Second occurrence of spinal epidural metastases

We reviewed records of 79 men with spinal epidural metastases diagnosed from July 1984 to July 1989, imaged by myelography or MRI, and treated with radiation therapy. Thirteen men (16%) had second epidural metastases. The mean time between lesions that developed within two vertebral bodies of a prior lesion was 2.8 months, compared with 15.2 months for lesions that were three or more vertebral bodies from a prior lesion. Some secondary spinal metastases occurring soon after the initial metastasis may represent regrowth of tumor at the border of the radiation port, suggesting that larger radiation ports be constructed for patients with lengthy expected survival times.     

Hepatitis B immunisation rates among infants in ethnic groups with high prevalences of hepatitis B surface antigen carriers

Abstract: To determine hepatitis B immunisation rates in infants from ethnic groups with hepatitis B surface antigen chronic carrier prevalence over 5 per cent, a questionnaire was sent to all Maternal and Child Health Centres in Victoria, requesting information on the hepatitis B and diphtheria–tetanus–pertussis (DTP) or combined diphtheria–tetanus (CDT) immunisation status for all infants born between 1 July 1992 and 30 June 1993 and at risk of hepatitis B infection because of maternal ethnicity. We received data on 3611 of 5744 infants (62.9 per cent) in targeted ethnic groups. Of these, 12.8 per cent had not received hepatitis B vaccine, and 81.6 per cent, 76.8 per cent and 64.0 per cent had received at least one, two and three doses respectively, while 84 per cent had received at least three doses of DTP vaccine and/or CDT vaccine. Coverage with DTP or CDT was higher than for hepatitis B vaccine ( P < 0.001), and coverage was better in areas with a higher percentage of infants in high–prevalence ethnic groups ( P < 0.001). Changes in the program in Victoria in terms of timing of the first dose of vaccine plus greater attention to follow–up may lead to improved hepatitis B immunisation rates among infants in targeted ethnic groups. Adoption of universal infant hepatitis B immunisation, by increasing familiarity with hepatitis B vaccine, is likely to be the best way to increase immunisation coverage for these infants.     

Peptide T inhibits HIV-1 infection mediated by the chemokine receptor-5 (CCR5)

Peptide T, which is derived from the V2 region of HIV-1, inhibits replication of R5 and dual-tropic (R5/X4) HIV-1 strains in monocyte-derived macrophages (MDMs), microglia, and primary CD4(+)T cells. Little to no inhibition by peptide T was observed with lab adapted X4 viruses such as IIIB, MN, or NL4-3 propagated in CD4(+) T cells or in the MAGI entry assay. The more clinically relevant R5/X4 early passage patient isolates were inhibited via either the X4 or R5 chemokine receptors, although inhibition was greater with R5 compared to X4 receptors. Virus inhibition ranged from 60 to 99%, depending on the assay, receptor target, viral isolate and amount of added virus. Peak inhibitory effects were detected at concentrations from 10(-12) to 10(-9) M. Peptide T acted to block viral entry as it inhibited in the MAGI cell assay and blocked infection in the luciferase reporter assay using HIV virions pseudotyped with ADA envelope. These results using early passage virus grown in primary cells, together with two different entry reporter assays, show that peptide T selectively inhibits HIV replication using chemokine receptor CCR5 compared to CXC4, explaining past inconsistencies of in vitro antiviral effects.     

Hormone receptors in male breast carcinoma

It is well established that approximately 60% of female breast cancers contain estrogen receptors (ER+). The hormonal receptor status of male breast cancers remains relatively unknown. Tumor tissue from 14 patients has been reviewed at the University of Oregon Health Sciences Center. Specimens of all 14 patients were ER+ with a range of 5.5 to 374 fmol/mg protein. Eight of 12 patients had tumors which also contained progesterone receptors (PR+) with a range of 42 to 1852 fmol/mg protein. Nine patients were treated by modified radical mastectomy, two by radical mastectomy, one by simple mastectomy, and two by biopsies only. Twelve patients remain free of disease with a mean follow-up of less than 2 years. The two patients who developed metastases both responded to endocrine ablation by orchiectomy and subsequent adrenalectomy. These data suggest that male breast cancer is highly endocrine sensitive and that endocrine ablation can play an integral part in those men unfortunate enough to develop disseminated disease.     

Metabolic effects of pivalate in isolated rat hepatocytes

Pivalate (trimethylacetic acid) administration in humans or rat has been reported to cause metabolic changes and increased urinary carnitine excretion secondary to pivaloylcarnitine generation. As pivaloylcarnitine formation is dependent on intracellular activation of pivalate, the effects of pivalate on cellular coenzyme A and acyl-CoA contents and oxidative metabolism were defined using isolated rat hepatocytes. During incubations with pivalate (1.0 mM), hepatocyte coenzyme A content fell to less than 0.05 nmol/10(6) cells (vs 0.97 nmol/10(6) cells in the absence of pivalate) as pivaloyl-CoA accumulated. Pivalate (5 mM) inhibited 14CO2 generation from 10 mM [1-14C]pyruvate by 34%, but had no effect on 0.8 mM [1-14C]palmitate oxidation. Pivaloyl-CoA was a substrate for hepatocyte carnitine acyltransferase activity, but supported acylcarnitine formation at rates only 10-20% of those observed with equimolar acetyl-CoA or isovaleryl-CoA as substrates. Thus, hepatocytes activate pivalate to pivaloyl-CoA, which can then be used as a substrate for pivaloylcarnitine formation. The sequestration of hepatocyte coenzyme A as pivaloyl-CoA is associated with inhibition of pyruvate oxidation. As with other organic carboxylic acids, activation of pivalate to the coenzyme A thioester is an important aspect in the biochemical toxicology of the compound.     

A neonatal preventive intervention study: Issues of recruitment and retention

Intervention to prevent negative mental health outcomes in families of ill and premature newborns is an important part of neonatal care. This study addresses the factors which influence participation in a parent support group for parents of ill and premature newborns. Demographic, social support, and infant health data were examined to determine how support group participants and nonparticipants differed. In addition, efforts at enhancing recruitment and retention into support groups were examined. Results showed participants in the support group to have less healthy infants with longer hospital stays than nonparticipants. Participants reported more favorable financial situations, slightly higher incomes and less social support as measured by fewer contacts with family and friends than nonparticipants. Recommendations for future intervention research are discussed.The authors acknowledge the help of the group leaders who volunteered to participate in the study, as well as the exceptional efforts of Susan Grossbard in recruitment of subjects. In addition, the support and assistance of Drs. Ruth Stein, Henry Ireys and Dorothy Jessop throughout the research project is greatly appreciated.The authors are affiliated with the Preventive Intervention Research Center for Child Health, the Division of Neonatology, and the Low Birthweight Infant Follow-up & Evaluation Program of the Department of Pediatrics, Albert Einstein College of Medicine—Montefiore Medical Center (supported in part by Grant #P50-MH38280 from the Branch for Prevention Research of the National Institute of Mental Health).     

Adolescent mothering: assessing their parenting capabilities and their health education needs

Adolescent mothering was investigated in 95 adolescent mothers who were 15-19 years old. Adolescent mothering behavior was found to be related to age of the mother, grade in school, sex of the infant and maintenance of a relationship with the baby's father. Specific deficits were noted in areas of social, emotional and cognitive growth-fostering behavior and in response to infant distress. Health teaching, support, reinforcement and anticipatory guidance were some implications for nursing.     

Construct validity of the San Diego Neuropsychological Test Battery.

A group of 259 normal adults were administered the San Diego Neuropsychological Test Battery. Factor analysis of the SDNB supported the construct validity of the battery according to a Luria-based functional systems assessment approach. Using expert ratings to interpret the obtained factor loadings, the following factors were identified: (a) arousal, (b) mnestic processes, (c) complex intelligence, and (d) planning. A second factor analysis of the SDNB, using a sample of 100 schizophrenic and head injured cases, achieved a factor structure very similar to that of the normal sample, offering further empirical support for a functional assessment approach with clinical populations. The clinical factor analysis yielded slightly different proportions of variance contributed by the test measures and two planning factors. The results are discussed as they relate to Luria's qualitative analysis of cortical organization applied to a quantitative methodology.