The fine and ultra fine size of diesel particulate mater (DPM) are of great health concern and significantly contribute to the overall cancer risk. In addition, diesel particles may contribute a warming effect on the planet's climate. The composition of these particles is composed principally of elemental carbon (EC) with adsorbed organic compounds, sulfate, nitrate, ammonia, metals, and other trace elements. The purpose of this study was to depict the seasonality and modeling of particulate matter in the Southeastern US produced by the diesel fueled sources (DFSs). The modeling results came from four one-month cases including March, June, September, and December to represent different seasons in 2003 by linking Models-3/CMAQ and SMOKE. The 1999 National Emissions Inventory Version 3 (NEI99) was used in this analysis for point, area, and non-road sources, whereas the National Mobile Inventory Model (NMIM) was used to create the on-road emissions. Three urban areas, Atlanta, Birmingham, and Nashville were selected to analyze the DPM emissions and concentrations. Even though the model performance was not very strong, it could be considered satisfactory to conduct seasonal distribution analysis for DPM. Important hourly DPM seasonality was observed in each city, of which higher values occurred at the morning traffic rush hours. The EC contributions of primary DPM were similar for all three sites (~74%). The results showed that there is no significant daily seasonality of DPM contribution to PM 2.5 for any of these three cities in 2003. The annual DPM contribution to total PM 2.5 for Atlanta, Nashville, and Birmingham were 3.7%, 2.5%, and 2.2%, respectively.

The potential health impact of ambient ozone and PM 2.5 concentrations modulated by climate change over the United States is investigated using combined atmospheric and health modeling. Regional air quality modeling for 2001 and 2050 was conducted using CMAQ Modeling System with meteorology from the GISS Global Climate Model, downscaled regionally using MM5, keeping boundary conditions of air pollutants, emission sources, population, activity levels, and pollution controls constant. BenMap was employed to estimate the air pollution health outcomes at the county, state, and national level for 2050 caused by the effect of meteorology on future ozone and PM 2.5 concentrations. The changes in calculated annual mean PM 2.5 concentrations show a relatively modest change with positive and negative responses (increasing PM 2.5 levels across the northeastern U.S.) although average ozone levels slightly decrease across the northern sections of the U.S., and increase across the southern tier. Results suggest that climate change driven air quality-related health effects will be adversely affected in more than 2/3 of the continental U.S. Changes in health effects induced by PM 2.5 dominate compared to those caused by ozone. PM 2.5 -induced premature mortality is about 15 times higher than that due to ozone. Nationally the analysis suggests approximately 4000 additional annual premature deaths due to climate change impacts on PM 2.5 vs 300 due to climate change-induced ozone changes. However, the impacts vary spatially. Increased premature mortality due to elevated ozone concentrations will be offset by lower mortality from reductions in PM 2.5 in 11 states. Uncertainties related to different emissions projections used to simulate future climate, and the uncertainties forecasting the meteorology, are large although there are potentially important unaddressed uncertainties (e.g., downscaling, speciation, interaction, exposure, and concentration-response function of the human health studies).

The relative contributions of PM 2.5 and ozone precursor emissions to air pollution-related premature mortality modulated by climate change are estimated for the U.S. using sensitivities of air pollutants to precursor emissions and health outcomes for 2001 and 2050. Result suggests that states with high emission rates and significant premature mortality increases induced by PM 2.5 will substantially benefit in the future from SO 2 , anthropogenic NO X and NH 3 emissions reductions while states with premature mortality increases induced by O 3 will benefit mainly from anthropogenic NO X emissions reduction. Much of the increase in premature mortality expected from climate changeinduced pollutant increases can be offset by targeting a specific precursor emission in most states based on the modeling approach followed here.

A sensitive and specific radioenzymatic norepinephrine (NE) assay based on the conversion of norepinephrine to tritiated epinephrine has been modified for myocardial needle biopsy specimens. The tritiated epinephrine is quantitated by scintillation counting of similarly processed standards and specimens and is reported as micrograms of NE per gram of wet tissue. Norepinephrine levels have been determined in 5-to 30-mg samples of canine left ventricular free wall, ventricular apex, and right ventricular free wall and of rat right and left ventricles. The technique is compared to other previous spectrofluorometric methods.

Thirty-minute perfusion of isolated rabbit lungs with a Krebs-Ringer bicarbonate buffer containing 420 @f paraquat (PQ) or nitrofurantoin (NF) resulted in increases in lung oxidized glutathione (GSSG) content of 589 and 2656%, respectively, over control levels. The degree of glutathione efflux was also increased with both agents, i.e. 77 and 238% above control leakage for PQ and NF respectively. The pulmonary toxicity of both compounds is known to be heightened by conditions of hyperoxia(O2). Ventilation of lungs with 95% Or-5% CO2 did not, in itself, significantly alter glutathione efflux, GSH or GSSG levels. However, ventilation with 95% 0r5% CO* increased lung GSSG levels in PQ-perfused lungs 225% over PQ-air-perfused lungs, a combined effect not observed with NF-02, wherein mean GSSG levels were only 72% of that observed with NF-air. Glutathione efflux in PQ-OZ-treated lungs declined somewhat (20%) compared to that observed with PQ-air, but a significant increase in the amount of glutathione efflux was seen with NF-Or-treated lungs, i.e. 120 and 310%, respectively, over that attributable to NF or O2 alone. Although the biochemical mechanisms of toxicity of these compounds are thought to be very similar, the disparate degree of GSH oxidation observed with equimolar levels of PQ and NF may indicate differences in reactivity towards glutathione and other lung s~~ydryl pools. The stim~ation of the oxidative effects of PQ and NF on lung GSH due to hyperoxic ventilation may be related to the reported 02 enhancement of their toxicity.

Assisted circulation by extracorporeal and extracardiac bypass techniques must be based on the requirements of the heart and of the total body, though these may differ. The cardiac problem in cardiogenic shock is more likely to be a biventricular problem demanding decom- ...

Paraquat (PQ) was administered to rats for 7 days by iv infusion from osmotic minipump at dosage rates of 250 and 500 nmol PQ/hr. The efficacy of putrescine in attenuating pulmonary PQ accumulation in vivo and the resulting PQ-induced biochemical changes and lung injury were assessed in these animals by coinfusion of putrescine at rates of 2500 or 5000 nmol/hr. Dose-dependent, steady-state blood levels of both PQ and putrescine were achieved by 18 hr and maintained throughout the in&ion period. Lung PQ content at 7 days was dose-dependent and up to 1 I-fold greater than corresponding blood levels. No evidence of toxicity was observed in low-dose PQ animals while weight loss and overt toxicity was ob served in high-dose PQ rats between Days 4 and 5. Histopathological examination of highdose PQ rat lungs revealed qualitative changes typical of PQ toxicity. Significant (p < 0.05) increases in lung glutathione and activities of glucos&-phosphate dehydrogenase and GSSG reductase resulted from both PQ doses, reflecting PC&induced oxidant stress and increased demand on lung NADPH. A net decrease in lung NADPH (p < 0.05) was directly measured in high-dose PQ rats and may have contributed to the PQ-induced lung injury. Although putrescine is an effective inhibitor of pulmonary PQ uptake in vitro, the blood putrescine levels achieved in this study did not appear to inhibit this process in vivo. This was evidenced by putrescine's failure to decrease 7-day lung PQ content, PQ-induced biochemical changes, or lung injury. 8 1988 ~ademic Prcs, Inc.

Twenty-one 8-14 kg adult male stumptailed macaques, Mucuca arctoides, were fed a standard laboratory diet and divided into 3 groups. The high-dose group and lowdose group were exposed to cigarette smoke at the human equivalent of 3 packs and 1 pack per day, respectively, 7 days per week, for 3-5 years. Eight animals served as cage and sham controls. Peak blood carboxyhemoglobin (COHb) levels measured immediately after smoking showed levels of 0.5 * O.l%, 3.6 f l.O%, and 5.7 f 2.8% for .sham controls, low, and high dose smokers, respectively. Hemoglobin and hematocrit values were 2-7s higher (N.S. to P < 0.05) for smoking groups, presumably as a consequence of chronically elevated COHb levels. No significant differences were seen in total plasma cholesterol and lipoprotein cholesterol concentration measured at four intervals over a period of one year. We conclude from these data that, while fed a low fat diet, chronic cigarette smoke inhalation fails to alter plasma lipoprotein levels in this animal model.

Paraquat (PQ) was administered to rats for 7 days by iv infusion from osmotic minipump at dosage rates of 250 and 500 nmol PQ/hr. The efficacy of putrescine in attenuating pulmonary PQ accumulation in vivo and the resulting PQ-induced biochemical changes and lung injury were assessed in these animals by coinfusion of putrescine at rates of 2500 or 5000 nmol/hr. Dose-dependent, steady-state blood levels of both PQ and putrescine were achieved by 18 hr and maintained throughout the in&ion period. Lung PQ content at 7 days was dose-dependent and up to 1 I-fold greater than corresponding blood levels. No evidence of toxicity was observed in low-dose PQ animals while weight loss and overt toxicity was ob served in high-dose PQ rats between Days 4 and 5. Histopathological examination of highdose PQ rat lungs revealed qualitative changes typical of PQ toxicity. Significant (p < 0.05) increases in lung glutathione and activities of glucos&-phosphate dehydrogenase and GSSG reductase resulted from both PQ doses, reflecting PC&induced oxidant stress and increased demand on lung NADPH. A net decrease in lung NADPH (p < 0.05) was directly measured in high-dose PQ rats and may have contributed to the PQ-induced lung injury. Although putrescine is an effective inhibitor of pulmonary PQ uptake in vitro, the blood putrescine levels achieved in this study did not appear to inhibit this process in vivo. This was evidenced by putrescine's failure to decrease 7-day lung PQ content, PQ-induced biochemical changes, or lung injury. 8 1988 ~ademic Prcs, Inc.

Heat-related mortality in US cities is expected to more than double by the mid-to-late 21st century. Rising heat exposure in cities is projected to result from: 1) climate forcings from changing global atmospheric composition; and 2) local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas: Atlanta, Georgia, Philadelphia, Pennsylvania, and Phoenix, Arizona. Employing separate health impact functions for average warm season and heat wave conditions in 2050, we find combinations of vegetation and albe...

Heat-related mortality in US cities is expected to more than double by the mid-to-late 21 st century. Rising heat exposure in cities is projected to result from: 1) climate forcings from changing global atmospheric composition; and 2) local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas:

Eleven adult male stumptailed monkeys (Macaca arctoides) were chronically exposed to either a low dose (human equivalent of 1 pack/day) or a high dose (human equivalent of 3 packs/day) of high-tar, high-nicotine University of Kentucky reference cigarette smoke for 4-8 years. Several parameters of their immunological response were compared to six nonsmoked control animals. The results from these experiments suggest that cigarette smoking does not significantly affect the response of spleen cells to the mitogens phytohemagglutinin or lipopolysaccharide. However, spleen cells from animals subjected to the heavy dose of cigarette smoke demonstrated a significant reduction in their natural killer cell-mediated lytic activity and a decreased response to coneanavalin A. These results suggest that cigarette smoking may have a differential effect on lymphocyte subpopulations, and that the effects on the immune response are related to the dose of cigarette smoke.

Serum triglycerides and serum total, esterified, and free (unesterified) carnitine were measured in 21 male Macaca arctoides that were switched from a low fat (5.2% w/w), high carbohydrate diet to a high fat (15.9% w/w), low carbohydrate diet for 90 days and then returned to the original low fat diet for a subsequent 76-day period. Serum triglycerides and total carnitine levels fell significantly (p less than 0.05) during the initial 2 wk of feeding the high fat diet and the ratio of esterified/unesterified carnitine rose significantly (P less than 0.05) on the high fat diet. A return to the low fat diet reversed these changes; triglycerides rose significantly (p less than 0.05) within 3 days and the ratio of esterified/unesterified carnitine fell significantly (p less than 0.05) within 3 days and the ratio of esterified/unesterified carnitine fell significantly (p less than 0.05) during the same period. A return of total carnitine levels to those initially observed on the low fat d...

1. Tobacco use is linked to excessive rates of cardiovascular disease, lung disease, and many fatal neoplasms. In the United States it is the number one cause of illness and premature death. Cigarettes and other combusted forms of tobacco generate environmental tobacco smoke, a major contributor to asthma attacks, heart attacks, and lung cancer among nonsmokers. 2. Cigarettes are the most prevalent and abused form of tobacco, but other forms, such as cigars and smokeless tobacco, also contain nicotine and may cause dependency in high risk groups that consume these products. 3. The addictiveness of tobacco products, especially cigarettes, is particularly detrimental to vulnerable groups such as youth, women, blue collar workers, and other high risk and economically disadvantaged populations. 4. Effective treatment programs (e.g., individual and group counseling, close monitoring, drug treatment) are available to treat nicotine dependency, but many health care providers have been relu...

Assisted circulation by extracorporeal and extracardiac bypass techniques must be based on the requirements of the heart and of the total body, though these may differ. The cardiac problem in cardiogenic shock is more likely to be a biventricular problem demanding decompression of both sides. Extra pulmonary oxygenation should be avoided because of complexity in long-term use. Principles of assisted circulation may be applied in an extra-thoracic temporary manner or as an intracorporeal long-term device without removal of the heart. We have compared a number of extracorporeal mechanical bypass techniques (left ventricular bypass, left atrial bypass, right atrial plus left ventrical bypass, and right atrial plus left atrial bypass) in dogs at different flow rates with control groups (nitroprusside, metabolic substrates, and no therapy) for survival during and after 4-hour treatment periods in a standard severe myocardial infarction preparation with biventricular failure. The left ven...

In the last year, hundreds of scientific papers on the health effects of air pollution have been published reporting on effects ranging from respiratory symptoms to premature mortality. The studies extend our understanding of the shortand long-term effects of exposure to common air pollutants, provide new information on potential cardiovascular mechanisms, and identify especially susceptible populations, including children.

Needs Assessment Implementation References Acknowledgements Little Milligan Elementary School in rural Carter County, Tennessee was provided with health literacy resources in the form of health education Go-Packs––easily implementable lessons contained in a small storage tote– –as part of the community project requirement of the James H. Quillen College of Medicine Rural Primary Care Track Curriculum. These Go-Packs included detailed lesson plans and accompanying materials that were designed to facilitate health education in the classrooms by providing easily deployable lessons for the teachers to utilize. Four Go-Packs were provided for hygiene, oral health, tobacco use, and nutrition that teachers used to augment instruction during teachable moments that arose in their classrooms. Our objective was to determine whether the development and implementation of these Go-Packs increased the amount of health education delivered to the students and determine what barriers persist to provi...

Acute cardiogenic shock or bridging to transplantation often involves the need for circulatory and cardiac support systems that are more effective than the intraaortic balloon pump. Biventricular failure, which is present in many cases, is generally treated with total cardiac replacement or with a complex of pumps and oxygenator that makes application difficult. With the goal of developing a universally applicable method of cardiac and circulatory support, we undertook a series of canine experiments designed to evaluate the effect of various treatment methods on survival, hemodynamics, and metabolic function. The series involved 123 dogs, in which cardiogenic shock was induced by means of multiple coronary artery ligations. The individual animals were then subjected to bypass, treated medically, or left untreated, depending on random selection. Each treatment lasted for 4 hours and was followed by a 2-hour period of observation. The following single-pump methods were tested: 1) left...