Diabetes, pre-diabetes and insulin resistance screening in Native American children and youth.

OBJECTIVES: Early identification of pre-diabetes and insulin resistance (IR) provides an important window of opportunity for diabetes prevention. Little is known about the prevalence of pre-diabetes and IR in Native American (NA) youth. We designed a cross-sectional, community-based study of NA children to estimate the prevalence of diabetes, pre-diabetes and IR and their association with other diabetes risk factors. STUDY DESIGN: NA children (5-18 years) were screened with body mass index (BMI), blood pressure, oral glucose tolerance test (OGTT), lipids, insulin and highly sensitive C-reactive protein (hsCRP), and calculated homeostatic model assessment of IR (HOMA-IR). RESULTS: Mean age of the cohort (n=201) was 10.8 ± 3.8 years (± s.d.; 94/107 M/F). BMI percentile for age and sex (BMI%) was elevated (≥ 85 th percentile) in 58.6% of 5-11 years and 51.1% of 12-18 years, and positively correlated with HOMA-IR, blood pressure, triglycerides and hsCRP (P<0.05). The prevalence rate for pre-diabetes and diabetes were 6.5% (3.5-10.8%) and 1.0% (0.1-3.6%), respectively. Mean HOMA-IR was greater in the older than younger age group while prevalence of pre-diabetes was the same. Those with pre-diabetes and diabetes had a greater HOMA-IR, abdominal circumference and BMI% than normal youth. CONCLUSION: In the first prospective, community-based screening for pre-diabetes, IR and diabetes in United States NA youth using OGTT, while the number of diabetes cases was low, pre-diabetes was found in a significant number of youth, particularly in those with BMI ≥ 95 th%. As proportions of pre-diabetes were similar in 5-11 and 12-18 year olds, diabetes risk begins early in NA youth.

Herbicide resistance and cross-resistance: changes at three distinct sites in the herbicide-binding protein.

Plants and algae resistant to the commonly used s-triazine herbicides display a wide spectrum of cross-resistance to other herbicides that act in a similar manner. Analysis of uniparental mutants of the green alga Chlamydomonas reinhardi showed that three different amino acid residues in the 32-kilodalton thylakoid membrane protein can be independently altered to produce three different patterns of resistance to s-triazine and urea-type herbicides. These results clarify the molecular basis for herbicide resistance and cross-resistance. Two of the mutations do not alter normal electron transport and thus may have applications of agronomic interest.

Peripheral intravenous myocardial contrast echocardiography using a 2% dodecafluoropentane emulsion: identification of myocardial risk area and infarct size in the canine model of ischemia.

OBJECTIVES: This study assessed the accuracy of 2% dodecafluoropentane (EchoGen), an intravenous echocardiographic contrast agent, in identifying myocardial area at risk and infarct size in the canine model of myocardial ischemia. BACKGROUND: Myocardial contrast echocardiography allows determination of myocardial area at risk and infarct size but requires intracoronary injection in humans. The development of agents that can be delivered by peripheral intravenous injection could enable bedside myocardial contrast echocardiographic assessment of risk area, infarct size and reperfusion. METHODS: Two protocols were used. Protocol 1 assessed the accuracy of myocardial contrast echocardiography using intravenous dodecafluoropentane in defining myocardial area at risk and infarct size in the canine model of regional myocardial ischemia versus gross pathologic specimens stained with monastral blue to determine area at risk and triphenyltetrazolium chloride to determine the area of necrosis. Protocol 2 assessed the effects of repeated injections of dodecafluoropentane (0.5 ml/kg body weight, four doses 30 min apart or eight doses 10 min apart) on myocardial blood flow and hemodynamic variables. RESULTS: Myocardial contrast echocardiography accurately defined area at risk and infarct size (r = 0.96 vs. triphenyltetrazolium chloride). Myocardial blood flow remained stable after multiple serial injections of dodecafluoropentane. However, a significant increase in pulmonary artery pressure and pulmonary vascular resistance, along with a decrease in arterial oxygen saturation and cardiac output, was seen in dogs that received eight injections at 10-min intervals. CONCLUSIONS: Myocardial contrast echocardiography using intravenous dodecafluoropentane accurately defined myocardial area at risk and infarct size. Hemodynamic variables and regional myocardial blood flows remained stable when dodecafluoropentane was injected at 30-min intervals for up to four doses; more frequent administration led to cardiopulmonary deterioration. Dodecafluoropentane offers the potential for reliable, noninvasive assessment of reperfusion after therapeutic interventions.

Lipids increase after solitary pancreas transplantation.

OBJECTIVE: The aims of this study were to determine 1) changes in lipids after solitary pancreas transplantation (SPTX) in patients with type 1 diabetes and 2) factors that influence those changes. RESEARCH DESIGN AND METHODS: Lipids were evaluated prospectively in 24 patients who underwent SPTX. Three were excluded because of early graft failure. The remaining patients (n = 21; 13 men, 8 women) were studied for changes in lipids over time (pre-SPTX, 0-2, 3-6, 7-12, and > 12 months). Glycohemoglobin, serum creatinine, BMI, and medications were also analyzed for their effects on lipid changes. RESULTS: Cholesterol, HDL, and LDL decreased in the immediate postoperative period (0-2 months), whereas triglycerides (TGs) increased (P < 0.05). At 3-6 months, cholesterol, HDL, and TG were higher than before the SPTX, whereas LDL returned to pre-SPTX levels. After 12 months, HDL and TG remained higher than their pre-SPTX levels (P < 0.05). During the study, systolic and diastolic blood pressure increased, renal function decreased, glyco-hemoglobin improved, and weight was unchanged. Changes in cholesterol/HDL ratio, HDL, and TG correlated with changes in prednisone dose (P < 0.05), and changes in TG correlated with changes in creatinine (P < 0.05). The same pattern of lipids occurred in patients prescribed or not prescribed hypolipidemic agents. CONCLUSIONS: Lipids do not improve within the 1st year after SPTX, despite improved glycemic control and blood pressure control, and renal function is worse. These results are in contrast to those reported for combined kidney-pancreas transplantation, where lipids, blood pressure, and renal function improved immediately after transplant. Further studies are needed to determine whether lipids continue to change with time after SPTX. The impact of these changes after SPTX on overall cardiovascular risk is unknown.

Structure and variation of human ribosomal DNA: molecular analysis of cloned fragments.

Eco-RI-A fragments of the human ribosomal RNA gene family from two types of tissue and three individuals were cloned in lambda vectors and compared by restriction enzyme digestion and electron microscopy. The EcoRI fragment A contains (i) 0.2 kb of the 3' end of the 18S rDNA, (ii) 2.5 kb of internal transcribed spacer and the 5.8S rDNA, and (iii) 4.6 kb of the 28S rDNA gene. All of the six cloned rDNA fragments isolated are identical by these analyses. Moreover, all contain a HincII site that is absent in about 50% of the rDNA identified by genomic blotting. Polymorphism in the nontranscribed spacer rDNA was studied in genomic blots of BamHI-digested DNA, using the 3' end of the 28S rDNA as a probe. The boundaries between the 18S rDNA, internal transcribed spacer, 28s rDNA, and external nontranscribed spacer were determined by R-loop analysis, further defining the organization of the ribosomal RNA precursor.

Reproductive hormones after pancreas transplantation.

BACKGROUND: Reproductive hormone function after pancreas transplantation (PTX) is unknown as it has not been studied. METHODS: We prospectively studied PTX recipients to determine changes in reproductive hormones after PTX. Testosterone or estradiol, leutinizing hormone, follicle stimulating hormone, and prolactin were determined before and 1 year after PTX in 23 patients (10 women, 13 men) followed for more than 1 year after PTX. Of these, 11 received simultaneous kidney-PTX; 8 PTX only; and 4, PTX after kidney. Average age was 38.4+/-1.6 years and average duration of diabetes was 24.5+/-1.3 years. Nine (four women, five men) patients had been on dialysis pre-PTX. Sixteen of 23 patients were treated with cyclosporine and seven with FK-506 along with prednisone and azathioprine post-PTX. RESULTS: Mean testosterone in men was normal pre- and post-PTX. Two men had secondary hypogonadism pre-PTX with resolution in one and persistence in the other post-PTX. Five of the ten women had evidence of hypogonadism pre-PTX: three had primary hypogonadism and two had secondary hypogonadism. Post-PTX, 7 of 10 women had abnormal reproductive hormones: 4 had primary hypogonadism, 2 had secondary hypogonadism, and 1 developed hyperestrogenemia with elevated estradiol (482 pg/ml) and leutinizing hormone (41 IU/liter). Mean prednisone dose and cyclosporine trough level were higher in the women than the men (P<0.05). No cases of secondary hypogonadism that developed or resolved post-PTX were related to changes in prolactin, renal function, or hyperglycemia. CONCLUSIONS: Women are more likely than men to have reproductive hormone abnormalities pre- and post-PTX and the causes may be multiple.

The eyespot of Chlamydomonas reinhardtii: a comparative microspectrophotometric study.

The eyespot of Chlamydomonas reinhardtii is believed to utilize a rhodopsin-like pigment in its responses to light. This paper examines its eyespot by means of microspectrophotometry with the finding of an absorption spectrum with two bands, an A-band in the blue, and a B-band in the green. This spectrum is identical to that previously recorded from the eyespot of Euglena gracilis. As with Euglena the B-band was found to have dichroic character and its spectrum was similar to the absorption curve of rhodopsin. This A-B-spectrum was always recorded from a single granule in each cell. It is concluded that both E. gracilis and C. reinhardtii may utilize a rhodopsin-like pigment as the photopigment associated with the eyespot response to light. In both these algae a few particles in each cell were found whose spectra consisted of two other bands, C and D, blue- and red-shifted, respectively, relative to the eyespot A-B-bands. There is some reason to believe that the C-D-granules may also be involved in certain light-controlled activities of the cells.

Anemia.

OBJECTIVES: To provide an overview of the disorders that cause anemia and to review clinical and laboratory assessment and medical and nursing management of the anemic patient. DATA SOURCES: Published articles and book chapters that pertain to red blood cell physiology and the major causes and types of anemia. CONCLUSIONS: Advances in molecular and genetic aspects of anemia are leading to new developments in the diagnosis and management of all types of anemia. Symptomatic relief to maintain quality of life is essential for all anemic patients. IMPLICATIONS FOR NURSING PRACTICE: Nurses can play a major role in the supportive care of patients with anemia through interventions related to pharmacological therapy, blood transfusions, nutritional counseling, and symptom management.

Update on Hodgkin's disease.

Hodgkin's disease is a rare lymphoma usually diagnosed in adults presenting with painless lymphadenopathy. Treatment includes radiation therapy for early stages of the disease and chemotherapy for advanced stages. While the majority with Hodgkin's disease will be cured of their disease, patients must complete a period of therapy with risks of significant acute side effects and serious long-term complications. This article provides an overview of the natural history, diagnosis, and staging of Hodgkin's disease as well as a discussion about treatment modalities and associated complications.

Confessions of a butch straight woman.

ABSTRACT According to stereotypical homosexual images of the stone-faced woman stomping around in work boots, lesbians adopt a more masculine demeanor and style of dress after coming out. In this article the author debunks this notion by sharing her personal experience of how her appearance changed through the course of her coming out process. She contrasts her views about beauty and how she felt about her body when she lived as a straight woman to her newfound comfort and freedom as a lesbian expressing the feminine and masculine sides of herself. In an ironic twist, coming out allowed her to shed the heterosexual beauty prescriptions, reconnect with her feminine side, and come out as beautiful.

Chromosome assignment of the owl monkey MOS and MYC gene loci.

Southern blot hybridizations of rodent x owl monkey hybrid DNAs with human cDNA probes allowed the mapping of the MOS and MYC gene loci to owl monkey chromosome 16 of karyotype VI (2n = 49 male/50 female) and to the homologous chromosome 15 of karyotype V (2n = 46). Synteny of MOS and MYC gene loci in both man and owl monkey suggests this chromosome segment's conservation in primates, contrasting with its disruption in the mouse.

A molecular basis for discrete size variation in human ribosomal DNA.

The tandemly repeated human ribosomal RNA (rRNA) genes contain a region of size heterogeneity that is present in the nontranscribed spacer of every individual examined. This heterogeneity has been previously examined by Southern analysis of BamHI-digested human DNA. Using a ribosomal DNA (rDNA) probe specific for the 3' end of the 28S rRNA gene, at least four discrete sizes of BamHI fragments were seen in human populations. Molecular analysis of the cloned DNA from this region reveals tandem duplication of a segment of spacer rDNA located 388 base pairs (bp) 3' to the end of the 28S ribosomal RNA gene. Five hundred fifty bp of DNA, flanked on either side by a 150-bp repeated element, is either duplicated or deleted to produce a series of spacers that differ in size by 850 bp. These duplications/deletions appear to be the product of unequal homologous exchange, mediated by the small repeated element. Thus, human rDNA fragments cloned in lambda vectors and propagated in E. coli generate the same apparent size variation seen in genomic DNA. This study suggests that unequal homologous exchange is the molecular basis for the observed length heterogeneity in the spacer rDNA and may be a common mechanism for the generation of human genetic diversity.

Possible role of endogenous retinoid (Vitamin A) toxicity in the pathophysiology of primary biliary cirrhosis.

Primary biliary cirrhosis (PBC) is a chronic, cholestatic disease of unknown etiology commonly affecting women. It is characterized by progressive destruction of the small intrahepatic bile ducts and portal inflammation, leading to fibrosis and cirrhosis. The major signs and symptoms of PBC, which include pruritus, lethargy, the sicca syndrome, and osteoporosis, closely resemble the manifestations of hypervitaminosis A. Based on a review of the literature and other observations connecting PBC with retinoid metabolism (vitamin A and its derivatives), the hypothesis is proposed that exposure to excess endogenous retinoids contributes to the pathogenesis of PBC and may be to the cause of some of the signs and symptoms associated with the disease.

Chlamydomonas reinhardii gene for the 32 000 mol. wt. protein of photosystem II contains four large introns and is located entirely within the chloroplast inverted repeat.

The chloroplast psbA gene from the green unicellular alga Chlamydomonas reinhardii has been localized, cloned and sequenced. This gene codes for the rapidly-labeled 32-kd protein of photosystem II, also identified as as herbicide-binding protein. Unlike psbA in higher plants which is found in the large single copy region of the chloroplast genome and is uninterrupted, psbA in C. reinhardii is located entirely within the inverted repeat, hence present in two identical copies per circular chloroplast genome, and contains four large introns. These introns range from 1.1 to 1.8 kb in size and fall into the category of Group I introns. Two of the introns contain open reading frames which are in-frame with the preceding exon sequences. We present the nucleotide sequence for the C. reinhardii psbA 5'-and 3' -flanking sequences, the coding region contained in five exons and the deduced amino acid sequence. The algal gene codes for a protein of 352 amino acid residues which is 95% homologous, excluding the last eight amino acid residues, with the higher plant protein.

Social aspects of venereal disease aboard a U.S. navy destroyer.

This paper describes the social characteristics of venereal disease patients aboard a US Navy destroyer. The research team administered questionnaires to 247 crew members at the outset of the ship's 7 month-overseas deployment. When the ship returned to home port, the research staff gathered demographic and occupational information plus disciplinary records, job performance ratings, and complete dispensary visit information for the deployment period. The morbidity data indicated that 48% of the entire crew experienced at least one case of VD, and of these VD patients, 38% had multiple infections. A set of variables that best predicted VD incidence was determined by means of multiple regression analysis. These variables included disciplinary record, pay grade, division or type of job ("blue-collar" versus "white-collar"), and education. Other variables that correlated with VD incidence were age, length of service, marital status, performance ratings, and verbal aptitude scores.