Diagnosis on death certificates of sudden death due to ischemic heart disease

This study was undertaken to evaluate the quality of diagnoses of sudden death (SD) caused by ischemic heart disease (IHD) on death certificates. A random sample of 10% (100 cases) was drawn from all such deaths which occurred in 1970 among Oklahoma City residents. The medical records of each case were reviewed and the quality of the diagnosis was rated, by the use of predetermined standard criteria, as confirmed and valid or unconfirmed and invalid. Among 100 IHD deaths, SD constitute 45%. Of these SDs, 18% were unobserved, without information as to the manifestations of the attack or the interval from onset of symptoms to death. According to criteria of the American Heart Association and WHO Expert Committee, the diagnosis in this 18% was unconfirmed and invalid. Thus there is insufficient quantitative evidence to justify the use of SD, as found on death certificates, as an indication of frequency of ischemic heart disease.     

Relationships between hearing loss and cognition in normally hearing aged persons

The relationships between mild hearing losses and cognitive functioning were studied for two independently selected samples of aged subjects whose hearing was within normal limits. One group had 47 males of mean age 71.5 (SD 4.8) who were selected for their excellent health status. The second group consisted of 38 females of mean age 75.9 (SD 5.3), all of whom had some significant physical pathology. Hearing losses at various frequency levels (from 125 to 8000 cps) were correlated with performance on cognitive tests such as the WAIS, with age effects then being partialled out. The results reveal substantial associations between hearing losses and scores achieved on the intellectual measures for both samples. Verbal type tests show these relationships much more extensively than the performance tests. The findings imply that aged subjects may be more intellectually capable than their test performances suggest and that hearing is an important variable to be considered in the assessment of their cognitive functioning.     

Serologic response to revaccination with two rubella vaccines

Three years after receiving rubella vaccine, 1,060 elementary school children living on the island of Maui, Hawaii, were revaccinated with either HPV-77 DE-5 or RA 27/3 rubella vaccine given subcutaneously or intranasally in order to compare the effectiveness of these two vaccines in raising antibody titers. RA 27/3 was the more effective booster vaccine, producing fourfold or greater titer rises in 20.1% of recipients, including 80% of children with hemagglutination-inhibiting antibody titers less than or equal to 1:40 at the time of revaccination, intranasal revaccination was not significantly more effective than subcutaneous revaccination, although it did elicit higher titers in children who responded. Responses differed according to the vaccine that children had received three years earlier. Because antibody titers have persisted in vaccinated children, routine administration of a second dose of rubella vaccine is not currently recommended.     

Cholera in Lima, Peru, correlates with prior isolation of Vibrio cholerae from the environment

The authors utilized a recently developed DNA probe technique to obtain quantitative data on occurrence of Vibrio cholerae in samples collected monthly from 12 environmental sites in Lima, Peru, from November 1993 through March 1995. Peak V. cholerae counts ranged from 10(2)/ml to 10(5)/ml, with the highest counts in sewage-contaminated areas and irrigation water. With our methodology, no V. cholerae cases were detected at any site during the winter months of July through October. Counts were detectable in the environment before onset of cholera in the community, with counts at "cleaner" sites upriver correlating significantly with occurrence of community disease 2 and 3 months later. In sites with heavy sewage contamination, V. cholerae could still be detected before the onset of cases in the community; however, in contrast to upriver sites, counts at these latter sites correlated most closely with the number of concurrently occurring cholera cases. These data support a model of cholera seasonality in which initial increases in number of V. cholerae in the environment (possibly triggered by temperature) are followed by onset of illness in the community, with these human cases further amplifying the organism as the epidemic cycle proceeds.     

Processing prosodic and musical patterns: a neuropsychological investigation

To explore the relationship between the processing of melodic and rhythmic patterns in speech and music, we tested the prosodic and musical discrimination abilities of two "amusic" subjects who suffered from music perception deficits secondary to bilateral brain damage. Prosodic discrimination was assessed with sentence pairs where members of a pair differed by intonation or rhythm, and musical discrimination was tested using musical-phrase pairs derived from the prosody of the sentence pairs. This novel technique was chosen to make task demands as comparable as possible across domains. One amusic subject showed good performance on both linguistic and musical discrimination tasks, while the other had difficulty with both tasks. In both subjects, level of performance was statistically similar across domains, suggesting shared neural resource for prosody and music. Further tests suggested that prosody and music may overlap in the processes used to maintain auditory patterns in working memory.     

CD95 (Fas/APO-1) induces ceramide formation and apoptosis in the absence of a functional acid sphingomyelinase

CD95 is a potent inducer of apoptosis. It activates the caspase cascade, but also induces ceramide (Cer) production, reportedly involving acid sphingomyelinase (aSMase) activity. A role for Cer as a second messenger for apoptosis induction was proposed, based on the finding that synthetic Cer analogues can induce cell death. We have tested whether aSMase is required for 1) apoptosis induction and 2) Cer production by CD95. For this purpose, we have used cultured Niemann-Pick disease (NPD) lymphoid cells with a defined mutation (R600H) in the aSMase protein. Despite their inherited deficiency of aSMase, we found that these cells readily undergo apoptosis upon CD95 stimulation. After retrovirus-mediated gene transfer of the aSMase cDNA, the transduced (i.e. "corrected") NPD cells showed neither increased levels of apoptosis nor altered kinetics of caspase-8 and caspase-3 activation and apoptosis induction as compared with empty vector-transduced cells. The slow sustained elevation of Cer levels in response to CD95, which we have previously documented for Jurkat T cells (Tepper, A. D., Boesen-de Cock, J. G. R., de Vries, E., Borst, J., and van Blitterswijk, W. J. (1997) J. Biol. Chem. 272, 24308-24312), was similarly found in NPD cells. Moreover, the kinetics of Cer formation remained unaffected after aSMase transduction. These results indicate that this Cer does not result from aSMase activity. We conclude that aSMase is not required for and does not facilitate CD95-mediated apoptosis and that it is not responsible for the late Cer response.     

Clinical-physiological characteristics and hormone therapy of patients with typical form of climacteric syndrome

Clinical and physiological examinations of 76 women in the postmenopause revealed in 64 of them the typical form of the climacteric syndrome, characterized by not only typical symptoms ("flushes", increased exudation, headaches, etc.), but also by various emotional vegetative disturbances detected at profound clinical neurological examination of the autonomic nervous system and the emotional sphere. Individual hormone therapy was associated with an appreciable alleviation of all psychovegetative disorders: "flushes", exudation, irritability, arterial hypertension, severity of vegetative dystonia, hysterical stigmata.     

A longitudinal assessment of hormonal and physical alterations during normal puberty in boys. I. Serum growth hormone-binding protein

Previous studies have provided compelling evidence that GH secretion increases transiently during midpuberty in normally growing children. Although it is likely that the increase in GH production serves a primary role in generating the pubertal growth spurt, such a conclusion necessarily assumes that other essential "down-stream" components of the GH axis responsible for mediating the effects of GH remain unchanged. To investigate this concept, we assessed longitudinally another important component of the endogenous GH axis, the serum GH-binding protein (GHBP)/receptor system, in a cohort of 11 normal boys as they matured through normal puberty. At 4-month intervals over 4.0-5.1 yr, 24-h serum GH concentration profiles and serum GHBP activity were evaluated. Serum GHBP levels varied over a more than 12-fold range (40-504 pmol/L) among all subjects. However, the values for individual subjects consistently varied within more narrow limits. The coefficient of variation for values from all subjects was 51% compared to the mean intrasubject coefficient of variation of only 30% (P < 0.05). Although the highest GHBP level (all subjects) was 12.6-fold greater than the lowest, the mean intrasubject range was only 3.1 +/- 0.5-fold (P < 0.05). The overall mean serum GHBP level correlated directly with the overall mean body mass index (r = 0.69; P = 0.018), but correlated inversely with the mean 24-h GH concentration (r = -0.61; P < 0.05). There was no significant increase in the GHBP level during puberty. However, because mean 24-h GH concentrations did increase during midpuberty, the data suggest that an increase in the relative amounts of free vs. bound GH develops during the period of the pubertal growth spurt. These data indicate that serum GHBP levels are regulated in individual children within much more narrow limits than those present in the larger population and do not undergo the dramatic changes during puberty typical of GH secretion and linear growth velocity. As a consequence, alterations may develop in the relative amounts of free vs. bound GH present in serum during the midpubertal years compared to those present during either the prepubertal or postpubertal periods. The majority of the known age-related increase in serum GHBP levels probably occurs before the period of active pubertal development. These findings strengthen further the concept that the midpubertal changes in GH secretion serve a primary role in generating the growth spurt.(ABSTRACT TRUNCATED AT 400 WORDS)