Showing papers by "University of Miami published in 1991"

Effects of Price, Brand, and Store Information on Buyers’ Product Evaluations:

Abstract: The authors report a study of the effects of price, brand, and store information on buyers’ perceptions of product quality and value, as well as their willingness to buy Hypotheses are derived fro

Matrix metalloproteinases and their inhibitors in connective tissue remodeling.

Abstract: Matrix metalloproteinases are an important group of zinc enzymes responsible for degradation of the extracellular matrix components such as collagen and proteoglycans in normal embryogenesis and remodeling and in many disease processes such as arthritis, cancer, periodontitis, and osteoporosis. A matrixin family is defined, comprising at least seven members that range in size from Mr 28,000 to 92,000 and are related in gene sequence to collagenase. All family members are secreted as zymogens that lose peptides of about 10,000 daltons upon activation. Latency is due to a conserved cysteine that binds to zinc at the active center. Latency is overcome by physical (chaotropic agents), chemical (HOCl, mercurials), and enzymatic (trypsin, plasmin) treatments that separate the cysteine residue from the zinc. Expression of the metalloproteinases is switched on by a variety of agents acting through regulatory elements of the gene, particularly the AP-1 binding site. A family of protein inhibitors of Mr 28,500 or less binds strongly and stoichiometrically in noncovalent fashion to inhibit members of the family. The serum protein alpha 2-macroglobulin and relatives are also strongly inhibitory.

Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. A randomized, double-blind, placebo-controlled trial. The HA-1A Sepsis Study Group.

Abstract: Background HA-1A is a human monoclonal IgM antibody that binds specifically to the lipid A domain of endotoxin and prevents death in laboratory animals with gram-negative bacteremia and endotoxemia Methods To evaluate the efficacy and safety of HA-1A, we conducted a randomized, double-blind trial in patients with sepsis and a presumed diagnosis of gram-negative infection The patients received either a single 100-mg intravenous dose of HA-1A(in 35 g of albumin) or placebo (35 g of albumin) Other interventions, including the administration of antibiotics and fluids, were not affected by the study protocol Results Of 543 patients with sepsis who were treated, 200 (37 percent) had gram-negative bacteremia as proved by blood culture For the patients with gram-negative bacteremia followed to death or day 28, there were 45 deaths among the 92 recipients of placebo (49 percent) and 32 deaths among the 105 recipients of HA-1A (30 percent; P = 0014) For the patients with gram-negative bacteremia and sho

Development of a shoulder pain and disability index.

Abstract: A shoulder pain and disability index (SPADI) was developed to measure the pain and disability associated with shoulder pathology. The SPADI is a self-administered index consisting of 13 items divided into two subscales: pain and disability. Thirty-seven male patients with shoulder pain were used in a study to examine the measurement characteristics of the SPADI. Test-retest reliability of the SPADI total and subscale scores ranged from 0.6377 to 0.6552. Internal consistency ranged from 0.8604 to 0.9507. SPADI total and subscale scores were highly negatively correlated with shoulder range of motion (ROM) supporting the criterion validity of the index. Principal components factor analysis with and without varimax rotation supported the construct validity of the total SPADI and its subscales. High negative correlations between changes in SPADI scores and changes in shoulder ROM indicated the SPADI detected changes in clinical status over short time intervals. The SPADI should prove useful for both clinical and research purposes.

Photochemical degradation of dissolved organic carbon and its impact on the oceanic carbon cycle

Abstract: THE processes that regulate the cycling of oceanic dissolved organic carbon (DOC), one of the largest carbon reservoirs on the Earth's surface1, are largely unknown. DOC residues in the deep sea, below 500 m, seem to be composed mainly of biologically refractory compounds2–10 such as humic substances11. The average apparent 14C age of this refractory DOC is >6,000 yr in the deep Pacific2, suggesting that its rate of turnover is slow, but the pathways and rates responsible for this apparent slow turnover are unknown. Several studies have shown that aquatic humic substances are photochemically degraded by sunlight into biologically labile and/or volatile organic compounds12–14 and carbon monoxide15,16. Here we present new data which suggest that this photochemical degradation pathway is the rate-limiting step for the removal of a large fraction of oceanic DOC. This rate will increase with increasing flux of solar ultraviolet-B radiation. We estimate the oceanic residence time of biologically refractory, photochemically reactive DOC to be 500–2,100 yr, which is less than its average apparent 14C age. The injection of 'old carbon' from sediments into the deep sea may explain this discrepancy.

Longitudinal studies of effects of divorce on children in Great Britain and the United States

Abstract: National, longitudinal surveys from Great Britain and the United States were used to investigate the effects of divorce on children. In both studies, a subsample of children who were in two-parent families during the initial interview (at age 7 in the British data and at ages 7 to 11 in the U.S. data) were followed through the next interview (at age 11 and ages 11 to 16, respectively). At both time points in the British data, parents and teachers independently rated the children's behavior problems, and the children were given reading and mathematics achievement tests. At both time points in the U.S. data, parents rated the children's behavior problems. Children whose parents divorced or separated between the two time points were compared to children whose families remained intact. For boys, the apparent effect of separation or divorce on behavior problems and achievement at the later time point was sharply reduced by considering behavior problems, achievement levels, and family difficulties that were present at the earlier time point, before any of the families had broken up. For girls, the reduction in the apparent effect of divorce occurred to a lesser but still noticeable extent once preexisting conditions were considered.

Child Anxiety Sensitivity Index.

Abstract: Presents a scale for measuring anxiety sensitivity (i.e., the belief that anxiety symptoms have negative consequences): the Child Anxiety Sensitivity Index (CASI). The CASI is shown to have sound psychometric properties for both a normal and a clinical sample. Support is provided for the view that anxiety sensitivity is a separate concept from that of anxiety frequency and that it is a concept applicable with children. The CASI is shown to correlate with measures of fear/ anxiety and also to account for variance on the Fear Survey Schedule for ChildrenRevised and the State-Trait Anxiety Inventory for Children (Trait form) that cannot be explained by a measure of anxiety frequency. The possible role of anxiety sensitivity as a predisposing factor in the development of anxiety disorders in children is discussed.

Rhodopsin mutations in autosomal dominant retinitis pigmentosa.

Abstract: DNA samples from 161 unrelated patients with autosomal dominant retinitis pigmentosa were screened for point mutations in the rhodopsin gene by using the polymerase chain reaction and denaturing gradient gel electrophoresis. Thirty-nine patients were found to carry 1 of 13 different point mutations at 12 amino acid positions. The presence or absence of the mutations correlated with the presence or absence of retinitis pigmentosa in 174 out of 179 individuals tested in 17 families. The mutations were absent from 118 control subjects with normal vision.

The Reliability and Specificity of Delta Versus Residualized Change as Measures of Cardiovascular Reactivity to Behavioral Challenges

Abstract: The statistical parameters that influence the reliability of delta and residualized change were examined in the context of the assessment of cardiovascular reactivity. A comparison of the relative reliabilities of these two quantification methods was performed using systolic blood pressure, diastolic blood pressure, and heart rate data from two samples of 134 and 109 subjects observed during baseline and either two or four behavioral challenges. The results indicated that both delta and residualized change scores can yield reliable measures of blood pressure and heart rate reactivity to behavioral challenges, and that their reliabilities will be comparable under the conditions observed in laboratory reactivity studies. Correlations between baseline and delta did not indicate that these two measures were systematically related. Finally, delta scores are more appropriate than residuals when assessing the generalizability of responses across a variety of tasks.

Adjuvant chemotherapy for resectable squamous cell carcinomas of the head and neck: Report of intergroup study 0034

Abstract: To test the efficacy of sequential chemotherapy as an adjuvant to surgery and postoperative radiotherapy for patients with locally-advanced but operable squamous cell cancers of the head and neck region, a randomized clinical trial was conducted under the auspices of the Head and Neck Intergroup (Radiation Therapy Oncology Group, Southwest Oncology Group, Eastern Oncology Group, Cancer and Leukemia Group B, Northern California Oncology Group, and Southeast Group). Eligible patients had completely resected tumors of the oral cavity, oropharynx, hypopharynx, or larynx. They were then randomized to receive either three cycles of cis-platinum and 5-FU chemotherapy followed by postoperative radiotherapy (CT/RT) or postoperative radiotherapy alone (RT). Patients were categorized as having either "low-risk" or "high-risk" treatment volumes depending on whether the surgical margin was greater than or equal to 5 mm, there was extracapsular nodal extension, and/or there was carcinoma-in-situ at the surgical margins. Radiation doses of 50-54 Gy were given to "low-risk" volumes and 60 Gy were given to "high-risk" volumes. A total of 442 analyzable patients were entered into this study with the mean-time-at-risk being 45.7 months at the time of the present analysis. The 4-year actuarial survival rate was 44% on the RT arm and 48% on the CT/RT arm (p = n.s.). Disease-free survival at 4 years was 38% on the RT arm compared to 46% on the CT/RT arm (p = n.s.). At 4 years the local/regional failure rate was 29% vs. 26% for the RT and CT/RT arms, respectively (p = n.s.). The incidence of first failure in the neck nodes was 10% on the RT arm compared to 5% on the CT/RT arm (p = 0.03 without adjusting for multiple testing) and the overall incidence of distant metastases was 23% on the RT arm compared to 15% on the CT/RT arm (p = 0.03). Treatment related toxicity is discussed in detail, but, in general, the chemotherapy was satisfactorily tolerated and did not affect the ability to deliver the subsequent radiotherapy. Implications for future clinical trials are discussed.

Isolation and functional characterization of Schwann cells derived from adult peripheral nerve

Abstract: To facilitate the development of autologous transplantation techniques with which to test the ability of Schwann cell (ScC) implantations to treat nervous system injury, we have developed a method for procuring large, essentially pure populations of ScCs from adult peripheral nerve. By allowing small explants of peripheral nerve trunk to undergo axonal and myelin breakdown in vitro, rather than dissociating the nerve immediately after harvest, we are able to (1) rid the explant of nearly all fibroblasts and (2) capitalize on the intrinsic ScC mitogenic response to peripheral nerve degeneration. Here, we describe a method that yields up to 98% pure ScC populations from adult rat sciatic nerve (based on cell soma and nuclear morphology, S100 staining, and behavior of dissociated cells on neurites) at cell yields of greater than 2 x 10(4) cells/mg of starting nerve weight. The purification technique was successfully applied to human tissue; human phrenic nerve yielded 98% pure ScC populations at cell yields of 2 x 10(4) cells/mg of initial nerve weight. Similar to neonatally derived ScCs, adult rat cells can be expanded in coculture with dorsal root ganglion (DRG) neurons or in isolation in the presence of glial growth factor and forskolin. Cells expanded indefinitely on DRG neurons, or up to 10 weeks on chemical mitogens, return to quiescence following removal of the mitogenic stimulus. Expanded adult-derived rat ScCs retain functional capacity, as evidenced by their ability to myelinate DRG neurites and to support regeneration of processes from embryonic rat retinal explants.

Coral reef bleaching in the 1980s and possible connections with global warming.

Abstract: Scleractinian corals and their symbiotic dinoflagellate algae build massive, wave-resistant coral reefs that are pre-eminent in shallow tropical seas. This mutualism is especially sensitive to numerous environmental stresses, and has been disrupted frequently during the past decade. Increased seawater temperatures have been proposed as the most likely cause of coral reef bleaching, and it has been suggested that the recent large-scale disturbances are the first biological indication of global warming. This article describes recent bleaching events and their possible link with sea warming and other environmental stresses, and offers some speculation on the fate of coral reefs if the Earth enters a sustained period of warming.

Corneal epithelial wound healing in the absence of limbal epithelium.

Abstract: Corneal epithelial stem cells are thought to be at the limbus. The limbal epithelium was surgically removed in 12 New Zealand white rabbits. After 6 months, four showed mild vascularization. To challenge the remaining proliferative reserve, two consecutive 7.5-mm epithelial woundings were created 3 weeks apart in 11 limbal-deficient corneas and 11 controls. After the first wounding, five of the limbal-deficient corneas showed delayed healing, and seven became moderately vascularized; the controls healed normally. After the second wounding, eight experimental corneas showed intense vascularization; the controls did not. Recurrent erosions with delays in healing were noted in nine experimental animals but not in controls. Flat-mount preparation and impression cytology revealed centripetal migration of conjunctival epithelium with goblet cells onto the experimental corneas. These results indicate that only limited proliferative capacity of corneal epithelium remains in the absence of limbus. The constellation of delayed healing with recurrent erosion, corneal vascularization, and conjunctival epithelial ingrowth can be considered possible signs of limbal stem cell dysfunction.

Fractionation of the stable isotopes of oxygen and carbon in carbon dioxide during the reaction of calcite with phosphoric acid as a function of temperature and technique

Abstract: The fractionation factor (α) between the 18O/16O ratio in calcite and CO2 gas produced as a result of reaction with phosphoric acid has been determined as a function of temperature for two of the most widely used variations of the dissolution technique, reaction in a sealed vessel and reaction in an acid bath. Although these methods show approximately the same relationship between temperature and α, they are offset from one another by between 0.2 and 0.4% over the temperature range 25–90°C. There appears to be no temperature- or technique-dependent fractionation on carbon over the range of temperatures examined in this study. The difference between these two methods arises from three main processes: (1) isotopic exchange between the CO2, the phosphate polymers in the acid and water produced in the reaction; (2) dissolution of CO2 in the acid; and (3) incomplete removal of CO2 during the extraction process. Of these two methods the “acid bath” method probably provides the most accurate isotopic composition of the calcite. As a result of the fact the original fractionation factors were determined using the “sealed vessel” method, we have calculated our temperature [T (K)] - dependent fractionation factor (αT) taking into account the difference between the two methods at 25°C. For the “sealed vessel” method: (a) αT= [5.60 (± 0.33) × 102] T−2 + 1.003943 (± 0.000067). For the “common acid bath” technique: (b) αT = [5.25 (± 0.08) × 102] T −2 + 1.003970 (± 0.000034).

Biological and optical properties of mesoscale coccolithophore blooms in the Gulf of Maine

Abstract: Two coccolithophore blooms in the Gulf of Maine were studied in 1988 and 1989. Each bloom was about 50,000 km* in area and confined to the top 20 m of the water column. Maximal cell concentrations were -2,000 cells ml-* and coccolith densities of 3 x lo5 ml-’ were observed. The coccolith : cell ratio was highest in the bloom center (region of most intense reflectance) and lowest at the bloom periphery, an indication of varying organic vs. inorganic C production. Chlorophyll concentrations were generally low within the bloom and no relation could be observed between major nutrients and coccolithophore abundance. Backscattered light was profoundly affected by coccolith density and was slightly wavelength-dependent. We calculated total backscattering as well as backscattering (bh) caused exclusively by coccoliths and derived the algorithm relating coccolith density to backscattering. Although cells were efficient light absorbers, coccoliths showed negligible light absorption. Diffuse attenuation was lowest in the green and blue-green part of the visible spectrum. At the center of the bloom, coccoliths contributed ~75% of the backscattering signal and > 50% of the beam attenuation signal. The most accurate way to estimate coccolith concentrations via remote sensing is to measure water-leaving radiance in the green wavebands. The coccolithophore Emiliania huxleyi (Lohm) Hay et al. Mohler (class Prymnesiophyceae) is thought to be the most abunI Present address: Lockheed Engineering and Sciences, P.O. Box 58561, Houston, Texas 77258. Acknowledgments Many thanks to Capt. Donald Bradford and the crew of the RV Argo Maine for ship handling and help with sampling. Shiptime for leg 1 of the 1988 cruise was provided by Charles S. Yentsch. Howard Gordon provided the light scattering photometer as well as the software for calculating total backscattering. Robert Evans and Jody Splain arranged for the transfer of AVHRR data from Miami to Bigelow Lab. Janet Campbell and Thor Aarup analyzed the satellite data during the cruise and relayed the information to the ship. Stephen Groom calculated the visible band reflectance from the AVHRR data. Jeffrey Brown, Tracy Skinner, and Albert Chapin were instrumental in completing many measurements at sea and in the laboratory. Dave Townsend coordinated the CTD measurements. Elin Haugen and R. R. L. Guillard provided an inverted microscope for the 1988 cruise. Christodant calcifying organism on earth (Westbroek et al. 1985). Of all coccolithophore species, E. huxleyi is numerically dominant and can be found from tropical to subarctic regions of the Atlantic, extending into waters with temperatures

Distribution of CGRP-, VIP-, D beta H-, SP-, and NPY-immunoreactive nerves in the periosteum of the rat.

Abstract: In light of the possible role peripheral nerves may play in bone metabolism, the morphology of calcitonin gene-related peptide (CGRP)-, vasoactive intestinal peptide (VIP)-, substance P (SP)-, neuropeptide Y (NPY)-, and dopamine-β-hydroxylase (DβH)-immunoreactive nerve fibers was examined in whole-mount preparations of periosteum of membranous bones (calvaria, mandible) and long bones (tibia) from the rat. Periosteum from animals treated to remove selectively either the sympathetic or fine-caliber primary afferent nerves was also examined to determine the origin of the nerve fibers. We found a consistent and often dense innervation of the periosteum. The innervation patterns of the calvaria and mandible were similar, with networks of nerves spread across the surface of the bone. Nerves in the tibial periosteum were oriented in the longitudinal axis and were more numerous at the epiphyses than in the mid-shaft region. CGRP-immunoreactive fibers were widely and densely distributed. The presence of populations of CGRP-immunoreactive fibers of differing calibers and perivascular arrangements suggests that such nerves in bone tissues may serve different functions. SP-immunoreactivity was present in a fine network of varicose fibers in the superficial layers of the periosteum. CGRP- and SP-immunoreactive nerve fibers were dramatically reduced in periosteum of capsaicin-treated animals as compared to controls, indicating the sensory origin of these nerves. VIP-immunoreactive nerve fibers were distributed in the periosteum of mandible and calvaria as small networks and individual fine varicose fibers. In tibial periosteum, larger networks of these fibers were visible. VIP-immunoreactive nerve fibers in the periosteum were associated with both vascular and nonvascular elements within the layers of cells closest to the bone, suggesting that VIP may serve more than one function in periosteal tissues. NPY-immunoreactive fibers were largely confined to vascular elements; occasional fibers were observed among the bone-lining cells. DβH-immunoreactivity was associated only with blood vessels. VIP-, NPY-, and DβH-immunoreactivities were dramatically reduced in the periosteum of guanethidinetreated animals, indicating the sympathetic origin of these nerves.

Normal Hip and Knee Active Range of Motion: The Relationship to Age

Abstract: Abnormal joint mobility is an important factor in movement dysfunction and physical disability. Because the decision to treat impaired joint mobility in an older individual may be influenced by assumptions concerning normal range of motion (ROM) at older ages, it is important to establish population-based normative values for hip and knee ROM by age, race, and sex. This study used data from the first National Health and Nutrition Examination Survey (NHANES 1), which involved a national probability sample of persons drawn from the civilian noninstitutionalized population of the United States. Goniometric measurements of hip and knee active range of motion (AROM) were obtained from a subset of the sample consisting of 1,892 subjects. This analysis was limited to the 1,313 white and 370 black subjects. Univariate statistics, weighted by the probability of selection into the sample, were calculated for 12 sex-race-age-group-specific categories. These normal AROM values for the hip and knee calculated from this population based sample were found to differ from estimates found in textbooks by as much as 18 degrees. With one exception, normal values for all motions were lower in the oldest age group than in the youngest age group. The differences in mean AROM were generally small, ranging from 3 to 5 degrees. Only in the case of hip extension did the difference in mean AROM between the youngest and the oldest age groups constitute a decline of more than 20% of the arc of motion. With the possible exception of hip extension, this study supports the conclusion that, at least to age 74 years, any substantial loss of joint mobility should be viewed as abnormal and not attributable to aging and therefore should be treated much as it would be in a younger individual.

Minimum iron requirements of marine phytoplankton and the implications for the biogeochemical control of new production

Abstract: The Fe : PO., ratio at which nutrient limitation of final cell yield shifts from one nutrient to the other was determined for 22 species of marine phytoplankton. Among eucaryotic phytoplankton, coastal species have subsistence optimum Fe: P molar ratios of lo-* to 10-3.1, but most oceanic species have ratios of < 1 O--4, indicating that oceanic species have been able to adapt their biochemical composition to the low availability of Fe in the open ocean. In contrast, both coastal and oceanic species of cyanobacteria have relatively high Fe : P molar ratio requirements, ranging from 1O-1.4 to 1O-2.7. A simple comparison of these requirement ratios with the ratios of the Fe and PO, fluxes to the photic zone from deep water and the atmosphere indicates that new production of cyanobacterial biomass is Fe limited, but new production of eucaryotic algal biomass is not. Because of the large differences among species in their Fe requirements, especially between procaryotes and eucaryotes, changes in the relative inputs of Fe and PO, to the photic zone are expected to lead to changes in the species composition of phytoplankton communities. Indeed, the ratio of atmospheric to deep-water inputs of nutrients and the resulting Fe : P input ratios appear to influence the relative abundance of unicellular cyanobacteria and Trichodesmium and their vertical and biogeographic distributions. Because some phytoplanlcton species have adaptations that reduce their dependence on combined N and Fe but not on P, it is concluded that PO, is the ultimate limiting nutrient of new production of organic C on a geochemical and evolutionary time scale, even though N and Fe are important growth rate-limiling nutrients on an ecological time scale. What controls the rate of new production of organic C in the ocean is of great interest because of its influence on atmospheric 0, and C02, sedimentation and organic burial, and fisheries. One of the first to consider the geochemical control of new production in the ocean, Redfield (195 8) conducted a gedanken experiment in which he compared the ratio of NO3 to PO, in deep water with the ratio of N to P in marine biota and asked which nutrient would be depleted first by the biota if the deep water was upwelled into the photic zone. At that time,, trace metals were not generally considered as important limiting nutrients because of the high concentrations observed in the ocean as a result of inadequate techniques and serious contamination problems. As a result of greatly improved techniques, we now know that many trace metals are present in the ocean

Differences and similarities between children, mothers, and teachers as informants on disruptive child behavior.

Abstract: Prevalence rates of disruptive child behaviors, based on structured psychiatric interviews, are presented for samples of clinic-referred prepubertal boys at two sites to investigate differences and similarities among reports of the behaviors from children, parents, and teachers. Children reported significantly less hyperactive/inattentive and oppositional behaviors than either parents or teachers. In contrast, children did not differ from parents or teachers in their report on the prevalence of more serious conduct problems. These results were well replicated across two sites, despite the fact that there were significant differences between the sites in the level of hyperactive/inattentive child behaviors and conduct problems. The ranking of parents' and teachers' reported prevalence of specific child behavior problems in each of the three domains of disruptive behavior was strikingly similar. With one exception, the concordance between the prevalence ranking based on the children's reports was lower than that based on adults'reports, Children's reports on their own behavior did not predict various child handicaps 1 year later as well as did adults' reports. The results are discussed in relation to the usefulness of certain child behaviors in symptom lists for diagnostic purposes; the reliability of children's reports on their own behavior; and the possible reasons why prevalence rankings, as perceived by adults, are so similar.

Comparative Effect of Transient Global Ischemia on Extracellular Levels of Glutamate, Glycine, and γ-Aminobutyric Acid in Vulnerable and Nonvulnerable Brain Regions in the Rat

Abstract: We evaluated whether regional differences in the magnitude of glutamate, γ-aminobutyric acid (GABA), and glycine release could explain why some regions are vulnerable to ischemia whereas others are spared. By means of the microdialysis technique, the temporal profile of ischemia-induced changes in extracellular levels of glutamate, GABA, and glycine was compared in regions that demonstrate differing susceptibilities to a 10- and 20-min ischemic insult (dorsal hippocampus, anterior thalamus, somatosensory cortex, and dorsolateral striatum). The degree of ischemia (as established by local cerebral blood flow reduction) and the magnitude of histopathoiogical neuronal damage were also evaluated in these regions. The blood flow reduction was severe and uniform in all regions; however, the histopathoiogical outcome illustrated a different pattern. Whereas the CA1 sector of the hippocampus was severely damaged, the thalamus and cortex were relatively spared from both 10 and 20 min of ischemia. Striatal neurons were resistant to a 10-min insult but severely damaged after 20 min of ischemia. Ischemia-induced increases in glutamate and GABA content were of a similar magnitude and temporal profile in all four brain regions. A uniform increase in extracellular glycine levels was also observed in all four brain structures. The postischemic response, however, was different Glycine levels remained twofold higher than baseline in the hippocampus but fell to baseline in the cortex and thalamus after both 10- and 20-min insults. In the striatum, glycine levels returned to baseline after 10 min of ischemia but remained relatively high after a 20-min insult Although ischemic neuronal damage was not related to glutamate release, it correlated with the „excitotoxic index,” whose value was derived from the following equation: [glutamate] X [glycine]/[GABA]. No significant changes were observed in the excitotoxic index during ischemia. However, a significant increase in the index was observed in vulnerable brain regions during the early and late recirculation periods. These results suggest that the imbalance between excitation and inhibition, reflected by changes in the excitotoxic index, may account for regional vulnerability to ischemia.

Predictors of survival in systemic sclerosis (scleroderma).

Abstract: We conducted followup of 264 patients with definite systemic sclerosis (SSc) who were entered into the multicenter Scleroderma Criteria Cooperative Study (SCCS) during 1973-1977. At the end of the study (average 5.2 years of followup), 38% were known to be alive, 50% were dead (68% of these deaths definitely related to SSc), and 12% were lost to followup. Survival analyses of 484 demographic, clinical, and laboratory items recorded at entry into the SCCS (within 2 years of physician diagnosis of SSc) were performed. Survival declined linearly, and the cumulative survival rate was less than 80% at 2 years, 50% at 8.5 years, and 30% at 12 years after entry. Analysis using combinations of entry variables identifying organ system involvement confirmed that renal, cardiac, pulmonary, and gastrointestinal involvement in SSc predicted reduced survival; however, data on organ system involvement at study entry could not be used to consistently predict which organ system would ultimately be involved as the primary cause of death. By survival tree analysis, the individual entry variables best predicting reduced survival included older age (greater than 64 years), reduced renal function (blood urea nitrogen greater than 16 mg/dl), anemia (hemoglobin less than or equal to 11 gm/dl), reduced pulmonary diffusing capacity for carbon monoxide (less than or equal to 50% of predicted), reduced total serum protein level (less than or equal to 6 gm/dl), and reduced pulmonary reserve (forced vital capacity less than 80% with hemoglobin greater than 14 gm/dl or forced vital capacity less than 65% with hemoglobin less than or equal to 14 gm/dl). Cox proportional hazards model analysis confirmed these results. Different combinations of variables led to markedly different survival rates. The poorest prospects for survival were in patients with SSc who were less than or equal to 64 years old with a hemoglobin level less than or equal to 11 gm/dl, and in those greater than 64 years old with a blood urea nitrogen level greater than 16 mg/dl. These results may be useful in predicting individual patients at risk for shortened survival.

Cognitive-behavioral stress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity

Abstract: Forty-seven asymptomatic, healthy gay men were randomly assigned to a cognitive-behavioral stress management (CBSM) condition or an assessment-only control group 5 weeks before being notified of their HIV-1 antibody status. Seventy-two hours before and 1 week after serostatus notification, blood samples and psychometric data were collected. Control subjects showed significant increases in depression, but only slight decrements in mitogen responsivity and lymphocyte cell counts pre- to postnotification of seropositivity. Seropositive CBSM Ss did not show significant pre-post changes in depression, but did reveal significant increases in helper-inducer (CD4) and natural killer (CD56) cell counts as well as a slight increment in proliferative responses to phytohemagglutinin (PHA). Individual difference analyses suggest that the psychological buffering and immunomodulating effects of the CBSM manipulation may be attributable, in part, to relaxation skills learned and practiced or to a general willingness to comply with the intervention guidelines.

Foreign bank activity in the United States: An analysis by country of origin

Abstract: The presence of foreign banks in the United States has grown dramatically in recent years. In particular, Japanese bank activity has grown rapidly and has raised concern from domestic bankers who have felt competitive pressure. This paper assesses the extent of the foreign bank presence in the United States and indicates its distribution by country of origin. The paper develops a formal model of determinants of the value of foreign bank assets and the number of foreign bank offices in the United States based on the country of origin of the investing banks and tests the model using recently available data from the Federal Reserve System. The empirical results indicate that foreign investment in the U.S., foreign trade with the U.S., and the size of the banking sector in the foreign country are positively correlated with that country's bank presence in the U.S. Less stable countries have greater foreign bank penetration, and geographic distance is somewhat positively correlated with bank presence.

Visuospatial impairment in Parkinson's disease

Abstract: We explored the nature of the visuospatial deficit in Parkinson9s disease (PD) and its progression as a function of disease duration. We compared the performance of 183 patients with idiopathic PD and 90 control subjects matched for age and education on six visuospatial measures. We divided patients into three groups according to the disease duration: early (1 to 4 years), middle (5 to 10 years), and advanced (> 10 years). Performance deteriorated in five of the six visuospatial measures, as a function of disease duration. However, the pattern of visuospatial decline depended on whether dementia was present. The results were not influenced by age or anticholinergic medication. These findings support the presence of visuospatial deficits in PD patients, with a changing pattern of impairment related to dementia and progression of the disease.