Faculty Bibliography

Kuschyk, whose main research field is sudden death, said his interest in roller coasters began when a journalist asked about the dangers of coasters to the heart. When Kuschyk searched databases, he found no studies in scientific journals. One potential danger is a coaster's magnetic brakes, which can interfere with the function of pacemakers and defibrillators, Kuschyk said. The study, conducted in Hassloch, Germany, involved 55 adults and Expedition GeForce, a 120-second ride that starts with a 62-meter, or 203-foot, ascent followed by a free fall. The coaster has changes in gravity of six G's in four seconds, and a maximum speed of 120 kilometers an hour, or 75 miles an hour. The author, Dr. Jurgen Kuschyk, a cardiologist at the University of Mannheim, found that one participant's heart rate reached 200 beats a minute, which could cause dangerous rhythm abnormalities

In the first controlled study of the effects of pet therapy in a random sample of acute and critically ill heart patients, anxiety as measured on a standard rating scale dropped 24 percent for those visited by a dog and a human volunteer, by 10 percent for those visited by a volunteer alone and not at all for those with no visitors. Similar results were found in measures of heart and lung function. All participants were screened for heart disease before the experiment, and their heart rates were monitored throughout the ride. Heart rates appeared to rise more from psychological stress and fear at the beginning of the ride, rather than from the increased G force, Dr. [Jurgen Kuschyk] said. After the ride, about half the participants had abnormal heartbeats even though their heart rates had returned to a normal range. One potential danger is a coaster's magnetic brakes, which can interfere with the function of pacemakers and defibrillators, Dr. Kuschyk said. He said he knew of one heart-related roller coaster death, a man in Germany who was initially resuscitated but died three days later

Dr. [Catherine J. Ryan] studied 12 common symptoms: chest discomfort; shoulder, arm, or hand discomfort; neck or jaw discomfort; back discomfort; abdominal discomfort; indigestion; nausea and vomiting; shortness of breath; sweating; dizziness and light-headedness; weakness; and fatigue. According to her analysis, using standard statistical techniques, people with the shortest delay time, a mean of 9.78 hours, had a greater probability of experiencing the largest number of symptoms. People with the longest delay time, a mean of 22.77 hours, had a moderate probability of experiencing chest pain and shortness of breath. Sweating emerged as an important factor, Dr. Ryan said

Among those affected by the delay is Dr. Gerberding's mother, Bette Gerberding, of Brookings, S.D., who asked her daughter if she should go to a neighboring state to get a flu shot, Dr. Gerberding said. Because there is no influenza outbreak in Brookings, and Mrs. Gerberding's doctor expects a shipment by the end of the month, Dr. Gerberding said she advised her mother, ''Just wait and make your appointment so that you can get it when it's available.'' President Bush's proposal to spend $7.1 billion for a possible influenza pandemic will help manufacturers expand capacity and prevent shortages for regular influenza in the long run, Dr. Gerberding said

The gonorrhea rates began soaring in the late 1960s and peaked in the '70s because of changes in sexual mores and behavior, wide use of oral contraceptives, and decreased use of condoms, said [Ronald O. Valdiserri] and Dr. John M. Douglas, who directs STD prevention at the disease centers in Atlanta. The rates dropped in the 1980s as health officials stepped up control measures. Still, Douglas said, the 330,132 gonorrhea cases reported in 2004 are believed to be less than half the 700,000 cases estimated to have occurred that year

''There's definitely a resource challenge,'' said Dr. Ronald O. Valdiserri, acting director of the AIDS and S.T.D. prevention unit at the disease centers. ''We certainly hear from state and local health departments that they do not always have the resources they require to address all the S.T.D. issues that they need to address.'' The gonorrhea rates began soaring in the late 1960's and peaked in the 1970's because of changes in sexual mores and behavior, wide use of oral contraceptives, and decreased use of condoms, said Dr. Valdiserri and Dr. John M. Douglas, who directs S.T.D. prevention at the disease centers in Atlanta. The rates dropped in the 1980's as health officials stepped up control measures. Still, Dr. Douglas said, the 330,132 gonorrhea cases reported in 2004 are believed to be less than half the 700,000 cases estimated to have occurred that year. Rates for early-stage syphilis, which reached an all-time low in 2000, have increased for four straight years to 2.7 cases per 100,000 people in 2004. The rise is largely due to increases in early syphilis infections among gay men, to 4.7 cases per 100,000 from 2.6 cases in 2000, the disease centers said

Activation of melanocortin-4-receptors (MC4Rs) reduces body fat stores by decreasing food intake and increasing energy expenditure. MC4Rs are expressed in multiple CNS sites, any number of which could mediate these effects. To identify the functionally relevant sites of MC4R expression, we generated a loxP-modified, null Mc4r allele (loxTB Mc4r) that can be reactivated by Cre-recombinase. Mice homozygous for the loxTB Mc4r allele do not express MC4Rs and are markedly obese. Restoration of MC4R expression in the paraventricular hypothalamus (PVH) and a subpopulation of amygdala neurons, using Sim1-Cre transgenic mice, prevented 60% of the obesity. Of note, increased food intake, typical of Mc4r null mice, was completely rescued while reduced energy expenditure was unaffected. These findings demonstrate that MC4Rs in the PVH and/or the amygdala control food intake but that MC4Rs elsewhere control energy expenditure. Disassociation of food intake and energy expenditure reveals unexpected divergence in melanocortin pathways controlling energy balance.

Scarce supplies of the antiviral drug Tamiflu might be extended as much as 100 percent by using it in combination with a second drug in the event of a pandemic of influenza, the journal Nature reported

CONTEXT/BACKGROUND:The effects of cortisol are mediated by the alpha-isoform of the glucocorticoid receptor (GR). GR-alpha levels and activity are modulated by alternative splicing of the common pre-mRNA into mRNAs for the GR-beta and GR-P isoforms. OBJECTIVE:The objective of this study was to investigate whether chronic hypercortisolism, chronic hypocortisolism, or acute, relative hypocortisolism influences the expression levels of the GR splice variants in mononuclear leukocytes. DESIGN/METHODS:This was a case-control study. SETTING/METHODS:The study was performed at a university hospital. PARTICIPANTS/METHODS:Eighteen patients with Cushing's syndrome, five patients with hypocortisolemia, seven patients undergoing metyrapone testing, and 14 controls were studied. MAIN OUTCOME MEASURES/METHODS:The main outcome measures were mRNA levels, GR affinity, and number per cell. RESULTS:All three GR mRNA isoforms were detected in participants from all groups at relative levels of alpha/P/beta = 1:0.25:0.001. There was a significant correlation between the expression levels of the three splice variants and between the mRNA levels and the number of receptors per cell. The GR in Cushing patients had an increased Kd (P < 0.05) preoperatively. GR number was not significantly different. Postoperatively, the Kd decreased. GR-beta mRNA expression was increased compared with controls (P < 0.05) and was decreased after surgery (P < 0.05). In patients with chronic hypocortisolism, GR-alpha mRNA expression was increased, and receptor numbers were increased (P < 0.05), whereas GR affinity was normal. No changes were observed in patients undergoing a metyrapone test. CONCLUSIONS:Cushing's syndrome is accompanied by a reversible decrease in GR affinity, possibly related to an increased GR-beta expression, which may be a compensatory mechanism to GC excess. In chronic hypocortisolism, adaptive changes in GR status seem to occur at the level of GR number.

Surgical repair of recurrent postmyocardial infarction septal defect is associated with a high mortality rate. We present 2 patients whose recurrent defects were closed percutaneously using an Amplatzer device