Prediction of coronary events following myocardial infarction using a discriminant function analysis

This study was undertaken to derive an index for predicting coronary events in the first year after a myocardial infarction in "low-risk" patients enrolling in a Cardiac Rehabilitation Program. Data from 145 consecutive patients were analysed. The events were classified as follows: angina requiring further therapy, re-infarction and coronary death. Seventy patients had events: Angina--52, Re-infarction--8, Coronary Death--10. A discriminant function analysis was performed to predict such events using data available at the time of discharge from hospital. The following were significant predictors: (1) previous infarction/angina, (2) radiological evidence of cardiomegaly or lung congestion in the Coronary Care Unit, (3) Non-Q wave infarction and (4, 5 and 6) angina, atrial arrhythmias and a decrease in R wave amplitude in V5 during a pre-discharge exercise test. The jack-knife method classified correctly 71.2% of those with events and 72.6% of those without events. In patients with discriminant scores greater than +0.2, 82% developed events.     

Attainment of therapeutic fluoride levels in serum without major side effects using a slow-release preparation of sodium fluoride in postmenopausal osteoporosis

The bioavailability, biochemical effects, and safety of a slow-release preparation of sodium fluoride were examined. In 8 normal volunteers, a single administration of slow-release sodium fluoride (25 mg) caused a slow rise and gradual decline in serum fluoride concentration, thus avoiding sharp peaks produced by a rapid-release preparation. In 37 patients with postmenopausal osteoporosis, serum fluoride concentration was kept within the "therapeutic window" (95-100 ng/ml) during long-term intermittent sodium fluoride (slow-release) therapy (25 mg twice/day, given for 3 months in each 5-month cycle over five cycles). Serum fluoride was also kept within the therapeutic window in 64 patients who took sodium fluoride (slow release) continuously over 12 months. Serum osteocalcin concentration increased progressively during fluoride treatment (correlation coefficient of 0.88, p less than .001 for the relationship between serum osteocalcin and duration of therapy). Side effects to slow-release sodium fluoride therapy, assessed in 101 patients at two study sites, were minor and included diarrhea in 2 patients, nausea in 2 patients, abdominal pain and cramping in 2 patients, foot pain in 2 patients, and joint pain in 6 patients. Thus, slow-release sodium fluoride confers desired level of fluoride in serum, while providing safety of usage.     

Fenfluramine treatment in infantile autism. Neurochemical, electrophysiological, and behavioral effects

As part of a multicenter, collaborative project, response to fenfluramine was assessed in 10 autistic outpatients. After 4 months of treatment, blood serotonin concentrations decreased an average of 60 per cent and returned to pretreatment levels after 2 months on placebo. This reduction was accompanied by a decrease in certain behavioral symptoms, including motor activity, distractibility, and mood disturbances. Baseline evoked potential recordings indicated that autistic patients tended to have a larger amplitude of the P3 component to frequent tones as compared to age-matched controls. A tendency toward "normalization" of the P3 effect was observed during the medication trial and during the final placebo period. Treatment response was not related to initial serotonin levels, and no major clinical side effects were associated with fenfluramine.     

Effects of priming duration on retention over the first 1 1/2 years of life

Exposing individuals to an isolated component (a prime) of a prior event alleviates its forgetting. Two experiments with 120 human infants between 3 and 18 months of age determined the minimum duration of a prime that can reactivate a forgotten memory and how long the reactivated memory persists. Infants learned an operant task, forgot it, were exposed to the prime, and later were tested for renewed retention. In Experiment 1, the minimum duration of an effective prime decreased logarithmically with age, but was always longer than the duration of a mere glance. In Experiment 2, the reactivated memory was forgotten twice as fast after a minimum-duration prime as after a full-length one, irrespective of priming delay and infant age. These data reveal that the minimum effective prime duration psychophysically equates the accessibility of forgotten memories. We conclude that priming is perceptually based with effects that are organized on a ratio (log) scale.     

The influence of abductor lever-arm changes after shoulder arthroplasty

Clinically, pain relief is usually satisfactory after shoulder arthroplasty, but the range of motion can be limited. The changes of the lever-arms of deltoid and supraspinatus muscles are considered to be important factors influencing postoperative active motion. After excluding patients with muscle weakness resulting from a neurologic condition, patients with chronic rotator-cuff tears, patients who did not follow rehabilitation guidelines, and patients with bilateral arthroplasties, 22 arthroplasty cases remained and were evaluated. Compared with the unaffected side, four radiologic parameters were assessed: (A) offset of humeral head, (B) lateralization of humeral head, (C) acromiohumeral interval, and (D) superoinferior migration of humeral head. The differences were measured and statistically analyzed. In summary: (1) The active and passive range of motion of abduction in scapular plane were 89.5° ± 26.1° and 109.7° ± 25.0°. (2) Parameters A, B, and C statistically changed (p < 0.05). (3) B value of the operated side was reduced below zero in six (27.3%). (4) There was a tendency to create medial shifting and inferior subluxation with the arthroplasty. This had a moderate adverse correlation to the active range of motion (correlation coefficient 0.498). (5) Before normalization for bone size, only C as a single parameter had moderate correlation with motion; after normalization, this decreased. (6) If combined parameters were assessed, A + C had a moderate correlation (correlation coefficient 0.435) with motion. (7) If an accurate anatomic relationship cannot be completely restored, A seemed more significant than any other parameters (p = 0.002); namely, shoulders with a smaller offset had a more limited active range of motion in abduction.     

Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection.

Both experimental and epidemiologic studies have linked a low dietary intake of selenium with an increased risk of cancer. The authors examined the association between plasma selenium levels and risk of hepatocellular carcinoma (HCC) among chronic carriers of hepatitis B and/or C virus in a cohort of 7,342 men in Taiwan who were recruited by personal interview and blood draw during 1988-1992. After these men were followed up for an average of 5.3 years, selenium levels in the stored plasma were measured by using hydride atomic absorption spectrometry for 69 incident HCC cases who were positive for hepatitis B surface antigen (HBsAg) and/or antibodies against hepatitis C virus (mostly HBsAg positive) and 139 matched, healthy controls who were HBsAg positive. Mean selenium levels were significantly lower in the HCC cases than in the HBsAg-positive controls (p = 0.01). Adjusted odds ratios of HCC for subjects in increasing quintiles of plasma selenium were 1.00, 0.52, 0.32, 0.19, and 0.62, respectively. The inverse association between plasma selenium levels and HCC was most striking among cigarette smokers and among subjects with low plasma levels of retinol or various carotenoids. There was no clear evidence for an interaction between selenium and alpha-tocopherol in relation to HCC risk.     

The expression of cytokeratin 18 in transitional cell carcinoma comparing with hepatoma

The epithelium in kidneys and urinary bladders contain CK18 as in liver cells. The modulation of cytokeratin 18 during tumor transformation in hepatoma had been previously recognized through a series of biochemical and immunological approaches. A 14 KD hepatoma related molecules was found in the previous studies. We would like to utilize the hepatoma transformation model to study the changes in CK18 in transitional cell carcinoma, using immunoblotting and western blotting techniques. The result is that transitional cell carcinoma retain their CK18 molecule. Furthermore, CK18 related molecules similar to those seen in hepatoma also present in transitional cell carcinoma. The conclusions are transitional cell carcinoma contains CK18 related proteins similar to those seen in hepatoma tissues. We suggest that this element would be responsible for the change during the malignant transformation processes.