RESUMO
Many previous studies have shown that a proportion of patients with carcinoma of the prostate have increased activity of the creatine kinase (E.C. 2.7.3.2) isoenzyme designated BB in sera from their peripheral blood. We have analyzed tissues from prostatic hyperplasia of 22 patients and from prostatic carcinoma of 23 additional patients. Prostatic carcinomas contain less (p less than 0.001) creatine kinase activity (units/g) than do prostates with benign prostatic hyperplasia. The facts that (a) histochemical studies that we performed confirmed the observation reported previously by others that creatine kinase activity is found primarily in the epithelial elements of hyperplastic prostates and prostatic carcinomas, (b) the carcinomas that we examined had, on the average, a somewhat larger epithelial component than the hyperplastic prostates that we examined, and (c) prostate cancer was found to contain less creatine kinase activity than hyperplastic prostates suggest that the epithelial cells in prostate cancers contain less creatine kinase activity per cell than do those from hyperplastic prostates. The BB form of creatine kinase accounts for 98% of the activity in prostatic carcinoma and in prostates without cancer. Creatine kinase has been discussed as a possible marker for prostatic carcinoma, and we had hoped that it might be useful for the assay of tumor burden. Our data suggest that, if creatine kinase is to be useful in the monitoring of tumor burden, it will be useful only in the contexts of particular patients studied longitudinally since the creatine kinase activity varies enormously among different prostatic carcinomas.
Assuntos
Creatina Quinase/metabolismo , Hiperplasia Prostática/enzimologia , Neoplasias da Próstata/enzimologia , Idoso , Creatina Quinase/isolamento & purificação , Humanos , Isoenzimas , Cinética , Masculino , Pessoa de Meia-IdadeRESUMO
ABSTRACT The population structure of Cronartium ribicola from eastern and western North America was studied to test the null hypothesis that populations are panmictic across the continent. Random amplified polymorphic DNA markers previously characterized in eastern populations were mostly fixed in western populations, yielding high levels of genetic differentiation between eastern and western populations (phi(st) = 0.55; theta = 0.36; P < 0.001). An unweighted pair-group method, arithmetic mean dendro-gram based on genetic distances separated the four eastern and four western populations into two distinct clusters along geographic lines. Similarly, a principal component analysis using marker frequency yielded one cluster of eastern populations and a second cluster of western populations. The population from New Mexico was clearly within the western cluster in both analyses, confirming the western origin of this recent introduction. This population was completely fixed (H(j) = 0.000; n = 45) at all loci suggesting a severe recent population bottleneck. Genetic distances were low among populations of western North America (0.00 to 0.02) and among eastern populations (0.00 to 0.02), indicating a very similar genetic composition. In contrast, genetic distances between eastern and western populations were large, and all were significantly different from 0 (0.07 to 0.19; P < 0.001). Indirect estimates of migration were high among western populations, including the number of migrants among pairs of populations (Nm > 1) between New Mexico and British Columbia populations, but were smaller than one migrant per generation between eastern and western populations. These results suggest the presence of a barrier to gene flow between C. ribicola populations from eastern and western North America.
RESUMO
The spread rate of tomentosus root disease, caused by Inonotus tomentosus, was investigated by a new technique employing temporal differences in the initiation of the reduced annual radial increment between pairs of diseased trees. Pairs of infected trees (stumps) located on the periphery of disease centers were selected in each of six widely separated spruce (Picea spp.) stands in British Columbia. Distances between 12 pairs of stumps were measured, and disks were collected from each stump. Similarly, disks from four additional pairs were collected from trees in a younger stand. Uninfected control disks were collected for all sites. Tree-ring measurements were determined for all disk samples and the year in which the reduction of the annual increment attributable to I. tomentosus began was determined for infected trees. The difference between initiation years for pairs of infected trees divided into the distance between them produced an average annual spread rate of 20 cm/yr. This rate will be used in developing a model for the disease.
RESUMO
During forest pest surveys in the Watson Lake area (60°N 129°W) of the Yukon Territory (YT), sporocarps, tentatively identified as Inonotus tomentosus (Fr.:Fr.) S. Teng, were observed in association with old mortality (25+ years) and root rot of old (200 to 275 years) white spruce (Picea glauca (Moench) Voss) growing in riparian zones. I. tomentosus primarily attacks spruce throughout North America (1). Cultures from collected sporocarps and from a decayed root of a living tree produced chlamydospore-like hyphal swellings typical of I. tomentosus(2). Although three of the collected sporocarps were bracketlike, none bore hooked hymenial setae, typical of I. circinatus (Fr.) R. L. Gilbertson. All sporocarps collected possessed straight setal hyphae and were confirmed as I. tomentosus (1). These specimens are filed at the Pacific Forestry Centre herbarium as DAVFP 25375 and DAVFP 25376. This is the first western Canadian report of this major conifer root disease north of about 55°N latitude. Sporocarps have been collected at about the same latitude as Watson Lake, but from 21° farther west, near Fairbanks and Anchorage, AK (L. Trummer, USDA For. Serv. Anchorage, AK, personal communication). For several years, other stump and root decay samples have been collected in the YT as far west as Haines Junction (about halfway between Anchorage and Watson Lake), but the pathogen has never been successfully cultured nor sporocarps collected. Because the decay pattern can be confused with that caused by Phellinus pini (Thore:Fr.) A. Ames, and other diagnostic features were lacking, there has been a reluctance to accept that I. tomentosus is present in the YT. However, it seems likely that I. tomentosus is much more widespread north of 55°N in western Canada than has previously been recognized. References: (1) R. L. Gilbertson and L. Ryvarden. North Am. Polypores. Fungiflora 1:403, 1986. (2) R. S. Hunt. Can. J. Plant Pathol. 19:307, 1997.
RESUMO
The Canadians have been impressive in delivering universal healthcare access and high-quality care. Operating under global budgets set by provincial governments, Canadian hospitals have prudently managed available resources to meet community needs. A weakness of this single-payer system, however, is its inability to effectively coordinate and integrate services delivered by hospitals, physicians, and other providers. As the U.S. health system faces stringent cost containment with President Bill Clinton's proposal, significant savings are expected of U.S. hospitals. New alliances constrained by global budgets might require healthcare services managers to operate under a disparate set of assumptions and incentives. Before making such a transition, we can learn from the experiences of our Canadian colleagues. The challenges for both nations in the remaining years of this century will be drawn primarily from the effective macromanagement controls of the Canadian system and the lessons being learned from the U.S. managed care networks. This will occur as each nation strives to provide a more effective, less costly, integrated delivery of healthcare services.
Assuntos
Reforma dos Serviços de Saúde/organização & administração , Seguro Saúde , Programas Nacionais de Saúde/organização & administração , Orçamentos , Canadá , Eficiência Organizacional , Estudos de Avaliação como Assunto , Reforma dos Serviços de Saúde/economia , Administração Hospitalar/economia , Administração Hospitalar/normas , Custos Hospitalares , Sistemas Multi-Institucionais , Programas Nacionais de Saúde/economia , Responsabilidade Social , Tecnologia de Alto Custo/estatística & dados numéricos , Estados UnidosAssuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Modelos Organizacionais , Continuidade da Assistência ao Paciente/organização & administração , Estudos de Avaliação como Assunto , Conselho Diretor , Sistemas Pré-Pagos de Saúde/organização & administração , Sistemas Multi-Institucionais/organização & administração , New York , Cultura Organizacional , Inovação OrganizacionalRESUMO
A simple five-step quality assessment model has been easily and economically implemented in emergency departments of varying size and activity. The model has encouraged quick action in correcting deficiencies, systematic problem solving, and the development of ED standards and criteria.
Assuntos
Serviço Hospitalar de Emergência/normas , Qualidade da Assistência à Saúde , PennsylvaniaRESUMO
OBJECTIVE: Our purpose was to measure and compare plasma, urinary, and salivary concentrations of 8-epi-prostaglandin F(2alpha) (8-isoprostane) in women with normotensive pregnancies and the respective concentrations in pregnancies complicated by preeclampsia. STUDY DESIGN: Plasma, urinary, and salivary 8-isoprostane levels were measured in pregnant women with preeclampsia (n = 40), normotensive pregnant women (n = 20), and nonpregnant women (n = 10). One-way analysis of variance was used to determine significant differences. RESULTS: Plasma free 8-isoprostane concentrations were increased in women with severe preeclampsia (342 +/- 50 pg/mL), in comparison with nonpregnant women (129 +/- 17 pg/mL) and normotensive pregnant women (150 +/- 11 pg/mL; P =.003, and.0001, respectively). Urinary excretion of 8-isoprostane was slightly but not significantly decreased in preeclampsia (1200 +/- 227 pg/mL), in comparison with urinary excretion in nonpregnant women (1625 +/- 364 pg/mL) and normotensive pregnant women (2149 +/- 432 pg/mL). Salivary concentrations of 8-isoprostane were increased in normotensive women (496 +/- 113 pg/mL), in comparison with nonpregnant women (150 +/- 27 pg/mL) but were not related to preeclampsia (419 +/- 96 pg/mL; P =.003). CONCLUSION: Free 8-isoprostane concentrations are increased in the plasma of women with severe preeclampsia. Further studies are warranted to determine whether such increases are caused by an increase in phospholipase A(2) activity, or by lipid peroxidation, or by a decrease in renal excretion.