The use of successive blood-pressure measurements to estimate blood-pressure variability

Multiple daily, self-determined blood-pressure measurements were obtained from 254 hypertensive patients for 1 month. In an effort to establish a practical and reliable technique for estimating blood-pressure variability, standard deviations from three (at one time of day) or nine (throughout the day) successive self-determinations were compared with a reference value, taken to be the standard deviation for the entire month (252 determinations per subject). Neither the standard deviation of three measures taken on one occasion nor that of nine measures taken throughout the day correlated well with the reference value (average R₃=.21 for SBP, .20 for DBP; average R₉=.39 for SBP, .38 for DBP). However, when a sample consisting of 12 measures (taken three at a time, at the same time of day, weekly for 4 weeks) was used, the average correlation rose to .60 for SBP and .54 for DBP. Thus, it appears that 12 samples taken in this way provide a reliable estimate of the standard deviation for an entire month, and it is suggested that this sampling technique also would enhance the reliability of conclusions drawn from assessments of the prognostic value of blood-pressure variability.     

Refining the diagnosis of hydatidiform mole: image ploidy analysis and p57KIP2 immunohistochemistry

AIM: To determine whether image analysis of ploidy status and immunohistochemical analysis of p57KIP2 (a paternally imprinted, maternally expressed gene) can be used to refine the diagnosis of molar pregnancy. METHODS AND RESULTS: The original histological diagnosis in 40 randomly selected cases of hydatidiform mole was reviewed and confirmed in 38 cases (22 complete moles, 16 partial moles). These cases were anonymized and submitted for further analysis. Tissue from each case was submitted for flow cytometric assessment of DNA ploidy using a FACSort flow cytometer and for automated image cytometric assessment using a novel digital imaging system. Tissue sections from each case were immunostained with a monoclonal mouse antibody to p57KIP2. Correlations between the histopathological diagnosis, image cytometry, flow cytometry and p57KIP2 immunohistochemistry were determined using kappa statistics. The concordance between histological diagnosis and p57KIP2 was very good (kappa = 0.89). Twenty of the 22 (90.9%) complete moles showed no immunoreactivity for p57KIP2. The remaining two cases showed nuclear immunoreactivity in villous cytotrophoblast. In one of these, the pattern of staining resembled that of a partial mole. In the other, the staining pattern supported the diagnosis of a twin molar/non-molar pregnancy. All 16 partial moles were p57KIP2 immunoreactive. On flow cytometry, all 22 complete moles were diploid and 12/16 partial moles were triploid (the remaining four cases originally diagnosed as partial moles were found to be diploid). On image cytometry, one case originally diagnosed as complete mole was found to contain a triploid population. Thus, by using a combination of image cytometry and p57KIP2 status we were able to refine the diagnosis of molar pregnancy in five (13%) of the cases studied. CONCLUSIONS: Automated image cytometry is a readily performed investigation which is comparable to, but more sensitive than, flow cytometry. Complementary use of ploidy analysis and p57KIP2 status can now help to distinguish a diploid hydropic miscarriage (p57KIP2-positive), diploid complete mole (p57KIP2-negative) and triploid partial mole (p57KIP2-positive).     

Vaccine-Induced Protection from Homologous Tier 2 SHIV Challenge in Nonhuman Primates Depends on Serum-Neutralizing Antibody Titers

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Histologic studies of human skin test responses to ragweed and compound 48/80: III. Effects of alternate-day steroid therapy

Our previous studies have shown depressed eosinophil responses in skin test reactions to pollen antigens and compound 48/80 in those just completing a 1-wk course of daily steroids. Wheal reactions were unaffected. In this study, 6 ragweed-sensitive atopic subjects were studied before and on the seventh day (“day on”) and day 8 (“day off”) of a course of alternate-day steroids. Blood neutrophil levels rose on day 7 and were similar to baseline on day 8, whereas blood eosinophil levels were significantly reduced on both days 7 and 8. Neutrophil responses in skin test reactions were depressed on day 7 and normal on day 8. In contrast, the tissue eosinophil responses were depressed significantly, and to similar degree, on both days 7 and 8. These findings are of potential significance in evaluating the clinical effects of steroids in allergic diseases.     

Antigens of Streptococcus sanguis

An antigenic analysis of the alpha-hemolytic streptococci isolated from dental plaque was performed by use of antisera against a strain of Streptococcus sanguis (M-5) which was isolated from dental plaque. Immunoelectrophoretic and Ouchterlony tests of Rantz and Randall extracts of 45 strains gave positive reactions with the M-5 antisera. These strains represented 60% of the strains tested. The number of antigens which could be identified in these extracts varied from one to five and were designated a to e. The a antigen was found in 36 of the strains tested, including reference strains of S. sanguis and the group H streptococci. The strains reacting with the M-5 antisera were divided into two majors types: type I consisted of 23 strains in which the a antigen was found alone or with one or more of the c, d, and e antigens; type II consisted of 13 strains in which both the a and b antigens were found with or without one or more of the c, d, and e antigens. The remaining strains contained, either singly or in combination, the b, c, d, and e antigens but not the a antigen. Biochemical tests of representatives of each serotype and reference strains indicated that strains reacting with M-5 antisera were S. sanguis. These findings suggest that S. sanguis strains share common physiological and serological properties.     

Projections from the paratrigeminal nucleus and the medullary and spinal dorsal horns to the peribrachial area in the cat

The projections from the medullary and spinal dorsal horns to the dorsolateral pons were investigated in the cat utilizing both the retrograde and anterograde transport of a wheat germ agglutinin-horseradish peroxidase complex and the retrograde transport of the fluorescent dyes Fast Blue and Nuclear Yellow. After injections of wheat germ agglutinin-horseradish peroxidase into the area surrounding the brachium conjunctivum, numerous neurons were labeled ipsilaterally near levels of the obex in the paratrigeminal nucleus. Such neurons were located in connected pockets of neuropil located within the spinal trigeminal tract and along its medial edge. Most of the neurons labeled in the dorsal horns after such injections were found in lamina I. Those found in the medullary dorsal horn were mostly ipsilateral to the injection while those in the spinal dorsal horn were found bilaterally. Some labeled neurons were also found in lamina V of both the medullary and spinal dorsal horns bilaterally. When the injection was centered in either the medial parabrachial nucleus or the Kolliker-Fuse nucleus, a greater number of neurons were labeled ipsilaterally in lamina V of the medullary dorsal horn. Since neurons in lamina I of the medullary dorsal horn also project to the medial thalamus, fluorescent dyes were used to determine if the same neuron might project to both targets. Fast Blue was first injected into either the peribrachial area or the medial thalamus. After an appropriate period, Nuclear Yellow was injected into that target not injected first with Fast Blue. The injection of Nuclear Yellow was always placed on the side of the brain opposite to the first injection. Both dyes were transported retrogradely and were found in neurons located in lamina I of the medullary dorsal horn. However, no double-labeled neurons were seen. In general those labeled after injections of the medial thalamus were more superficial than those labeled after injections of the dorsolateral pons. The anterograde transport of wheat germ agglutinin-horseradish peroxidase was used to determine the termination of the projections from neurons in the medulary dorsal horn and the cervical spinal cord to the peribrachial area. After injections into these areas a moderate to sparse labeling of the lateral parabrachial nucleus and the Kolliker-Fuse nucleus was seen. It was mostly ipsilateral in cases with injections of the medullary dorsal horn but was bilateral following injections into the cervical enlargement.(ABSTRACT TRUNCATED AT 400 WORDS)     

The Development of a Multilevel Intervention to Optimise Participant Engagement with an Obesity Prevention Programme Delivered in UK children’s Centres

Prevention Science - Poor participant engagement threatens the potential impact and cost-effectiveness of public health programmes preventing meaningful evaluation and wider application. Although...