Component analysis in smoking prevention research: Effects of social consequences information

The purpose of this study was to evaluate the effects of information about the negative social consequences of cigarette smoking on adolescents' beliefs and intentions to smoke. In contrast to the large-scale, multiple component interventions most commonly conducted, this study compared two brief videotaped messages that contained either social consequences or control information. Fifty-four seventh graders enrolled in health education classes participated. Measures collected immediately after the intervention and at a one month follow-up indicated that the social consequences information successfully altered subjects' smoking-related beliefs. The social consequences information also affected intentions to smoke in the future, but only for subjects who had previously experimented with smoking. Female smokers' intentions to continue smoking were reduced, but the intervention had the opposite effect on male smokers. The discussion addresses the importance of examining the effects of prevention program components on different subsamples of adolescents in small-scale process evaluations.     

Musical murmurs: An echo-phonocardiographic study

Five patients with musical murmurs were studied noninvasively with simultaneous echocardiography and phonocardiography. Three patients had aortic regurgitation, one mitral regurgitation and one tricuspid regurgitation. The frequency of the musical murmurs ranged from 40 to 158 cycles/sec. The patient with tricuspid regurgitation manifested an inspiratory honk. Simultaneous echo-phonocardiography revealed regular valve leaflet flutter (aortic, mitral or tricuspid) at a frequency identical to that of the simultaneously recorded musical murmur. This study demonstrates that echocardiography is a useful noninvasive tool in identifying the site of origin of musical murmurs.     

Ammonia production in inhalation chambers and its relevance to chlorine inhalation studies.

Inhalation exposure of animals to low concentrations of chlorine (ca. 1 ppm) may be complicated by the formation of chloramines from the reaction of ammonia, evolved from animal urine and feces, with chlorine. To address this problem, ammonia levels were determined by an indophenol method during a 6-hr period, in inhalation chambers using male, Fischer 344 rats under varying conditions of air flow and animal loading. At chamber air flows of 13, 26, or 40 liters/min, ammonia concentrations were obtained at 2, 4, and 6 hr for 1, 3, or 5% animal loading. Ammonia concentrations increased with time, peaking at 6 hr; they increased with increased percentage animal loading and decreased with increased chamber air flow. At 6 hr, for 13 liters/min, and 1, 3, or 5% animal loading, ammonia concentrations were 0.46, 1.91, and 2.42 ppm, respectively. At 40 liters/min, the ammonia levels at 6 hr were 0.22, 0.39, and 1.30 ppm for 1, 3, or 5% animal loading. Chloramines were detected in a chamber containing low concentrations of chlorine and ammonia (ca. 2 ppm each) by using a modified methyl orange method. These results suggest that, depending upon the variables indicated, sufficient ammonia may be evolved from animals in an inhalation chamber to reduce the amount of free chlorine present. Taken in conjunction with the toxic action of chloramines, such reduction may affect the outcome of chronic, low-level exposures to chlorine.     

Pulmonary hypertension and cor pulmonale in the sickle hemoglobinopathies

Although pulmonary hypertension is frequently mentioned as a complication of the sicklemic state, careful review of the medical literature revealed only a single subject in whom cardiac catheterization data substantiated this diagnosis. In two additional patients, both clinical and autopsy findings of pulmonary vascular disease and cor pulmonale were described, although no hemodynamic studies had been performed. We have therefore detailed the clinical history, cardiac catheterization results, and autopsy findings in three previously undescribed patients. These three patients, along with the three case reports culled from the medical literature, form the substance of this review. Pulmonary hypertension should be suspected in patients with sickle hemoglobinopathy in whom either fixed dyspnea or unexplained syncope develops. Early in the course of the disease, right heart catheterization remains the only way to establish the diagnosis with certainty. Noninvasive studies such as chest x-ray, electrocardiography, and echocardiography tend to be nondiagnostic until late in the course of right ventricular failure. Although specific therapy has yet to be defined, the ominous prognosis of this complication of sickle hemoglobinopathy supports the application of experimental modalities such as continuous oxygen therapy, partial exchange transfusion, or even limited phlebotomy.     

Risk factors for hyperglycemia in children with leukemia receiving L-asparaginase and prednisone

We determined retrospectively the frequency and risk of hyperglycemia in 421 children with leukemia who had received L-asparaginase and prednisone as part of their remission induction therapy. Forty-one patients (9.7%) developed this complication, 39 within one week after the first dose of L-asparaginase. Hyperglycemia resolved in all patients and in 32 before the end of the four-week induction period. Age, obesity, and Down syndrome each had a significant bearing on the frequency of hyperglycemia. Children 10 years of age or older were more likely to develop the complication than were younger children. When more than one factor was present in a child, the risk of hyperglycemia increased significantly. A family history of diabetes mellitus also appeared related to an increased risk of hyperglycemia. Childhood leukemia patients with any of the risk factors identified here should be closely monitored for glucosuria while receiving prednisone and L-asparaginase for remission induction.     

A monoclonal antibody (SJ-9A4) to P24 present on common alls, neuroblastomas and platelets - I. Characterization and development of a unique radioimmunometric assay

We report the development and characterization of SJ-9A4, a monoclonal antibody (MoAb) produced against common acute lymphoblastic leukemia (C-ALL) cell lines. SJ-9A4 reacted with C-ALL, B-cell chronic lymphocytic leukemia (B-CLL), platelets and C-ALL neuroblastoma (NB) and the K562 cell lines. It had no significant reactivity with erythrocytes, granulocytes, circulating T or B lymphocytes, monocytes, granulocytic cell lines or a Ewing's sarcoma cell line. SJ-9A4 was shown to recognize the same region as two other MoAb to the p24 antigen, BA-2 and DU-ALL-1, as demonstrated by their ability to inhibit the binding of labeled SJ-9A4 to NALM-1 and NB cells. Other MoAb: J5, PI 153/3 and monoclonal anti-HLA-DR antibodies gave no inhibition. A solid phase indirect radioimmunometric assay (IRA) was developed which enabled the detection of P24 from C-ALL cells, utilizing its ability to bind the Ricinus communis agglutinin (RCA1) or wheat germ agglutinin (WGA) and SJ-9A4 simultaneously. When BA-2 and DU-ALL-1 were used in place of SJ-9A4, similar IRA results were obtained. Using the RCA1/SJ-9A4-IRA, P24 from as few as 1.6 X 10(4) cells of a C-ALL cell line could be detected; however, similar extracts of NB cell lines were negative despite high levels of SJ-9A4 binding to intact cells. The presence of P24 in NB extracts was demonstrated by (1) preincubation of NB extracts with SJ-9A4 which blocked MoAb binding to P24 and (2) immunoadsorption of P24 from solubilized membranes of 35S-methionine (met) labeled NB cells. Treatment of NB cells with neuraminidase did not result in IRA binding when either RCA1 or WGA were used as the solid phase lectin indicating that the differences in lectin affinity are not due to over sialation of NB membrane glycoproteins. These findings demonstrate a difference in the glycosylation of P24 from C-ALL and NB cells.     

Abdominopelvic computed tomography in the preoperative evaluation of early cervical cancer

The efficacy of abdorainopelvic computed tomography (CT) in determining the extent of disease in the patient with early cervical cancer was evaluated in 24 patients (FIGO Stage Ia-1, Ib-18, IIa-5). The CT stage was compared to both the clinical and surgical pathological staging, CT was accurate only in 58% of the cases in determining parametrial extension. It was unable to detect any of the 6 cases of histologically documented lymph node metastases. CT appears to have limited use in the patient with early cervical carcinoma because with parametrial thickening it lacks sufficient specificity to differentiate between malignant and nonmalignant tissues and there is not sufficient sensitivity to detect early nodal involvement.