Increased expression of type 2 3alpha-hydroxysteroid dehydrogenase/type 5 17beta-hydroxysteroid dehydrogenase (AKR1C3) and its relationship with androgen receptor in prostate carcinoma.

Type 2 3alpha-hydroxysteroid dehydrogenase (3alpha-HSD) is a multi-functional enzyme that possesses 3alpha-, 17beta- and 20alpha-HSD, as well as prostaglandin (PG) F synthase activities and catalyzes androgen, estrogen, progestin and PG metabolism. Type 2 3alpha-HSD was cloned from human prostate, is a member of the aldo-keto reductase (AKR) superfamily and was named AKR1C3. In androgen target tissues such as the prostate, AKR1C3 catalyzes the conversion of Delta(4)-androstene-3,17-dione to testosterone, 5alpha-dihydrotestosterone to 5alpha-androstane-3alpha,17beta-diol (3alpha-diol), and 3alpha-diol to androsterone. Thus AKR1C3 may regulate the balance of androgens and hence trans-activation of the androgen receptor in these tissues. Tissue distribution studies indicate that AKR1C3 transcripts are highly expressed in human prostate. To measure AKR1C3 protein expression and its distribution in the prostate, we raised a monoclonal antibody specifically recognizing AKR1C3. This antibody allowed us to distinguish AKR1C3 from other AKR1C family members in human tissues. Immunoblot analysis showed that this monoclonal antibody binds to one species of protein in primary cultures of prostate epithelial cells and in LNCaP prostate cancer cells. Immunohistochemistry with this antibody on human prostate detected strong nuclear immunoreactivity in normal stromal and smooth muscle cells, perineurial cells, urothelial (transitional) cells, and endothelial cells. Normal prostate epithelial cells were only faintly immunoreactive or negative. Positive immunoreactivity was demonstrated in primary prostatic adenocarcinoma in 9 of 11 cases. Variable increases in immunoreactivity for AKR1C3 was also demonstrated in non-neoplastic changes in the prostate including chronic inflammation, atrophy and urothelial (transitional) cell metaplasia. We conclude that elevated expression of AKR1C3 is highly associated with prostate carcinoma. Although the biological significance of elevated AKR1C3 in prostatic carcinoma is uncertain, AKR1C3 may be responsible for the trophic effects of androgens and/or PGs on prostatic epithelial cells.

Occupational physical activity and pregnancy outcome.

OBJECTIVE: To determine the effect of occupational physical activities on the outcome of pregnancy. METHODS: A case control study included two groups; the first one included 562 patients with spontaneous abortion as a case group, while the second one included 1200 ladies with full term deliveries as a matched control group. Occupational physical activity has been evaluated through the energy expenditure (fatigue score and intensity score) and the biomechanic load (abdominal pressure intensity score, relative chronic pressure and peak pressure scores) in both groups. RESULTS: The group of spontaneous abortion had a significant higher intensity score, fatigue score, unfavourable working hours and high working speed than the group of favourable pregnancy outcome. The study showed a significantly higher biomechanic load among the group of spontaneous abortion represented by higher peak pressure score, chronic pressure score, lifting and bending activities. The group of spontaneous abortion had a significant (P<0.05) higher housekeeping working hours per day than that of the control group. Also they had a significant larger family size and had a significant lower helping in housekeeping activities than the group of favourable outcome. CONCLUSION: Excessive occupational physical activity has a definite detrimental effect on the outcome of pregnancy.

The impact of activity based cost accounting on health care capital investment decisions.

For the future survival of the rural hospitals in the U.S., there is a need to make sound financial decisions. The Activity Based Cost Accounting (ABC) provides more accurate and detailed cost information to make an informed capital investment decision taking into consideration all the costs and revenue reimbursement from third party payors. The paper analyzes, evaluates and compares two scenarios of acquiring capital equipment and attempts to show the importance of utilizing the ABC method in making a sound financial decision as compared to the traditional cost method.

Formation of homocitrulline during heating of milk.

Homocitrulline arises from the reaction between cyanate and the epsilon-amino group of lysine residues; in milk, cyanate derives from heat-induced urea breakdown. Since homocitrulline levels were unknown in heated milk, its formation was studied in the temperature range 100-150 degrees C. Firstly, an analysis method based on ion-exchange chromatography using an amino acid analyser was developed. Homocitrulline, liberated from milk protein by enzymic hydrolysis, was eluted well separated from other amino acids and could be readily distinguished using this technique. Secondly, homocitrulline levels were determined for various time-temperature combinations in samples of milk, milk to which 10 mM-urea had been added, and milk that was made urea-free. No homocitrulline was formed in urea-free milk, while homocitrulline formation was stimulated by urea addition. Upon prolonged heating, we found extensive subsequent breakdown of homocitrulline. The kinetics of homocitrulline formation was quite complicated, but an approximation was possible as the initial formation reaction could be modelled using zero order reaction kinetics. The apparent activation energy for homocitrulline formation was estimated at approximately 90 kJ/mol. In general, the levels of homocitrulline to be expected in heated milk appeared to be quite low: approximately 0.3 mM in in-bottle sterilized milk, and < 0.01 mM in UHT sterilized milk.

Tax Equity and Fiscal Responsibility Act of 1982: an incentive to improve productivity in health care.

The productivity incentives of TEFRA are compared, using a sample that includes ten patients, four on Medicare and the remainder being either private pay patients or patients covered by commercial insurance. The effect of a ten percent increase or decrease in productivity on Medicare reimbursement before and after TEFRA is examined.