Cardiovascular intervention for high-risk families: the Heart Smart Program

The Heart Smart Family Health Promotion Program is a multidisciplinary, school-based program for cardiovascular risk reduction among high-risk children and their families. As a program that includes young adults at high risk, it is adaptable to a clinical practice. Nineteen fourth and fifth graders were selected as probands for elevated risk factors after a general screening to identify families for an intervention program. Twenty-three parents participated in a 12-week program focused on eating, exercise, and smoking behavior changes enhanced by behavicral support strategies. Weekly sessions were held in the auditorium/cafeteria of the elementary school and consisted of orientation and presentations, cardiovascular (CV) screening with medical feedback, activities, self-monitoring, counseling, and contingency contracting. Information gathered before and after the program included medical history, CV health knowledge and relevant behavior, blood pressure, serum lipid and lipoprotein values, anthropometric measurements, and urine electrolyte excretion. Both children and parents showed positive changes in eating habits and physical activity and significant changes in knowledge and blood pressure levels, while the children halted their weight gain. We believe this multidisciplinary, behavior-oriented, school-based program can be an effective cardiovascular risk intervention adaptable for a clinical office practice.     

Relation of body fat distribution to hyperinsulinemia in children and adolescents: the Bogalusa Heart Study

The relation of body fat distribution to plasma levels of glucose and insulin during an oral glucose tolerance test was examined in 355 Black and White school-age children. Both central and peripheral fat were similarly related to fasting, 30-min, and 1-h glucose. Unlike peripheral fat, central body fat was more strongly related to the 1-h insulin response (r = 0.35 vs 0.26); this association remained significant for central fat independent of peripheral fat (r = 0.18). The strong relation of central fat to insulin response was noted in both races and sexes but not in either sexually immature or relatively thin children. These findings indicate that, even in early life, a central body fat pattern relates positively to insulin response to glucose load. Thus, knowledge of body fat localization may help identify persons most susceptible to hyperinsulinemia in early life.     

NMDA receptors regulate developmental gap junction uncoupling via CREB signaling

Signaling through gap junctions (electrical synapses) is important in the development of the mammalian central nervous system. Abundant between neurons during postnatal development, gap junction coupling subsequently decreases and remains low in the adult, confined to specific subsets of neurons. Here we report that developmental uncoupling of gap junctions in the rat hypothalamus in vivo and in vitro is associated with a decrease in connexin 36 (Cx36) protein expression. Both developmental gap junction uncoupling and Cx36 downregulation are prevented by the blockade of NMDA glutamate receptors, action potentials and the calcium-cyclic AMP response element binding protein (CREB), and are accelerated by CREB overexpression. Developmental gap junction uncoupling and Cx36 downregulation are not affected by blockade of non-NMDA glutamate receptors, and do not occur in hypothalamic neurons from NMDA receptor subunit 1 (NMDAR1) knockout mice. These results demonstrate that NMDA receptor activity contributes to the developmental uncoupling of gap junctions via CREB-dependent downregulation of Cx36.     

Safety and efficacy of internal mammary artery grafts for left main coronary artery disease. A preliminary report

Questions regarding the relative safety and efficacy of internal mammary artery (IMA) grafts versus saphenous vein grafts (SVG) in patients with left main coronary artery disease (LMCAD) have not been specifically addressed in the literature. To elucidate this point, we analyzed 196 patients with LMCAD who underwent myocardial revascularization between January 1975 and December 1981, 98 by IMA and SVG and 98 by SVG, IMA was used most often to bypass the left anterior descending (LAD). Chi Square and "t" tests were performed on all demographic, cardiac and operative data comparing IMA to SVG. All results were non-significant, indicating that the two groups were comparable. Anginal pattern was progressive or unstable in 93%. IMA was used in 4 patients who were on intra-aortic balloon pump. The mean number bypass grafts per patient was 3.1. Postoperative complications were comparable for both groups, including early and late myocardial infarction. Overall operative mortality was 2.6%. Results of a survival analysis indicated no significant difference in the mortality rates of patients operated on by SVG versus IMA-SVG. Cumulative mortality rates at a mean followup of 20.5 months were 12.2% for SVG and 7.1% for IMA patients. Significant mortality risk factors were ejection fraction less than 55% (p less than 0.05); and perioperative myocardial infarction (p less than 0.001). Twenty-five patients with recurrent chest pain underwent repeat cardiac catheterization. This revealed 10 of 10 patent IMA grafts, 6 of 8 single patent SVG to LAD and 6 of 9 patent sequential vein grafts to the diagonal and LAD arteries.(ABSTRACT TRUNCATED AT 250 WORDS)     

A new rosette in retinoblastoma

Retinoblastoma, the most common primary malignant intraocular tumor of childhood is a great success story in pediatric and ocular oncology. Pathology of retinoblastoma is important to guide the treatment modalities. Differentiated retinoblastoma is commonly seen in younger age group. Since a hundred years, we have been observing two typical true rosettes in retinoblastoma in the form of Flexner-Wintersteiner (FW) and Homer Wright (HW) rosettes and in many occasions pseudorosettes have been documented. In the present case report, a third new type of rosette was identified in a differentiated retinoblastoma which had an unusual anterior segment involvement.     

Effects of Lactuca sativa extract on exploratory behavior pattern,locomotor activity and anxiety in mice

ObjectiveTo evaluate antianxiety property of Lactuca sativa, an important and commonly used leafy vegetable known for its medicinal properties belongs to Asteraceae family.MethodsElevated plus maze (EPM), open field test (OFT), rat exposure test, hyponeophagia and marble burying test were performed in mice models to assess the exploratory behaviour and to assess anxiolytic property of hydro-alcohol extract of Lactuca sativa. Diazepam (1 mg/kg body wt.) served as the standard anxiolytic agent for all the tests. The dried extract of the plant leaf in doses of 100, 200 and 400 mg/kg body weight was administered orally to mice for duration of 15 or 30 days and evaluated exploratory behaviour, locomotor and anxiolytic activities.ResultsTime spent and number of entries into the open arm was measured in EPM followed by total locomotor activity in OFT and latency to enter the food zone in hyponeophagia.ConclusionsThe study suggested that hydro-alcohol extract of Lactuca sativa leaves possess potent anxiolytic property.