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In 30 years of follow-up of 5,209 participants in the Framingham Study, 193 men and 183 women developed atrial fibrillation (AF). Among this group, "lone" AF occurred in 32 men and 11 women free of coronary heart disease, congestive heart failure, rheumatic heart disease, and hypertensive cardiovascular disease. To determine the characteristics and prognosis of lone AF, each case was matched to controls in the remaining Framingham sample. Comparisons indicated that levels of several risk factors associated with coronary heart disease were similar between the two groups. Atrial fibrillation cases, however, had significantly higher rates of preexisting nonspecific T- or ST-wave abnormalities and intraventricular block as determined by electrocardiograms. Follow-up for new cardiovascular events indicated similar rates of coronary heart disease and congestive heart failure, but the rate of strokes was significantly greater in the lone AF group. Findings suggest that subjects with lone AF, despite similar cardiovascular risk profiles to normal controls, have a distinct preponderance of preexisting electrocardiographic abnormalities. Furthermore, contrary to general belief, lone AF is not a benign condition; it has a serious prognosis, indicating a greater need for detection and treatment.(JAMA 1985;254:3449-3453)

The epidemiology of varicose veins was examined in 3,822 adults in the Framingham Study. Findings indicate that the incidence of varicose veins is higher among women than men, with no clear age differences. Compared to women without varicose veins, women with varicose veins were more often obese (p < .01), had lower levels of physical activity (p < .001) and higher systolic blood pressure (p < .001), and were older at menopause (p < .001). Women who reported spending eight or more hours in an average day in sedentary activities (sitting or standing) also had a significantly higher incidence of varicose veins than those who spent four or fewer hours a day in such activities (p < .05). For men, varicose veins coexisted with lower levels of physical activity (p < .05) and higher smoking rates (p < .05). While men and women with varicose veins had a higher incidence of atherosclerotic cardiovascular disease than those without varicose veins, only the excess risk of coronary heart disease in women was statistically significant (p < .05). However, this finding was not significant after controlling for body mass and systolic blood pressure. These results suggest that increased physical activity and weight control may help prevent varicose veins among adults at high risk, and reduce the overall risk of atherosclerotic cardiovascular disease as well.

We treated 60 patients with cisplatin-based combination chemotherapy before definitive surgery and/or radiation. All had squamous cell tumors of the head and neck, stages II to IV, M0. Twelve patients (20%) achieved a complete remission after chemotherapy. Eight of these patients showed no histologic evidence of residual disease after biopsy or surgery. Definitive local therapy with surgery and/or radiation was carried out on almost all patients regardless of the extent of the response to preceding chemotherapy. Chemotherapy-induced complete responders have had an improved survival rate in comparison with patients achieving a partial response or less. The extent of primary tumor correlates inversely with a complete response to chemotherapy.

The prevalence and predisposing conditions for primary and secondary Raynaud's phenomenon (RP) were examined in The Framingham Study based on 16 years of follow-up of a cohort of 4182 men and women. The association with atypical chest pain and migraine headache was also investigated.Over the 16 years of follow-up there were 130 men and 171 women who developed primary RP. The prevalence in women (9.6%) was somewhat higher than in men (8.1%) and 81.4% of the RP was primary. Secondary RP was equally prevalent in men (18.6%) and women (19.7%). The most common causes of secondary RP were beta-blocker use (34.2%), carpal tunnel syndrome (10.5%) and rheumatoid arthritis (7.2%).Primary RP cases differed from noncases by having lower systolic blood pressure (p≤ 0.001) and diastolic blood pressure (p< 0.0001), and more coronary disease (p= 0.009), smoking (p≤ 0.01) and higher blood sugars (p≤ 0.009).Atypical chest pain was present more often than noted previously in The Framingham Study general population survey, and was equally prevalent in primary and secondary RP and in the two sexes. Associated migraine was more prevalent in women (14.4%) than men (5.0%). Vibrating tool use with associated RP occurred in 14.6%.

While no unanimity of opinion exists regarding the risk to physical health from smoking marihuana, we have seen four cases that demonstrate clearly that intravenous usage is hazardous. The severity of the multisystemic involvement is dose-related. On initial examination, signs of most severe overdosage included fulminant gastroenteritis, hypoalbuminemia, toxic hepatitis confirmed by serial biopsy, acute renal failure, electrolyte disturbances, leukocytosis, anemia, and a relative thrombocytopenia. In three patients who shared a common needle, gingivostomatitis also developed.(JAMA 233:351-354, 1975)

We treated 60 patients with cisplatin-based combination chemotherapy before definitive surgery and/or radiation. All had squamous cell tumors of the head and neck, stages II to IV, M0. Twelve patients (20%) achieved a complete remission after chemotherapy. Eight of these patients showed no histologic evidence of residual disease after biopsy or surgery. Definitive local therapy with surgery and/or radiation was carried out on almost all patients regardless of the extent of the response to preceding chemotherapy. Chemotherapy-induced complete responders have had an improved survival rate in comparison with patients achieving a partial response or less. The extent of primary tumor correlates inversely with a complete response to chemotherapy.

A group of 75 institutionalized elderly patients was studied to determine the relationship of involuntary relocation to life adjustment in a nursing home. Data were collected by means of medical records and structured questionnaire. Patients who had experienced enforced relocation from other institutions expressed greater life dissatisfaction than those who had relocated voluntarily from their own home environment. For the group in general, life dissatisfaction was correlated with financial dependence, poor health, and limited social participation. Length of stay in the institution was not related to life satisfaction. The evidence suggests that involuntary placement, multiple moves, disruption of social networks, and financial dependence may contribute to life dissatisfaction among institutionalized elderly.

One hundred and fourteen chronically-ill patients six months after discharge from a general hospital revealed a high readmission rate (34.2%), a high utilization of hospital services, out-patient clinics, and family practitioners reflecting the problem of chronically-ill old people. The study of compliance with physician's recommendations showed that 42.1% of all patients interviewed did not comply with one or more recommendations. The reasons for not complying with the orders were related to the deficiencies of community health and social agencies, the patient's attitude or understanding of the instructions, the cost of drugs, and other factors. The lack of compliance was associated with marital status, education, income, and severity of disease.

Uric acid values were obtained on subjects of the original Framingham cohort at their fourth and 13th biennial examinations. The mean uric acid value for men was 5.0 mg/dl at the fourth examination and 5.7 mg/dl at examination 13 and was 3.9 mg/dl and 4.7 mg/dl, respectively, for women. This secular trend was due to both "laboratory drift" and increasing use of diuretics. Serum uric acid values were consistently higher in subjects of both sexes who were taking antihypertensive drugs at both examinations. Serum uric acid values correlated with systolic and diastolic blood pressure in both sexes; the relationship was stronger in women than in men and for systolic than for diastolic pressure. Correlations were stronger at examination 4 than at examination 13 when more antihypertensive treatment was used. Examination 4 serum uric acid predicted the subsequent development of coronary heart disease, in general, and myocardial infarction, in particular, but not angina pectoris. The uric acid relationship with myocardial infarction was equally strong in both sexes, even correcting for antihypertensive treatment. However, in multivariate analysis, including age, systolic blood pressure, relative weight, cigarette smoking, and serum cholesterol, serum uric acid did not add independently to the prediction of coronary heart disease.

The genes encoding the photosynthetic cytochrome b6 (petB) and subunit 4 (petD) have been cloned and sequenced from the unicellular, photoheterotrophic, transformable cyanobacterium Synechococcus sp. PCC 7002, formerly designated Agmenellum quadruplicatum. The gene arrangement was found to be similar to that reported in the cyanobacterium Nostoc PCC 7906. The DNA and derived protein sequences were compared to chloroplast and the other cyanobacterial sequences. By pulsed-field electrophoresis, the petBD operon and the petCA operon, encoding the Rieske iron-sulfur protein and cytochrome f, were found to be located on separate, unlinked,Not I-digested DNA fragments. ThepetBD operon was found on the third largest Not I fragment (NC-325) while the petCA operon was found on the second largest Not I fragment (NB-370). These results suggest the two operons are not in proximity. The 1.35 kb transcript was shown to be light-regulated. Transcripts from cells grown under constant illumination showed a decrease in petB transcript levels to undetectable levels within 2 h after the cells were placed in the dark. Upon reillumination, transcript levels rose to three-fold over that seen initially under constant illumination.

A new TL extremity dosimetry system optimised for routine personnel monitoring is presented. It was developed at GSF, based on several GSF patents, and consists of a flexible plastic strip type detector holder with permanent ID code containing the phosphor and a PC controlled standard TL reader. The holder is prepared for single use and designed as a finger ring of adjustable size. It is comfortable to wear even under surgical gloves, water and solvent proof, heat resistant up to autoclave temperatures and can be used with all common TL detectors, limited only by their size. Each phosphor is labelled with an automated readable permanent ID code using a newly developed technique for direct inscription of TL crystals, to allow an individual calibration before application. The software controlling the TL reader includes a computerised glow curve deconvolution (CGCD) algorithm for data analysis and a database system. The CGCD algorithm replaces all annealing procedures in additional furnaces and saves up to 65% processing time at the GSF personnel monitoring service, when using LiF:Mg,Ti (TLD-100) TL detectors. The modular system design gives the possibility of modifying all equipment parts, e.g. detector holder, phosphor or TL reader, for the combined use with components from TL systems commonly used at monitoring services. The extremity dosemeter is type tested by the Physikalisch Technische Bundesanstalt (PTB) and is in routine use at the official personnel monitoring service of GSF.