Physical attractiveness of boys with gender identity disorder

University students blind to group status rated boys with gender identity disorder and clinical control boys regarding their physical attractiveness. Ratings were made of the face and upper torso from photographs taken at the time of clinical assessment ( age, 8.1 years). On all five adjectives (attractive, beautiful, cute, handsome, and pretty), boys with gender identity disorder were judged to be more attractive than were the clinical control boys. Attractiveness correlated with extent of behavioral femininity in the clinical control group, but not in the group of boys with gender identity disorder. The extent to which the group differences in attractiveness were due to objective, structural differences in facial attractiveness vs. socially created, or subjective, processes is discussed.A version of this article was presented at the meeting of the International Academy of Sex Research, Sigtuna, Sweden, August 1990.     

改良尿道拖入术治疗外伤性后尿道狭窄

自1994年以来,我院采用改良的尿道拖人术治疗外伤性后尿道狭窄22例,取得满意疗效,现报道如下。l临床资料本组病例均为男性,为严重车祸伤或高处跌伤致骨盆骨折所致,年龄则一46岁,平均35岁。临床症状有尿道四溢血、尿摊留、腹胀、肛周青紫肿胀,有休克者2例,合并直肠损伤2例,磅眈破裂6例。术中发现前列腺尖游离者4例。所有病例不能将导尿管插入膀跳,而均行单纯“耻骨上膀胜造疾术”,有膀脱破裂者行“膀脱破裂修补术”,有直肠损伤者,行“乙状结肠造疫术”。患者于术后3－6个月来院行尿道重建术。术前常规尿道造影,显示膜部尿道狭…     

Activated clotting time (ACT) testing: analysis of reproducibility

Activated Clotting Time (ACT) has been the standard for monitoring heparin anticoagulation in cardiac surgery for three decades. Although a 10% coefficient of variation (CV) is the referenced standard for the test, no recent reports of precision are available. The precision of Hemochron FTCA510 (celite) and KACT (kaolin) ACT test tubes was evaluated using a retrospective analysis of results from both laboratory studies and routine clinical usage. Laboratory studies of reproducibility included analysis of the CV from repetitive testing using multiple lots of ACTs. Substrates used included 40 consecutive lots of control plasma and freshly heparinized donor blood. Across the lots of control plasma, the celite ACT yielded an average CV of 5.4% for the normal control level and 4.0% in the abnormal control level (range 3.6-9.7% and 2.7-6.3%, respectively). The KACT showed similar performance for the normal (mean = 4.5%, range 2.2-7.8%) and abnormal (mean = 3.8%, range 2.0-10.0%). These values, significantly less than 10%, reflect the combined variability of both the ACT tests and the lyophilized, single use vial, control material. Fresh whole blood samples exhibited improved ACT precision when compared to this artificial substrate. CVs for the celite ACT range from 0.6-6.0% at one unit heparin/ml blood to 2.4-11.6% at 5 units/ml where clotting times exceed 650 sec. The KACT showed even lower CVs at all heparin levels, with values of 2.4-7.0%. Clinical evaluations included samples (N = 56) collected from cardiac surgery patients with celite ACT values ranging to 744 sec. Duplicate values differed by an average of 7.5 sec or 1.8%. There was only one clinically significant difference in paired values; a 376 sec paired with a 406 sec, 400 sec being the clinical target time. This retrospective data analysis demonstrates that Hemochron ACT variability is significantly less than 10%.     

Internal pilot studies II: comparison of various procedures

The two-stage design involves sample size recalculation using an interim variance estimate. Stein proposed the design in 1945; biostatisticians recently have shown renewed interest in it. Wittes and Brittain proposed a modification aimed at greater efficiency; Gould and Shih proposed a similar procedure, but with a different interim variance estimate based on blinded data. We compare the power of Stein's original test, an idealized version of the Wittes-Brittain test, and a theoretical optimal test which can be approximated in practice. We also compare two procedures that control the conditional type I error rate given the actual final sample size: Gould and Shih's procedure and a newly proposed 'second segment' procedure. The comparison among the first three procedures indicates that the Stein test is, unexpectedly, the test of choice under the original design alternative, whereas the approximate-optimal and Wittes-Brittain procedures appear to have superior power for detecting smaller treatment differences. As between the latter two procedures, the second segment procedure is more powerful when many observations are likely to be taken after the interim resizing, whereas otherwise the Gould-Shih procedure is superior.     

Antiapoptotic activity of bovine papilloma virus

Transformed fibroblasts have been recently shown to be sensitive for induction of apoptosis by TGF-beta-treated neighbouring untransformed cells. Cells transformed by a variety of different transformation principles were regularly sensitive for intercellular induction of apoptosis, but fibroblasts transformed by bovine papillomavirus (BPV) represented a striking exception. In contrast to chemically transformed C127 cells, BPV-transformed C127 cells showed resistance against intercellular induction of apoptosis. In addition, BPV-transformed cells were resistant against induction of apoptosis by ROS in glutathione depleted cells. The antiapoptotic function of papillomaviruses may be of central importance for papillomavirus-induced tumor formation as it can protect transformed cells from intercellular control of oncogenesis.     

Renal nerve and blood pressure responses to stimulation of cardiac receptors in dogs and cats by bradykinin

Summary It has been recently demonstrated in anesthetized, sinoaortic denervated-vagotomized (SAD+V_x) cats that epicardial or intracoronary (IC) bradykinin (BK) evokes an increase in efferent renal nerve activity (RNA) and a pressor response which is mediated by the cardiac sympathetic afferent nerves. The purpose of this study was to compare the effect of epicardial, IC, and left atrial (LA) administration of BK on arterial blood pressure (ABP) and RNA in intact and SAD+V_x cats and dogs. A total of seven cats and eight dogs anesthetized with chloralose were prepared with a left circumflex coronary arterial catheter (dogs) or a LA catheter (cats). Changes in ABP and RNA were determined in both dogs and cats when 1 to 100 g/ml of BK was applied to the anterior surface of the left ventricle or injected IC or LA (0.3 and 3.0 g/kg BK) in the intact and SAD+V_x state. In both the intact and SAD +V_x cat, a pressor response was consistently elicited with epicardial BK. In the SAD+V_x state, epicardial BK increased ABP by 33.4±4.7 mm Hg (p<.001). RNA followed this same trend showing a consistent and significant increase with both LA and epicardial BK (+24.8±8.4% in the SAD+V_x state; P<.05). Changes in RNA in dogs were highly variable with epicardial and IC BK in intact and in SAD V_x dogs, resulting in insignificant changes in this parameter. The results of this study demonstrate that the reflex effects of stimulation of cardiac sympathetic afferents by BK are species specific and need not evoke an increase in peripheral sympathetic outflow.Supported by National Institutes of Health Gran #HL-22594 and American Heart Association Grant # 81672.     

An efficient multiple-exposure analysis of the toxicity of crisnatol,a DNA intercalator in phase II clinical trials

To investigate the toxicity and mechanism of action of crisnatol (CRS), a new DNA intercalator currently in phase II clinical trials, we analyzed cellular and nuclear flow cytometric (FCM) parameters of murine erythroleukemic cells (MELC) exposed to a range of CRS concentrations over three exposure conditions: short-term (4 h), long-term (24 h), and short-term with recovery (4 h⁺/19 h^–). At 0.5–1.0M CRS, 4 h exposure results in a reversible G₂-phase block, while 24 h exposure results in > G₂ polyploidy. At 5–10M CRS concentrations, cells exhibit persistent retardation of S-phase progression or irreversible G₂ and/or > G₂ blocks, depending on duration of exposure. Cells terminally blocked in G₂ exhibit increased nuclear/cellular volumes and increased nuclear fluorescein isothiocyanate (protein) staining, suggestive of unbalanced growth. At 25–50M CRS concentrations, MELC exhibit severe membrane perturbation (loss of viability) regardless of exposure. In contrast, following similar exposures to an inactive isomer of CRS, MELC exhibit minimal cell cycle effects, suggesting that cell cycle kinetics may be a useful criterion for assessing potential efficacy. Similar analyses with different classes of chemotherapeutic agents reveal that the range of induced cellular/nuclear perturbations varies with the class of compound used. Taken together, these results suggest that drug toxicity can vary with both concentration and duration of exposure and, as such, a selective multiple-exposure FCM analysis may better represent the spectrum of drug action for drug development and pharmacodynamic studies.Abbreviations m-AMSA amsacrine - ARA-C cytosine arabinoside - BrdU 5-bromodeoxyuridine - CF 5,6-carboxyfluorescein - CFDA 5,6-carboxyfluorescein diacetate - CRS crisnatol - FCM flow cytometry - FITC fluorescein isothiocyanate - 5-FU 5-fluorouracil - DMSO dimethylsulfoxide - MELC Friend murine erythroleukemic cell - MLP melphalan - PBS phosphate-buffered saline - PI propidium iodide - TAX taxol - topo topoisomerase - VBL vinblastine sulfate - cis-Pt cis-platinum     

A limited-sampling method for evaluation of the area under the curve of ultrafilterable carboplatin in children

Carboplatin is a widely used cytotoxic agent in numerous solid tumors of children. Since there is a large degree of interpatient variability in the area under the curve of free carboplatin for a given dose of the drug, the current tendency is to adjust the carboplatin dose so as to reach a target area under the curve rather than to determine a carboplatin dose on the basis of the body surface area. A limited-sampling method was developed for estimation of the ultrafilterable carboplatin area under the curve and for adjustment of the carboplatin dose on subsequent treatments. Population parameters were obtained from 16 children (reference group). We used the maximum a posteriori (MAP) Bayesian approach on 15 children with complete carboplatin pharmacokinetic data (test group). Two blood samples were sufficient to obtain reliable prediction of the area under the curve. The best sampling times were: (a) 30 min after the end of the infusion and (b) 5 h after the end of the infusion. On the basis of these data it is possible to prescribe prospectively a target area under the curve for free carboplatin given in a fractionated daily infusion and to adapt the carboplatin dose directly to ultrafilterable carboplatin measurements. Received: 8 June 1997 / Accepted: 9 January 1998     

Childhood obesity increases duration of therapy during severe asthma exacerbations.

OBJECTIVES: Childhood obesity contributes to a wide array of medical conditions, including asthma. There is also increasing evidence in adult patients admitted to the intensive care unit (ICU) that obesity contributes to increased morbidity and to a prolonged length of stay. We hypothesized that obesity is associated with the need for increased duration of therapy in children admitted to the ICU with status asthmaticus. DESIGN: Retrospective cohort study. SETTING: A tertiary pediatric ICU in a university-affiliated children's hospital. PATIENTS: We retrospectively examined data from all children older than 2 yrs admitted to the ICU with status asthmaticus between April 1997 and June 2004. Children were classified as normal weight (<95% weight-for-age percentile) or obese (>95% weight-for-age). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the 209 children admitted to the ICU with asthma, 45 (22%) were obese. Compared with children of normal weight, the obese children were older (9.7 +/- 4.4 vs. 8.0 +/- 4.3 yrs, p = .02), more likely to be female (60% vs. 37%, p < .01), and more likely to have been admitted to the ICU previously (40% vs. 20%, p = .01). The obese children also had a statistically significant difference in race (more likely to be Hispanic) and in baseline asthma classification (more likely to have persistent asthma). Despite similar severity of illness at ICU admission, obese children had a significantly longer ICU length of stay (116 +/- 125 hrs vs. 69 +/- 57 hrs, p = .02) and hospital length of stay (9.8 +/- 7.0 vs. 6.5 +/- 3.4 days, p < .01). Obese children also received longer courses of supplemental oxygen, continuous albuterol, and intravenous steroids. CONCLUSIONS: Childhood obesity significantly affects the health of children with asthma. Obese children with status asthmaticus recovered more slowly from an acute exacerbation, even after adjustment for baseline asthma severity and admission severity of illness.