Centers for disease control and prevention lead guidelines: do pediatricians know them?

American Academy of Pediatrics (AAP) fellows responded to a questionnaire measuring knowledge of 1991 Centers for Disease Control and Prevention (CDC) guidelines. Generalists' scores on a knowledge scale were positively correlated with reporting CDC and AAP documents as knowledge sources, and negatively correlated with private practice, medical school as a knowledge source, and age. However, private practitioners who read AAP documents scored well.     

Evaluation of the accuracy of real-time ultrasonic measurements of backfat and loin muscle area in swine using multiple statistical analysis procedures

Real-time ultrasonic measurements of 10th-rib backfat (BF10) and loin muscle area (LMA) were made by a single technician at four mean BW (67.4, 80.3, 93.4, and 104.9 kg) on live hogs to assess the accuracy of predicting carcass measurements before and at slaughter weight. Records were evaluated on 655 purebred barrows and 472 purebred gilts in two tests. Residual correlations-accounting for test, sex, and breed effects, among and between scans and carcass measurements--were moderate to high for BF10 (r=.69 to .82) and LMA (r=.57 to .68), with the largest correlations at 104.9 kg of live weight. Ultrasonic BF10 and LMA were within +/-4 mm and +/-6.45 cm2, respectively, of the corresponding carcass measurement 75.9 and 89.8% of the time. Sex differences for LMA bias were significant (P < .001); ultrasonic LMA was overestimated in barrows by .75 cm2 and underestimated in gilts by .91 cm2. Breed differences were significant (P < .001) for BF10 and LMA bias. Standard errors of prediction (SEP) for BF10 and LMA across the two tests were 3.46 mm and 4.04 cm2, respectively. The SEP for BF10 were 3.60 mm for barrows and 3.19 mm for gilts. The SEP for LMA were 3.77 cm2 for barrows and 4.22 cm2 for gilts. The SEP for BF10 within breeds ranged from 3.25 to 3.72 mm, and for LMA, ranged from 2.98 cm2 to 4.90 cm2. Ultrasound measurements overestimated the carcass measurement by .57 mm for carcasses measuring < 24.1 mm and underestimated by 2.81 mm carcasses with BF10 > 30.3 mm. Ultrasonic LMA overestimated the carcass by 2.35 cm2 in carcasses measuring < 32.5 cm2 and underestimated by 2.29 cm2 in carcasses measuring greater than 37.9 cm2. Results indicate that the magnitude of the carcass measurement affects bias and accuracy of prediction for real-time ultrasonic measurements of BF10 and LMA. The SEP statistic is more consistent in evaluating accuracy of ultrasonic measurement than bias, absolute deviations, and percentage of absolute deviation.     

Cell-associated viral RNA expression during acute infection with HIV type 1

The mechanism of decline in viremia following acute infection with HIV is unknown. To characterize this process virologically, the expression of viral RNAs was analyzed in samples of peripheral blood mononuclear cells (PBMCs) from a patient who experienced a 100-fold decline in plasma viremia over a 13-day period prior to the initiation of antiretroviral therapy. Cell-associated viral RNA declined in association with the decline in plasma virus. During the initial 7 days of observation, plasma viremia declined more than 10-fold with no change in the ratio of unspliced to multiply spliced mRNAs. The efficiency of viral gene expression did not decline during the study period and varied from 380 to 2800 unspliced RNA copies per productively infected cell. Together, these data indicate no change in the relative proportion of cells in late- and early-stage gene expression during the initial decline and provide evidence against shortening of the viral replication cycle by immune surveillance. However, the prevalence of productively infected cells declined markedly during the 13 days of observation, from 1 in 250 to 1 in 25,000 PBMCs. These data are compatible with depletion of available target cells during the initial decline in viremia. As the level of plasma virus stabilized after 8 days of observation, the ratio of unspliced to multiply spliced mRNAs rose; this rise was due to a relatively greater decline in multiply spliced mRNA. These data suggest the possible onset of a blockade to new infection events (for example, by neutralizing antibody or chemokines), causing an increase in the relative proportion of cells in late-stage gene expression. They may also be explained, however, by the persistence of cell-associated virions together with the near disappearance of productively infected cells from the circulation.     

Dexter: a device for the assessment of microsurgical instrumentation and instruction of trainees

We present an easily constructed devise, which allows the testing and comparison of microsurgical apparatus, providing a numerical result for statistical analysis. It also enables the trainee microsurgeon to practise basic microsurgical skills in a safe environment. Construction and uses are discussed.     

The biology of prothrombin

Prothrombin and thrombin are involved in diverse biological functions. The structure of prothrombin has been studied extensively and its cDNA has been cloned from several species. The tissue-specific expression of this protein has been studied, as well as the developmental expression pattern. The structure of the human gene coding for prothrombin has been determined, and gene regulation studies have been performed that indicate that HNF-1 might be responsible for the liver-specific expression of this protein. Other regulatory elements have been identified. In order to further study the biological properties of prothrombin, prothrombin-deficient mice have been generated using gene targeting technology. Prothrombin deficiency in mice results in partial embryonic lethality. The mice that survive to birth die from bleeding events. The embryonic lethality occurs between embryonic days 9.5 and 11.5 and appears to be due to the loss of integrity of the vasculature due to a failure in blood coagulation. These results indicate that prothrombin plays not only a key role in hemostasis but suggests that it may be important for mouse development.     

Radioimmunoscintigraphy with In-111-labeled capromab pendetide predicts prostate cancer response to salvage radiotherapy after failed radical prostatectomy

PURPOSE: We investigated the ability of In-111-capromab pendetide to separate patients who have failed radical prostatectomy into categories of those who would versus those who would not respond to salvage radiotherapy. METHODS: Prostate-specific antigen (PSA) levels in 32 men with prostate cancer who had failed radical prostatectomy and had undergone a whole-body In-111-capromab pendetide scan were followed-up for 13 months (median) after salvage radiotherapy to the pelvis. A logistic regression model was used to determine whether the scan findings, as well as other clinical variables, were associated with a durable complete response (DCR), a nondurable response (NDR), or no response (NR). RESULTS: Sixteen of 23 (70%) men with a normal scan outside the prostatic fossa achieved a DCR after salvage radiotherapy versus two of nine (22%) who had a positive scan outside the prostate fossa and pelvis (P = .0225, Fisher's exact test). Predicted probability (95% confidence interval [CI]) that a DCR would be obtained with a normal scan was 0.88 (0.55 to 0.98); for men with a positive scan limited to the prostatic fossa it was 0.62 (0.42 to 0.79); and for men with a positive scan outside the pelvis it was 0.27 (0.09 to 0.58). No other variables before radiotherapy showed a significant association with the DCR rate. CONCLUSION: Salvage radiotherapy is statistically more likely to lead to a durable complete PSA response in men with prostate cancer who have failed radical prostatectomy and have a negative In-111-capromab pendetide scan outside the pelvis as compared with those who have a positive scan.