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INTRODUCTION One of the most prevalent complications of any thoracic trauma, a pneumothorax (PTX), is commonly encountered in emergency settings with a 40%-50% occurrence in all fatal cases. (1,2) Traumatic [...]

Background. Previous studies have provided conflicting results concerning the effects of a family history of prostate and other cancers on breast cancer risks. Methods. Three groups of families were studied to determine the effects of a family history of prostate cancer on breast cancer risks. Also considered were the effects of a family history of melanoma, colon, lung, ovarian, and endometrial cancers. Included were 422 first-degree female relatives of 114 patients with bilateral breast cancer, 320 first-degree relatives of 88 male patients with breast cancer, and 633 relatives of 186 unselected female patients. For estimating relative risks, observed numbers of breast cancers in relatives were compared with expected numbers based on population incidence data. Multiple logistic-regression also provided odds ratios of relatives affected with breast cancer. Results. A family history of prostate cancer increased the breast cancer risks in each of the groups, compared with families without prostate cancer. Ovarian cancer in a family increased the breast cancer risks only in the bilateral breast cancer group, and endometrial cancer increased the risks in the bilateral and unselected groups. These increases in risk appeared to be the consequence of families with multiple cancers, including those with hereditary breast-ovarian cancers and the cancer family syndrome. A family history of melanoma, lung, or colon cancer did not increase breast cancer risks. Conclusions. A family history of prostate cancer, as well as endometrial and ovarian cancer, significantly increases the risk of breast cancer.

Background. Studies comparing patients with familial and sporadic breast cancer have indicated that a family history of the disease can increase a woman's risk for having the disease twofold to threefold and that patients with familial breast cancer have a younger age at diagnosis and have a higher frequency of bilateral disease than those with sporadic breast cancer. Also, at least four types of breast cancers have been shown to be inherited. These findings led to the hypothesis that familial and sporadic breast cancer are the consequence of two biologically distinct mechanisms. Methods. A two-step mutation model proposed by Knudson in 1971 provides a link between the molecular mechanisms underlying familial and sporadic breast cancer. According to this model, both cancers involve the same genomic change in homologous chromosomes. The only difference is that the first mutation is inherited and the second is somatic in familial cancer, whereas in sporadic cancer both mutations are somatic. Mutation is used in a broad sense and refers to either a point mutation at a specific locus or the loss of a locus by deletion or nondysfunction. Results. This model has been shown to apply to several childhood and adult cancers, including breast cancer. Based on this model, patients with familial breast cancer will have their disease earlier in life and will have more bilateral cancer than patients with sporadic breast cancer. Moreover, the two types of patients should show no differences in clinicopathologic characteristics because both types involve the same genomic change and the pathogenesis of both types should be the same, thus arguing against the early hypothesis that patients with familial and sporadic breast cancer are the consequence of biologically distinct mechanisms. Conclusions. Breast cancer appears to involve the cumulative effect of several genetic lesions involving the activation of oncogenes and the inactivation of tumor-suppressor genes. Which genes are involved specifically as causative factors of breast cancer (the inherited gene or genes) and which are important somatically in its continued development and progression (oncogenes and tumor-suppressor genes) requires additional study.

Background: Previous studies have provided conflicting results concerning the familial effect of male breast cancer on breast cancer risks in female relatives. Purpose: We studied breast cancer risks in first-degree relatives of male patients and compared them with relatives of female patients. Methods: Our study included 88 consecutively ascertained male patients and 320 of their first-degree relatives as well as 186 consecutively ascertained female patients and 633 of their first-degree relatives. Observed numbers of breast cancers in relatives were compared with the expected number derived from the Connecticut Tumor Registry. Multiple logistic regression analysis was also performed. Results: Relatives of male patients exhibited a significant twofold increased risk when compared with expected rates and no difference in risk when compared with that of relatives of female patients. Prostate cancer in the family of a male patient resulted in a significant fourfold increased breast cancer risk compared with a risk of 1.4 in families with no history of prostate cancer. A family history of lung cancer, colon cancer, or melanoma had no effect on increasing risks of breast cancer. Conclusion: The familial effect of male breast cancer is the same as that of female breast cancer. Implications: Any estimates of breast cancer risk provided to individuals should also consider the occurrence of prostate cancer in the family, since prostate cancer appears capable of at least doubling the underlying twofold risk. [J Natl Cancer Inst 84:1114-1117, 1992]

The University of Tennessee College of Veterinary Medicine (UTCVM) Department of Large Animal Clinical Sciences has developed an intensive training program that all large animal veterinary interns are required to complete at the onset of their internship year. This program was designed to establish a uniform approach to entrustable professional activity (EPA) skills deemed essential by the large animal faculty. These EPA skills emphasize the clinical approaches and skills that interns should understand and demonstrate competency in early in their internship year. The EPA program, completed over 4 consecutive days, was coined the “Intern Boot Camp” and structured to fuse case-based lecture discussions and hands-on wet labs designed to develop or improve skills and techniques. At the conclusion of the boot camp, participants were given an evaluation survey to provide feedback on the program. The results were overwhelmingly positive, with 90% of the participants giving the program a rating of 5 on a scale ranging from 1 (poor opinion or experience) to 5 (excellent opinion or experience). Nearly 95% of participants stated that they felt more prepared for their internship year after attending the boot camp, and 100% of the participants indicated that they would recommend this program to future candidates. Given the positive outcomes over the past 4 years, the implementation of the Veterinary Intern Entrustable Professional Activities program (Intern Boot Camp) is considered a valuable component of the veterinary intern training program and could readily be adapted to other programs.

The broad goal of this study is to measure remote effects of cancer on brain physiology and behaviors that underpin instrumental activities of daily living such as automobile driving. Studies of hematological malignancies (HM) have demonstrated impairments in multiple brain functions shown to be critical for safe automobile driving. In the current pilot study, brain physiology during driving simulation was examined in 14 HM patients and 13 healthy comparison drivers. Electroencephalography was used to measure the eye fixation-related potential (EFRP)—a positive amplitude deflection evoked approximately 100 milliseconds after eye movement termination. Previous studies have demonstrated sensitivity of EFRP activity to information-processing capacity. All drivers completed visual search tasks to evaluate the relationship between driving-related changes in performance and EFRP activity. Results showed smaller EFRP amplitudes in drivers who had: (1) greater driving-related changes in visual search performance (p= 0.03, Cohen’s d= 0.91); and (2) HM diagnosis (p= 0.18, Cohen’s d= 0.54). Extending previous studies, these results provide neural evidence of reduced information-processing capacity associated with cancer diagnosis. Future large-scale studies are needed to confirm these results, given the high level of uncertainty and small sample size. This study provides a novel platform for linking changes in brain physiology and safety-critical driving behaviors.

I believe that Reichardt and Saari misinterpreted the suggestion by Orser to use the term accept rather than believe when discussing topics such as evolution (Letters to the Editor, July/ [...]

The Faithful: A History of Catholics in America James M. O' Toole (Harvard University Press, 2008, 362pp) 978-0674028180, $27.95 [ILLUSTRATION OMITTED] DURING THE APRIL VISIT OF Pope Benedict XVI to [...]

THE TELEVISED IMAGES OF poor, black families--especially mothers holding their small children in an inadvertent and ironically grotesque replica of a Madonna and child--trudging through the rising flood waters of [...]

With a thorough knowledge of the anatomy of the foot, and basic surgical instruments, digit surgery can be performed in field situations. Sepsis of the distal interphalangeal and proximal interphalangeal joints should be treated surgically because conservative treatment is often ineffective. Most of the diseases described in this article are chronic and often the animals have been suffering for some time. Perioperative analgesia is important to alleviate the pain of those animals. All those procedures should be performed under local or regional anesthesia.

Long bone fractures and disorders of tendons and ligaments represent a significant proportion of surgical orthopedic cases presented to ruminant veterinarians. The presentation of these patients, their diagnostic work-up, surgical treatment, and expected outcome will be discussed. The outcome of these cases depends largely on the presenting problem; however, accurate diagnosis and prompt surgical intervention can greatly improve the outcome of many of these cases.

A wide variety of disorders affecting the intestinal tract in cattle may require surgery. Among those disorders the more common are: intestinal volvulus, jejunal hemorrhage syndrome and more recently the duodenal sigmoid flexure volvulus. Although general principles of intestinal surgery can be applied, cattle has anatomical and behavior particularities that must be known before invading the abdomen. This article focuses on surgical techniques used to optimize outcomes and discusses specific disorders of small intestine. Diagnoses and surgical techniques presented can be applied in field conditions.

Procedures to improve animal and handler safety, shape production parameters, and directly address the prosperity of individuals in need of assistance are performed routinely. Techniques to accomplish these tasks have been described in many venues. Painful procedures are expected in feedlot practice. Assessing and managing pain and welfare for these procedures has strengthened significantly over the past decade to address increased public concerns and also to support the desires of the operators/managers to progress. Methods to perform common procedures are described, including evidence and techniques for managing the pain and distress while performing them.

Injuries, infections, and disorders of the musculoskeletal system are common in feedlot calves. These conditions often are amenable to surgical treatment with return of the calf to productivity. Weight gain and carcass quality are expected to be significantly adversely affected by pain and debilitation. The goal of surgical management of disorders of the joints, muscles, and feet should be resolution of the inciting cause, mitigation of pain, and restoration of form and function. If these are achieved, calves should return to acceptable, if not normal, feed intake, rate of gain, and carcass quality.

The Presbyterian Church (USA) voted June 20 to allow local and regional bodies to ordain gays to the church's ministries. After nearly three hours of debate, delegates voted 298 to [...]

Religious and human rights groups, along with a top U.N. official, are calling on the Zimbabwe government to end its campaign of evicting the urban poor and destroying their shacks [...]

The All Africa Council of Churches has called on the Zimbabwe Electoral Commission to 'urgently' investigate claims of irregularities in that country's March 31 parliamentary election. The election gave President [...]

Sudan The Sudanese government and the main rebel group, the Sudan People's Liberation Army/Movement, pledged November 19 to stop a decades-old civil war by the end of 2004. All 15 [...]

As an increasingly impatient Bush administration presses the world community to give its backing to a massive American-British military strike against Iraq, a group of U.S. leaders has offered a [...]

Presiding Bishop Frank Griswold of the Episcopal church has warned that unilateral American military action against Iraq could alienate American allies and further destabilize the Middle East. 'Further, unilateral military [...]

ABSTRACTA prophylactic vaccine to prevent the congenital transmission of human cytomegalovirus (HCMV) in newborns and to reduce life-threatening disease in immunosuppressed recipients of HCMV-infected solid organ transplants is highly desirable. Neutralizing antibodies against HCMV confer significant protection against infection, and glycoprotein B (gB) is a major target of such neutralizing antibodies. However, one shortcoming of past HCMV vaccines may have been their failure to induce high-titer persistent neutralizing antibody responses that prevent the infection of epithelial cells. We used enveloped virus-like particles (eVLPs), in which particles were produced in cells after the expression of murine leukemia virus (MLV) viral matrix protein Gag, to express either full-length CMV gB (gB eVLPs) or the full extracellular domain of CMV gB fused with the transmembrane and cytoplasmic domains from vesicular stomatitis virus (VSV)-G protein (gB-G eVLPs). gB-G-expressing eVLPs induced potent neutralizing antibodies in mice with a much greater propensity toward epithelial cell-neutralizing activity than that induced with soluble recombinant gB protein. An analysis of gB antibody binding titers and T-helper cell responses demonstrated that high neutralizing antibody titers were not simply due to enhanced immunogenicity of the gB-G eVLPs. The cells transiently transfected with gB-G but not gB plasmid formed syncytia, consistent with a prefusion gB conformation like those of infected cells and viral particles. Two of the five gB-G eVLP-induced monoclonal antibodies we examined in detail had neutralizing activities, one of which possessed particularly potent epithelial cell-neutralizing activity. These data differentiate gB-G eVLPs from gB antigens used in the past and support their use in a CMV vaccine candidate with improved neutralizing activity against epithelial cell infection.

WASHINGTON - The religious right emerged from the 1994 election like a tiger, claiming a clear-cut victory in turning Congress over to conservative Republican control. After this week's election, while [...]

Saying there is nothing in Episcopal doctrine to bar noncelibate homosexuals from becoming deacons and priests, a church court dismissed heresy charges against a retired bishop May 15. In dropping [...]

NEW YORK -- The former treasurer of the Episcopal Church embezzled $2.2 million in church money over five years, spending it on real estate, jewelry, clothing, trips abroad and limousine [...]

WASHINGTON -- A month ago, in a highly nuanced, somewhat abstract passage of his latest encyclical, Pope John Paul II said cases warranting capital punishment 'are very rare, if not [...]

FtsZ is a guanosine triphosphatase (GTPase) that mediates cytokinesis in bacteria. FtsZ is homologous in structure to eukaryotic tubulin and polymerizes in a similar head-to-tail fashion. The study of tubulin’s function in eukaryotic cells has benefited greatly from specific and potent small molecule inhibitors, including colchicine and taxol. Although many small molecule inhibitors of FtsZ have been reported, none has emerged as a generally useful probe for modulating bacterial cell division. With the goal of establishing a useful and reliable small molecule inhibitor of FtsZ, a broad biochemical cross-comparison of reported FtsZ inhibitors was undertaken. Several of these molecules, including phenolic natural products, are unselective inhibitors that seem to derive their activity from the formation of microscopic colloids or aggregates. Other compounds, including the natural product viriditoxin and the drug development candidate PC190723, exhibit no inhibition of GTPase activity using protocols in this work or under published conditions. Of the compounds studied, only zantrin Z3 exhibits good levels of inhibition, maintains activity under conditions that disrupt small molecule aggregates, and provides a platform for exploration of structure–activity relationships (SAR). Preliminary SAR studies have identified slight modifications to the two side chains of this structure that modulate the inhibitory activity of zantrin Z3. Collectively, these studies will help focus future investigations toward the establishment of probes for FtsZ that fill the roles of colchicine and taxol in studies of tubulin.

WASHINGTON - Leaders of the nation's black churches recently ended a historic two-day summit meeting on the environment pledging to make their denominations players in the environmental policy debate. The […]

NEW YORK - How far does the imperative of Christian unity stretch? Not yet far enough to allow an ordained United Methodist minister to be a member of the Roman [...]

A 4-year 10-month-old, intact female dromedary camel had progressive left carpal joint swelling and lameness for 7 months. Radiographs showed multifocal lytic lesions in the carpal and proximal metacarpal bones. Surgical biopsy of the synovial capsule and carpal bones suggested neoplasia, and the camel was subsequently euthanized. At necropsy, a white to pale pink, firm, multilobulated, soft tissue mass was located on the palmar aspect of the left carpal joint. Two smaller masses were present on the dorsal aspect of the carpal joint. The masses infiltrated all the carpal bones and the proximal region of the metacarpal bone. The joint capsule was diffusely thickened. The articular surfaces of the carpal bones and the metacarpal bone were multifocally eroded. The lungs contained multiple, firm, raised, gray, randomly distributed nodules. The neoplastic cells stained positive for vimentin and S-100. Chondrosarcoma arising from around the carpal joint with infiltration of carpal and metacarpal bones, and pulmonary metastasis, was diagnosed based on the histopathological and immunohistochemical evaluation.

Site‐specific management of soil fertility has been based on soil sampling in grid patterns or within soil mapping units without taking full advantage of terrain–soil relationships. The goal of this study was to determine whether terrain attributes relate significantly to soil K availability. The topographic wetness index (TWI), a terrain attribute that comprises the upstream contributing area and the slope for a portion of land, relates to soil wetness. We evaluated Mehlich‐3 K (M3K), plant‐available nonexchangeable K (PANK) with a modified tetraphenylboron extraction, effective cation exchange capacity (ECEC), and other soil variables from soil samples taken at three depths, and terrain attributes in a 3.6‐ha farmed site in the Cincinnati catena, a major toposequence in the Muscatatuck Uplands region of Indiana. The PANK and M3K were significantly (P< 0.0001 and P< 0.05, respectively) related to TWI and relative elevation in models with anisotropic spatial autocorrelation variance estimates in three dimensions (latitude, longitude, and soil depth). The PANK and M3K increased with decreasing TWI in the following drainage class order: poorly < somewhat poorly < moderately well drained. The M3K decreased with soil depth, while PANK increased. The PANK/M3K ratio was significantly higher in the poorly drained soils than in the moderately well‐drained soils, implying greater mobility or weathering of K in wetter soils. The ECEC also related strongly to terrain attributes (P< 0.0001 for relative elevation, TWI, and interaction effects). Possible mechanisms include lateral downslope lessivage and K leaching. Terrain attributes can aid in soil K fertility evaluations on the Cincinnati catena because they relate well to soil K fertility measurements.

T-cell immunoglobulin- and mucin-domain-containing molecule-3 (Tim-3) was the first, and is presently the only, surface molecule that can specifically identify TH1 cells in both mice and humans. Engagement of Tim-3 by its ligand galectin-9 negatively regulates IFN-γ secretion and influences the ability to induce T cell tolerance in both mice and man. Numerous studies have demonstrated that Tim-3 influences autoimmune diseases, including diabetes and multiple sclerosis, and its role in other inflammatory diseases including allergies and cancer is beginning to become clear.

Using simian immunodeficiency virus (SIV) infection of rhesus macaques to model human immunodeficiency virus (HIV) infection of humans, we assessed whether broadly reactive vaccine-induced humoral immunity would remain broadly reactive after viral challenge, and whether there would be significant differences in anamnestic antibody responses if animals were challenged when predominately effector or memory lymphocyte populations were present. Animals immunized over a prolonged period and challenged 11 months after vaccination mounted more broadly reactive and stronger humoral immunity than those rapidly vaccinated and challenged 2 weeks after their final vaccinations. These data suggest that vaccination schedule and the timing of virus challenge should be considered when evaluating future candidate HIV vaccines.

Human immunodeficiency virus type 2 (HIV-2) evolved from the zoonotic transmission of simian immunodeficiency virus (SIV) that naturally infects sooty mangabeys found in West Africa. Using sera from HIV-2–infected humans, we discovered that an hypervariable region (the V4 loop) of HIV- 2 induces antibody responses only weakly reactive against itself but strongly reactive against analogous sequences from the V4 loop of strains of SIV. Available sequence data indicates that all strains of HIV-2 have large deletions in the V4 region that truncate an immunodominant neutralizing B cell epitope among strains of SIV. Infection of a macaque with a sequenced clone of HIV-2 similarly elicited antibodies that poorly recognized the V4 loop of HIV-2 but readily bound to analogous SIV sequences. Our data are consistent with a scenario whereby a disparate antibody response directed against the V4 loop may have influenced the selective expansion and survival of HIV-2 in humans.

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO), which plays an important role in natriuresis. We determined whether changes in endothelium-dependent vasodilation (EDD) and plasma ADMA predict changes in blood pressure (BP) after salt loading in normotensive postmenopausal women (PMW).

Original antigenic sin describes a phenomenon in which the antibody response elicited in an individual after a secondary viral infection reacts more strongly to the viral variant that originally infected the individual. As T helper cells play critical roles in promoting antibody responses, a similar phenomenon may hold true for T helper cell responses. This concept is particularly relevant to the development of vaccines against viruses such as human immunodeficiency virus and hepatitis C virus, in which myriad viral variants are present throughout the human population. We have compared the effects of priming the immune system with a single peptide epitope or with a cocktail of related peptides based on the epitope. Our data demonstrate that immunization with multiple peptide variants expands a more broadly reactive and durable T helper cell response than does immunization with a single peptide. This vaccine strategy may circumvent original antigenic sin.

The RAD50gene of Saccharomyces cerevisiaeis one of several genes required for recombinational repair of double-strand DNA breaks during vegetative growth and for initiation of meiotic recombination. Rad50 forms a complex with two other proteins, Mre11 and Xrs2, and this complex is involved in double-strand break formation and processing. Rad50 has limited sequence homology to the structural maintenance of chromosomes (SMC) family of proteins and shares the same domain structure as SMCs: N- and C-terminal globular domains separated by two long coiled-coils. However, a notable difference is the much smaller non-coil hinge region between the two coiled-coils. We report here a structural analysis of full-length S. cerevisiaeRad50, alone and in a complex with yeast Mre11 by electron microscopy. Our results confirm that yeast Rad50 does have the same antiparallel coiled-coil structure as SMC proteins, but with no detectable globular hinge domain. However, the molecule is still able to bend sharply in the middle to bring the two catalytic domains together, indicating that the small hinge domain is flexible. We also demonstrate that Mre11 binds as a dimer between the catalytic domains of Rad50, bringing the nuclease activities of Mre11 in close proximity to the ATPase and DNA binding activities of Rad50.

A previous study found high resting end tidal CO2(PetCO2) to be an independent determinant of systolic blood pressure in women, but not men. The present study investigates the association of PetCO2with the common carotid artery intima–media thickness (IMT) and wall-to-lumen (W/L) ratio in a sample of normotensive men and women.

Lameness is a significant cause of economic loss, premature culling, and loss of genetics in cow-calf operations. In recent years, attention to treatment and prevention of lameness has increased. Veterinarians must be aware of factors associated with lameness such as genetics, environment, and nutrition so that preventive measures can be instituted in consultation with rancher.

Digital diseases are commonly seen in cattle. Cattle affected by digital disorders do not always respond to conservative therapy and require surgery. Surgical procedures for the common digital disorders are described, with emphasis on the different approaches to the distal interphalangeal joint.

Veterinarians are often asked to examine cattle for lameness. A good history, observation of stance and stride, and physical examination are critical to the diagnosis of lameness in cattle. Methods of examination, including observation of the animal at a distance and during movement, are described. Lameness grading systems and ancillary diagnostic tests are also discussed.

A detailed knowledge of anatomy is essential to understand the various pathologic processes and to perform different surgical techniques involving the limbs of cattle. This article reviews macroscopic anatomy of the distal limb, muscle-tendon units, neurovascular anatomy, and external and microanatomy of the claw.

The minimally invasive nature of laparoscopic techniques and shorter convalescent periods have made these techniques increasingly popular for use in New World camelids (llamas and alpacas). This article outlines the instruments and steps needed to perform laparoscopic surgery on the female reproductive tract in llamas and alpacas.

To compare synovial fluid characteristics of cattle with infectious and noninfectious arthritis.Retrospective cohort study.130 cattle.Synovial fluid was analyzed for total nucleated cell count (NCC), absolute number and percentages of polymorphonuclear (PMN) and mononuclear cells, total protein (TP) concentration, and specific gravity. Cattle were categorized as having infectious or noninfectious arthritis based on physical and lameness examinations, joint radiographs, and microbial culture results. Kruskal-Wallis 1-way analysis of variance was used to compare synovial fluid analysis data from different categories. Selection of cut-off values for the calculation of likelihood ratios, sensitivity, specificity, and positive and negative predictive values was based on examination of the distribution of the data using histograms.Cattle with infectious arthritis had significantly higher numbers of total NNC, PMN cells, TP concentration, and specific gravity ( P= .0001 ) and a significantly higher percentage of PMN cells compared with cattle with noninfectious arthritis ( P= .0001 ). The percentage of mononuclear cells was significantly higher in cattle with noninfectious arthritis ( P= .0001 ). Synovial fluid analysis is useful for differentiation of infectious and noninfectious causes of joint disease in cattle.Cattle with a synovial fluid total NCC > 25,000 cells/μL, a PMN cell count > 20,000 cells/μL or more than 80% PMN cells, and TP > 4.5g/dL should be considered to have infectious arthritis.