflected in both National Institute for Drug Abuse (NIDA) and military guidelines, requires an initial immunoassay followed by gas chromatography/mass spectrometry (GC/MS) confirmation. The GC/MS confirmatory procedures mandate extraction of the drug from the urine matrix, followed in most cases by chemical derivatization, prior to injection into the gas chromatograph. Classically, the extraction step has been accomplished using liquid-liquid techniques, but in recent years, the use of solid phase chromatographic techniques has become increasingly popular. Numerous companies now market solid phase columns that are designed specifically for extraction of drugs, some of them containing as many as three different components for extracting acidic, basic, and neutral drugs. A survey of NIDA laboratories, conducted specifically for this review article, revealed that 40 to 50% of the extraction procedures currently performed involved the use of solid phase cartridges. This article reviews chromatographic separation techniques in general, specific products that are currently available on the market, the performance of those products, and examines the results of the survey of NIDA-certified laboratories.

Rapid drug screening using Toxi-Lab extraction followed by capillary gas chromatography/mass spectroscopy.

We report here a method of analyzing drugs in body fluids by gas chromatography/mass spectroscopy (GC/MS) without the necessity for derivatization. Specimens (urine and serum) were extracted one time using Toxi-Lab extraction tubes. The organic extract was evaporated to dryness, taken up in methanol, and injected directly onto a Hewlett-Packard 5995B GC/MS equipped with a 20-m, 5% phenylmethylsilicone capillary column. Most drugs of clinical interest eluted in 1-10 min and were identified by their mass spectra. Amphetamines were readily distinguished from other sympathomimetic amines; cocaine and its principal metabolite ecgonine methyl ester were readily detected without derivatization. We conclude that the combination of Toxi-Lab extraction and capillary GC/MS analysis provided a rapid, versatile, and efficient method for screening and/or confirming the presence of drugs in biological specimens.

Abdominal mesothelioma induced by occupational asbestos exposure.

Asbestos bodies were demonstrated within an abdominal mesothelioma, proving the tumour-inductive role of asbestos fibres. Asbestos fibres were also found earlier in a case of bile duct carcinoma (17).

A radioimmunoassay for the measurement of human cardiac myosin light chains.

A double-antibody radioimmunoassay that specifically measures serum or urinary concentrations of human cardiac myosin light chains has been developed. The assay is both sensitive and specific for myosin light chain I. The antiserum used in the assay is capable of detecting 1--2 ng/ml of cardiac myosin light chain I and shows no cross-reaction to cardiac myosin, the heavy chains of myosin, actin, tropomyosin, or light chain II. Of 114 patients admitted to the Coronary Care Unit, 227 measurements obtained from 84 patients without myocardial infarction revealed that the serum light chain level of 2.0 +/- 0.18 ng/ml was not significantly different from that of a control group (2.1 +/- 0.17 ng/ml, n = 12). In contrast, 89 measurements from 30 patients with myocardial infarction evidence clinically, electrocardiographically, and by creatine phosphokinase determinations were found to have an average serum light chain I concentration of 10.9 +/- 1.39 ng/ml (P less than 0.001). Thus, the radioimmunoassay for human cardiac myosin light chain I provides a sensitive and specific marker for myocardial damage.

Clinical assessment of serum myosin light chains in the diagnosis of acute myocardial infarction.

Serum myosin light chain levels were quantitated with radioimmunoassay in patients admitted to the coronary care unit. In this study there were 29 patients with acute myocardial infarction, 84 with chest pain but without myocardial infarction and 5 with chest pain but with preexisting electrocardiographic abnormalities that could not be interpreted using standard criteria. Values for human cardiac light chains in normal human sera averaged less than 2 ng/ml, and values in the 84 patients without myocardial infarction fell into this category. The 29 patients with myocardial infarction all had elevated light chain concentrations (average 10.9 +/- 1.3 ng/ml; range 4 to 35 ng/ml). In this study there were no false positive or false negative results. Use of this assay has permitted separation of patients with and without myocardial infarction. The assay for cardiac light chains provides a biochemical marker of high sensitivity and specificity that is useful in the diagnosis of infarction.