Regional HmPAO SPECT and CT measurements in the diagnosis of Alzheimer's disease.

BACKGROUND: This study investigated the hypothesis that the combination of regional CT brain atrophy measurements and semiquantitative SPECT regional blood flow ratios could produce a diagnostic test for Alzheimer's disease (AD) with an accuracy comparable to that achieved with the present clinical gold standard of the NINCDS-ADRDA criteria. METHODS: Single proton emission computed tomography (SPECT) and CT head scans were performed on 122 subjects referred an UBC Alzheimer clinic and diagnosed as either 'not demented' (ND-37) or 'possible/probable AD' (AD-85) by the NINCDS-ADRDA criteria. Stepwise discriminant analysis (SDA) was performed on the bilateral SPECT regions of interest and compared to bilateral CT qualitative/quantitative assessment in the frontal, parietal and temporal lobes to determine which were most accurate at ND/AD distinction. Receiver operating curves (ROC) were then constructed for these variables individually and for their combined discriminant function. RESULTS: The left temporal qualitative cortical atrophy score (CT) and left temporal perfusion ratio (SPECT) were selected in the SDA. The combined discriminant function was more specific at AD/ND distinction than either of CT or SPECT alone. The accuracy of AD/ND distinction with the combined discriminant function was below that achieved by clinical diagnosis according to the NINCDS-ADRDA criteria and was not significantly different from that achieved with SPECT or CT alone as defined by ROC curve analysis. CONCLUSION: The measurements of left temporal cortical atrophy and regional cerebral blood flow were most indicative of AD; however they lacked the sensitivity and specificity to recommend their use as a diagnostic test for AD.

Presence of WBC, decreased strength, and delayed soreness in muscle after eccentric exercise.

The purposes of this study were to assess the presence of 99mTc-labeled white blood cells (WBC) in exercised muscle compared with nonexercised muscle over time and to determine the time course of delayed onset muscle soreness (DOMS) and eccentric torque in 10 female subjects. A pretest was followed by 300 eccentric repetitions of the right quadriceps. DOMS and eccentric torque were measured at 2, 4, 20, 24, 48, and 72 h postexercise. Eccentric torque was also tested at 0 h. Radionuclide images of both quadriceps were taken at 2, 4, 20, and 24 h postexercise. The presence of 99mTc-WBC in the exercised muscle was significantly greater (P < 0.001) than in the nonexercised muscle. Eccentric torque declined at 0 and 24 h postexercise. DOMS peaked at 24 h postexercise. The presence of 99mTc-WBC in the exercised muscle in the first 24 h suggests that acute inflammation occurs as a result of exercise-induced muscle injury. The bimodal pattern of eccentric torque supports the hypothesis that more than one mechanism is involved.

[Women in the labor force and migration. The female labor market between 1950 and 1990 and female migration to Santiago, Chile]. / La mujer en el trabajo y la migration. El mercado laboral femenino entre 1950 y 1990 y la inmigracion de mujeres a la ciudad de Santiago de Chile.

"This article examines the relationships between changes in the volume, relative importance and growth rates of female migration to Santiago [Chile], and modifications in the structure of the female labour market during the past four decades. It also analyzes changes in the characteristics of occupational insertion of migrants as compared to non-migrant women." The author investigates the impact of modernization, education, access to contraceptives, rural labor markets, and development strategies. (SUMMARY IN ENG)

[Women in labor and migration. The female labor market between 1950 and 1990 and migration of women to Santiago, Chile]. / La mujer en el trabajo y la migracion. El mercado laboral femenino entre 1950 y 1990 y la inmigracion de mujeres a la ciudad de Santiago de Chile.

PIP: Changes in the volume of female migration to Santiago and in the employment patterns of migrant women are analyzed in relationship to changes in the female labor market from 1950 onward, with special emphasis on the years 1970-90. Data sources include published works, the censuses of 1952 to 1982, a 1962 survey on in-migration to Santiago, employment surveys conducted by the University of Chile and the National Institute of Statistics, special tabulations for subsamples of the 1970 and 1982 censuses, and household employment survey information from the fourth quarter of 1993. In 1973 Chile embarked on a process of structural adjustments that affected social expenditures and employment, profoundly modifying urban labor markets. The Chilean economy is currently in a phase of consolidating its productive transformation, with positive results for economic growth and recuperation of employment, but with no reduction of poverty. The explanation of the growth in poverty should be sought in modifications in the conditions of employment of the Chilean population during the productive transformation. Modernization processes such as increased education and access to fertility control contributed to an increase in the number of highly educated women in nonmanual occupations in Santiago, but have not significantly influenced the volume or direction of female migration or modified the disadvantageous occupational profile of migrant women. Gender considerations including cultural norms governing female sexual behavior and nuptiality appear to exercise a decisive influence on the occupational status of migrant women in Santiago. Low status, single women migrating to Santiago have been concentrated in domestic service in part because of their need to find work providing safe living quarters. After 1975, migrant women encountered an increasing proportion of urban women working and looking for work and a structural transformation of domestic service marked by massive absorption of low status nonmigrant women. The disadvantages of migrant women related to their lower age, education, and urban experience have declined or disappeared, but disadvantages related to lack of family and housing in the city have persisted. Continuing high rates of urban poverty in Santiago and substitution of precarious employment for open unemployment have resulted in continuing high rates of female employment. The lack of dynamism in the expansion of female employment, the persistence of gender segmentation of the labor market, continuing tertiarization of female employment, and new trends to precarious employment and increased economic participation of nonmigrant women suggest that occupational patterns of migrant women will not change greatly in the 1990s. Although they have become better educated and prefer to avoid live-in domestic service, their employment options appear limited.^ieng

[Migration and social gender relations: the anthropological perspective]. / Migracion y relaciones sociales de genero: aportes de la perspectiva antropologica.

"This article reviews Mexican research of female migration. An analysis is made of socio-demographic and anthropological studies that cover the relations between inequality among the genders, the causes and features of migration, and the work performed by female migrants in their places of origin and destination. The paper responds to the growing interest shown in international literature [on] migration in order to determine the influence of gender identity in the motivations and features of the migration of women, as well as the consequences of spatial mobility on their social conditions and their autonomy." (SUMMARY IN ENG)

[Gender inequality and reproductive health: a perspective for the program]. / Desigualdad de genero y salud reproductiva: una perspectiva para el programa.

PIP: Research on the influence of the social, economic, and cultural context on reproductive health is just beginning in Mexico. Because health risks and damage appear to be associated with living conditions of the population, the mechanisms through which social inequality affects reproductive health should be analyzed. Gender inequality is of particular importance to the study of reproductive health. The construction of feminine identity, centered on motherhood and the ability to relate to others, has decisive consequences for self-esteem, social valuation, and the capacity of women to make decisions and act in their own self interest. The obstacles that women face in making decisions about sexuality and reproduction have psychological, affective, and health costs. Women living in contexts of limited female autonomy are often pressured into early pregnancy and union and to having large families. The need to satisfy expectations for their gender and social position, fear of being devalued or abandoned, and the desire to cement affective relationships may restrict their capacity to exercise their sexuality with autonomy and to separate it from procreation. The low rates of use of contraceptives by men and the almost exclusive focus on women of contraceptive technologies and programs also reflect the inequality of the sexes. The lesser access to resources and exercise of power by women in the household may lead to nutritional disadvantages, and societal standards that tolerate extramarital sexual activity for men but not for women leave women vulnerable to sexually transmitted diseases. The health effects of gender inequalities are magnified by poverty and other forms of social disadvantage. The Program of Reproductive Health and Society aims to contribute to improved reproductive health in the Mexican population through study of the consequences of social and gender inequality.^ieng

Bone and gallium scans in postradiotherapy osteonecrosis of the jaw.

The role of radiographic and nuclear imaging in evaluation of postradiotherapy osteonecrosis of the jaw was studied. Patients who had received imaging at diagnosis and following hyperbaric oxygen therapy were studied. Radiographic changes did not correlate with the clinical status of patients. All bone scans were abnormal at the time of diagnosis of osteonecrosis, but remained abnormal following changes in the clinical status of patients. Thus, the bone scan may aid in the detection of osteonecrosis. Gallium uptake did not aid i diagnosis, but did correlate with clinical findings following treatment. Persisting positive gallium scans may indicate the need for surgery following hyperbaric oxygen therapy.

[Female migrant workers in Santiago, Chile, during the 1980s]. / Trabajadoras inmigrantes en Santiago de Chile en los anos ochenta.

The author examines the status of female migrant workers in Santiago, Chile, in the 1980s, with a focus on the level of poverty and social inequalities. Aspects considered include "the dramatic transformation in domestic service, the increase in the number of non-migrant, lower class women participating in the economy, and the limited and precarious status of women's employment in the more dynamic sectors of the economy." (SUMMARY IN ENG)

Membrane depolarization inhibits thrombin-induced calcium influx and aggregation in human platelets.

The relationship between thrombin-evoked changes in intracellular calcium concentration [( Ca2+]i) and aggregation was examined in Indo-1-loaded human platelets. The stimulus-induced intracellular calcium release and external calcium influx, as well as platelet aggregation, were studied in the same cell preparation. A close correlation between the sustained high [Ca2+]i level, depending on calcium entry, and the aggregation response was found. Gramicidin, at a concentration high enough to induce membrane depolarization, strongly inhibited the calcium influx and aggregation, but did not influence the thrombin-induced intracellular calcium release. We conclude that calcium influx through depolarization-inhibited calcium channels is a prerequisite of thrombin-induced platelet aggregation.

[The dimensions of the labor market, temporary migration, and domestic reproduction. A case study in the rural zone of the state of Mexico]. / Dimensiones del mercado de trabajo, migraciones temporales y reproduccion domestica. Un caso en la zona rural del Estado de Mexico.

PIP: The author analyzes the impact of temporary migration on the reproduction of households in agricultural communities in Malinalco, Mexico. The interrelationship between the demographic structure of households and trends in temporary migration is studied, and the role of different types of economic activity in households is considered.^ieng

Volume regulatory mechanisms of human granulocytes in hypoosmotic media.

Human neutrophil granulocytes, when placed into hypoosmotic media, first swell, than show a regulatory volume decrease (RVD) reaction. This RVD is the most effective at pH 7.5 when inosine is used as a metabolic substrate. The RVD reaction is blocked by the inhibitors of the calcium-induced K+ transport, such as quinine, quinidine, trifluoperazine (TFP), as well as by those of the conductive Cl-transport (dipyridamole, SITS, oligomycin C). Removal of external calcium by EGTA, or addition of the calcium channel inhibitor, verapamil, reduce the RVD. Ouabain affects RVD only after long preincubation and furosemide or phloretin have hardly any effect on this process. In a hypoosmotic KCl medium neutrophils show a TFP-, and SITS-sensitive secondary volume increase. All these data indicate the opening of Ca2+-induced K+ channels and of conductive Cl- channels in hypoosmotically shocked neutrophils. Under these conditions, however, direct measurement of cytoplasmic calcium by Indo-1 does not show any major change in the overall cytoplasmic free Ca2+ levels. In neutrophils, the reduced calcium signal evoked by formyl-methionyl-leucyl-phenylalanine (fMLP) after a hypoosmotic shock, suggests that cellular calcium metabolism is altered under these conditions.

Volume regulatory mechanisms of human platelets.

Platelets were found to defend themselves against hypoosmotic swelling by a regulatory volume decrease mechanism, similar to that of T-lymphocytes. An oligomycin C sensitive Cl- -channel and a Ca2+-dependent, quinine- and trifluoperazine-sensitive K+-channel play a significant role in the process: platelets lose K+ and Cl- (and consequently water) through these. Activation of platelets accelerates the volume regulatory mechanism in spite of the fact that the Na+/H+ exchange process, activated simultaneously, works against volume decrease. The most rapid volume regulation was observed in activated platelets with inhibited Na+/H+ exchange process.

Laser treatment of obstructive endobronchial tumors: factors which determine response.

To investigate whether computerized tomography (CT) and radionuclide quantitative ventilation-perfusion lung scan add any useful information to a carefully performed endoscopic examination in determining the response of patients with obstructive endobronchial tumors to laser treatment, the findings in 40 patients treated with photodynamic therapy (PDT) or the Nd:YAG laser were analysed. Endoscopic laser treatment was found to be most effective when the tumor was polypoid in appearance bronchoscopically, with little or no submucosal invasion or peribronchial extension seen on CT. When bronchoscopy and CT showed increasing submucosal and/or peribronchial disease, the immediate and long-term response to treatment was poorer. CT provided valuable information regarding the extent of the peribronchial involvement and airway distortion which were often underestimated by bronchoscopy alone. Reduction of regional perfusion out of proportion to ventilation on scintigraphy in the involved lung zone was found to be associated with extensive peribronchial involvement. We conclude that the addition of CT and radionuclide quantitative ventilation-perfusion lung scan to bronchoscopic examination is useful in predicting the response of patients with obstructive endobronchial tumors to laser treatment. Whether PDT or YAG laser is more effective in relieving endobronchial obstruction by tumor awaits a randomized controlled trial.

Predicting the response of obstructive endobronchial tumors to photodynamic therapy.

To investigate the usefulness of bronchoscopic examination, computerized tomography (CT), and radionuclide quantitative ventilation-perfusion lung scan to determine the response of patients with obstructive endobronchial tumors to photodynamic therapy (PDT), the findings in 24 patients treated with PDT were analyzed. PDT was found to be most effective when the tumor was bronchoscopically polypoid in appearance, with little or no submucosal invasion or peribronchial extension seen on CT scans. With increasing submucosal and/or peribronchial extension, the immediate response to treatment was poorer. Patients who had 50% or more of the airway obstruction due to mucosal tumor had no evidence of local tumor recurrence for a median interval of 22 weeks after treatment. In patients with predominant submucosal and/or peribronchial tumor, the duration of response was 7 weeks. Response to treatment did not correlate with the degree of airway obstruction. CT provided valuable information regarding the extent of the peribronchial involvement and airway distortion, which was often underestimated by bronchoscopy alone. Absent perfusion or reduction of regional perfusion out of proportion to ventilation on scintigraphy in the involved lung zone was found to be associated with extensive peribronchial involvement and a poor outcome. The authors conclude that the addition of CT and radionuclide quantitative ventilation-perfusion lung scan to bronchoscopic examination is useful in predicting the response of patients with obstructive endobronchial tumors to PDT.