Retrospective analysis of Naval Special Boards of Flight Surgeons, 1974-83

The Naval Special Board of Flight Surgeons was established in 1956 for the evaluation of Navy, Marine Corps, and Coast Guard problem aeromedical cases. This paper examines a sample 248 of these cases for the period of 1974-83 with respect to the characteristics of those referred, their referral diagnostic category, and the recommendation of the Special Board regarding return to a flying status. Those cases with a referral diagnostic category of ENT and Ophthalmology were less likely to be returned to flight status. Older, more senior pilots, and pilots with more total flight time were less likely to be returned to unrestricted flying than were their younger, more junior, and less experienced counterparts. Otherwise, no significant difference in outcome based on age, rank, marital status, branch of service, specialty, or flight hours was detected. Overall, 61% of those evaluated by the SBFS were returned to flight status.     

颈内动脉接近完全闭塞时的处理

目的由于卒中风险随着狭窄严重程度的增加而升高，因此认为颈内动脉（ICA）接近闭塞患者的卒中风险很高。在现有的随机试验中，还没有专门针对这种情况进行探讨，因此其处理尚存在争汶。方法：对相关文献进行系统评价。结果：对ICA接近闭塞患者的处理还存在争议：一些学者支持进行干预，而另一些学者则认为存在风险或没有益处而反对进行干预。在ICA接近闭塞的有症状患者中进行一项比较外科治疗与最佳内科治疗的多中心前瞻性随机试验似乎非常困难，因为这类研究需要大量的患者。尽管如此，基于目前的证据，似乎很难拒绝手术治疗。结论：由于目前对ICA接近闭塞患者的最佳处理方案仍存在着争议，因此需要前瞻性观察性研究以证实其在有症状和无症状人群中的患病率以及相关的卒中风险。基于目前的证据，大多数医疗中心选择手术治疗，但它相对干内科治疗的特粱尚右待证章．     

Alteration in myelin-associated proteins following spinal cord irradiation in guinea pigs.

The aim of this study was to investigate the pathological and cellular basis for radiation-induced myelopathy in guinea pigs by monitoring biochemical alterations in levels of myelin basic protein and 2',3'-cyclic nucleotide phosphohydrolase. Guinea pigs were irradiated to the lumbar region with various doses of neutrons or cobalt gamma irradiation. The ED50s for paralysis were 17.2 Gy and 67.5 Gy for neutron and cobalt irradiation, respectively, and was histologically associated with demyelination. In spinal cords taken from animals at the onset of paralysis myelin basic protein levels were decreased in direct relationship to the radiation dose. The lowest doses to cause paralysis led to a 25% decrease in MBP levels. In a separate experiment, alterations in MBP were measured in the spinal cords over the time period leading up to paralysis. Surprisingly, decreases in MBP were found immediately after the end of the 4 week irradiation period. These early changes in MBP were not markedly dose dependent and occurred with nonparalyzing doses. Dose-dependent decreases were found only just before the onset of paralysis. CNPase activity measured in the same specimens showed changes that were essentially similar to those for MBP. In the CSF, MBP levels were essentially constant until onset of paralysis. This study showed that demyelination, as assessed by the levels of the myelin-associated proteins MBP and CNPase, can occur soon after spinal cord irradiation but that profound dose-dependent changes are seen only immediately preceding the onset of paralysis. Although increases in MBP in the CSF were associated with the onset of radiation-induced myelopathy, its assay is unlikely to predict this complication of irradiation.     

Comparison of the MEASLESTAT M test kit with the sucrose density gradient centrifugation-hemagglutination inhibition method for detection of measles virus-specific immunoglobulin M.

A new commercial kit, MEASLESTAT M (Whittaker Bioproducts, Inc.), was compared with the sucrose density gradient centrifugation-hemagglutination inhibition method for the detection of measles virus-specific immunoglobulin M. Overall agreement between the two procedures was 97.1% for 104 single and paired serum samples tested. The sensitivity and specificity of MEASLESTAT M were 98.4 and 95.2%, respectively.     

Relative body fat and anthropometric prediction of body density of female athletes

Summary Ninety-one percent (n=182) of the female members of South Australian representative squads in 14 sports volunteered to act as subjects. Twenty-seven percent of them had represented Australia. The underwater weighing method together with the measurement of residual volume (RV) by helium dilution were used to determine body density (BD); the percent body fat (% BF) was then computed according to Siri.A stepwise multiple regression analysis yielded a correlation coefficient (R) of 0.863 between the criterion (BD) and the best weighted sum of predictors (anthropometric variables): BD (g·cm^–3)=1.14075–0.04959 (log₁₀ triceps, subscapular, supraspinale and calf skinfolds in mm)+0.00044 (age in decimal years)–0.000612 (waist girth in cm)+0.000284 (height in cm)–0.000505 (gluteal girth in cm)+0.000331 (breast girth in cm).Only those predictors which resulted in a statistically significant increase inR (p0.05) were included. The standard error of estimate of 0.00597 g · cm^–3 was equivalent to 2.7% BF at the mean. This equation was shown to be largely population specific. There was a range of 7.6–35.8% of BF and the overall mean of 18.5% was significantly lower (p<0.001) than that of 23.4% obtained on a moderately active reference sample of similar age (n=135). If group sizes of only one or two are regarded as too small for meaningful comparison, then the lowest mean of 13.5% was achieved by the long-distance runners (n=14). The highest averages were registered by the heavyweight rowers (24.2%;n=7) and soccer players (22.0%;n=11). The overall average for games players (n=107) was 19.4%.This study was supported by a grant from the National Health and Medical Research Council of Australia     

Androgen receptor YAC transgenic mice carrying CAG 45 alleles show trinucleotide repeat instability

X-linked spinal and bulbar muscular atrophy (SBMA) is caused by a CAG repeat expansion in the first exon of the androgen receptor (AR) gene. Disease-associated alleles (37-66 CAGs) change in length when transmitted from parents to offspring, with a significantly greater tendency to shift size when inherited paternally. As transgenic mice carrying human AR cDNAs with 45 and 66 CAG repeats do not display repeat instability, we attempted to model trinucleotide repeat instability by generating transgenic mice with yeast artificial chromosomes (YACs) carrying AR CAG repeat expansions in their genomic context. Studies of independent lines of AR YAC transgenic mice with CAG 45 alleles reveal intergenerational instability at an overall rate of approximately 10%. We also find that the 45 CAG repeat tracts are significantly more unstable with maternal transmission and as the transmitting mother ages. Of all the CAG/CTG repeat transgenic mice produced to date the AR YAC CAG 45 mice are unstable with the smallest trinucleotide repeat mutations, suggesting that the length threshold for repeat instability in the mouse may be lowered by including the appropriate flanking human DNA sequences. By sequence-tagged site content analysis and long range mapping we determined that one unstable transgenic line has integrated an approximately 70 kb segment of the AR locus due to fragmentation of the AR YAC. Identification of the cis - acting elements that permit CAG tract instability and the trans -acting factors that modulate repeat instability in the AR YAC CAG 45 mice may provide insights into the molecular basis of trinucleotide repeat instability in humans.