An analysis of race and demographic factors among motor vehicle fatalities.

Background: According to the National Highway Traffic Safety Administration, from 1982 through 1995 safety belts are estimated to have saved 74,769 lives. Even more lives could be saved and serious injuries avoided if there was increased seat belt use in the United States.

Methods: This study analyzed safety belt use among drivers and passengers involved in fatal motor vehicle crashes from 1993 through 1995.

Computer-aided bootstrap generation of characteristic curves for radiographic imaging systems.

Determination of the characteristic curve is essential for quantitative evaluation of digital as well as screen-film radiographic imaging systems. When it is not practical to generate the entire curve through variation of a single exposure parameter, bootstrap methods can be used. For the bootstrap method used here, curve segments are generated by varying one exposure parameter and multiple segments are produced at different exposure levels by varying a second parameter.

Material property determination of sub-surface objects in a viscoelastic environment.

Modeling human organs and soft tissue or anatomic regions for the purpose of medical training and simulation is a relatively new area. The data presented here is the groundwork for our ongoing development of a real-time haptic virtual environment for abdominal soft tissue palpation. The purpose of modeling the human abdomen is twofold.

Future directions for studies of women's mental health.

Women's mental health is increasingly recognized as a major field with an impact on the well-being of individuals, their families, and society. It is also recognized that this field is in its infancy and needs to be well delineated: Definitions and assessment procedures for the various topics need to be developed; the pathobiologies are as yet unknown; and time course, variations, and treatment outcome of most of the entities included are unknown or not confirmed. Also, interactions among phenomena, biology, environment, and sociopsychological aspects have not been well studied.

The dorsomedial hypothalamic nucleus revisited: 1998 update.

This article reviews data that have accumulated since the early 1970s on the role of the dorsomedial hypothalamic nucleus (DMN) in neuroendocrine and autonomic homeostasis. Both the ventromedial hypothalamic nucleus (VMN) and the lateral hypothalamic area (LHA) project to the DMN, which in turn projects to the paraventricular nucleus of the hypothalamus (PVN), thus placing the DMN at an important nodal point of neuroendocrine/autonomic circuitries. The DMN is composed of cells and fibers containing neuropeptide Y (NPY), and the nutritional status (starvation-refeeding) is reflected in NPY levels of both VMN and DMN in Sprague-Dawley, Zucker (fa/fa), and corpulent rats (cp/cp JCR:LA).

The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects.

Objectives: To compare the incidences and severities of pain experienced by healthy volunteers undergoing spinal immobilization in the neutral position with and without occipital padding. To compare the incidence of pain when immobilized in the neutral position with the incidence in a nonneutral position.

Methods: Thirty-nine healthy volunteers over the age of 18 years who had no acute pain or illness, were not pregnant, and had no history of back problems or surgery voluntarily participated in a prospective, randomized, crossover study conducted in a clinical laboratory setting.

Metallothionein-induced increase in mitochondrial inner membrane permeability.

Objective: To elucidate the effect of metallothionein on the permeability of the mitochondrial inner membrane.

Background: Metallothionein (MT) is a 6-7-kDa protein which is rapidly produced by stressed cells. MT is induced by cytokines and other factors thought to mediate the stress response.

The pharmacologic treatment of depression.

Background: Family physicians often provide the first line of treatment for patients with depression. Many effective drugs are now available for the pharmacologic treatment of depression.

Methods: We searched Medline from 1991-96 under the topics of depressive disorders/treatment and antidepressant medications.

Making time for tobacco cessation counseling.

Background: The objective of this study was to examine the incidence, targeting, and time demands of tobacco cessation advice by community family physicians.

Methods: Research nurses directly observed 2 days of outpatient visits to 138 family physicians in northeast Ohio. Smoking status was identified by patient questionnaire.

Family physicians' attitudes about and use of clinical practice guidelines.

Background: The use of clinical guidelines is one strategy intended to improve health care quality, rein in costs, and standardize medical practice. Clinical guideline development has been prodigious, while less effort has been expended on the guidelines' dissemination and implementation. This study examines family physician attitudes toward and perceived uses of clinical guidelines in practice.

Gestational resistance to the pulmonary vasoconstrictor effect of the TxA2 mimetic U-46619: possible mechanism.

Pregnancy is associated with the reduction of vascular sensitivity to vasoconstrictor compounds. We have examined whether pregnancy in rabbits induces hyposensitivity of the pulmonary vascular system to U-46619. Anesthetized, mechanically ventilated nonpregnant (NP; n = 7) and late-pregnant (P; n = 7) rabbits were studied.

Geropsychiatric consultation for African-American and Caucasian patients.

We assessed differences in the referral rates of African-American and Caucasian elderly for geropsychiatric consultation. Reasons for referral, assigned diagnoses, and interventions made were also compared. A retrospective chart review of psychiatric consultations was completed for patients aged 65 years and older for a 2-year period.

Primary beam exposure outside the fluoroscopic field of view.

Fluoroscopic units can irradiate an area outside the displayed field of view (FOV) which provides no additional information to the fluoroscopist and may significantly increase the integral dose to the patient. This unnecessary exposure can be reduced using region of interest (ROI) filtration techniques to attenuate the x rays peripheral to the ROI as well as outside the displayed FOV [Granger et al., Med.

Xanthine oxidase inhibition prevents mesenteric blood flow deficits after resuscitated hemorrhagic shock by preserving endothelial function.

To determine the contribution of xanthine oxidase-mediated endothelial dysfunction to the blood flow deficits seen in the mesenteric circulation after resuscitated hemorrhagic shock, rats were prepared for intravital microscopic study then bled to 50% of baseline blood pressure for 60 min. Treatment animals received a 50 mg/kg bolus and a 25 mg/kg/hr infusion of the xanthine oxidase inhibitor allopurinol (allo) after shock but before resuscitation with shed blood and an equal volume of Ringer's lactate. A similarly resuscitated group (Std Res) and a nonhemorrhage group served as controls.

Premenstrual dysphoric disorders: a diversified cluster of vulnerability traits to depression.

Some biological factors which have been shown to be abnormal in subgroups of women with dysphoric premenstrual syndromes (PMS) have not been limited to the symptomatic late luteal phase of the menstrual cycle, but also existed during the non-symptomatic mid-follicular phase of the cycle. Personality, cognitive functions, alpha 2 and imidazoline binding, sensitivity to inducement of panic attacks, relative hypothyroidism, and some but not all serotonergic functions of women with dysphoric PMS differ from those with no PMS, and also differ during a non-symptomatic phase of the cycle. It is suggested that premenstrual symptoms are an expression of vulnerability traits that might surface in response to a trigger.

Muscle function and gait in patients with knee osteoarthritis before and after muscle rehabilitation.

Patients with knee osteoarthritis (OA) have reduced functional capacity and muscle function that improves significantly after quantitative progressive exercise rehabilitation (QPER). The effects of these changes on the biomechanics of walking have not been quantified. Our goal was to quantify the effects of knee OA on gait before and after QPER.

Assessment of preventive health care: design considerations.

Objective: To design an instrument to assess the performance of a clinic in the delivery of preventive health services to a general population.

Methods: The study utilized a chart review of services delivered, abstraction of data from electronic databases, and a standardized provider assessment of each eligible patient. The study was conducted in a primary care clinic staffed primarily by internal medicine residents in an urban academic medical center.

Increasing the utility of the mammographic phantom image.

To increase the utility of the monthly accreditation mammographic phantom image, the authors added a light sensitometric strip on the same film. The optical densities of the steps on the sensitometric strip with values nearest those of the phantom background and disk were measured, and these optical densities and the density difference were recorded and plotted on a control chart. The ability was increased to determine if changes in the contrast or optical density on an image were due to film and associated processing or to the x-ray source.

Isolation and characterization of the Haemophilus influenzae tolQ, tolR, tolA and tolB genes.

The tolQ, R, A and B genes have been isolated from the DNA of Haemophilus influenzae and sequenced. The deduced amino acid (aa) sequence of the H. influenzae TolQ, TolR, TolA and TolB show 67, 63, 41 and 62% identity with Escherichia coli TolQRAB proteins, respectively.

Movement disorders associated with the serotonin selective reuptake inhibitors.

Background: To review the case reports and case series of movement disorders ascribed to the use of serotonin selective reuptake inhibitors (SSRIs).

Method: Reports of SSRI-induced extrapyramidal symptoms (EPS) in the literature were located using a MEDLINE search and review of bibliographies.

Results: Among the 71 cases of SSRI-induced EPS reported in the literature, the most common side effect was akathisia (45.

Low plasma gamma-aminobutyric acid levels during the late luteal phase of women with premenstrual dysphoric disorder.

Objective: Plasma gamma-aminobutyric acid (GABA) levels have been reported to be low in some patients with major depressive disorder. Premenstrual dysphoric disorder is often associated with major depressive disorder. Therefore, the authors sought to determine whether women with premenstrual dysphoric disorder with or without prior major depressive disorder also had low plasma GABA levels.

Predictors of clonidine response in Tourette syndrome: implications and inferences.

Clonidine is an alpha-adrenergic agonist which may alleviate emerging symptoms in Tourette syndrome, an observation that has fueled speculation regarding involvement of stress-sensitive central noradrenergic systems in this disorder. We conducted a retrospective study of 53 juvenile patients with Tourette syndrome to assess predictors of short-term behavioral and tic response to oral clonidine and to examine the relationship, if any, among pretreatment blood pressure, tic severity, and clonidine response. When adverse effects were considered, older subjects experienced a better therapeutic response to clonidine, independent of dose.

Proposed structure of putative glucose channel in GLUT1 facilitative glucose transporter.

A family of structurally related intrinsic membrane proteins (facilitative glucose transporters) catalyzes the movement of glucose across the plasma membrane of animal cells. Evidence indicates that these proteins show a common structural motif where approximately 50% of the mass is embedded in lipid bilayer (transmembrane domain) in 12 alpha-helices (transmembrane helices; TMHs) and accommodates a water-filled channel for substrate passage (glucose channel) whose tertiary structure is currently unknown. Using recent advances in protein structure prediction algorithms we proposed here two three-dimensional structural models for the transmembrane glucose channel of GLUT1 glucose transporter.