Development, structure, and keratin expression in C57BL/6J mouse eccrine glands.

Eccrine sweat glands in the mouse are found only on the footpads and, when mature, resemble human eccrine glands. Eccrine gland anlagen were first apparent at 16.5 days postconception (DPC) in mouse embryos as small accumulations of cells in the mesenchymal tissue beneath the developing epidermis resembling hair follicle placodes. These cells extended into the dermis where significant cell organization, duct development, and evidence of the acrosyringium were observed in 6- to 7-postpartum day (PPD) mice. Mouse-specific keratin 1 (K1) and 10 (K10) expression was confined to the strata spinosum and granulosum. In 16.5 and 18.5 DPC embryos, K14 and K17 were both expressed in the stratum basale and diffusely in the gland anlagen. K5 expression closely mimicked K17 throughout gland development. K6 expression was not observed in the developing glands of the embryo but was apparent in the luminal cell layer of the duct by 6 to 7 PPD. By 21 PPD, the gland apertures appeared as depressions in the surface surrounded by cornified squames, and the footpad surface lacked the organized ridge and crease system seen in human fingers. These data serve as a valuable reference for investigators who use genetically engineered mice for skin research.

1,2,3-triazolyl amino acids as AMPA receptor ligands.

The central nervous system glutamate receptors are an important target for drug discovery. Herein we report initial investigations into the synthesis and glutamate receptor activity of 1,2,3-triazolyl amino acids. Two compounds were found to be selective AMPA receptor ligands, which warrant further investigation.

The effect of anticipatory discharge orders on length of hospital stay in staff pediatric patients.

Effective discharge planning should serve to reduce length of stay (LOS) and lower readmission rates. A combined prospective/retrospective study was undertaken to assess the effectiveness of anticipated discharge order forms in decreasing LOS for staff pediatric patients. Resident physicians provided advance notice of the planned discharge date to nursing staff and patient family members. Patient selection was random, and the data were collected prospectively. These subjects were matched with patients for whom the order form was not used, and the data was collected retrospectively. Matching variables included: diagnosis, age, gender, race, and method of payment. There were 103 matched pairs. LOS was collapsed into low and high categories. There was a significant difference when comparing subject groups (chi 2 = 8.5; P = 0.005). Whereas only 14% of experimental patients were categorized as high LOS, 32% of control patients were classified as such. Physician prediction of discharge date helped decrease patient LOS.

Hospital-based primary prevention strategy in child abuse: a multi-level needs addressment.

The purpose of this study was to evaluate a primary prevention effort in child maltreatment, the focus of which was a community-wide endeavor (i.e., subjects were not prescreened for risk potential). Specific components of the planned intervention addressed four causal levels of maltreatment: individual, family, community, and cultural factors. That assessment was intended to build strengths in those parenting areas which are predictive of abusive or neglectful outcomes. Target areas included knowledge of child development, child-rearing attitudes, mother-infant interaction patterns, and parenting skills. A posttest-only control group design was employed. The control postpartum mothers received traditional or routine hospital services; experimental mothers received special in-hospital and after-care services by trained student nurse volunteers. These volunteers functioned in a dual educative/supportive role. Experimental mothers reported more realistic expectations of behavior, embraced more democratic child-rearing principles, providing more verbal stimulation to their infants (reflecting an increased sensitivity), and displayed increased problem-solving abilities.

An analysis of civil aviation propeller-to-person accidents: 1965-79.

The interest of manufacturing, governmental, and safety personnel in using paint schemes on propeller and rotor blades is based on improving the visual conspicuity of those blades when they are rotating. While propeller and rotor paint schemes may serve to reduce the number of fatalities and injuries due to contact with a rotating blade, there is little information about the circumstances surrounding such accidents. Brief reports provided by the National Transportation Safety Board of all "propeller-to-person" accidents from 1965-79 were examined and analyzed in terms of airport lighting conditions, actions of pilots, actions of passengers and groundcrew, phase of flight operations, weather conditions, and others. Analyses based on 319 accidents showed a marked drop in the frequency of "propeller-to-person" accidents from 1975 through 1978. Several types of educational efforts directed toward pilots and groundcrew, both prior to and during that 4-year period, were examined as possible factors contributing to the accident rate decline. Accident patterns provide a basis for assessing the probable efficacy of various recommendations, including propeller conspicuity, for further reducing "propeller-to-person" accidents.

A joint Department of Defense/American Cancer Society health promotion project.

A joint venture expanding cancer control programs and services to overseas activities is described. A pilot project tests the feasibility of using the U.S.-based American Cancer Society programs and techniques at overseas sites. Volunteer-led service-specific organizations deliver services, and recruit and maintain volunteers. Primary focus is tobacco control programs. Periodic evaluations identify problems, successes, and on-going needs. Demonstrated benefits to the community include resources for public and professional education, public information, tobacco use cessation, nutrition education, and DoDDS (youth) programs. The major challenge to success and expansion is to establish and maintain a stable volunteer force.

Household pesticide usage in the United States.

A total of 10,000 U.S. households in 25 standard metropolitan statistical areas and 25 counties were included in the United States. More than 8,200 households granted an interview. Nine of every ten households in the United States used some types of pesticide in their house, garden, or yard. Households in the southeastern United States used the most pesticides. Although more than 500 different pesticide formulations were used by the sampled households, 15 pesticides accounted for 65.5% of all pesticides reported in this study. Thirteen of these 15 pesticides were insecticides, one was a herbicide, and one was a rodenticide.

Adolescent health care: an assessment of referral activities.

The referral activities of 45 agencies (90% of the sample originally polled) in a moderate-sized midwest community were investigated with respect to agency referral patterns and professionals' appraisal of adolescents' health care status. A combined analysis of qualitative and quantitative data provided valuable insight into the problems of unmet adolescent health care needs and underutilization of adolescent health care services. Referral activity characteristics which may hinder the successful networking of services for adolescents are highlighted.

Using focus group methodology to develop breast cancer screening programs that recruit African American women.

Public communication campaigns are designed to increase the number of women who receive mammograms, breast examinations, and cervical exams. However, these campaigns have failed to recruit sufficient numbers of African American women. Focus group techniques were used to provide data to develop a communication campaign that would increase the knowledge, assess the attitudes, and change behaviors of African American women, aged 40-65, about the aforementioned preventive health practices. The discussions revealed that participants distrusted "clinics" and preferred being examined by "their own" or a private physician. Results further revealed that the personal influence of opinion leaders, combined with interpersonal contacts that encourage preventive care, help influence women to participate in mammography and cervical cancer screening.

A comparison of prostate knowledge of African-American and Caucasian men: changes from prescreening baseline to postintervention.

PURPOSE: This study was undertaken to determine if a community screening program designed to overcome key barriers (lack of awareness, cost of program, ease of access to care) could successfully impact on African-American males' knowledge, attitudes, and behaviors regarding prostate cancer screening. The focus of this report is knowledge. To date, there are no reported studies that examine differences in knowledge from a prescreening baseline to a postintervention level for minority participants. PATIENTS AND METHODS: A total of 944 men were enrolled in the study in a 20-month period. Prostate screening and education were offered as a new service at an existing senior health clinic. In addition, mass screenings were offered approximately monthly at various locations in the community (including senior community centers, senior apartment complexes, and some public housing projects). Screening included both the digital rectal examination and the prostate specific antigen test. A brief questionnaire was administered during client intake (the pretest) and repeated after the education and screening participation (the posttest). Test items targeted three constructs: (1) etiology, (2) risk status, and (3) clinical factors. RESULTS: The largest difference on pretest scores between the racial groups resulted from clinical factor knowledge. African-American men were significantly less likely than Caucasian men to correctly identify early symptoms of prostate cancer and the basic components of a prostate checkup. Although scores were initially significantly lower for African-American participants, these differences were not evident after program involvement. There was a significant increase in knowledge level for all men when comparing pretest and posttest scores. Significant improvement was noted for each test item, with the exception of one key item. Even after participation in the program, African-American men were still more likely to believe that "pain" was the first symptom of prostate cancer. DISCUSSION: An item-by-item analysis revealed that there was only one test item in which program participation did not "correct" knowledge. African-American men were still more likely to believe that pain was the first symptom that would alert them to the presence of cancer. The screening program included information (both printed and oral content) that emphasized the importance of routine screening to detect cancer at an early stage, because most men would experience no symptoms. The only other reported study that examined knowledge documented similar findings with respect to an understanding of symptomology. These findings can be used to direct or guide the educational component of future screening programs that hope to target African-American men.

Fetal exposure to involuntary maternal smoking and childhood respiratory disease.

BACKGROUND: Several studies have now gone beyond the effects of smoking during pregnancy to examine the effects of involuntary maternal smoke exposure on fetal development. A link has also been indicated between postnatal environmental smoke exposure and long-term respiratory problems in infants. OBJECTIVE: Our study examines whether an association exists between maternal exposure to environmental tobacco smoke and childhood respiratory disorders. METHODS: A cross-sectional design was implemented utilizing a maternal questionnaire survey. The surveys were distributed throughout the county's health department and outlying clinic immunization sites. The county population is a diverse community of all racial and socioeconomic levels and includes a metropolitan population of approximately 300,000. The questionnaire comprised inquiries about the child's wheeze, acute respiratory illnesses, and maternal and paternal exposure to passive smoke and/or other environmental air pollutants. RESULTS: Chi-square and logistic regression analysis showed no statistically significant difference between passively smoke-exposed-in-utero subjects and non-smoke-exposed in-utero subjects on the outcomes of allergy and wheeze. Asthma, however, did show a statistically significant association to passive smoke exposure (chi2 = 12.4, P = .05 and Log reg = 8.7, P = .03). CONCLUSION: Passive maternal exposure to tobacco smoke during pregnancy is associated with increased incidence of asthma and supports other research findings that children born of mothers who are passively exposed to smoke during pregnancy are at risk for patterns of negative developmental outcomes.

A new procedure for the labeling of peptides and amino acids.

Several stable, water soluble cyclohexa-2,4-dien-1-ones have been prepared and their photolytic coupling reactions in aqueous solution at 28 degrees C with various amino acids and dipeptides investigated. This procedure represents a new and high yielding method for the labeling of the terminal amino functionality of peptides and amino acids.

Dilated coronary sinus in the fetus: misinterpretation as an atrioventricular canal defect.

The ostium of the coronary sinus opens directly into the right atrium in close proximity to the insertion of the atrioventricular values. If the coronary sinus is dilated, it can create the appearance of atrioventricular canal defect in the fetal echocardiographic four-chamber view. The diagnosis of a serious heart lesion, such as a canal defect, necessitates decisions regarding pregnancy termination or optimal timing/location of delivery. We present three women who were referred at 23, 36 and 38 weeks' gestation with a preliminary diagnosis by level II ultrasound of a fetal atrioventricular canal defect. In each patient, the targeted fetal echocardiogram demonstrated a dilated coronary sinus and no evidence of an atrioventricular canal defect. The fetal echocardiographic presentation of a dilated coronary sinus can be mistaken for an atrioventricular canal defect. Misdiagnosis can be avoided by utilizing both variable angulation in the four-chamber projection and additional transducer views to confirm an intact atrioventricular septum and two normal atrioventricular valves.

Mechanistic investigations on the reaction between 1,2-dioxines and bulky stabilized phosphorus ylides: an efficient route to closely related cyclopropane stereoisomers.

The bulky stabilized ylides (2a-d) react with a range of 1,2-dioxines (1a-d) to afford the diversely functionalized cyclopropanes 7 in excellent yield and diastereomeric excess. This is in direct contrast to the situation when nonbulky ester ylides are utilized which results in a completely different cyclopropyl series. Through a combination of isolation, spectroscopic, temperature, and deuterium and additive effects studies, the mechanism of cyclopropane formation from this second pathway can be proposed. Importantly, enolate quenching of the intermediate 1-2lambda(5)-oxaphospholanes 4 prior to collapse results in an equilibrium mixture of intermediates 10 and 11 which have been fully characterized, and their formation is primarily a result of the steric bulk of the stabilized ester ylide. These intermediates (10/11) then collapse further and result in formation of the observed closely related cyclopropyl stereoisomers 7 and 8. Moreover, the addition of LiBr to these reactions allows for the control of which of the two possible cyclopropanation pathways will be dominant. Finally, optimal protocols that demonstrate the potential of this new cyclopropanation methodology for the ready construction of closely related cyclopropyl stereoisomers are presented.

Differences between African American and Caucasian men participating in a community-based prostate cancer screening program.

Prostate cancer is a major contributor to morbidity and mortality in the male population, but public awareness of the cancer has been reported as minimal. We evaluated the effectiveness of an educational prostate cancer screening program on 944 men in a midwest urban community. Digital rectal examinations and PSA blood tests were provided at no charge to participants with a grant from the Michigan Department of Community Health. An educational intervention that stressed the importance of prostate cancer early detection and treatment was conducted before screenings. A brief questionnaire administered before and after the videotape and screenings, targeted both knowledge and attitudes concerning prostate cancer. Pre-test results revealed that African American men were significantly (t = 3.7, P = .00) less likely then white men to correctly identify early symptoms of prostate cancer and the basic components of a prostate checkup. Following program involvement, scores significantly improved in all areas and differences were no longer significant between the races. Racial differences were also found for screening preferences and modes of reaching men to participate in screening. African American men were twice as likely as white men to choose private appointments over mass screening (OR = 2.2, P = .00). Radio reached the most African Americans (25%) while newspaper reached the most Caucasians (34%). The decreased level of knowledge among African Americans regarding prostate etiology and clinical factors highlights the need for educational programs to target minority populations. The need for discretion also applies by providing minority-favored access with screening through private appointments.

Guidelines for topical photodynamic therapy: report of a workshop of the British Photodermatology Group.

Topical photodynamic therapy (PDT) is effective in the treatment of certain non-melanoma skin cancers and is under evaluation in other dermatoses. Its development has been enhanced by a low rate of adverse events and good cosmesis. 5-Aminolaevulinic acid (ALA) is the main agent used, converted within cells into the photosensitizer protoporphyrin IX, with surface illumination then triggering the photodynamic reaction. Despite the relative simplicity of the technique, accurate dosimetry in PDT is complicated by multiple variables in drug formulation, delivery and duration of application, in addition to light-specific parameters. Several non-coherent and coherent light sources are effective in PDT. Optimal disease-specific irradiance, wavelength and total dose characteristics have yet to be established, and are compounded by difficulties comparing light sources. The carcinogenic risk of ALA-PDT appears to be low. Current evidence indicates topical PDT to be effective in actinic keratoses on the face and scalp, Bowen's disease and superficial basal cell carcinomas (BCCs). PDT may prove advantageous where size, site or number of lesions limits the efficacy and/or acceptability of conventional therapies. Topical ALA-PDT alone is a relatively poor option for both nodular BCCs and squamous cell carcinomas. Experience of the modality in other skin diseases remains limited; areas where there is potential benefit include viral warts, acne, psoriasis and cutaneous T-cell lymphoma. A recent British Photodermatology Group workshop considered published evidence on topical PDT in order to establish guidelines to promote the efficacy and safety of this increasingly practised treatment modality.