Genetic and environmental factors affecting bone mineral density in large families

This study assessed whether relatives with low bone mineral density (BMD) could be identified in five large families using historical, biochemical, and genetic markers for osteoporosis. Fifty of 65 relatives had their bone density and bone turnover markers measured, together with an assessment of their risk factors for osteoporosis. Only 33% (5/15) of siblings, 50% (6/12) of children and 43% (10/23) of nephews and nieces had entirely normal BMD. There was no difference in life-style risk factors for osteoporosis, history of previous fractures or body mass index between normal subjects and those with osteopenia or osteoporosis. Osteopenic individuals had a significantly higher than normal osteocalcin value. Within families, there was no clear association between BMD and any of the genetic markers (vitamin D receptor gene polymorphisms, COL 1A1 and COL 1A2 polymorphisms of the collagen gene), either alone or in combination. The addition of genetic markers to the other risk factors for low BMD did not improve the prediction of BMD. In conclusion, we suggest that the presence of osteoporosis in a first degree relative should be one of the clinical indications for bone density measurement as the individuals at risk would not be picked up by other methods.     

Primary nonampullary/periampullary adenocarcinoma of the duodenum

Primary duodenal adenocarcinoma not involving the ampullary region is rare. Our aim was to review the outcome of these patients and determine the factors that affect survival. We performed a retrospective review of all patients with primary, nonampullary duodenal adenocarcinoma at the Cleveland Clinic Foundation from January 1986 through December 1996. Twenty-six patients with primary, nonampullary duodenal malignancies were identified. There were 16 adenocarcinomas, 3 gastrinomas, 3 stromal tumors, 3 leiomyosarcomas, and 1 carcinoid tumor. Patients with adenocarcinoma had symptoms present an average of 6.1 months. Tumors were identified by upper gastrointestinal contrast study and esophagogastroduodenoscopy in 90 per cent and 87 per cent of patients, respectively. Twelve of 13 (93%) cancers found in the third or fourth portion of the duodenum were adenocarcinomas. Seven of the 16 adenocarcinomas were resectable on exploration. Those that were contained within the serosa have not recurred (mean, 6 years); one of the two patients with locally invasive adenocarcinoma remains disease free. The average survival for patients with unresectable disease was 6.7 months. The 5-year survival rates were: all adenocarcinoma, 38 per cent; resectable, 86 per cent; and unresectable, 0 per cent. All patients presenting with weight loss or obstructive symptoms died of disease; those with melena survived long term. Patients with tumors other than adenocarcinoma had a 90 per cent 5-year survival. We conclude that patients typically present with a long history of symptoms. Distal duodenal malignancies are most frequently adenocarcinomas. Upper gastrointestinal contrast study or endoscopy is often diagnostic. Patients with weight loss and/or obstructive symptoms had invasive disease and a morbid prognosis. Aggressive surgery is warranted, and most with resectable disease (86%) had long-term survival.     

The effect of verbal elaborations on memory in young and older adults

The Stein paradigm was used to examine the circumstances under which verbal elaborations enhance memory in young and older adults. Subjects studied target adjectives that were embedded in one of three sentence contexts that varied in elaboration of the subject-adjective relationship: (1) nonelaborated base sentences; (2) base sentences with semantically consistent, but arbitrary verbal, elaborations; and (3) base sentences with explanatory verbal elaborations that clarified the significance of the subject-adjective relationship. The presence of the elaborations was varied at encoding and retrieval, and cued recall of the target adjectives was tested with incidental and intentional learning procedures. In Experiments 1A and 1B, explanatory elaborations at encoding and retrieval yielded the largest memorial facilitation for both young and older adults, and the benefit was comparable for the incidental and intentional learning measures. In Experiment 2, age-related differences in recall were minimal with explanatory elaborations at encoding and retrieval, but larger age differences occurred in the nonelaborated comparison conditions. In Experiment 3, explanatory elaborations present at encoding but not at retrieval enhanced recall when the original Stein stimuli were used, but not with the present stimuli. The implications of these results with regard to the mnemonic efficacy of verbal elaborations for young and older adults are discussed.     

生态型绿化法在上海"近自然"群落建设中的应用

应用生态型绿化法建设"近自然"群落是城市植被恢复的种新途径.生态型绿化以生态学潜在自然植被和群落演替基本理论为依据,选择适生乡土植物,应用容器育苗和"近自然"苗木种植技术,超常速、低造价地营造具有群落结构完整、物种多样性丰富、生物量高、趋于稳定状态、后期完全遵循自然循环规律的"少人工管理型"绿地.生态型绿化法已在世界各地广泛应用,对于推动我国城市绿化也将起到重要作用.     

Iron status and diet in athletes

Plasma ferritin (F) concentrations were measured (range 12-245 ng.ml-1) as an indicator of iron status in 24 male and 45 female healthy, nonanemic athletes. Usual food intake was assessed using a self-completed but supervised food frequency questionnaire. Linear regression was applied to determine the relationship between log F (as data was skewed) and average daily intake of iron (Fe), meat (M), protein (Pr), carbohydrate (CHO), fat (Fa), fiber (Fi), and kilojoules (Kj). There were negative correlations between F and each of Kj (P < 0.01) and CHO (P < 0.001), and a positive correlation between F and Pr/Kj (P < 0.01). No significant relationship existed between F and any of Fe, M, Fa, or Fi. These data suggest that iron or meat intake may not be important determinants of iron status in these athletes. Instead, the percentage of protein in the diet may be more influential on F, as may the (negative) effect of Kj and CHO intake, or at least their reflection of energy expenditure.     

A comparative analysis of embryos derived from routine in-vitro fertilization and subzonal microinsemination

Embryos obtained from patients undergoing routine in-vitro fertilization (IVF) and embryo transfer were compared with those undergoing subzonal microinsemination (SUZI) for male factor infertility. Overall, the proportion of cleaved embryos was significantly higher in the IVF group in comparison with the SUZI group at 48 h post-insemination [1533 out of 1609 (95.3%) versus 776 out of 952 (81.5%)]. The mean +/- SD grading score of the IVF-derived embryos of 3.61 +/- 0.50 was significantly better than that for SUZI of 2.97 +/- 0.86 (P < 0.0005) at the same time. The implantation rates following the replacement of IVF or SUZI embryos at 48 h were comparable: 14.3 and 10.0% respectively. However, the IVF embryo implantation rate of 15.1% at 72 h was significantly better than that following the replacement of SUZI embryos at either 48 (10.0%) or 72 h (8.0%). The replacement of SUZI-derived embryos at 48 h resulted in significantly higher pregnancy (25.0%) and implantation rates (10.0%) than at 72 h, with rates of 10.8 and 8.0% respectively. Similarly, the overall embryo quality deteriorated following in-vitro culture for up to 72 h. The clinical pregnancy loss rate (33.0%) was highest following the replacement of SUZI embryos at 72 h, although the data were limited. It is suggested that these data indicate that a combination of in-vitro manipulation, the injection of multiple spermatozoa into the subzonal space and probably the genomic capacity of spermatozoa derived from poor-quality semen may contribute to the poorer outcome of embryo development following SUZI. Prolonged in-vitro culture beyond 48 h appears to be deleterious to the development of SUZI cleaved embryos and the subsequent outcome of treatment, and hence should be avoided.     

Comparison of fixation disparity curve variables measured with the Sheedy Disparometer and the Wesson Fixation Disparity Card

BACKGROUND: Previous studies suggest differences in the fixation disparity curves obtained with the Sheedy Disparometer and the Wesson Fixation Disparity Card, the two most commonly used methods for measuring fixation disparity. In one study the investigators proposed that the differences do not exist for subgroups divided by phoria. The purpose of this paper is to try to clarify this issue by use of two large sets of data. METHODS: Dissociated phorias were measured by the von Graefe method. Fixation disparity curves were plotted using the Disparometer and the Wesson card. RESULTS: Type I fixation disparity curves were most common with the Wesson card. Type II curves were found more often with the Disparometer than with the Wesson card. The x-intercepts were shifted in the base-in (BI) direction with the Wesson card compared to the Disparometer. The y-intercepts were shifted in the exo direction with the Wesson card compared to the Disparometer. The differences were statistically significant regardless of whether the dissociated phoria was exo or eso. The slope of the fixation disparity curve was steeper with the Wesson card than with the Disparometer. The difference was statistically significant for exophores but not for esophores. The differences between results obtained with the two instruments are not consistent from one subject to another as shown by high standard deviations of the differences. CONCLUSIONS: The fixation disparity curves measured with these two instruments are different. Fixation disparity parameters obtained from one of these instruments cannot be used with normative findings from the other.