The FAMTOOL family health assessment tool

The purpose of this study was to design and validate a family health assessment tool (FAMTOOL) based on a concept analysis of family and health. Preliminary testing of this instrument by a convenience sample of 80 adults resulted in an internal consistency coefficient of .90. A retest 2 weeks later produced a stability coefficient of .96. The FAMTOOL provides rehabilitation nurses with a quick, positive assessment instrument for helping patients and their family members assess their own family's health, compare responses with each other, and see strengths they might not have considered otherwise. As the family health system should be included in the initial assessment of everyone entering the healthcare system, the FAMTOOL may prove helpful to nurses in a wide variety of primary, secondary, and tertiary settings.     

Treatment with growth hormone and dexamethasone in mice transgenic for human islet amyloid polypeptide causes islet amyloidosis and beta-cell dysfunction

Islet amyloid derived from islet amyloid polypeptide (IAPP) is a well-recognized feature of type II diabetes. However, the mechanism of islet amyloidogenesis is unknown. In vitro studies suggest that amino acid residues 20-29 in human, but not mouse, IAPP confer amyloidogenicity consistent with the absence of spontaneous islet amyloidosis in mice. Several clinical and in vitro studies suggest that increased synthetic rates of IAPP predispose to IAPP-amyloidosis. In the present study, we sought to test the hypothesis that pharmacological induction of insulin resistance in a mouse transgenic (TG) for human IAPP would induce islet amyloid and beta-cell dysfunction. TG and non-transgenic (N-TG) control mice were treated with both rat growth hormone (12 micrograms/day) and dexamethasone (0.24 mg/day) (dex/GH) or received no treatment for 4 weeks, after which animals were killed to examine islet morphology. Treatment with dex/GH caused hyperglycemia (7.3 +/- 0.4 vs. 5.2 +/- 0.1 mmol/l, TG vs. N-TG, P < 0.001) associated with a decreased plasma insulin concentration (595 +/- 51 vs. 996 +/- 100 pmol/l, TG vs. N-TG, P < 0.05) in TG versus control mice. Islet amyloid was induced in treated TG mice but not in control mice. Islet amyloid was identified in both intra- and extracellular deposits, the former being associated with evidence of beta-cell degeneration. We conclude that dex/GH treatment in mice TG for human IAPP induces IAPP-derived islet amyloid, hyperglycemia, and islet dysfunction. The present model recapitulates the islet morphology and phenotype of type II diabetes.     

Subunit composition of neurofilaments specifies axonal diameter

Neurofilaments (NFs), which are composed of NF-L, NF-M, and NF-H, are required for the development of normal axonal caliber, a property that in turn is a critical determinant of axonal conduction velocity. To investigate how each subunit contributes to the radial growth of axons, we used transgenic mice to alter the subunit composition of NFs. Increasing each NF subunit individually inhibits radial axonal growth, while increasing both NF-M and NF-H reduces growth even more severely. An increase in NF-L results in an increased filament number but reduced interfilament distance. Conversely, increasing NF-M, NF-H, or both reduces filament number, but does not alter nearest neighbor interfilament distance. Only a combined increase of NF-L with either NF-M or NF-H promotes radial axonal growth. These results demonstrate that both NF-M and NF-H play complementary roles with NF-L in determining normal axonal calibers.     

Long-term effects of vincristine on the peripheral nervous system

A total of 317 mandibular fracture patients treated and diagnosed at the Oulu University Hospital and at the Department of Oral and Maxillofacial Surgery, University of Oulu, Finland, between 1981 and 1990 were analyzed from patient files and radiographs. The mean number of mandibular fracture patients per year was 31.7 (range 21 and 45) and the mean age of the patients 31.3 years (range 4-78 years). The female:male ratio was 1:3.1. There seemed to be a tendency for decrease in the proportion of violence and traffic accidents as causes of mandibular fractures toward the end of the period concerned, reflecting partly the influence of mandatory use of safety belts and partly that the hospital in the northernmost part of Finland, where the consumption of alcohol is higher than in the province of Oulu, could treat all mandibular fractures itself during the last year studied thus decreasing the injuries caused by violence at the Oulu University Hospital. It was also noted that fewer fractures were caused at weekends than on weekdays during the latter years of the decade and that the proportion of male victims decreased except for the last year examined, 1990.     

Interactions between adult human prostatic epithelium and rat urogenital sinus mesenchyme in a tissue recombination model

We compared the results of visual and quantitative evaluation of imaging of myocardial perfusion with 201Tl-SPECT and 13NH3-PET in the 7 non-myocardial infarction (non-MI) and 42 myocardial infarction (MI) patients. On the 201Tl-SPECT and 13NH3-PET imaging, the degree of accumulation of each radioisotope (RI) was visually classified into four grades of defect score. The percentage of uptake was also quantitatively evaluated. RESULTS: In the 7 non-MI patients, NH3% uptake in the lateral wall was significantly lower than in the septum, and in the lateral wall NH3% uptake was significantly lower than Tl% uptake. For the 42 MI patients, segmental defect scores (DS) on 201Tl-SPECT were compared with those on 13NH3-PET, and a high degree of concordance in DS was found for all territories of the left ventricle, antero-septum MI and inferior MI territories. Average Tl% uptake/NH3% uptake was near 1, a highly positive correlation was found between Tl% uptake and NH3% uptake in all territories of the left ventricle and antero-septum MI territories, and Tl% uptake/NH3% uptake was larger than 1, but, a significant positive correlation existed between Tl% uptake and NH3% uptake in the territory with inferior MI. CONCLUSION: These findings indicate that results of 201Tl-SPECT imaging were similar to those of 13NH3-PET in evaluation of myocardial perfusion in the antero-septum and inferior. However, a difference in distribution was observed between 201TlCl and 13NH3 in the lateral wall, indicating that particular attention should be paid to the results of imaging of myocardial perfusion in the lateral wall.     

Catamenial hemoptysis. Diagnosis with MRI

Thoracic endometriosis is a rare disorder. We report a case of a 26-year-old woman with a 4-year history of catamenial hemoptysis due to thoracic endometriosis which was diagnosed by MRI and treated successfully by means of video-assisted thoracoscopic wedge-resection of the solitary pulmonary lesion. Medical therapy with hormones was not necessary. There is no evidence of recurrence 10 months after the operation. This case demonstrates that MRI of the chest may be considered for the diagnostic work-up of patients with catamenial hemoptysis. It also shows that wedge-resection of pulmonary endometriosis foci by means of video-assisted thoracoscopy-an approach that has not been described in the literature thus far-is an effective therapy in localized peripheral pulmonary parenchymal endometriosis.