Attitudes towards hormone replacement therapy among middle-aged women and men.

OBJECTIVES: To survey the attitudes of middle-aged women and men towards HRT and associated issues. Men were included because of the possible influence of their attitudes on womens decisions to use HRT. METHODS: Two-hundred women and 311 men, (not wife and husbands), between 45 and 55 years of age, from a general population sample, were queried about their attitudes towards menopause and HRT and on their knowledge about side effects of HRT. RESULTS: The men had a more negative attitude towards HRT than the women. Two-thirds of the subjects, mostly women, considered menopause to be a medical issue and not a developmental stage in the life cycle. The most mentioned benefits of HRT were the prevention of osteoporosis and cardiopathy, and the disadvantages were "cancer" and "side effects". The concept of menopause as a medical entity was significantly correlated with a positive attitude towards HRT and whether the responder currently used HRT. CONCLUSIONS: The attitudes of most women and men towards menopause and its psycho-social meaning play a vital role in the decision of whether women should start HRT. Education on HRT should be extended to include men who seem to have a more negative attitude towards HRT and are less informed about its benefits. Our results indicate that a positive attitude to HRT is associated with factual knowledge about its benefits and disadvantages, while a negative attitude is based more on emotional arguments.

The contribution of personal resources to physical and mental health: looking into age and gender effects.

In this study, a model that specified the effects of socioeconomic and psychological resources on physical and mental health was investigated. It was hypothesized that (a) both kinds of resources would affect physical and mental health more strongly in older than in younger adults, and that (b) socioeconomic resources would exert stronger effects in men, whereas psychological resources would exert stronger effects in women. Data were collected in an Israeli national sample. Structural modeling analyses indicated that the model fit the data. A comparison of 4 groups of participants (2 age groups--18-39 and 40-84--and both genders) showed that, for men, the respective effects of socioeconomic and psychological resources on physical and mental health were strong in the older, but not in the younger, group. For women, socioeconomic resources had nonsignificant effects, whereas psychological resources had strong effects on mental health in both age groups; psychological resources also had a moderate effect on physical health in the older group. The results suggest that the contribution of personal resources to health is regulated by the joint impact of age and gender, presumably involving shifting roles and vulnerabilities of men and women across the life span.

Prevalence of glucocerebrosidase mutations in the Israeli Ashkenazi Jewish population.

Gaucher disease is the most prevalent inherited disease among Ashkenazi Jews. It is very heterogeneous due to a large number of mutations within the glucocerebrosidase gene, whose impaired activity is the cause for this disease. Aiming at determining Gaucher carrier frequency among the Ashkenazi Jewish population in Israel, 1,208 individuals were molecularly diagnosed for six mutations known to occur among Ashkenazi Jewish Gaucher patients, using the newly developed Pronto Gaucher kit. The following mutations were tested: N370S, 84GG, IVS2+1, D409H, L444P, and V394L. Molecular testing of these mutations also allows identification of the recTL allele. The results indicated that Gaucher carrier frequency is 1:17 within the tested population. The prevalence of N370S carriers is 1:17.5. This implies that approximately 1:1225 Ashkenazi Jews will be homozygous for the N370S mutation. Actually, in our study of 1,208 individuals one was found to be homozygous for the N370S mutation. The actual number of known Ashkenazi Jewish Gaucher patients with this genotype is much lower than that expected according to the frequency of the N370S mutation, suggesting a low penetrance of this mutation. Results of loading experiments in cells homozygous for the N370S mutation, as well as cells homozygous for the L444P and the D409H mutations, exemplified this phenomenon.

High-frequency oscillatory ventilation versus conventional ventilation in a piglet model of early meconium aspiration.

OBJECTIVE: To compare the cardiopulmonary effects of high-frequency oscillatory ventilation (HFO) and conventional ventilation (CV) in a piglet model of meconium aspiration syndrome. DESIGN: Prospective, randomized control study. SUBJECTS: Piglets 1 to 2 wks of age. INTERVENTIONS: Meconium aspiration was induced in 30 piglets. They were then randomized to CV, HFO at 10 Hz, or HFO at 15 Hz. MEASUREMENTS AND MAIN RESULTS: Arterial blood gas, and systemic and pulmonary hemodynamics were measured serially. Airway opening pressure (P-Flex), static lung compliance (Crs), and trapped gas volume (TGV) were derived. Meconium instillation produced similar stable decreases in Crs (6.7 +/- 0.7 [SEM] to 4.7 +/- 0.4 mL/cm) and increases in pulmonary vascular resistance (68 +/- 6.4 vs. 91.9 +/- 8.5 mm Hg/mL/kg/min). A greater proportion of animals (40%, p< .007) remained hypercarbic during HFO at 15 Hz. Oxygenation indices were similar for all groups. In regards to high-frequency support, both power and deltaP were higher in the HFO at 15 Hz group (p< .001). When compared with both CV and HFO at 10 Hz, the TGV in the HFO at 15 Hz group was significantly higher following randomization to ventilator type. P-Flex was also greatest in the 15 Hz group, followed by the 10 Hz group and the CV group. Higher airway opening pressures, given identical compliance, suggest that HFO at 15 Hz resulted in greater large airway obstruction. With HFO's inherent low tidal volumes, progression of meconium to the distal airways may be delayed. CONCLUSIONS: Early institution of HFO at 15 Hz in meconium aspiration may exacerbate air trapping. HFO at lower rates may be the optimal method of respiratory support in meconium aspiration syndrome. HFO may extend the window of time available for removal of meconium.

A benign polymorphism in the aspartoacylase gene may cause misinterpretation of Canavan gene testing.

We found normal individuals whose aspartoacylase gene Y231X mutation site consistently gave no signal in a primer extension assay. We determined the nucleotide sequence of the relevant region of the gene in those individuals, and found a new allele with a thymidine residue at the mutation site instead of a cytidine. Since both TAC and TAT code for tyrosine, this sequence polymorphism has no effect on the amino acid sequence of the ASPA protein. We found the relative frequencies of the 693C and the 693T alleles in the tested population to be 0.75 and 0.25 respectively.

Effect of modulators of hypoxic pulmonary vasoconstriction on the response to inhaled nitric oxide in a neonatal model of severe pulmonary atelectasis.

Hypoxic pulmonary vasoconstriction (HPV) is an intrinsic mechanism that facilitates ventilation to perfusion matching and preservation of oxygenation. We investigated the neonatal HPV response from extensive atelectasis and tested the hypothesis that (I) the resulting hypoxemia is corrected by inhaled nitric oxide (NO); (2) the "pulmonary steal" of blood away from hypoxic area is further improved by modulators of the HPV. Intratracheal injection of steel beads in 32 piglets (7 to 20 days) resulted in atelectasis of 50% to 75% of the lungs. The piglets were then randomized to receive saline (control), indomethacin (IND) 2 mg/kg, doxapram (DOX) 0.5 mg/kg/h or almitrine (ALM) 4 micrograms/kg/min. After 30 minutes, all animals were subjected to NO at 40 ppm. Atelectasis resulted in severe impairment in oxygenation (PaO2 - 105 +/- 6 mm Hg, AaDO2 = 536 +/- 9 mm Hg; shunt fraction = 31% +/- 2%) and moderate pulmonary hypertension. Mean pulmonary artery pressure (PAP) increased to 35 +/- 0.8 mm Hg. NO reduced pulmonary vascular resistance (PVR) from 128 +/- 14 mm Hg/kg/mL/min to 74 +/- 9 mm Hg/kg/mL/min and improved gas exchange (PaO2 = 180 +/- 50 and AaDO2 = 438 +/- 50 mm Hg). Following the development of atelectasis, the peripheral chemoreceptor agonists (ALM and DOX) did not modify gas exchange and had no significant cardiovascular effect. ALM and DOX failed to enhance the response to NO. IND did not alter HPV, but prevented the improvement in gas exchange associated with NO-induced pulmonary vasodilation.

A nation's response to attack: Israelis' depressive reactions to the Gulf War.

We examined Israelis' reactions to the Gulf War and SCUD missile attacks. Four national samples of Israelis (n = 3,204) were interviewed as to depressive mood on four occasions--prior to the Gulf Crisis, as the war approached, during the SCUD missile attacks, and after cessation of hostilities. There was an expected increase in depressive mood during the period of SCUD missile attacks and a quick return to base-line levels following the hostilities. Less educated and older individuals reported higher base-line levels of depressive mood and were at higher risk for clinical depression. Women and men did not differ in depressive mood before or after the SCUD missile attacks. However, women experienced a marked increase in depressive mood when the SCUD missile attacks occurred.

Prevalence of nine mutations among Jewish and non-Jewish Gaucher disease patients.

The frequency of nine different mutated alleles known to occur in the glucocerebrosidase gene was determined in 247 Gaucher patients, of whom 176 were of Jewish extraction, 2 were Jewish with one converted parent, and 69 were of non-Jewish origin. DNA was prepared from peripheral blood, active glucocerebrosidase sequences were amplified by using the PCR technique, and the mutations were identified by using the allele-specific oligonucleotide hybridization method. The N37OS mutation appeared in 69.77% of the mutated alleles in Jewish patients and in 22.86% of the mutated alleles in non-Jews. The 84GG mutation, which has not been found so far among non-Jewish patients, existed in 10.17% of the disease alleles among Jewish patients. The IVS + 1 mutation constituted 2.26% of the disease alleles among Jewish patients and 1.43% among the non-Jewish patients. RecTL, a complex allele containing four single-base-pair changes, occurred in 2.26% of the alleles in Jewish patients and was found in two (1.43%) of the patients of non-Jewish extraction. Another complex allele, designated "RecNciI" and containing three single-point mutations, appeared in 7.8% of alleles of non-Jewish patients and in only two (0.56%) of the Jewish families. The prevalence of the L444P mutation among non-Jewish Gaucher patients was 31.43%, while its prevalence among Jewish patients was only 4.24%. The prevalence of two other point mutations--D409H and R463C--was 5.00% and 3.57%, respectively, among non-Jewish patients and was not found among the Jewish Gaucher patient population. The prevalence of the R496H mutation, found so far only among Jewish patients, was 1.13%. The results presented demonstrate that seven mutations identify 90.40% of the mutations among Jewish patients and that these seven mutations allow diagnosis of only 73.52% of the non-Jewish patients. Identification of additional mutant alleles will enhance the accuracy of carrier detection.

Three unique base pair changes in a family with Gaucher disease.

Single-stranded cDNA was prepared from RNA obtained from a patient with type 1 Gaucher disease. The cDNA was amplified in vitro and analyzed by sequencing. Three base-pair changes were identified which included a G to C transversion at nucleotide 3119 of the active gene (Asp140----His), an A to C transversion at nucleotide 3170 (Lys157----Gln) and a G to A change at nucleotide 5309 (Glu326----Lys). To study the mode of inheritance of the three different base-pair changes, genomic DNA was prepared from blood or skin fibroblasts of several family members. Genomic glucocerebrosidase DNA sequences were amplified and subjected to hybridization with allele-specific oligonucleotides (ASOs). The hybridization profiles demonstrated that two of the base-pair changes originated from the mother and were transmitted to her two affected sons and to a grandchild, while the third base-pair change, originating from the father, was transmitted to his two affected sons, a carrier daughter and a second grandchild. Tests of other patients with Gaucher disease failed to disclose the presence of the three base-changes. This is a unique family with three base-pair changes tightly linked to Gaucher disease.

Measuring depressive mood in elderly Israeli: reliability and validity of the Depression Adjective Check Lists.

To establish the psychometric properties of the state form of the Depression Adjective Check List (DACL) with elderly Israeli, a 1981 Hebrew version of the DACL by Lomranz, Lubin, Eyal, and Medini, along with the Zung Self-rating Depression Scale and Cantril's Self-anchoring Striving Scale, were administered to 86 independently functioning elderly persons (35 men and 51 women) living in a home for the aged. Reliability estimates (alphas and test-retest) were moderate to high; validity estimates (concurrent and construct) were again moderate to high. It was concluded that the state form of the Depression Adjective Check List is suitable for use with elderly Israeli.

Molecular aspects of Gaucher disease.

Gaucher disease is the most common sphingolipid storage disorder. Due to its high prevalence it may appear with a nonrelated neurological disease and be misinterpreted as Gaucher type 3. A family is described in which 2 Gaucher brothers presented different clinical signs. Molecular analysis has shown that both carried two mutated alleles. One allele had a G to C transversion at nucleotide 3119 of the active gene (Asp140-His) while the other presented two base pair changes, an A to C transversion at nucleotide number 3170 (Lys157-Gly), and a G-A transition at nucleotide number 5309 (Glu324-Lys). Therefore, both presented the same type of Gaucher disease which was accompanied with a nonrelated neurological disease in one of them. Molecular diagnosis of 161 patients has provided a relative abundance of different mutations among Jewish and non-Jewish patients and allowed some genotype-phenotype correlation. Differential expression of the murine glucocerebrosidase activator gene (the prosaposine) has been demonstrated using Northern technique and in situ hybridization. High expression levels were observed in the brain and testes. In the testes the prosaposine expression was confined to the supporting cells. In the female gonad prosaposine expression has also been shown, in the corpus luteum. In a 12 1/2-day-old embryo, prosaposine gene expression was detected mainly in brain stem, in dorsal ganglia and in the genital ridge.

Prevalent and rare mutations among Gaucher patients.

Sequence analysis of gcs cDNA (encoding glucocerebrosidase) or genomic fragments originated from Gaucher patients revealed novel mutations. Two rare mutations were found in a type-2 non-Jewish Gaucher patient: a G----A transition (Gly325----Arg) at nucleotide (nt) 5306 of the active gene and a T----G transversion (Cys342----Gly) at nt 5357. These mutations were not found in any other patient. A G----C transversion (Asp409----His) at nt 5957 was identified in two non-Jewish patients, and was designated TL. Two recombinant alleles were found. One recombinant allele designated recTL contained four single-nt mutations. These mutations included: (1) a G----C transversion at nt 5957 (Asp409----His) (the TL mutation); (2) a T----C transition at nt 6433 (Leu444----Pro) creating a new NciI site (NciI mutation); (3) a G----C transversion at nt 6468 (Ala456----Pro; 456 mutation); and (4) a G----C transversion at amino acid (aa) 460 (nt 6482), not associated with any aa change. Sequence analysis indicated that at least part of exon 9, intron 9 and exon 10 of the recombinant gene derived from the pseudogene. The other recombinant gene, designated recNciI, contained a mutation at aa 444 (NciI mutation), and mutations 456 and 460 described above; at least exon 10 of this gene originated from the pseudogene. We hypothesize that the presence of the pseudogene close to the active gene causes transfer of mutations into the active gene via gene conversion or nonhomologous recombination, thus accounting for the high frequency of mutations observed in the gcs gene.

Mutation analysis of an Ashkenazi Jewish family with Gaucher disease in three successive generations.

Seven members of an Ashkenazi Jewish family with Gaucher disease in 3 successive generations were tested for the presence of the 2 common mutations known to occur in the glucocerebrosidase gene. Genomic DNA from blood or skin fibroblasts of relatives was amplified by using the PCR technique and individual mutations identified by oligonucleotides specific to the mutated sequences. Four individuals were homozygous for a mutation at amino acid 370 (370 mutation) known to occur only in type 1 disease. The other 3 affected relatives were compound heterozygotes for this mutation and for a mutation at amino acid 444 (NciI mutation) which, in the homozygous state, is associated with neurological disease. Clinical severity was more marked in the compound heterozygotes than in the homozygotes. Since the mutation is present in Ashkenazim, molecular diagnosis in families which carry the NciI mutation should prove useful in assessing their risk of the neurologic forms of Gaucher disease.

Subjective well-being and its domains across different age groups: an Israeli sample.

Subjective well-being (SWB) across the life span was studied in a representative Israeli sample by a national survey of 1183 subjects, ranging from 18 to 80 years of age. Subjects were given "life scales", on which they rated their SWB in their present life, as well as their satisfaction regarding health, relations with friends, family, work, economic status, sense of personal achievement, and sense of control. The results indicate that: (a) SWB is negatively correlated with chronological age; (b) the relative strength of most of SWB domains changes in the different age groups; (c) SWB is best explained by different sets of domains in different age groups; and (d) economic status is the strongest domain, accounting for SWB in 6 out of 8 age groups. Explanations for these results confronted the developmental view of changing tasks across the life span vs cohort-based differences between the age groups. The decreasing number of domains that account for SWB variance with progressing age, as well as some unexpected findings with regard to the oldest age group (71-80) are also discussed.

Genotype assignment in Gaucher disease by selective amplification of the active glucocerebrosidase gene.

Genomic DNA prepared from human cells in culture was amplified by the polymerase chain-reaction technique using two primers specific for the active human glucocerebrosidase gene. The 1,036-bp amplified fragment derived from the active gene was tested for the existence of three mutations--designated "370," "NciI," and "HhaI"--by allele-specific oligonucleotide hybridization. The results obtained from the cell lines examined permitted a clear distinction between homozygous affected, heterozygous, and normal genotypes. However, 28% of the possible affected loci were normal with respect to the three mutations, indicating the presence of additional mutations that remain to be elucidated. While the NciI mutation could be found in both Ashkenazi Jewish and non-Jewish type 1 patients, the only homozygotes with this mutation had the neurological (type 2 or type 3) form of the disease. The 370 mutation, on the other hand, was only present in type 1 patients and was not identified among any of the patients with neurologic forms of the disease.

Indoor and outdoor activities of aged women and men as related to depression and well-being.

This article examines the relations between reported level of activity and measures of affect in old people exploring possible sex differences. It was hypothesized that these relations are mediated by the satisfaction from the specific activity. The sample consisted of fifty-four women and forty-five men, ranging in age from sixty to eighty, functioning normally in the community. A questionnaire assessed participants' levels of indoor/outdoor activities. Participants rated their satisfaction for each of these activities. Negative affect was measured by Zung's Self-Rating Depression Scale, and positive affect was measured by Bradburn's Well-Being (Affect-Balance) Scale. For male respondents, results showed significant negative correlations between depression and both activities, and significant positive correlations with respect to well-being. Significant positive correlation was obtained only between well-being and outdoor activity for female respondents. When satisfaction from the specific activity was controlled for, only two correlations remained significant in the male participants, lending partial support to the hypothesis. A multiple regression analysis revealed reported levels of activity could predict both depression and well-being for men much better than for women, whereas satisfaction from activity could do that much better for women than for men. Discussion deals with the sex differences regarding the meaning of activity in old age and its implications for affect. The differentiation between kinds of activity as well as measures of affect is also referenced.

A Hebrew version of the Depression Adjective Check Lists.

In order to develop a Hebrew version of the Depression Adjective Check Lists (DACL) for use in research, the lists were translated by linguists and the adequacy of the translations determined. Reliability (split-half, alternate form, internal consistency, and test-retest) of translated lists E, F, and G were sufficiently high in the case of the first three and sufficiently low in the case of test-retest reliability of the state DACL. Concurrent validity was determined in three separate samples: correlations with (a)a 7-point self-rating scale of depression, (b)the MMPI-D Scale, (c)the Bradburn Scale of Psychological Well-being, the Cantril Self-anchoring Striving Scale, and the Katz Social Adjustment Symptom Subscale, and demographic variables. Magnitude of correlations were sufficiently high and in the expected direction. Also, correlations with part scores of the Bradburn Scale of Well-being demonstrated the discriminant validity of the Hebrew version of the DACL.

Norms for the revised Hebrew version of the Depression Adjective Check List.

In order to reduce the readability level of the Hebrew version of the DACL, a new list of words with high frequency of usage in the Hebrew language was created from the translations of E, F, and G. Ninety-four Ss completed the revised form and the translated standard form E in randomized order; the correlation was .90 (p less .001). Split-half reliability for the revised form was .83 (N = 1,230, p less than .001). The revised DACL was included in a national probability sample survey (N = 1253; 699 females and 544 males). T score and percentile norm distributions are skewed toward the left. Raw scores above 20 are rare.