Sex specific impact of prodromal chest pain on pre-hospital delay time during an acute myocardial infarction: Findings from the multicenter MEDEA Study with 619 STEMI patients.

BACKGROUND: Scarce evidence yields conflicting results regarding the effect of prodromal chest pain (PCP) on pre-hospital delay during an acute myocardial infarction (AMI). We aimed to assess the impact of PCP on delay. METHODS: Data was collected on 619 ST-elevated MI patients from the multicenter Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study. Patients with any PCP (which was subdivided into undefined PCP, possible and definite angina) within a year before AMI were identified using the Rose questionnaire, administered in bedside interviews. The influence of PCP and its subdivisions (all compared to no PCP) was assessed using logistic regression (with cut-offs of 2 h, 6 h, and a 4-category ordinal outcome). RESULTS: Any type of PCP was reported by men (50.6%) more than women (34.6%) (OR=1.9; 95% CI: 1.3 to 2.8; p=.001). The median delay of patients with PCP was not significantly different to delay in patients with no PCP (p=.327). Prolonged delay times were observed in women with PCPs of lesser degree of cardiac confirmation, while the opposite was observed in men. In women, possible angina was more strongly associated with delay <2 h (OR=6.8; 95% CI=2 to 23.8) than any PCP (OR=2.6; 95% CI=1.2 to 5.7). CONCLUSIONS: For men, PCPs of increasing cardiac confirmation are associated with prolonged delay. For women, PCPs of lesser cardiac confirmation are more likely to lead to prolonged delay. Future studies should investigate mediating factors.

Flow paths of plant tissue residues and digesta through gastrointestinal segments in Spanish goats and methodological considerations.

A sequence of eight twice-daily meals, each marked with different rare earth elements, was fed to 24 Spanish goats (BW = 20.6 +/- 1.94 kg) to produce meal-based profiles of rare earth markers within segments of the gastrointestinal digesta on subsequent slaughter. Accumulative mean residence time and time delay of rare earths and segmental and accumulative mean residence times of indigestible NDF (IDF) were estimated for each sampled segment. Diets consisted of ad libitum access to bermudagrass hay with a limit feeding of one of four supplements: 1) minerals (basal, B); 2) B + energy (E); 3) B + CP (CP); or 4) B + E + CP for 84 d. Mean daily intake (g/kg of BW) during the 5 d before slaughter differed (P < 0.05) via diet for DM but not for IDF (8.0 +/- 0.35 g/kg of BW). Larger estimates of cumulative mean residence time for IDF vs. rare earths were suggested to be the consequence of a meal-induced bias in the single measurement of IDF pool size by anatomical site. The rare earth compartment method was considered more reliable than the IDF pool dilution method because it yielded flow estimates based on the flux of eight meal-dosed rare earth markers over 4 d and was independent of anatomical definitions of pool size. Statistically indistinguishable estimates for gastrointestinal mean residence times for IDF and rare earths conform to assumed indelibility for the specifically applied rare earths and indigestibility of IDF. The potentially digestible NDF (PDF):IDF ratio of dietary fragments (0.8) progressively decreased in the following order: caudodorsal reticulorumen (0.390) > crainodorsal reticulorumen (0.357) approximately reticulum (0.354) > mid-dorsal reticulorumen (0.291) approximately ventral reticulorumen (0.286), to that within the omasal folds and in the abomasum (0.259). Such a gradient of progressively aging mixture of plant tissue fragments is consistent with age-dependent flow paths established in the reticulorumen and flowing to the omasum and abomasum. Such heterogeneity of fragment ages within the reticulorumen is also indicated by the superior fit of marker dose site double dagger marker sampling site model assumptions. Additionally, cyclic meal- and rumination-induced variations in escape rate occur. Estimates of mean escape rates over days, needed for the practice of ruminant nutrition, must consider the complex interactions among plant tissues and the dynamics of their ruminal digestion of PDF.

Effects of fish meal and sodium bentonite on daily gain, wool growth, carcass characteristics, and ruminal and blood characteristics of lambs fed concentrate diets.

We evaluated the effects of replacing some soybean meal (SBM) protein with fish meal (FM) protein in diets adequate and slightly deficient in CP, with or without .75% sodium bentonite (NaB) on performance and ruminal and blood metabolites of individually fed Suffolk lambs. Diets were based on corn, SBM, and cottonseed hulls. In Exp. 1, five lambs were assigned to each of the three dietary treatments (11% CP with 3% FM, 13% CP with 0 or 3% FM). Lambs fed diets that contained 11% CP with 3% FM or 13% CP with 0% FM had similar DMI and ADG. Gain and feed efficiency were slightly improved (P = .18) by the 13% CP diet with 3% FM. In Exp. 2, 32 lambs were assigned to four dietary treatments (13.5% CP of DM) in a 2 x 2 factorial arrangement (0 or 3% FM, and 0 or .75% NaB on an as-fed basis). The DMI and ADG were increased (P < .05) by FM and NaB supplementation. Interactions (P < .05) revealed that NaB increased DMI, ADG, gain per feed (g/kg of DMI), and plasma urea N concentration in the absence of FM but not in the presence of FM in the diet. Neither FM nor NaB influenced (P = .25) wool growth. Total ruminal VFA were increased (P < .06) by FM and NaB. Differences in mineral content of phalanx bone, liver, and kidney were small and may be related to the mineral content of diets and the effect of NaB on mineral solubilities. Similar DMI and ADG of lambs fed FM and NaB separately and in combination suggest that their beneficial effect is not additive.

Overrepresentation of 3q and 8q material and loss of 18q material are recurrent findings in advanced human ovarian cancer.

In order to define the ability of comparative genomic hybridization (CGH) to detect and map genetic imbalances, we investigated 47 malignant ovarian tumors and 2 ovarian tumors of low malignant potential. The most common genetic changes in order of frequency included DNA gains of chromosome arms 8q (53%), 3q (51%), 20q (43%), 1p (32%), 19q (30%), 1q (28%), 12p (28%), 6p (21%), and 2q (19%). The smallest regions of overrepresentation could be defined in 3q26-qter, 8q23-qter, 1p35-pter, 12p 12, and 6p21-22, respectively. Losses were detected on 18q (23%), chromosome 4 (23%), 13q (17%), and 16q (17%) with the smallest underrepresented regions on 18q22-qter, 13q21, and 16q23-qter. Also, losses of the X chromosome (19%) were detected, correlating with higher ages of the patients. Therefore, some of these X chromosome losses might be due to a well-known aging phenomenon and in these cases will be more preferably lost during cell division and tumor progression. Our findings show that ovarian carcinomas reveal consistent chromosomal abnormalities. Further detailed studies of these regions with specific molecular genetic techniques may lead to the identification of oncogenes and/or tumor suppressor genes playing an important role in the tumorigenesis of ovarian carcinomas.

Recurrent cytogenetic aberrations in human ovarian carcinomas.

Successful cytogenetic analysis was performed on short-term cultures of 62 malignant ovarian tumors from 42 patients. Twenty-three tumors from 18 patients revealed clonal chromosome abnormalities. Five cases showed nonclonal chromosome changes. In the remaining 19 cases, a normal female karyotype was found. Numerical or single structural changes were found in only 11 carcinomas from nine patients. Trisomy 12 and 7 were each the sole abnormality in two cases a piece. One tumor showed a trisomy 6 as the only karyotypic change. Four tumors revealed simple translocations and deletions affecting the chromosomes X, 1, 2, 6, and 7. Twelve of the cytogenetically abnormal tumor samples showed complex karyotypes with both numerical and structural aberrations leading to hyperdiploid, near-triploid, and near-tetraploid stemlines. The recurrent numerical imbalances were losses of the chromosomes 1 (N = 5), X (N = 3), and 17 (N = 3), and gains of the chromosomes 12 (N = 5) and 20 (N = 3). Regarding structural rearrangements, the chromosome bands 11p13-14 and 19p13 were the most frequently affected regions. 11p13-14 was rearranged in four tumors. In two cases, a deletion 11p13-14 was found. Two tumors revealed a nonreciprocal translocation involving 11p13-14 and leading to the loss of distal 11p material. The most consistent finding was a 19p+ marker chromosome, which was present in five different ovarian carcinomas. Our results are in accordance with a recent cytogenetic report describing a 19p+ marker and loss of 11p material as consistent cytogenetic aberrations in human ovarian carcinomas.

Loss of constitutional heterozygosity on chromosome 11p in human ovarian cancer. Positive correlation with grade of differentiation.

BACKGROUND: There is increasing evidence suggesting that genes located on the short arm of chromosome 11 play an important role in the development of human ovarian cancer. Recent cytogenetic and molecular studies have demonstrated the loss of genetic material in this region. Loss of normal growth regulatory genes may allow for the expression of tumorigenicity or lead to tumor progression. METHODS: The authors used DNA recombinant techniques to examine the frequency of allelic losses at four loci spanning the chromosomal region 11p15.1-11p15.5 in 40 patients with malignant ovarian tumors. DNA extracts from normal leukocytes and 48 tumor samples were analyzed by Southern blotting using the polymorphic probes pEJ6.6 (HRAS1), phins310 (INS), p20.36 (PTH), and pEM36 (CALCA). RESULTS: Reduction to homozygosity in the tumor DNA was found in 47.5% of the informative cases (19 of 40). Comparing the results with clinical parameters, none of the well-differentiated tumors (6 of 40, Grade 1) and only one of the early stage tumors (6 of 40, International Federation of Gynecology and Obstetrics [FIGO] Stage I or II) showed alterations in this chromosome region. Statistical analysis revealed a strong correlation of rate of loss of constitutional heterozygosity (LOH) and grade of differentiation, in the sense of higher 11p allele losses occurring in poorly differentiated tumors. CONCLUSIONS: The authors concluded that the relatively high incidence of 11p allele losses marks an important step in ovarian cancer development. Furthermore, statistical analysis showed that loss of 11p alleles was strongly correlated with poorly differentiated ovarian cancer, indicating the location of genes involved in cellular functions associated with the development of more anaplastic tumors.

Cytogenetic analysis of an adenoid cystic carcinoma of the Bartholin's gland. A rare, semimalignant tumor of the female genitourinary tract.

Cytogenetic analysis has been performed on short-term cultures from a 56-year-old woman suffering from an adenoid cystic carcinoma of Bartholin's gland. Beside a normal female karyotype, the tumor revealed an abnormal cell line with complex chromosome changes involving the chromosomes 1, 4, 6, 11, 22, and 14. The mainly structural and nonbalanced rearrangements led to the loss of the chromosome segments 1p31----qter, 4q22----q28, 6p12----qter, 11p11.2----pter, 14q24----qter, and 22q13----qter. Clonal numerical aberrations were not observed. To our knowledge, such a tumor has to-date not been cytogenetically investigated.

The Mental Impairment and Evaluation Treatment Service: staff attitudes and staff-client interactions.

This study describes and evaluates a new short-term residential service for adults with mild learning difficulties and challenging behaviour, the Mental Impairment Evaluation and Treatment Service. The study examines staff attitudes towards management practices, towards the potential achievement of individuals with learning difficulties, the staff's perceived involvement in decision making, and also the nature of their interaction with the clients, in two different settings on the Unit. The Unit's management practices were found to be client-orientated in nature and staff were more in agreement with client-orientated than institution-orientated management practices. Staff were generally optimistic about clients' potential and felt involved in decision making. Correlations between certain staff characteristics, attitudes and interactions are discussed. The study extends the range of services that have been evaluated in this way, and provides a description of the service in its early stages, which will provide an important comparison point for it when it is more permanently established.

Homoeologic aberrations in human and chimpanzee Y chromosomes: inverted and satellited Y chromosomes.

An inverted and a satellited Y chromosome detected in peripheral blood lymphocytes of a chimpanzee and a pygmy chimpanzee, respectively, were characterized cytogenetically by various banding techniques. A detailed comparison with an inverted and a satellited Y chromosome in man suggested that the corresponding aberrations were homoeologic.

[Psychophysiological studies of EEG, operational performance and the dynamics of vigilance regulation. II. EEG activity and reactivity during tracking performance in a control loop with varying degrees of difficulty (author's transl)]. / Psychophysiologische Studien zum Verhalten der hirnelektrischen Wachaktivität bei definierter Vigilanzbeanspruchung. 2. Mitteilung: Das hirnelektrische Verhalten bei visuomotorischen Regelaufgaben steigenden Schwierigkeitsgrades

In ten male students the EEG occipital activity was recorded during a visuo-motor task consisting of pursuit-tracking. The degree of task difficulty varied systematically depending on the modification of the transfer function of control element dynamics. The EEG data were evaluated by serial spectral analysis. The distribution functions of the total power estimates and their minima and maxima reflect the dynamics of the regulation of cortical vigilance and permit to differentiate the degree of effort which corresponds to the varying degree of task difficulty. The study of task-irrelevant acoustically evoked potentials showed that with increasing cortical activation the amplitudes of N1-P2 and P2-N2 are diminished. These results might suggest that evoked potentials induced by task-irrelevant stimuli can serve as indicators of the neuronal capacity available for information processing that is not task-oriented.