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In the previous article (Vol 8(6): 387-93) the background information and study aims/limitations of the Dementia Information and Advice Lines (DIAL-log) project were outlined. This article introduces the main findings of the project and suggests that the transition into dementia is experienced through rising degrees of uncertainty and anxiety. People with the early experience of dementia also requested strategies for coping with memory loss and uncertainty over the meaning and purpose of memory testing. Building on the main findings of the project, the article concludes with a five-stage framework to help shape future research and service support.

Between July 1996 and December 1997 telephone helpline staff from the Alzheimer's Disease Society (ADS) in London, and six participating ADS regions in England and one in Northern Ireland, documented calls from people with dementia who contacted the service. Each call was recorded as soon as practicable after its completion on a Dementia Information and Advice Line (DIAL) log form (DIAL-log). Sixty-four calls were recorded in this way and 62 completed DIAL-logs were included in the study findings. Analysis of the data was undertaken via SPSS 6.1 for Windows. This article, the first of two, introduces the background to the study and notes that callers reported memory loss and forgetfulness as the most frequently noticed first signs of dementia. The study aims and limitations are also outlined in this first article. The second article will detail the main findings and the challenges that the DIAL-log study may provide for future dementia care practice and research.

Purpose: To describe the expectations of those seeking presymptomatic gene testing for Huntington disease (HD). Identification of the gene for HD makes it possible to conduct testing to determine if a healthy person with a family history of HD has a mutation in this gene. Presymptomatic gene testing reveals the likelihood that a person will develop an inherited disease in the future. Understanding expectations allows for more complete assessment and counseling before presymptomatic gene testing for genetic diseases., Design: Descriptive qualitative. The population was people with a family history of HD. The sample was 17 asymptomatic adults with a positive family history of HD who requested presymptomatic gene identification at one tertiary genetic counseling program, 1995 to 1996., Methods: Semi-structured interviews concerning expectations of adults seeking presymptomatic genetic testing were conducted by telephone. Interviews occurred after the individuals had requested presymptomatic gene identification but before results were reported. Content analysis was used to identify the expectations and questions of those who had decided to seek presymptomatic testing., Findings: Common expectations included anticipating relief from uncertainty, hoping to plan for their future health care and life decisions, wanting to know if their children were at risk of developing HD, anticipating loss of family support from relatives, expecting relief from self monitoring, venturing into the unknown, and planning for disclosure. Participants attempted to avoid their loss of genetic privacy by withholding the decision to seek testing from their primary care providers., Conclusions: Participants seeking presymptomatic HD gene testing consider the effect of gene identification on themselves and their families. A desire to limit insurance or employment discrimination contributes to subjects not seeking input from health care providers in their decision making.

Controlling a child's eating habits is counterproductive. By allowing children to make decisions about what and how much to eat, parents empower children to self-regulate their eating. The parent's role is to offer a variety of healthful foods, oversee the planning and assembly of meals, and set the schedule for meals and snacks. The child's responsibility is to decide what, how much, and even whether to eat.

One hundred twenty-four Papanicolaou smears were studied to compare the yield of endocervical cells obtained with the Cytobrush/Ayre spatula method to that of the cotton-tipped applicator/Ayre spatula method. Forty-nine of the 62 Pap smears (79%) obtained with the combination Cytobrush/Ayre spatula method contained endocervical cells, compared to 22 of the 62 smears (35%) obtained with the cotton swab/Ayre spatula method (chi 2 = 24.02, P less than 0.0001). The Cytobrush/Ayre spatula method obtained endocervical cells in 14 of 17 (82.4%) of the patients with stenotic ora, compared to 0 of 12 (0%) patients for the cotton swab/Ayre spatula method (P less than 0.001). The Cytobrush/Ayre spatula method obtained endocervical cells in 8 of 11 (72.7%) postmenopausal patients, compared to 4 of 14 (28.6%) patients for the cotton swab/Ayre spatula method (P = 0.05). Using the cervical Cytobrush for Pap smears increases the recovery rate of endocervical cells, which may improve the detection of cervical dysplasia in the patient population as a whole, in postmenopausal women, and in women with stenotic cervical ora.

Plasma free epinephrine, norepinephrine, and dopamine concentrations were determined in 48, 63, and 45 patients, respectively, with overt congestive heart failure, and compared with those in 26 patients with stable angina but without heart failure. Systemic hemodynamic values were determined to assess the severity of heart failure. Arterial epinephrine levels were not different between patients with heart failure (73 +/- 92 pg/ml) and patients without heart failure (55 +/- 73 pg/ml). In patients with congestive heart failure, norepinephrine (665 +/- 510 pg/ml, mean +/- SD) and dopamine (407 +/- 405 pg/ml) levels were significantly higher than in patients with stable angina without heart failure (norepinephrine 184 +/- 136 pg/ml, p less than 0.001, and dopamine 197 +/- 259 pg/ml, p less than 0.02). However, in patients with congestive heart failure, the plasma norepinephrine levels did not correlate with cardiac index (r = 0.21, p = NS), pulmonary capillary wedge pressure (r = 0.11, p = NS), mean arterial pressure (r = 0.11, p = NS), or systemic vascular resistance (r = 0.18, p = NS). Similarly, there was no correlation between dopamine levels and the hemodynamic abnormalities in patients with congestive heart failure. These findings suggest that although endogenous norepinephrine and dopamine levels are frequently elevated in patients with heart failure, reflecting enhanced sympathetic activity, catecholamine levels do not reflect the severity of heart failure.

We have applied free flow electrophoresis to separate the canalicular and basolateral (sinusoidal and lateral) domains of rat hepatocyte plasma membranes. Hepatocyte plasma membranes were prepurified by rat zonal and discontinous sucrose gradient centrifugation. In electrophoretic separation, the canalicular membranes were more deflected toward the anode than the basolateral membranes. Na+-dependent taurocholate uptake could be measured in both membrane fractions, transport activity being highest in fractions containing the highest specific activity in the basolateral marker enzyme Na+-K+-ATPase. Thus, differences in electrophoretic mobility permit the separation of functional intact plasma membrane vesicles derived from basolateral and canalicular plasma membrane domains of rat hepatocyte.

The effect of two parameters regulating renal phosphate excretion, namely parathyroid hormone application and dietary phosphate intake, on the transport properties of isolated rat renal brush border membrane vesicles was investigated. In the first set of experiments brush border membrane vesicles from young normal rats injected i.m. with 30 USP parathyroid hormone or i.v. with 1 mg dibutyryl cAMP were compared. PTH and dbcAMP injection decreased specifically the Vmax of the sodium-dependent phosphate transport system by appr. 30%. In a second set of experiments rats were kept on phosphate-rich and phosphate-poor diet and after 6-8 weeks the brush border membranes were isolated. The membranes obtained from phosphate-depleted animals showed a markedly (approximately 100%) higher initial sodium-dependent phosphate uptake than membranes isolated from animals kept on phosphate-rich diet. Again only the sodium-dependent phosphate uptake was affected, sodium-independent phosphate permeability, sodium-dependent D-glucose transport, mannitol permeability and sodium permeability remained unchanged.

The selective demonstration of ATP dependent calcium uptake and calcium dependent phosphorylation of a 135 kD intermediate in isolated basolateral liver plasma membrane vesicles suggest that the basolateral plasma membrane of rat hepatocytes contains an ATP dependent calcium transport system with an apparent molecular weight of 135,000. The failure to demonstrate ATP dependent calcium uptake in simultaneously isolated canalicular plasma membrane vesicles suggests the absence of a similar ATP dependent calcium transport system on the canalicular domain. Additional phosphoproteins of 200 and 110 kD could be assigned to microsomal contamination of the isolated plasma membrane subfractions. A canalicular specific 70 kD phosphorylated intermediate presumably does not represent a Ca++ ATPase. Calcium dependent phosphorylation of the basolateral 135 kD intermediate is maximal at physiologic pH (7.0, 7.5), when the calcium pump is active but not at pH 8.0. The 135 kD phosphoprotein has also been shown for erythrocyte Ca++ ATPase and for kidney basolateral Ca++ ATPase (De Smedt et al., 1984; Niggli et al., 1979).

ATP-dependent Ca2+ uptake was measured in vesicles of rat liver cell basolateral plasma membranes. Nucleotide-dependent uptake was specific for ATP and observed at pH 7.0 and 7.4/7.5 but not at pH 8.0. ATP-dependent Ca2+ transport was only observed in the presence of Mg2+. Kinetic analysis of ATP-dependent transport revealed an apparent Km in the submicromolar region. Addition of calmodulin and trifluoperazine had no effect on ATP-dependent uptake. A Ca2+-dependent, phosphorylated intermediate with the apparent molecular weight of 135,000 could be demonstrated in the basolateral plasma membranes. Phosphorylated intermediates with apparent molecular weights of 200,000 and 110,000 were demonstrated in microsomes and appeared to contaminate 'basolateral' membrane protein phosphorylation. The results suggest that a 135,000 molecular weight protein is a Ca2+-ATPase and the enzymatic expression of the liver cell basolateral membrane Ca2+ pump.

In this study, 152 Papanicolaou-stained pulmonary cytologic smears from 15 known cases of pulmonary fungal infection were randomly mixed with 194 control pulmonary smears. All slides were examined for fungi by three observers, first by light microscopy and then by fluorescent microscopy. The results of the light and fluorescent microscopy were compared. It was concluded that when both methods were used for fungal detection, the yield of positive results was higher.

This study was designed to measure and evaluate the dietary intake and symptoms of anorexia nervosa in female university dancers (no. = 21) and a control group of female university non-dancers (no. = 29). Three-day food records were analyzed for calories, protein, vitamin A, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, and iron. Symptoms of anorexia nervosa were determined through the use of an objective questionnaire, the Eating Attitudes Test (EAT). The percent of subjects who consumed less than two-thirds of the Recommended Dietary Allowance (RDA) for energy was significantly higher in the dance group (28.6% vs. 10.3%, p less than .005). Seventy percent of the total study population consumed less than two-thirds of the RDA for at least one nutrient, and 24% consumed less than two-thirds of the RDA for three or more nutrients. Thirty-three percent of the dancers and 13.8% of the controls scored in the range symptomatic of anorexia nervosa on the EAT, a difference that was statistically significant (p less than .005). The results indicate that both female university dancers and female university students may be at risk for nutrient deficiency and anorexia nervosa.

The interaction of acetylcholine (ACh) and d-tubocurarine (dTC) on the membrane potential of end-plate free parts of rat diaphragm muscle fibres was studied using a conventional microelectrode technique. ACh only caused membrane depolarizations when the external chloride concentration was diminished. Therefore, all experiments were performed in a 40 mM Cl- containing medium. A bell-shaped log-dose response curve was obtained with ACh. Maximal depolarization occurred at 3.10(-4) M. The pD2 value for ACh was calculated to be 4.2. The log-dose response curve was shifted to the right in the presence of dTC; besides, the maximum seemed to be depressed. The pA2 values for dTC appeared to be 4.9. It was concluded from these data that the cholinergic receptors outside the end-plate region have binding properties, which differ considerably from those of end-plate or postdenervational receptors.

The effect of carbachol (10(-3)M) on the membrane potential of rat diaphragm muscle fibres near and remote from the endplate has been investigated by means of a microelectrode technique. In the endplate region a rather slow depolarization was observed followed by spontaneous repolarization. Outside the endplate region similar, but smaller, responses could be measured. In a muscle part separated from the endplate zone, carbachol had no depolarizing effect. Inhibition of the sodium pump by ouabain (10(-4)M) or potassium-free medium not changing the membrane potential itself, allowed carbachol to exert a depolarizing effect on this endplate-free membrane, while in endplate-free regions continuous with the endplate-zone the depolarizations already observed were enhanced. In low chloride solutions carbachol also had a depolarizing effect on endplate-free muscle membrane. It is concluded from these experiments that a direct effect of cholinergic drugs on endplate-free muscle membrane of rat diaphragm is counteracted by the sodium pump in combination with passive chloride movements. The results are discussed in the context of known receptor densities and chloride effects.