Clinical outcomes associated with sleep-disordered breathing in Caucasian and Hispanic children--the Tucson Children's Assessment of Sleep Apnea study (TuCASA)

STUDY OBJECTIVES: This report describes clinical outcomes and threshold levels of respiratory disturbance index (RDI) associated with sleep-disordered breathing in children participating in the Tucson Children's Assessment of Sleep Apnea study. DESIGN: A community-based, prospective cohort study designed to assess the severity of sleep-related symptoms associated with sleep-disordered breathing in children aged 6 to 11 years. SETTING: Students attending elementary school in the Tucson Unified School District. PARTICIPANTS: Unattended home polysomnograms were completed on 239 children-55.2% boys, 51% Hispanic, and 55% between the ages of 6 and 8 years. MEASUREMENTS AND RESULTS: Based on full home polysomnography, levels of RDI that correspond to a higher prevalence of clinical symptoms of sleep-disordered breathing in children aged 6 to 11 were observed. An RDI of at least 5 was associated with frequent snoring (20.3% vs 9.1%, P<.01), excessive daytime sleepiness (22.9% vs 10.7%, P<.01), and learning problems (8.5% vs 2.5%, P<.04) when no oxygen desaturation accompanied the respiratory event. An RDI of at least 1 was associated with these symptoms when a 3% oxygen desaturation was required, snoring (24.0% vs 10.4%, P<.006), excessive daytime sleepiness (24.0% vs 13.4%, P<.04), and learning problems (10.7% vs 3.0%, P<.02). Hispanic or Caucasian ethnicity, sex, age category, obesity, insomnia, and witnessed apnea were not associated with RDI regardless of event definition. CONCLUSIONS: The Tucson Children's Assessment of Sleep Apnea study has shown that there are values of RDI based on polysomnography that correspond to an increased rate of clinical symptoms in children ages 6 to 11 years.     

Phenotypic Characteristics and Diagnoses of Patients Referred to an Iron Overload Clinic

Background  

There are limited data on the phenotypic differences between patients with hereditary hemochromatosis (HH) and other forms of iron overload.     

Clinical Assessment of Scapular Positioning in Musicians: An Intertester Reliability Study

Context:

The reliability of the measurement of the distance between the posterior border of the acromion and the wall and the reliability of the modified lateral scapular slide test have not been studied. Overall, the reliability of the clinical tools used to assess scapular positioning has not been studied in musicians.

Objective:

To examine the intertester reliability of scapular observation and 2 clinical tests for the assessment of scapular positioning in musicians.

Design:

Intertester reliability study.

Setting:

University research laboratory.

Patients or Other Participants:

Thirty healthy student musicians at a single university.

Main Outcome Measure(s):

Two assessors performed a standardized observation protocol, the measurement of the distance between the posterior border of the acromion and the wall, and the modified lateral scapular slide test. Each assessor was blinded to the other''s findings.

Results:

The intertester reliability coefficients (κ) for the observation in relaxed position, during unloaded movement, and during loaded movement were 0.41, 0.63, and 0.36, respectively. The κ values for the observation of tilting and winging at rest were 0.48 and 0.42, respectively; during unloaded movement, the κ values were 0.52 and 0.78, respectively; and with a 1-kg load, the κ values were 0.24 and 0.50, respectively. The intraclass correlation coefficient (ICC) of the measurement of the acromial distance was 0.72 in relaxed position and 0.75 with the participant actively retracting both shoulders. The ICCs for the modified lateral scapular slide test varied between 0.63 and 0.58.

Conclusions:

Our results demonstrated that the modified lateral scapular slide test was not a reliable tool to assess scapular positioning in these participants. Our data indicated that scapular observation in the relaxed position and during unloaded abduction in the frontal plane was a reliable assessment tool. The reliability of the measurement of the distance between the posterior border of the acromion and the wall in healthy musicians was moderate.     

Synthesis of Telechelic Oligomers via Atom Transfer Radical Polymerization, 1

Summary: Atom Transfer Radical Polymerization (ATRP) of styrene was carried out at 110 °C using various substituted 2‐bromoisobutyrates as initiators and the homogeneous catalyst CuBr/1,1,4,7,10,10‐hexamethyltriethylenetetramine (HMTETA). Telechelic oligomers were obtained by coupling the bromo terminated polymers using Cu(0)/PMDETA catalyst at 90 °C. The products were characterized by ¹H NMR and MALDI‐TOF and some unsaturated polymer chains were observed. They could originate from either disproportionation reaction or dehydrohalogenation of halogen terminated oligomers during MALDI analysis. Using this method, polymers with hydroxy, acid, or ester end groups were synthesized in a range of molecular weights from 1 000 to 13 000 g · mol^?1. Coupling efficiency was between 79 and 100%, depending on the structure of the initiator.

Coupling reaction of substituted polystyrenes using Cu(0)/PMDETA system at 90 °C.     

Increased chromosome instability but not cancer predisposition in haploinsufficient Bub3 mice

Mitotic spindle checkpoint proteins have been shown to play a crucial role in the accurate segregation of chromosomes during cell division. Bub3 is a member of a group of mitotic checkpoint proteins that are essential for this process. To investigate the role of Bub3 in chromosome segregation and cancer development, we analyzed haploinsufficient cells in mice. Heterozygous Bub3 embryonic fibroblasts displayed increased aneuploidy and premature sister-chromatid separation. In addition, when challenged with the microtubule disruptor nocodazole, the cells showed a slight increase in chromatid breakage and a decrease in the mitotic index. No substantial differences were observed between wild-type and Bub3 heterozygous mice in the frequency or the rate at which tumors appeared. Crossing Bub3(+/-) mice onto a heterozygous tumor-suppressor background of Trp53 or Rb1 similarly revealed no substantial differences in either the number or the rate at which tumors appeared. These results suggest that haploinsufficiency of Bub3 causes a slight increase in chromosome instability but is not clearly associated with a noticeable rise in the probability of tumor formation in the animal, possibly because of a partially functional mitotic checkpoint, or cells exhibiting chromosome instability could have activated the apoptosis pathway and thus escaped tumor induction and detection.     

Human dendritic cell responses to lipopolysaccharide and CD40 ligation are differentially regulated by interleukin-10

We evaluated the effects of interleukin (IL)-10 on the maturation of human dendritic cells (DC) induced either by lipopolysaccharide (LPS) or CD40 engagement. For this purpose, DC generated by culturing plastic-adherent peripheral blood mononuclear cells for 7 days with granulocyte/macrophage-colony-stimulating factor and IL-4 were incubated for 3 days with either LPS (10 ng/ml) or 3T6 fibroblasts transfected with the gene encoding CD40 ligand, in absence or presence of IL-10. First we found that the membrane expression of CD83, a marker of mature DC, was inhibited by IL-10 when induced by LPS but not by CD40 engagement. Likewise, IL-10 inhibited LPS-induced but not CD40-dependent CD86 (B7.2) up-regulation on DC. Furthermore, IL-10 inhibited the production of IL-8 and tumor necrosis factor-α by DC when activated by LPS but not by CD40. In contrast, IL-10 inhibited IL-12 production in both activation systems. We conclude that IL-10 differentially influences LPS-dependent and CD40-dependent pathways of DC maturation.     

Molecular pathogenesis of uterine smooth muscle tumors from transcriptional profiling

Uterine smooth muscle tumors range from the very common benign leiomyoma to the uncommon, but frequently lethal, leiomyosarcoma. Morphological and clinical differences between these tumors are presumed to result from differences in gene expression. To test this hypothesis, RNAs from four normal uterine myometria, seven uterine leiomyomas, and nine uterine leiomyosarcomas were profiled using microarrays of oligonucleotides representing about 7,000 unique probe sets. RNAs whose levels distinguished any of the three sample types were selected by analysis of variance (ANOVA). The 153 (2.2% of the total) probe sets representing 146 unique genes with the highest test statistic selected for further analysis met minimum ratio and range thresholds between groups. Cluster analysis distinguished benign and malignant samples at the first node, and myometrium and leiomyoma were resolved in a secondary node. Downregulation of specific genes in uterine leiomyosarcoma was the most common pattern of differential gene expression selected by the three-way ANOVA. Four extrauterine leiomyosarcomas had profiles most similar to that of the uterine leiomyosarcomas. Functional analysis of the 146 genes did not reveal any strong biological theme. These genes were distributed throughout the genome, but there was slight overrepresentation of genes on 1p and 2q. These genes define a tumor signature for uterine smooth muscle neoplasia, and they suggest that the molecular pathways in leiomyoma and leiomyosarcoma are distinct.     

A comparison of seasonal variation between suicide deaths and attempts in Hong Kong SAR

BACKGROUND: Seasonal variations in suicide deaths and attempted suicides have been reported for many countries. Recent research has suggested that seasonal patterns of suicide deaths have diminished considerably. The seasonality pattern between attempts and completed ones are not the same. This paper is the first one to examine seasonal variation between suicide deaths and attempts simultaneously. METHOD: Census and Statistics Department and the Hospital Authority provided mortality and morbidity data on suicides for the period 1997-2001 in Hong Kong SAR, respectively. Seasonal patterns of suicide deaths and attempts were examined by a harmonic analysis and a non-parametric chi-square test. RESULTS: A significant seasonal variation was detected in suicide attempts with a markedly bi-seasonal pattern was found amongst females with a peak in May and October; only a cyclic pattern was observed for males with a peak in summer. The female attempters who used non-violent suicide methods contributed to the second peak in October. On the other hand, there was no evidence of significant differences in the seasonal distribution among the suicide deaths for males and females. Only a mild pattern was found amongst females involving in violent suicide deaths, while others can be treated as a random event and no significantly pattern was observed in our study. Overall, a significant difference in seasonal variation existed between suicide deaths and attempts (p-value<0.01). CONCLUSIONS: This study reinforces the findings that seasonal variation in suicide appears to be diminishing. Also, suicide attempters and completed suicides in Hong Kong seem to arise from two non-identical but overlapping groups in the community.