Creating a population-based linked health database: a new resource for health services research

Cytologically, the distinction between bronchioalveolar carcinoma and reactive/reparative processes of respiratory epithelium can be difficult. Retrospectively, we have identified 11 consecutive cases of bronchioalveolar carcinoma from the cytology files of University Missouri-Kansas City/Truman Medical Center. On average, a combined 5.71 cytologic/histologic procedures were performed before reaching a definitive diagnosis for this group. An additional seven random cases of reactive/reparative respiratory cases of adult respiratory distress syndrome patients were used as a control. Cytomorphometric analysis was performed. The mean average nuclear diameter for the carcinoma group was 13.76 microns and for the reactive/reparative group was 13.29 microns. There was no statistical difference between the two groups (paired student t test, P > .05). It appears from our data that mean nuclear diameter is not a discriminator for the cytologic distinction between bronchioalveolar carcinoma and reactive/reparative respiratory epithelium and that the accepted cytologic parameters of for bronchioalveolar carcinoma are more valid.     

In vitro activities of the oxazolidinone antibiotics U-100592 and U-100766 against Staphylococcus aureus and coagulase-negative Staphylococcus species

U-100592 and U-100766 are closely related antibiotics of the oxazolidinone class. Their in vitro activities were determined against 100 isolates of Staphylococcus aureus and 100 isolates of coagulase-negative Staphylococcus species by broth and agar dilution test methods. The MICs of both compounds by either test method at which 50 and 90% of isolates are inhibited were 2 and 4 micrograms/ml, respectively, for S. aureus and 1 to 2 micrograms/ml for coagulase-negative staphylococci. Time-kill assay with selected strains indicated a primarily bacteriostatic effect against staphylococci.     

Interobserver variation in the evaluation of neurological signs: observer dependent factors

We have previously reported that polymorphonuclear granulocyte (PMN) and monocyte oxidative metabolism is reduced in polycythemia vera (PV) patients compared to healthy control subjects, after stimulation with cell surface receptor-dependent stimuli such as n-formyl-methionyl-leucyl-phenylalanine, leukotriene B4 and platelet-activating factor (PAF). In contrast, the oxidative response to phorbol myristate acetate (PMA) is normal. We now show that, in PV patients exhibiting significantly reduced PMN chemiluminescence after PAF stimulation, PAF induced platelet aggregation was also reduced--40 +/- 3% compared to 50 +/- 2% in controls (p < 0.01). The defective aggregatory response to PAF in PV remained over a wide range of stimuli concentrations. Platelet aggregation induced by PMA and ADP, however, was similar in PV and controls. In contrast, platelet aggregation induced by PAF (or by ADP and PMA) was not significantly reduced in patients with chronic myeloid leukemia, essential thrombocythemia and multiple myeloma. Furthermore, the release of beta-thromboglobulin was slightly but not significantly higher after PAF stimulation in PV and this argues against an abnormal PAF receptor as the cause of the defective function. Thus, not only PV neutrophils, but also PV platelets show a discrete defect of the stimulus response coupling for PAF, indicating a disease-specific abnormality that appears to be of clonal origin.     

Agonistic activity of a CD40-specific single-chain Fv constructed from the variable regions of mAb G28-5

A single-chain Fv (sFv) was expressed from the variable regions of the CD40-specific mAb G28-5. The molecule bound CD40 with a high affinity (2.2 nM) and was a monomer in solution. Surprisingly, G28-5 sFv was a potent CD40 agonist that rapidly crosslinked CD40 on the cell surface but did not crosslink CD40-Ig in solution. G28-5 sFv was a more potent agonist than G28-5 IgG and was able to stimulate CD40 responses by B cells and monocytes. G28-5 IgG partially blocked, whereas G28-5 sFv augmented CD40 responses during stimulation with natural ligand (gp39-CD8 fusion protein). These results indicate that the functional activity of ligands built from the binding site of G28-5 is highly dependent upon the size and physical properties of the molecule both in solution and on the cell surfaces.     

Interlaboratory study of the analysis of ampicillin by liquid chromatography

A liquid chromatographic method for the analysis of ampicillin was examined in a collaborative study involving seven laboratories. The method included an isocratic part, which is used in the assay. The isocratic part is similar to the assay method for ampicillin of the US Pharmacopeia XXIII Revision. When the isocratic part is combined with gradient elution, the method is suitable for purity control. Six samples of ampicillin (anhydrous, trihydrate and sodium salt) with varying purity were analysed. The main component and related substances were determined. An analysis of variance proved the absence of consistent laboratory bias. The laboratory-sample interaction was significant. Estimates of the repeatability and reproducibility of the method, expressed as standard deviations of the result of the determination of ampicillin, were calculated to be about 0.9 and 1.1 respectively.     

Multi-weight unipolar codes for multimedia spectral-amplitude-coding optical CDMA systems

A novel balanced detection scheme for multi-access interference cancellation in multimedia spectral-amplitude-coding optical code-division multiple-access system is proposed. The receiver is capable of handling both equal and unequal in-phase cross correlation of optical orthogonal codes. A novel class of constant-length variable-weight optical orthogonal codes able to support multimedia services with different quality-of-service requirements is proposed as well. The construction is based on the pairwise balanced designs, or more specifically, on an incidence structure defined on an integer sub-lattice.     

Pharmacokinetics of intracerebroventricular tBuOOH in young adult and mature mice

The aim was to describe the quality of life of people suffering from coronary artery disease. The patients had been treated with medication (n = 80), percutaneous transluminal coronary angioplasty (n = 100) and coronary artery bypass surgery (n = 100). Of the 280 patients, 189 were men and 91 women. The patients who participated in this study were seriously ill, as nearly half of them had three or more stenosed coronary arteries. Male patients were most numerous in the bypass surgery group and female patients in the angioplasty group. The quality of life was evaluated using the Nottingham Health Profile (NHP) instrument relation to an age- and sex-matched general population, the background factors and the severity of the coronary disease. The NHP questionnaire consists of 38 statements on health problems, making up six dimensions of subjective health: physical mobility, pain, sleep, energy, emotional reactions and social isolation. The health-related quality of life of coronary patients before the invasive procedures was significantly poorer on all the six dimensions than the quality of life in an age- and sex-matched general population. The most obvious differences were seen on the following dimensions: energy, pain, emotional reactions, sleep and physical mobility. The smallest differences occurred in social isolation. Both males and females had the lowest value for energy and social isolation in the youngest age group (35-54 years). The index values of emotional reactions in the two youngest groups were significantly higher among females than males, which reflects poor quality of life. The women in the age group of 35-54 years found the manifestation of a serious disease extremely hard to face. Our findings clearly suggest that while choosing the mode of treatment, the patient's quality of life should be considered along with the clinical severity of the disease, especially in the case of young women. From the societal and social points of view, the patient's symptoms and quality of life are even more important than the objective medical outcome. In clinical decision-making, the goal is to integrate the results of health-related quality of life assessments with clinical decisions, and this underlines the need to evaluate whether the treatment given is congruent with the patient's quality of life. On the basis of the present findings, the NHP instrument seems to be applicable to quality of life measurements among coronary patients. It does not, however, necessarily give an accurate and profound view of an individual's overall quality of life.